SWEDANA: THERAPEUTIC HEAT
The second major aspect of the preparatory procedures of Purvakarma is called swedana, the therapeutic application of heat to the body. Though swedana literally means “sweat,” the main purpose of swedana is not to produce sweat, but to dilate the body’s shrotas or channels so that oleation’s objective — removing ama from the dhatus — can be more easily achieved. Sweat results naturally when the channels widen. In addition, the application of heat also counteracts the coldness of both vata and kapha, reduces the body’s stiffness and heaviness, and counters the slow, heavy and sticky attributes of ama.
As the influence of agni bhuta increases, it begins to soften or melt ama’s density. Ama gets liquefied and shrinks in volume, making it easier to be carried from the tissues. The heating action of swedana also mobilizes the doshas, which are responsible for transporting these toxic waste materials from the deep tissues to the gastrointestinal tract.
In addition, swedana produces tissue expansion, which also facilitates ama’s release. Dilating the body’s internal channels creates a freer pathway for the removal of toxins and waste products. As ama leaves, rigidity and stiffness in the dhatus is reduced, giving the body greater flexibility and suppleness.
Primary Types of Swedana Used in Purvakarma
Swedana assists and enhances the process begun with snehana. Many types of swedana exist, but the two primary forms used during Panchakarma’s preparatory procedures are nadi and bashpa swedana.
Nadi Swedana: Penetrating Heat
Nadi, which means “tube,” uses steam from an herbal water decoction. In ancient times steam was created in a clay pot and administered to the surface of the body through a bamboo tube. Today, this process is facilitated by the use of a pressure cooker and a nylon reinforced plastic hose which eases the steam’s application to the body’s surface. Nadi is a more penetrating type of wet heat than bashpa, because the steam actively drives the heat and oil (from bahya snehana) deep into the tissues through the pores of the skin.
Although this type of steam treatment is given to the whole body, it focuses on the thick and complex structures of the joints to improve their mobility. Nadi swedana usually lasts for five to seven minutes. Outside the Panchakarma process, it can be used with snehana for reducing pain, muscle spasm and rigidity in localized areas. This treatment can be very helpful in the palliative management of backache, inflammation of the spine, hip and knee, and for generalized muscle pain.
Bashpa Swedana: Steam Bath
Bashpa, the second type of agni swedana, generally follows immediately after nadi swedana is administered. Bashpa literally means “steam” and unlike the more directed form of heat used in nadi swedana, bashpa applies steam evenly to the entire body. Bashpa swedana uses a sweat box, in which the patient either sits or lies down on his back. Every part of the body is exposed to the steam except the head, because it cannot tolerate high temperatures. In fact, a technician continuously places cool compresses on the forehead during the treatment to maintain the head’s normal temperature. To avoid dehydration, the patient is given a glass of water before administering bashpa swedana.
These small, one-person steam baths are normally constructed of wood with a thermostat that allows their temperature to be easily controlled. Herbal steam is released into the box according to the needs of the patient. The duration of treatment is seven to ten minutes, or until sweat begins to bead on the face and forehead.
The signs of effective and complete swedana include sweat, a reddish color to the skin and warmth in the body, with no chill or stiffness. The patient should feel light and more enthusiastic, as the heat liquefies ama and its heaviness decreases. It is important not to apply excessive heat, as this aggravates pitta dosha. Signs of too much heat include increasingly red skin, faintness, giddiness, exhaustion or feeling burning hot. Breathing difficulty may appear in extreme cases. To counteract theses symptoms and reduce body temperature, the patient can be given cool liquids to drink.
Though bashpa swedana is an important preparatory procedure, it is not appropriate for people with heart disease or hypertension, since the heat may cause a rise in heart rate and blood pressure. Individuals with blood disorders, such as anemia or leukemia, also cannot tolerate the temperatures used to induce a full body sweat during bashpa swedana. In such cases, nadi swedana may be used because its penetrating heat is milder and has only a localized effect.
The procedures of snehana and swedana are essential to the success of Panchakarma’s five main eliminative treatments. The process of purification needs snehana’s internal and external oleation to penetrate the deep tissues and liquefy ama. It needs swedana’s heating effect to dilate the body’s channels, mobilize the doshas and facilitate ama’s extraction and transport back to the gastrointestinal tract.
Without these two procedures, toxins would not be available for complete disposal. If the elimination procedures are attempted without proper preparation, only the most superficial layers of the body are cleansed and the process could place undue stress on the body’s tissues. For example, if someone takes a purgative without preparation, it removes only the ama in the gastrointestinal tract from the past forty-eight hours. It is similar to trying to squeeze juice from an unripened fruit. The fruit does not produce juice, and is so damaged in the process that it may not be able to ripen and give juice in the future. The preparatory procedures “ripen” or prepare the body in a way that insures that no harm is done to the underlying structures and substances of the body during the cleansing process.
Once the dhatus give up their accumulated toxins and wastes and the doshas successfully transport them back to the gastrointestinal tract, the body must eliminate these wastes through the closest orifice. This is the job of the second stage of Panchakarma therapy.