Suitable And Unsuitable Patients For Sweating Treatment

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Introduction

Swedana or sudation therapy, wherein sweating is induced by providing heat is an important treatment and an ideal remedy for many diseases as explained in Ayurveda. It forms an important inclusion in treatment principles (chikitsa sutras and siddantas) for many diseases and is found explained within the thick and thin of Ayurvedic treatises. 

Swedana, along with Snehana (oleation) is not only an integral and mandatory part of Panchakarma therapies (snehana and swedana are given before Panchakarma therapies and thus are the purvakarmas or pre-treatment procedures for these therapies) but is also an independent remedy for many ailments.

In this article we will list out the candidates eligible to undergo Swedana or sudation therapy.

Indications for sudation

Swedana Yogya (Swedana Arha) – Indications (eligibility) for Sudation 

References: Charaka Sutrastnaha 14/20-24
Sushruta Samhita Chikitsa Sthana 32/10-11

Swedana can be given in the below mentioned conditions –

• Pratishyaya – cold, rhinitis, nasal discharges, catarrh
• Kasa – cough (mainly vata and kapha types)
• Hikka – hiccough
• Shwasa – breathlessness (short of breath due to congestion), dyspnea, asthma
• Anga gaurava (alaghava) – heaviness in the body and body parts
• Karna shula – earache
• Manya shula – pain in the sides of the neck (cervical pain)
• Shira shula – headache
• Swarabheda – hoarseness of voice
• Galagraha – gripping discomfort in the neck region, stiffness in the neck
• Ardita – facial paralysis
• Ekanga vata – disease caused due to vitiation of vata in specific regions or particular parts of the body
• Sarvanga vata – disease caused due to vitiation of vata in the entire body
• Pakshaghata – paralysis, hemiplegia,
• Vinamaka – diseases in which there is bending of body
• Aanaha – flatulence
• Vibandha – constipation
• Shukraghata – seminal obstruction (blockage of flow of semen or lack of ejaculation)
• Jrimbha – yawning
• Parshva graha – catches or stiffness (gripping discomfort) in the sides of the body or flanks
• Prushta graha – catches or stiffness (gripping discomfort) in the back (spine)
• Kati Graha – catches or stiffness (gripping discomfort) in the sides of the body or flanks
• Kukshi graham – catches or stiffness (gripping discomfort) in the abdomen and pelvis region
• Gridhrasi – sciatica
• Mutra krichra – difficulty in urination, dysuria,
• Mushka vriddhi – swelling of scrotum / inguinal hernia
• Angamarda – pain in the body parts as if someone is hitting hard
• Pada arti – pain in the foot
• Jangha arti – pain in the calf muscles / muscles on the back of your leg (leg)
• Janu arti – pain in the knee joints
• Uru arti – pain in the thighs
• Pada graham – stiffness in the feet
• Jangha graham – stiffness in the calf muscles
• Janu graham – stiffness in the knee joints
• Uru graham – stiffness in the thighs
• Pada shotha – swelling in the feet
• Janu shotha – swelling in the knee joints
• Uru shotha – swelling in the thighs
• Jangha shotha – swelling in the legs (calf muscles)
• Shwayathu – swelling in the body parts
• Khalli – foot sprain, calcaneal spur
• Ama dosha – diseases caused due to excessive accumulation and circulation of ama (immature essence of digestion, improperly formed digestive juices) in the body
• Shaitya – feeling of excessive coldness in the body
• Vepathu – tremors in the body parts
• Vatakantaka – pain in the calcaneum, ankle joints
• Sankocha – contractures
• Aayasa – short of breath, tiredness
• Stambha – stiffness in the body parts
• Gaurava – heaviness in the body and body parts
• Supti – numbness (absence of feel)
• Granthi – cysts
• Aadhya vata – gout, rheumatoid arthritis
• Nasya arha – those who are fit to undergo (or about to undergo) nasya or nasal medication
• Basti yogya – those who are about to undergo (fit to undergo) basti or enema therapy
• Vamana yogya – those who are about to undergo (fit to undergo) vamana or therapeutic emesis
• Virechana yogya – those who are about to undergo (fit to undergo) Virechana or therapeutic purgation
• Shalya apahruta – in those whose shalya (foreign bodies embedded in body tissues) has been removed or extracted (through surgical procedures)
• Samyak prajaata – to a woman who has delivered normally
• Mudha garbha – impacted fetus (after the removal of or delivery of impacted fetus)
• Bhagandara – anal fistula
• Arsha – piles (hemorrhoids)
• Ashmari – stones in the kidney and urinary bladder

Gist of Swedana Arha / Yogya
Thus swedana or sudation can be given in the below mentioned conditions –

• Vata disorders – like pakshaghata, ardita etc
• Kapha disorders – like pratishyaya, kasa etc
• Samshodhya rogas – diseases wherein shodhana should be given – like vamanarha, virechanarha etc

As we know that Swedana or sudation is the treatment of choice in Vata disorders and Kapha disorders. Swedana is not indicated in Pittaja or Raktaja vyadhis (diseases caused due to vitiation of pitta and blood). Pitta by nature has ushna (hot) teekshna (intense) etc qualities which will be further increased by the swedana having the same qualities. Still swedana can be done in a mild form in some pitta disorders, but has to be done under the supervision of a physician. Similarly the pitta disorders which are eligible for shodhana (cleansing) should be subjected to mrudu swedana (mild sudation) after proper snehana (oleation). The diseases in which swedana is contraindicated (swedana ayogya) should never be treated with swedana.

Contraindications for sudation

Swedana Ayogya – contraindications for sudation therapy

Swedana or sudation should not be administered in the below mentioned conditions –

• Kashaya Nitya – those who consume decoctions on daily basis
• Madhya nitya – those who consume alcohol on daily basis (alcoholic addicts)
• Garbhini – pregnant women
• Raktapitta – those suffering from bleeding disorders
• Pitta prakriti – those having pitta constitution
• Atisara – those suffering from diarrhea
• Rukshanam – those whose body is excessively dried up
• Madhumeha – those suffering from diabetes mellitus and chronic and complicated urinary disorders
• Vidagdha – those suffering from burns or burn scars of the skin (complications of burns)
• Bhrashta – prolapsed of organs
• Bradhna – prolapsed rectum
• Visha peeta – those who have consumed poison
• Madhyaja vikara – those suffering from alcoholic intoxication or suffering from disorders caused due to excessive consumption of alcohol
• Shranta – those who have been exhausted due to excessive physical work
• Nashta sangjna – those who have lost consciousness (unconsciousness)
• Sthoola – those who are obese
• Pittaja Meha – diabetes or urinary disorders caused due to vitiation of pitta
• Trishna – those suffering from severe thirst (disorders associated with severe thirst)
• Kshudhita – those suffering from severe hunger
• Kruddhanaam – those who are always angry
• Shochataam – those who are always worried
• Kamala – those suffering from jaundice
• Udara – those suffering from abdominal disorders
• Kshata – those suffering from injuries, especially those suffering from ura kshata (chest injuries leading to bleeding within the chest cavity)
• Adhya roga – those suffering from gout, stiffness of thigh (urustambha)
• Ati durbala – those who are excessively debilitated (loss of strength)
• Ati vishushka – those who are suffering from excessive dryness of body parts
• Upaksheena shukra – those suffering from excessive loss of semen
• Upaksheena ojas – those suffering from excessive loss of ojas or essence of all the dhatus (tissues) of the body which depicts the entire immunity system (loss of immunity)
• Timira – those suffering from feeling of darkness before the eyes (loss of sight or vision)
• Pandu roga – anemia, chronic liver disorders (compromised liver)
• Kshaya – excessive loss of tissues, debilitating disorders, phthisis, tuberculosis
• Ajeerna – those suffering from indigestion
• Visharta – those suffering from poisoning
• Chardi – those having acute or chronic vomiting
• Stambhaneeya – those eligible for stambhana treatment (treatments or medicines given to block the flow of supporting tissues and fluids from the body)
• Visarpa – those suffering from herpes
• Kushta – those suffering from skin diseases
• Peeta Madhya – those who have consumed alcohol
• Peeta ksheera – those who have consumed milk
• Peeta dadhi – those who have consumed curds
• Peeta sneha – those who have consumed fats
• Virikta – those who have been administered with purgation
• Guda bhramsha – those suffering from prolapsed of anus or rectum
• Glani – extreme exhaustion, fatigue
• Rajaswala stree – to a woman in menstrual cycle (active periods)

Gist and summary of Swedana Ayogya

After seeing the list of contraindications we get a short list of the below mentioned categories wherein swedana should not be done –

• Pitta predominant diseases – like raktapitta, trishna, madhyaja vikaras etc
• Chronic diseases wherein the disease condition is very severe – like urakshata, sanjgna nasha (murcha) etc
• Conditions wherein sudation is not tolerated due to weakness (debility) – like parishranta, ati durbala, shosha etc

In the above mentioned conditions, if swedana is done, the diseases get worsened. They may even cause death.
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