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Technoayurveda’s
Practical SOP Panchakarma
Ayurmitra Prof Prasad KSR
Prof Meena S Deogade
(According to NABH needs)
Regd: 4654 of 2017
Technoayurveda's Practical SOP Panchakarma
Technoayurveda’s
Practical SOP Panchakarma
(According to NABH needs)
Prof KSR
Prof Meena S Deogade
Prasad
Regd: 4654 of 2017
Title of the book:
Name of Author (s)/Editor:
Edition:
Copyright
Name and address of publisher:
Center for Organizing Ayurveda Research
Name and address of printer
Place of publication: Hyderabad
Price: INR /-
First, 2018 (
Second, 2021 (ISBN 978-93-5593-180-1)
Flat No: 301, Plot No. 138, Sri Satya Residency,
Besides Sakshi School, Anupama Nagar, Hastinapuram,
Hyderabad - 500079, Telangana
Http://www.technoayurveda.com/
Technoayurveda's (According to NABH needs)
Practical SOP Panchakarma
KSR Prasad (TechnoAyurveda)
Ayurmitra, Nadi Bhishak, Jyotisha Vaidya
Meena Shamrao Deogade
Self Published by KSR Prasad (TechnoAyurveda)
technoayurveda@gmail.com
Dept. of Dravyaguna, All India Institute of Ayurveda,
Mathura Rd, Gautam Puri, Sarita Vihar, New Delhi, Delhi 110076
ISBN 978-93-5288-790-3)
technoayurveda@gmail.com
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Technoayurveda's Practical SOP Panchakarma
Technoayurveda's Practical SOP Panchakarma
Technoayurveda's Practical SOP Panchakarma
To my beloved Parents
Smt. Chandrakala Shamrao Deogade & Sri
Meena Shamrao Deogade (Co-Author)
Shamrao Shivram Deogade
Dedicated to Our Parents
To my beloved Parents
Smt. Seetharamamma Kethamakka & Late Sri Satyanarayana Kethamakka
Shiva Rama Prasad Kethamakka (Author)
Technoayurveda's Practical SOP Panchakarma
Dr. Vedprakash Mishra
Chancellor
Krishna Institute of Medical Sciences
(Deemed to be University), Karad
FOREWORD
It is heartening to note that the initiative and the effort diligently articulated by Dr. K. S.
R. Prasad Vice Dean and Head Department of Panchkarma and Dr. Meena Deogade, a
Professor Department of Dravyaguna at Mahatma Gandhi Ayurved College, Hospital &
Research Centre a constituent unit of Datta Meghe Institute of Medical Sciences (Deemed to be
University), Nagpur have authored a book titled “Technoayurvedas Practical SOP
Panchakarma” (according to NABH need) is exemplary at one end and genuinely praiseworthy
at the other.
It is indeed an effort to compile all the relevant intellectual inputs on a significantly vital
area and render them in such a free flowing manner, so that it is easy to understand, decipher
and assimilate by the learner, teacher a professional and otherwise a reader, as well.
This has been singularly achieved by the authors by virtue of their writings which are in
easy textual format and are appropriately lineated, so as to render the desired grasp and sought
after understanding of the subject in a handy but yet in an immaculate manner, which turns out
to be the unique feature of this authorship, which makes it look and feel different from the other
available reading material on the subject as of now.
The authors have brought out the Standard Operating Procedure including all the
techniques and methodology for practices of Panchakarma for all the institutions and
Panchkarma Clinical practical in accordance with the guidelines of NABH in a very deserving,
appropriate, chronological, free flowing, griping and lucid manner.
As a matter of fact, the extent of coverage worked out by the authors is indeed very vast
but has been so well capsulated that it makes it poignantly a very interesting reading and
learning material, as well. The contents being commensurate with the prescribed syllabi for the
subject by the various teaching and affiliating health sciences universities are bound to be of
great use to the learners of the subject at both undergraduate and postgraduate level.
Technoayurveda's Practical SOP Panchakarma
(Dr.Vedprakash Mishra)
Pro-Chancellor, Datta Meghe Institute of Medical Sciences (Deemed University), Nagpur
Chairman, Academic Committee, Medical Council of India, New Delhi
Chairman, National Medical Education Board, IMA Headquarters, New Delhi
I am sure that this elegant piece of creative literature embodied in the book format by
the authors will make every user feel that he could avail all that he desired, needed and expected
out of it. I have no hesitation in putting on record my appreciation for the effort undertaken by
the authors in terms of a loud statement that they have generated a 'satiety centre' for quenching
the 'inquisitional thirst' in the domain of Panchakarma.
I am not only sure but quite confident that this book would prove itself to be a
'benchmark' in respect of its utility to all concerned and also go a long way in shaping and
guiding the learners in times to come.
I record my greatest sense of admiration and appreciation for the learned duo for their
painstaking effort in bringing out this epitome of creativity, which is boldly capable of
narrating all about Panchakarma in all its faces, facets, contours, connotations, niceties
including nuances as well.
Technoayurveda's Practical SOP Panchakarma
Abbhyudaya D. Meghe
Officer on Special Duty, DMIMS
Founder President of Utkarsha Jan Kalyan Shikshan Sasthan
PREFACE
It gives me the immense pleasure to address the book entitled “Technoayurveda's
Practical SOP Panchakarma” written by Ayurmitra Prof KSR Prasad, Vice Dean and Head of
Panchakarma Department and Prof. Meena Deogade, Dravyaguna Department, of Mahatma
GandhiAyurved College, Hospital and Research Center, Wardha under Datta Meghe Institute
of Medical Sciences (Deemed to be University),Wardha.
The efforts taken by the authors are incredible and felt to reveal, educate and train the
Panchakarma related all aspects according to NABH standards for recording and analysis of
the data for future developments. The comprehensive narration of each section is helpful for a
layman who wishes to understand the procedures of Panchakarma and their benefits. The
information given generates the interest to undergo the treatments to get their benefit.
Eventually the entire fraternity of Ayurveda from students to the specialists can avail the
content of this book for precision in practicing the Panchakarma.
The content is comprehensive, informative, methodical, scientific, unbiased,
experiences recorded with narration of Concepts and terminology, indications and
contraindications, time and duration of the procedure, benefits and alternative measure in case
of patients non acceptance along with procedural sequences. The procedures are carefully
narrated step by step with pre operative steps, main procedure steps in sequence and where
ever required with diagrams of explanation and post procedural steps and precautions. The
input of possible complications and commonly used list of medicines with possible usage
disease conditions attracts the reader to follow the author.
The highlighted area in this book is Panchakarma procedural area plans and procedural
preparation techniques. They are vividly described with number of possibilities and dialects of
practice.The book included the NABH indicator reporting methods also.
The introduced NABH methods for a Panchakarma procedural establishment,
initiation and maintenance with formats of approach, bifurcation of nutritional needs,
Technoayurveda's Practical SOP Panchakarma
medicinal and procedural prescription are really new thought to be practiced. Even in the
follow-up the same style is followed is recommendable. The format of requisition for
Panchakarma procedure, nutritional assessment, care plan, and NABH necessary
documentation models are also incorporated in the book as easy and ready reference to reader.
Any student or institution wish to start a new Panchakarma therapy rooms or establish
a section of Panchakarma with standards (NABH), this book is one spot reference book and
gives entire information at a glance. This book “Technoayurveda's Practical SOP
Panchakarma” from the hands of Prof KSR Prasad, offer a regulated methodical result
oriented Panchakarma procedural information describes not with words but also
diagrammatically is impressive to learns the strokes and movements of rhythms followed in
Panchakarma with timing. The selection of patient and medicine in short described is
sufficient to initiate the interest in Panchakarma.
The herbs commonly used in Panchakarma for different procedures are summarized
with its properties and utility showing a photograph catches the reader. The effort taken by
Prof. Meena Deogade, is remarkable and appreciable.
This maiden effort of revealing the hidden techniques of Panchakarma for all
Ayurveda community is encouraged with great respect. This intellectual property should go
with copyrights and patents for recording the developments of Ayurveda in 21st century. The
future additions of this book edition should include more information related to drug usage and
research aspects also.
I admit my deep sense of appreciation for the efforts taken by the authors. The
blessings of Ayurveda may remain with authors forever to bring more such innovative and
explorative books useful for theAyurveda community.
Abbhyudaya D. Meghe
M.Sc (Tech) Applied Geology (NU), Bachelor of Journalism BMC (NU)
PGDHA & M (Symbiosis), PGDHA & M (Chennai), M.H.A. & M (DMIMS(DU)
Officer on Special Duty, DMIMS
Founder President of Utkarsha Jan Kalyan Shikshan Sasthan
(Mob. +91 992 360 0517)
Technoayurveda's Practical SOP Panchakarma
Unexpected entry in Ayurveda in
1977 at Hyderabad brought me to this stage
of knowing the traditions and its values. The
Ayurveda not only provided food for me and
my family it has given a lot inexplicable
knowledge. The schools of thoughts are
more valued in our system and I am proud to
be stated as the successor of Dr VVS Sastri
who is famous for his works on Tridosha
Theory and direct disciple of Dr
Dwarakanath.
Author's Message
KSR Prasad
Ayurmitra, Nadi Bhishak, Jyotisha Vaidya
As the entry in to the academics made in 1996, the study methods and Panchakarma
practices were disappointing to me. When I leap in to PG Curriculum of Kayachikitsa and
Research avenues, I found where exactly we are lacking. From that day in many scholarly
gatherings even though I keep my voice there was no response as people are interested in only
outcomes but not at the level of understanding the Ayurveda. It is funny always; the rules are
made but not followed. From 2008, I am extending help and Free Service to the researchers of
Ayurveda and PG scholars on the name of Technoayurveda. Even though the responses got are
limited but satisfactory. I know to myself that the ideology what I am expressing takes another
10 years to implement inAyurvedic community.
The methodical Panchakarma practiced is depended upon dialects of provinces and the
practice gets the colloquial instead of authentication. Many provincial observations are made
across India and wonder how the small idea of an individual is enormously dramatically alter
the result of the process. But the idea is armature and needs refining at the dictums ofAyurveda.
This made me to bring a common Panchakarma practice book useful for the students, teachers
and also practitioners where the data recording and analysis is possible on common platforms.
The plotting of theTechnoayurveda's SOPPanchakarma was done in the year 2000; the
idea was fruitful when the NABH norms become mandatory to all. The support given by Shree
Technoayurveda's Practical SOP Panchakarma
Dattaji Meghe to establish and run the Panchakarma as I feel to do is remarkable. I am
dedicating this work to him as gratitude. The constant support given by Shree Abhyudayji
Meghe in establishment of units and Shree Sagarji Meghe for all round support is best of its
kind to any level.
I know this work is helpful for the students and who wish to make a new establishment
of Panchakarma with standards or the best in research activity. May my approach will boost
the energy for readers and awake the dormant community to their destiny of Ayurveda
Panchakarma Practice.
This is first publication ofTechnoayurveda and promise to the community for bringing
the evidence based scientificAyurveda literature on this platform for community benefit. I am
happy with the work contribution of
Fellowship scholar of .
Many names to take here for sculpting me, Dr Kasturi Ramachandra Rao, Jagat Sham
Kushi and my parents Satyanarayana and Seetaramamma, spouse Valli Sree, Children Harun
Kowshik and Harsha Kowshik. Many friends are backing me with their thoughts, I am
thankful to one and all here on this occasion.
Ayurvedically Yours
Second Edition :
Dr Meena Deogade Professor Dravyaguna and
Panchakarma
Presently I am working as Vice Dean, Professor and Head of the Department of
Panchakarma, Mahatma Gandhi Ayurved College, Hospital & Research Centre, Salod
(Hirapur), WARDHA (Maharastra), A Constituent college of Dutta Meghe Institute of
Medical Sciences (Deemed to be University) and offer my sincere thanks to all my collogues.
I am very much thankful to Dr Punit R Fulzele, working as Asso. Professor, Dept of
Pedodontics, SPDC, Datta Meghe Institute of Medical Sciences, Wardha (MS) India, and
Secretary, IPR cell, Head, Dept of Educational Research, School of Health Professional
Education & Research; Convener, BETiC Innovation Cell, for his timely help to make the
copyrights of the 21 formats of Panchakarma, which made the book more prize worthy.
Ayurmitra. Dr. K.S.R. Prasad
Vilambi, Chaitra, Sukla Panchami,
First Edition : 22nd March 2018
Technoayurveda's Practical SOP Panchakarma
Personal Information
Ayurmitra, Nadi Bhishak, Jyotisha Vaidya
Dr. Shiva Rama Prasad Kethamakka
Born : 3rd October 1960
Parents : Smt Seetharamamma & Sri Satyanarayana Kethamakka
Spouse : Valli sree Piratla
Children : Late. Er. Harihara Prasad (Son)
Er. Harun Kowshik (Son) Sreedevi (Wife)
Kaivalya Kowshik
Sowmya Kowshik (Grand child)
Harsha Kowshik (Daughter) Phani Kiran K (Son-in-law)
Ayan Kartikeya
Mentors : Dr Sampat Narasimha Char
Dr. V.V.S. Sastry
Dr. Kasturi Ramachandra Rao
Dr. Jagat Shyam Kushi Kasturi
Graduation : B.A.M.S in 1983 from Osmania University, Hyderabad, AP
Post Graduation : M.D. (Kayachikitsa) in 1989 from Osmania University,
Hyderabad, AP
Other Qualification : M.A. (Jyotish & Vastu), PSTU, HYD.
Ph.D. (Vaidya Jyotisham), PSTU, HYD
C.O.P. (German), CIEFL, OU, Hyderabad
Member Ex-BOS Member, University of Calicut, Kerala
Ex-Secretary, AMGAI, AP Branch
Awards Awarded “Ayurmitra” 15 August 2012
Nadi Bhishak 26, January 20
Email : technoayurveda@gmail.com / technoayurveda@yahoo.com
Website : http://www.technoayurveda.com
In nutshell : Innovative, Developmental,
Research oriented, Communicative,
A good Teacher with Computer skills
(Grand child)
Awarded “ ” 20
Awarded “Best Panchakarma Physician” 02 November 2021
Technoayurveda's Practical SOP Panchakarma
Guided Dissertations : More than 50 thesis and PG & Ph.D.
Examiner for many universities
Panel Speaker : More than 100National & International Seminars
Favorite Research : Educational & Clinical research,.
Other credentials : Ex Editor, “Zodiac Family” Jyotish monthly magazine
Ex Editor, “Amruta Bindu” a bilingual (English & Kannada)
monthly News magazine
Ex Chief Editor, Journal of Indian System of Medicine
Book Editor : Essentials of Basic Ayurveda Concepts,
authored by Late Dr.V.V.S.Sastri,
Best Practices in Panchakarma, , Multiple Authors
2000
2017
Authorship : Evidence Based Panchakarma in 2012
Practical SOP Panchakarma in 2018
Art of Panchakarma Vol-I in 2019
Ayur-Jyotisham (Ayurveda Astrology) in 2021
Section - I Chapter Pages
1.1 Practical SOP Panchakarma 1 - 8
1.2 9
Introduction to
Patient Care - 26
1.3 NABH Indicator Reporting 27 - 30
1.4 Setting A Panchakarma Theater 31 - 40
1.5 Panchakarma Kitchen - Panchavidha Kashaya Kalpana 41 - 50
1.6 Panchakarma Kitchen - Anya Kalpana 51 - 58
1.7 Panchakarma Kitchen - Pancha Pathya Kalpana 59 - 62
Section - II SOP of Procedure 63 - 64
2.1 Snehapana 65 - 74
2.2 Gatra Abhyanga 75 - 90
2.3 Shiro Abhyanga 91 - 98
2.4 Mukha Abhyanga 99 -104
2.5 Padabhyanga 105 - 110
2.6 Padaghata 111 - 116
2.7 Bhaspa Sweda 117 - 120
2.8 Avagaha Sweda 121 - 122
2.9 Tapa Sweda (Pansa patra, Arkapatra) 123 - 124
2.10 Pinda Sweda (Valuka, Churna, Patra, Jambeera, Shastikashali) 125 - 132
2.11 Dhara (Sarvanga, Shiro) 133 - 140
2.12 Shirovasti 141 - 146
2.13 Shiropakalpana (Shiropichu, Talam) 147 - 152
2.14 Lepa Kalpana (Shiro Lepa, Annalepa) 153 - 158
2.15 Upanaha 159 - 164
2.16 Ksheera Dhooma 165 - 170
2.17 Sthaneya Vasti 171 - 176
(Shirovasti, Greevavasti, Hrudvasti, Kativasti, Prushtavasti, Januvasti)
2.18 Vamana 177 - 184
2.19 Virechana 185 - 192
2.20 Vasti (Niruha, Anuvasana, Matra) 193 - 202
Technoayurveda's Practical SOP Panchakarma
Contents of
Technoayureda’s Practical SOP Panchakarma
Technoayurveda's Practical SOP Panchakarma
2.21 Uttra Vasti (Male, Female) 203 - 210
2.22 Nasya 211 - 216
2.23 Dhumapana 217 - 222
2.24 Raktamokshana 223 - 228
Section - III Physiotherapy 229 - 230
3.1 Traction Therapy 231 - 232
3.2 Infrared Therapy 233 - 234
3.3 Electric Stimulation Therapy 235 - 236
3.4 Short Wave Diathermy 237 - 238
3.5 Ultrasound Therapy 239 - 240
3.6 Exercise Therapy 241 - 244
Section - IV Herbs Used in Panchakarma 245 - 272
(Alphabetically arranged herbs)
Technoayurveda's Practical SOP Panchakarma
Section - I
Pre Panchakarma Preparation
Technoayurveda's Practical SOP Panchakarma
“Ayurveda the way of living” begin from the day of great flood, when the lands are
appeared together and the species on the earth started flourishing. The legend of Manu (a
human) in impending catastrophic flood first appears in (Sanskrit the
language of Gods) (700300 BCE), and is further detailed in (250500 CE).
Manu [1] collects and preserves all the grains, Herbs and living creatures of the world in a boat.
When the flood destroys the world, Manu accompanied by the seven great sages survives by
boarding the ark and initiates the life on planet Earth. Such flood myth (Bible - Genesis 6:9-
9:17) originated in Mesopotamia in Akkadian (the language of Babylon) is dating from about
1600 BCE [2]. Here Noah, a righteous man instructed by God to build an ark in which he, his
sons, and their wives, together with male and female of all living creatures, would be saved
from the waters. The flood lasted (40 days according to Genesis 7:17, 150 according to 7:24)
long and the ark rested on Ararat. Even the Islam [3] supports the story of great flood. It
happens long ago as many as 70 million years ago when the Gondwana Land came out after the
flood. Later present Indian continent is separated as an island on the name of 'Jambudhweepa'.
Rich vegetation made human to explore the uses of it and Ayurveda flourished naturally with
natural available mechanism.
It is evidential from the daily prayers, time line spell out of Indian community as
Vaivaswata manvantare etc.TheVaivaswata is 71 generation from Manu. Each Manvantara is
with 71 Chaturyugas i.e. 1 life span of Manu. 1 human year (in Hindu calendar) = 1 Deva
Ahoratra for God (1 day and 1 night) and such 360 Deva Ahoratras = 1 Deva Vatsara. The
12,000 Deva Vatsara becomes 1 Chaturyuga (4320000 years). 12,000 Deva Vatsaras are
defined as, 4,800 Deva Vatsaras of satya yuga, 3,600 Deva Vatsaras of TretaYuga, 2,400 Deva
Vatsaras of Dvapara Yuga and 1,200 Deva Vatsaras of Kali Yuga (which is 1,200 * 360 =
432,000 human years); summing up to 12000 [4]. The actual duration of a Manvantara,
according to the Vishnu Purana is seventy one times the number of years contained in the f
Shatapatha Brahmana
Matsya Purana
st
our
Yugas, with some additional years, adding up to 852,000 divine years, or 306,720,000 human
years. According to Vedas, there are 504 000 Manus manifested during the lifetime of one
Introduction to
Practical SOP Panchakarma
1.1
Technoayurveda's Practical SOP Panchakarma
Technoayurveda's Practical SOP Panchakarma
8
Art of PanchakarmaVol-1 authored by Ayurmitra, Nadi Bhishak, Jyotisha Vaidya Prof. Dr. KSR
Prasad with Panchakarma Purvakarma Snehana & Swedana with detailed explanation.
Contact for details and ordering the book.
technoayurvedasales@gmail.com
Patient Care 1.2
Patient is a person receiving or registered to receive medical treatment. Ayurveda
defines the patient as first of four components called as 'Chikitsa Chatushpada', which forms
the accomplishment of therapeutics. The four mainstay of therapeutics are - Patient (Rogi),
Physician (Bhishak), Medicine (Aushadha) andAttendant (Upastata) [1].The qualities of each
are enumerated well to make assessment. As like the student centered education (SCE) in
health education system, the patient centered therapeutics (PCT) is evolved in healthcare
system.
The qualities of patient is affirmed well in Charaka Samhita [2] as
Sushruta [3] added few more qualities to the patients for his surgical interventions
applicable as
1.
2.
3.
4.
1.
Smruti recollection; Patient should have a good memory of recollecting the
sequence of disease manifestation in terms of signs and symptoms.
Nirdesha karitwam (Charaka) - Vaidya vakyastha (Sushruta) Bhishakvasya
(Vagbhata) following instructions; Patient is expected to follow the instructions
given by the physician, if not the expected relief is not possible.
Abheerutwam fearless; many times patients impose self restrictions or may be
submissive to the kith and kin ideology and there by fearful about the treatments.
Such fear should not be and trust should be expressed towards the physician and
the management.
Jnapaktwam (Charaka - Vagbhata) memory; for following instructions of
physician one should have good memory. Not only to follow the instructions even
at the time of treatment one may be subjected with either action or adversity of
medication, so, even such incidents without forgetfulness should be reported and
recorded.
Ayushman Healthy signs; for any treatment to undergo we need to observe the
complications and signs of recovery. As Sushruta is surgical in practice, he
observes the patients fitness forsurgery and recovery.
Technoayurveda's Practical SOP Panchakarma
2.
3.
4.
5.
)
b)
c)
d)
e)
f)
g)
Satwavan (Sushruta - Vagbhata) strong; strong is in terms of physical fitness.
The physical fitness is required for various procedures to adopt and psychological
fitness is also required in the same manner. For example a patient is indicated for
Vamana Karma, but the patient is with no physical fitness may lead to
complications.
Atmavan strong by mind; psychological fitness is also important as like
physical fitness. For example a patient is indicated for Vamana Karma, but the
patient is with no psychological anchoring to accept the management may lead to
complications.
Astikyo religious;Ayurveda has given importance to the individual beliefs and
its regulations. Usually God (almighty) acceptance offers regularities imposed as
they believe Heaven and Hell.
Sadhyo Dravyavan Adhyo-rogi (Vagbhata) [4] money makes many things.
Both Sushruta and Vagbhata brought this point out as acquiring the necessary
medicines orthe money required forit is very much essential.
1]Access,Assessment and Continuity of Care (AAC) 7 standards (21 elements)
a Define and Display the Services provided
Patient registration process
Patient initial assessment
Patient's referral / transfersystem
Prescription method of Medicine / Procedure
Regularperiodic reassessment
Multi-disciplinary continuous care
NABH for Panchakarma Units/ Clinics Patient care is distributed in 5 chapters with 32
standards having 131 elements in it.The detailed care aspects are discussed as under.
Summarization of this section could be in the following steps.
Any Panchakarma unit is commonly practicing the internal and external procedures.
The services provided should be provided in a prominent place clearly visible and readable for
the consumer along with price list. It is preferable to display is in local language, National
Language (Hindi) and International language (English). A photograph and information
regarding the procedure viz. Name of the procedure, its usefulness, approximate time taken for
the procedure, price, etc.
NABH in Patient Care
a] Define and Display the Services provided
Technoayurveda's Practical SOP Panchakarma
10
NABH Indicator Reporting 1.3
Regular clinical audits are required for validating the NABH indicators through
collective reporting. Few items are validated continuously and few are at quarterly and half
yearly. All the key performance indicators are reported and discussed for any vulnerable,
adverse or sentinel events and are noted for rectification with preventable measures brought
out.
Establish baseline information and working standards as standard protocols in the
department of Panchakarma. All procedure benchmark performances are well identified
against national and international standards. Clinical quality, evidence based practices,
analysis of procedure outputs in valid parameters, resource utilization, instruments downtime,
etc., are needed to report, analyze and taken probable actions in response.
To prepare the reporting we have to start with the scheduling of the patient and
fulfilling the patient procedural needs for next day. The Male and Female patient procedure
requirements to place in different charts and displayed on the Panchakarma procedural area
notice board and copy is supplied to corresponding wards (Schedule-1). The patients may
require Vasti or Patrapinda sweda, etc., in such time the therapist are scheduled to prepare
either Kwatha or Pottali according to the need. Thus the kitchen duty schedules with
requirements are placed to prepare the necessary material well in before (Schedule-2). It needs
the following schedulers.
Technoayurveda's Practical SOP Panchakarma
Technoayurveda's Practical SOP Panchakarma
Schedule-1: Patient Procedure Scheduling (Male / Female) Date:
Schedule-2: Procedure Preparation Scheduling Date:
Therapist allotted __________________________________________________________
SNo Material required Quantity Special instructions if any
1 Dashamoola Kwatha 1000ml
2 Triphala Kashaya 600ml
3 Musta Sadhita Takra 500ml
4 Nirgundi, Arka patra, Shigru patra 2 pottali
5
6
SNo IPD/
OPD
Name of
Patient
Procedures required Room
Allotted
Reporting
Time
Schedule
Time
From-To
Estimate
d Time
Hr:Min
1 IPD Badrinath Gatra Abhyanga, Bhaspa
Sweda (Box), Kativasti
1 8.45AM 9.00 to
10.30AM
1.30
2 OPD Kamalnath Gatra Abhyanga, Bhaspa
Sweda (Nadi), Niruhavasti
2 8.45AM 9.00 -
10.00AM
1.30
3 IPD Rajesh Shirobhyanga, Gatra
Abhyanga, Bhaspa Sweda
(Box), Shirodhara (Takra)
2 10.15AM 10.30 -
12.40PM
2.10
4 IPD Kumar Kativasti, Lumbar Traction 1 10.15AM 10.30 -
11.15AM
0.45
5 IPD Pawan Local Massage, Patrapinda
Sweda
1 11.00AM 11.15 -
12.00PM
0.45
6 2 12.30OM 12.40PM-
SNo Therapist Name Room
Number
Special instructions if any
1 Pramod 2 Check the material for
Niruhavasti, Takradhara at
arrival
2 Kamalesh 1
3 Jayawardhan 1
4 Pandu 2
Schedule-3:Therapist RoomAllottment Scheduling Date:
28
Technoayurveda's Practical SOP Panchakarma
29
Technoayurveda's Practical SOP Panchakarma
30
Setting
Panchakarma Theater
1.4
Panchakarma as it is of with five major (Vamana, Virechana, Vasti, etc) and many
minor procedures of purification of the body either through elimination (Shodhana) or
pacification (shaman) of Dosha do require a special place and instrumentation in a good
infrastructure for the procedures. Thus the setting of the Panchakarma Theater is necessary
well before initiation of the procedures.
Even though CCIM, the governing body of the Ayurveda has given minimum
specifications of establishment to run a well organized Panchakarma theater we require to set
the best for the convenience and satisfaction of the patient. A Panchakarma theater require a
minimum of Droni (8 x 3 feet), Swedana box (4 x 4 feet), a table for heating equipment and
other medicines to place (3 x 4 feet) and working place around the Droni.The room is attached
with changing area (5 x 4 feet) and attached western commode shower room (5 x 4 feet). This
completes the minimum requirement of infrastructure for one Panchakarma theater. Thus the
room specifications will go as 12 x 12.5 feet (adjustable to 12 x 15 feet) with 6 x 5 changing
room and 6 x 5WC, in total 240 square feet area.
Most of the institutions run central kitchen but practically it is very inconvenient.Any
major preparations even though undertaken in central kitchen the fire connections with Gas are
problematic. Thus using Gas connection for central kitchen and electric stove for room is a
better option.To avoid transporting hurdles from kitchen a four room connected kitchen model
is opt for the situation. The model diagram is shown as Fig-1 with dimensions. The proposed
four room Panchakarma unit undertakes 1) Abhyanga, Pindasweda, Nasya and Local Vasti
like Januvasti, Kativasti, etc. 2) Vamana, Virechana and Vasti Karma, 3) Sarvanga Dhara,
Shirodhara, Shirovasti Shastikashali Pindasweda, etc and 4) Agnikarma, Jaluka,
Raktamokshana, etc, with a central kitchen 18 x 15 feet. For these procedures to perform we
require a minimum equipment in individual room is as under.
,
Setting a PanchakarmaTheater
Technoayurveda's Practical SOP Panchakarma
Technoayurveda's Practical SOP Panchakarma
40
Technoayurveda's Ayur Jyotisham (Ayurveda Astrology) authored by Ayurmitra, Nadi Bhishak,
Jyotisha Vaidya Prof. Dr. KSR Prasad with Panchakarma Purvakarma Snehana & Swedana with
detailed explanation.
Contact for details and ordering the book.
technoayurvedasales@gmail.com
Technoayurveda's Practical SOP Panchakarma
Panchakarma Kitchen
Panchavidha Kashaya Kalpana
1.5
Panchakarma kitchen not only provides materials for Panchakarma procedures but
also the for patients. Under the specifications discussed earlier, the kitchen provides Kashaya
Kalpana,Takra Kalpana, Rice varieties, Patra pinda varieties, etc.
There are mainly five types of Kashaya kalpana preparations inAyurveda, collectively
known as Pancha Kashaya Kalpana.
Svarasa - The juice of the plant, which is the strongest of all, is extracted by pounding
or grinding it in a blender.
Kalka - The herbs are crushed and made into a pulp form in the required consistency
by adding sufficient water.
Kwatha - It is prepared by boiling the herbs in water until the preparation is reduced to
one-fourth of the original amount.
Phanta - Hot infusion is obtained by immersing the herbs in hot water for some time.
Hima -The herbs are soaked in cold water overnight for preparing a cold infusion.
Swarasa is juice of wet drug pondered and crushed from it. It is having Guru guna
(heaviness as quality), thus consumed in small quantity.The usage of Swarasa in Panchakarma
unit is very less. Fresh green leaves of bulk in nature gives good quantity of juice but few
leaves or stems may not. Such drugs are socked in water for 24 hours to get the juice out of it.
Sprinkling little water is acceptable in the process. The wet grinder can be used for grinding
and getting the Swarasa.
There is another method of getting Swarasa from dry herbs. The drugs are crushed and
placed one day in double quantity of water. The next day the filtered water is collected as
Swarasa.
1.5.1] Swarasa
Concept andTerminology:
Technoayurveda's Practical SOP Panchakarma
1.6
Panchakarma Kitchen
Anya Kalpana
1.6.1: Ksheera Kalpana
Concept and Terminology:
Material Required:
Process of Preparation:
Panchakarma kitchen needs to prepare Ksheerapaka or Ksheera for the process of
Dhara treatments. Different Ksheera are used in Dhara viz. Go Ksheera, Sthanya Ksheera, etc.
Few drugs and additives are used in Ksheera Kalpana preparation. For ksheera Kalpana 1: 4
parts of milk and water is taken. At the end only milk quantity is remained for sheera dhara.
Usually 1500ml of milk is required for Shirodhara and 3000ml for Sarvanga Dhara.
Go Ksheera / Sthanya according to prescription
Vessels
Measuring jars
Drugs like Bala, Shatavari, Jatamamasi, Guduchi etc
Clean cloth / mesh filter
Collect the composition of material as per formula Bala, Shatavari, etc.
Ponder well in to course powder separately
Collect the vessel according to the type and quantity of Ksheera Kalpana prepared.
Add the Dravya, Milk and prescribed water
50 gms of Dravya (Jatamamsi),
1500 ml of Milk and 6000ml of water
Expose it to low fire
. Do not cover the vessel
Check the volume is reduced 1500ml i.e. only milk is remained
Filter the Milk in a clean cloth or mesh filters
Allow to cool the milk
If any additives are to be added like coconut water or any prescribed Nirgundi or
Dashamoola Kwatha,Triphala Kwatha, etc. are added in half or equal quantity.
Store in a glass jar or vessel for usage
1.
2.
3.
4.
A.
B.
5.
6
7.
8.
9.
10.
11.
Technoayurveda's Practical SOP Panchakarma
1.7
Panchakarma Kitchen
Pancha Pathya Kalpana
Concept and Terminology:
After the Panchakarma (Vamana, Virechana and Vasti), the diet restrictions are
imposed to patient as the Annavaha srotas and stomach is sensitive. The dietetics of
Panchakarma is called as 'Sansarjana Krama'. In the process of Sansarjana Krama, different
consistency food materials are supplied according toAnnakala. Usually this diet is prescribed
at the completion of the procedure as post procedural measures even when the procedure is
inadequate. The Pancha Pathya Kalpana are given to the recovering patients, as a post
procedural diet program and aged who can't digest heavy food. It consists of nutritive and
instant energy providers as easily digestible preparations of rice and helps in fast recovery.The
diet is structured in stages, going from more liquid to solid preparations in increasing order.
The diet consists of old Lohita (Rakta) Shali Tandula, which is a mostly easily
digestible carbohydrate. The consistency of the food is brought with the quantity of the water
added while cooking. The process is followed for 3 to 7 days according to the need of the
patient. Daily two servings of diet is made in the noon and evening. No breakfast or snacks are
served in between. The quantity of serving is based upon the 'Agni bala' i.e. digestive capacity
of patient.Addition of condiments, unctuous substances or meat / meat soups are according to
the dietitian advises. The permitted vegetables (Pathya) are added to the diet accordingly. The
different foods served are Peya, Vilepi, Yusha, Rasa and Odana (Charaka Sutra 15/21-24).
These preparations relieve constant thirst and tiredness.
Rice has unique nutritional value and contains very low amount of saturated fats and
cholesterol making it a healthful food for heart. Rice is a good source of fiber and has minerals
such as calcium and iron, vitamins, such as niacin, vitamin D, thiamine and riboflavin and
therefore, improves digestion. Rice softens the channels and balances the normalcy of all
body parts and makes an increase in body energy and also act as Diuretics. Rice is good during
illness or recovery of digestion as it is very light and easy to digest. Rice improves appetite and
also digestive power. It helps in Vata (flatus) and Mala (feces) to move downwards and
relieves constipation.
Technoayurveda's Practical SOP Panchakarma
Table -1: Self explanatory Annakala for the 3 to 8 days procedure of diet
scheduling
Day Annakala Time of food
consumption
Fully Dosha
Eliminated
Halfway
Dosha
Eliminated
Minimal
Dosha
Eliminated
1 1 Morning Procedure Procedure Procedure
2 Evening Peya /Manda Peya /Manda Peya /Manda
2 3 Morning Peya Peya Peya
4 Evening Peya Vilepi Vilepi
3 5 Morning Vilepi Vilepi /
Akruta Yusha
Yusha
(Krutu
/Akruta)
6 Evening Vilepi Yusha /
Kruta Yusha
Rasa
(Krutu
/Akruta)
4 7 Morning Vilepi /
Akruta Yusha
Yusha /
Akruta Rasa
Odana
8 Evening Yusha /
Akruta Yusha
Rasa /
Kruta Rasa
5 9 Morning Yusha /
Kruta Yusha
Kruta Rasa /
Odana
10 Evening Yusha /
Akruta Rasa
Odana
6 11 Morning Rasa /
Akruta Rasa
12 Evening Rasa/
Kruta Rasa
7 13 Morning Kruta Rasa /
Odana
14 Evening Odana
8 15 Morning Odana + Roti
60
Technoayurveda's Practical SOP Panchakarma
Table-2: Preparations of Anna Kalpana with ratio of proportions additions
Type of diet Rice
quantity
Water
quantity
Additions Remarks
Peya (Gruel) or
porridge
1 8 or 14 Salt, Zinger, Pepper Clear Gruel without
Rice fragments
Manda 1 8 or 14 Salt, Zinger, Pepper No fragments of Rice
are seen in Gruel
Yavagu 1 6 Salt, Zinger, Pepper Fragments of Rice are
seen in Gruel
Vilepi
(Thick Gruel):
1 5 Salt, Zinger, Pepper,
Ghee, Cooked
Vegetables
Thick Gruel with
fragments of Rice
Akruta Yusha 1 4 Salt, Pepper, Cooked
Vegetables,
Added with
Greengram (Mudga)
Yusha – without Ghee
Kruta Yusha 1 4 Salt, Zinger, Pepper,
Cooked Vegetables,
Added with
Greengram (Mudga)
Yusha – and Ghee
Akruta Rasa 1 3 Salt, Pepper, flesh
juices / soups
(chicken),
Hot water sipping
required in between
Kruta Rasa 1 3 Salt, Zinger, Pepper,
Chili, flesh juices /
soups (chicken),
Cooked Vegetables,
Hot water sipping
required in between
Odana 1 part 2 parts NIL Normal cooked Rice
consumed with
Vegetables as regular
servings
61
Technoayurveda's Practical SOP Panchakarma
Kruta andAkruta:
Special precautions:
Akruta means not added salt, unctuous substances and condiments. In Kruta all
required condiments along with oil or ghee and salt is present. Peya and Vilepi are bland and
not having salt or Ghee. Few condiments lime Ardraka, Maricha, Ela, Twak, etc. are added
accordingly.
Use always moderate fire required
Serve hot always
Check the appetite before servings.
Patient should receive his/her the next meal when the patient should feel hungry
again
Add minimum quantities of grated ginger, pinch of pepper powder and required
quantity of table salt only
Check the thickness of servings
Odana, which means cooked rice and has the consistency of normal, soft, cooked
rice.
1.
2.
3.
4.
5.
6.
7.
Vilepi Odana (Anna)
62
Technoayurveda's Practical SOP Panchakarma
Section - II
SOP of Procedures
Section II
'Procedure Information Brochure'
'Procedure sequence'
'Procedure Format of Assessment'
Demographic Data
Vital examination
Ayurvedic Examination
:
The Abhyantara (Internal) Panchakarma, Bahya (External) Panchakarma and
Anushastra (semi-surgical) Panchakarma are sequentially enlisted in this section. All
commonly practiced Procedures of Panchakarma are sectioned here as Information Brochure,
Format ofAssessment and Procedure sequence according to the needs of NABH program.
The first section contains Concept and
Terminology, Procedure Variations, Indications and Contraindications, dose and Duration,
procedure Benefits along withAlternative measures are elaborated.
The second section contains Materials required, Pre operative
procedure steps, Main Procedure steps, Post procedure steps, Special precautions to be taken,
Complications and their management and list of Commonly Used Medicines in the procedure.
The third section is with Identification of
patient, Vital Examination, Investigations concern, Fitness certificate, Procedure sequence
and Assessment and Reassessment of procedures are incorporated in format.
:
Patient Name, Age, Gender, Contact Number, UID Number, OPD Number, IPD Number,
Ward, Bed No, Diagnosis and Consultant Dr. Name are self explanatory in demographic data.
This includes the measurements of Height, Weight, BMI, Blood Pressure, Pulse Rate and body
Temp in °C as a routine to understand the vitals of the patient.
All the following factors of examination helps to fix the dose of Snehapana.
General Guidelines for Filling Forms
63
Technoayurveda's Practical SOP Panchakarma
64
Koshta
Agni
Twak
Mala
Mutra
Medas
Prakruti
:
:
:
:
:
:
:
Koshta is gut that includes the digestive system from mouth to anus. The
softness or hardness of it is estimated as � Mrudu (Soft) � Madhya (moderate) and �
Krura (Hard).
Agni is digestive capacity of the individual. It is observed as �Sama (normal)
�Manda (low digestion) �Teekshna (high digestion) �Vishama (unequal digestion).
Twak means the skin. The �Snigdha (softness) or � Ruksha (hardness) is
noted.
Mala means the faecal. The action of defecation and content validation is made
through the terms - �Normal �Ati (excess) �Alpa (scanty) �Snigdha (soft) �Drava
(liquidy) � Ghana (hard).
Mutra is urine and it is examined as �Normal � Poly � Scanty
Medas is fat or flabbiness of fat depositions. The person is observed with the
�Lean �overweight �obesity �Morbid depositions of fat.
Prakruti is constitution. The constitution in Ayurveda based upon the tridosha -�
Vata � Pitta � Kapha. The dominance is noted in the patient. If two or three are
observed their involvement than the percentages are noted.
Lungs, Heart and Abdomen are examined methodically under inspection, palpation,
percussion and auscultation methods.
In physician after careful observation and examination
summarizing the investigations decides that whether the patient is fit for Snehapana or not.
There after he explains the entire procedure to the patient to seek the consent and acceptance
for the procedure.
is consolidated statement of the patient after understanding
his health condition based upon the investigations and necessity of treatment and details of
procedure and its benefits and consequences.
Systemic Examination
Physician Fitness Statement,
Patient's acceptance Statement
Technoayurveda's Practical SOP Panchakarma
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Introduction to Evidence Based Panchakarma authored by Ayurmitra, Nadi Bhishak, Jyotisha
Vaidya Prof. Dr. KSR Prasad with Panchakarma Purvakarma Snehana & Swedana with detailed
explanation.
Contact for details and ordering the book.
technoayurvedasales@gmail.com
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158
Technoayurveda's InKspirations (Guest lectures of KSR Prasad) authored by Ayurmitra, Nadi
Bhishak, Jyotisha Vaidya Prof. Dr. KSR Prasad with Panchakarma Purvakarma Snehana &
Swedana with detailed explanation.
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technoayurvedasales@gmail.com
Technoayurveda's Practical SOP Panchakarma
170
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3. TANTU Level 2 (Gross Dosha Perception Location of Pulse)
4. TANTU Concept of Gati & Explanation of different Gati
5. TANTU Level 3 (Ardha Dosha Perception & Analysis)
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Sthaneya Vasti 2.17
Technoayurveda's Practical SOP Panchakarma
Local Vasti
(Januvasti, Kativasti, Prushtavasti, Manyavasti, Hrudvasti, etc)
Concept andTerminology:
Variations:
Indications:
Contraindications:
Duration:
Benefits:
Alternative measures:
Januvasti, Kativasti, Prushtavasti, Manyavasti, Hrudvasti, etc., local Vasti are the
modifications of Snigdha Vasti, in which Sneha is allowed to stay for a stipulated time over the
advised part of the body. Commonly used in pain or inflammatory conditions of the movable
joints such as knee, elbow and spinal column. To place the oil a brim of circular or elongated is
constructed and the oil is placed for time period maintaining the temperature.
Januvasti circular brim is placed over knee joint
Kativasti circular or elongated brim is placed over lumbar spine area
Prushtavasti circular or elongated brim is placed over thoracic spine area
Manyavasti circular or elongated brim is placed over cervical spine area
Hrudvasti circular brim is placed over chest in heart area
Januvasti Joint pain Kativasti lumbar pain
Prushtavasti thoracic pain Manyavasti cervical spondylosis
Hrudvasti Cardiac pain
No specific contraindications
Avoid in case of open ulcers
20 60 minutes for 7 14 days.
Pain relief Joint flexibility
Regeneration of tissues
Pichu
Vasti Karma 2.20
Technoayurveda's Practical SOP Panchakarma
Concept and Terminology
Variations:
:
Vasti commonly referred as enema but the functionality differs. Vasti is medicines that
are administered through rectal route for Dosha elimination and /or for disease pacification.
Thus it is half the way putative (Ardha Shodhana) and the other half is treatment (Ardha
Chikitsa). The liquids used in Vasti are Kashaya (water soluble active principles), Taila (fat
soluble active principles), Ksheera (Lacto soluble active principles), Mamsarasa (meat soup),
etc. Added with Saindhava Lavana (to balance electrolytes), Madhu (honey fructose &
Glucose to give strength and amalgamate the oil in the presence of salt), Kalka (paste of
Pachana drug or diseases pacification medicine), and sometimes even the prepared medicines
such as Shankha basma, Pravala Bhasma, Vata vidhwansini Ras, etc. Materials used in Vasti
are wide in range and eight types of urines, six types of Rasa skandha Dravya, Lavana, etc.Are
used inVasti.
To induce Vasti, a special pouch made of animal bladder or polythene bag is used
attaching the specified dimension made Vasti Netra (nozzle). Enema can is also used but not to
gets the sufficient pressure to reach the medicine at high rectal area.
The Vasti is classified basically as Niruha (decoction) andAnuvasna (oil) Vasti. Depends upon
the area where the medicine is inserted Pakwashayagata (Rectal), Vrana (ulcer) Vasti are
practiced. The other two Mutrashayagata (urinary bladder) and Garbhashaya (uterine) Vasti
are termed as Uttaravasti. The action based Vasti classification is as Shodhana (eliniation),
Shamana (pacification), Lekhana (scraping), Brumhana (nourishing), Vajikara (aphrodisiac),
Vandhyatwahara (infertility management), etc. On the other hand the based on number Yoga
(8), Kaala (15) and Karma (30)Vasti are given. Even on the basis of quantity the MatraVasti are
designed. Many other types of Vasti are available to practice are Yapana Vasti, Siddha Vasti,
PrasrutayogikiVasti, Picchavasti, RaktaVasti,VrushyaVasti,VaitaranaVasti, etc.
This is otherwise called as Niruhavasti in which Kashaya is the main
ingredient and given 600 to 1440 ml mixing in combination of Sandhava, Madhu, Taila,
Asthapana Vasti:
Technoayurveda's Practical SOP Panchakarma
Raktamokshana 2.24
Concept andTerminology:
1] Raktamokshana without Shastra
2] Raktamokshana with Shastra (instruments)
3] Raktamokshana using both
Indications:
Raktamokshana is an effective blood purification therapy, in which carefully
controlled removal of small quantities of blood is conducted to neutralize accumulated Pitta
and other toxins of blood-borne diseases. This is because Raktamokshana decreases the
quantum of enhanced Pitta Dosha and thus the diseases caused by Pitta are also relieved.
Mainly two types
Jaluka (Leach) -Tridoshaja, Pindita Rakta; Non poisonous Leach is selected.
Siravyadha (vein section) Two dosha
Prachhanna (multiple puncture) Two dosha, Rakta Dosha,
Srunga (modified with syringe) Tridoshaja, Uthana dosha
Ghati /Alabu (cupping) -Tridoshaja, Uthana dosha
Arshas Arumshika
Chronic non healing wounds Daha
Kitibha / Eka Kushta Netra Roga (Raktabhishyanda,)
Pain and inflammatory conditions Raktapitta
Shiroruja Shlipada
Shookaroga Skin diseases
Sotha Tandra
Tumors Upadamsha
Vatarakta Vicharchika
Visarpa Vyanga
Yavani Pitika
Variations:
Technoayurveda's Practical SOP Panchakarma
224
Contraindications:
Duration:
Benefits:
Alternative measures:
Materials required:
Pre operative procedure steps:
Main Procedure steps:
When there is generalized swelling
Pandu
Udara
Sosha
Garbhini
In case open bloodletting wait till the flowing blood is clotted. Usually it is 5 to 10
minutes in duration.
In case of Jaluka the leach itself leaves or wait for 20 to 30 minutes and release it
applying Sandhava Lavana or Haridra Churna.
The Raktamokshana is done repeatedly at an interval of 3 to 5 days.
Disease is pacified
Purification of blood is done
Any type of above Raktamokshana is alternative for one to another. In case of non
acceptabilityVirechana can be administered instead of Raktamokshana.
Therapist 1
Comfortable Bed / Chair -1
Haridra / Saindhava Lavana (in case of Jaluka)
Instrument according to prescription Needle, Blade, Scalp vein set, Syringe,
Cupping Glass, etc.
Kidney tray
Cotton
Bandage cloth
Patient is given Snehapana and Sweda karma if prescribed by the physician
The area, where Raktamokshana is done is shaved and cleaned
Patient is advised to lie-down comfortably.
The selected area is exposed under window towel after cleaning
The selected procedure of Raktamokshana is administered
Jaluka
-
-
-
-
-
1.
2.
3.
A)
Technoayurveda's Practical SOP Panchakarma
225
B)
C)
D)
Ghati :
Siravyadha:
Prachhanna:
Haridra / Saindhava lavana application for Jaluka
Applying cotton under pressure and bandaging
Rest for 30 60 minutes
The Leach used is put in Haridra Jala (Turmeric water) till it vomits the sucked blood.
Once this process is completed the Leach is transferred in to a fresh water container.
Free movements of Leach suggest that the sucked blood is totally vomited.
Check Jaluka whether it is poisonous or not
The entire material used should be sterile in nature
Irritation stop the procedure and apply Haridra lepam.
When the patient is subjected for Raktamokshana, patient is required to undergo few
investigations to understand the diseases condition and to take prophylactic measures in the
process. Based on these investigation reports the patient is accepted or rejected to perform the
procedure.
It is common investigation for estimation of blood and anemic patients are
contraindicated for Raktamokshana.
Differential count of blood is seen for any acute or chronic infections
and deviated results are at the discretion of physician to select for procedure.
Random Blood Sugar is tested as the Raktamokshana process to
prevent the infections.
Bleeding Time / Clotting Time: This test is intended to know the bleeding tendency of the
patient. If BT& CTare not within normal range the Raktamokshana is not done.
The physician prescribed Purvakarma such as Abhyanga and Swedana, etc are
undergone or not is noted. If Jaluka is used, Jaluka is prepared for the Raktamokshana.Type of
Raktamokshana is noted whether it is Prachhanna, Siravyadha, Alabu /Ghati or Juluka. The
indicated number of days is reflective in the prescription is noted.
Blood Pressure and Pulse Rate are recorded at regular intervals along with Initiation
Haemoglobin %:
Differential Count:
Random Blood Sugar:
Post procedure steps:
Special precautions:
Complications and management:
Investigations:
Raktamokshana Progress
Raktamokshana Format filling guidelines
Technoayurveda's Practical SOP Panchakarma
226
time, Completion time andTotal time taken for the procedure.
Day, Date, Raktamokshana Type, Body Temp in °C, Initiation time, Retention Time,
Completion time, and output along with remarks if any are noted for prescribed days
and intervals as directed by the physician.
Vyapat are observed as None, Headache, Fainting, irritation, Itching, and Jwara
(fever), etc.
Post Raktamokshana Procedures are given such as Bandaging, Jalauka Shodhana and
Shamana Chikitsa if required.
The Output is measured as Samyak (well) orAyoga (imperfect) with the observation of
below mentioned symptoms.
Samyak Raktamokshana is reflective with No pain and comfortable and Lightness in
Body, Good feeling and Clarity of Mind and Senses are observed.
Ayoga (imperfect) Raktamokshana is noted with Burning sensation, Inflammation and
inadequate blood flow.
Atiyoga Raktamokshana is noted with Pallor (anemia), Fainting and Dry / Rough skin.
Output is recorded based on the above symptoms as Samyak, Ayoga or Atiyoga of
Uttaravasti.
The Concluding Remarks by Physician is given at the end as observed in the patient along with
Signature.
Jaluka Application
Technoayurveda's Practical SOP Panchakarma
227
Technoayurveda's Practical SOP Panchakarma
228
Technoayurveda's Practical SOP Panchakarma
Physiotherapy (Physical Therapy) is a health care profession concerned with human
functional disabilities and movement restrictions. It is concerned with identifying and
improving quality of life and movement potential within the vicinity of promotion, prevention,
treatment/intervention, habilitation and rehabilitation. It is science-based, committed to
extend, apply, evaluate and review the evidence in its practice.
Physiotherapists assess, plan and implement programs that improve or restore human
motor functions, maximize movement ability, relieve pain syndromes. They plan
rehabilitative and treatments for diseases and also for preventing physical challenges
associated with injuries or impairments. They apply a full range of physical therapies and
techniques such as physical movements, ultrasound, heating, laser and other techniques.
Most of the techniques like Joint mobilization and manipulation, soft tissue Massage
and deep massage techniques, Muscle stretching, etc. are followed inAyurveda Panchakarma.
But few therapies works on Neurodynamics, Taping, Minimal Energy Techniques,
Physiotherapy exercises are based on physics and Anatomy of human body needs special
attention.
Section - III
Physiotherapy
Technoayurveda's Practical SOP Panchakarma
230
Cervical Traction Lumbar Traction
Transcutaneous Electrical Nerve Stimulation (TENS)
Equipment
Section - IV
Herbs Used in Panchakarma
4.0
Technoayurveda's Practical SOP Panchakarma
01-Agnimantha-Clerodendrum phlomidis
02-Amalaki-Emblica officinalis
There are many herbs that are used in the Panchakarma as main ingredients or
additives. Out of many herbs commonly used are enlisted here with. The utilized part and the
effect of herb over Dosha and where it is used are made available as alphabetically arranged
easy reference.
1]Agnimantha
( Linn.f.)
2] Amalaki
( Gareth)
Clerodendrum phlomidis
Emblica officinalis
(Premna latifolia Roxb.)
Rasa : Tikta, Katu, Kashaya, Madhura
Guna : Laghu, Rooksha
Veerya : Ushna
Vipaka : Katu
Useful part : Root
Dosha karma : Balances Vata and Kapha
Rogadhikara : Vatavyadi
Panchakarma usage : Vasti, Swedana
Rasa : Pancharasa(Amla pradhana/Lavana
varjit)
Guna : Rooksha, Laghu, Sara
Veerya : Sheeta
Vipaka : Madhura
Useful part : Fruit
Dosha karma : Balances Tridosha
Rogadhikara : Ushnaprashamana
Panchakarma usage : Talam,
Virechanopaga
Technoayurveda's Practical SOP Panchakarma
272
81]Vidanga
( Burm.f.)
82] Yashtimadhu
( L.)
83] Yava
( L.)
Embelia ribes
Glycyrrhiza glabra
Hordeum vulgare
Rasa : Katu, Kashaya
Guna : Laghu, Rooksha, Teekshna
Veerya : Ushna
Vipaka : Katu
Useful part : Seeds
Dosha karma : Balances Kapha, Vata
Rogadhikara : Unmada, Apasmara, Krimi
Panchakarma usage : Shirovirechana
Rasa : Madhura
Guna : Guru, Snigdha
Veerya : Sheeta
Vipaka : Madhura
Useful part : Root
Dosha karma : Balances Vata, Pitta
Rogadhikara : Netraroga, Trushna,
Vatapittaja vyadhi
Panchakarma usage : Vamanopaga
Rasa : Kashaya, Madhura
Guna : Laghu, Rooksha
Veerya : Sheeta
Vipaka : Katu
Useful part : Seeds
Dosha karma : Balances Kapha, Pitta
Rogadhikara : Medoroga
Panchakarma usage : Udvartana
81- Vidanga- Embelia ribes
82- Yashtimadhu- Glycyrrhiza glabra
83- Yava - Hordeum vulgare

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Sop panchakarma sample2

  • 1. Technoayurveda’s Practical SOP Panchakarma Ayurmitra Prof Prasad KSR Prof Meena S Deogade (According to NABH needs) Regd: 4654 of 2017
  • 2. Technoayurveda's Practical SOP Panchakarma Technoayurveda’s Practical SOP Panchakarma (According to NABH needs) Prof KSR Prof Meena S Deogade Prasad Regd: 4654 of 2017
  • 3. Title of the book: Name of Author (s)/Editor: Edition: Copyright Name and address of publisher: Center for Organizing Ayurveda Research Name and address of printer Place of publication: Hyderabad Price: INR /- First, 2018 ( Second, 2021 (ISBN 978-93-5593-180-1) Flat No: 301, Plot No. 138, Sri Satya Residency, Besides Sakshi School, Anupama Nagar, Hastinapuram, Hyderabad - 500079, Telangana Http://www.technoayurveda.com/ Technoayurveda's (According to NABH needs) Practical SOP Panchakarma KSR Prasad (TechnoAyurveda) Ayurmitra, Nadi Bhishak, Jyotisha Vaidya Meena Shamrao Deogade Self Published by KSR Prasad (TechnoAyurveda) technoayurveda@gmail.com Dept. of Dravyaguna, All India Institute of Ayurveda, Mathura Rd, Gautam Puri, Sarita Vihar, New Delhi, Delhi 110076 ISBN 978-93-5288-790-3) technoayurveda@gmail.com Contact for Copies © Author © All rights are reserved. No part of the publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopy, recording or otherwise, without the prior permission of the author. {Copyrights Registered: 405/2018-CO/L, L-73441/2018; 410/2018-CO/L, L-73446/2018; 412/2018-CO/L, L-73443/2018; 7414/2018-CO/L, L-73444/2018; 417/2018-CO/L, L-73440/2018; 419/2018-CO/L, L-73442/2018; 420/2018-CO/L, L-73445/2018; Dairy Number: 3354/2018-CO/L; 3392/2018-CO-L; 3396/2018-CO-L; 3398/2018-CO-L; 3402/2018-CO-L; 3403/2018-CO-L; 3404/2018-CO-L; 3407/2018-CO-L; 3412/2018-CO-L; 3418/2018-CO-L; 3422/2018-CO-L; 3476/2018-CO-L; 3477/2018-CO-L; 3478/2018-CO-L;} C/o Technoayurveda COAR ® 950 + Postage - technoayurvedasales@gmail.com Prakhya Art Printers Pvt. Ltd. 1-8-724/A/31 (GHMC No. 29), Veg. Market St, Nallakunta, Hyderabad, Telangana 500044, India Technoayurveda's Practical SOP Panchakarma
  • 5. Technoayurveda's Practical SOP Panchakarma To my beloved Parents Smt. Chandrakala Shamrao Deogade & Sri Meena Shamrao Deogade (Co-Author) Shamrao Shivram Deogade Dedicated to Our Parents To my beloved Parents Smt. Seetharamamma Kethamakka & Late Sri Satyanarayana Kethamakka Shiva Rama Prasad Kethamakka (Author)
  • 6. Technoayurveda's Practical SOP Panchakarma Dr. Vedprakash Mishra Chancellor Krishna Institute of Medical Sciences (Deemed to be University), Karad FOREWORD It is heartening to note that the initiative and the effort diligently articulated by Dr. K. S. R. Prasad Vice Dean and Head Department of Panchkarma and Dr. Meena Deogade, a Professor Department of Dravyaguna at Mahatma Gandhi Ayurved College, Hospital & Research Centre a constituent unit of Datta Meghe Institute of Medical Sciences (Deemed to be University), Nagpur have authored a book titled “Technoayurvedas Practical SOP Panchakarma” (according to NABH need) is exemplary at one end and genuinely praiseworthy at the other. It is indeed an effort to compile all the relevant intellectual inputs on a significantly vital area and render them in such a free flowing manner, so that it is easy to understand, decipher and assimilate by the learner, teacher a professional and otherwise a reader, as well. This has been singularly achieved by the authors by virtue of their writings which are in easy textual format and are appropriately lineated, so as to render the desired grasp and sought after understanding of the subject in a handy but yet in an immaculate manner, which turns out to be the unique feature of this authorship, which makes it look and feel different from the other available reading material on the subject as of now. The authors have brought out the Standard Operating Procedure including all the techniques and methodology for practices of Panchakarma for all the institutions and Panchkarma Clinical practical in accordance with the guidelines of NABH in a very deserving, appropriate, chronological, free flowing, griping and lucid manner. As a matter of fact, the extent of coverage worked out by the authors is indeed very vast but has been so well capsulated that it makes it poignantly a very interesting reading and learning material, as well. The contents being commensurate with the prescribed syllabi for the subject by the various teaching and affiliating health sciences universities are bound to be of great use to the learners of the subject at both undergraduate and postgraduate level.
  • 7. Technoayurveda's Practical SOP Panchakarma (Dr.Vedprakash Mishra) Pro-Chancellor, Datta Meghe Institute of Medical Sciences (Deemed University), Nagpur Chairman, Academic Committee, Medical Council of India, New Delhi Chairman, National Medical Education Board, IMA Headquarters, New Delhi I am sure that this elegant piece of creative literature embodied in the book format by the authors will make every user feel that he could avail all that he desired, needed and expected out of it. I have no hesitation in putting on record my appreciation for the effort undertaken by the authors in terms of a loud statement that they have generated a 'satiety centre' for quenching the 'inquisitional thirst' in the domain of Panchakarma. I am not only sure but quite confident that this book would prove itself to be a 'benchmark' in respect of its utility to all concerned and also go a long way in shaping and guiding the learners in times to come. I record my greatest sense of admiration and appreciation for the learned duo for their painstaking effort in bringing out this epitome of creativity, which is boldly capable of narrating all about Panchakarma in all its faces, facets, contours, connotations, niceties including nuances as well.
  • 8. Technoayurveda's Practical SOP Panchakarma Abbhyudaya D. Meghe Officer on Special Duty, DMIMS Founder President of Utkarsha Jan Kalyan Shikshan Sasthan PREFACE It gives me the immense pleasure to address the book entitled “Technoayurveda's Practical SOP Panchakarma” written by Ayurmitra Prof KSR Prasad, Vice Dean and Head of Panchakarma Department and Prof. Meena Deogade, Dravyaguna Department, of Mahatma GandhiAyurved College, Hospital and Research Center, Wardha under Datta Meghe Institute of Medical Sciences (Deemed to be University),Wardha. The efforts taken by the authors are incredible and felt to reveal, educate and train the Panchakarma related all aspects according to NABH standards for recording and analysis of the data for future developments. The comprehensive narration of each section is helpful for a layman who wishes to understand the procedures of Panchakarma and their benefits. The information given generates the interest to undergo the treatments to get their benefit. Eventually the entire fraternity of Ayurveda from students to the specialists can avail the content of this book for precision in practicing the Panchakarma. The content is comprehensive, informative, methodical, scientific, unbiased, experiences recorded with narration of Concepts and terminology, indications and contraindications, time and duration of the procedure, benefits and alternative measure in case of patients non acceptance along with procedural sequences. The procedures are carefully narrated step by step with pre operative steps, main procedure steps in sequence and where ever required with diagrams of explanation and post procedural steps and precautions. The input of possible complications and commonly used list of medicines with possible usage disease conditions attracts the reader to follow the author. The highlighted area in this book is Panchakarma procedural area plans and procedural preparation techniques. They are vividly described with number of possibilities and dialects of practice.The book included the NABH indicator reporting methods also. The introduced NABH methods for a Panchakarma procedural establishment, initiation and maintenance with formats of approach, bifurcation of nutritional needs,
  • 9. Technoayurveda's Practical SOP Panchakarma medicinal and procedural prescription are really new thought to be practiced. Even in the follow-up the same style is followed is recommendable. The format of requisition for Panchakarma procedure, nutritional assessment, care plan, and NABH necessary documentation models are also incorporated in the book as easy and ready reference to reader. Any student or institution wish to start a new Panchakarma therapy rooms or establish a section of Panchakarma with standards (NABH), this book is one spot reference book and gives entire information at a glance. This book “Technoayurveda's Practical SOP Panchakarma” from the hands of Prof KSR Prasad, offer a regulated methodical result oriented Panchakarma procedural information describes not with words but also diagrammatically is impressive to learns the strokes and movements of rhythms followed in Panchakarma with timing. The selection of patient and medicine in short described is sufficient to initiate the interest in Panchakarma. The herbs commonly used in Panchakarma for different procedures are summarized with its properties and utility showing a photograph catches the reader. The effort taken by Prof. Meena Deogade, is remarkable and appreciable. This maiden effort of revealing the hidden techniques of Panchakarma for all Ayurveda community is encouraged with great respect. This intellectual property should go with copyrights and patents for recording the developments of Ayurveda in 21st century. The future additions of this book edition should include more information related to drug usage and research aspects also. I admit my deep sense of appreciation for the efforts taken by the authors. The blessings of Ayurveda may remain with authors forever to bring more such innovative and explorative books useful for theAyurveda community. Abbhyudaya D. Meghe M.Sc (Tech) Applied Geology (NU), Bachelor of Journalism BMC (NU) PGDHA & M (Symbiosis), PGDHA & M (Chennai), M.H.A. & M (DMIMS(DU) Officer on Special Duty, DMIMS Founder President of Utkarsha Jan Kalyan Shikshan Sasthan (Mob. +91 992 360 0517)
  • 10. Technoayurveda's Practical SOP Panchakarma Unexpected entry in Ayurveda in 1977 at Hyderabad brought me to this stage of knowing the traditions and its values. The Ayurveda not only provided food for me and my family it has given a lot inexplicable knowledge. The schools of thoughts are more valued in our system and I am proud to be stated as the successor of Dr VVS Sastri who is famous for his works on Tridosha Theory and direct disciple of Dr Dwarakanath. Author's Message KSR Prasad Ayurmitra, Nadi Bhishak, Jyotisha Vaidya As the entry in to the academics made in 1996, the study methods and Panchakarma practices were disappointing to me. When I leap in to PG Curriculum of Kayachikitsa and Research avenues, I found where exactly we are lacking. From that day in many scholarly gatherings even though I keep my voice there was no response as people are interested in only outcomes but not at the level of understanding the Ayurveda. It is funny always; the rules are made but not followed. From 2008, I am extending help and Free Service to the researchers of Ayurveda and PG scholars on the name of Technoayurveda. Even though the responses got are limited but satisfactory. I know to myself that the ideology what I am expressing takes another 10 years to implement inAyurvedic community. The methodical Panchakarma practiced is depended upon dialects of provinces and the practice gets the colloquial instead of authentication. Many provincial observations are made across India and wonder how the small idea of an individual is enormously dramatically alter the result of the process. But the idea is armature and needs refining at the dictums ofAyurveda. This made me to bring a common Panchakarma practice book useful for the students, teachers and also practitioners where the data recording and analysis is possible on common platforms. The plotting of theTechnoayurveda's SOPPanchakarma was done in the year 2000; the idea was fruitful when the NABH norms become mandatory to all. The support given by Shree
  • 11. Technoayurveda's Practical SOP Panchakarma Dattaji Meghe to establish and run the Panchakarma as I feel to do is remarkable. I am dedicating this work to him as gratitude. The constant support given by Shree Abhyudayji Meghe in establishment of units and Shree Sagarji Meghe for all round support is best of its kind to any level. I know this work is helpful for the students and who wish to make a new establishment of Panchakarma with standards or the best in research activity. May my approach will boost the energy for readers and awake the dormant community to their destiny of Ayurveda Panchakarma Practice. This is first publication ofTechnoayurveda and promise to the community for bringing the evidence based scientificAyurveda literature on this platform for community benefit. I am happy with the work contribution of Fellowship scholar of . Many names to take here for sculpting me, Dr Kasturi Ramachandra Rao, Jagat Sham Kushi and my parents Satyanarayana and Seetaramamma, spouse Valli Sree, Children Harun Kowshik and Harsha Kowshik. Many friends are backing me with their thoughts, I am thankful to one and all here on this occasion. Ayurvedically Yours Second Edition : Dr Meena Deogade Professor Dravyaguna and Panchakarma Presently I am working as Vice Dean, Professor and Head of the Department of Panchakarma, Mahatma Gandhi Ayurved College, Hospital & Research Centre, Salod (Hirapur), WARDHA (Maharastra), A Constituent college of Dutta Meghe Institute of Medical Sciences (Deemed to be University) and offer my sincere thanks to all my collogues. I am very much thankful to Dr Punit R Fulzele, working as Asso. Professor, Dept of Pedodontics, SPDC, Datta Meghe Institute of Medical Sciences, Wardha (MS) India, and Secretary, IPR cell, Head, Dept of Educational Research, School of Health Professional Education & Research; Convener, BETiC Innovation Cell, for his timely help to make the copyrights of the 21 formats of Panchakarma, which made the book more prize worthy. Ayurmitra. Dr. K.S.R. Prasad Vilambi, Chaitra, Sukla Panchami, First Edition : 22nd March 2018
  • 12. Technoayurveda's Practical SOP Panchakarma Personal Information Ayurmitra, Nadi Bhishak, Jyotisha Vaidya Dr. Shiva Rama Prasad Kethamakka Born : 3rd October 1960 Parents : Smt Seetharamamma & Sri Satyanarayana Kethamakka Spouse : Valli sree Piratla Children : Late. Er. Harihara Prasad (Son) Er. Harun Kowshik (Son) Sreedevi (Wife) Kaivalya Kowshik Sowmya Kowshik (Grand child) Harsha Kowshik (Daughter) Phani Kiran K (Son-in-law) Ayan Kartikeya Mentors : Dr Sampat Narasimha Char Dr. V.V.S. Sastry Dr. Kasturi Ramachandra Rao Dr. Jagat Shyam Kushi Kasturi Graduation : B.A.M.S in 1983 from Osmania University, Hyderabad, AP Post Graduation : M.D. (Kayachikitsa) in 1989 from Osmania University, Hyderabad, AP Other Qualification : M.A. (Jyotish & Vastu), PSTU, HYD. Ph.D. (Vaidya Jyotisham), PSTU, HYD C.O.P. (German), CIEFL, OU, Hyderabad Member Ex-BOS Member, University of Calicut, Kerala Ex-Secretary, AMGAI, AP Branch Awards Awarded “Ayurmitra” 15 August 2012 Nadi Bhishak 26, January 20 Email : technoayurveda@gmail.com / technoayurveda@yahoo.com Website : http://www.technoayurveda.com In nutshell : Innovative, Developmental, Research oriented, Communicative, A good Teacher with Computer skills (Grand child) Awarded “ ” 20 Awarded “Best Panchakarma Physician” 02 November 2021
  • 13. Technoayurveda's Practical SOP Panchakarma Guided Dissertations : More than 50 thesis and PG & Ph.D. Examiner for many universities Panel Speaker : More than 100National & International Seminars Favorite Research : Educational & Clinical research,. Other credentials : Ex Editor, “Zodiac Family” Jyotish monthly magazine Ex Editor, “Amruta Bindu” a bilingual (English & Kannada) monthly News magazine Ex Chief Editor, Journal of Indian System of Medicine Book Editor : Essentials of Basic Ayurveda Concepts, authored by Late Dr.V.V.S.Sastri, Best Practices in Panchakarma, , Multiple Authors 2000 2017 Authorship : Evidence Based Panchakarma in 2012 Practical SOP Panchakarma in 2018 Art of Panchakarma Vol-I in 2019 Ayur-Jyotisham (Ayurveda Astrology) in 2021
  • 14. Section - I Chapter Pages 1.1 Practical SOP Panchakarma 1 - 8 1.2 9 Introduction to Patient Care - 26 1.3 NABH Indicator Reporting 27 - 30 1.4 Setting A Panchakarma Theater 31 - 40 1.5 Panchakarma Kitchen - Panchavidha Kashaya Kalpana 41 - 50 1.6 Panchakarma Kitchen - Anya Kalpana 51 - 58 1.7 Panchakarma Kitchen - Pancha Pathya Kalpana 59 - 62 Section - II SOP of Procedure 63 - 64 2.1 Snehapana 65 - 74 2.2 Gatra Abhyanga 75 - 90 2.3 Shiro Abhyanga 91 - 98 2.4 Mukha Abhyanga 99 -104 2.5 Padabhyanga 105 - 110 2.6 Padaghata 111 - 116 2.7 Bhaspa Sweda 117 - 120 2.8 Avagaha Sweda 121 - 122 2.9 Tapa Sweda (Pansa patra, Arkapatra) 123 - 124 2.10 Pinda Sweda (Valuka, Churna, Patra, Jambeera, Shastikashali) 125 - 132 2.11 Dhara (Sarvanga, Shiro) 133 - 140 2.12 Shirovasti 141 - 146 2.13 Shiropakalpana (Shiropichu, Talam) 147 - 152 2.14 Lepa Kalpana (Shiro Lepa, Annalepa) 153 - 158 2.15 Upanaha 159 - 164 2.16 Ksheera Dhooma 165 - 170 2.17 Sthaneya Vasti 171 - 176 (Shirovasti, Greevavasti, Hrudvasti, Kativasti, Prushtavasti, Januvasti) 2.18 Vamana 177 - 184 2.19 Virechana 185 - 192 2.20 Vasti (Niruha, Anuvasana, Matra) 193 - 202 Technoayurveda's Practical SOP Panchakarma Contents of Technoayureda’s Practical SOP Panchakarma
  • 15. Technoayurveda's Practical SOP Panchakarma 2.21 Uttra Vasti (Male, Female) 203 - 210 2.22 Nasya 211 - 216 2.23 Dhumapana 217 - 222 2.24 Raktamokshana 223 - 228 Section - III Physiotherapy 229 - 230 3.1 Traction Therapy 231 - 232 3.2 Infrared Therapy 233 - 234 3.3 Electric Stimulation Therapy 235 - 236 3.4 Short Wave Diathermy 237 - 238 3.5 Ultrasound Therapy 239 - 240 3.6 Exercise Therapy 241 - 244 Section - IV Herbs Used in Panchakarma 245 - 272 (Alphabetically arranged herbs)
  • 16. Technoayurveda's Practical SOP Panchakarma Section - I Pre Panchakarma Preparation
  • 18. “Ayurveda the way of living” begin from the day of great flood, when the lands are appeared together and the species on the earth started flourishing. The legend of Manu (a human) in impending catastrophic flood first appears in (Sanskrit the language of Gods) (700300 BCE), and is further detailed in (250500 CE). Manu [1] collects and preserves all the grains, Herbs and living creatures of the world in a boat. When the flood destroys the world, Manu accompanied by the seven great sages survives by boarding the ark and initiates the life on planet Earth. Such flood myth (Bible - Genesis 6:9- 9:17) originated in Mesopotamia in Akkadian (the language of Babylon) is dating from about 1600 BCE [2]. Here Noah, a righteous man instructed by God to build an ark in which he, his sons, and their wives, together with male and female of all living creatures, would be saved from the waters. The flood lasted (40 days according to Genesis 7:17, 150 according to 7:24) long and the ark rested on Ararat. Even the Islam [3] supports the story of great flood. It happens long ago as many as 70 million years ago when the Gondwana Land came out after the flood. Later present Indian continent is separated as an island on the name of 'Jambudhweepa'. Rich vegetation made human to explore the uses of it and Ayurveda flourished naturally with natural available mechanism. It is evidential from the daily prayers, time line spell out of Indian community as Vaivaswata manvantare etc.TheVaivaswata is 71 generation from Manu. Each Manvantara is with 71 Chaturyugas i.e. 1 life span of Manu. 1 human year (in Hindu calendar) = 1 Deva Ahoratra for God (1 day and 1 night) and such 360 Deva Ahoratras = 1 Deva Vatsara. The 12,000 Deva Vatsara becomes 1 Chaturyuga (4320000 years). 12,000 Deva Vatsaras are defined as, 4,800 Deva Vatsaras of satya yuga, 3,600 Deva Vatsaras of TretaYuga, 2,400 Deva Vatsaras of Dvapara Yuga and 1,200 Deva Vatsaras of Kali Yuga (which is 1,200 * 360 = 432,000 human years); summing up to 12000 [4]. The actual duration of a Manvantara, according to the Vishnu Purana is seventy one times the number of years contained in the f Shatapatha Brahmana Matsya Purana st our Yugas, with some additional years, adding up to 852,000 divine years, or 306,720,000 human years. According to Vedas, there are 504 000 Manus manifested during the lifetime of one Introduction to Practical SOP Panchakarma 1.1 Technoayurveda's Practical SOP Panchakarma
  • 19. Technoayurveda's Practical SOP Panchakarma 8 Art of PanchakarmaVol-1 authored by Ayurmitra, Nadi Bhishak, Jyotisha Vaidya Prof. Dr. KSR Prasad with Panchakarma Purvakarma Snehana & Swedana with detailed explanation. Contact for details and ordering the book. technoayurvedasales@gmail.com
  • 20. Patient Care 1.2 Patient is a person receiving or registered to receive medical treatment. Ayurveda defines the patient as first of four components called as 'Chikitsa Chatushpada', which forms the accomplishment of therapeutics. The four mainstay of therapeutics are - Patient (Rogi), Physician (Bhishak), Medicine (Aushadha) andAttendant (Upastata) [1].The qualities of each are enumerated well to make assessment. As like the student centered education (SCE) in health education system, the patient centered therapeutics (PCT) is evolved in healthcare system. The qualities of patient is affirmed well in Charaka Samhita [2] as Sushruta [3] added few more qualities to the patients for his surgical interventions applicable as 1. 2. 3. 4. 1. Smruti recollection; Patient should have a good memory of recollecting the sequence of disease manifestation in terms of signs and symptoms. Nirdesha karitwam (Charaka) - Vaidya vakyastha (Sushruta) Bhishakvasya (Vagbhata) following instructions; Patient is expected to follow the instructions given by the physician, if not the expected relief is not possible. Abheerutwam fearless; many times patients impose self restrictions or may be submissive to the kith and kin ideology and there by fearful about the treatments. Such fear should not be and trust should be expressed towards the physician and the management. Jnapaktwam (Charaka - Vagbhata) memory; for following instructions of physician one should have good memory. Not only to follow the instructions even at the time of treatment one may be subjected with either action or adversity of medication, so, even such incidents without forgetfulness should be reported and recorded. Ayushman Healthy signs; for any treatment to undergo we need to observe the complications and signs of recovery. As Sushruta is surgical in practice, he observes the patients fitness forsurgery and recovery. Technoayurveda's Practical SOP Panchakarma
  • 21. 2. 3. 4. 5. ) b) c) d) e) f) g) Satwavan (Sushruta - Vagbhata) strong; strong is in terms of physical fitness. The physical fitness is required for various procedures to adopt and psychological fitness is also required in the same manner. For example a patient is indicated for Vamana Karma, but the patient is with no physical fitness may lead to complications. Atmavan strong by mind; psychological fitness is also important as like physical fitness. For example a patient is indicated for Vamana Karma, but the patient is with no psychological anchoring to accept the management may lead to complications. Astikyo religious;Ayurveda has given importance to the individual beliefs and its regulations. Usually God (almighty) acceptance offers regularities imposed as they believe Heaven and Hell. Sadhyo Dravyavan Adhyo-rogi (Vagbhata) [4] money makes many things. Both Sushruta and Vagbhata brought this point out as acquiring the necessary medicines orthe money required forit is very much essential. 1]Access,Assessment and Continuity of Care (AAC) 7 standards (21 elements) a Define and Display the Services provided Patient registration process Patient initial assessment Patient's referral / transfersystem Prescription method of Medicine / Procedure Regularperiodic reassessment Multi-disciplinary continuous care NABH for Panchakarma Units/ Clinics Patient care is distributed in 5 chapters with 32 standards having 131 elements in it.The detailed care aspects are discussed as under. Summarization of this section could be in the following steps. Any Panchakarma unit is commonly practicing the internal and external procedures. The services provided should be provided in a prominent place clearly visible and readable for the consumer along with price list. It is preferable to display is in local language, National Language (Hindi) and International language (English). A photograph and information regarding the procedure viz. Name of the procedure, its usefulness, approximate time taken for the procedure, price, etc. NABH in Patient Care a] Define and Display the Services provided Technoayurveda's Practical SOP Panchakarma 10
  • 22. NABH Indicator Reporting 1.3 Regular clinical audits are required for validating the NABH indicators through collective reporting. Few items are validated continuously and few are at quarterly and half yearly. All the key performance indicators are reported and discussed for any vulnerable, adverse or sentinel events and are noted for rectification with preventable measures brought out. Establish baseline information and working standards as standard protocols in the department of Panchakarma. All procedure benchmark performances are well identified against national and international standards. Clinical quality, evidence based practices, analysis of procedure outputs in valid parameters, resource utilization, instruments downtime, etc., are needed to report, analyze and taken probable actions in response. To prepare the reporting we have to start with the scheduling of the patient and fulfilling the patient procedural needs for next day. The Male and Female patient procedure requirements to place in different charts and displayed on the Panchakarma procedural area notice board and copy is supplied to corresponding wards (Schedule-1). The patients may require Vasti or Patrapinda sweda, etc., in such time the therapist are scheduled to prepare either Kwatha or Pottali according to the need. Thus the kitchen duty schedules with requirements are placed to prepare the necessary material well in before (Schedule-2). It needs the following schedulers. Technoayurveda's Practical SOP Panchakarma
  • 23. Technoayurveda's Practical SOP Panchakarma Schedule-1: Patient Procedure Scheduling (Male / Female) Date: Schedule-2: Procedure Preparation Scheduling Date: Therapist allotted __________________________________________________________ SNo Material required Quantity Special instructions if any 1 Dashamoola Kwatha 1000ml 2 Triphala Kashaya 600ml 3 Musta Sadhita Takra 500ml 4 Nirgundi, Arka patra, Shigru patra 2 pottali 5 6 SNo IPD/ OPD Name of Patient Procedures required Room Allotted Reporting Time Schedule Time From-To Estimate d Time Hr:Min 1 IPD Badrinath Gatra Abhyanga, Bhaspa Sweda (Box), Kativasti 1 8.45AM 9.00 to 10.30AM 1.30 2 OPD Kamalnath Gatra Abhyanga, Bhaspa Sweda (Nadi), Niruhavasti 2 8.45AM 9.00 - 10.00AM 1.30 3 IPD Rajesh Shirobhyanga, Gatra Abhyanga, Bhaspa Sweda (Box), Shirodhara (Takra) 2 10.15AM 10.30 - 12.40PM 2.10 4 IPD Kumar Kativasti, Lumbar Traction 1 10.15AM 10.30 - 11.15AM 0.45 5 IPD Pawan Local Massage, Patrapinda Sweda 1 11.00AM 11.15 - 12.00PM 0.45 6 2 12.30OM 12.40PM- SNo Therapist Name Room Number Special instructions if any 1 Pramod 2 Check the material for Niruhavasti, Takradhara at arrival 2 Kamalesh 1 3 Jayawardhan 1 4 Pandu 2 Schedule-3:Therapist RoomAllottment Scheduling Date: 28
  • 26. Setting Panchakarma Theater 1.4 Panchakarma as it is of with five major (Vamana, Virechana, Vasti, etc) and many minor procedures of purification of the body either through elimination (Shodhana) or pacification (shaman) of Dosha do require a special place and instrumentation in a good infrastructure for the procedures. Thus the setting of the Panchakarma Theater is necessary well before initiation of the procedures. Even though CCIM, the governing body of the Ayurveda has given minimum specifications of establishment to run a well organized Panchakarma theater we require to set the best for the convenience and satisfaction of the patient. A Panchakarma theater require a minimum of Droni (8 x 3 feet), Swedana box (4 x 4 feet), a table for heating equipment and other medicines to place (3 x 4 feet) and working place around the Droni.The room is attached with changing area (5 x 4 feet) and attached western commode shower room (5 x 4 feet). This completes the minimum requirement of infrastructure for one Panchakarma theater. Thus the room specifications will go as 12 x 12.5 feet (adjustable to 12 x 15 feet) with 6 x 5 changing room and 6 x 5WC, in total 240 square feet area. Most of the institutions run central kitchen but practically it is very inconvenient.Any major preparations even though undertaken in central kitchen the fire connections with Gas are problematic. Thus using Gas connection for central kitchen and electric stove for room is a better option.To avoid transporting hurdles from kitchen a four room connected kitchen model is opt for the situation. The model diagram is shown as Fig-1 with dimensions. The proposed four room Panchakarma unit undertakes 1) Abhyanga, Pindasweda, Nasya and Local Vasti like Januvasti, Kativasti, etc. 2) Vamana, Virechana and Vasti Karma, 3) Sarvanga Dhara, Shirodhara, Shirovasti Shastikashali Pindasweda, etc and 4) Agnikarma, Jaluka, Raktamokshana, etc, with a central kitchen 18 x 15 feet. For these procedures to perform we require a minimum equipment in individual room is as under. , Setting a PanchakarmaTheater Technoayurveda's Practical SOP Panchakarma
  • 27. Technoayurveda's Practical SOP Panchakarma 40 Technoayurveda's Ayur Jyotisham (Ayurveda Astrology) authored by Ayurmitra, Nadi Bhishak, Jyotisha Vaidya Prof. Dr. KSR Prasad with Panchakarma Purvakarma Snehana & Swedana with detailed explanation. Contact for details and ordering the book. technoayurvedasales@gmail.com
  • 28. Technoayurveda's Practical SOP Panchakarma Panchakarma Kitchen Panchavidha Kashaya Kalpana 1.5 Panchakarma kitchen not only provides materials for Panchakarma procedures but also the for patients. Under the specifications discussed earlier, the kitchen provides Kashaya Kalpana,Takra Kalpana, Rice varieties, Patra pinda varieties, etc. There are mainly five types of Kashaya kalpana preparations inAyurveda, collectively known as Pancha Kashaya Kalpana. Svarasa - The juice of the plant, which is the strongest of all, is extracted by pounding or grinding it in a blender. Kalka - The herbs are crushed and made into a pulp form in the required consistency by adding sufficient water. Kwatha - It is prepared by boiling the herbs in water until the preparation is reduced to one-fourth of the original amount. Phanta - Hot infusion is obtained by immersing the herbs in hot water for some time. Hima -The herbs are soaked in cold water overnight for preparing a cold infusion. Swarasa is juice of wet drug pondered and crushed from it. It is having Guru guna (heaviness as quality), thus consumed in small quantity.The usage of Swarasa in Panchakarma unit is very less. Fresh green leaves of bulk in nature gives good quantity of juice but few leaves or stems may not. Such drugs are socked in water for 24 hours to get the juice out of it. Sprinkling little water is acceptable in the process. The wet grinder can be used for grinding and getting the Swarasa. There is another method of getting Swarasa from dry herbs. The drugs are crushed and placed one day in double quantity of water. The next day the filtered water is collected as Swarasa. 1.5.1] Swarasa Concept andTerminology:
  • 29. Technoayurveda's Practical SOP Panchakarma 1.6 Panchakarma Kitchen Anya Kalpana 1.6.1: Ksheera Kalpana Concept and Terminology: Material Required: Process of Preparation: Panchakarma kitchen needs to prepare Ksheerapaka or Ksheera for the process of Dhara treatments. Different Ksheera are used in Dhara viz. Go Ksheera, Sthanya Ksheera, etc. Few drugs and additives are used in Ksheera Kalpana preparation. For ksheera Kalpana 1: 4 parts of milk and water is taken. At the end only milk quantity is remained for sheera dhara. Usually 1500ml of milk is required for Shirodhara and 3000ml for Sarvanga Dhara. Go Ksheera / Sthanya according to prescription Vessels Measuring jars Drugs like Bala, Shatavari, Jatamamasi, Guduchi etc Clean cloth / mesh filter Collect the composition of material as per formula Bala, Shatavari, etc. Ponder well in to course powder separately Collect the vessel according to the type and quantity of Ksheera Kalpana prepared. Add the Dravya, Milk and prescribed water 50 gms of Dravya (Jatamamsi), 1500 ml of Milk and 6000ml of water Expose it to low fire . Do not cover the vessel Check the volume is reduced 1500ml i.e. only milk is remained Filter the Milk in a clean cloth or mesh filters Allow to cool the milk If any additives are to be added like coconut water or any prescribed Nirgundi or Dashamoola Kwatha,Triphala Kwatha, etc. are added in half or equal quantity. Store in a glass jar or vessel for usage 1. 2. 3. 4. A. B. 5. 6 7. 8. 9. 10. 11.
  • 30. Technoayurveda's Practical SOP Panchakarma 1.7 Panchakarma Kitchen Pancha Pathya Kalpana Concept and Terminology: After the Panchakarma (Vamana, Virechana and Vasti), the diet restrictions are imposed to patient as the Annavaha srotas and stomach is sensitive. The dietetics of Panchakarma is called as 'Sansarjana Krama'. In the process of Sansarjana Krama, different consistency food materials are supplied according toAnnakala. Usually this diet is prescribed at the completion of the procedure as post procedural measures even when the procedure is inadequate. The Pancha Pathya Kalpana are given to the recovering patients, as a post procedural diet program and aged who can't digest heavy food. It consists of nutritive and instant energy providers as easily digestible preparations of rice and helps in fast recovery.The diet is structured in stages, going from more liquid to solid preparations in increasing order. The diet consists of old Lohita (Rakta) Shali Tandula, which is a mostly easily digestible carbohydrate. The consistency of the food is brought with the quantity of the water added while cooking. The process is followed for 3 to 7 days according to the need of the patient. Daily two servings of diet is made in the noon and evening. No breakfast or snacks are served in between. The quantity of serving is based upon the 'Agni bala' i.e. digestive capacity of patient.Addition of condiments, unctuous substances or meat / meat soups are according to the dietitian advises. The permitted vegetables (Pathya) are added to the diet accordingly. The different foods served are Peya, Vilepi, Yusha, Rasa and Odana (Charaka Sutra 15/21-24). These preparations relieve constant thirst and tiredness. Rice has unique nutritional value and contains very low amount of saturated fats and cholesterol making it a healthful food for heart. Rice is a good source of fiber and has minerals such as calcium and iron, vitamins, such as niacin, vitamin D, thiamine and riboflavin and therefore, improves digestion. Rice softens the channels and balances the normalcy of all body parts and makes an increase in body energy and also act as Diuretics. Rice is good during illness or recovery of digestion as it is very light and easy to digest. Rice improves appetite and also digestive power. It helps in Vata (flatus) and Mala (feces) to move downwards and relieves constipation.
  • 31. Technoayurveda's Practical SOP Panchakarma Table -1: Self explanatory Annakala for the 3 to 8 days procedure of diet scheduling Day Annakala Time of food consumption Fully Dosha Eliminated Halfway Dosha Eliminated Minimal Dosha Eliminated 1 1 Morning Procedure Procedure Procedure 2 Evening Peya /Manda Peya /Manda Peya /Manda 2 3 Morning Peya Peya Peya 4 Evening Peya Vilepi Vilepi 3 5 Morning Vilepi Vilepi / Akruta Yusha Yusha (Krutu /Akruta) 6 Evening Vilepi Yusha / Kruta Yusha Rasa (Krutu /Akruta) 4 7 Morning Vilepi / Akruta Yusha Yusha / Akruta Rasa Odana 8 Evening Yusha / Akruta Yusha Rasa / Kruta Rasa 5 9 Morning Yusha / Kruta Yusha Kruta Rasa / Odana 10 Evening Yusha / Akruta Rasa Odana 6 11 Morning Rasa / Akruta Rasa 12 Evening Rasa/ Kruta Rasa 7 13 Morning Kruta Rasa / Odana 14 Evening Odana 8 15 Morning Odana + Roti 60
  • 32. Technoayurveda's Practical SOP Panchakarma Table-2: Preparations of Anna Kalpana with ratio of proportions additions Type of diet Rice quantity Water quantity Additions Remarks Peya (Gruel) or porridge 1 8 or 14 Salt, Zinger, Pepper Clear Gruel without Rice fragments Manda 1 8 or 14 Salt, Zinger, Pepper No fragments of Rice are seen in Gruel Yavagu 1 6 Salt, Zinger, Pepper Fragments of Rice are seen in Gruel Vilepi (Thick Gruel): 1 5 Salt, Zinger, Pepper, Ghee, Cooked Vegetables Thick Gruel with fragments of Rice Akruta Yusha 1 4 Salt, Pepper, Cooked Vegetables, Added with Greengram (Mudga) Yusha – without Ghee Kruta Yusha 1 4 Salt, Zinger, Pepper, Cooked Vegetables, Added with Greengram (Mudga) Yusha – and Ghee Akruta Rasa 1 3 Salt, Pepper, flesh juices / soups (chicken), Hot water sipping required in between Kruta Rasa 1 3 Salt, Zinger, Pepper, Chili, flesh juices / soups (chicken), Cooked Vegetables, Hot water sipping required in between Odana 1 part 2 parts NIL Normal cooked Rice consumed with Vegetables as regular servings 61
  • 33. Technoayurveda's Practical SOP Panchakarma Kruta andAkruta: Special precautions: Akruta means not added salt, unctuous substances and condiments. In Kruta all required condiments along with oil or ghee and salt is present. Peya and Vilepi are bland and not having salt or Ghee. Few condiments lime Ardraka, Maricha, Ela, Twak, etc. are added accordingly. Use always moderate fire required Serve hot always Check the appetite before servings. Patient should receive his/her the next meal when the patient should feel hungry again Add minimum quantities of grated ginger, pinch of pepper powder and required quantity of table salt only Check the thickness of servings Odana, which means cooked rice and has the consistency of normal, soft, cooked rice. 1. 2. 3. 4. 5. 6. 7. Vilepi Odana (Anna) 62
  • 34. Technoayurveda's Practical SOP Panchakarma Section - II SOP of Procedures Section II 'Procedure Information Brochure' 'Procedure sequence' 'Procedure Format of Assessment' Demographic Data Vital examination Ayurvedic Examination : The Abhyantara (Internal) Panchakarma, Bahya (External) Panchakarma and Anushastra (semi-surgical) Panchakarma are sequentially enlisted in this section. All commonly practiced Procedures of Panchakarma are sectioned here as Information Brochure, Format ofAssessment and Procedure sequence according to the needs of NABH program. The first section contains Concept and Terminology, Procedure Variations, Indications and Contraindications, dose and Duration, procedure Benefits along withAlternative measures are elaborated. The second section contains Materials required, Pre operative procedure steps, Main Procedure steps, Post procedure steps, Special precautions to be taken, Complications and their management and list of Commonly Used Medicines in the procedure. The third section is with Identification of patient, Vital Examination, Investigations concern, Fitness certificate, Procedure sequence and Assessment and Reassessment of procedures are incorporated in format. : Patient Name, Age, Gender, Contact Number, UID Number, OPD Number, IPD Number, Ward, Bed No, Diagnosis and Consultant Dr. Name are self explanatory in demographic data. This includes the measurements of Height, Weight, BMI, Blood Pressure, Pulse Rate and body Temp in °C as a routine to understand the vitals of the patient. All the following factors of examination helps to fix the dose of Snehapana. General Guidelines for Filling Forms 63
  • 35. Technoayurveda's Practical SOP Panchakarma 64 Koshta Agni Twak Mala Mutra Medas Prakruti : : : : : : : Koshta is gut that includes the digestive system from mouth to anus. The softness or hardness of it is estimated as � Mrudu (Soft) � Madhya (moderate) and � Krura (Hard). Agni is digestive capacity of the individual. It is observed as �Sama (normal) �Manda (low digestion) �Teekshna (high digestion) �Vishama (unequal digestion). Twak means the skin. The �Snigdha (softness) or � Ruksha (hardness) is noted. Mala means the faecal. The action of defecation and content validation is made through the terms - �Normal �Ati (excess) �Alpa (scanty) �Snigdha (soft) �Drava (liquidy) � Ghana (hard). Mutra is urine and it is examined as �Normal � Poly � Scanty Medas is fat or flabbiness of fat depositions. The person is observed with the �Lean �overweight �obesity �Morbid depositions of fat. Prakruti is constitution. The constitution in Ayurveda based upon the tridosha -� Vata � Pitta � Kapha. The dominance is noted in the patient. If two or three are observed their involvement than the percentages are noted. Lungs, Heart and Abdomen are examined methodically under inspection, palpation, percussion and auscultation methods. In physician after careful observation and examination summarizing the investigations decides that whether the patient is fit for Snehapana or not. There after he explains the entire procedure to the patient to seek the consent and acceptance for the procedure. is consolidated statement of the patient after understanding his health condition based upon the investigations and necessity of treatment and details of procedure and its benefits and consequences. Systemic Examination Physician Fitness Statement, Patient's acceptance Statement
  • 36. Technoayurveda's Practical SOP Panchakarma 116 Introduction to Evidence Based Panchakarma authored by Ayurmitra, Nadi Bhishak, Jyotisha Vaidya Prof. Dr. KSR Prasad with Panchakarma Purvakarma Snehana & Swedana with detailed explanation. Contact for details and ordering the book. technoayurvedasales@gmail.com
  • 37. Technoayurveda's Practical SOP Panchakarma 158 Technoayurveda's InKspirations (Guest lectures of KSR Prasad) authored by Ayurmitra, Nadi Bhishak, Jyotisha Vaidya Prof. Dr. KSR Prasad with Panchakarma Purvakarma Snehana & Swedana with detailed explanation. Contact for details and ordering the book. technoayurvedasales@gmail.com
  • 38. Technoayurveda's Practical SOP Panchakarma 170 School of TechnoAyurveda offers TANTU Pulse Diagnosis (TechnoAyurveda Advanced Nadi Therapeutic Utility Course) 1. Basics of Pulse review (History, Tradition & Technology) 2. TANTU Level 1 (Sarpa Nadi Energy Levels & Importance of Meditation) 3. TANTU Level 2 (Gross Dosha Perception Location of Pulse) 4. TANTU Concept of Gati & Explanation of different Gati 5. TANTU Level 3 (Ardha Dosha Perception & Analysis) 6. TANTU Level 4 (Deep Level Dosha Perception) 7. TANTU Level 5 (Blocking Method Perception) 8. Identification TANTU Shodhana Nadi for Interpretation & proper Panchakarma See for more details at - Https://technoayurveda.com/course-pulse-diagnosis/ Subject details of learning TANTU [4654 of 2017] School of Techno Ayurveda ® TANTU Pulse Diagnosis
  • 39. Sthaneya Vasti 2.17 Technoayurveda's Practical SOP Panchakarma Local Vasti (Januvasti, Kativasti, Prushtavasti, Manyavasti, Hrudvasti, etc) Concept andTerminology: Variations: Indications: Contraindications: Duration: Benefits: Alternative measures: Januvasti, Kativasti, Prushtavasti, Manyavasti, Hrudvasti, etc., local Vasti are the modifications of Snigdha Vasti, in which Sneha is allowed to stay for a stipulated time over the advised part of the body. Commonly used in pain or inflammatory conditions of the movable joints such as knee, elbow and spinal column. To place the oil a brim of circular or elongated is constructed and the oil is placed for time period maintaining the temperature. Januvasti circular brim is placed over knee joint Kativasti circular or elongated brim is placed over lumbar spine area Prushtavasti circular or elongated brim is placed over thoracic spine area Manyavasti circular or elongated brim is placed over cervical spine area Hrudvasti circular brim is placed over chest in heart area Januvasti Joint pain Kativasti lumbar pain Prushtavasti thoracic pain Manyavasti cervical spondylosis Hrudvasti Cardiac pain No specific contraindications Avoid in case of open ulcers 20 60 minutes for 7 14 days. Pain relief Joint flexibility Regeneration of tissues Pichu
  • 40. Vasti Karma 2.20 Technoayurveda's Practical SOP Panchakarma Concept and Terminology Variations: : Vasti commonly referred as enema but the functionality differs. Vasti is medicines that are administered through rectal route for Dosha elimination and /or for disease pacification. Thus it is half the way putative (Ardha Shodhana) and the other half is treatment (Ardha Chikitsa). The liquids used in Vasti are Kashaya (water soluble active principles), Taila (fat soluble active principles), Ksheera (Lacto soluble active principles), Mamsarasa (meat soup), etc. Added with Saindhava Lavana (to balance electrolytes), Madhu (honey fructose & Glucose to give strength and amalgamate the oil in the presence of salt), Kalka (paste of Pachana drug or diseases pacification medicine), and sometimes even the prepared medicines such as Shankha basma, Pravala Bhasma, Vata vidhwansini Ras, etc. Materials used in Vasti are wide in range and eight types of urines, six types of Rasa skandha Dravya, Lavana, etc.Are used inVasti. To induce Vasti, a special pouch made of animal bladder or polythene bag is used attaching the specified dimension made Vasti Netra (nozzle). Enema can is also used but not to gets the sufficient pressure to reach the medicine at high rectal area. The Vasti is classified basically as Niruha (decoction) andAnuvasna (oil) Vasti. Depends upon the area where the medicine is inserted Pakwashayagata (Rectal), Vrana (ulcer) Vasti are practiced. The other two Mutrashayagata (urinary bladder) and Garbhashaya (uterine) Vasti are termed as Uttaravasti. The action based Vasti classification is as Shodhana (eliniation), Shamana (pacification), Lekhana (scraping), Brumhana (nourishing), Vajikara (aphrodisiac), Vandhyatwahara (infertility management), etc. On the other hand the based on number Yoga (8), Kaala (15) and Karma (30)Vasti are given. Even on the basis of quantity the MatraVasti are designed. Many other types of Vasti are available to practice are Yapana Vasti, Siddha Vasti, PrasrutayogikiVasti, Picchavasti, RaktaVasti,VrushyaVasti,VaitaranaVasti, etc. This is otherwise called as Niruhavasti in which Kashaya is the main ingredient and given 600 to 1440 ml mixing in combination of Sandhava, Madhu, Taila, Asthapana Vasti:
  • 41. Technoayurveda's Practical SOP Panchakarma Raktamokshana 2.24 Concept andTerminology: 1] Raktamokshana without Shastra 2] Raktamokshana with Shastra (instruments) 3] Raktamokshana using both Indications: Raktamokshana is an effective blood purification therapy, in which carefully controlled removal of small quantities of blood is conducted to neutralize accumulated Pitta and other toxins of blood-borne diseases. This is because Raktamokshana decreases the quantum of enhanced Pitta Dosha and thus the diseases caused by Pitta are also relieved. Mainly two types Jaluka (Leach) -Tridoshaja, Pindita Rakta; Non poisonous Leach is selected. Siravyadha (vein section) Two dosha Prachhanna (multiple puncture) Two dosha, Rakta Dosha, Srunga (modified with syringe) Tridoshaja, Uthana dosha Ghati /Alabu (cupping) -Tridoshaja, Uthana dosha Arshas Arumshika Chronic non healing wounds Daha Kitibha / Eka Kushta Netra Roga (Raktabhishyanda,) Pain and inflammatory conditions Raktapitta Shiroruja Shlipada Shookaroga Skin diseases Sotha Tandra Tumors Upadamsha Vatarakta Vicharchika Visarpa Vyanga Yavani Pitika Variations:
  • 42. Technoayurveda's Practical SOP Panchakarma 224 Contraindications: Duration: Benefits: Alternative measures: Materials required: Pre operative procedure steps: Main Procedure steps: When there is generalized swelling Pandu Udara Sosha Garbhini In case open bloodletting wait till the flowing blood is clotted. Usually it is 5 to 10 minutes in duration. In case of Jaluka the leach itself leaves or wait for 20 to 30 minutes and release it applying Sandhava Lavana or Haridra Churna. The Raktamokshana is done repeatedly at an interval of 3 to 5 days. Disease is pacified Purification of blood is done Any type of above Raktamokshana is alternative for one to another. In case of non acceptabilityVirechana can be administered instead of Raktamokshana. Therapist 1 Comfortable Bed / Chair -1 Haridra / Saindhava Lavana (in case of Jaluka) Instrument according to prescription Needle, Blade, Scalp vein set, Syringe, Cupping Glass, etc. Kidney tray Cotton Bandage cloth Patient is given Snehapana and Sweda karma if prescribed by the physician The area, where Raktamokshana is done is shaved and cleaned Patient is advised to lie-down comfortably. The selected area is exposed under window towel after cleaning The selected procedure of Raktamokshana is administered Jaluka - - - - - 1. 2. 3. A)
  • 43. Technoayurveda's Practical SOP Panchakarma 225 B) C) D) Ghati : Siravyadha: Prachhanna: Haridra / Saindhava lavana application for Jaluka Applying cotton under pressure and bandaging Rest for 30 60 minutes The Leach used is put in Haridra Jala (Turmeric water) till it vomits the sucked blood. Once this process is completed the Leach is transferred in to a fresh water container. Free movements of Leach suggest that the sucked blood is totally vomited. Check Jaluka whether it is poisonous or not The entire material used should be sterile in nature Irritation stop the procedure and apply Haridra lepam. When the patient is subjected for Raktamokshana, patient is required to undergo few investigations to understand the diseases condition and to take prophylactic measures in the process. Based on these investigation reports the patient is accepted or rejected to perform the procedure. It is common investigation for estimation of blood and anemic patients are contraindicated for Raktamokshana. Differential count of blood is seen for any acute or chronic infections and deviated results are at the discretion of physician to select for procedure. Random Blood Sugar is tested as the Raktamokshana process to prevent the infections. Bleeding Time / Clotting Time: This test is intended to know the bleeding tendency of the patient. If BT& CTare not within normal range the Raktamokshana is not done. The physician prescribed Purvakarma such as Abhyanga and Swedana, etc are undergone or not is noted. If Jaluka is used, Jaluka is prepared for the Raktamokshana.Type of Raktamokshana is noted whether it is Prachhanna, Siravyadha, Alabu /Ghati or Juluka. The indicated number of days is reflective in the prescription is noted. Blood Pressure and Pulse Rate are recorded at regular intervals along with Initiation Haemoglobin %: Differential Count: Random Blood Sugar: Post procedure steps: Special precautions: Complications and management: Investigations: Raktamokshana Progress Raktamokshana Format filling guidelines
  • 44. Technoayurveda's Practical SOP Panchakarma 226 time, Completion time andTotal time taken for the procedure. Day, Date, Raktamokshana Type, Body Temp in °C, Initiation time, Retention Time, Completion time, and output along with remarks if any are noted for prescribed days and intervals as directed by the physician. Vyapat are observed as None, Headache, Fainting, irritation, Itching, and Jwara (fever), etc. Post Raktamokshana Procedures are given such as Bandaging, Jalauka Shodhana and Shamana Chikitsa if required. The Output is measured as Samyak (well) orAyoga (imperfect) with the observation of below mentioned symptoms. Samyak Raktamokshana is reflective with No pain and comfortable and Lightness in Body, Good feeling and Clarity of Mind and Senses are observed. Ayoga (imperfect) Raktamokshana is noted with Burning sensation, Inflammation and inadequate blood flow. Atiyoga Raktamokshana is noted with Pallor (anemia), Fainting and Dry / Rough skin. Output is recorded based on the above symptoms as Samyak, Ayoga or Atiyoga of Uttaravasti. The Concluding Remarks by Physician is given at the end as observed in the patient along with Signature. Jaluka Application
  • 47. Technoayurveda's Practical SOP Panchakarma Physiotherapy (Physical Therapy) is a health care profession concerned with human functional disabilities and movement restrictions. It is concerned with identifying and improving quality of life and movement potential within the vicinity of promotion, prevention, treatment/intervention, habilitation and rehabilitation. It is science-based, committed to extend, apply, evaluate and review the evidence in its practice. Physiotherapists assess, plan and implement programs that improve or restore human motor functions, maximize movement ability, relieve pain syndromes. They plan rehabilitative and treatments for diseases and also for preventing physical challenges associated with injuries or impairments. They apply a full range of physical therapies and techniques such as physical movements, ultrasound, heating, laser and other techniques. Most of the techniques like Joint mobilization and manipulation, soft tissue Massage and deep massage techniques, Muscle stretching, etc. are followed inAyurveda Panchakarma. But few therapies works on Neurodynamics, Taping, Minimal Energy Techniques, Physiotherapy exercises are based on physics and Anatomy of human body needs special attention. Section - III Physiotherapy
  • 48. Technoayurveda's Practical SOP Panchakarma 230 Cervical Traction Lumbar Traction Transcutaneous Electrical Nerve Stimulation (TENS) Equipment
  • 49. Section - IV Herbs Used in Panchakarma 4.0 Technoayurveda's Practical SOP Panchakarma 01-Agnimantha-Clerodendrum phlomidis 02-Amalaki-Emblica officinalis There are many herbs that are used in the Panchakarma as main ingredients or additives. Out of many herbs commonly used are enlisted here with. The utilized part and the effect of herb over Dosha and where it is used are made available as alphabetically arranged easy reference. 1]Agnimantha ( Linn.f.) 2] Amalaki ( Gareth) Clerodendrum phlomidis Emblica officinalis (Premna latifolia Roxb.) Rasa : Tikta, Katu, Kashaya, Madhura Guna : Laghu, Rooksha Veerya : Ushna Vipaka : Katu Useful part : Root Dosha karma : Balances Vata and Kapha Rogadhikara : Vatavyadi Panchakarma usage : Vasti, Swedana Rasa : Pancharasa(Amla pradhana/Lavana varjit) Guna : Rooksha, Laghu, Sara Veerya : Sheeta Vipaka : Madhura Useful part : Fruit Dosha karma : Balances Tridosha Rogadhikara : Ushnaprashamana Panchakarma usage : Talam, Virechanopaga
  • 50. Technoayurveda's Practical SOP Panchakarma 272 81]Vidanga ( Burm.f.) 82] Yashtimadhu ( L.) 83] Yava ( L.) Embelia ribes Glycyrrhiza glabra Hordeum vulgare Rasa : Katu, Kashaya Guna : Laghu, Rooksha, Teekshna Veerya : Ushna Vipaka : Katu Useful part : Seeds Dosha karma : Balances Kapha, Vata Rogadhikara : Unmada, Apasmara, Krimi Panchakarma usage : Shirovirechana Rasa : Madhura Guna : Guru, Snigdha Veerya : Sheeta Vipaka : Madhura Useful part : Root Dosha karma : Balances Vata, Pitta Rogadhikara : Netraroga, Trushna, Vatapittaja vyadhi Panchakarma usage : Vamanopaga Rasa : Kashaya, Madhura Guna : Laghu, Rooksha Veerya : Sheeta Vipaka : Katu Useful part : Seeds Dosha karma : Balances Kapha, Pitta Rogadhikara : Medoroga Panchakarma usage : Udvartana 81- Vidanga- Embelia ribes 82- Yashtimadhu- Glycyrrhiza glabra 83- Yava - Hordeum vulgare