Samsarjana Krama – Graduated Dietetic Protocol After Cleansing Treatments

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

Samsarjana Krama is a special type of dietetic regimen explained in Ayurveda. It is a graduated form of dietetic protocol in which, form of food is gradually graduated from liquid to semisolid form and from semisolid to solid and normal food.

Introduction

In other terms, diet is graduated from light to heavy foods and later to normal and regular food. Such type of diet is explained in context of post-treatment protocol of cleansing treatments especially after completion of therapeutic emesis and therapeutic purgation.
Read – 11 Ayurvedic eating tips for good health

Samsarjan kram

Sansarjan Krama is a graduated dietetic regimen administered after therapeutic emesis and purgation. This means that diet needs to be gradually altered from lighter to heavier foods, from liquid to solid foods. At end of samsarjan kram, patient is allowed to take regular diet. Read – Understanding Digestion Process From An Ayurveda View

What is need of such graduated diet?

After cleansing treatments digestive fire would get weak due to excessive elimination of doshas. In such conditions if patient consumes excessive food, it will impart pressure on digestive system and its functional entity i. e. digestive fire. Weakened fire will not be capable of digesting food properly and hence indigestion may set in. Undigested food may consequentially cause many complications. Hence normal and regular food should not be given after cleansing treatments. Apart from this, beneficial effects of cleansing treatment will be nullified. Therefore, to strengthen digestive fire and to make it capable enough of digesting all forms of food, diet is gradually graduated from liquid to solid foods until patient is allowed to consume regular foods compatible to him at end of regimen. Read – Ayurvedic Home Remedy To Improve Digestion

Commentator Jejjata tells that during cleansing treatment doshas get liquefied and come into stomach (due to oleation and sudation). These doshas cause irritation and disturbance in stomach and naturally cause sluggishness in digestive fire therein. As a result, peya etc samsarjanam krama is essential. Read – Quality Of Foods – Astanga Hridaya Sutrasthana 6 – Annaswaroopa

Why is form of food graduated from liquid to semisolid to solid forms?

When food is graduated slowly from liquid diet to semisolid diet to solid diet, stomach will get rest to recover from after effects of cleansing treatment and also fire will get gradually kindled. By end of Samsarjanam Kramam i. e. by time person starts taking normal solid food, digestive fire would have come back to its normal form and would be at its functional best.

Liquid diet at beginning of sasarjana karma will be easiest one to get digested. This will kindle digestive fire to an extent and make it strong enough to digest semisolid food. Therefore in next schedule, semisolid diet is introduced. As person takes semisolid diet, fire further gets kindled and gets prepared to digest normal solid food. Therefore at end of samsarjana krama, once fire has been kindled to its maximum strength and optimum digesting capacity, person is given normal and regular food.

Thus Sansarjana Krama is a dietetic protocol in which diet is gradually graduated from peya etc ‘light to digest diets’ to ‘heavy to digest diets’ and ultimately finishing with introduction of normal diet. Read –What Is The Right Time For Food? How Many Meals A Day? – Ayurveda

Simily to understand Samsarjan Karm

Acharya Charaka has given a good simili which makes understanding of concept of samsarjana krama easy.

Just like a small flame of fire gets ignited and becomes enormous and ‘all burning’ when fuel like dry cow dung, grass etc are put on it, digestive fire which has got weakened due to administration of cleansing treatment i. e.therapeutic emesis and purgation gets kindled, enormous and ‘all digesting’ on administration of peyadi krama i. e. samsarjana krama. digestive fire gradually gets increased due to consumption of samsarjana krama and becomes capable of digesting even hardest and heaviest of foods. Read – Eating Etiquette: Healthy Eating Rules

How is Samsarjana Krama conducted?

Types of shuddhi – body cleansing

Samsarjana Krama is dependent on type of cleansing. There are three types of cleansing –

• Pravara Shuddhi – means maximum cleansing, which is done when there is large quantity of morbid doshas in body.
• Madhyama Shuddhi – means moderate cleansing, which is preferred when there is moderate amount of dosha aggravation in body.
• Heena or Avara Shuddhi – means cleansing of body in small quantity, done when doshas are aggravated in small quantities.

Dietetic inclusions of Samsarjanam Kramam

• Peya – gruel of rice, filtrate having only essence of red rice in liquid form, no solid part
• Vilepi – gruel of red rice, thicker than peya, has more of liquid and less of rice
• Akruta Yusha – soup of green gram, horse gram, etc
• Kruta Yusha – soup of green gram, horse gram etc flavored and added with salt, ghee, spices like pepper, ginger etc, sour substances like pomegranate etc
• Akruta Mamsarasa – meat soup of birds like partridge etc
• Kruta Mamsarasa – meat soup flavored and added with salt, ghee, spices like pepper, ginger etc, sour substances like pomegranate etc

These dietetic inclusions are used in chronological way as explained above. Read – Vamana Therapy – Right Method, Side Effects, Management

Annakala – Graduated dietetic protocol is given during annakalas i. e. time for eating food. Here 2 annakalas are considered in a day. First annakala is in morning, i. e. timing of breakfast and second annakala is in evening, i. e. time of dinner. Samsarjana krama is started at dinner time of day on which cleansing treatment has been given. This is counted as first annakala. Number of annakalas differs for optimum, moderate and minimum cleansing.

• In optimum cleansing, samsarjana krama is given for 12 annakalas.
• In moderate cleansing, given for 8 annakalas.
• In minimum cleansing, given for 3 annakalas.

In Pravara Shuddhi

Samsarjana Krama in those who have had Pravara Shuddhi

In people who had undergone optimum cleansing, each of peya etc diets mentioned above are administered for 3 annakalas i. e. 3 timings of food.

Thus, in optimum cleansing, graduated diet will be given for 12 annakalas over a period of 7 days as mentioned below –

• Peya – served in 3 annakalas, i. e. 1^st, 2^nd and 3^rd food timings
• Vilepi – served in 3 annakalas, i. e. 4^th, 5^th and 6^th food timings
• Kruta – Akruta Yusha – served in 3 annakalas, i. e. 7^th, 8^th and 9^th food timings
• Kruta – Akruta Mamsarasas – served in 3 annakalas, i. e. 10^th, 11^th and 12^th food timings

Normal diet should be given during dinner time of 7^th day.

Read – Anna Visha – When Food Turns Toxic: Causes, Symptoms

Madhyama Shuddhi

Samsarjana Krama in those who have had Madhya Shuddhi

In people who had undergone moderate cleansing, each of peya etc diets are administered for 2 annakalas i. e. 2 timings of food.

Thus, in moderate cleansing, graduated diet will be given for 8 annakalas over a period of 5 days as mentioned below –

• Peya – served in 2 annakalas, i. e. 1^st and 2^nd food timings
• Vilepi – served in 2 annakalas, i. e. 3^rd and 4^th food timings
• Kruta – Akruta Yusha – served in 2 annakalas, i. e. 5^th and 6^th food timings
• Kruta – Akruta Mamsarasas – served in 2 annakalas, i. e. 7^th and 8^th food timings

Normal diet should be given during dinner time on 5^th day.

Read – Virechana Therapy – Right Method, Side Effects, Management

Avara Shuddhi

Samsarjana Krama in those who have had Jhaganya / Avara Shuddhi

In people who had undergone minimum cleansing, each of peya etc diets are administered for 1 annakala i. e. 1 timing of food.

Thus, in minimum cleansing, graduated diet will be given for 4 annakalas over a period of 3 days as mentioned below –

• Peya – served in 1 annakalas, i. e. 1^st food timings
• Vilepi – served in 1 annakala, i. e. 2^nd food timing
• Kruta – Akruta Yusha – served in 1 annakala, i. e. 3^rd food timings
• Kruta – Akruta Mamsarasas – served in 1 annakala, i. e. 4^th food timing

Normal diet should be given during dinnertime of 3^rd day.

Note: Kruta-Akruta Yusha and Kruta-Akruta Mamsarasa should be given with hot water as vehicle. Read – Anupan – Co Drinks, After Drinks, Adjuvants For Ayurveda Products

Tabulated Schedule

Samsarjana Krama – Tabulated schedule of graduated diet

Limitations

Limitations of administering Samsarjana Krama

Samsarjana Krama is mentioned to be administered after cleansing treatments but is only administered after therapeutic emesis and purgation. Samsarjana krama has been explained in context of post-treatment procedures of therapeutic emesis. This can be extended to post-treatment procedures of therapeutic purgation also. But samsarjana krama has not been indicated to be given after medicated enemas and nasal medication, both of which are also types of shodhana. Read – Pakwashaya Shodhana Basti: Medicated Enemas For Colon Cleanse

Benefits

Benefits of Samsarjana Krama

It is a mandatory post-treatment procedure i. e. diet schedule which should necessarily be given to all those who have undergone therapeutic emesis and purative type of body cleansing. This is to kindle digestive fire and strengthen it. Digestive fire would have become weak due to excessive dosha elimination in therapeutic emesis and purgation. Samsarjana krama restores strength of this fire such that it becomes capable enough to digest all forms of food. Read – Brimhana Therapy – Nourishing Ayurvedic Treatment Principle

Apart from this, diets mentioned in samsarjana krama can be judiciously used in many other conditions.

•  It can be used as pathya kram i. e. normal diet and can be consumed even by healthy people regularly or occasionally to keep their digestive fire strong.
• They can be used in enhancing metabolism.
• Best in expelling ama and cleansing body channels.
• Help in establishing health, strength and immunity.
• They are used as part of dietetic schedule in treating many diseases.

Read – Role of Langhana, Tarpana and Peya in the treatment of Raktapitta

Sansarjan for All Panchakarma?

Can Samsarjana Krama be advised for all shodhana or Panchakarma treatments?

Panchakarma treatments are five in number. They are –

• Vamana – therapeutic emesis
• Virechana – therapeutic purgation
• Asthapana Vasti – enema with herbal decoctions
• Anuvasana Vasti – enema with medicated oils and ghee
• Nasya – nasal instillation of medicines

Note: Bloodletting is included by other school of thought, while considering both forms of enemas as single unit i. e. vasti.

These treatments are basically considered to serve purpose of cleansing body of its impurities and toxins. But Anuvasana Vasti is basically nourishing and not purely a cleansing treatment.

Samsarjana is indicated to be administered in post-treatment procedures of therapeutic emesis and purgation.

Samsarjana krama is not indicated in oil/fat enema and nasal instillation. Read – Basti treatment procedure, Benefits- Astangahrudayam Sutrasthana 19

Why only for Vamana, Virechana?

Why is Samsarjana Krama limited to only Vamana and Virechana?

Though cleansing of body includes almost all forms of Panchakarma, though all have cleansing roles, dietetic restrictions in form of Samsarjana Krama is only explained for therapeutic emesis and purgation.

Samsarjana Krama is only explained in context of therapeutic enema, same procedure is also extended for virechana i. e. to be taken after completion of purgation treatment. Read –Vamana Virechana – Emesis and Purgation – Astang Hriday Sutrasthana 18

Chakrapani, commentator of Charaka Samhita tells that in vamana and virechana there is prabhuta mala or dosha nirharana i. e. morbid doshas are expelled in excessive quantity. As a result, digestive fire will be more hampered and would get weak enough so as to become incapable of digesting even small quantities of food and heavy foods. Therefore to strengthen digestive fire and bring it back to normal samsarjana krama is a must after vamana and virechana. Read – Ayurvedic Panchakarma Treatment: simple explanation for easy understanding

Same rule is not applicable for enema and nasal instillation, wherein doshas are eliminated in small quantities. Agni is not hampered to an extent as found after therapeutic emesis and purgation. Therefore samsarjana krama is not needed after these cleansing procedures.

Following a proper diet is a mandatory thing after completion of any treatment or as a part of follow up of any disease. For this, dietetic inclusions which are mentioned in samsarjana krama i. e. peya, vilepi, mamsarasa, yusha can be advised, but not necessarily in a method as explained in samsarjana krama.

Example, after medicated enemas or nasal medication, person may have weak digestion might have continued. In these instances, manda or vilepi or mamsarasa may be used as per necessity, as per condition of patient and strength of fire, as per strength and endurance of patient or as per decision of consulting physician. Read – Nasya Karma Procedure, Types, Benefits, Contra Indications

Similarly, diet recommendations are explained in treatment of many systemic disorders. Therefore peya, manda, mamsarasa, yusha etc dietetic inclusions of samsarjana krama are used as part of diet as essential inclusion of treatment protocol of many diseases.

Example- yavagu, peya, etc are found explained in treatment of diseases like jwara, atisara, raktapitta etc. Read – 21 Foods That Are Incompatible With Milk

Wide Horizon

Various areas of usage of Samsarjana Krama, wide horizon of uses and benefits of graduated dietetic protocol

Samsarjana as a part of Paschat Karma of Panchakarma – Paschat Karma means post-treatment schedules. Samsarjana krama strengthens digestive power which has been weakened after therapeutic emesis and purgation. For this Samsarjana Krama is planned as an essential and mandatory part of post-treatment schedules of emesis and purgation.

As Pathya Krama – diet used in samsarjana krama also form pathya kalpana i. e. food substances which are wholesome and conducive to cells, tissues and channels of body. Thus inclusions of samsarjana krama i. e. peya, manda etc can be regularly used in day to day life, even by healthy people, as a part of regular diet.

As metabolism enhancing and correcting medicine and diet – diet included in samsarjana like peya, manda, vilepi, meat soup etc are prescribed as diets in various disorders wherein there is sluggish digestion. Almost all diseases are said to have their origin weak digestive fire according to Ayurveda. Therefore first strategy in treating many diseases will be correcting digestive fire and bringing it to normalcy, to correct appetite and digestion of food. This can be achieved by administering deepana and pachana medicines, but since an ideal healthy diet is essential part of treatment protocol of any disease, peya, vilepi, mamsarasa etc mentioned in samsarjana krama can be used as diet for correcting metabolic and digestive errors. They can be used either individually or by processing these dietetic variations of food with fire kindling i. e. deepana and ama digesting herbs.

As easiest digestive food and wholesome diet – Members of samsarjana krama are wholesome food either individually or in combination with each other i. e. when used methodically as explained in post operative part of cleansing treatments. Seeing them closely, they comprise of carbohydrates, as in manda and vilepi, proteins and carbohydrates as in yavagu, proteins and fat as in krta yusha and meat soup, fat in akrta meatsoup etc.

As ama expelling medicine and diet – Samsarjana also means ‘to expel’. Samsarjana is a dietetic protocol, when used individually or processed with medicines will help in expelling residual ama and doshas from body. Samsarjana krama and its members like manda etc are also used in presence of ama in system. These foods will help in digesting and expelling ama and also to cleanse channels and micro-channels in body and thus availability of easily digestible diet to all tissues of body.

Read – Srotas: Body Channels and Duct systems – Easy Explanation 

Used for srotoshodhana – Peya, Manda, Vilepi etc which are part of samsarjana krama are ideal for tissues, channels and ducts of body. These dietetic preparations kindle gut and tissue fire, dissolves and expels ama and excreta from body, removes blocks created from same and hence help in clearing channels and ducts of body from their blocks. When channels are cleansed and when lightness is induced in body due to kindling of fire, tissues will be prepared to take optimum nutrition and use them in best possible way. Cleansed channels and ducts carry nutrition and essential materials without obstruction and help in strengthening and nourishing tissues.

Used in establishing health, strength and immunity – Since diets prepared in samsarjan kram helps in kindling and strengthening gut and tissue fires, in cleansing channels in body, to enhance circulation of nutrients in body and making them available to tissues and helps in tissues regaining their strength, these diets help in establishing health, strength and immunity in body.

As a part of dietetic schedule in comprehensively treating systemic disorders – Samsarjana helps in recovery from a disease process and also to strengthen tissues, apart from being best and healthy diets. Diet restrictions and modifications always help in recovery from many diseases. Every chapter dealing with treatment of diseases in Ayurvedic treatises emphasise on beneficial and non-conducive foods to be taken in a disease and during recovery.

Many diseases including fever, diarrhea, anemia etc are caused due to errors in metabolism and formation of toxins. All these systemic diseases will be associated with sluggish digestion and loss of appetite. In these conditions patient needs light food. Therefore, manda, peya etc diets mentioned in samsarjana can be used in effective healing along with disease modifying medicines.

Chapters have mentioned these diets according to context. Meat soup is also used to induce strength and endurance in recovery phase of many diseases.

Santarpana for Samsarjana

Santarpana = satiating, refreshing, strengthening, restorative Chikitsa = treatment

Though samsarjana karm is a mandatory treatment which needs to be administered after therapeutic emesis and purgation, it cannot be given in all conditions. In conditions wherein samsarjana cannot be given, tarpana chikitsa should be given. Santarpana means strengthening treatments.

Peya, which is an essential part of samsarjana karma, indicated at beginning of graduated diet, is abhishyandi i. e. that which causes defluxions, effusions and oozing and kapha vardhakara i. e. that which increases kapha. Therefore it cannot be administered while there is more kapha, fluids or residual kapha after therapeutic emesis and purgation.

Therefore after having analyzed predominance of doshas, Tarpanadi Krama should be administered in place of samsarjana krama. Read – Soup Of Green Gram, Chickpea And Horse Gram – Health Benefits

Sushruta has suggested administration of soup of horse gram, Cajanus cajan, green gram and meat soup of animals and birds living in desert regions. Sushruta also uses word ‘api’ which means etc. Dalhana, commentator of Sushruta Samhita tells that Sushruta accepts peyadi krama i. e. use of peya, vilepi, krita and akruta yusha and kruta and akruta mamsarasa in format of samsarjana krama apart from soups of horse gram etc. Read – Bad Food Combinations And Solution As Per Ayurveda

According to Dalhana –

• Meat soup – should be given when there is abundance of vata
• Peya or rice gruel having more of watery ingredient and less of cooked rice should be given when there is deficit of kapha
• Horse gram soup – should be given when there is increase in kapha

Charaka’s view on Tarpana –

Acharya Charaka, after having given an elaborate explanation on graduated dietetic regimen in samsarjana krama, has also explained need of Tarpana chikitsa.

• Kapha pitte – when there is predominance of kapha with association of pitta having moderate vitiation
• Alpa shuddham – in whom improper emesis or purgation has occurred.
• Madhyapa – those addicted to alcohol
• Vata paittike – those of vata pitta dual constitution

In above mentioned conditions, peya etc samsarjana krama should not be given, instead tarpana should be given.

Acharya Vagbhata gives a similar opinion.

Read – Importance Of Diet (Pathya) For Specific Diseases

Opinions on tarpana

Chakrapani, commentator of Charaka tells that:

• Swachcha tarpana – dilute nourishing drinks should be given in place of peya
• Ghana tarpana – concentrated nourishing drinks should be given in place of vilepi

Commentator Jejjata’s opinion

Green gram soup and meat soup are considered as tarpana. This means to tell that whenever tarpana is indicated, green gram soup or meat soup should be given. Physician can consider prescribing green gram soup in vegetarians and meat soup for non-vegetarians requiring tarpana. Read –

Vagbhata too has a similar opinion on tarpana.

Arunadatta, commentator of Ashtanga Hridaya opines that, for tarpana –

• Tarpana prepared from fresh sattu i. e. flour prepared from ground cereals and pulses should be given in first annakala or time of food
• Rice prepared from old rice should be given in second annakala
• Meat soup should be given in third annakala

Read – Can Fruits Be Consumed With Meals? Ayurveda Explains

Tarpana examples

Examples of Tarpana given by Charaka –

Equal portions of sugar, powder of long pepper, sesame oil, ghee of cow and honey are mixed together. Sattu i. e. flour of pulses and cereals is taken twice quantity of all above mentioned ingredients mixed together. Sattu is added with sugar etc ingredients and mixed to make a homogeneous compound. Churned drink should be prepared from this compound. This is sharkaradi tarpana. This nourishing drink mitigates thirst and upward movement of vata, good for emaciated person suffering from fever and those suffering from difficulty in urination. Tarpana prepared from mixing sattu, madhya i. e. a form of fermented medicine, honey and sugar candy will expel morbid vata, pitta, kapha, feces and urine.

Tarpana prepared from phanita i. e. inspissated juice of sugarcane, sattu, ghee, supernatant water of curds and kanji i. e. fermented medicated drink cures udavarta i. e. upward movement of vata.

Tarpana in form of churned drink of dates, raisins, tamarind, pomegranate, gooseberry, Grewia asiatica and Garcinia indica is refreshing and rejuvenating.

Samsarjana Krama In Pravara, Madhya And Avara Shuddhi

Plan of Samsarjana Krama for patients who have had Pravara Shuddhi or optimum cleansing

In those who have had optimum cleansing, each of diet preparations i.e. peya, vilepi, akruta yusha, kruta yusha, akruta mamsarasa and kruta mamsarasa are administered for 3 annakalas i.e. 3 timings of food. This means to tell that peya should be given for 3 annakalas, vilepi should be given for 3 annakalas and so on. While doing so, normal food should be given on 7^th day. It means to tell that dietetic regimen consisting of peya, vilepi etc should be given for 7 days beginning from day of emesis or purgation and ends on 7^th day when patient is given with normal food.

Thus, after pravara shuddhi, graduated dietetic regimen is served for 12 annakalas, for 7 days and patients are allowed to take normal food on 7^th day evening itself. Read – What Is The Right Time For Food? How Many Meals A Day? – Ayurveda

Method of administering samsarjana krama in those who had optimum cleansing is as explained below –

Peya – Peya should be given for 3 annakalas i.e. during three food times.

• 1^st serving or annakala – On the same evening of emesis or purgation, peya prepared properly from old red rice should be given. Strength of digestion of food in patient at that particular point of time should be analyzed and peya given according to it. Charaka mentions ‘manda sadrusha yavagu’ i.e. gruel or yavagu similar to manda. Manda is a lighter diet in comparison to peya. Many opine to use peya in this schedule i.e. during first three annakalas. This becomes 1^st day dinner time.
• 2^nd annakala – Peya given next day morning, this becomes 2^nd day breakfast time.
• 3^rd serving – Peya given on 2^nd day evening too, this becomes 2^nd day dinner time.

Read – Eating Etiquette: Healthy Eating Rules

Vilepi – Like Peya, Vilepi too should be given for three annakalas as explained below –

• 4^th serving – Vilepi prepared properly from rice should be served with or without adding ghee and salt. This becomes 3^rd day breakfast time.
• 5^th annakala – Vilepi served on 3^rd day evening, this becomes 3^rd day dinner time.
• 6^th annakala – Vilepi served on 4^th day morning, this becomes 4^th day breakfast time.

Kruta Akruta Yusha – This should be served during 7^th, 8^th and 9^th annakalas i.e. 3 servings, as explained below –

• 7^th annakala – Kruta Yusha and Akruta Yusha should be used with rice prepared by cooking 2 prasruta i.e. approximately 192 grams of rice in water, added with little quantity of salt and ghee on 4^th day evening. This becomes 4^th day dinner time.
• 8^th annakala – Kruta and Akruta Yusha used on 5^th day morning, this becomes 5^th day breakfast time.
• 9^th annakala – Kruta and Akruta Yusha used on 5^th day evening, this becomes 5^th day dinner time.

Read –Quality Of Foods – Astanga Hridaya Sutrasthana 6 – Annaswaroopa

Kruta Akruta Mamsarasa – This should be served during 10^th, 11^th and 12^th annakalas i.e. 3 servings, as explained below –

• 10^th annakala –Meat soup prepared with meat of Lavaka, Kapinjala etc, added with salt should be served hot on 6^th day morning, during food time, this becomes 6^th day breakfast time.
• 11^th annakala – Mamsarasa mentioned above should be served on 6^th day evening too, this becomes 6^th day dinner time.
• 12^th serving or annakala – Given again for third time on 7^th day morning, this becomes 7^th day breakfast time.

Note: Kruta-Akruta Yusha and Kruta-Akruta Mamsarasa should be given with hot water as vehicle. Read – Benefits Of Drinking Hot Water, Contra Indications

Prakrita Bhojana – Normal food as compatible to one’s body constitution, habituated and good for digestive power of that particular person should be administered on 7^th day evening, i.e. normal food should be consumed on 7^th day dinner time. From here onwards, person is permitted to consume normal food. Read –Classification Of Foods And Drinks – Charaka Sahmita Sutrasthana 27

Note:

• Manda – liquid diet without solid portion of rice
• Peya – liquid diet with some solid portion of rice in it
• Vilepi – thick liquid diet or semisolid diet with adequate solid portion of cooked rice with less watery ingredient in it
• Akruta Yusha – soup not added with spices like pepper, ginger etc, sour substances like pomegranate etc and with ghee and salt
• Kruta Yusha – soup added with spices like pepper, ginger etc, sour substances like pomegranate etc and with ghee and salt
• Akruta Mamsarasa – meat soup not added with spices like pepper, ginger etc, sour substances like pomegranate etc and with ghee and salt
• Kruta Mamsarasa – meat soup added with spices like pepper, ginger etc, sour substances like pomegranate etc and with ghee and salt

Read – Ayurveda Mahodadhi Dhanya Varga – Types Of RiceI

Distribution of Kruta-Akruta Yusha and Mamsarasa

According to Chakrapani –

In Kruta Akruta Yusha mentioned to be served during 7^th, 8^th and 9^th annakalas, Akruta Yusha should be administered during 7^th annakala and Kruta Yusha during 8^th and 9^th annakalas. Thus, Akruta yusha will have 1 serving and Kruta yusha will have 2 servings, totally will complete 3 annakalas.

Similarly in Kruta and Akruta Mamsarasa mentioned to be served during 10^th, 11^th and 12^th annakalas, Akruta Mamsarasa should be administered during 10^th annakala and Kruta Mamsarasa during 11^th and 12^th annakalas. Thus, Akruta mamsarasa will have 1 serving and Kruta mamsarasa will have 2 servings, totally will complete 3 annakalas. Read – Ayurveda Lifestyle and Diet For Fever – 45 Important Things To Know

Arrangement of yusha and mamsarasa in vegetarians

For those who are pure vegetarians and in those where meat soup is contraindicated or for those in whom meat is incompatible, meat soup should be avoided in samsarjana krama.

For these people, 3 annakalas of akruta yusha in 7^th, 8^th and 9^th annakalas and 3 annakalas of kruta yusha in 10^th, 11^th and 12^th annakala should be given. This means to tell that kruta yusha is given in place of kruta and akruta mamsarasa in last 3 annakalas. On 7^th day evening normal diet should be given as scheduled.

Read – Bad Food Combinations And Solution As Per Ayurveda

Samsarjana Plan

Plan of Samsarjana Krama for patients who have had Madhya Shuddhi or moderate cleansing

In those who have had moderate cleansing, each of diet preparations i.e. peya, vilepi, akruta yusha,  kruta yusha,  akruta mamsarasa and kruta mamsarasa are administered for 2 annakalas i. e. 2 timings of food. Graduated dietetic regimen is served for 8 annakalas, for 5 days and patients are allowed to take normal food on 5^th day evening itself. Read – Ayurvedic Panchakarma Treatment: simple explanation for easy understanding

Peya

• 1^st annakala – On the same evening of emesis or purgation, peya should be given. This is 1^st day dinner time.
• 2^nd serving – Likewise, Peya should be given next day morning, this becomes 2^nd day breakfast time.

Vilepi –

• 3^rd annakala – Vilepi served on 2^nd day dinner time.
• 4^th annakala – served on 3^rd day breakfast time.

Kruta Akruta Yusha

• 5^th   annakala – Kruta Yusha and Akruta Yusha should be used with rice prepared by cooking 2 prasruta i. e. approximately 192 grams of rice in water, added with little quantity of salt and ghee on 3^rd day evening. This becomes 3^rd day dinner time.
• 6^th annakala – served on 4^th day breakfast time.

Read – 11 Ayurvedic eating tips for good health

Kruta Akruta Mamsarasa

• 7^th annakala – Meatsoup served hot on 4^th day dinner time.
• 8^th serving – given on 5^th day breakfast time.

Prakrita Bhojana – Normal food should be given on 5^th day dinner time after having considered one’s constitution and digestive capacity and also one’s compatibility with respect to food. Read –Understanding Digestion Process From An Ayurveda View

Distribution of Kruta-Akruta Yusha and Mamsarasa

In Kruta Akruta Yusha mentioned to be served during 5^th and 6^th annakalas, Akruta Yusha should be administered during 5^th annakala and Kruta Yusha during 6^th annakalas. Thus, Akruta yusha and Kruta yusha will have 1 serving each; totally they will complete 2 annakalas.

Similarly in Kruta and Akruta Mamsarasa mentioned to be served during 7^th and 8^th annakalas,  Akruta Mamsarasa should be administered during 7^th annakala and Kruta Mamsarasa during 8^th annakala. Thus, Akruta mamsarasa and Kruta mamsarasa will have 1 serving each 2 totally they will complete 3 annakalas. Read – Importance Of Diet (Pathya) For Specific Diseases

Arrangement of yusha and mamsarasa in vegetarians

For these people, 2 annakalas of akruta yusha in 5^th and 6^th annakalas and 2 annakalas of kruta yusha in 7^th and 8^th annakala should be given.

Plan of Samsarjana Krama for patients who have had Jaghanya / Avara Shuddhi i. e cleansing in smaller scale

In those who have had mild cleansing, each of diet preparations i. e. peya,  vilepi etc are administered for 1 annakala. Graduated dietetic regimen is served for 4 annakalas, for 3 days and patients are allowed to take normal food on 3^rd day evening itself. Read – 5 Ayurvedic Tips For A Healthy Lifestyle

Method of administering samsarjana krama in those who had moderate cleansing is as explained below –

Peya – Peya should be given for 1 annakala i. e. during one food time.

• 1^st annakala – On same evening of emesis and purgation, peya should be given. This is 1^st day dinner time.

Vilepi –

• 2^nd serving – Vilepi should be served on 2^nd day breakfast time.

Read – 21 Foods That Are Incompatible With Milk

Kruta Akruta Yusha –

• 3^rd annakala – In this annakala,  Kruta and Akruta Yusha should be given but any one preparation can be given because only one annakala is allotted for yusha in this format. This should be judiciously planned. A preparation which combines both kruta and akruta yusha shall be administered. This means to tell that yusha shall be mixed with small quantity of ghee and little salt and served as Krutakruta Yusha on 2^nd day dinner time.
• Alternatively,  physician can decide to choose between kruta and akruta yusha depending on need and condition of patient.

Read – How To Know That Your Digestion System Is Working Fine?

Kruta Akruta Mamsarasa –

• 4^th serving or annakala –  A preparation which combines both kruta and akruta mamsarasa shall be administered. Meatsoup shall be mixed with small quantity of ghee and little salt and served as Krutakruta mamsarasa on 3^rd day breakfast time.
• Alternatively, physician can decide to choose between kruta and akruta mamsarasa depending on need and condition of patient.

Note: Kruta-Akruta Yusha and Kruta-Akruta Mamsarasa should be administered with hot water as vehicle.

Prakrita Bhojana – Normal food in mild cleansing should be given on 3^rd day evening. Read – Ayurvedic Home Remedy To Improve Digestion

Distribution of Kruta-Akruta Yusha and Mamsarasa

In Kruta Akruta Yusha mentioned to be served during 3^rd annakala, either kruta or akruta yusha shall be administered or a blend of both i. e krutakruta yusha with soup being mixed with small quantity of salt and ghee should be used.

In Kruta Akruta Mamsarasa mentioned to be served during 3^rd annakala,  either kruta or akruta mamsarasa shall be administered or a blend of both i. e.  krutakruta mamsarasa with soup being mixed with small quantity of salt and ghee should be used. Read – Bad Food Combinations And Solution As Per Ayurveda

Arrangement of yusha and mamsarasa in vegetarians

In these conditions a small adjustment in protocol shall be made. In 3^rd annakala,  akruta yusha shall be given and in 4^th annakala, kruta yusha shall be given in place of krutakruta mamsarasa. Thus,  kruta yusha is given in place of krutakruta mamsarasa in last annakalas. On 3^rd day evening normal diet should be given as scheduled.

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