Dhanyamla Dhara, Kanji Dhara: Benefits, Procedure

Article by Dr Raghuram Y.S. MD (Ay)
Dhanyamla Dhara is a special type of treatment explained in Ayurveda which is extensively used in clinical and hospital practises for effectively treating inflammatory diseases like Rheumatoid Arthritis and also Vata disorders having an association of morbid kapha and or ama (toxic products formed as a result of faulty metabolism). In this, fermented liquids are poured over the body in streams for a fixed amount of time as is done in any type of Sarvanga dhara. The procedure almost resembles that of Kaya Seka or Pizhichil. 

Read more about Pizhichil or Kaya Seka here

Other names for Dhanyamla dhara –
Kanji dhara
Kanjika dhara
Aranala dhara

Introduction

Dhanyamla dhara is a term which generally describes an Ayurvedic treatment procedure in which the fermented liquid obtained after fermenting cereals and other medicinal herbs is poured over the body of the patient in monitored streams for a fixed duration of time. It is a type of Parisheka Sweda (steaming or sweat inducing treatment in which hot or warm liquids are poured or sprinkled or showered over the body in streams).

Thus, Aranala dhara or Dhanyamla dhara is a type of Sarvanga dhara (hot fomentation given by pouring hot or warm medicated liquids over the body in the form of shower or stream), to be precise – a type of Parisheka Sweda resembling Kaya Seka in which liquid obtained after fermenting cereals and medicinal herbs is used for stream pouring.

Category of Dhanyamladhara / Kanjika dhara:
Dhanyamla dhara falls into the category of Swedana (fomentation, sweat inducing, sudation) type of treatment. To be precise, it falls into the Parisheka Sweda (stream pouring of warm medicated liquids like oil, ghee, milk, kashayam, buttermilk etc) sub-category of Swedana Chikitsa. It is also a variant of Kaya Seka or Pizhichil wherein fermented liquids are used in place of warm medicated oils.
Before knowing what Dhanyamla dhara or Kanji dhara or Aranala dhara is, I will try to give you all a brief introduction of Swedana and Parisheka Sweda for a better understanding.

Swedana

Swedana or fomentation (sudation, sweat inducing treatments, steaming treatment) is a specialized treatment of Ayurveda which helps in providing unparalleled relief in pain, swelling and stiffness associated with many systemic diseases, especially in rheumatological conditions like Amavata vis-à-vis Rheumatoid arthritis, Sandhigata Vata (Osteoarthritis), Kati Shula (Low back pain), Mamsagata Vata (Myalgia), Fibromyalgia and many types of neuromuscular and musculoskeletal diseases etc.

Stambha gaurava sheetaghnam swedanam sweda kaarakam (Ref-Charaka sutra sthana 22/12)
Swedana is a treatment procedure in which sweat is induced by application of heat and warmth in the form of steam or by bringing the body / body parts in contact with heated medicaments (powders, leaves, processed rice, sand etc) tied in boluses. Swedana provides relief from Stambha (stiffness and catches), Gaurava (heaviness) and Sheeta (coldness) in the body or body parts.
Swedana is said to be the best form of treatment in expelling morbid Vata and Kapha and also destroying the diseases manifested due to morbid Vata and Kapha.

Swedana is usually done after Abhyanga and or Snehana (administration of medicated oils and ghee for oral consumption in metered doses, as a pre-treatment procedure for cleansing treatments like Vamana – Therapeutic vomiting and Virechana – Therapeutic purgation).
After Swedana, the body starts sweating, we feel lighter and energetic, the cells get activated and flush the toxins away. The cellular metabolism improves and we feel light and at ease.

There are many types of Swedana as explained in Ayurvedic texts. There are about 13 types of Sagni Sweda’s (sweat inducing treatments administered by procedures involving utilization of fire or heated materials) and 10 types of Niragni Sweda (sweat inducing treatments where in the fire or heated materials are not utilised ex. sleeping covering thick blankets until we sweat etc).

Again, Swedana can be done in 2 ways – Ruksha Sweda (dry fomentation) and Snigdha Sweda (wet fomentation or sweat inducing treatment done after giving oil massage or by using the medicinal drugs which are processed or fried in herbal oils). In some pathological conditions both forms can be skillfully combined as and when required. In conditions where pain and associated symptoms are due to ama (metabolic toxins having a sticky nature, tending to block the transport systems of the body and cause painful conditions), meda (contaminated or accumulated fat) and or kapha (morbid kapha) we generally prefer doing Ruksha Sweda or dry fomentation. In conditions where the pain and related symptoms are due to vitiation of only morbid Vayu, we generally prefer Snigdha Sweda (wet or unctuous fomentation)

Every form of Sweda can provide relief from pain, stiffness and swelling. But their area of utilization and the diseases and pathological conditions in which they are administered or preferred will differ. In this context I would limit my discussion to Parisheka Sweda (warm medicated liquids stream pouring type of fomentation) with special reference to Sarvanga Dhara.
Parisheka Sweda is a Sagni Sweda and drava sweda (sweating or steaming treatments wherein hot or warm medicated liquids are used)

Note –
Ama means metabolic wastes created by low metabolism and indigestion which have a sticky nature and has a tendency to produce pain and stiffness.
Meda means fat.

Parisheka Sweda

Vaatikottara vaatikaanaam punaha moolaadeenaam utkwaathaihi sukha ushnaihi kumbhau varshulikaaha pranaadihi vaa poorayitvaa yathaarha siddham sneha abhyaktam gaatram vastra avachchannam parishechayet iti parishekaha (Ref Dharakalpa 1)
Stream pouring or sprinkling or showering of warm kwatha (decoction or herbal extract) prepared with herbs which destroy or pacify Vata or Vata-Kapha morbidity over the body is called Parisheka. Since it is a type of Swedana or sweat inducing treatment the word Sweda has been added as a suffix to Parisheka. Thus Parisheka Sweda means stream pouring of hot medicinal liquids over the body so as to produce sweating.

Other names for Parisheka – Dhara, Seka, Kayaseka, Pizhichil (Sarvanga Taila Dhara – stream pouring of medicated oil)
Parisheka, like any other form of Sweda is done to a person who has undergone Abhyanga (herbal oil massage). Thus Abhyanga forms an essential Purva-karma (pre-treatment procedure) for Parisheka.

Parisheka is done in 3 different ways (depending on the equipment used for conducting Parisheka):

Kumbha Parisheka – In this the medicaments (Kwatha) is filled in a small earthen pot or metal pot with a small tube fitted to it with its one end opening into the space of the pot and the other end at the rear end of the tube. The tube has a u bend at the centre so that the liquid does not rush out of the pot once for all. The vessel is filled with liquid. The masseur tilts the pot to an adjusted angle such that the liquid falls on the body of the person subjected with Abhyanga through the tube is a small stream. The liquid is poured all over the body.
Alternatively, the pot itself has an orifice at the end into which cotton wick or wick of a sterile cloth is fit. In this set up the pot doesn’t consist of the lateral tube. The medicine dribbles through the wick and falls in stream over the body of the patient.
Another variant is a small vessel or pot with a tapering orifice. The liquid is poured in streams through this narrow tapering passage.

Varshulika Parisheka – Varshulika is a pot which is also called sahsradhara which means 1000 orifices. As the name indicates, the bottom of the pot has many small holes. When the vessel is filled with the liquid, it falls as a stream of shower over the body of the patient who has been given a massage.

Pranadika Parisheka – Pranadika means a tube. It is a modification of Varshulika. Just as in Kumbha Parisheka, the pot or vessel will have a bent tube fit to one of its lateral walls. At the end of the tube a cap with many holes is fit. Just as in Varshulika, the liquid falls as a stream of shower over the body of the person after he has taken a massage.
The medicated liquid filled in the vessel or pot may be Kashaya (decoction), Ksheera (milk), Dhanyamla (fermented liquid), Ghrita (ghee), Taila (oil) etc. all these are called Dhara or Parisheka. The names will follow the material or liquid used. Ex. When milk is used, the treatment will be called as Ksheera Dhara, when oil is used it will be called Taila Dhara etc. Sarvang Taila Dhara wherein the medicated oils or ghee or both are poured in streams over the body of the patient for an allotted period of time is called Pizichil or Kaya Seka.

Dhanyamla Dhara

What is Dhanyamla Dhara?

The term Dhanyamla Dhara is made up of 3 words:
Dhanya means cereals,
Amla means sour / soured or fermented,
Dhara means stream pouring or showering or sprinkling
Thus, Dhanyamla Dhara means stream pouring of liquids obtained by fermenting cereals and other herbal medicines over the body of the patient. In this, the term Dhanya strictly means cereals. But we can include the other herbal medicines which are used in the preparation of the fermented liquid under the term Dhanya itself.

Kanji, Kanjika or Aranala are synonyms of Dhanyamla and these terms are interchangeable
It is highly beneficial in tackling inflammatory diseases like Rheumatoid Arthritis (Amavata). Dhanyamla dhara is extensively used as a treatment of choice in Amavat when the disease is at the gut level or in earlier stages. Here it not only tackles the disease pathology effectively but also corrects the errors of metabolism which has occurred on the back-stage of the disease. It is also used as an important Purvakarma (pre-treatment procedures) in many systemic illnesses before the prescribed treatment or medications for the disease in question are prescribed. It is also a treatment of choice in all Vata disorders like neuromuscular and musculoskeletal disorders especially when there is association of morbid Kapha and or ama (metabolic toxins formed due to errors of metabolism, clog cells and channels of the body and disturb the smooth functioning of the cells and organs) and also morbid meda (fat). Diseases like myalgia, fibromyalgia, etc are also tackled by Kanji dhara.

Benefits

Benefits of Dhanyamla Dhara or Kanji dhara –

Relieves pain, stiffness and swelling associated with arthritis and other painful conditions, effective remedy for many musculoskeletal disorders
Provides strength to the tissues, mainly muscle tissue
Rejuvenates and energizes the body, relieves fatigue and exhaustion
Highly effective in combating neurological disorders and neuromuscular disorders (Vata associated with ama and or kapha)
Prevents wasting of muscles and degeneration of joints and soft tissues
Pacifies the morbidity of Vata, Kapha, Vata-Kapha and Ama
Deha sthairyam – makes the body strong
Agni sthairyam – establishes the normalcy of digestive fire and corrects metabolism
Destroys ama and hence removes blocks from the body tissues and channels enabling proper nutrition
Causes sweating and brings about lightness and a feeling of health in the afflicted joints, muscles and soft tissues
When combined with Nitya Virechana, Dhanyamla dhara eliminates the body toxins, establishes health and tones up the joints and soft tissues
Improves the movements of the joints and enhances flexibility of the body
Soothes the nerves and improves blood circulation, good for heart
Removes stress, relaxes mind
Improves blood circulation to skin and improves skin glow and complexion
Softens and exfoliates the dead skin cells, dirt and debris, tones and detoxifies the skin
Nitaraam doshaan – controls and creates equilibrium in all the doshas
Pushtidam – promotes nourishment
Sroto-vishodhanam – helps in cleansing channels of the body
Removes excessive fat from the body, enables weight loss (has to be combined with other suitable treatments and medicines for better results)
Destroys excessive sleepiness and bestows good sleep
Provides Bala (provides strength to tissues), Veerya (vigour and confidence), Jeevana (Sustenance of life), Preenana (nourishment and satiety), Harshana (exhilaration) & Arogya (good health and immunity)

Dhanyamla Dhara can be done with caution and under supervision in Diabetes and Hypertension if doing it is mandatory and no other better options are available or if the condition demands the treatment to be done. Dhanyamla dhara has hypoglycaemic action and care should be taken while conducting the treatment. Care should be taken to see that there is no excessive sweating and resulting dehydration.

Indications

In which conditions is Dhanyamla Dhara or Aranala dhara done?

Dhanyamla Dhara is highly beneficial in the below said conditions –
Ama – Ama is a by-product of metabolic errors. It is formed in the stomach as a result of sluggish digestion and weak metabolism. Since the fire in the gut (according to Ayurveda) controls the fire and metabolism in each and every cell, the gut fire has a direct impact on the cellular fire. When the gut fire is weak, the cellular fire too gets weak. Thus the cellular metabolism also becomes sluggish. The cells gradually start accumulating the things supplied to them without converting them into useful products needed to maintain life. This indicates the formation of cellular ama (toxins). This leads to blocks in the cells, channels and transport systems of the body. Ama on the other hand damages the cells of the body. Supply of nutrients and essentials to the different parts of the body is blocked. This leads to manifestation of various diseases including auto-immune diseases and inflammatory diseases.

Ama has a capacity to create blocks in the body due to its property of sticking to the surface of the cells and channels of the body (transport systems).
Sluggish digestion or weak metabolic fire (gut fire, the active components taking part in the digestion of food at the gut level including the stomach acids) leads to indigestion. This leads to the formation of erratic or unprocessed food essence (ahara rasa) which is about to get into the circulation for being distributed to nourish the body tissues. From this, the first tissue rasa dhatu is improperly formed and is unprocessed. This unprocessed and contaminated ahara rasa formed in the amashaya (stomach or upper gut) is called ama.

Characteristics of Ama
Avipakwam asamyuktam durgandham bahu pichchilam
Sadanam sarva gaatraanaam aama iti abhidheeyate (Ref – Madhava Nidanam, Amavata nidanam, Madhukosha teeka)
Avipakwam – unprocessed
Asamyuktam – disintegrated
Durgandham – foul smelling
Bahu pichchilam – very sticky
Sadanam sarvagatrani – causes weakness of all the body parts

Avipakwam asamyuktam durgandham bahu pichchilam
Sadanam sarva gaatraanaam aama iti abhidheeyate (Ref – Madhava Nidanam, Amavata nidanam, Madhukosha teeka)
Avipakwam – unprocessed
Asamyuktam – disintegrated
Durgandham – foul smelling
Bahu pichchilam – very sticky
Sadanam sarvagatrani – causes weakness of all the body parts

Due to the above said characteristic features, ama tends to stick within the cells and the channels of transportation in the body leading to multiple blocks. Due to these blocks the tissues are not nourished in a good way resulting in weakness and fatigue due to deficit nutrition. Ama further predisposes to sluggish gut and tissue metabolism. Sluggish metabolism leading to indigestion and formation of ama and ama once again predisposing to weak digestion and formation of more ama becomes a vicious cycle as time progresses. If this condition is not attended ama acts as a toxin and starts producing pain, swelling and stiffness at the site of its adherence and localisation. Thus ama when vitiated causes many painful conditions at the place of its vitiation and lodgement.

Dhanyamla dhara is highly effective in combating ama – Ama is a root element for the formation of many psychosomatic and systemic diseases. Ama is invariably formed before the manifestation of any systemic disease. This ama has to be expelled before giving any treatment to the diseases and Dhanyamla dhara forms the treatment of choice in all these conditions. Thus Dhanyamla dhara acts as a Ama-Pachana i.e. ama expelling treatment / medicine. Dhanyamla dhara thus has its applications in all the disorders caused by and associated with ama.

Vata, Kapha and Vata-Kapha disorders – Dhanyamla dhara is highly effective in combating the morbidity of Vata, kapha or Vata-Kapha and also cures the diseases caused by them.

Agnimandhya and Ajirna – Sluggish metabolism and indigestion are the causes of all the systemic disorders. They also give rise to ama which in turn causes multiple blocks in the body. Dhanyamla dhara is the best in the business of combating errors of digestion and thus blocking the pathway of formation of excessive ama.

Sama Vata – Vata disorders associated with ama is called Sama Vata condition. Ama and morbid Vata have independent capacity to produce painful conditions in the body. We can imagine the dimension of pathology and morbidity when these 2 lethal factors combine with each other.
The symptoms of Sama Vata are as below mentioned –
Vibandha – constipation
Agnisadana – weakening of digestive fire
Tandra – drowsiness
Antrakujana – gurgling sounds in the tummy
Vedana – non-specific pains
Shopha – swelling
Nistoda – pricking pains
Vicharet yugapat – the pains and associated symptoms keep fluctuating from place to place
Staimitya – feeling of a wet cloth wrapped around the body
Gourava – feeling of heaviness
Snigdhata – unctuousness or oiliness of the body parts
Arochaka – tastelessness
Alasya – lethargy
Shaitya – feeling of cold
Snehadhyaihi vriddim apnoti – symptoms get aggravated on consumption of oil or ghee, application of oils over the body, exposure to cold or intake of cold substances etc
Surye-meghodaye-nishi vriddhi – symptoms get worsened early in the morning (sunrise), cloudy environment and night (evening)
Katu-ruksha abhilasha – affinity or liking towards hot, pungent and dry foods

Dhanyamla dhara is highly effective in combating this lethal combination of Ama and Vata and getting rid of the related morbidities.

Sama Kapha – Dhanyamla Dhara is also used in conditions where the morbid kapha or kapha disorders are associated with ama. Ama and kapha have similar qualities. Thus when both are associated, we can find a lot of accumulation of toxins in the liquid form clogging and blocking the cells and channels of the body. Swelling will be a predominant feature of Sama Kapha with mild to moderate pain and heaviness.
The symptoms of Sama Kapha are as enlisted below –
Aavila-tantula-styanaha – The Sama Kapha will be cloudy and turbid (un-clear), thread, thick and heavy. It causes –
Kanta deshe avatishtati – Blocking in the throat
Durgandham – Foul smelling phlegm
Kshut vighata krut – supresses hunger
Udgara vighata krut – suppresses belching

Sama Pitta (Early inflammatory changes related to errors of metabolism) – Dhanyamla dhara is also highly effective when the combination of morbid Pitta or Pitta disorders and ama prevail. This has an impact of a wet fire causing burning pains in various parts of the body (afflicted by pitta associated ama). Early inflammatory signs and symptoms along with symptoms related to weak digestion can be found in these cases.
The symptoms of Sama Pitta are as below mentioned –
Durgandha-harita-shyava-amla-saandra-guru – Sama Pitta will be foul smelling, greenish, black-brown, sour, dense and heavy. It produces:
Amlika – sour belching
Kanta Daha – burning sensation in the throat
Hrid-daha – burning sensation in the chest (region of heart)
Other signs of inflammation like burning sensation, redness, swelling, redness etc

Note: Due to similarities in the properties of Dhanyamla and Pitta and Rakta, Dhanyamla dhara tends to aggravate pitta and rakta when administered in morbidity associated with these elements. Care should be taken while conducting the treatment in high pitta and high rakta morbidity. Generally dhanyamla dhara is skipped in these conditions.

Rheumatoid Arthritis (Amavata) – It is a chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet and ankles. It has an autoimmune component also. Dhanyamla dhara will be useful in the acute stages of RA wherein the inflammation and the stage of ama have set in. This will be the stage of the disease when it is still budding at the gut level. Dhanyamla dhara is also useful in chronic stages of RA if there is association of ama along with disease.

Symptoms of Gut-stage (premonitory stage) or early manifestation of Rheumatoid Arthritis (Amavata) wherein Dhanyamla dhara can be administered –
Angamarda aruchi trushna aalasyam gauravam jwaraha
Apakataa shoonataa angaanaam aamavatasya lakshanam (Ref – Madhava Nidanam, Amavata nidanam 25/6)
Angamarda – Vague body pains (beating pains all over the body)
Aruchi – Tastelessness
Trushna – Thirst
Aalasya – Lethargy / Loss of interest in all activities
Gauravam – Heaviness of the body
Jwara – Fever
Apakata – Indigestion
Shoonataa angaanaam – Swelling in the body parts

Musculo-skeletal pains – as in myalgia and or fibromyalgia (Mamsagata Vata) wherein we find association of ama.
Neuromuscular diseases and various musculoskeletal disorders – associated with ama
High Pitta and or High Rakta – conditions wherein there are signs of presence of ama and acute inflammation (The treatment shall be done with caution and for a limited duration only until the signs of ama have subsided. If better options are available, Dhanyamla dhara should be avoided in high pitta and high rakta morbidity)
When ama or kapha symptoms are found in the below said conditions –
Various forms of arthritis and spondylosis with signs of inflammation
Ankylosing Spondylitis – It is a form of arthritis which primarily affects the spine. It causes severe inflammation of the vertebrae that might eventually lead to chronic pain and disability. The disease will cause pain and stiffness in other parts of your body. Other large joints such as the shoulders, hips and knees can be involved as well.
Polymyalgia Rheumatica – It is an inflammatory disorder that causes pain and stiffness in various parts of the body. It commonly affects neck, shoulders, arms, thighs and hips.
Fibromyalgia – It is a rheumatic condition characterized by muscular or musculoskeletal pain with stiffness and localized tenderness at specific points on the body
Guillain Barre Syndrome – It is a rare condition in which your immune system attacks your nerves leading to muscle weakness and even paralysis. There is a rapid onset of muscle weakness as a result of damage of the peripheral nervous system
Obesity and over-weight conditions
Fevers
Hemiplegia, Paralysis
Sthanika Dhanyamla Dhara (local treatment) – can be done in the below said conditions when ama, kapha and vata with ama are predominant –
Frozen Shoulder – Chronic pain and stiffness of the shoulder joint with limitation of range of movements, also known as adhesive capsulitis
Osteoarthritis of joints
Elbow pain due to various conditions like Tendinitis, Olecranon bursitis, elbow sprain, cellulitis, arthritis, nerve entrapment etc
Low back pain or Lumbago (Lumbar spondylosis)
Sacroiliac Joint Syndrome or Sacroiliac Joint Dysfunction (Kati-shula / Kati-graha),
Cervical spondylosis (Greeva-shula, Greeva-stambha),
Sciatica (Gridhrasi),
Spondylolisthesis (is a forward displacement of a vertebra, especially a 5th lumbar vertebra)

Sandhana Kalpana

How is Dhanyamla prepared?
Dhanyamla, as already discussed is a fermented liquid or gruel which is processed and prepared in a method called Sandhana Kalpana which means fermentation process. Sandhana Kalpana is one of the most popular and effective pharmaceutical preparations which is in practise among Ayurvedic doctors since ages. It is a unique method in which medicated acidic and or alcoholic fermented formulations are prepared by fermenting cereals, pulses and medicinal herbs. In these methods, the final products attain acidic nature and their taste is basically sour.

Advantages, classification

Advantages –
Medicines prepared from Sandhana Kalpana have –
Longer shelf life
The medicines are quickly absorbed in both forms of usage i.e. external as in Dhanyamla dhara and internal consumption as is prescribed in various systemic disorders
The action of these medicines is quick
They have excellent therapeutic usage and efficacy

Classification of Sandhana Kalpana –
Depending on whether acidic products are formed or alcoholic products are formed at the end of Sandhana Kalpana, the Sandhana Kalpana is broadly classified into –
Madhya Sandhana – In this alcohol is predominantly formed at the end i.e. the final products formed after Sandhana attain alcoholic form and nature. It is further subclassified into Asava, Arishta, Surakalpa and Surasava.
Shukta Sandhana – In this acid is predominantly formed at the end i.e. the final products formed after Sandhana attain acidic form and nature. Especially vinegar is formed which gives Dhanyamla a sour taste. It is further subclassified into Madhura Shukta (those which gain acidic nature and yet have sweet taste) and Amla Shukta (those which gain acidic nature and sour taste).
Dhanyamla is a form of Amla Shukta sub-type of Sandhana Kalpana. Kanjika and Takrarishta are the other types of Amla Shukta. Kanjika is also used as a synonym of Dhanyamla in various contexts. Most of the ingredients of Dhanyamla predominantly have Madhura Rasa (sweet taste). As a result of fermentation procedure, the Madhura Rasa of these ingredients gets converted into Amla Rasa (sour taste). Amla rasa is due to the formation of acids, mainly vinegar.

Synonyms of Dhanyamla

Aranala (that which has an acidic odour)
Kanjika (fermented liquid prepared with gruel of half boiled black gram, rice and barley)
Souveeraka (available in Souveera desha or region)
Kunjala (a type of fermented water)
Kulmasha (made up of half cooked Masha or black gram)
Abhishuta (prepared from half cooked cereals)
Avantishoma (Available in Avanti desha or region)
But the regularly used synonyms are Kanjika or Kanji and Aranala.

Kanjika Preparation (Dhanyamla)

Ingredients of Dhanyamla:
Tandula – Oryza sativa (rice) – 10 prastha quantity (7680 grams)
Pruthuka – Compressed form of rice / Rice flakes – 10 prastha quantity (7680 grams)
Kulattha – Macrotyloma uniflorum – Horse gram – 40 pala quantity (1920 grams)
Laja – Puffed form of rice – Popcorn – 40 pala quantity (1920 grams)
Kangubeeja – Panicum sumatrense – Little millet – 1 adhaka quantity (3072 grams)
Kodrava – Paspalum scrobiculatum – Kodo millet – 4 prastha quantity (3072 grams )
Nagara – Zingiber officinale – Ginger – 2 prastha quantity (1536 grams)
Nimbuka – Citrus aurantifolia – Lime – 2 adhaka quantity (6144 grams)
Deepyaka – Trachyspermum involucratum – Carom seeds – 8 kudava quantity (1536 grams)
Jala – water – 200 prastha (153.6 litres)

Method of preparation:
The medicines mentioned above should be collected on an auspicious day. A big earthen pot also is collected on an auspicious day.
Pooja and Swasthi vachana – Auspicious rituals like worshiping God and enchanting holy hymns are carried out before preparing the Dhanyamla. The medicines and vessel are also worshipped, including the fuel, stove (oven) and fire.
The pot is now placed on the oven or stove in a direction decided by auspicious terms. Alternately large vessels can be used.

Water in said proportion is added and boiled. The above said herbs and cereals are taken and pounded so as to obtain their coarse powder. They are individually pounded and measured at the end so that the powder quantity is equal to the raw medicine taken. Almost all herbs and cereals yield less powder in comparison to their original form (before being pounded). Therefore after measuring them at the end the difference of quantity is added to balance the proportions. To do this, some more raw medicine is taken, pounded, measured and added to the calculated powder.
The powders are tied into separate bundles or boluses using sterile cotton clothes. Now these bundles are put into the vessel containing boiled water. The lid of the vessel is covered. The contents are now kept and left for fermentation to take place.

Fermentation procedure:
The vessel containing the bundles of medicines should be kept on oven or stove and heated on moderate fire continuously for a period of 7 days, uninterruptedly. Not even for a single minute the vessel should be kept away from the contact of fire. It should also be watched carefully overnight.
By the 8th day, the contents would have fermented as evident by the smell emitted by the contents. The product thus followed would have acquired medicinal properties due to the processing. The resultant liquid is called Dhanyamla or Kanjika or Aranala. The Dhanyamla is now ready to be used for Dhanyamla dhara.
On the 8th day required amount of liquid should be taken out (quantity needed for treatment). Same quantity of water or boiled water is added to the vessel containing the bundles of medicines.
This method shall be followed in marshy places (Anupa desha) and also in winter and cold seasons.

Method 2 –
The water along with medicinal bundles should be boiled on moderate fire for a period of 1-2 hours. Later the vessel is removed from the fire. A lid should be closed on it and sealed tightly. The sealed vessel is kept in a corner and left in place for 7 days. The fermentation process takes place within 7 days and Dhanyamla would be ready. Now Dhanyamla is ready to be used for treatment. This method is more suitable to be done in dry and desert regions (Jangala desha) and during hot season and summer.

Method 3 –
The hot water along with the bundles of medicines is boiled for one day. Then as said in the 2nd method, the vessel is closed with a lid and sealed. The sealed vessel is left in place for 7 days for the fermentation process to get completed and Dhanyamla to be formed.

Method 4 –
The vessel with bundles of medicines and water is heated on moderate fire for one hour on first day. The vessel is closed and kept in place overnight. This process of heating for 1 hour and keeping in place is followed for 7 consequent days. On the 8th day, the Dhanyamla would have been prepared. This method is useful in places having climate which doesn’t undergo too many variations (Sadharana desha).

For how many days Dhanyamla can be kept for fermentation?
The shelf life of Dhanyamla is said to be 4-6months if all precautions are taken. The medicine can be kept and used for the mentioned period without the medicine having lost its strength and potency in a notable way. The quantity of liquid taken for treatment should be immediately replaced.
Properties of Dhanyamla –
Rasa (taste) – Amla rasa (sour taste)
Guna (qualities) – Laghu (light), Teekshna (intense, deep penetrating), Snigdha (unctuous), Vyavayi (spreads quickly), Vikashi (produces looseness of joints), Ashukari (quickly acts), Vishada (viscid), Sukshma (enters through minute pores)
Veerya (potency) – Ushna (hot)
Vipaka (post-digestion effect) – Amla (sour)
Sparsha (touch) – Sheeta (cold)
Dosha karma (action on body humours) – Vata-Kapha hara (mitigates vitiated Vata, Kapha or Vata-kapha), Pittakrut (aggravates Pitta)

Properties, uses

Jeevana – Sustainer of life
Preenana – satiating, nourishing
Harshana – exhilarating
Trushna hara – relieves thirst
Deepana – increases digestive power
Pachana – destroys ama and helps in easy digestion of food
Daha nashana – destroys burning sensation
Vibandhagna – relieves constipation, acts like a laxative
Shoshahara – checks wasting of tissues
Bhedi – acts like a purgative
Mukha vairasya hara – eliminates bad taste of the mouth
Mukha daurgandhya hara – eliminates foul smell of the mouth
Mukha malahara – eliminates dirt and stickiness in the mouth
Jwarahara – cures fever
Hrudhya – good for heart, cardiac tonic
Shramahara – relives fatigue
Klamahara – relieves exhaustion
Ruchya – increases taste
Vasti shulahara – cures urinary colic
Krusha-sthula hitam – suitable for both lean and obese people
Ati-Nidra Hitham – destroys excessive sleepiness
Nashta nidra hitam – bestows good sleep
Svarakrut – good for voice
Pushtidam – promotes nourishment
Sroto-vishodhanam – helps in cleansing channels of the body
Bala pradham – provides strength to tissues
Veerya pradam – promotes confidence
Arogyakrut – provides good health and immunity

Methods of administration

Methods of administration of Dhanyamla –
Dhanyamla can be used both externally and internally. Thus before going into the details of how Dhanyamla is used for dhara let us also learn about different dimensions of the usage of Dhanyamla and its areas of utility.
Bahya chikitsa (External administration) –
Dhanyamla can be used externally in the below said methods (treatment procedures):
Dhara / Parisheka Sweda – stream pouring over the body (will be discussed in detail in this article) – in diseases like Jwara (fever), Daha (burning sensation), Vatadhika Vata Shonita (gout caused by predominant morbidity of Vata), Kaphadhika Vata Shonita (gout caused by predominant morbidity of Kapha)
Nadi Sweda – Pipe or tube fomentation – in diseases like Rajayakshma (tuberculosis, wasting diseases), Karna Shula (earache), Vataja Galaganda (goitre or neck swelling caused by morbid Vata), Shataponaka Bhagandara (multiple fistulae) etc
Avagaha Sweda – Tub fomentation – in Jwara (fever), Daha (burning sensation), Shushka Arshas (dry type of piles or haemorrhoids in which bleeding or other discharges do not occur) etc
Upanaha Sweda – Poultice fomentation – In Vata Vyadhi (Neurological disease) especially associated with ama and kapha morbidity, Vatodara (type of abdominal disorder caused by morbid Vata), Vata Vidradhi (abscess caused by morbid Vata), Gulma (abdominal tumour) etc
Udvartana – Rubbing in reverse direction (opposite to the normal direction of body hairs) – in Sidhma Kushta (Cholasma)
Utkarika – a type of poultice – in diseases like Hikka (hiccough), Shwasa (Asthma, breathing disorders), Vrana (ulcers and woulnds) etc

Alepa – as a paste – in diseases like Amavata (Rheumatoid arthritis), Shankaka (temporal headache), Suryavarta (Migraine), Ardhavabhedaka (Hemicrania), Gridhrasi (Sciatica), Urustambha (stiffness and rigidity of thighs), vataja galaganda (type of goitre caused by morbid Vata), Adhmana (flatulent disorders), Kaphadhika Vatarakta (gout caused by predominant morbid Kapha), Trushna (Thirst), Karnashula (earache), Sidhma Kushta (cholasma) etc
Karna purana – ear filling – in Vataja Karna Shula (ear ache caused by morbid Vata)
Gandusha – holding in the mouth – in Sarvasara Mukha Roga (oral diseases, stomatitis)
Kavala – mouth gargling – in Sarvasara Mukha Roga (oral diseases, stomatitis)

Shiro dhara (pouring liquid medicaments over the forehead in stream) and Shiro Vasti (holding or pooling of medicated liquids over the head within an encapsulated elongated vertical cap) – in diseases like Vata Vyadhi (neurological disorders), Pakshaghata (Hemiplegia), Anidra (sleeplessness), Shiras hula (headache), Ardhavabhedaka (Migraine) etc
Kaya Seka or Pizhichil – Squeezing medicated liquid over the body – in diseases like Amavata (Rheumatoid Arthritis), Sandhigata Vata (Osteoarthritis), Pakshaghata (Hemiplegia), Gridhrasi (Sciatica)

Panchakarma procedures –
Virechana – as a purgative – in diseases like Grahani (sprue), Pandu (Anaemia), Gulma (Abdominal tumours), Shotha (oedema)
Asthapana Vasti – decoction enema – in diseases like Ama Roga (diseases caused due to endotoxins formed due to errors of digestion and metabolism), Alasaka (intestinal obstruction), Apachi (Scrofula), Gulma (Abdominal tumours), Krumi roga (worm infestations), Kaphaja Pandu (Anaemia caused by morbid Kapha), Alasya (Lassitude), Madatyaya (Alcoholic addiction and related diseases), Vata Vyadhi (neurological diseases caused by morbid Vata)
Abhyantara Chikitsa (Internal treatment or administration) –
Pana (as a drink) in:
Vataja Kasa (cough caused by morbid Vata)
Kaphaja Kasa (cough caused by morbid kapha)
Peenasa (rhinnorrhoea)
Pratishyaya (acute coryza)
Atisthoulya (obesity)
Vata Gulma (abdominal tumour caused by morbid Vata)
Vataja Ashmari (urinary calculi or stone caused by morbid Vata)
Vataja Shula (colic caused by morbid Vata)
Parshva shula (flank pain)
Shataponaka Bhagandara (multiple fistulas in anus)

Anupana (adjuvant drink or co-drink) – Dhanyamla is used as anupana with Shunti Churna, Alambushadi Churna, Vishvanara Churna, Alambushadi Churna and Pathyadi Churna in the below said conditions:
Amavata – Rheumatoid arthritis
Shataponaka bhagandara – multiple fistulae
Antar vidradhi – internal abscess
Vatarbuda – tumour caused by morbid Vata
Vataja Shula – colic caused by morbid Vata
Krimija Hridroga – Heard disease cause by micro-organisms
Udavarta – retrograde movement of Vata
Vishuchika – Gastro-enteritis

As a part of formulations – Dhanyamla or Kanjika is a part and ingredient of some medicinal preparations like Kanjika Shatpala Ghruta, Rasona Pinda etc
As a part of Yusha (soup) – in all types of Kasa roga (cough) and Atisara (Diarrhoea)

Dhanyamla Dhara procedure

Dhanyamla dhara is done in the below said method –

Purvakarma

Purvakarma (Pre-treatment procedures): This includes –

Preparation of the patient:
The patient is thoroughly examined. The Prakriti (basic constitution) and Vikriti (details of morbidity) are documented in detail. The disease is also examined. After careful assessment, it is decided if Kaya Seka is suitable to the disease and diseased or not. The treatment line-up, materials and medicines which need to be used are enlisted.

Preparation for the treatment:
Materials needed for the treatment are collected beforehand. They are:
Dhanyamla
For Abhyanga – The below mentioned taila’s are used for Abhyanga or massage –
For Abhyanga (massage) – Taila (medicated oil) both suitable to the disease and diseased are collected and stored beforehand. Some effective oils used for Abhyanga are
For Shiro-Abhyanga (Head Massage): Ksheerabala Taila, Chandanabala Lakshadi Tailam, Shatavari Tailam, Lakshadi Tailam etc
For Sharira Abhyanga (body massage): Sahacharadi Taila, Ksheerabala Taila, Kottamchukkadi Tailam, Chandanabala Lakshadi Tailam, Dhanwantara Tailam, Mahanarayana Tailam, Balashwagandhadi Tailam, Karpasastyadi Tailam, Panchaguna Tailam etc keep in view the body constitution, morbid doshas and nature of morbidity involved

Options according to morbidity: Sahacharadi Tailam is preferably used in kapha morbidity and Dhanwantaram Tailam or Mahanarayana Tailam is used in Vata morbidity etc.
For Tala-dharana: Since Tala-dharana should be done during Parisheka Sweda, it has to be done before conducting Dhanyamla Dhara also. The materials required for Tala dharana should be kept ready – Amalaki churna (fine powder of Indian gooseberry), Bandage clothes, Chandanabala lakshadi tailam, Ksheerabala tailam etc

The other materials needed for Dhanyamla Dhara are –
Small pots or vessels to carry on the dhara procedure (6-8 in number) or Sterile clothes (8-10 in number) for dipping in Dhanyamla and squeezing over the body instead of pouring from vessels
Small vessels for heating oil
Spoons
Stove for heating
Sterile clothes, sponges, napkins or tissue papers for wiping etc

Pradhana karma

Pradhana Karma – Treatment proper (Dhanyamla dhara procedure):

Dhanyamla dhara or Kanjika dhara is generally done as Swedana procedure (sweat inducing treatment) and is thus a part of Parisheka Sweda as we have already discussed in the earlier passages. In this the heated Dhanyamla (aranala / kanjika) need to be continuously poured over the body for a fixed duration of time until sweating occurs and the patient starts feeling light and good.
The patient fit for and chosen for Dhanyamla Dhara is made to sit in the Droni, a special type of table made in the shape of a boat, with elevated edges all around.

Dhara Droni or Dhara Table –
The table is made up of woods of medicinal plants like Plaksha (Ficus lacor), Udumbara (Ficus glomerata), Chandana (sandal wood), Varuna (Crataeva nurvala), Devadaru (Cedrus deodara), Ashoka (Saraca asoka), Amra (mango), Nimba (neem), Bilwa (Aegle marmelos), Arjuna (Terminalia arjuna), Khadira (Acasia catechu), Agnimantha (Clerodendrum phlomidis) etc. its dimensions are that which can accommodate the body of an average individual.
The foot end of the table consists of an orifice or a tapered opening through which the liquid poured over the patient’s body flows down into a collection vessel. This collected liquid can be reheated and reused for the Dhara until the completion of treatment duration.
Similarly at the head end, there is an elevation for headrest which forms a bridge between an elongated portions of the table meant to accommodate the rest of the body from a small chamber (portion of table) which is extended behind the head end. The oils poured on the head as a part of Dhanyamla Shirodhara collects in this chamber and flows back into an orifice or tapered opening at its centre a few inches away from the crown of the head and gets collected in another collection pot. This too can be recycled and reused just like the oil of Pizhichil is done.
Dhara droni is generally mounted on a frame consisting of 4 limbs of convenient height so that the masseurs can easily carry out the treatment procedure on the patient sleeping on it. Alternatively, the Droni can be kept on the floor on a small raised platform so that the vessels can be kept below the openings at the foot and head ends of the table. The masseurs in this case can sit around the table (instead of standing) and conduct the treatment.

Dhara patra (Dhara pot or vessel) –
The dhara pot too is made up of the similar material as is the table. It is also made up of metals like silver, brass or earthen pot. A small hole which entertains the finger of the patient into it is made at the bottom. It is fit with a sterile cotton or cloth wick in case of Shiro-dhara pot. The Shirodhara pot is fit to an adjustable stand such that it is hung a few inches above the centre of the forehead.

Swasthi Vachana (welfare prayers) –
The patient should be brought on to the table after having performed the prayers, worship and recited holy hymns as a ritualistic practice. This is done for the welfare of the patient and for the success of the treatment.
The patient should have undressed to their convenience for better results. Alternatively they may be allowed to wear a thin dress (after having conducted massage)

Abhyangam (herbal oil massage) –
Head and body massage is given with one among the above said oils for 15-20 minutes. Any other suitable oil can be used as per the choice of the physician. Abhyanga can be considered as Purvakarma (pre-treatment procedure) for Dhanyamla Dhara but I have included it in the discussion of the treatment proper because it is done in continuation with dhara (immediately before dhara).
For massage – oils prepared with herbs having hot potency should be used for the body and oils prepared with herbs having cold potency are used for head.
Oils can also be used as per the disease and morbidity of doshas. Ex. Kottamchukkadi Tailam or Sahacharadi Tailam in kapha morbidity and Ksheerabala Tailam or Dhanwantaram Tailam or Mahanarayana Tailam in Vata morbidity etc should be used.

Tala-dharana (application and tying of coolant medicines over the head) –
A small pre-treatment procedure called Amalaki Tala-dharana is done mandatorily after massage.
On the previous day of Parisheka Sweda (Dhanyamla dhara here), Amalaki Churna (powder of Emblica officinalis) 10 tola (120 grams) in quantity is boiled and processed in 20 tola (240 grams) of buttermilk. When being processed it gains semisolid consistency, the contents are grinded and made into a soft mass. It is kept in a cool place for cooling.
This paste is used for Tala Dharana. Tala Dharana means applying the paste on the crown of the head and tie a bandage cloth around it to keep it in position such that the knot occupies the place near the ear.

To do this, a small compartment / cabin with elevated walls is constructed with the paste of Amalaki so as to cover a small area on the crown of the scalp. The space within the wall of the cabin is filled with coolant oils like Chandanabala Lakshadi Tailam etc. Over this, leaf of a plant having a capacity of alleviating Vata like leaf of Nirgundi (Vitex negundo), Eranda Patra (castor leaf) etc is placed. A bandage cloth is wrapped around the construction and the knot is tied near the ear.
Dhanyamla dhara or Aranala dhara is a procedure which includes pouring of hot medicinal liquids over the body of the patient for more than 1 hour. The head might affect the brain and sense organs in due process. To protect these organs, Amalaki Tala Dharana is done. This provides a coolant effect on the body and mind of the patient.

If Tala-dharana is not done, pitta gets aggravated due to heat and the aggravated Pitta causes symptoms like giddiness, burning sensation, feeling of darkness in front of the eyes, fainting etc.
When doing Dhara for a part of the body like low back or lower limb or upper limb or shoulder, we need not tie the Tala-dharana since the heat will be provided for a portion of the body and for a short time.

Alternately a sterile cloth (thin) is tied over the head while doing Shiro-dhara to avoid spilling of the liquid contents into the eyes. As a precaution during Dhanyamla dhara or Shiro dhara, sterile cotton pads are kept over the closed eyes of the patient to avoid sprinkling of medicaments into the eye.

The procedure of Dhanyamla Dhara:

We need at least 4 attendants or masseurs to carry on the treatment in a synchronized and uninterrupted way on either side of the patient. The stream pouring of liquid medicines over the body of the patient on both sides of the body (left and right) should be done in a rhythmic way by all the 4 masseurs. They should be trained in such a way that they should be able to efficiently carry out the treatment procedure. 2 masseurs should stand on one side of the patient and the other 2 on other side. We need a 5th person as helper (can have 2 helpers too). He should be standing near the stove, on which the vessel consisting of liquid medicines is being heated on mild flame. He will be constantly supplying he heated liquid medicines to the masseurs.
As and when the liquid collected in the vessels at the foot and head end of the table lose temperature, the masseurs return it to the helpers and in turn receive the heated liquid medicine from him. This method is conducted for the prescribed duration without interruption. Care should be taken that neither Dhanyamla nor the body of the patient gets cold at any point of the treatment (The only exception being Sarvanga dhara done with cold liquids in case of Pitta and Rakta morbidity). This is possible only with a cyclic synchronizing between the main masseurs and the helpers in terms of how they keep changing and exchanging the liquid so as to maintain the heat throughout the treatment procedure. The masseurs should not only be skilled but also should be compassionate towards the patient.

Two masseurs should take in charge of stream pouring hot Dhanyamla over the body of the patient in a gentle way and cover the lower portion of the body i.e. one masseur should attend the hip, buttock, anterior and posterior portions of thigh, leg, knee, ankle and lumbo-sacral area on the right side and the other masseur on the left side. Dhanyamla should be tolerably hot.
The other 2 masseurs should carry on the procedure simultaneously on the upper portion of the body. One among them should cover the abdomen, chest, sides of the chest, flanks, upper back, neck (nape), shoulder, elbow, wrist and small joints of the hands, arm and forearm of the right side and the other masseur should cover the left side of the body.\

The treatment should be carried out in a skilful and synchronized way on both left and right sides of upper and lower portions of the body by all the 4 masseurs in an uninterrupted way.
The masseurs should have small Dhara pots in their hands (1 pot in each masseur’s hands). The liquids filled in it should be allowed gently and in a synchronized way on the patient’s body in the form of stream.

The stream should neither be too thick nor too thin, not falling in a rush or too slowly, neither too hot not too cold. It should neither fall from a lot of height from the patient’s body nor from too proximal distance. The procedure should be done so gently that it should not create a fear in the mind of the patient.

Alternately, Dhanyamla Dhara / Kanjika Dhara should be done with the help of sterile cloths of 18×18 inches dimension dipped in the dhara liquids. The masseur should take the cloth in his hand and squeeze in such a way the liquid should fall on the body of the patient in a stream flowing through his thumb which is pointing towards the body of the patient. While the masseur uses his right hand to squeeze the cloth and allow the stream to fall on the body of the patient, he should simultaneously stroke the body part on which the liquid is falling and give a light massage through his left hand.

Just as in Kaya Seka, in Dhanyamla Dhara also the medicine should fall on the body of the patient from a height of 12 angula’s (i.e. approximately 9 inches). The temperature of the liquid medicine should be only so much that it is tolerable to the patient. The masseur’s should therefore check the temperature of the liquid every time before pouring it on the patient’s body. If the drava (dhara liquid) is too hot, it may cause burns and if it is not hot, the objective of Swedana is not achieved and there is no relief from the disease. Experienced masseurs will be able to do it to the perfection.
Before doing the Dhara, the masseurs should allow the stream of liquid to fall on their left hand and test the temperature and conduct the Dhara after confirming that the patient can tolerate that temperature. The patient also should be asked if he or she can tolerate that particular temperature. Their consent forms a yardstick so as to what temperature they can tolerate. This comes only by experience.

The kanjika poured in stream over the body of the patient (or on head as in Dhanyamla Shirodhara) flows through the tapered opening at the foot end of the table and gets collected in a vessel kept beneath it after flowing through a pipe connected to the opening. In some tables, the tapered end bends towards and extends downwards, opening into the collecting vessel.

Recycling of Dhanyamla – The helper (5th person) collects the oil in the vessel, heats it and gives it back to the masseurs for conducting Dhanyamla Dhara. This procedure is done until the duration meant to conduct Aranala dhara gets completed. Care should be taken to see that the kanjika used in dhara should not get cooled throughout the length of the treatment. Maintenance of uniform temperature of the oil is important in Dhanyamla dhara. The helpers should be sharp and quick enough to heat the dhanyamla and give it back to the masseurs conducting Dhanyamla dhara.

Change of liquid in Dhanyamla dhara:
The liquid used for Dhanyamla dhara shall be used at a stretch for the whole length of treatment or can be changed in between. It depends on the decision of the doctor, the quality of Dhanyamla, the nature of the disease and affordability of the patient.

The fermented liquid in Dhanyamla dhara shall changed once in 3 days. Generally the fermented liquid used on first day is used for 3 days. This kanjika is stored in a bottle or vessel. On 4th day fresh dhanyamla is taken. This dhanyamla is used for Parisheka unto 6th day. On 7th day, this dhanyamla is mixed with the dhanyamla used for first 3 days and Dhara is carried out.

Again on the 8th day fresh dhanyamla is taken for the treatment. For best results of the treatment, the dhanyamla should be changed on daily basis. Since the medicine will be very costly and will add on to the cost of the treatment, everyone cannot afford to get it changed every day. When the same liquid is used on 2nd day or 3rd day, the sweat and dirt of the body too gets mixed in the oil which may lessen its efficacy. For those who cannot afford the cost of the treatment, the same liquid can be continued for 7 days.

Duration of treatment:
As a general rule, Dhanyamla dhara should be done until the proper signs of Swedana (sweating treatment) have occurred or until the patient sweats

Duration for Dhanyamla Dhara / Kanjika Dhara:
Again as a rule sweating is an indication for stoppage of treatment, i.e. Dhanyamla dhara shall be done until sweating occurs. For this to happen 1 ½ hours (3 ½ nadika kala) will be sufficient.
Vata vyadhi – In Vata disorders, Dhanyamla dhara can be done up to 2 hours time duration (5 nadika kala) in case of association of ama or kapha or meda
In Vata-Kapha disorders – up to 1 and a half hours (3 ½ nadika kala)
The fomentation given by Aranala dhara or Parisheka sweda method should reach all parts of the body. To achieve this, the procedure should be carried out in all the 7 postures in which Abhyanga (herbal oil massage) is done.

The 7 postures of doing Dhanyamla dhara are, keeping patient in –
Sitting posture
Sleeping by facing the roof (supine position)
Sleeping in left lateral position (towards left)
Sleeping on tummy (prone position or face downwards)
Sleeping in right lateral position (towards right)
Sleeping back by facing the roof
Sitting posture

The treatment procedure is carried out for 10-15 minutes in each posture. Thus the time duration of the treatment ranges from 70-105 minutes. By the time we finish off this procedure, the patient would be sweating, which gives a sign to stop the treatment.

According to dhara kalpa book – the oil will enter the orifices of skin within 300 matra kala (1/2 minute approximately) of stream pouring. The oil is said to reach the roots of other tissues within 300-500 matra kala.

Signs of proper fomentation (Samyak Swinna or Samyak Swedana Lakshanas) –
Sheeta shula vyooparame stambha gaurava nigrahe
Sanjaate maardave cha eva svedanaat viratirmataa (Ref – Sushruta Chikitsa 14/23)
Sveda sraavo vyaadhi haanihi laghutvam sheetaarthitvam maardavaha cha aaturasya
Samyak svinnae lakshanam praahuhu etaan mithyaa svinne vyatyyane etadeva (Ref – Sushruta Chikitsa 32/23)
Properly done sweating therapy brings about the below said signs –
Sheetoparama – The feeling of coldness pacifies
Shuloparama – Pacification of pain
Stambha nigraha – reduction of stiffness
Gaurava nigraha – reduction of the feeling of heaviness
Maardava – smoothness of the body or body parts
Sweda praadurbhaava – sweating of body or body parts subjected to fomentation
Roga lakshana prashamanam – Pacification or reduction of the symptoms of the disease
Sheetaartitvam – Liking towards taking cold foods and comforts
Care should also be taken so as to see that the patient is not subjected to excessive or deficit sweating

Parameters for improper / less sweating (Asamyak / Heena Swinna / Aswinna Lakshana) –
In this the symptoms opposite to those explained in the Ati Swinna Lakshana are manifested i.e.
Sheeto anuparama – no relief from the feeling of cold
Shula anuparamam – non-pacification of pain
Stambha anigraha – no relief from stiffness
Gaurava anigraha – no relief from heaviness
Amaardavam – lack of smoothness of the part
Aswedam – absence of manifestation of sweat
Alaghutvam – no feeling of lightness
Vyadhi anupashama – no relief from disease

Parameters of excessive / over sweating (Ati Swinna Lakshana) –
Pitta prakopa – aggravation of pitta
Asra prakopa – aggravation of rakta
Trushna – thirst
Murcha – loss of consciousness
Svara sadana – weakness of voice
Anga sadana – weakness of the body
Bhrama – giddiness
Sandhi peeda – joint pains
Jwara – fever
Shyava-rakta mandala – brownish-red eruptions
Chardi – vomiting

Paschat karma

Paschat Karma (Post-treatment procedures):

After Dhanyamla dhara, the person should be allowed to relax for a while. The body should not be immediately exposed to cold or cold measures. Doing so might induce some symptoms like cold, muscle cramps etc. For those who are cold sensitive or even in general a cloth can be covered on the body after the procedure. Alternatively, dhara could be carried over with a thin layer of dress on.
The Tala-dharana is slowly removed; the construction of Amalaki and the containing oil are also removed. The head is wiped off with a sterile cloth.
Abhyanga – After a while, the patient is once again given a soothing massage. The whole body and the head should be given massage with herbal oil. This can also be avoided in Kapha and Meda disorders.
Snana – Following the massage a hot water bath should be given. Alternatively water boiled with Nirgundi (Vitex negundo), Nimba (neem) or Dashamula (10 roots) shall be used for bathing purpose. Patient is advised to take a refreshing hot water bath after going home or after a few hours if the patient is being handled as in-patient. Water processed with coolant medicines like Amalaki (Indian gooseberry), Chandana (sandalwood) etc is used for head bath.
After hot water shower, decoctions like Shunti Kwatha, Jeerakadi Kwatha or Gandharvahastadi Kwatha should be administered for oral intake either in the clinic or hospital or at home after discharge. These herbal extracts keep correcting the disturbed metabolism in the body and also keep micro-cleansing the system by removing blocks from the cells.
Nitya Virechana – Daily metered dose of purgation with purgative decoctions especially Gandharvahastadi Kashayam should be administered every day after Kaya Seka. It should be given in a dose of 24-48 ml at bedtime. This herbal extract is basically a laxative and best one in the business of controlling the morbidity and vitiation of Vayu.
After Dhanyamla dhara (Kanjika or Aranala dhara) small amounts of toxins are released from the cells into the gut every day. These toxins should be removed as and when they come towards Koshta (gut). Gandharvahastadi Kashayam / Kwatham are the best option for removing these toxins. Care should be seen that constipation should not develop during the whole schedule of Dhanyamla dhara. If constipation develops, the person will suffer from flatulence, distension of abdomen, sounds in gut, sluggish metabolism, indigestion, tastelessness and an increase in the morbidity and existing disease.

Laghu Ahara –
When the patient gets hungry, he or she should be served with light and easily digestible food. The food should preferably be liquid or semi-solid and should have been processed with ginger.
Light digestible food always complements Dhanyamla dhara and helps in quick recovery from the ailments. Light food is also advised for healthy individuals undergoing Dhanyamla dhara. Hot liquid diet garnished with kitchen spices like ginger, pepper, cumin seeds etc should be prescribed. Laghu ahara also serves the purpose of deepana and pachana.

The lightest food format comes in the forms of:
Yavagu – is a liquid preparation in the form of thin gruel wherein rice (1part) is processed in 6 times water. It is seen that the final preparation has more of liquid than solid.
Vilepi – is a liquid preparation in the form of thin gruel wherein rice (1part) is processed in 4 times water. It is seen that the final preparation is of a semisolid nature. Apart from being nutritious and tasty, it is known to destroy ama by its root and kindle the belly fire.
Peya – is a liquid preparation in the form of thin gruel wherein rice (1part) is processed in 14 times water. It is seen that the final preparation has a small quantity of solid portion left over.
Manda – is a liquid preparation in the form of thin gruel wherein rice (1part) is processed in 14 times water. It is seen that the entire solid content is filtered out from the final preparation such that only liquid remains.
Yusha – is a liquid preparation in the form of thin gruel wherein dal i.e. grams mainly green gram (1part) is processed in 18 times water and its extract is filtered out.
During Dhanyamla dhara, the patient should keep his mind in a pleasant condition.
Pariharya (what not to do after Dhanyamla dhara?): The person who has undertaken Dhanyamla dhara should abstain from these things for at least the same number of days as the duration of treatment (i.e. if the treatment has been done for 14 days, the restrictions should be followed strictly for at least next 14 days):
Indulgence in sexual intercourse, being in the proximity or company of women (men) which includes seeing, touching or thinking about them,
Strenuous physical exercises,
Exposure to sunlight,
Forcibly withholding the natural urges or reflexes of the body like those of defecation, urination, hunger, thirst, sleep, sneeze etc,
Exposure to cold or intake of cold food substances and smoking,
Excessive sleeping,
High or low levelled pillows while sleeping,
Standing in cool breezy or dusty areas for long time,
Grief and anger,
Keeping awakened till late nights,
Walking for long distances,
Speaking or shouting in excess, speaking loudly etc.

The person should use hot water for bathing and drinking purposes. He should keep on a reasonably light diet and should not eat unnecessarily or in excess quantity. He should follow celibacy.

Complications, management

Management of complications if any:
When Dhanyamla dhara is done with wrong methodology like keeping the liquid hotter than is prescribed, doing it from too high or too near etc will lead to some complications like burning sensation, herpes, tiredness, hoarse voice, splitting pain in joints, vomiting, bleeding, fever, itching patches, skin eruptions, rashes, etc. In this case, the treatment should be stopped immediately.
Remedy – Rest and light food should be given to the patient and a counselling should be given. Light food should include gruel and soup preparations prepared with rice, grams, ginger etc

Measures to control Vayu and other complications should be done by administering Gandusha and Kavala (gargles) should be given with medicated liquids, Nasya (nasal instillation of medicines), Shunti Kwatha (ginger decoction), sneha vasti (enema with medicated oils and or ghee) or Niruha Vasti (decoction enema) should be administered depending on the condition. On the 5th day Dhanyamla dhara should be begun once again after making sure that the complications have come down and after thorough examination of the patient once again. On restart of treatment extra precaution should be taken to see that the procedure is done in correct methodology so as to not give rise to complications.

Discharge – The patient is discharged on daily basis (out-patient) or after the course has been completed (in-patient) after giving proper lifestyle and diet advices along with suitable medicines (oral). The patient is also advised to undergo the treatment twice or thrice in a year. Disease specific and morbidity specific medicines should be prescribed to be taken during the treatment process and also during the follow up period. The follow up period and quantity of medicines prescribed will depend on the nature of disease morbidity and the percentage of recovery observed after a course of the treatment.

Duration of the course –
The number of days of treatment varies from 7-28 days depending on the nature and intensity of the disease. It is usually done for 7, 14, 21 or 28 days.

Mode of action

Probable mode of action of Dhanyamla Dhara –

Dhanyamla is prepared after fermenting cereals and medicinal herbs in hot water. Here the chemical reactions of the herbs and cereals will produce acids at the end of fermentation. The original taste, smell and medicinal properties would have changed as a result of this Sandhana. The intention of Sandhana is to induce these properties in the medicine. The final product is acidic in nature and sour in taste due to the formation of acids / vinegar. We have already learnt about the properties of Dhanyamla including its Rasa, guna, Veerya, Vipaka and Dosha-karma.

Amla rasa or sour taste – according to Ayurveda kindles the agni and acts as deepana (increases digestive power) and also gets rid of ama (endotoxins formed due to errors of metabolism) and acts as pachana. Since many diseases are manifested as a consequence of bad metabolism, Dhanyamla dhara (or consumption of Dhanyamla as a medicine) de-roots these diseases from base. Thus Dhanyamla dhara forms the first line of treatment in many systemic disorders having their origin from weak digestion or errors of metabolism.

Apart from this, Amla Rasa is Hridhya (good for heart), Rochana (enhances taste), Laghu (easy and light for digestion) and Snigdha (unctuous). The digestive power of agni or core fire in the body will get enhanced due to the impact of Laghu and Teekshna Guna’s of Dhanyamla.
Due to its Ushna Guna (hot property) and Ushna Veerya (hot potency), Dhanyamla destroys the vitiated Vata or Kapha or Vata-Kapha. The same properties make Dhanyamla antagonistic to ama and Meda (morbid fat). With the help of these properties, Dhanyamla removes the blocks in the cells and channels of transportation and nutrition. The cells will start getting proper nutrition and building elements, which in turn enhances the strength and immunity of the body. Dhanyamla is thus highly effective in ama disorders, Vata disorders, Kapha disorders and Vata-Kaphaja Disorders.

Impact of Dhanyamla on srotas and diseases originating from the morbidity affecting the srotas
Owing to the Deepana, Pachana, Rochana and Preenana properties, Dhanyamla will have an unparalleled healing impact on diseases getting their origin from Annavaha (channels related to carrying the food) and Rasavaha (channels related to carrying the essence of digestion or nutritive substances formed after primary digestion in gut) srotas (channels). These properties will enable enhancement and fortification of Agni and destruction of ama. Thus Dhanyamla eradicates the errors of metabolism which is the root source for many systemic illnesses.

Jwara (fever) is one of the diseases originating from morbidity in Rasavaha Srotas. It is a rasa pradushta vikara (disease caused due to morbid essence of food or improperly formed food essence in circulation). Jwara, having its origin in the stomach is invariably associated with ama. Conversely almost all the diseases having ama association have Jwara as one of the symptom. Dhanyamla dhara is one of the best treatments which can be carried out in cases of Jwara.
Similarly diseases associated with disturbance in Annavaha Srotas and ama like Amavata (Rheumatism), Urustambha (stiffness of thighs) and Ajeerna (indigestion) etc can be effectively combated with Dhanyamla.

On the other hand since Dhanyamla corrects metabolism, it is also a handy remedy for emaciation and weakness. It strengthens patients suffering from emaciation and weakness and promotes bulk. This happens owing to properties like Jeevana, Bala Prada, Veerya Prada, Shramahara, Klamahara and Shoshahara.

Owing to its properties of Vatanulomana (vata expelling property), Shula prashamana (analgesic), Nadi uttejaka (nerve stimulant), Vedana sthapana (pain reliever), Masthishka balakaraka (brain tonic) and Sheeta prashamana (antagonistic to cold), Dhanyamla effectively combats Vata, Vata disorders (neurological and neuromuscular disorders) and diseases of Asthivaha Srotas (channels controlling bone functioning and nutrition) like Osteoarthritis etc.

Dhanyamla has properties similar to that of Pitta and Rakta (blood tissue). Thus Dhanyamla will not be suitable in high Pitta conditions, Pitta and Rakta morbidity and diseases caused by vitiated Pitta and Rakta. Thus Dhanyamla will not be effective in diseases like Raktapitta (bleeding disorders), Amlapitta (gastritis, GERD etc), Kamala (jaundice) etc wherein Pitta and Rakta aggravation is found.

Chemical action perspective –

Dhanyamla is rich in phyto-chemicals like flavonoids and tannins. Flavonoids are good antioxidants. Tannins promote healing process by increasing formation of capillaries. A glucoside called Hesperidin present in Dhanyamla has the ability to prevent capillary bleeding and reduces inflammation. It is used often for haemorrhoids, varicose veins and poor circulation conditions. The properties of flavonoids based on its antioxidant properties include anticancer, antiviral, anti-inflammatory activities and an ability to inhibit human platelet aggregation.

The ingredients exhibit unparalleled analgesic and anti-inflammatory actions and thus are highly useful in combating inflammatory diseases.
Dhanyamla is also said to have hypoglycaemic and anti hyperlipidaemic actions. Thus it is useful in eliminating metabolic disorders like obesity (atisthoulya).
Anti-oxidant and anti-toxic actions of Dhanyamla will help in reducing the progression of degenerative disorders.

Limitations

Limitations of Dhanyamla Dhara / Kanjika dhara –

Dhanyamla dhara or Kanjika dhara is one of the best Ayurvedic treatments which are used in combating disorders caused due to errors of digestion and metabolism, those diseases caused by morbid Vata, Ama and or Meda. It is known for providing strength to the tissues and strengthening the body. It has an unparalleled analgesic and anti-inflammatory role and fits apt in the treatment protocol of many diseases. It is efficient in combating many neuromuscular, neurological and musculoskeletal disorders (oral consumption of Dhanyamla covers a broader spectrum of systemic disorders but this article is limited to the discussion of Dhanyamla being used as an external therapy with special reference to dhara treatment). It provides good energy and immunity.
But on the other hand it is not a sole remedy in these conditions. Parallel to it we might have to add some disease modifying drugs and or compounds and effective treatments for better relief.
Along with Dhanyamla dhara some oral medications which enhance strength and stability should be included along with some immune-modulators, anti-ageing medicines and rejuvenators. Disease modifying herbal formulations should be prescribed along with the treatment and also as a part of follow up. Holistic mind-body healing is always the motto of Ayurveda.

Just Before Finishing,
Dhanyamla dhara is an unparalleled treatment from the books of Ayurvedic experience. It is a time tested remedy for Rheumatoid Arthritis and many diseases caused due to errors of metabolism. It is highly recommended in many neuromuscular and musculoskeletal disorders for its proven analgesic and anti-inflammatory role. It not only provides symptomatic cure from symptoms like pain, swelling and stiffness but also corrects the disturbed metabolism at its backdrop.

It is unparalleled in prevention of degeneration and inflammation apart from its known efficacy to enhance strength, immunity and nutrition to the tissues. This is achieved by the property of quick action and deep penetrating effect of Dhanyamla through which it removes multiple blocks in the body cells and channels, enables proper supply of nutrition and re-establishment of health and feel of lightness. Important thing to make a note in this aspect is that Dhanyamla dhara is also useful in preventing and halting the progression of many disorders.

It is high time that you get rid of many diseases in their budding stage itself and feel rejuvenated. It is your right to enjoy comprehensive health status and a never experienced feeling of well being. If you are prone to get some auto-immune health issues like Rheumatoid arthritis or one or the other neuromuscular or musculoskeletal disorder or if you have a strong family history suggesting the same then you need to take it as an early alarm.

Just look out if you are at a few yards distance from an Ayurvedic clinic or doctor who can help you to keep your diseases at bay. Ayurveda provides many time tested treatments at your disposal. Dhanyamla dhara is one among the lot.
Click to Consult Dr Raghuram Y.S. MD (Ayu)