Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Acharya Sushruta emphasizes on consideration of three major factors in determining the dose and action of Shamana Aushadhas i.e. palliative medicines. He stresses that the treatment will be highly effective and successful if these medicines are administered after considering all these three factors in each and every patient.
He says that administration of all medicines and herbs should be done after considering the below mentioned three factors. They are –
The factors to be considered are –
1. Vyadhi bala – strength of the disease,
2. Agni bala – strength of the digestive fire and
3. Purusha / Atura bala – strength of the body of the patient
These rules are explained with special reference to ‘shamana aushadhas’ i.e. palliative medicines but the understanding can be extended to include administering various other medicines and medicine forms, including shodhana aushadhas – purificatory medicines also.
Consideration of Vyadhi Bala, Agni Bala and Purusha Bala in determining the dose of Shodhana Aushadhas – purificatory medicines
एवं संशोधनमतिपातयति।
Sushruta also emphasizes that the same factors shall be considered even in administration of shodhana aushadhas – purificatory medicines i.e. strength of vyadhi, agni and bala should be considered.
If shodhana medicines are administered in excess of strength of the disease, digestive fire and body of the patient, they would cleanse the body (evacuate) excessively and in turn trouble the patient immensely.
Ref – Sushruta Sutra Sthana, Chapter 39, verse 10 (Su.Su.39/10)
The reasons for considering these factors have not been specified in the text, but I have put forth the explanation on the basis of inference.
Dose of shodhana medicine vs strength of disease
The dose of the shodhana aushadha should not be in excess of the strength of the disease. If excessive shodhana medicine is administered in case of weak or moderate strength diseases, it will surely break the chain of pathogenesis but will also expel doshas and malas in excess. Further on, it will also cause tissue damage and cause extreme weakness apart from producing ati Shuddhi lakshanas – symptoms of excessive purification.
Dose of shodhana medicine vs strength of digestive fire
The dose of the shodhana medicine, just like shamana medicine should be in sync with the strength of agni and should not be in excess of it. Shodhana should never be administered in the presence of low or moderate agni and if it is administered in excess, it is too dangerous. When there is low agni, there will be excessive ama in the body, the tissues too will have weak strength. Shodhana medicine given in excess will try to expel the sama doshas. This will destroy the tissues and the body also.
Dose of shodhana medicine vs strength of the body of the patient
If shodhana medicine is administered to a person having weak body strength, the person will not tolerate the cleansing effect or action of shodhana medicine. The medicine will damage the tissues and the body and may also cause death.
रोगे शोधनसाध्ये तु यो भवेद्दोषदुर्बलः ॥
तस्मै दद्याद्भिषक प्राज्ञो दोषप्रच्यावनं मृदु॥११॥
चले दोषे मृदौ कोष्टे नेक्षेतात्र बलं नृणाम्॥
अव्याधिदुर्बलस्यापि शोधनं हि तदा भवेत्॥१२॥
स्वयं प्रवृत्तदोषस्य मृदुकोष्टस्य शोधनम् ॥
भवेदल्पबलस्यापि प्रयुक्तं व्याधिनाशनम् ॥१३॥
To eliminate slightly increased doshas in a smooth way, the Shodhana medicines should be administered in mild / less doses and the same rule shall be followed only in cases of diseases curable with purificatory therapies. On the other hand, shodhana medicine should not be administered if the disease or diseases is not fit for shodhana.
Even in the patients who have become weak due to the impact of strong and morbid doshas, the same rule is applicable i.e. shodhana medicines should be administered in mild doses even to them
The strength of the person should not be considered when –
– Chale doshe – the doshas are not steady i.e. they are in circulation and
– Mrdau Koshte – the bowel movement is soft
The reason is that shodhana aushadha is beneficial even in those persons who are not debilitated by diseases.
The purificatory drugs when administered would cure the diseases when –
– the doshas are going out of the body on their own and
– in those having soft bowel movements
Shodhana or Purgative medicines would cure the disease even when the person has poor strength.
