Proper and Improper Sweating Therapy Symptoms and Treatment

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

Introduction

Swedana is an important treatment (therapy) in Ayurveda. It is a remedy for many diseases either individually or in combination with other treatments. It also has a preventive role. 

Swedana is a treatment procedure in which sweat is induced in the body. This is a means of expanding (opening up) the srotases or channel systems and micro-channels and ducts in the body so as to enable the free flow of toxins and wastes from the cells (tissues, dhatus) towards the stomach or gut, usually done after snehana (oleation or external treatments done by applying oil to the body inclusive of abhyanga or massage etc).

This will help in further expelling the toxins from the body through Vamana (therapeutic emesis) or Virechana (therapeutic purgation). Thus Swedana will be an important and integral part of the Purvakarma (pre-treatment procedures or pre-operative procedure) for Panchakarma therapies (5 cleansing therapies) inclusive of vamana and virechana.

Swedana is also a pradhana karma or main treatment when done individually in combination with snehana, not essentially as a part of Panchakarma treatment schedule.

Thus Swedana is sudation therapy in which sweating is induced in the patient by providing heat through different procedures. Swedana can be Saagni (sweating induced through heat provided using procedures involving use of fire) and Niragni (sweating induced through heat provided using procedures not involving the fire).

But the important question is ‘how much swedana or sudation is good enough?’ and ‘when do we know that enough or sufficient sudation or swedana has been given to a person?’

In this article we will have a look at signs of proper sudation i.e. samyak swedana or swinna lakshanas. Appearance of these signs is an indication that the sudation (swedana) has been properly done and it is time to stop the therapy.

Samyak Swinna Lakshanas

शीतशूलव्युपरमे स्तम्भगौरवनिग्रहे| सञ्जाते मार्दवे स्वेदे स्वेदनाद्विरतिर्मता||१३|| Charaka Sutrasthana 14/13

स्वेदास्रावो व्याधिहानिर्लघुत्वं शीतार्थित्वं मार्दवं चातुरस्य | सम्यक्स्विन्ने लक्षणं प्राहुरेतन्मिथ्यास्विन्ने व्यत्ययेनैतदेव ||२३|| Sushruta Chikitsa Sthana 32/23

Samyak Swinna Lakshanas – Signs of proper sudation (Samyak Yoga of Swedana)

When the sudation or sweating therapy is done in a proper way, the below mentioned signs are seen –

• Sheetoparama – pacification of coldness in the body (pacification of feeling of abnormal coldness in the body due to increased vata or kapha or vata-kapha)
• Shuloparama – pacification of pain
• Stambha nigraha – reduction of stiffness (catches) or tightness in the body parts
• Gaurava nigraha – reduction of the ‘feeling of heaviness in body parts’
• Maardava (mridutva) – smoothness of the body or body parts (feel as if the body parts have become smooth)
• Sweda praadurbhaava – sweating of body or parts of the body which have been subjected to swedana or sudation
• Roga lakshana prashamanam – pacification or reduction of the symptoms of the disease for which the swedana is being administered
• Sheetaartitvam – want or crave of cold things (liking towards taking cold foods & comforts)

Hina and Atiyoga

How to recognize that the sudation has not been administered properly?

Many times due to faulty administration or lack of care and supervision or negligence of the facts which need to be taken care of properly may lead to improper sudation. Improper sudation may be either

• Deficit or insufficient administration (asamyak swedana or heena swedana or aswinna) of sudation, also called Heena Yoga of Swedana
• Excessive administration (atiswinna or atiyoga) of sudation, also called Ati Yoga of Swedana

Care should also be taken so as to see that the patient is not subjected to excessive or deficit sweating.

Aswinna Lakshanas

Aswinna Lakshana – Signs of deficit sudation (Heena Yoga of Swedana), management
Many times due to faulty administration of Swedana, the sudation can either occur in deficit (aswinna, heena yoga) or in excess (ati swinna, ati yoga). Both are harmful to the body in one way or the other and are going to produce signs of inadequate and excessive administration respectively. In both these conditions, there will be absence of Samyak Swinna Lakshanas.

Asamyak Swinna / Heena Swinna / Aswinna Lakshana – Signs of improper / less sweating (Heena Yoga of Swedana)
Aswinna lakshanas or signs of deficit administration of sudation will be opposite to those explained in the Samyak Swinna Lakshana (proper administration of sudation) i.e.

• Sheeto anuparama – there will be no relief from the feeling of coldness
• Shula anuparamam – there will be no reduction in pain
• Stambha anigraha – relief from stiffness is not experienced
• Gaurava anigraha – relief from heaviness is not obtained
• Amaardavam – the part of the body subjected to swedana will not become smooth (no feel of smoothness)
• Aswedam – sweat is not manifested
• Alaghutvam – lightness of the body is not experienced
• Vyadhi anupashama – the disease for which the sudation has been administered will not get pacified

Management of Heena Yoga

Management of Heena Yoga of Swedana
These signs of heena yoga of swedana indicate that sudation has not been done properly and needs to be done again to perfection.

Many times in spite of sweating not occurring (after swedana), the patient may experience symptoms like giddiness, burning sensation etc. This shows less tolerance towards swedana.

In such (both the above mentioned) cases, –

• The swedana should be stopped immediately.
• Causes for inadequate sudation should be searched for.
• The patient should be rehabilitated and strengthened for some days with proper food, rest and assurance.
• Once the person develops physical and mental strength and endurance, the swedana shall be repeated.
• If snehana has not been done properly in the previous schedule care should be taken to see that snehana done properly (especially if it is abhyantara snehana or intake of medicated ghee and oils in metered and increased doses until signs of proper oleation have been observed).
• Care also should be taken to give a proper oil massage (abhyanga) before doing swedana because swedan yields best results only when done on the backdrop of proper abhyantara snehana or bahya snehana (abhyanga etc).
• If the instrumentation or selection of method of swedana were not proper in the previous schedule, they need to be addressed.

Ati Swinna Lakshanas

Ati Swinna Lakshana – Signs of excessive sweating or over sweating (Atiyoga of Swedana)
Below mentioned are the signs of excessive administration of sudation therapy (atiyoga swedana).

• Pitta prakopa – aggravation of pitta
• Murcha – fainting, loss of consciousness
• Anga sadana – body weakness
• Daha / Vidaha – Burning sensation
• Sarva Anga Daurbalya – weakness in all the parts of the body
• Sandhi peeda – pain in bony joints
• Sphota utpatti – manifestation of blisters
• Asra (rakta) prakopa – aggravation of rakta
• Bhrama / Bhranti – vertigo, giddiness
• Trushna – excessive thirst
• Klama – fatigue
• Svara sadana – hoarseness of voice, weakness of voice
• Jwara – fever
• Shyava-rakta mandala – brownish-red colored eruptions at the place which has been subjected to sudation
• Chardi – vomiting

Management of Atiyoga

Management of Ati Yoga of Swedana

Ati Yoga or excessive administration of sudation will lead to many complications as mentioned above. It is very necessary that this condition is taken care of and addressed as soon as possible.

Below mentioned are the immediate measures which need to be taken in case of manifestation of ati swinna lakshanas –

• Stop the Swedana as quickly as possible
• The patient should be taken away from the heat zone and rested.
• Shita upachara – Immediate cold measures i.e. cold foods and comforts should be adopted (kuryaat toornam tatra sheetam vidhaanam – Su.Su.32/24)
• Greeshma Rutu Vidhi Vidhana – all the measures and regimen followed in Greeshma Ritu i.e. summer season should be followed in ati yoga of swedana, mainly the sheeta prakriyas i.e. cold comforts.
• Stambhana – The patient should be administered with stambhana chikitsa (tatra stambhanam aushadham – A.Hr.Su. 17/16, 17). Stambhana actually means to stop (the flow of anything) and it is the opposite (antagonistic) treatment of Swedana (where there is flow of sweat or movement of body fluids). On the other hand it was already said that the swedana would relieve stambhana.

Related Reading – Stambhana Chikitsa

Other important remedies (measures) for atiyoga of swedana (as mentioned in Grishma Ritucharya and others)

• Madhura (sweet taste), sheeta (cold), drava (liquid), snigdha (unctuous) foods and drinks should be provided.
• Lavana (salt rich), amla (sour), katu (pungent), ushna (hot) foods and drinks should be avoided.
• Sheeta mantha (cold churned drinks made with coolant herbs) mixed with sharkara (sugar) should be given.
• Shruta-sheeta jala – boiled and cooled water should be provided for drinking (lukewarm water).
• Shali bhojana – only rice preparations should be given (only rice) to the patient.
• Madhya varjya – alcohol or alcoholic preparations should not be given. If the patient is an alcoholic, alcohol should be stopped with immediate effect.
• Sheeta griha – the patient should be stationed (rested) in sheeta griha (cold rooms or air conditioned rooms) during the day time.
• During the night time, the patient should be made to sleep on the roof-top of the house getting exposed to the moonlight or rays of moon.
• Chandana lepa – paste of sandalwood should be applied on the body of the patient.
• The fans should be sprinkled with chandanodaka (sandalwood water) and the patient should be exposed to the breeze coming from such fans.
• The patient should be made to stroll or sit in beautiful gardens or on the river or lake banks or on the banks of any water reservoirs.

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