Activities done by an individual from morning to evening are alluded to as Dincharya. 

In Ayurveda, dincharya is considered as an action to forestall physical, mental and social issues. A decent food style and a limited way of life are the key standards establishing such measures in Ayurveda. Varoius step included as:

• Brahm mahurta Jagran (Waking up) and Malatyag (Defecation)

Brahma muhurta is typically 1-1.5 hours before dawn. It shifts from one locale to another. In the event that the hour of dawn in your nation is 6 a.m. then, at that point your Brahma Muhurata will be somewhere near 4:30 toward the beginning of the day. 

Getting up late causes lethargy and laziness and makes the entire day slow. To work with the absorption of food devoured the earlier evening, getting up early is pivotal. Predominance of Vata in this period assists with passing the Mala (pee/stools) early. In this way, getting up early aides in refinement of body. As the term of the stay of the Mala inside the body expands, the vulnerability of the body to deft diseases increments.

• Nasya – Nasal therapy

Charak Samhita suggests placing a couple of drops of Anu Thailam in every nostril consistently toward the beginning of the day. This cycle is called Nasya or nasal treatment in ayurveda. Charak advocates it during three seasons: 

• Pouring Season 
• Pre-winter
• Spring

• Oral wellbeing brushing, tongue scratching and oil pulling

In the wake of awakening the following most significant custom in Ayurveda is dealing with your oral wellbeing. It’s anything but a three-venture measure, 

• Brushing your teeth (Dhantdhavna)

In Ayurvedic dinacharya, teeth are brushed utilizing a blend of various spices. The flavor of these spices fluctuates from sweet to better and contains every one of the six preferences for Ayurveda. 

Brushing your teeth with spices gives a cleaning activity that eliminates plaque and buildup from your teeth. The counter microbial and hostile to contagious specialists created by the fundamental oils in the spices help in keeping the germs under control. 

• Oil pulling (Kavla-Gandoosha)

The second significant thing you can accomplish for your oral wellbeing is oil pulling. In Ayurveda, the vast majority perform oil pulling as a custom once per week. You can either do a day by day oil pulling or you can do it’s anything but seven days. I like to do it’s anything but seven days as it were. 

• Tongue scratching 

Tongue scratching is the main thing you can accomplish for your oral wellbeing in Ayurveda. No place in current medication, it is needed to scratch your tongue. Every one of the germs and microscopic organisms that produce terrible breath are available on your tongue. 

Your taste buds are available on your tongue. The poisons aggregated for the duration of the night are likewise present on the tongue.

• Drink water (Usha pana)

Water subsequent to awakening is the principal thing that enters your stomach toward the beginning of the day. Ayurveda suggests drinking warm water for all doshas. Warm water builds your digestion toward the beginning of the day and keeps it dynamic for the duration of the day. 

It likewise helps in the disposal and flushing of abundance poisons from the body. 

Drinking warm water with nectar and lemon to builds your admission of Vitamin C toward the beginning of the day and improves your resistance.

• Exercise (Vyayama)

This should be possible in any structure, be it Yoga ex. Surya Namaskar or running. Exercise will eliminate stagnation and fat from your body and will reinforce your muscles. Find out about the different advantages of yoga. 

• Daily Abhyanga/Massage

A day by day Abhyanga practice is suggested in Ayurvedic dinacharya for all dosha types. An every day abhyanga practice ought to be done on an unfilled stomach prior to washing. 

It is otherwise called Snehana in Ayurveda which means love. Kneading your oil with warm oil each day is an extremely cherishing and relieving custom. A day by day abhyanga has a great deal of advantages in Ayurveda, 

• Builds blood course 
• Eliminates poisons 
• Saturates skin 
• Opens up sweat organs for poison development 
• Opens up nerve channels 
• Permits oxygen course in the body 
• Initiates and empowers the body 
• Disposes of dry layered skin

• Bathing (Snana)

Bathing or Snana is one of the Yamas in Ayurveda and has been laid exceptional accentuation on. Washing is the custom of physical and mental cleanliness in Ayurveda. An every day shower permits your body to dispose of the overabundance heat caught for the duration of the evening. 

It revives your psyche and improves cerebrum lucidity toward the beginning of the day. It readies your body for another day. 

Bathing ought to be finished with cleaning activity on your body, to eliminate abundance oil and dead skin from the body. 

• Breakfast

Eating is an individual decision. In the wake of following this dinacharya, a great many people will be eager. On the off chance that you feel hungry, have a basic feast with some fat to keep you full for a more extended time frame. 

Since it is the main dinner, it should uphold and feed your stomach related framework. Eating zesty, difficult to process food in the first part of the day will squeeze your stomach related fire. 

Purvakarma Definition

Viitated Doshas are constantly situated in the body parts where the sickness is delivered. All Doshas are to be gathered into the kostha from where they are killed through Panchakarma, for gathering all Doshas (toxins) in the nutritious waterway Snehana (oleation treatment) and svedana (perspiring treatment) are finished. Both the treatments snehana and svedana assume a significant part as Purvakarma as well as fills in as a line by preliminary measures. Previously, the genuine methodology of decontamination/detoxification starts, there is an extraordinary need to set up the body for the necessary strategies to urge it to relinquish the poisons. Thus, there are 3 procedures of Purvakarma.

1. Deepana & Pachna
2. Snehna
3. Svedna

• Deepna & Pachna

Deepna: The Drugs which builds Agni however doesn’t having Amapachana (digestion of undigested material waste) property called as Deepana. 

Pachna: Which drugs invigorate Agni to do Aharapaka (metabolic change) is called as Pachana. Eg. Langhana (the methodology which achieves daintiness in the body) and Musta 

Deepna & Pachna: The medications which are having the two properties called as Deepana and Pachana drugs. eg. Chitraka so we reason that Deepana-Pachana (hors d’oeuvre digestives) tranquilizes fundamentally Agni Mahabhoot (Elements) overwhelming. 

Advantages of Deepna & Pachna 

Deepana Dravya (drugs) which invigorate the appetite14 (~usually served before a feast) by remedy of Mandaagni (low stomach related fire). All medications of Deepana having Katu Rasa, (Pungent taste)Katu Vipaka (post-digestivetaste) & Usna Virya (dynamic rule) for instance Chitraka (Plumbago zeylanicum) Maricha (Piper nigrum, Pippali (Piperlongum), Pippalimoola (root of Piper longum), and Jeeraka, (Cuminum cyminum) so all medications are useful to improve Agni and Ignite Vata Dosha.

Pachana Dravya for instance Hingu, (Ferula foetida) Guduchi (Tinospora cordifolia),, Nagkeshar (Mesua ferrea) Musta (Cyperus rotundus)&Ajmoda(Trachyspermum roxburghianum) having Katu-Tikta Rasa, Ushana Virya (dynamic guideline), Katu Vipaka (bio change) are invigorate peristalsis of digestive system, expanded neighborhood blood supply, increment emission of stomach related proteins and increment retention of supplements. So it Deepana(appetizer) medications can be taken before the suppers and Pachana(digestive) medications can be endorsed after feast. So Deepana-Pachana (canapé digestives) drugs having comparative properties act distinctively depending on the time endorsed for their admission. 

• Snehana (Oil therapy)

This treatment makes the body delicate and breaks down the poisons. There are two sorts of snehana for example Inner Snehana and External Snehana. In interior snehana cured Siddha Ghrita or cured Siddha Taila is utilized orally as per the portion recommended by the specialist, this oil or ghee is known as sneha. It’s anything but an ointment and assists with diminishing the dryness of the body. In outer snehana there are incorporated a wide range of body rub with the assistance of Sneha exhorted by the educator. This treatment is helpful for all skin issues. Snehana is likewise executed to the patients of vamana and virechana.

Advantages of Abhyanga (External Snehana)

Abhyanga or External Oleation implies use of unctuous material (with tila oil/different sedated oils/ghrita and so on) on the outside surface of the body for example skin which mellow and gives gloss to the skin and eliminates dryness from the body. The upsides of Abhyanga according to Ayurvedic writings are- 

• It (rub) balances the maturing interaction ( Jaraahara) 
• It loosens up the tractable muscles subsequently helping in unwinding. (Shramahara) 
• As Abhyanga is finished with Sneha Dravyas which pacifiy vata dosha (Vatahara). 
• Abhyanga improves nature of vision. (Drishti Prasadakara) 
• Abhyanga sustains different body segments (dhatu), delivering pushti. (Pushtikara) 
• It expands life expectancy of person. (Ayushyakara) 
• It helps in prompting sound rest. (Swapnakara) 
• It makes skin flawless and expands its sound status. (Twak Dandhyakara) 
• It instigates strength in body, making it versatile for enduring a wide range of unfriendly conditions. (Klesha Sahatva) 
• People who routinely practice Abhyanga are very little influenced by any kind of injury. (Abhighata Sahatva) 
• It eliminates the earth, improves appearance of body and builds its solidarity. (Mrujavarna Balaprada)

• Swedana (Sweating)

Swedana is the method that eases Stambha, Gaurava, Sheeta which actuates Swedana (Sweating). It plays a double part in Purvakarma just as Pradhanakarma. 

Swedana has unwinding and detoxifying consequences for the human body. Sweda is ordered into various assortments as per the diverse Acharyas. 

As per Charaka, two primary types are Sagnisweda (warm) and Niragnisweda (Non thermal). 

Niragnisweda is additionally arranged into ten types viz. Vyayama (work out), Ushnasadana (warm rooms), Guru Pravarana (substantial covers), Kshudha (hunger), Bahupana (over the top drinking), Bhaya (dread), Krodha (outrage), Upanaha (mortars), Ahava (war) and Atapa (sunbath). 

Sagnisweda is ordered into 13 types viz. Sankara (blended), Prastara (hotbed), Nadi (steam pot), Parisheka (baptism), Avagaha (shower), Jentaka (sudatorium), Asmaghana (stone bed), Karshu (channel), Kuti (lodge), Bhu (ground bed), Kumbhi (pitcher bed), Kupa (pit sudation) and Holaka (under the bed). Where as 

Acharya Sushruta ordered Swedana into primary 4 types: 

Tapa sweda (Direct warmth), Ushmasweda (Steam), Upanah Asweda (poultice), Dravasweda (warm liquid)

Advantages of Swedna: 

• Equilibriums Vata and Kapha humors in the body 
• Disengages poisons; ousts them through the minuscule pores of the skin alongside sweat 
• Expands course; decreases aggravation 
• Renews and restores the skin 
• Improves absorption 
• Eliminates daze 
• Follows up on fat tissues 
• Assuages pressure 
• Facilitates sore muscles 
• Diminishes deadness, solidness, unbending nature, substantialness; improves portability

INTRODUCTION-

Acharya Sushruta, while dealing with the diseases of the nose, devoted a separate chapter to Pratishyaya after explaining Nasagata Roga in detail.DushtaPratishyaya has not been mentioned as a separate disease but, rather, is considered to be the complication of different types of Pratishyaya.

The features of the DushtaPratishyaya are similar to that of chronic sinusitis in modern science. Sinusitisis an inflammation or swelling of the tissue lining the sinuses. Sinusesmake mucus, which keeps the inside of your nose moist. That, in turn, helps protect against dust, allergens, and pollutants.

Healthy sinuses are filled with air. But when they become blocked and filled with fluid, germs can grow and cause an infection.  In ayurveda, Nasya is one of the most significant treatment for sinus infection.

INDICATIONS OF NASYAM-

• Sinus pain and congestion 
• Stiffness or pain of head, neck, or jaw
• Headache and Migraine
• Toothache, loose teeth, receding gums
• Hoarseness of voice
• Twitching or drooping eyelids
• Tingling sensations on face
• Obstruction in throat
• Uvulitis, Tonsillitis, Laryngitis, Pharyngitis
• Speech disorders and loss of speech
• Bell’s Palsy (facial paralysis)
• Goiter (gandamaala)
• Glaucoma (Adhimantha)
• Pituitary or space-occupying tumor
• Unconsciousness/fainting
• Depleted sexual energy
• Any disorders above clavicle area

How is Nasyam perfomed?

• This Ayurvedic treatment is one of the five detoxing actions of a Panchakarma.
• The nose is the door to consciousness and the pathway to our inner pharmacy. 
• Medications that are administered via the nasal passages affect the mind, pranavata, tarpakakapha, sadhaka pitta, and majjadhatu.
• Nasya means putting medicated herbal oils, herbal extracts or herbal powders in each nostril according to dosha
• It starts with facial oil massage and application of steam to face, forehead, head, ears and neck which helps to loosen the adhesive doshas.
• After this, drops of lukewarm medicated oil is instilled in both the nostrils. 
• The soles of the feet, shoulder, neck, ears and palms are then gently massaged. 
• one of the main formulation of nasya is anutailam.
• Anutailam is a strong herbal formulation. After nasya with anutailam there may be slight burning sensation and headaches present. This will help to expel the impurities out.
• The powerful Nasyam (purgative) is used for treating diseases above the chest, such as diseases of ear, nose, eyes and throat.
• By nasya the impurities accumulated over the head including sinus cavities, ears, eyes and throat are expelling out.
• Nasya is very good to improve the clarity of voice, mind, improve memory and relief the stiffness of facial muscles
• The main indication of nasya includes sinusitis, migraine, various headaches, problems of eyes, ear, anxiety, nasal polyps, nasal congestion, neurological disorders and premature greying of hair.
• The excess of toxins accumulated in the throat, nose and head is eliminated.

TYPES OF NASYAM-

There are five types of Nasyam which are mentioned below:

1. VIRECHANA NASYAM– 

• Strong medicines are used in virechana(cleansing) nasyato expel out the doshasincontiently from the head region.
• Commonly used substances include vacha (calamus), brahmi (gotu kola), and jatamamsi.

2. BRIMHANA NASYAM

• Nutritive/brimhananasya is good for vatadosha.
• It nourishes and strengthens the head region, senses and intellectual functions.
• In this type of nasyaused substances are medicated ghee, salt, shatavari ghee, ashwagandha ghee, medicated milk, and various oils.

3. SAMANA NASYAM–

• Sedativenasyasubsidises the increase of a dosha without expelling it out.
• It is moderate, neither too strong nor too mild. 
• This is good mainly in conditions like skin discolouration, hair loss and eye diseases. 
• Substances used include brahmighee (for pitta), vacha oil (kapha or vata), and tikta ghee (vata or pitta).
• The amount of medicines can be either 4 or 6 drops of medicated oil depending upon the dosha involvement.

4. NAVANA NASYA–

• Decoctions (kadhaa), fresh juices, and oils are mixed together and administered according to the aggravated dosha.
• Navananasyavery useful in pitta-vata or pitta-kapha disorders.
• Substances used include brahmi juice (for pitta) and vacha juice (for kapha or vata).

5 MARSHYA NASYA-

• A little ghee or oil is administered into the both nostrils with the little finger.
• This, along with gentle massage, helps to relieve stress and opens the deep tissues. 
• It can be done on a regular basis or occasionally as desired.

BENEFITS OF NASYAM –

• Nasya improves the activity of sense organs and protects the person from diseases of upper thorax.
• Nasya is a great choice of treatment for sinusitis.
• Nutritative nasya lubricates the nasal passage.
• Relieves from chronic headache.
• It relieves from earache,tinitisand clears the throat.
• Releases stress and tension from shoulder and neck area
• Relieves from migraine pain.
• Nasyam keeps the eyes, nose and ear healthy.
• It prevents premature greying of hair.
• It prevents early aging process.

CONTRAINDICATIONS-

• Children under  age of 7
• Old age (over 80)
• Pregnant womens
• during periods nasya is contraindicated
• Just before or after shower/bath
• Indigestion (Ajeerna) or full stomach
• Diarhhea (Atisara)
• Hunger or Hypoglycaemia
• Thirst or Dehydration
• After Exertion
• Intoxication
• Physical exercise
• Just having done purgation or basti
• Acute fever
• Grief
• Same time as neti pot nasal cleansing 

SHUDHA RAKTA LAKSHANA (FEATURES OF PURE BLOOD)

• Slightly sweet and salt in taste 
• Neither cold nor hot
• Resembling the colour of lotus, Indragopa insect, gold, blood of sheep and rabbit

EFFECTS OF VITIATED BLOOD ON THE BODY

Blood usually gets vitiated by Pitta and Kapha. It produces diseases mentioned below

• Visarpa- Herpes
• Vidradhi – Abscesses
• Pleeha – Disease of the spleen, or Splenomegaly
• Gulma – Tumors of the abdomen 
• Agnisadana – Dyspepsia
• Jvara –  fever
• Mukha, Netra Shiroroga – diseases of the mouth, eyes and the head
• Mada – Intoxication- toxicity
• Trut – excessive thirst
• Lavanasyata – salty taste in the mouth,
• Vatasra- Gout
• Pittasra- bleeding disease
• Belching with pungent and sour tastes in mouth and dizziness.
• Diseases which give us hard time curing, in which we don’t get results even after appropriate cold or hot, unctuous or dry treatment should be understood to be originated from aggravated rakta/blood. 

In order to drain out the vitiated blood in these diseases blood letting is done.

INDIVIDUALS UNSUITABLE FOR VENESECTION

• Who are less than 16years old and more than 70 years of age
• who have had no bleeding previously due to any cause
• who have undergone excess of Snehakarma and sweating therapies(Swedanam)
• Chardi – Vomiting
• Pandu – Anemia
• Chardi – Vomiting
• Dropsy
•  Those suffering from diseases of Vata origin, 
• The pregnant woman, the woman in parturition, 
• Those suffering from bleeding diseases, indigestion, Shwasa (dyspnoea)
• Kasa – cough, cold
• Atisara – Diarrhoea, dysentery
• Udara – Ascites, intestinal obstruction/enlargement of the abdomen
• Those who have been given fat, ghee or oil to drink, as a part of oleation therapy(Snehana karma)
•  Who are undergoing the Panchakarma treatment.

THINGS TO KEEP IN MIND DURING VENESECTION

• Without enforcing control on the body, the vein should not be cut.
• The vein which is horizontal, that which has not been raised up
• Should not be done on very hot or cold, too windy, or cloudy days.

SELECTION OF VENESECTION SITE

It can be done by following mentioned tips

• DISEASES OF HEAD AND EYE – Veins situated on the forehead, outer angle of the eyes or the area around the nose should be cut
• DISEASES OF THE EAR – Veins near the ear.
• DISEASES OF THE NOSE – Vein situated at the tip of the nose
• RHINITIS – vein located in the nose and forehead, Jaw or palate.
• TUMOURS OF PARTS ABOVE THE SHOULDER – Vein situated in the tongue, lips, lower Jaw or palate.
• IN TUMOURS OF PARTS ABOVE THE SHOULDER – Veins in neck region, ears, temples, jaw or the head.
• ALL DISEASES OF THE HEAD – Vein situated in between the eyebrows.
• VIDHRADHI (ABSCESS) AND PAIN ION FLAK REGION– vein situated between the flanks, Axilla and breast
• EVERY THIRD DAY FEVER(TRITIYAKA JVARA) – vein in the centre of the shoulders.
• EVERY FOURTH DAY FEVER (CHATURTHAKA JVARA) – Below the shoulder.
• DYSENTERY WITH PAIN – Vein situated two Angula away from the pelvis.
• DISEASES OF PENIS OR SEMEN – Vein situated in the penis.
• APACHI OR GLANDULAR ENLARGEMENT OF NECK – Vein situated in the thigh.
• GRIDHASI OR SCIATED – Vein situated four Angula below or above the knee joints.
• GOITER – Vein situated two Angula below the indrabasti (a vital spot in the centre of calf muscles)
• GOUT, PADAHARSHA (TINGLING SENSATION IN FEET), VIPADIKA (FISSURES IN FEET), Vatakantaka(sprain of the foot or Ankle), Chippa (A diseases of the nails of the toes) – Vein situated two Angula above the Kshipramarma  (A vital Spot in between the big toe and the next toe to it)
• VISHVACHI (PAIN IN THE ARMS just like Sciatica but in arms) – Venesection of sciatica should be done.

If the veins are not visible, another vein which is devoid of vital spots and situated nearby, should be cut.

VENESECTION RITUALS AND PROCEDURE

• The patient should follow Snehana procedure first.
• All the necessary equipments for blood letting should be kept ready.
• The person should be strong, should perform Auspicious rites and have boiled rice with meat soup and ghee.
• For sudation/sweating the person should be exposed to sunlight or fire heat.
• He is asked to sit on a stool of his knee height 
• A band of soft cloth is tied around his head at the lower border of the hair or his hairline.
• He should keep elbows on his knees.
• A pad of cloth is held in fists and patients neck is massaged briskly with fists.
• Patient is asked to Grind the teeth, cough, inflate the mouth to enlarge the cheeks.
• Trunk should be wound with a band of cloth, fixed with the knots at the back
• His neck should also be tied with a band of cloth and tightened
• By this mode we raise the deep seated veins.
• Then the physician taps the raised vein with his middle finger tripped off by the thumb, noticing the elevation, once again he raises it by kneading it with the thumb, then holding the axe with his left hand, places its edge on the middle portion of the vein and applies the small cut with Axe without Shaking.
• Axe should be lifted up in the same way, tapping and kneading of the vein is done for making more blood to come out. 

INSTRUMENTS FOR PERTICULAR VEINS

• The vein- of the nose should be cut with the Vrihimukha Sastra (the Lancet with its face shaped like a grain of rice after raising the tip)
• The vein situated underneath the tongue should be cut by asking the patient to keep the tip of the tongue raised and biting it holding it firmly by the upper row of teeth. 
• The veins of the hands should be cut when the patient is sitting comfortably, keeping his arm straight without bending at elbow, he should clench the first with the fingers folded inside, a band of cloth is tied four Angula above the site of cutting. 
• The veins of the flanks are cut by keeping the arms hanging loose,
• Foot veins – feet are kept steady, the foreleg is massaged briskly from the knee towards the Ankle with the hands, the other leg is kept slightly bent, by tying a band similar to the method described for hand venesection.
• On fleshly parts of the body, the Vrihimukha Sastra (Lancet) should be used and the vein is cut to the size of a rice grain only,
• Veins on the bones should be cut to the size of half Yava (barley) by using the axe. 

SAMYAK VIDH LAKSHANA

When the cutting is proper

• The blood flows out in a steady stream.
• Bleeding stops when the control (tourniquet) is released or untied.

ASMYAKA VIDHA

When the cutting is inadequate

• The blood flow is only for a short time and that too less in quantity
• In this condition it should be rubbed with oil mixed with lime powder to increase the bleeding.

ATI VIDH LAKSHANA AND CAUSES

When the cut is LARGE

• The blood flows out with a sound and stops with great difficulty. 
• Fear, fainting, loose tourniquet, blunt instruments, over- satiation (excess eating), debility, holding the urges of urine, faeces etc.

REASONS FOR LESS FLOW

•  Not doing swedana therapy prior to the bloodletting, is the causes of absence of blood flow.
• When the blood is not flowing out in sufficient quantity, the cut end of the vein should be smeared with oil which is processed in Vidanga, Haridra, Vyosha (Trikatu), Nata, Lavana. But when the blood is flowing out properly, the cut site should be smeared with warm oils and salt. 

THINGS YOU SHOULD KNOW

• Vitiated blood always flows out first, its color is like the yellow- juice from the second seeds of Kusumbha before its oil flows out.
• The flow stops by itself after sufficient bleeding. Blood after that should be considered as pure or unvitiated blood and further flow should not be encouraged.
• If the patient faints during the flow, the touriniquet should be released, to make him conscious, he should be fanned with fans and procedure should be continued. If the patient faints again, bloodletting should be postponed for a day or two.

DUSHITRAKTA LAKSHANA- CHARACTERISTICS OF IMPURE BLOOD

• VATA VITIATED BLOOD – It will be blue or crimson in color, dry, non slimy, flows with force, clear and frothy
• PITTA VITIATED BLOOD – It will be yellow or black, foul smelling, because of increase of heat not too thick, mixed with glistening particles.
• KAPHA VITIATED BLOOD – It will be unctuous in nature, color is pale/yellowish or white, has small threads, slimy and thick.
• If it is vitiated by two doshas or all three, it will have features of all.

SRAVA PRAMANA – QUANTITY OF BLOOD FLOW

• Vitiated blood more than one Prastha that is 768 ml should not be allowed to flow out, even in strong patients.
• Excess bleeding can lead to either death or dreadful diseases of vata origin. In this type of situation, oil massage, milk mixed with blood are the treatment.
• After the sufficient flow of blood, torniquet should be removed slowly, wash the site with cold water, cover the cut end of the vein with a swab soaked in oil and bandage the area.
• If there is still vitiated rakta, it should be removed again either in the same evening or next day or It should be removed again after a fortnight according to patient’s bala or strength, after administering proper Snehana therapy. 
• If it’s just a small residue of vitiated blood left, then it will not cause any harm and so it’s allowed to stay. So, excess flow of blood should not be attempted, it’s better to leave a little dosha instead. 
• Such residual blood can also be removed by shringa(sucking horn) and Jalauka(leech). 
• It can be purified by cold comforts, by formulations prescribed for Raktapitta (bleeding diseases) or by panchkarma purification therapies.

IF BLEEDING DOES NOT STOP

If the bleeding does not stop following methods should be adopted 

• the orifice of the wound should be smeared with the powder of either Rodhra, Priyangu, Pattanga, Masha (black gram), Yashti (licorice), Gairika, Mritkapala (pot shred), Kshana Masha, ash of flax or of the bark and sprouts of trees with milky Sap
•  by cold infusion prepared from drugs of Padmakadi Gana – vide chapter 15 should be taken as a drink;
•  the same vein should be cut again and the ends of the vein should be touched with a red hot rod. (cautery) with a red hot rod. 

DIET

• Foods which are neither very hot nor very cold
• Which are light or easy to digest
•  Which enhances digestive fire or hunger are suitable after the raktamokshana because after bloodletting procedure, the body has decreased digestive fire.

FEATURES OF A PERSON WITH HEALTHY/PURE BLOOD

• Color and complexion is enhanced
• Power of sense organs is enhanced.
• Good perception of objects by sense organs.
• Enhanced digestive fire or improved hunger.
• Enjoyment of life comforts with good nutrition and immunity.

 KSHARA SRESTHATA (ADVANTAGES OF ALKALINE CAUTERY)-

Kshara is an effective Ayurvedic medicine for healing wound.Of all the sharp instruments and accessory instruments, Kshara (caustic alkali) is the best. Kshara performs many functions like incising, excising . It can be used even in impassable places. Success can be obtained by it can be used even in the form of a drink and its very useful  in diseases which are very difficult to treat .

INDICATIONS-

• Paneeya Kshara Yogya(drinkable alkali Indications) –

• Arsha – haemorrhoids,
• Agnisada – dyspepsia,
• Ashma – renal calculus,
• Gulma – Tumors of the abdomen
• Udara – ascites, enlargement of the abdomen
• Garavisha – chronic poisoning etc.

• Pratisarana Kshara Yogya (alkali applicationIndications)-

• Mashaka – moles – warts,
• Shvitra – leucoderma,
• Bahya Arsha – external piles
• Kushta – skin diseases
• Supti – anesthetic patches,
• Bhagandara – rectal fistula,
• Arbuda – cancerous growth,
• Granthi – tumour, fibroid
• Dushta Nadi vrana – foul and sinus ulcers etc.

Ksharaguna-

 There are the ten ideal qualities of the caustic alkali which are mentioned below:

• Naati teekshna – Not too strong
• Shlakshna – smooth
• Na vishyandi –doesn’t  produce too much of exudation or moistness
• Sheeghraga – quick in spreading
• Sita – white in colour
• Sukha nirvapya – easy to remove
• Na ati ruk –it does not cause much pain
• Na ati mrudu – not too mild
• Shikhari –Kshara Like a mountain peak
• Picchila – slimy

Ksharakarma-

• Kshara  does all the functions of the sharp surgical instrument (Shastra karma) and also the fire (Agni karma).
• By actions such as sucking quickly
• Very good healing effect over the body
• kshara spreads everywhere because of it’sheeghraga ghuna. 
• Kshara pulls out all the Doshas (vitiating materials) by their root.

KSHARA NIRMANA – PREPARATION OF CAUSTIC ALKALI:-

• The whole plant (panchanga) of Achyranthes aspera ( Apamarga) 5 kgs should be collected, dried up and burnt.
• The whole ash 500 gms were collected and mixed with 6 times (3 litters) of plain water and filters 21 times. The filtrate is clear and clean like color of cow’s urine (gaumutra).
• Then filtered water is kept on mild fire and liquid evaporates to 1/3rd of its original quantity. 
• This is known as Mrudu (mild potency) comncentrate kshara. 
• Then add 50 gms of red hot shukti (Limestone) to the filtrate solution and continuously stirred well until it’s evaporates to 1/3rd of its original quantity.
• This is known as Madhyama or moderate kshara. 
• Moderate/Madhyama Kshara should be further heated up by admixture 5 gms of Chitraka kalka (Plumbago gelanica).
• When  this dense solution is obtained which is known as Pratisaraneeya Teekshana kshara (highly concentrate kshara).
• At the end of Kshara preparation process it should be collected and stored in air tight container.

KSHARA NISEDHA (CONTRAINDICATION)-

• When Pitta and Rakta are aggravated 
• Manda  Vata
• Atisara – diarrhoea, dysentery
• Hrut Murdha Roga – diseases of the heart and head,
• Pandu – anemia
• Aruchi – anorexia,
• Timira – blindness
• Fever-jwara
• Bheeru-who are fearful, coward.
• The pregnant, the menstruating woman, woman who has difficult menstrual flow, or woman who has displacement of either vagina or uterus
• children and old persons
• Places which are poor of muscles, the testes, penis, orifices, passages, interior of the nails
• In eye diseases except the eyelids.
• During cold, rainy and hot seasons (Sadharana kala)  and on days when sun in not seen.
• Aama – indigestion condition
• Kruta samshuddha – in those who have been recently administered Panchakarma therapies 
• Sarvagshotha – who have swelling of the entire body

 INDICATIONS OF THREE KINDS OF ALKALI-

Mrudu Kshara/Mild Potency Alkali – Mild alkali is used In diseases

arising from  Asra/Rakta and Pitta Doshas – Rakta and heamorrhoids, 

Madhyama Kshara – alkali of medium potency is useful in those diseases which are not very difficult to treat. 

Teekshna Kshara (Strong Potency Alkali)– 

Alkali of strong potency should be used in diseases which are arising from Vata Dosha, Kapha Doshas, and Medas (fat) and also used in Arbuda (Cancerous or non-cancerous growth) etc. 

PROCEDURE FOR KSHARA KARMA-The patient anaesthetized with small dose of anesthesia to relax the muscles and to put in a sleep like state so that no pain and discomfort is experienced during the kshara karma therapy.

•  Lubricated proctoscope should be introduced into the anus and Kshara applied over the internal pile mass and wait until the pile mass turns to the color of reddish black and burning of it.
• Next, the pile mass is washed with lemon juice to neutralize the Kshara and a rectal pack is applied.
• Kshara cuts and drains the pus from fistula in ano and fissure in ano or hemorrhoids and also preserves the continence of anal canal.
• Kshara karma helps for quick healing and reduces the chance of recurrence.

ADVANTAGE OF KSHARA KARMA-

• Postoperative pain is mild in intensity
• No  bleeding
• Minimum hospitalization – only one day care.
• Systemic diseases are also undergoing this procedure.
• No surgical complications such as stenosis,incontinence, and stricture
• Cost-effective and ambulatory.
• Faster healing and recovery
• No scope for infection and recurrence 

Precautions After Kshara Karma Therapy-

• A physician customized diet plan for patients who have undergone Kshara karma therapy. 
• This should be followed strictly to avoid constipation and to clear the bowel regularly.
• The diet plan incorporates fibre rich foods with lots of vegetables and fruits along with plenty of water. 
• All fried and spicy food items should be avoided because they disturbed proper functioning of the digestive system.
•  For improve the blood circulation to all extremities of the body regular physical activity (with less strain) like walking is required.
• Avoid prolonged sitting that can apply pressure on the area.

DEFINITION:-

Aschotana Anjana Vidhi is an Ayurvedic treatment methods in which  Eye drops, Eye salve Therapy is performed in the eye.  

These Treatment Therapies Methods are Following:-

These Therapies are divided into 2 parts:-

 Aschotana and Anjana

Aschotana:- In this method application of the medicated liquid drug in the eyes in the form of drops. The herbal eye drops are very beneficial for the eyes in all disorders of the eyes.

It is very helpful to prevent the following:-

• Ruk – eye pain
• Toda – pricking pain
• Kandu – eye itching
• Gharsha – the feeling of friction in the eyes
• Ashru – excessive lacrimation, tears
• Daha – burning sensation
• Raga – eye redness 

1. In the condition of Vata Dosha imbalance, The Eye drops of medicated liquids should be warm.
2. In the condition of Kapha Dosha imbalance and cold in blood (Rakta), The eye drops of the medicated liquid should be Lukewarm.

PROCEDURE (Vidhi):-

1. Aschotana Vidhi:-

–The patient should lie on a bed. The patient’s eyes should be opened with the left hand of the Doctor. The medicine dispenser, either a wick or seashell is held in the right hand of the Doctor with two fingers above the inner eye angle or inner canthus. The medicated liquid is put into both eyes only 10 – 12 drops should pun into an eye. After this procedure, the eyes should be cleaned with soft cotton. Then with a piece of soft cotton Mild fomentation is given, the cotton should be rinsed in warm water in the disease of Kapha doshas and Vata doshas.

 –In Pitta vitiation and blood disorders, The eyes should be mopped with a soft cloth or cotton which  dipped in to cold water, because in this procedure the 2 – 4 strong and Very hot medicinal drops cause pain, loss of vision, and redness.

–Very cold drops can cause loss of movement of eyeballs, pricking pain, and discomfort of the eyes.

 –Excess therapy produces can cause roughness of the eyelids, difficulty in opening of the eyelids, and friction in the eyelids.

–Less therapy also leads to worsening of the diseases, redness, increase of swelling, and absence of lacrimation (tears). 5-6 Medicine drops are put into the eyes, entering into the fornices of the eyes, head, nose and face, can cause the imbalanced of  Doshas which are situated in the upper parts of the body.

2. Anjana Vidhi :-

In this procedure of applying Eye salve or collyrium into the eyes. In this procedure the patients who has purified his body by the Vamana, and Virechana the application of collyrium or eye salve is suitable for those patients. In the condition of slight edema (Alpa shopha), severe itching (Ati kandu) and sliminess (Paichilya) the Doshas are generally localized in the eyes.

When the Patient’s Doshas are imbalanced,     like Vata, Pitta, and Kapha, the excretions of the eyes may thick in those patients.

TYPES OF ANJANA:-

There are Three Types Of Anjana:-

लेखनं रोपणं ितसादनमत धा

1. Lekhana – scarifying  
2. Scraping Ropana– healing
3. Drishti prasadana– making the vision clear, soothing to the eyes

Lekhana Anjana:-

In This procedure the Anjana is prepared from the Herbs of astringent, sour, salt, and pungent tastes and hot potency.

Ropana Anjana:-

In this the Anjana is prepared from herbs of a bitter taste.

Drishti Prasadana Anjana:-

In this procedure the Anjana is prepared from Herbs of sweet taste and cold potency. To reduce the side effects of strong collyrium, generally, the Prasadana Anjana is used.

Anjana Shalaka (Collyrium apparatus):-

Anjana Shalaka is a type of metal rod, its length is 10 Angula, In the middle it’s thin, with the tips resembling a bud of a flower suited for application of the Anjana.

-Lekhana Anjana, The Shalaka should be made of copper    For the procedure of  Lekhana Anjana.

Ropana Anjana, The Shalaka should be made from iron or the finger itself can also be used for the Ropana Anjana.

Prasadana Anjana, The Shalaka of gold and silver is used for the Prasadana Anjana

Kinds Of Anjana (Eye Salve)/ Anjana Bheda:-

There are Three Kinds of Anjana:-           

1. Pinda (Pill) – This is used in case of imbalance of doshas.

The quantity of Pinda Anjana is prepared from the strong herb that is Harenu.

The quantity of Pinda Collyrium prepared from mild herbs is that is two Harenu.

2. Rasakriya– In this, the gel, confection, semisolid got from boiling decoction till solidity of Medicinal drug. This is used in a moderate imbalance of the Dosha.

The quantity of Rasakriya is prepared from Vella  (Vidanga)

3. Churna(Powder) – In this procedure, the powder form of Anjana is used. It used in the case of mild imbalance of doshas.

The quantity of the Churna Anjana is two rods full in the condition of strong herbs and three rods full in condition of mild herbs.

TIMINGS FOR ANJANA:-

The Application of the Anjana/collyrium (eye-salve) should not be performed during the night time, during sleep, or at midday, and if the eyes are fatigued by strong sun rays. Otherwise, it may lead to eye disorders because the Doshas are increased during these timings, and the doshas may spread to other sites of eyes and get liquefied. So The Anjana should always be applied in the morning time or in evening time, when the sun is not present, This will help to mitigate the Doshas.

The Ayurvedic Doctors says that, during the day time the strong Anjana should not be applied, because the eye after the purgation treatment of strong herbs, become weak due to rays of the sun.

Importance of Sleep and Night for Healthy Eyes:-

The eye is made from Agneyi mahabhot (Fire elements) So the eye being comforted to cold. The eye nourished by the coolant nature and strength after a good sleep at night. So the Lekhana Anjana is require In condition of extreme increase of Kapha or scraping types of disease. Teekshana Anjana (strong type) This Anjana can be used during the day time, only if the day is not very hot.

During the severe cold conditions, application of strong Anjana should not performed, because it not good even at night time, because it does not cause the removal of the Doshas from the eyes. So it can produce itching, inactivity of the eyeballs. and the Doshas get stagnated in the eyes, due to the cold effect, even after Anjana therapy.

Patients unfit for application of Anjana/Anjana  Anarha:-

 Application of Anjana should not be performed in the following patients:-

• Bheeta – The Patient In fear, Vamita
• Virikta – The patient who have been administered Vamana and Virechana and who are hungry.
• Shitavegita – The patients with the urges of urine or  faeces.
• Kruddha – Patient who are in anger.
• Jvarita – The patients who suffering from fever and his eyes are fatigued.
• Shiroruk – During headache
• Shoka – during Bouts of grief and Jagara like conditions.
• Anidra — Loss of sleep.
• Adurshte Arke – This is the condition when the sun is fully covered with clouds.
• Shira Snate – Suddenly after the head bath and after smoke inhalation, and drinking of wine
• Ajirne – In condition of indigestion, fatigued from excess exposure to sun, and fire.
• Divasupte – just after the day time sleep.
• Pipasite – During Thirst.

Unsuitable Anjan:-

The following types of Anjana should not be used:-

1. Very strong or very mild Anjanas.
2. Very little or very large in quantity Anjanas.
3. Very thin or very thick inconsistency.
4. Very rough or coarse.
5. Very cold or very hot.

After the application of the Anjana, The eyeballs should be moved up and rotated slowly, the eyelids should also be moved slightly by massaging over it; by these procedures the strong Anjana spreads to all places. But squeezing or washing, opening and closing of the eyelids should not be done.

 If the eyes have regained strength, after the cessation of the activity of the drugs, the eyes should be washed with water (hot or cold)according to the disease, season and Doshas. otherwise, doshas give rise to the disorder. So, The Doctor should lift and hold the upper lid of the left eye with a piece of soft cotton held in his right thumb and wash the right eye; with his right hand, the other eye.

In the conditions of itching and inactivity the strong Anjana or inhalation of strong smoke should be done.

When the eyes are fatigued by strong Anjana, applying a Pratyanjana Anjana (counter eye-salve) this is in powder form. Cold effects should be done.

INTRODUCTION-

Agnikarma( Fire/thermal cautery) is better than even the Kshara, In Agnikarma the recurrence of the diseases will not be there if once they are treated and cured by it. Agnikarma  can be used even in diseases which have not been successfully cured by Aushdha (Medicine), Kshara (Alkali) or Shastrakarma (Surgery).  

 Acharya Sushrut included Agnikarma in the Anushastra i.e. parasurgical procedures. Agnikarma could be correlated to thermal cauterization.

TYPES OF AGNIKARMA-

Acharya sushrut described  four types  of Agnikarma

1. Tvacha (Skin)
2. Mansa (Muscles)
3. Sira (Vessels) and Snayu (ligaments,tendons) 
4. Sandhi (joints) and Asthi (bones) But some other says only twaka and mansa

Types of Agnikarma According to pattern of Agnikarma (Dahana Vishesha)

1. Circular (Valaya)
2.  Dotted (Bindhu) 
3. Straight line (Vilekha) 
4. Wide spread (Pratisarana) 
5.  Semi lunar (Arthachandra) 
6. Four tailed mark (Swastika) 
7. Eight tailed mark (Ashtapada)

INDICATION OF AGNI KARMA-

• The pain aggravated by vata in tvacha (skin) , mans (muscle), sira, snayu (Ligament), sandhi (Joint) and asthi (Bone)
• Chronic wound having some hard elevated tissue.
• Cystic lesion and tumors
• Rectal fistula and foul ulcers
• Sinus lymphadenopathy
• To stop bleeding from cut vessels.
• In diseases like black moles
• Filarial disease  (Medas vikara)
• Moles on skin
• Glucoma/Adhimantha- a disease of the eye
• Hernia
• Warts on skin and cysts 
• Hemorrhoids
• Joint disorders (Sandhi vikara)
• Glands in neck
• Profuse haemorrhages

PROCEDURE OF AGNIKARMA- 

• The careful examination of patients as well as disease is must prior to the Agnikarma procedure. 
• Required equipments for Agnikarma should be kept ready.
• Sheeta and Picchila Ahara should be given 
• In  Mooda Garbha, Ashmari, Bhagandara, Udara Roga, Arshas and Mukha Rogas Agnikarma should be done on empty stomach
• Take the red hot shalaka(Rod) and touch the shalaka on identified marks for few seconds and withdraw it followed by immediate application of aloe vera pulp (ghritkumari swaras). 
• After proper burning of site apply  medicated ghee and honey, paste of drugs which are unctuous and cold in potency (snigdha, sheeta).
• Patient should be advised to avoid wet that area up-to 24 hrs.

Features Of Adequate Burning (Samyaka Dagdha Lakshana)-

• Pain is in mild intensity
• Ana-Awagadha Vranata (wound which is not too deep)
• Easy wound healing 
• Proper burning are stoppage of bleeding
• Emergence of crackling sound accompanied with lymph
• The area having color resembling a ripe tala fruit or pigeon dark grey. 
•  The burn injury which is not very superficial
• Susamshita vrana (without elevation and depression).

TYPES OF AGNIDAGDHA- 

• Tuccha/Plushta Dagdha- 

• The affected part become different in color from skin
• Very severe burning sensation.
• Condition almost similar to first degree burn.

• Durdagdha-

• Sphota-Blisters formation
• severe burning sensation
• redness
• Paka-suppuration and exudation
• pain remains for very long time

In case of durdagdha hot (Ushna) and cold (Sheet) treatment should be done.

• Samyaka Dagdha-

• In Samyaka  dagdha The burnt area is not much deep.
• The burn injury is not more superficial.
• Samyaka dagdha site appear like Asian palm fruit (taal phal varna),
• This is not considered as injury when performed for the therapeutic purpose. 
• Sira Snayu Dagdha Lakshanas are ulcer becoming black and elevated, cessation of exudation Agnikarma
• Dagdha Lakshana of Sandhi and Asthi are appearance of dryness and slight red colour, roughness and firmness.

In case of Samyagdadha a paste (Kalka) of Tavaksiri, Guggulu (commifera mukul), Chandana (Sandalwood), Gairika (Red ochre) and Guduchi (Tinospora cordifolia) mixed with ghee should be applied on the area of burn. 

• Atidagdha (Deep burn)- 

• Sankocha – constriction,
• Daha – burning sensation with pain
• Jwara-high grade fever
• Pipasa –excessive thirst
• Dhupana – feeling of hot fumes coming out
• Siradi nasha – destruction of veins etc
• Gambhira Vrana -Delayed wound healing/ worsening of the wound
• Vevarnya-Discoloration of particular part 
• Murchha-, loss of consciousness 
• Mrutyu – death.
• Mamsalambana – dropping down of the muscles

In case of Atidagdha (over burning) Visarpa of Pitta origin treatment should be done quickly. 

CONTRAINDICATION OF AGNI KARMA –

• Person who have pittaj and raktaj disorders
• Patients with concealed bleeding
• Agnikarma  should not be done for those who are unfit  for Kshara karma.
• It is contraindicated  or accumulation of blood inside the wound
• Persons who have perforation of intestine and abdominal viscera. 
• Person who are suffering from severe multiple wounds
• In children and old age person.
• Retain foreign body
• Who are not fit for Swedana Karma.