Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Shamana is one among the two broad classifications of treatments detailed in Ayurveda, the other being Shodhana.
Shamana – to pacify, subside, palliate
Chikitsa – treatment
While Shamana Chikitsa, as per its meaning tries to pacify the mild to moderately aggravated doshas in their places so that the do not aggravate more and trouble the body, Shodhana Chikitsa which means expelling the morbid doshas from the body is a treatment of choice in conditions wherein severely aggravated and excited doshas exist in the body. The Panchakarma therapies are included under Shodhana Chikitsa.
In this article, we will see what ‘Shamana’ is, its meaning, types and clinical uses, as explained by Acharya Vagbhata.
Ref – Ashtanga Hridaya Sutra Sthana, Chapter 14, verses 6-7 ½ (A.Hr.Su.14/6-7a)
Shamana Chikitsa
न शोधयति यद्दोषान् समान्नोदीरयत्यपि।
समीकरोति विषमान् शमनं तञ्च सप्तधा॥६॥
पाचनं दीपनं क्षुत्तृड्व्यायामातपमारुताः।
Definition
“The treatment which does not expel the increased doshas out of the body, does not increase the normal doshas, but makes the abnormal doshas normal is called as Shamana”.
Types of Shamana
Shamana (Chikitsa) is of 7 types. They are –
| Name of Shamana Chikitsa | Meaning |
| Pacanam (Ama Pachana) | Digestives, Carminatives – medicines which destroy ama |
| Dipanam | Those producing hungerThose kindling the digestive fire and hence enhancing the digestive capacityAppetizersStomachic medicines |
| Kshut | Making the patient withstand hungerEncourage the patient to observe fastingAvoid eating food |
| Trt / Trd | Withstanding hungerAvoid drinking waterAvoid intake of liquid foods |
| Vyayama | Indulgence in exercise, physical activities / workouts |
| Atapa | Exposure to sunlight |
| Maruta | Exposure to breeze |
Discussion
The treatment is called as Shamana when it satisfies the below mentioned rules –
– The administered treatment or medicine should not expel the increased dosha / doshas from the body because if it does, it will be called shodhana. This also is the main difference between these treatments i.e. shamana and shodhana.
– The administered treatment or medicine should not increase the doshas which are in a state of normalcy / balance.
– The administered treatment or medicine should be capable of bringing the abnormal (imbalanced) doshas to a state of normalcy (balance).
Discussing further,
Since the Shamana should not expel the increased doshas, it means that this treatment is also given when the doshas are increased, but not to such great extent that demands their expulsion from the body. When doshas are increased to great proportions, they should not be handled with shamana chikitsa. If done, the doshas do not subside properly or partially pacify for a short time or the medicine may become ineffective. Once there is prabhuta – excessive or utklishta – excited doshas wanting or waiting to be expelled, they fall into the territory of ‘shodhana’ i.e. expulsion from the body.
This further reflects that Shamana will be a choice for noisy yet not notorious doshas i.e. those doshas which have increased by mild to moderate proportions. So, all increased doshic conditions which do not require shodhana deserve to be treated by shamana chikitsa. So, here the physician should be intelligent enough to differentiate the states of dosha aggravation and when to prefer shamana over shodhana. Otherwise, he would administer shamana in cases demanding shodhana and shodhana in cases demanding shamana, both are dangerous from clinical perspective and end up producing serious complications and diseases.
Discussing the other rule of Shamana, it should not disturb the other normal doshas or bring imbalance in them. So, the shamana chikitsa should be dosha specific. It should subside the dosha which has increased and towards the pacification of which it has been administered, but should not meddle with the other normal or balanced doshas. Example, a medicine which has been given to subside kapha should subside kapha without disturbing, aggravating or exciting pitta or vata. If it does, it will produce vata or kapha disorders / symptoms in spite of treating kapha disorders. Here, this is a clue for the physician to make the right choice of shamana chikitsa, including dosha specific medicines.
And finally, the third rule – the shamana chikitsa should bring the abnormal or out of balance doshas to a state of balance. This is the main goal and expected outcome of shamana chikitsa, along with the treatment satisfying the above said conditions.
Seeing all the conditions which Shamana Chikitsa should satisfy, it can be considered as ‘palliative medicine’.
Discussing about the types of Shamana
Pachana
Pachana medicines help in digesting the ama. This is the first and foremost measure in treating any disease, especially in their earlier stages. Ama is a material formed in the stomach due to the action of weak digestive fire on food. Being sticky in nature it sticks to the walls of the tissues and channels and causes blocks. Ama also mixes up with doshas, dhatus and malas and causes various diseases. Acharya Charaka has included Pachana in Langhana. It should be administered to diseases of moderate strength and of kapha-pitta origin, like – vomiting and diarrhea, heart diseases, cholera, fevers, constipation, heaviness, belching, nausea and tastelessness.
Related Reading – ‘Pachana Therapy’
Dipana
Dipana medicines are beneficial for kindling the digestive fire. If this fire is activated and brought back to a state of its balanced functioning, it will also stimulate the dhatu agnis and Bhuta agni in the long run. All the diseases are caused due to mandagni i.e. weakness of digestive fire and kindling the same fire and bringing it to its original active form should be an essential principle in treating almost all conditions according to Ayurveda. This is usually done after pachana but some pachana herbs also cause dipana and some dipana herbs also bring about pachana of ama.
Kshut – Trit
Kshut is making the person to withhold hunger. It has been named as Upavasa by Acharya Charaka which translates to ‘fasting’. Both are one and the same. This measure will serve the purpose of pachana and dipana and will help in resolving ama which is present in small quantities and will kindle the agni. This measure is useful only in kapha and pitta aggravation of mild types.
Trt – is making the person to withhold thirst. More water in diseased conditions will pacify agni. It will also cause more moistness and liquidity in the tissues which will meddle with the healing process. This measure is useful only in kapha and pitta aggravation of mild types, as in Kshut. Acharya Charaka calls this as Pipasa Nigraha i.e. withholding thirst. Both are one and the same.
Master Charaka gives indications for doing these therapies.
एत एव यथोद्दिष्टा येषामल्पबला गदाः| पिपासानिग्रहैस्तेषामुपवासैश्च ताञ्जयेत्||२२||
He says that the same diseases mentioned in the context of Pachana when manifested with mild intensity, should be mitigated by fasting and controlling thirst.
Vyayama, Atapa, Maruta
Indulgence in exercise, exposure to heat of sun and wind are also forms of langhana as per Acharya Charaka. They bring about lightness of the body as per the rule of langhana.
They also pacify the doshas following the rule of shamana, without eliminating the doshas.
रोगाञ्जयेन्मध्यबलान् व्यायामातपमारुतैः| बलिनां किं पुनर्येषां रोगाणामवरं बलम्||२३||
Acharya Charaka specifies that these measures should be implemented in strong persons who are suffering from diseases of moderate intensity. In these people, any treatment measure should include indulgence of these three measures. Similarly, strong patients suffering from mild diseases or little imbalance of doshas should be treated by administering exercise and exposure to sun and wind.
Note – Other than Dipana, all the other six forms of shamana are included under Langhana by Acharya Charaka.
Other features of Shamana Chikitsa
These treatments focus on balancing the doshas with the help of herbs or formulations administered for that purpose.
They help in reducing or eliminating the disease symptoms and do not address the root cause of the disease. They just pacify the symptoms of dosha aggravation and the dosha itself and might not meddle with the samprapti i.e. pathogenesis. Since the dosha aggravation in these conditions are less or moderate, the disease caused by them is also not severe and hence the shamana medicines will also cure such diseases of mild to moderate strength.
They are usually administered in earlier stages of disease wherein doshas are less aggravated.
Shamana medicines are also used as ‘follow up medicines’ for Shodhana Chikitsa. Even after the severely aggravated doshas are expelled out of the body through Shodhana, the doshas which are left out in small proportions, in an excited state but not eliminated, Shamana medicines can be given for few days to pacify such lingering doshas, to establish dosha equilibrium. In some conditions, shamana aushadhas are given for a long duration after Shodhana, to see that the dosha balance is stabilized, especially so, in diseases which have shown tendency to relapse / recur in that patient.
Different disease specific formulations are administered as a part of Shamana chikitsa.
Changes advised to be made in dietetic and lifestyle practices are also included in the Shamana concept.
