14.

DVIVIDHOPAKRAMANIYA / द्विविधोपक्रमणीय
- two kinds of therapy

Dvividha Upakarma- two kinds of therapy :-

उपक्रम्यस्य हि द्वित्िाद् द्विधैषोपक्रमो मतः

एकः संतपपणस्तत्र द्वितीयाश्चापतपपणाः
बंिणो लङ्घनश्चेतत तत्पयापयािुदाहृतौ
बंिणं यद्बित्िाय लङ्घनं लाघिाय यत ्
दे िस्य

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).

भितः प्रायो भौमापममतरञ्च ते

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).

स्नेिनं रूक्षणं कमप स्िेदनं स्तम्भनं च यत ्

भूतानां तदवप द्िैध्याद्द्वितयं नाततितपते

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.

शोधनं शमनं चेतत द्विधा तत्रावप लङ्घनं

It is of two types.

a) Shodhana – Purification procedures

(Panchakarma) and

b) Shamana- palliative treatment.

SHODHANA – PURIFICATION PROCEDURES

(PANCHAKARMA)

यदीरयेद्बहिदोषान ् पञ्चधा शोधनं च यत ्

तनरूिो िमनं कायमशरोरे को अस्रविस्रुततः

· 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

न शोधयतत यद्दे षान ् समानोदीरयत्यावप

समीकरोतत विषमान ् शमनं तच्च सप्तधा
पाचनं दीपनं क्षुत्तड्व्यायामातपमारुताः

· 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.
बंिणं शमनं त्िेि िायोः वपत्तातनलस्य च

Brimhana- stoutening therapy also is Shamana

only

· because it alleviates/ mitigates both Vata

and Vata Pitta- combination .

BRIMHANEEYA -PERSONS REQUIRING

STOUTENING THERAPY -

बंियेद््याधधभैषज्यमध्यस्त्रीशोककमशपतान ्
भारोध्िारः क्षतक्षीणरूक्षदब
ु ल
प िातलान ्
गमभपणीसतू तकाबालिद्धान्ग्रीष्मेअपरानवप
मांसक्षीरमसतासवपपमध
प रु स्स्नग्धबस्स्तमभः
स्िप्नशय्यासख
ु ाभ्यङ्गस्नानतनितप तिषपणैः

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 –

मेिामदोषअततस्स्नग्धज्िर उरुस्तम्भकुस्ष्िनः
विसपपविद्रधधप्लीिमशरकण्िाक्षक्षरोधगणः
स्थूलांश्च लङ्घयेस्न्ग्नत्यं मशमशरे तु अपरानवप

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) –

तत्र संशोधनैः स्थौल्यबलवपत्तकफाधधकान ्

आमदोषज्िरच्छद्पहदरतीसारहृदामयैः
विबन्ग्धगौरिोद्गारहृल्लासाहदमभरातरु ान ्
मध्यस्थौल्याहदकान ् प्रायः पि
ू ं पाचनदीपनैः
एमभरे िामयैरातापन ् िीनस्थौल्यबलाहदकान ्
क्षुत्तष्णातनरिै दोषैस्त्िातापन ् मध्यबलैर्दपढान ्
समीरणातपायासैः ककमत
ु ाल्पबलैनरप ान ्

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.
न बंियेत ् लङ्घनीयान ् बंियांस्तु मद ु लङ्घयेत ्
यक्त
ु त्या िा दे शकालाहदबलतस्तान ् उपाचरे त ्

a) Those who are to be given

Langhana- thinning therapy, should not be
given Brimhana-stoutening;

b) those who are to be given

Brimhana should be given mild Langhana,

c) or both Langhana and Brimhana

together, simultaneously may be given
depending upon the nature of habitat, season,
strength etc.

बंिण लाभ – धचककत्सा फल / BENEFITS OF

BRUHMANA THERAPY –
बंहिते स्याद्बलं पस्ु ष्िस्तत ् साध्यामयसक्षयः

Brimhana therapy makes for

1. strength,
2. nourishment of the body,
3. and cure of such diseases which are curable
by that therapy.

लङ्घन लाभ / BENEFITS OF LANGHANA

THERAPY

विमलेस्न्ग्द्रयता सगोमलानां लाघिं रुधचः

क्षुत्तट्सिोदयः शद्
ु धहृदयोद्गारकण्िता
्याधधमादप िमुत्सािस्तन्ग्द्रानाशश्च लङ्तघते

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

अनपेक्षक्षतमात्राहदसेविते कुरुतस्तु ते
अततस्थौल्याहदकाष्यापदीन ्, िक्ष्यन्ग्ते ते च सौषधाः

These- therapies indulged into in great

measure than required, lead on to profound
obesity and emaciation etc, which will be
enumerated now, along with their treatment.
रूपं तैरेि च ज्ञेयमाततबहं ितलङ्तघते

ATI BRIMHANA- EXCESS OF STOUTENING

THERAPY :-

अततस्थौल्यापचीमेिज्िरोदरभगन्ग्दरान ्
काससन्ग्न्ग्यासकच्रामकुष्िादीनततदारुणान ्

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 -

तत्र मेदोतनलश्लेष्मनाशनं सिपममष्यते

कुलात्थजण
ू श्प यामाकयिमुद्गमधूदकम ्
मस्तुदण्डािताररष्िधचन्ग्ताशोधनजागरम ्
मधुना त्रत्रफलां मलह्याद्गुडूचीमभयां घनम ्
रसाञ्जनस्य मितः पञ्चमल
ू स्य गुग्गुलोः
मशलाजत]ु प्रयोगश्च सास्ग्नमन्ग्थरसो हितः
विडङ्गं नागरं क्षारः काललोिरजो मधु
यिामलक चण
ू ं च योगो अततस्थौल्यदोशस्जत ्

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.

्योषकििीिरामशरवु िडङ्गाततविषास्स्थराः
हिङ्गस
ु ौिचपलाजाजीयिानीधान्ग्यधचत्रकाः
तनशी बित्यौ िपष
ु ा पािामल
ू ं च केम्बक
ु ात ्
एषां चण
ू ं मधु घतं तैलं च सदशांशकम ्
सक्ततमु भः षोडशगण
ु ैयक्त
ुप तं पीतं तनिस्न्ग्त तत ्
अततस्थौल्याहदकान ् सिापन्रोगानन्ग्यांश्च तद्विधान ्
हृद्रोगकामलास्श्ित्रश्िासकासगलरिान ्
बद्
ु धधमेधास्मततकरं सन्ग्नस्याग्नेश्च दीपनम ्

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:-

अततकाश्ये भ्रमः कासस्तष्णाधधक्तयमरोचकः

स्नेिास्ग्नतनद्रार्दक्तरोत्रशक्र
ु ौजः क्षुत्स्िरक्षयः
बस्स्तहृन्ग्मध
ू ज
प ङ्घोरूत्रत्रकपाश्िपरुजा ज्िरः
प्रलापोध्िापतनलग्लातनच्छद्पहदपिापस्स्थभेदनम ्
िचोमूत्ररिाध्याश्च जायन्ग्ते अततविलङ्घनात ्
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

काष्यपमेि िरं स्थौल्यात ् न हि स्थूलस्य भेषजम ्

बंिणं लङ्घनं िाऽलस्म्तमेदोस्ग्निातस्जत ्

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.

मधुर स्स्नग्ध साहित्यैयत्प सौख्येन च नश्यतत

क्रमशमा स्थविमाअत्यन्ग्त विपरीत तनषेिणैः
योजयेत्बंिणं तत्र सिं पानान्ग्नभेषजम ्

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

अधचन्ग्त्या िषपणेन ध्रुिं संतपपणेन च

स्िप्नप्रसङ्गाच कशोिराि इि पुष्यतत

The emaciated person becomes stout like a

boar
· by absence of worry,
· by happiness,
· more use of nutritious food
· and more of sleep.

नहि मांससमं ककस्ञ्चदन्ग्यदे िबित्त्िकत ्

मांसादमांसं मांसेन सम्भतत्िात ् विशेषतः

There is nothing other than meat to stouten

the body, especially so the meat of
carnivorous animals, for they feed on meat
itself.

गुरु चातपपणं स्थूले विपरीतं हितं कशो

यिगोधूममुभयोस्तध्योग्याहितकल्पनम ्

1. Foods which are heavy and non- nutrition

are ideal for the 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

दोषगत्या अततररच्यन्ग्ते राहिमेध्याहदभेदतः

उपक्रमा न ते द्वित्िाद्मभन्ग्ना अवप गदा इि

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)