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Sop panchakarma sample pages

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Technoayurveda’s Practical SOP Panchakarma
By
Dr KSR Prasad
Dr Meena Deogade

High lights:
324 pages Text with Copyrighted Formats
Full length Explanation of Panchakarma Theater Planning
Easy narration for following Panchakarma Procedures and Preparations
Easy adoptable Procedure Formats (copyrighted) attached
Step by step procedure description
Herbs usage listed with colour pictures

Book your copy @Rs 499/- + Rs76 (postage) = Rs 575/-
Send RTGS or NEFT or any other payment method to -
Dr KSR Prasad, A/c 6178000100022207
IFSC code PUNB0617800
Punjab national bank, JNMC branch, Wardha
- Send your transaction receipt and full postal address to technoayurvedasales@gmail.com
• Contact for further Information to Dr KSR Prasad; 9503227966 / Dr Meena Deogade - 9765858072

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Sop panchakarma sample pages

  1. 1. Technoayurveda’s Practical SOP Panchakarma Ayurmitra Prof Prasad KSR Prof Meena S Deogade (According to NABH needs) Regd: 4654 of 2017
  2. 2. Regd: 4654 of 2017   Technoayurveda’s Practical SOP Panchakarma  By  Dr KSR Prasad  Dr Meena Deogade    High lights:  324 pages Text with Copyrighted Formats  Full length Explanation of Panchakarma Theater Planning  Easy narration for following Panchakarma Procedures and Preparations  Easy adoptable Procedure Formats (copyrighted) attached  Step by step procedure description  Herbs usage listed with colour pictures    Book your copy @Rs 499/‐ + Rs76 (postage) = Rs 575/‐  Send RTGS or NEFT or any other payment method to ‐  Dr KSR Prasad, A/c 6178000100022207  IFSC code PUNB0617800  Punjab national bank, JNMC branch, Wardha  ‐ Send your transaction receipt and full postal address to  technoayurvedasales@gmail.com   Contact for further Information to Dr KSR Prasad; 9503227966 /    Dr Meena Deogade ‐ 9765858072       
  3. 3. Technoayurveda's Practical SOP Panchakarma Technoayurveda’s Practical SOP Panchakarma Ayurmitra Prof Prasad KSR Prof Meena S Deogade (According to NABH needs) Regd: 4654 of 2017
  4. 4. Technoayurveda's Practical SOP Panchakarma Title of the book: Name of author (s)/Editor: Edition: Copyright Publishers Name and address of publisher: Center for Organizing Ayurveda Research Name and address of printer Place of publication: Price: INR 499/- First, 2018 C/o Dr KSR Prasad, Flat No: 301, Plot No. 138, Sri Satya Residency, Besides Sakshi School, Anupama Nagar, Hastinapuram, Hyderabad - 500070, Telangana Http://www.technoayurveda.com/ M/s Onkar Digital Lab, Ishprasad, Shriniwas Colony, Ramnagar, Wardha - 442001 Wardha Technoayurveda's Practical SOP Panchakarma (According to NABH needs) Ayurmitra Prof. Prasad KSR Vice Dean (PG), Chief Editor, Journal of Indian System of Medicine Head of Dept, Panchakarma Mahatma Gandhi Ayurved College Hospital & Research Center, Salod (H), Wardha - 44200, Maharashtra Technoayurveda@gmail.com Prof. Meena Shamrao Deogade Dept. of Dravyaguna, Mahatma Gandhi Ayurved College Hospital & Research Center, Salod (H), Wardha - 44200, Maharashtra © © 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;} Technoayurveda COAR® Contact for Copies technoayurvedasales@gmail.com
  5. 5. Technoayurveda's Practical SOP Panchakarma Dedicated to Shri Dattaji Meghe Chancellor, Datta Meghe Institute of Medical Sciences (Deemed to be University)
  6. 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 praiseworthyattheother. 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, decipherandassimilatebythelearner,teacheraprofessionalandotherwiseareader,aswell. 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 fromtheotheravailablereadingmaterialonthesubjectasofnow. 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,freeflowing,gripingandlucidmanner. 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
  7. 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 the subject by the various teaching and affiliating health sciences universities are bound to be of greatusetothelearnersofthesubjectatbothundergraduateandpostgraduatelevel. 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'inquisitionalthirst'inthedomainofPanchakarma. 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 guidingthelearnersintimestocome. 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 includingnuancesaswell.
  8. 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 Gandhi Ayurved College, Hospital and Research Center, Wardha under Datta Meghe Institute ofMedicalSciences(DeemedtobeUniversity),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. EventuallytheentirefraternityofAyurvedafromstudentstothespecialistscanavailthecontent ofthisbookforprecisioninpracticingthePanchakarma. 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 conditionsattractsthereadertofollowtheauthor. 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.ThebookincludedtheNABHindicatorreportingmethodsalso. The introduced NABH methods for a Panchakarma procedural establishment, initiation and maintenance with formats of approach, bifurcation of nutritional needs, medicinal and
  9. 9. Technoayurveda's Practical SOP Panchakarma 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 incorporatedinthebookaseasyandreadyreferencetoreader. 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 sufficienttoinitiatetheinterestinPanchakarma. 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.MeenaDeogade,isremarkableandappreciable. 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 researchaspectsalso. 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 explorativebooksusefulfortheAyurvedacommunity. 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 Abbhyudaya D. Meghe (Mob. +91 992 360 0517)
  10. 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 worksonTridoshaTheoryanddirectdiscipleofDrDwarakanath. 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 10yearstoimplementinAyurvediccommunity. 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 andalsopractitionerswherethedatarecordingandanalysisispossibleoncommonplatforms. 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 Author's Message Ayurmitra KSR Prasad Vice Dean, MGACHRC, Wardha Head, Panchakarma
  11. 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 kindtoanylevel. 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 PanchakarmaPractice. This is first publication of Technoayurveda 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 Fellowshipscholarof . 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 andHarshaKowshik. Manyfriendsarebackingmewiththeirthoughts,Iamthankful tooneandallhereonthisoccasion. Ayurvedically Yours Ayurmitra. Dr. K.S.R. Prasad Vilambi, Chaitra, Sukla Panchami, 22 March 2018 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),AConstituent college of Dutta Meghe Institute of Medical Sciences(DeemedtobeUniversity)andoffermysincerethankstoallmycollogues. nd 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 copyrightsofthe21formatsofPanchakarma,whichmadethebookmoreprizeworthy.
  12. 12. Technoayurveda's Practical SOP Panchakarma Personal Information Ayurmitra Dr. Shiva Rama Prasad Kethamakka Born : 3 October 1960 Parents : Smt Seetharamamma & Sri Satyanarayana Spouse : Valli sree Children : Late. Er. Harihara Prasad (Son) Er. Harun Kowshik (Son) (Sreedevi: Wife) Kaivalya Kowshik, Sowmya Kowshik (Grand children) Harsha Kowshik (Daughter) Mentors : 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” n 15 August 2012 Guided Dissertations : More than 50 thesis and PG & Ph.D. Examiner for many universities Panel Speaker : More than 50 National & International Seminars Favorite Research : Educational & Clinical research, Email : / Website : http://www.technoayurveda.com Innutshell : Innovative, Developmental,Researchoriented,Communicative, AgoodTeacherwithComputerskills. Other credentials : Authorof“EvidenceBasedPanchakarma”publishedin2012 ExEditor,“ZodiacFamily”Jyotishmonthlymagazine ExEditor,“AmrutaBindu”abilingual(English&Kannada)monthlyNewsmagazine ExChiefEditor,JournalofIndianSystemofMedicine Editor,“EssentialsofBasicAyurvedaConcepts”,authoredbyDr.V.V.S.Sastri Editor,“BestPracticesinPanchakarma”,authoredbymultipleAuthorsin2017 rd th technoayurveda@gmail.com technoayurveda@yahoo.com
  13. 13. Technoayurveda's Practical SOP Panchakarma Co-Author's Message Meena Deogade Professor, Dravyaguna MGACHRC, Wardha “Shree Swami Samarth” From childhood I had a passion for becoming Doctor. By the grace of God, I had an opportunity to study the sacredAyurveda, a traditional health science of India.After entering in to it, there was a passion and attraction towards the Panchkarma but did my post graduation in Dravyaguna. I understood that the Panchkarma is the backbone of the Ayurveda approach foracuteorchronicdiseasestreatment. These Panchkarma treatments are committed for healing the diseased and promotion of longevity through conservation and maintenance of health.Whenever the subtle balance of tridosha is disturbed, the disease emerges. The main objective of the Ayurveda is to restore doshas in to original state of equilibrium and pacify the manifested disease. The five-fold Panchakarma therapy can be used as preventive, curative and rejuvenator by dislodging and redden toxins from whole body and at cellular level also. The process of Panchakarma removes the toxins deposited and clears the channels for the body to re-establish an internal stateofbalanceandharmony. EveryAyurveda physician must know the clinical applicability of Panchakarma while handling various diseases. I always follow Dr KSR Prasad in this regard to learn the Panchakarma skills. My mentor, Dr KSR Prasad is an eminent, Skilful Panchakarma Specialist when asked me to contribute a chapter in his book “Technoayurveda's Practical SOP Panchakarma”, I had the privilege of being co-author in his book, looking at the present trend towards Panchakarma. The style and content of the book is proved to be a milestone and handyforstudents,teachers,researchersandpractitionersalso.
  14. 14. Technoayurveda's Practical SOP Panchakarma Ayurveda Physician should have knowledge of the Dravya, without of it there will be no success in treatment. Charaka Samhita, lists Dravya that are used in Panchakarma. But the drugs used specifically in present day Panchkarma practices are separated and only enlisted in this book. It is my privilege and fortune as with Dravyaguna specialization, I wrote the section of “Medicinal plants used in Panchakarma”. This book, explains the actual usages of drugs in Panchakarma. The specific use of each drug is given along with Rasa panchaka and related specific Karmas i.e. Vamana, Virechana, Vasti, Udwartana etc, depends on its specificity. The disease area afflicting the patient has also mentioned in this concern.The each drug cited here is with their botanical names and identifiable photographs makes easy to reader for identification of the authentic drug. I am sure; that the herb information brought out in this section will certainly open new ideology of researcher for developing new trend researches.As an example to state, theAshwagandha is indicated in Shwitra (leucoderma) is not in our understanding but wecanthinkofittouseinVamanaintheformofAshwagandhakwathafortreatingShwitra. I amthankfultoDr. KSR Prasad;mymentorwho mademeconfidentandofferedmethe co-authorship which is a dream. I am always grateful for his encouragement and promotion. I hopethisbookcertainlylikedbyAyurvedafraternity. Meena Shamrao Deogade I am thankful to my parents Shri Shamraoji Deogade and Sau Chandrakala Deogade for their blessings and able guidance made me possible to do something. I am thankful to my whole family Shriramji Deogade, Shekhar Deogade, Sushama Deogade, Kamlesh Deogade, Priti Deogade,Advait Deogade,Avanee Deogade andAkshaya Deogade; who supported me always andstandformeandtogivecourageinalladverseconditions.Myfamilyismystrength.
  15. 15. Section - I Chapter Pages 1.1 1 1.2 9 1.3 NABH Indicator Reporting 27 - 30 1. - Section - II 69 - 68 .1 Introduction to Patient Care - 26 1.4 Setting A Panchakarma Theater 31 - 40 5 Panchakarma Kitchen Panchavidha Kashaya Kalpana 41 - 50 1.6 Panchakarma Kitchen - Anya Kalpana 51 - 62 1.7 Panchakarma Kitchen - Pancha Pathya Kalpana 63 - 66 Procedure 2 Snehapana 69 - 80 2.2 Gatra Abhyanga 81 - 96 2.3 Shiro Abhyanga 97 - 106 2.4 Mukha Abhyanga 107 -114 2.5 Padabhyanga 115 - 122 2.6 Padaghata 123 - 128 2.7 Bhaspa Sweda 129 - 132 2.8 Avagaha Sweda 133 - 136 2.9 Tapa Sweda (Pansa patra, Arkapatra) 137 - 138 2.10 Pinda Sweda (Valuka, Churna, Patra, Jambeera, Shastikashali) 139 - 150 2.11 Dhara (Sarvanga, Shiro) 151 - 160 2.12 Shirovasti 161 - 168 2.13 Shiropakalpana (Shiropichu, Talam) 169 - 176 2.14 Lepa Kalpana (Shiro Lepa, Annalepa) 177 - 184 2.15 Upanaha 185 - 192 2.16 Ksheera Dhooma 193 - 200 2.17 Sthaneya Vasti 201 - 208 (Shirovasti, Greevavasti, Hrudvasti, Kativasti, Prushtavasti, Januvasti) Practical SOP Panchakarma - 8 Technoayurveda's Practical SOP Panchakarma Contents of Technoayureda’s Practical SOP Panchakarma
  16. 16. Technoayurveda's Practical SOP Panchakarma 2.18 Vamana 209 - 218 2.19 Virechana 219 - 228 2.20 Vasti (Niruha, Anuvasana, Matra) 229 - 240 2.21 Uttra Vasti (Male, Female) 241 - 248 2.22 Nasya 249 - 256 2.23 Dhumapana 257 - 262 2.24 Raktamokshana 263 - 270 3 273 - 276 3.2 Infrared Therapy 277 - 280 3.3 Electric Stimulation Therapy 281 - 284 3.4 Short Wave Diathermy 285 - 288 3.5 Ultrasound Therapy 289 - 292 3.6 Exercise Therapy 293 - 296 Herbs Used in Panchakarma Section - III Physiotherapy 271 - 272 .1 Traction Therapy Section - III 297 - 324 (Alphabetically arranged herbs)
  17. 17. 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. ThequalitiesofpatientisaffirmedwellinCharakaSamhita[2]as Smruti recollection; Patient should have a good memory of recollecting the sequenceofdiseasemanifestationintermsofsignsandsymptoms. Nirdesha karitwam (Charaka) - Vaidya vakyastha (Sushruta) Bhishakvasya (Vagbhata) following instructions; Patient is expected to follow the instructions given bythephysician,ifnottheexpectedreliefisnotpossible. 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 suchincidentswithoutforgetfulnessshouldbereportedandrecorded. Sushruta [3] added few more qualities to the patients for his surgical interventions applicableas 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 thepatientsfitnessforsurgeryandrecovery. Satwavan (Sushruta - Vagbhata) strong; strong is in terms of physical fitness. The 1. 2. 3. 4. 1. 2. Technoayurveda's Practical SOP Panchakarma
  18. 18. 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,butthepatientiswithnophysicalfitnessmayleadtocomplications. 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 nopsychologicalanchoringtoacceptthemanagementmayleadtocomplications. Astikyo religious; Ayurveda has given importance to the individual beliefs and its regulations. Usually God (almighty) acceptance offers regularities imposed as they believeHeavenandHell. Sadhyo Dravyavan Adhyo-rogi (Vagbhata) [4] money makes many things. Both Sushruta and Vagbhata brought this point out as acquiring the necessary medicines orthemoneyrequiredforitisverymuchessential. NABH for Panchakarma Units/ Clinics Patient care is distributed in 5 chapters with 32 standardshaving131elementsinit.Thedetailedcareaspectsarediscussedasunder. Summarizationofthissectioncouldbeinthefollowingsteps. a DefineandDisplaytheServicesprovided Patientregistrationprocess Patientinitialassessment Patient'sreferral/transfersystem PrescriptionmethodofMedicine/Procedure Regularperiodicreassessment Multi-disciplinarycontinuouscare 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 theprocedure,price,etc. A detailed brochure of the procedures displayed can be provided as a booklet in the Panchakarma lounge is preferred. In this booklet, more details like what time is suitable, who 3. 4. 5. NABHinPatientCare 1]Access,Assessment andContinuityofCare(AAC) 7standards (21elements) a]DefineandDisplaytheServicesprovided ) b) c) d) e) f) g) Technoayurveda's Practical SOP Panchakarma 10
  19. 19. Technoayurveda's Practical SOP Panchakarma 19
  20. 20. Technoayurveda's Practical SOP Panchakarma 21
  21. 21. Technoayurveda's Practical SOP Panchakarma 1.7Panchakarma 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 dietisstructuredinstages,goingfrommoreliquidtosolidpreparationsinincreasingorder. 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). Thesepreparationsrelieveconstantthirstandtiredness. 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 relievesconstipation.
  22. 22. 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 64
  23. 23. 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 65
  24. 24. Technoayurveda's Practical SOP Panchakarma KrutaandAkruta: 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) 66
  25. 25. Technoayurveda's Practical SOP Panchakarma Section - II SOP of Procedures Section II 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 of Assessment and Procedure sequence according to the needs of NABH program. The first section 'Procedure Information Brochure' contains Concept and Terminology, Procedure Variations, Indications and Contraindications, dose and Duration, procedureBenefitsalongwithAlternativemeasuresareelaborated. The second section 'Procedure sequence' 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 'Procedure Format of Assessment' is with Identification of patient, Vital Examination, Investigations concern, Fitness certificate, Procedure sequence and AssessmentandReassessmentofproceduresareincorporatedinformat.
  26. 26. ConceptandTerminology: Variations: 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 quantumofenhancedPittaDoshaandthusthediseasescausedbyPittaarealsorelieved. Mainlytwotypes 1]RaktamokshanawithoutShastra Jaluka(Leach)-Tridoshaja,PinditaRakta;NonpoisonousLeachisselected. 2]RaktamokshanawithShastra(instruments) Siravyadha(veinsection) Twodosha Prachhanna(multiplepuncture) Twodosha,RaktaDosha, 3]Raktamokshanausingboth Srunga(modifiedwithsyringe) Tridoshaja,Uthanadosha Ghati/Alabu(cupping)-Tridoshaja,Uthanadosha Arshas Arumshika Chronicnonhealingwounds Daha Kitibha/EkaKushta NetraRoga(Raktabhishyanda,) Painandinflammatoryconditions Raktapitta Shiroruja Shlipada Shookaroga Skindiseases Sotha Tandra Tumors Upadamsha Vatarakta Vicharchika Visarpa Vyanga YavaniPitika Raktamokshana 2.24 Technoayurveda's Practical SOP Panchakarma
  27. 27. 264 Technoayurveda's Practical SOP Panchakarma Contraindications: Duration: Benefits: Alternativemeasures: Materialsrequired: Preoperativeproceduresteps: MainProceduresteps: Whenthereisgeneralizedswelling Pandu Udara Sosha Garbhini In case open bloodletting wait till the flowing blood is clotted. Usually it is 5 to 10 minutesinduration. In case of Jaluka the leach itself leaves or wait for 20 to 30 minutes and release it applyingSandhavaLavanaorHaridraChurna. TheRaktamokshanaisdonerepeatedlyatanintervalof3to5days. Diseaseispacified Purificationofbloodisdone Any type of above Raktamokshana is alternative for one to another. In case of non acceptabilityVirechanacanbeadministeredinsteadofRaktamokshana. 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 PatientisgivenSnehapanaandSwedakarmaifprescribedbythephysician Thearea,whereRaktamokshanaisdoneisshavedandcleaned Patientisadvisedtolie-downcomfortably. Theselectedareaisexposedunderwindowtowelaftercleaning TheselectedprocedureofRaktamokshanaisadministered - - - - - 1. 2. 3.
  28. 28. A) B) C) D) Jaluka Ghati : Siravyadha: Prachhanna: Haridra/SaindhavalavanaapplicationforJaluka Applyingcottonunderpressureandbandaging Restfor30 60minutes 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. FreemovementsofLeachsuggestthatthesuckedbloodistotallyvomited. CheckJalukawhetheritispoisonousornot Theentirematerialusedshouldbesterileinnature Irritation stoptheprocedureandapplyHaridralepam. Postproceduresteps: Specialprecautions: Complicationsandmanagement: Technoayurveda's Practical SOP Panchakarma 265 Raktamokshana Format filling guidelines DemographicData: Vitalexamination Investigations: Haemoglobin %: Differential Count: Random Blood Sugar: Patient Name, Age, Gender, Contact Number, UID Number, OPD Number, IPD Number, Ward,BedNo,DiagnosisandConsultantDr.Nameareselfexplanatoryindemographicdata. : This includes the measurements of Height, Weight, BMI, Blood Pressure, Pulse Rate and body Tempin°Casaroutinetounderstandthevitalsofthepatient. 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 contraindicatedforRaktamokshana. Differential count of blood is seen for any acute or chronic infections and deviatedresultsareatthediscretionofphysiciantoselectforprocedure. Random Blood Sugar is tested as the Raktamokshana process to preventtheinfections.
  29. 29. Technoayurveda's Practical SOP Panchakarma 266 Bleeding Time / Clotting Time: This test is intended to know the bleeding tendency of the patient.IfBT&CTarenotwithinnormalrangetheRaktamokshanaisnotdone. AllthefollowingfactorsofexaminationhelptofixthedoseanddurationofRaktamokshana. : Koshta is gut that includes the digestive system from mouth to anus. The Mrudu (Soft) koshta people are sensitive thereby may be subjected for irritation or shock,Madhya(moderate)andKrura(Hard)patientscanwithstandtheprocedure. : Agni is digestive capacity a routine inquiry observed as Sama (normal) Manda (lowdigestion)Teekshna(highdigestion)Vishama(unequaldigestion). : Prakruti is constitution, usually the Rakta predominant people are subjected forSkindiseases. : Mala examination is the faecal content and defecation modes examined here. The Normal patients do not have any issues but Ati (excess), Alpa (scanty), Snigdha (soft), Drava (liquid) and Ghana (hard) mala patients may exhibit the irritation when Raktamokshanaisdoneatlowerlimbs. : Mutra is urine and it is examined as Normal does not have any deviations, if PolyorScantymayshowitsimpactonlumbarplexus. : Twak means the skin. The Snigdha (softness) or Ruksha (hardness) is noted to selecttheprocedure. Lungs, Heart, Abdomen and skin are examined methodically under inspection, palpation, percussion and auscultation methods. Apart from the Psychological examination is also undertaken to note the efficiency of involvement in Raktamokshana. Examination or enquiry ofSerologicalFitnessisalsoimportant. In physician after careful observation and examination summarizing the investigations decides that whether the patient is fit for Raktamokshana or not. There after he explains the entire procedure to the patient to seek the consent and acceptancefortheprocedure. is consolidated statement of the patient after understanding his health condition based upon the investigations and necessity of treatment and details of procedureanditsbenefitsandconsequences. 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 indicatednumberofdaysisreflectiveintheprescriptionisnoted. AyurvedicExamination Koshta Agni Prakruti Mala Mutra Twak SystemicExamination Physician Fitness Statement, Patient's acceptance Statement
  30. 30. Technoayurveda's Practical SOP Panchakarma 267
  31. 31. Technoayurveda's Practical SOP Panchakarma 268
  32. 32. Technoayurveda's Practical SOP Panchakarma 269 Raktamokshana Progress Blood Pressure and Pulse Rate are recorded at regular intervals along with Initiation time,CompletiontimeandTotaltimetakenfortheprocedure. 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 andintervalsasdirectedbythephysician. Vyapat are observed as None, Headache, Fainting, irritation, Itching, and Jwara (fever),etc. Post Raktamokshana Procedures are given such as Bandaging, Jalauka Shodhana and ShamanaChikitsaifrequired. The Output is measured as Samyak (well) orAyoga (imperfect) with the observation of belowmentionedsymptoms. Samyak Raktamokshana is reflective with No pain and comfortable and Lightness in Body,GoodfeelingandClarityofMindandSensesareobserved. Ayoga (imperfect) Raktamokshana is noted with Burning sensation, Inflammation and inadequatebloodflow. AtiyogaRaktamokshanaisnotedwithPallor(anemia),FaintingandDry/Roughskin. 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.
  33. 33. Technoayurveda's Practical SOP Panchakarma 270 Jaluka Application
  34. 34. 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 easyreference. 1]Agnimantha ( Linn.f.) 2] Amalaki ( Gareth) Clerodendrumphlomidis 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
  35. 35. Prof. Shiva Rama Prasad Kethamakka (3rd October 1960) known as “Technoayurveda” born & broghtup from Hyderabad, Telangana, apprentice of 'Tridosha Theory' fame Late Dr V.V.S. Sastry who was the disciple of 'Introduction to Kayachikitsa' fame Late Dr C. Dwarakanath graduated (1982) and post-graduated in M.D. Kayachikitsa in Oct 1989 from Dr. BRKR Govt. Ayurvedic College, Hyderabad. “Technoayurveda” is familiar for Ayurveda fraternity through his website http://www.technoayurveda.com and his disciples are distributed all over world in designated positions. Presently working as Vice- Dean, Professor and Head of Panchakarma (Postgraduate Dept) at Mahatma Gandhi Ayurved College, Hospital & Research Centre, Wardha. Dr KSR Prasad is working as Chief Editor for 'Journal of Indian System of Medicine' and associated with many journals in different designations. Formerly is in the Prof. Meena Shamrao Deogade (12 August born), belongs to Nagpur, Maharashtra, graduated and done her PG Dravayaguna (2006) from Shri Ayurved Mahavidyalaya, Nagpur. Her interests of areas are Synergism, Nano-technology, Molecular Biology, Analytical study and Panchakarma. Her contribution in Ph.D. Dravayaguna from DMIMS (DU) in 2017 is herbal antibiotic synergism is unique and opens the doors for next generation antibiotics with drug dose deduction. She obtained copyright for her teaching methodology. She is Guide for PG, th Presently she is working as Professor, Drvyaguna at Mahatma GandhiAyurved College Hospital & Research Center, Wardha (MS). service of “Amma” Mata Amritanandamai devi, in Amrita School of Ayurveda, Kerala and DGM Ayurvedic Medical College, Gadag, Karnataka as Head of Postgraduate Unit of Kayachikitsa (General Medicine). Dr KSR Prasad is M.A. in Jyotish-Vastu and Ph.D. in Astro-diagnosis from PSTU, Hyderabad to explore the knowledge linkage with Astrology and Ayurveda developed a new concept of Astro-Diagnosis with the help of “Nakshtra Vruksha” in his Ph.D. work. His guidance as guest lectures and keynote address in many International, National, CME and ROTP on different aspects and concepts of Ayurveda, Kayachikitsa, Panchakarma, Manasa Roga, Rasayana and Vajikarana are worthy to update Ayurveda are available in slideshare.net. He guided 50 PG dissertations, 6 Ph.D. and 2 Fellowship in Panchakarma thesis and published many papers in reputed indexed Ayurveda journals. His direct work is Introduction to Evidence Based PanchakarmaandeditedBestPracticesinPanchakarma(editor)andEssentialsofAyurvedaConcepts. He is interested in observing the different cultures and their influences onAyurveda, thus served Maharshi Mahesh yogimovementandvisitedmanycountriesforthedevelopmentofAyurveda. Published by T Printed at: echnoayurveda, Flat No: 301, Sri Satya Residency, Anupama Nagar, Hastinapuram, Hyderabad - 500070, Telangana M/s Onkar Digital Lab, Ishprasad, Shriniwas Colony, Ramnagar, Wardha - 442001 Technoayurveda’s Practical SOP Panchakarma Ayurmitra Prof. Prasad KSR & Prof. Meena S. Deogade (According to NABH needs) Ph.D. and inspired many students. Her interest made her to obtain Fellowship in Panchakarma and her contributioninliteraturethroughherpublicationsarememorable.Sheisextendingherservicesasreviewerfor variousjournals.DrMeenaDeogadeistheauthorofHandBookofDravyaguna(underprint).

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