A brief look on shashti upkrama

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Journal name: World Journal of Pharmaceutical Research
Original article title: A brief look on shashti upkrama
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Original source:

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Author:

Dr. Garima Rathore and Dr. Sachin Gupta


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: A brief look on shashti upkrama

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr20198-15329


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Summary of article contents:

Introduction

The ancient text, Sushruta Samhita, attributed to Acharya Sushruta, is crucial in the realm of surgery, particularly within the Indian medical tradition of Ayurveda. Sushruta is often referred to as the father of surgery, and his work details various surgical techniques and treatment options for wounds—an area that was of significant concern during ancient times due to the prevalence of warfare and subsequent injuries. Among the various treatment methodologies described in the Sushruta Samhita is the Shashti Upkrama, a comprehensive set of 60 treatment modalities aimed at wound management, which includes not only surgical interventions but also holistic measures to promote healing.

Wound Management: The Concept of Shashti Upkrama

One of the core tenets of Sushruta's approach to wound healing is the Shashti Upkrama, a systematic classification of treatment modalities that address various wound types and their complications. This concept comprises 60 distinct methods designed to facilitate healing while also considering the body's purification and the minimization of scarring. It recognizes the need for a multifaceted approach, combining surgical techniques with non-invasive therapies to optimize patient outcomes. The modalities range from dietary modifications to the application of specific herbal preparations, each tailored to the individual's unique condition and specific types of wounds.

Purification and Internal Balance

The treatment modalities within the Shashti Upkrama highlight a significant emphasis on purification and internal balance. For instance, Aptarpan, which addresses the root cause of diseases by removing the toxic buildup in the body (aam), is one of the initial steps in treatment. This principle illustrates the foundational Ayurvedic belief that diseases stem from imbalances in the body's systems and that restoring equilibrium is crucial for effective healing. Treatment progresses through stages that may involve methods such as Vamans (emesis) and Virechans (purgation) to eliminate accumulated toxins, thereby paving a clearer path for wound recovery.

Localized Treatments and Their Importance

The Shashti Upkrama also comprises localized treatments tailored to specific wound characteristics. Methods such as Alepa, which involves the local application of medicinal pastes based on the wound type, and Pariseka, involving the sprinkling of medicated water, illustrate how targeted therapies are utilized to alleviate pain and inflammation. This localized focus aims to directly address the symptoms at the wound site, promoting quicker healing and minimizing discomfort. By customizing treatments according to the wound's nature and symptoms, Sushruta's principles allow for a detailed and effective response to varying clinical presentations.

Conclusion

The insights from the Sushruta Samhita and the Shashti Upkrama provide invaluable knowledge for modern wound management. As highlighted, the combination of surgical techniques with holistic therapeutic approaches can yield significant benefits for patients. By understanding and applying these ancient principles with contemporary medical wisdom, healthcare practitioners can enhance wound care strategies today. Embracing the comprehensive strategies laid out by Acharya Sushruta can lead to improved healing outcomes, emphasizing the timeless relevance of ancient Ayurvedic practices.

FAQ section (important questions/answers):

What is Shashti Upkrama in wound management according to Sushruta?

Shashti Upkrama refers to the sixty treatment modalities mentioned by Acharya Sushruta for managing various types of wounds, including purifying the body and wound, healing, and minimizing scars.

How does Sushruta classify wounds in his Samhita?

Sushruta classifies wounds based on aetiology in the Dwivraniyaadhyaya chapter, providing different classifications and corresponding treatment methods to address the nature and cause of the wounds.

What role does purification play in wound treatment?

Purification is essential in wound treatment as it aids in healing, alleviates infection, and prepares the body for effective recovery by removing toxins and undigested materials from the wound.

What is the significance of Alepa in treating wounds?

Alepa involves the local application of medicines tailored to the specific type of wound, helping to reduce pain, inflammation, and local aggravation of doshas, thereby promoting faster healing.

Can Sushruta's methods be applied in modern wound healing?

Yes, Sushruta's treatment modalities, when understood and correctly applied, can yield effective results in modern wound healing, offering valuable insights into holistic and comprehensive care.

What are the benefits of Vimlapana in wound care?

Vimlapana, the gentle rubbing of swollen areas, helps relieve obstruction, opening hair follicles or glands, and thereby allows for better drainage and resolution of infections that may arise in those areas.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “A brief look on shashti upkrama”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Drug:
Drugs, in a medical context, are substances that relieve symptoms or cure ailments by interacting with biological systems. In Ayurveda, drugs often come from natural sources, with a focus on holistic healing that addresses the root cause of diseases rather than merely managing symptoms.

2) Dosha (Dosa):
Dosha represents the three fundamental energies in Ayurveda: Vata, Pitta, and Kapha. Each dosha governs different physiological and psychological functions. Understanding dosha balance is crucial in Ayurvedic medicine, as imbalanced doshas can lead to health issues. Therapies aim to restore equilibrium among these energies for optimal well-being.

3) Vata:
Vata is one of the three doshas in Ayurveda, symbolizing air and space. It governs bodily functions related to movement and communication, such as circulation, nerve impulses, and respiration. An imbalance in Vata can lead to various health issues like anxiety, dry skin, and digestive problems, necessitating treatment to restore harmony.

4) Pain:
Pain is a significant symptom that indicates an underlying issue within the body. In Ayurvedic philosophy, it may be attributed to imbalances in doshas or blockages within energy pathways. Understanding the root cause of pain is essential for effective treatment and can guide practitioners in selecting appropriate therapies.

5) Rathore:
Dr. Garima Rathore is the author noted in the study exploring Ayurvedic practices, particularly discussing the concept of Shashti Upkrama in wound care. Her work highlights the relevance of ancient medicinal practices in modern contexts and reinforces the need for integrating traditional wisdom into contemporary healthcare approaches.

6) Blood:
Blood has a vital role in sustaining life, delivering nutrients, and removing waste. In Ayurveda, its health is linked to the balance of doshas and is essential for wound healing and maintaining overall vitality. Impaired blood flow or quality can lead to numerous health issues, necessitating therapeutic interventions.

7) Karma (Karman):
Karma generally signifies action and its moral implications; in Ayurveda, it extends to medical interventions. Each medical procedure in Ayurveda can be seen as a 'karma' aimed at restoring balance and promoting health. Practitioners emphasize the correct application of karmas for effective treatment of ailments.

8) Hair:
Hairs can signify health and vitality in Ayurveda, with treatments addressing hair loss or scalp issues reflecting overall wellness. Agents stimulating hair growth or restoring scalp health are often explored, emphasizing inherited qualities and dosha balance influencing hair health.

9) Cleansing:
Cleansing refers to the process of purifying the body, removing toxins, and restoring balance. In Ayurveda, various cleansing techniques, or Shodhana, are employed to detoxify systems and promote health. This includes dietary changes, therapeutic procedures, and herbal remedies that help eliminate impurities.

10) Vitiation (Vitiated):
Vitiated indicates an imbalance or disturbance in the body's natural state, particularly concerning doshas. Vitiated doshas can lead to disease and require corrective measures to restore normal function. Ayurvedic treatments focus on identifying and addressing vitiated states to facilitate healing and promote health.

11) Swelling:
Swelling is often a physiological response to injury or inflammation, characterized by an accumulation of fluid in tissues. In Ayurveda, swelling is linked to an imbalance in doshas, especially Kapha. Treatments aim to reduce swelling through various therapies, addressing the underlying cause.

12) Disease:
Diseases encompass a variety of health conditions resulting from imbalances within the body. Ayurveda views diseases as manifestations of disrupted dosha balance. Treatment focuses on restoring equilibrium through personalized therapies, aiming to alleviate symptoms and address the root causes of ailments.

13) Inflammation:
Inflammation is the body's response to harmful stimuli, characterized by redness, heat, pain, and swelling. In Ayurveda, inflammation can signal an imbalance of doshas, particularly Pitta. Managing inflammation involves using indigenous herbs and therapies to cool the body and restore balance effectively.

14) Vimlapana:
Vimlapana is a specific Ayurvedic technique involving gentle rubbing or massaging of affected areas, particularly in cases of inflammation. This method aims to unclog channels, reduce swelling, and promote healing. It reflects the importance of restoring proper flow and balance in Ayurvedic treatments.

15) Shodhana (Sodhana):
Shodhana refers to cleansing or purification therapies in Ayurveda designed to eliminate toxins from the body. It plays a crucial role in maintaining health and preventing disease. Shodhana techniques may involve dietary interventions, herbal treatments, or therapeutic procedures tailored to individual imbalances.

16) Medicine:
Medicines made from natural sources and herbal formulations are fundamental in Ayurveda for treating ailments and supporting overall health. These medicines are tailored to address imbalances and promote well-being while respecting the holistic aspects of health.

17) Burning (Burn, Burned, Burnt):
Burning sensation is often a symptom indicating inflammation or irritation. In Ayurveda, it may relate to Pitta dosha being aggravated. Addressing this sensation may involve employing cooling therapies, dietary changes, and specific herbs that pacify Pitta and restore balance.

18) Animal:
Animal products, such as meat, milk, and ghee, may play various roles in Ayurvedic medicine. They are often considered for their nutritional value and therapeutic properties. Understanding the ethical and health implications of animal-derived substances is essential in forming a holistic dietary approach.

19) Powder:
Powder in Ayurveda typically refers to finely ground herbs and substances used for medicinal purposes. Powders may be applied topically or taken internally, depending on their properties and the intended therapeutic effects. They provide a concentrated form of agents promoting healing and balance.

20) Pitta:
Pitta is one of the three doshas in Ayurveda, representing fire and transformation. It governs digestion, metabolism, and energy production. An imbalance in Pitta can lead to conditions like acidity or inflammation. Treatments aim to balance Pitta through diet and herbal remedies to restore health.

21) Kapha:
Kapha is one of the three doshas in Ayurveda, embodying earth and water. It is responsible for structure, stability, and lubrication in the body. Imbalances in Kapha can lead to issues like obesity and congestion. Seeking balance involves dietary modifications and lifestyle changes tailored to individual needs.

22) Sutra:
Sutra signifies a collection of aphorisms or guidelines in Sanskrit literature. In Ayurvedic texts, sutras serve as foundational principles guiding practice and treatment. The Sushruta Samhita offers numerous sutras outlining surgical methods and medical knowledge essential for practitioners in the field.

23) Ahara:
Ahara refers to diet and nutrition, deemed fundamental in Ayurveda for maintaining health. It encompasses the quality, quantity, and types of food consumed. Ahara is aligned with individual dosha constitutions, and dietary recommendations are tailored to restore balance and support well-being.

24) Burning sensation:
Burning sensation usually indicates irritation or inflammation, often linked with Pitta aggravation in Ayurveda. Addressing this involves effective therapies to cool the body and restore balance. Specific herbs and dietary changes can alleviate the burning sensation while promoting recovery.

25) Purification:
Purification, or Shodhana in Ayurveda, refers to methods aimed at cleansing the body of toxins and impurities. These techniques are essential in preventing disease and restoring health. Ayurvedic practices emphasize tailored purification routines that consider individual dosha imbalances to facilitate holistic healing.

26) Patanjali:
Patanjali is a renowned figure associated with yoga and Ayurvedic practices. His teachings emphasize holistic health, combining physical, mental, and spiritual well-being. The principles set forth by Patanjali continue to guide practitioners in integrating Ayurvedic wisdom into contemporary health practices.

27) Activity:
Activity pertains to physical, mental, or emotional engagements crucial for maintaining health in Ayurveda. Regular activity promotes circulation, digestion, and overall vitality. Balanced activities aligned with an individual’s dosha and lifestyle can enhance well-being and prevent ailments.

28) Bleeding:
Bleeding, a medical condition indicating the loss of blood, can signify injury or underlying health issues. In Ayurveda, controlling bleeding involves evaluating dosha imbalances and employing targeted therapies that restore balance and promote proper healing to prevent complications.

29) Samhita:
Samhita refers to ancient texts with compilations of knowledge, particularly in Ayurveda. The Sushruta Samhita and Charaka Samhita serve as foundational texts, detailing medical practices, surgical techniques, herbal treatments, and lifestyle regulations essential for practitioners and scholars in the field.

30) Shastra (Sastra):
Shastra signifies a body of knowledge or scripture, often guiding medical practices in Ayurveda. It encompasses various texts detailing techniques, philosophies, and systematized practices in disciplines like surgery, herbal medicine, and patient care, enriching understanding and practice.

31) Itching:
Itching is a common symptom indicating irritation or skin issues, often associated with imbalances in doshas. In Ayurveda, treatments for itching may involve soothing herbs and dietary adjustments to alleviate discomfort and restore skin balance by addressing underlying causes.

32) Dravya:
Dravyas encompass various substances and materials used in Ayurvedic formulations, including herbs, minerals, and animal products. Understanding the properties and uses of different dravyas is essential for designing effective treatments and addressing specific health concerns.

33) Ropana:
Ropana refers to healing or reconstructive processes in Ayurveda aimed at promoting tissue regeneration and recovery from wounds. Modalities within Ropana involve using specific herbs and treatments to enhance healing and restore normal function, focusing on holistic regeneration.

34) Kshara (Ksara):
Ksara indicates alkaline substances utilized in Ayurveda for therapeutic interventions. Its application highlights the diverse approaches devised to address and purify various health conditions through traditional remedies.

35) Shopha (Sopha):
Shopha refers to swelling or edema in Ayurveda, typically indicating an imbalance within the body. Treatments target underlying dosha disturbances, particularly addressing Kapha excess. Various measures, including herbal formulations and dietary changes, aim to reduce shopha and alleviate discomfort.

36) Sthana:
Sthana denotes a location or place within the body or broader context in Ayurveda. Understanding sthana is vital in locating diseases and applying treatment accurately. This term also reflects the importance of specific anatomical sites in relation to health and healing.

37) Eranda (Eramda):
Eranda, known as castor oil plant, holds significant therapeutic value in Ayurveda. Its oil is utilized for its purgative properties and is common in managing digestive disorders. Eranda also serves as an emollient, promoting skin health and addressing inflammation.

38) Dushta (Dusta):
Dushta indicates deterioration or impurity in Ayurveda, often describing conditions or wounds that are infected or failing to heal properly. Treatments focus on purifying dushta aspects to restore health and promote healing processes through various therapeutic methods.

39) Wisdom:
Wisdom encompasses the accumulated knowledge and understanding necessary for making informed decisions in health and treatment. In Ayurveda, the wisdom of ancient practices guides practitioners in selecting appropriate therapies, respecting individual health conditions, and utilizing holistic approaches for healing.

40) Madhu:
Madhu, or honey, is regarded in Ayurveda for its medicinal properties, including antimicrobial effects and wound healing capabilities. It serves as a natural sweetener, promoting digestive health and supporting immunity while being an essential ingredient in various therapeutic preparations.

41) Mamsa (Mamsha):
Mamsa refers to muscle or flesh and plays a role in nutritional discussions in Ayurveda. Its consumption is considered for building strength and vitality, and treatments often address muscle-related conditions through dietary and therapeutic interventions tailored to dosha imbalances.

42) Agni:
Agni signifies the digestive fire and metabolic processes within Ayurveda. It reflects the individual's digestive capacity and overall health status. Maintaining balanced Agni is crucial for effective digestion and absorption of nutrients, and treatments aim to restore any disruptions to this vital element.

43) Medas (Meda, Medash):
Meda, representing fat or lipid metabolism, plays a role in the Ayurvedic understanding of body composition and health. Managing Meda levels is important in preventing obesity and related diseases, with dietary and lifestyle modifications helping to maintain balance.

44) Oil:
Oils are utilized in Ayurveda for their therapeutic properties, playing a crucial role in dermatological treatments, nutritional practices, and massages. Oils can enhance absorption of herbal components and are considered vital for both external and internal application in healing therapies.

45) Blood letting:
Blood letting is an ancient practice utilized in various traditional medicines, including Ayurveda, to alleviate excess accumulation and restore balance. It involves withdrawing blood to treat various ailments, particularly in cases of inflammation or congestion, aligned with the underlying dosha imbalances.

46) Cow urine (Cow's urine):
Cow urine, known as 'gomutra,' holds a sacred place in Ayurveda for its alleged therapeutic benefits. It's used in various treatments due to its believed purifying properties, helping in detoxification and rejuvenation, supporting digestive health, and enhancing overall well-being.

47) Goat milk:
Goat milk offers nutritional benefits, such as being easier to digest compared to cow's milk. In Ayurveda, it is considered beneficial for balancing Pitta and Kapha doshas. Its soothing properties also contribute to skin health and overall vitality.

48) Sushruta-samhita (Susruta-samhita):
Sushruta Samhita is a foundational Ayurvedic text attributed to Acharya Sushruta, defining surgical methods and medical principles. It provides detailed insights into surgical practices, wound healing, and treatments, making it essential for understanding ancient medical wisdom and contemporary applications.

49) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalya Tantra is the branch of Ayurveda that focuses on surgical interventions and the management of surgical conditions. It encompasses various techniques and treatments aimed at restoring health through surgery, reflecting the depth of Ayurvedic knowledge in aspects of surgery.

50) Blood-letting:
Blood-letting is a historical procedure where blood is withdrawn to treat disease and restore balance within the body. In Ayurveda, it is employed selectively for specific conditions associated with dosha imbalances, particularly to relieve congestion or inflammation.

51) Kalpasthana (Kalpa-sthana):
Kalpasthana refers to a section in Ayurvedic texts focusing on pharmaceutical preparations and formulations. It covers the methods of preparing medicines, including herbal concoctions and external applications, playing a key role in ensuring the efficacy of Ayurvedic treatments.

52) Alleviation:
Alleviation implies the act of reducing or relieving symptoms or discomfort. In Ayurveda, various modalities aim for alleviation, focusing on restoring balance and addressing root causes rather than just masking symptoms, thereby enhancing patient comfort and health.

53) Bhallataka:
Bhallataka, also known as Semecarpus anacardium, is a medicinal plant used in Ayurveda for its anti-inflammatory and analgesic properties. It plays a role in treatments for skin conditions and supports healing processes, emphasizing the importance of natural remedies in traditional healing.

54) Hastidanta (Hastin-danta, Hastidamta):
Hastidanta refers to the tusks of elephants, which are sometimes utilized in Ayurvedic formulations for various health benefits. They symbolize the integration of natural resources and traditional knowledge in Ayurveda, serving as ingredients in specific therapeutic contexts.

55) Agnikarma (Agni-karma):
Agnikarma signifies a treatment modality in Ayurveda where local heat or cauterization is applied to heal wounds or manage particular ailments by stimulating healing processes and restoring balance. This technique reinforces the significance of detailed interventions in traditional medicine.

56) Snake-bite:
Snake-bite refers to the injury caused by a snake's fangs, often requiring immediate medical attention. In Ayurveda, specific treatments focus on detoxifying the body and counteracting venom through herbal remedies, ensuring a holistic approach to managing snake-bite incidents.

57) Krimighna (Krmighna, Krimi-ghna):
Krimighna refers to treatments aimed at eliminating worms or parasitic infections in Ayurveda. Herbal formulations play a crucial role in addressing these conditions through purgative and cleansing properties, reinforcing the importance of detoxification in Ayurvedic practices.

58) Vishaghna (Visaghna, Visha-ghna):
Vishaghna describes remedies aimed at addressing poisoning or harmful substance exposure within the body, as seen in Ayurvedic practices. Treatments are designed to detoxify and restore balance while alleviating symptoms associated with poisoning, emphasizing the holistic nature of healing.

59) Rasakriya (Rasa-kriya):
Rasakriya involves a therapeutic process focused on restoring bodily functions and energy flow through fluid or essence-related treatments in Ayurveda. It pertains to methods promoting rejuvenation by enhancing the quality of bodily fluids and supporting overall health.

60) Rasanjana (Rasa-anjana, Rasamjana):
Rasanjana refers to a particular Ayurvedic formulation involving the use of specific herbs or substances believed to enhance health and vitality. It embodies a holistic approach inspired by ancient practices to rejuvenate the body and adapt to individual needs.

61) Siravedha (Sira-vedha):
Siravedha denotes a therapeutic intervention in Ayurveda where blood is drawn from a local area for treatment purposes. It is employed to relieve congestive conditions and restore proper balance, showcasing the unique methods utilized in Ayurvedic practices.

62) Suffering:
Suffering encompasses physical or emotional distress from various health conditions. In Ayurveda, understanding and alleviating suffering require addressing underlying imbalances through personalized treatments that respect individuals’ unique dosha constitutions and health contexts.

63) Ayurveda (Ayus-veda):
Ayurveda is an ancient healthcare system originating from India, emphasizing balance and harmony within the body. It encompasses holistic principles of wellness, incorporating lifestyle, diet, and natural remedies tailored to individual needs, aiming to treat the root causes of ailments.

64) Abhyanga (Abhyamga):
Abhyanga refers to the traditional Ayurvedic practice of oil massage. It promotes relaxation, enhances circulation, and helps eliminate toxins. Regular Abhyanga supports physical and mental health, aligning with Ayurvedic principles of self-care and nurturing overall well-being.

65) Haritala (Hari-tala):
Haritala, also known as orpiment, is a mineral used in Ayurvedic medicine for its purifying and detoxifying properties. It plays a role in addressing specific ailments, reflecting the unique integration of minerals in traditional herbal practices.

66) Sandhana (Samdhana):
Sandhana relates to the surgical practice of approximating and closing wounds, emphasizing the importance of healing techniques in Ayurveda. It reflects the ancient practices of wound management, ensuring optimal recovery and restoration of tissue integrity.

67) Parisheka (Pariseka):
Pariseka describes a process of sprinkling medicated liquids or herbal decoctions on affected areas to provide relief from inflammation and discomfort. This technique underscores the therapeutic use of water and herbal science in Ayurvedic practices.

68) Priyangu (Priyamgu):
Priyangu is an Ayurvedic herb known for its health benefits, particularly in treating various skin conditions and disorders. It plays an important role in herbal formulations aimed at detoxification and restoring balance within the body.

69) Shringa (Srnga, Shrimga):
Shringa, commonly known as a horn or horned element, refers to materials utilized in specific Ayurvedic practices, particularly in procedures like blood-letting or applying medicinal substances. It showcases the use of natural elements in therapeutic contexts.

70) Prameha:
Prameha refers to a group of disorders characterized by excessive urination, often linked to metabolic issues. Ayurveda treats Prameha through dietary modifications, lifestyle changes, and herbal remedies aimed at restoring balance within the body.

71) Dhupana:
Dhupana signifies the therapeutic practice of using fumes or incense from specific herbs to treat ailments, particularly related to respiratory issues or cleansing environments. It highlights the vital role of fragrance and smoke in traditional healing methods.

72) Jalauka:
Jalauka refers to medicinal leeches used in Ayurveda for therapeutic purposes, particularly in detoxification and blood-letting practices. They play a role in enhancing circulation and reducing inflammation, exemplifying the ancient methods integrated into traditional healing.

73) Kashmari (Kasmari):
Kasmari is an Ayurvedic herb used for its cooling properties and role in treating skin conditions. It embodies the use of plant-based remedies in achieving balance and alleviating symptoms associated with various dosha imbalances.

74) Brimhana (Brmhana):
Brmhana indicates a category of treatments aimed at promoting nourishment and strength within the body, particularly for individuals suffering from long-term ailments. Treatments are tailored to restore vitality, enhance health, and support recovery processes.

75) Karanja (Karamja):
Karanja, or Pongamia pinnata, is an oil-rich tree known for its medicinal properties in Ayurveda. It is often used in treating skin and inflammatory conditions, showing the importance of integrating local flora into therapeutic practices.

[Note: The above list is limited to 75. Total glossary definitions available: 133]

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