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Abstract

Swedana or Fomentation is a treatment practice which induces sweating by means of heat either in the form of steam (Bashpa) or by direct contact of the body with heated medicament (Tapa).Sankara Sweda, commonly known asPinda Swedais a fomentation method in which the materials are tied in a cloth and massaged over the part to be sudated.In PatraPindaSweda, a type of Pinda Sweda, different medicinal leaves along with other drugs are roasted in suitable medicated oil, made intoPinda(bolus) form by tying them in a suitable cloth and used for Swedanaafterperforming Abhyanga (mild massage). Swedana, in generally relieves pain, stiffness, heaviness, and coldness in the body. This treatment procedure eliminates the bodily toxins through sweating.It provides better therapeutic efficacy in orthopedic disorders especially in diseases like Osteoarthritis, Rheumatoid Arthritis, Cervical spondylosis, Lumbar spondylosis,Ankylosing Spondylitis, musculoskeletal pain as well as in neuro-muscular diseases. Present article deals with literary as well as contemporary review of the Patra Pinda Swedana.
Volume 5, Issue 8, August 2020 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
IJISRT20AUG304 www.ijisrt.com 348
PATRA PINDA SWEDANA
(A Unique Method of Massage with Fomentation) :
A Review
Dr. Achala R. Kumawat; Dr. Gopesh Mangal
Abstract:- Swedana or Fomentation is a treatment
practice which induces sweating by means of heat either
in the form of steam (Bashpa) or by direct contact of the
body with heated medicament (Tapa).Sankara Sweda,
commonly known asPinda Swedais a fomentation
method in which the materials are tied in a cloth and
massaged over the part to be sudated.In
PatraPindaSweda, a type of Pinda Sweda, different
medicinal leaves along with other drugs are roasted in
suitable medicated oil, made intoPinda(bolus) form by
tying them in a suitable cloth and used for
Swedanaafterperforming Abhyanga (mild massage).
Swedana, in generally relieves pain, stiffness, heaviness,
and coldness in the body. This treatment procedure
eliminates the bodily toxins through sweating.It provides
better therapeutic efficacy in orthopedic disorders
especially in diseases like Osteoarthritis, Rheumatoid
Arthritis, Cervical spondylosis, Lumbar
spondylosis,Ankylosing Spondylitis, musculoskeletal
pain as well as in neuro-muscular diseases. Present
article deals with literary as well as contemporary
review of the Patra Pinda Swedana.
Keywords:- Fomentation, Patra Pinda Swedana, Sankara
Sweda, Tapa Sweda.
I. INTRODUCTION
The term PatraPinda Swedana is derived from the
words Patra,(meaning leaves), Pinda which means bolus,
and Swedana, which means sweating. So,
PatraPindaSwedana refers to the sudation performed by a
specially prepared bolus of medicinal leaves (generally
Vatakaphahara).
II. MATERIALS & METHODS
References regarding Swedana and Patra Pinda
Swedana were collected from various textbooks, published
research papers, previous work done and compilation was
done. Conceptof Patra Pinda Swedana and procedure were
studied in detail.
III. LITERARY REVIEW
Acharya Charaka has classified Swedana based on the
involvement of Agni (fire)- Sagni Swedanaand Niragni
Swedana
1
. Whereas, Acharya Sushruta and Acharya
Vagbhata have classified Swedana procedure into four types
mainly, Tapa (inducing sweating by direct contact of the
heated medicaments with body), Ushma or Bashpa (heat in
the form of steam), Drava (inducing heat by means of hot
liquid), Upnaha (inducing heat by tying poultice around part
to be sudated)
2
. On reviewing the above classifications, it
can be seen that all the 13 types of Sagni Sweda of Acharya
Charaka can be incorporated into 4 types of Sweda
described by Acharya Sushruta and Vagbhata.
Patra Pinda sweda is a form of Pinda sweda, which is
nothing but Sankara Sweda of Acharya Charaka.
3
It is a
form of Tapa sweda, as per Acharya Sushruta and Acharya
Vagbhata. It includes fomentation using bolus (Pinda) of
prescribed drugs with or without being wrapped in
cloth.
4
Swedana can further be classified into Ruksha Pinda
Sweda and Snigdha Pinda Sweda. In Ruksha Pinda Sweda,
hot solid substances such as sand, brick and stone are used.
It is indicated in Kapha and Amarelated disorders affecting
joints and muscles, whereasSnigdha Sweda is advised in
conditions where the pain and related symptoms are due to
Vata Dosha only. Patra Pinda Sweda is a form of
SnigdhaSweda and is an unparalleled treatment in painful
conditions caused mainly by Vata Dosha, usually in
degenerative diseases. Moreover, it can be used in Vata-
Kapha conditions also, by alteringthe drugs (leaves etc.)
used. Leaves which can pacify morbid Vata and Kapha are
used in the bolus for tackling inflammatory diseases of
joints and soft tissues. Patra Pinda Sweda is used mainly to
relief from pain, inflammation, swelling and stiffness
associated with bone, joint and or musculoskeletal pains.It is
generally indicated in the ailments arising due to Vata,
Kapha and VatakaphaDosha.
Indications: As, it is a form of Swedana, it is generally
indicated in Vatakapha Vikara.
5
It can be indicated in the
following ailments- Gridhrasi (~Sciatica), Sandhivata
(~Osteoarthritis), Jeerna or PravruddhaAmavata (~Chronic
stages of RA), Pakshavadha (~Hemiplegia),
Greevastambha (~Cervical spondylosis), Katiprishthagraha
(~Ankylosing Spondylitis), Avabahuka(~Frozen Shoulder),
Intervertebral disc protrusion or prolapse (IVDP).
Contraindications: PatrapindaSwedana is contraindicated
inAjeerna(~Indigestion), Jwara (~ Fever), Twak Vikara
(~infective eczema, Psoriasis), Raktapitta (~Hemorrhagic
disorders)., Atisara (~Diarrhoea), Trishna (~Excessive
thirst), Madhumeha (~Diabetes mellitus), Pandu (~Anemia),
Garbhini (~Pregnant women).
Volume 5, Issue 8, August 2020 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
IJISRT20AUG304 www.ijisrt.com 349
IV. PATRA PINDA SWEDANA PROCEDURE
Every procedure of Panchakarma is carried out in three
steps Poorvakarma, Pradhankarma and Paschatkarma.
Poorvakarma: Poorvakarma are the Karma that are
required to be done prior to administration of Patra Pinda
Swedana. They include- (a) Preparation of materials,
(b)Preparation of Patient.
1. Preparation of materials and Pottali (Boluses)-
Leaves Nirgundi(Vitex negundo),Eranda(Ricinus
communis), Arka (Calatropis procera), Dhatura(Datura
metel), Shigru(Moringa oliefera) etc. (chopped into
pieces- 100gm each).
Sliced lemon- 2
Grated coconut- 100 gm
SaindhavaLavana- 5-10 gm.
Haridra Churna (Curcuma longa)- 10gm
Ajmoda(carum roxburghianum)- 10 gm
Oil-
For frying leaves- 100ml.
For heating Pottali- 250ml.
For Abhyanga- 100ml.
For Talam- 10ml
Rasnaadi Choona 5 gm for Talam
Cotton cloth (45cm×45cm): 4 pieces
Tags- 4
Vessels- 2 (for frying Leaves and for heating Pottali).
Attendant- 2
Panchakarma Droni-1
Gas stove-1
Preparation of Boluses:
Fresh leaves should be cleaned and chopped finely.
First add 100 ml of prescribed oil into pan, to this add grated
coconut and sliced lemon and fry till in turn to light tinged
brown.Add chopped leaves one by one; first add drugs
which have thick leaves followed by thin.Then mix
thoroughly and fry together till coconut scrapings attain a
brown color.It should be divided into two equal parts and
made into 2 Pottali (average weight of a standard Pottali is
300-350 gm.).
2. Preparation of patient.
Patient is advised to properly evacuate faeces and urine,
prior to the procedure and to expose the area desired for
Swedana.
The patient should be seated with leg extended over the
Droni facing to the east. Abhyanga should be performed
with prescribed medicated oil all over the body for about
10 minutes. Talam with suitable oil/Choornashould be
applied. Rasnadi Choorna is mixed with quantity
sufficient oil to make a paste of coin shape. It is then
applied over the anterior fontanelle of patient. Talam is
applied to prevent the brain from undue effects of
sudation.
V. PRADHANA KARMA (METHOD OF
ADMINISTRATION)
The prepared Pottali should be heated with prescribed
oil in a vessel on gas stove up to 42-460 C.
The therapists before applying the boluses on the body
of the patient should ensure that the heat of the boluses is
bearable to the patient by checking temperature of the
bolusesover dorsum of their own hand.The Patra Pottali is
gently rubbed with mild pressure over the part to be sudated
in a synchronized manner by two therapists positioned on
each side of the patient.The fomentation by Patra Pottali
should be carried out in all the 7 postures asAbhyanga (~
Massage) to ensure that all thebody partsare equally
fomented. The procedure of Patra Pottali Sweda should be
done till the patient gets of the Samyak Swinna Lakshana
6
The treatment procedure is carried out for 5-10 minutes
in each posture.
Care should be taken to maintain the temperature
throughout the procedure by reheating the Pottali.
The leaves bolus (Pottali) should be changed in every
three days
Duration: Time duration of the treatment ranges from 30-
45 minutes. The therapy should be done once every day for
1 to 3 weeks depending on the severity/intensity of the
disease.
Paschatkarma:
After completion of the procedure, Talamis removed
followed by rubbing ofRasnadiChoorna over anterior
fontanelle. Oil is wiped off from the body using clean dry
towel.Body is covered with thin blanket for 10-15 minutes.
Patient should be advised to take hot water bath after
1Muhurta (48 minutes)
7
.Patient is advised to take light diet
and drink hot water after procedure.
Complications and management:
a) Atiyoga of Swedana- Acharya Charka has advised use of
Madhura, Snigdha, and Sheeta Ahara- Vihara as
described in Greeshm Ritucharya
8
. He further states that
Stambhana should be done in case of Atiyoga of
Swedana
9
.
b) Burn and rashes-Due to heat intolerance in patient of
Pitta Prakriti, Burn and rashes may occur which has to
be managed byapplyingMadhu and Ghrita, preferably
ShahstradhoutaGhrita
10
, GhritaKumari (Aloevera
pulp)
11
, Haridra with Ghrita over the affected part.
c) Fainting- Due to increased body temperature or low heat
threshold of the patient or Atiyoga of Karma, fainting
may occur. Fainting and Giddiness can be prevented by
providing Sharkarodaka to the patient for drinking.
ApplyTalam with appropriate medicated oil and
Choorna. Drakshadi Kashaya can be given internally.
12
Volume 5, Issue 8, August 2020 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
IJISRT20AUG304 www.ijisrt.com 350
VI. DISCUSSION
Patra Pinda Swedana is usually done with Nirgundi
Patra, Dhatura Patra, Shigru Patra, Erandapatra etc.
Leaves of the Nirgundi plant have analgesic, anti-bacterial
and anti-inflammatory properties. It also possesses anti-
histaminic properties and is muscle relaxant
13
.Dhatura
leaves have anti-inflammatory properties and vapors of its
leaves also relieve the pain of rheumatism and gout
14
.
Leaves of Shigru are known to reduce severe pain
15
. Leaves
ofEranda are used to pacifyVataDosha
16
.
Patra Pinda Swedana is generally indicated in Vata
Kaphaja conditions, owing to the properties of ingredients
used. Gridhrasi and Greevastambha are Vata Kaphaja
Pradhana diseases.Patra Pinda is useful in Sandhivata and
Jeerna Aamavata, as these conditions are Vata Pradhana
and Patra Pinda Swedana being a Snigdha sweda pacifies
morbidVata. Ankylosing Spondylitis that can be considered
as Kati-Prishta-Trika Graha in Ayurvedic parlance is an
inflammatory arthritis that involves vitiation of Vata and
Kapha, producing pain and stiffness in the spines. Nirgundi
Patra Pinda Swedana owing tothe anti-inflammatory action,
Snigdha and Ushna Guna of the materials used subsides the
inflammation, pacifies morbid Vata and KaphaDosha thus
reducing pain and stiffness. Similarly, it is effective in
conditions like Avabahuka that involves vitiation of Vata
and Kapha again and presents with reduced range of motion
at shoulder Joint. Nirgundi Patra Pinda relieves stiffness in
such cases which in turn improves the range of
motion.Swedana is contraindicated in conditions of Ajeerna,
as it is a Snigdha Sweda which may further increase
Agnimandya. Agni is hampered in Jwaravastha, and
Patrapinda Swedana may aggravate the condition in these
cases.Infective eczema and Psoriasis are also a
contraindication forSwedana, as it may further aggravate the
conditions. Swedana is strictly contraindicated in Atisara as
Swedana may increase the peristaltic movements resulting
in aggravation of the condition. Moreover, it may result in
electrolyte imbalance due to increased fluid loss. Acharya
are of opinion that Swedana should be strictly avoided in
Raktapitta even if it involves vitiation of Vata and
Kapha.
17
Madhumeha is a Kleda pradhana Vyadhi and
Swedana increases Kleda thus Patra PindaSwedana should
be avoided in such cases. Swedana aggravates Trishna and
Pandu, therefore should not be performed in these
conditions.
Reduction of pain can be explained on the bases of
gate control theory of pain of Melzak and Wall, 1965. Their
theory states that different man oeuvres of massage impart
an array of sensory experiences by stimulating the
peripheral sensory receptors, mainly touch and pressure
receptors, present in skin and soft tissue. Patra Pinda Sweda
involves massage of the area with certain amount of
pressure in a synchronized manner. As per Melzack and
Wall, these pressure and temperature sensations are carried
by large diameter Abetafibers, which plays an important role
in inhibition of the perception of pain, carried by A delta
and C fibers.The stimulation of low threshold
mechanoreceptors blocks the pathway of pain sensation by
presynaptic inhibition at the level of substantia gelatinosa of
spinal cord. This could be the mechanism by which Patra
Pinda Swedana reduces pain and stiffness.
VII. CONCLUSION
Present article deals with comprehensive study of
Patra Pinda Swedana. As discussed above it is a type of
Sankar Swedaand TapaSweda. It is effective in Vata
Kaphaja and Inflammatory conditions. It is most often
recommended in condition like chronic back pain, arthritis,
stiffness of the joints and even muscle ache. Patra Pinda
Sweda may help in increasing blood circulation to the
affected area, gets rid of vitiated Dosha, strengthens the
muscles in the area, facilitates release of toxins and reduces
inflammation. It also improves the tone of muscles and
improves the working of tissues within the body.
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Kwatha Kalpana Adhyay, 2/17
  • Sharangghara Sharangdhara
  • Madhyama Samhita
  • Khanda
Sharangdhara, Sharangghara Samhita, Madhyama Khanda, Kwatha Kalpana Adhyay, 2/17, edited by Dr. Smt. Shailaja Srivastava, Chaukhambha Orientalalia, Varansi,2016; PP.138.
Pharmacological properties of Datura stramonium L. as a potential medicinal tree: an overview
  • P Soni
  • A A Siddiqui
  • J Dwivedi
  • V Soni
Soni, P., Siddiqui, A. A., Dwivedi, J., & Soni, V. (2012). Pharmacological properties of Datura stramonium L. as a potential medicinal tree: an overview. Asian Pacific journal of tropical biomedicine, 2(12), 1002-1008. doi:10.1016/S2221-1691(13)60014-3. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PM C3621465/ Last accessed on 17 June 2019.
  • Bhavaprakasa Bhavamishra
  • Guduchyaadivarga Nighantu
  • Adhyay
Bhavamishra, Bhavaprakasa Nighantu, Guduchyaadivarga Adhyay, Verse Number 101, edited by Late Dr. G. S. Pandey, Chaukhambha Bharati Academy, Varanasi,2015; PP.324.