Understanding Dvividha Upakarma: Two Kinds of Therapy in Ayurveda
Ayurveda outlines two main types of therapies - Brihmana (nourishing, enriching) and Langhana (depleting, cleansing) based on the body types of obese and lean. Brihmana therapy focuses on increasing weight and heaviness, while Langhana therapy aims to reduce weight and impart lightness. These therapies involve treatments such as Snehana (oleation), Rukshana (dryness), Swedana (sweating therapy), and Sthambhana (withholding). Additionally, Langhana therapy includes purification procedures (Panchakarma) and palliative treatments (Shamana) to bring balance to the body.
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DVIVIDHOPAKRAMANIYA - two kinds of therapy
Dvividha Upakarma-two kinds of therapy :- Because, that to be treated, the human body is of two types Obese and lean, the treatment is also of two kinds. 1. Santarpana- nourishing, enriching. It is also called as Brihmana (Stoutening, increasing weight, imparting heaviness) 2. Apartarpana depleting, cleansing. It is also called as Langhana (fasting, losing weight, imparting lightness etc).
Generally, Brihmana treatment is dominant with Prithvi (Earth element) and ap (water element). Langhana is dominant with the rest three elements (Fire, air and ether).
Functions such as a) Snehana (oleation/ lubrication) and b) Rukshana (imparting dryness), c) Swedana- (sweating therapy, sudation, diaphoresis), d) Sthambhana- (withholding, obstructing) are also of these two kinds- Brihmana and Langhana. a) Snehana and Sthambhana can be categorized as Brihmana and b) Rukshana and Swedana can be categorized as Langhana Thus all functions are not apart from two .
LANGHANA THERAPY to make the body light / thin imparts lightness to the body. It makes the body thin and light. It is of two types. a) Shodhana Purification procedures (Panchakarma) and b) Shamana- palliative treatment.
SHODHANA PURIFICATION PROCEDURES (PANCHAKARMA) Shodhana treatment expels imbalanced Doshas out of the body forcibly. It is of five kinds, viz 1. Niruha- decoction enema, 2. Vamana- emesis, vomiting therapy 3. Kaya reka- Virechana purgation for the body 4. Shiro reka Shiro Virechana nasya purgation for the head, nasal instillation of medicines. 5. Asra-visruti Raktamokshana blood letting .
SHAMANA PALLIATIVE TREATMENT is that which does not expel the increased Doshas out of the body, it does not increase the normal Dosha, but makes the abnormal- Doshas normal. In short, Shamana treatment brings imbalanced Dosha to normalcy.
Shamana 7 types 1. Pachana digestive, carminatives, 2. Deepana hunger producing, stomachic, 3. Kshut withstanding hunger, avoidance of food, fasting 4. Trut withstanding thirst/avoidance of water drinking, avoiding liquid food intake 5. Vyayama- physical activity, 6. Aatapa- exposure to sunlight and 7. Maruta- exposure of breeze.
BRIMHANEEYA -PERSONS REQUIRING STOUTENING THERAPY - Brimhana- stoutening therapy should be given to persons who are 1. Vyadhi karshita emaciated by diseases, 2. Bhaishajya Karshita emaciated by medicines- therapies, 3. Madya Karshita emaciated by alcohol 4. Stri Karshita Emaciated by excess sexual activity 5. Shoka karshita Emaciated by grief, 6. Bhara who carries heavy loads frequently
7. Adhva who has walked / travelled a long distance 8. Urakshata person with chest injury 9. KShatakseena who is debilitated due to injury 10. Ruksha who has excess dryness 11.Durbala debilitated 12. Vatala Person with Vata body type. 13. Garbhini pregnant 14. Sutika the women who has delivered, 15. Bala children, 16. Vruddha the aged and 17. Greeshma in the month of summer,even the other people, who are not indicated above should be given Nourishing therapy.
Method of Brihmana - a) by the use of meat, milk, sugar, ghee, b) enema prepared sweet substances and fats(oil, ghee), c) sleep, d) comfortable bed, e) oil- massage, f) bath, g) comforts, h) rest and i) happiness of the mind.
LANGHANEEYA PERSONS REQUIRING THINNING THERAPY Langhana- thinning, slimming therapy should be done to 1. Meha diabetics 2. Amadosha persons suffering from Ama 3. Atisnigdha who has undergone excess oleation treatment 4. Jvara fever 5. Urustambha stiffness of the thighs, 6. Kushta skin diseases 7. Visarpa herpes, 8. Vidhradi abscess, 9. Pleeha diseases of spleen, 10. Shira, Kanta Akshi roga head, throat, and eyes; 11. Sthula Those are obese 12. Even to others during Shishira winter, Langhana treatment should be done.
INDICATION FOR LANGHANA THERAPY BY MEANS OF SHODHANA (PANCHAKARMA) Patients with these diseases should be given Panchakarma treatment as the means for Langhana therapy. - a) Those who are very obese, b) strong and c) having predominance of Pitta and Kapha, d) those suffering from Amadosha, e) fever, f) vomiting, g) Diarrhoea , h) heart diseases, i) constipation, j) feeling of heaviness, k) excess of belching, l) nausea, etc.
Indication for Deepana, Pachana and then Shodhana (Panchakarma) - 1. Those who are moderately obese, 2. medium in strength of the body and 3. also of the diseases mentioned, first by administration of digestives and hunger producing substances generally, later with other purification therapies;
Indication for Shamana type of Langhana 1. Those who are troubled by increased Doshas, 2. who are of medium strength, 3. with medium strength disease, 4. who are capable of withstanding strain by the control of hunger and thirst; 5. those again of poor strength- of the body 6. and of disease by exposing them to breeze, sunlight and exercise.
BENEFITS OF BRUHMANA THERAPY Brimhana therapy makes for 1. strength, 2. nourishment of the body, 3. and cure of such diseases which are curable by that therapy.
BENEFITS OF LANGHANA THERAPY 1. Keenness and clarity of sense organs, 2. Expulsion of Malas- Doshas and wastes, 3. Feeling of lightness of the body, 4. Good taste perception, 5. Appearance of hunger and thirst together, 6. Feeling of purity in the chest region (heart), 7. Clear belching and 8. clear throat, 9. softening of the diseases- decreased severity, 10. increase of enthusiasm and 11.loss of stupor- laziness
ATI BRIMHANA-EXCESS OF STOUTENING THERAPY :- Excess of Brimhana therapy produces 1. Atisthaulya profound obesity 2. Apachi scrofula, 3. Meha Diabetes, UTI 4. Jvara fever 5. Udara enlargement of abdomen, 6. Bhagandara fistula-in-ano, 7. Kasa cough, 8. Sanyasa loss of consciousness, 9. Mutrakruchra Dysuria, 10. Ama- disorders of poor digestive activities, 11. Kushta -skin diseases which are very dreadful.
TREATMENT FOR OVER NOURISHING - 1. Treatments which reduce Medas- fat, Anila- Vata and Kapha are desirable; 2.Use of a) Kulattha horse gram Dolichos Biflorus, b) Jurna, c) Shyamaka, d) Yava Barley Hordeum Vulgare, e) Mudga green gram Averrhoa Carambola, f) and Honey water;
g) Indulgence in worry, h) stressful activities i) Purification therapies, j) avoidance of sleep, k) either Triphala, Guduci, Abhaya (Chebulic Myrobalan fruit rind Terminalia chebula) and Musta (Cyperus rotundus), should be licked with honey daily; l) Either Rasanjana (Aqueous extract of Berberis aristata), Brihat Pancamula (Agnimantha, Shyonaka, Gambhari, Patala, Bilva), Guggulu along with the fresh juice of Agnimnatha is suitable; m) Powder of Vidanga (False black pepper Embelia ribes), Nagara (Ginger), Kshara- Yavakshara and iron filing or powder of Yava (Barley Hordeum vulgare) and Amla along with honey should be licked daily.
TREATMENT FOR OVER NOURISHING - 1. Powder of Vyosha- (Trikatu pepper, long pepper and ginger), 2. Katvi, 3. Vara (Triphala), 4. Shigru (drum stick), 5. Vidanga (False black pepper Embelia ribes), 6. Ativisha, 7. Sthira (Desmodium gangeticum), 8. Hingu (Asa foetida), 9. Sauvarcala, 10. Ajaji (Cuminum cyminum),
11. Yavani (Trachyspermum ammi), 12. Dhanya, 13. Chitraka, 14. the two Nisa (turmeric and tree turmeric), 15. the two Brihati(brihati and kantakari), 16. Hapusa, 17. root of Patha (Cyclea peltata) 18. and of Kebuka, should be mixed with honey, ghee and oil in equal proportion and sixteen parts of saktu (corn flour), this mixture taken as a drink daily
cures severe obesity and all other diseases- mentioned earlier and even others of similar nature such as a) heart diseases, b) Jaundice, c) Leucoderma, d) Dyspnoea, e) cough, f) obstruction in the throat- hoarseness of voice etc. g) improves powder of thinking, h) intelligence, i) memory and j) kindles the weakened fire- digestive activity.
ATILANGHANA-EXCESS OF THINNING THERAPY:- 1. Profound emaciation, 2. Bhrama Delusion, Dizziness, 3. Kasa cough, 4. Trushna severe thirst, 5. Aruchi anorexia, 6. loss / decrease of moistness, 7. and digestive power, 8. of sleep, 9. vision, 10. hearing,
11. semen, 12. Ojas, 13. hunger 14. and voice; 15. Pain in the urinary bladder, heart, head, calves, thighs, upper shoulders and flanks; 16. fever, 17. delirium- excess of talk, 18. belching, 19. exhaustion, 20. vomiting, 21. cutting pain in the joints and bones; 22. non-elimination of faeces, urine etc., arise from excess of Langhana
Emaciation is better than obesity, there is no treatment for the obese, for, neither Brimhana nor Langhana are capable of vanquishing excess of fat, digestive activity and vata.
Emaciation gets cured by use a) of sweet and unctous- fatty foods and b) comfortable living, where as obesity gets cured by the use of a) The foods etc, of the opposites- qualities to the above that too when used in maximum quantity. b) There, liquids, foods and drugs which are Brimhana should be adopted
The emaciated person becomes stout like a boar by absence of worry, by happiness, more use of nutritious food and more of sleep.
There is nothing other than meat to stouten the body, especially so the meat of carnivorous animals, for they feed on meat itself.
1. obese 2. whereas the opposites- are ideal for the emaciated; 3. Yava Barley Hordeum vulgare- barley is heavy and non nutritious, ideal for obese and 4. Godhuma- wheat is light to digest and nutritious, Hence good for emaciated. 5. Yava and godhuma are good for both when prepared in a way as suitable to either Foods which are heavy and non- nutrition are ideal for the
Though the states of Doshas are innumerable and innumerable are the kinds of treatments such as Grahi withholding etc, still they do not surpass these two kinds- Brimhana and Langhana, just as the diseases- though innumerable fall into two kinds only, viz Sama and Nirama. (with and without Ama)