Therapeutic activity in Ayurveda (आयुर्वेदे कर्म)

Therapeutic activity of herbs or food articles or any other medicinal substance (द्रव्यम्) is known as Karma (Samskrit: कर्म) in Ayurveda. The term Karma literally means action, work, deed. Thus activity carried out by substances is called as karma. The karma of any substance decides what kind of change it will bring out in the body when it is consumed. This change is also dependent of few other factors like rasa (रसः), guna (गुणाः), veeryam (वीर्यम्), vipaka (विपाकः) and prabhava (प्रभावः) of that substance. However there exists a certain relationship between karma and other attributes of that substance. karma of any substance depends upon its rasa, veeryam, vipaka and prabhava. Substances with certain rasa or veerya have a specific type of karma or therapeutic activity. Thus many a times, karma of a substance is a gross product of its other attributes like rasa, veerya etc.

Etymology

Karma as a word is derived from kri  dhatu meaning to throw/move and the suffix manin

कृ + मनिन् । कर्त्तुः क्रियया यद्व्याप्यते तद्वा कियाव्याप्यं कर्म्मेति केचित् । तत्तु मतभेदन त्रिधा चतुर्धेति विभक्तमुच्यते । (Shabdakalpadruma)

Kri + manin = karma

यत्क्रियते तत् ।

OR

 क्रियते इति कर्म |

That which is done is called as karma. karma here is the action of a dravya (drug).

Karma is one of the padartha (पदार्थाः) amongst the 6 padarthas (dravya, guna, karma, samanya, vishesha and samavaya) explained in Vaisheshika darshana and Ayurveda. Any mechanism or activity which yields a certain outcome is termed as karma.

Definition

Tarkasamgraha, a treatise based of nyaya and vaisheshika darshanas, has defined karma as belows,

चलनात्मकं कर्म। (Tarkasamgraha)

Any kind of movement is identified as karma. Fundamentally it is believed to be of 5 types based on the direction of movement of/in object in space e.g. upward, downward etc.

In Charaka Samhita, karma is defined as below,

संयोगे च विभागे च कारणं द्रव्यमाश्रितम्| कर्तव्यस्य क्रिया कर्म कर्म नान्यदपेक्षते (Char. Samh. 1.52)

Meaning: That which is responsible for amalgamation and separation of a dravya (drug) composition. That transformation which happens in dravya is due to karma, that specific activity is termed as karma. The movement which is initiated by any effort is called as karma(action).

In simple words Acharya Charaka at other place defines karma as 'the activity that is carried out'.

यत् कुर्वन्ति, तत् कर्म (char. sutr. 26.13)

Meaning: The end product of any mechanism or activity is karma(action).

When the term karma is mentioned in our Ayurvedic treatises, it mainly refers to the action of the dravya in our body. However, Ayurveda does identify karma as deeds of this life and past life in the context of topics like Mrtyu, Ayu etc.

The concept of Karma according to Darshana Shastras

Karma is mentioned as one of the shad padartha (dravya, guna, karma, samanya vishesha and samavaya) or Sapta padarthas

According to vaisheshika darshana,

Karma is described as “ekadravyam” that which exists in a single dravya(substance). Karma is also “aguna” which means it is devoid of guna, here there is a difference drawn between guna and karma.

Karma exists wherever there is samyog (union) or vibhaga (separation) in a dravya. The activity which occurs because of samyoga and vibhaga inside a dravya is known as karma.

As per the Vaisheshika darshana, the karma is of 5 types. These 5 types are based on the direction or flow of movement of the object within the space.

उत्क्षेपणापक्षेपणाकुञ्चनप्रसारणगमनानि पञ्च कर्माणि॥ (Tark.)

उत्क्षेपणम् ॥ Utkshepana

ऊर्ध्वदेशसंयोगहेतुरुत्क्षेपणम् | (Tark.)

Meaning, upward or ascendent movement as an action is termed as utkshepana.

अपक्षेपणम् ॥ Apakshepana

अधोदेशसंयोगहेतुरपक्षेपणम्। (Tark.)

Meaning downward or descendent movement as an action is known as apakshepana.

आकुञ्चन ॥ Akunchana

शरीरसंनिकृष्टसंयोगहेतुराकुञ्चनम् (Tark.)

Meaning, that which causes contraction or action of bringing together or closeness is termed as akunchana.

प्रसारण ॥ Prasarana

विप्रकृष्टसंयोगहेतुः प्रसारणम्। (Tark.)

Meaning, that which moves away or expands is termed as prasarana.

गमन ॥ Gamana

अन्यत् सर्वं गमनम्। (Tark.)

Meaning, that which includes all the random movements or actions apart from the utkshepana etc are termed as gamana.

Prashstapada bhashyam describes in brief what all other movements can be included under the type 'Gamana' of krama,

गमनग्रहणाद्भ्रमणरेचनस्पन्दनोर्ध्वज्वलनतिर्यक्पतननमनोन्नमनादयो गमनविशेषा न जात्यन्तराणि । (Prash. Bhas.)

Meaning: Circular movement, purgation, vibration or pulsation, movement like that of fire which is in upward direction but still stationary, falling in sideways/laterally, bending down and raising or lifting are other examples of karmas grouped under 'Gamana'.

Dravya and Karma relatioship

Doshas (दोषाः), the principal body components responsible for health and illness, possess a certain panchamahabhuta (पञ्चमहाभूतानि) composition. When there is a pathological condition or disease formation, these elements (mahabhutas) are either in elevated form or decreased form in that dosha. Thus, when a certain drug (dravya) is to be administered as a therapeutic agent, the one which can bring these elements into balance through its karma is selected. Karma or any therapeutic activity can take place only when the substance possesses the ability to act in this way. This ability is dependent on the gunas (properties) of that dravya (substance) which shares inseparable relationship with the composition (related to panchamahabhutas) of dravya. Thus, the karma (action) is dependent on the composition of the dravya (drug). Thus karma as a concept is widely and importantly applied for the treatment of various diseases and maintaining health.

The Therapeutic activity (karma) of a dravya depends on certain qualities of the dravya which are rasa, veerya, vipaka etc and the panchamahabhuta predominance present in it. The dominant mahabhuta in any substance is largely responsible for its gunas as well as therapeutic activity or karma.

Various types of therapeutic activities (karmas) described in Ayurveda

Even though there are various categories of therapeutic activity based on the site of action, overall effect and end result.

षडविध उपक्रमाः ॥ 6 Primary therapeutic activities

Mainly the therapeutic activity is classified into 6 types. These activities are known as karma of medicinal substances. Specifically these 6 activities are also described as 6 upakramas (basic types of treatments). These are as follows,

लङ्घनम् ॥ langhana (therapeutic Fasting)

यत् किञ्चिल्लाघवकरं देहे तल्लङ्घनं स्मृतम्||

Langhana karma means therapeutic fasting. That which induces laghavam (लाघवम् | lightness) in the body is termed as langhana. Langhanam is advised in kapha dosha increase, presence of ama (the undigested part of food lying in the body in body which can neither be utilized or thrown out leading to disease development), illnesses like jwara (disease having rise in temperature of body as one of the chief symptoms like fever), chhardi (vomiting) etc.

बृहणम् ॥ Bhrimhana (Nourishing therapy)

बृहत्त्वं यच्छरीरस्य जनयेत्तच्च बृंहणम्|

That which causes nourishment to the body in qualitative and quantitative aspects is termed as Bhrimhana (बृहणम्) karma or nourishing therapy. This activity is required when then there is depletion of dhatus like mamsa, meda primarily. It is usually seen in cachexia, chronic illnesses, weight loss etc.

रुक्षणम् ॥ Rukshana (Dryness causing)

रौक्ष्यं खरत्वं वैशद्यं यत् कुर्यात्तद्धि रूक्षणम्||

The therapy which causes dryness, roughness in the body is termed as rukshana karma. This activity is desired when there is excess of unctuousness, over-hydration or excess meda dhatu present in body.

स्नेहनम् ॥ Snehana (Emolliating, hydrating)

         स्नेहनं स्नेहविष्यन्दमार्दवक्लेदकारकम् | (Char. Samh. 22.10)

Snehana is the therapy which provides snighdata (unctuousness) to the skin. Here snehana is done not just externally but internally as well. This procedure is done with the help of ghruta, taila etc. Sneha is believed to be the most important nourishing, strengthening and tissue protective component. Thus when there is excess dryness in body snehanam is advised. It generates not just unctuousness but also imparts softness, moisture and hydration in body.

स्वेदनम् ॥ Swedana (Fomentation)

स्तम्भगौरवशीतघ्नं स्वेदनं स्वेदकारकम् | (Char. Samh. 22.11)

Swedana is a process or therapy by which sweat is produced in our body using various methods. This procedure reduces stiffness, heaviness of the body. The set of dravya which carry out this action are called svedopaga gana dravya (स्वेदोपग गण द्रव्याः). Swedanam helps to reduce stiffness, heaviness and cold in the body. Thus Swedanam is one of the important therapeutic activity required in bone and joint related disorders.

स्तंभनम् ॥ Sthambana (Styptic Therapy)

स्तम्भनं स्तम्भयति यद्गतिमन्तं चलं ध्रुवम् |

The therapy which causes inhibition of bodily movements is termed as sthambana karma. The movement could be of any body component like blood, urine, feces etc. Therefore herbs and formulations having this therapeutic activity are chosen in the treatment of diarrhea, bleeding disorders, polyuria etc considering other relevant factors.

There is not a single heading under which karma can be categorized, but for the better understanding of the concept we can group them under some categories as described below.

पञ्चकर्माणि ॥ 5 karmas (Panchakarmas)

Panchakarma therapy is one of the most popular modality of Ayurveda treatment. In this type of therapy the unwanted excess doshas are thrown out of the body through a certain procedure. There exist 5 types of such methods through which a Vaidya perform kind of detoxification of the body of the patient. Since these are 5 in number and indicate activity or movement of body components in a specific manner outside the body, those are called 'Panchakarmas' (pancha- 5, karmas-therapeutic activities). Following are the panchakarmas.

नस्यम् ॥ Nasya (Errhine therapy)

A therapeutic measure where the medicated oil/ghee/liquid etc is used to administer in the nostrils for elimination of certain doshas located in head and neck region. Thus it is specifically recommended in diseases affecting organs situated in head and neck region.

वमनम् ॥ Vaman (emetic)

              तत्र दोषहरणमूर्ध्वभागं वमनसञ्ज्ञकम् | (Char. Samh. 1.4)

The dravya which emits out the undigested food, dosha orally are termed as emetic dravya and the procedure is termed as vaman. Thus vamana indicates upward movement of doshas and their expulsion through mouth similar to emesis.

विरेचनम् ॥ Virechana (Purgative)

            अधोभागं विरेचनसञ्ज्ञकम् | (Char. Samh. 1.4)

The process in which elimination of undigested food and morbid dosha occurs through anal route is termed as virechana karma. And the dravya which are responsible for it are known as virechana dravya (drugs). Virechana thus refers to the purgation like activity wherein according to Ayurveda scholars, the unwanted excess doshas especially like pitta dosha are excreted out of the body through fecal matter due to the drug administered orally.

बस्तिः ॥ Basti

When the medicinal preparations are administered per anum, to take out the unwanted doshas accumulated in Aantra (the last part of gut, equivalent to intestines) the procedure is called a basti karma. Since in the ancient times, these medicinal preparations were used to be filled in the basti (bladder) of animals (cleaned and prepared in a systematic manner) and then were pushed through the pipe attached to it, the procedure got its name as basti karma. However, in today's era, specially designed syringes, catheters and pouches are used to administer basti.

रक्तमोक्षणम् ॥ Raktamokshana

Blood letting procedure in Ayurveda is called as Rakta (blood) mokshanam (to let). It is described in depth including its preliminary 4 types. It is included under panchakarmas and believed to be the best method to detoxify the impurities in the blood.

विशिष्टानि कर्माणि॥ Activities based on end effect

चक्षुष्यम् ॥ Chakshushya (beneficial for eyes)

The dravya which act by keeping the vision and overall health of eyes in a good state. There is set of specific  dravya(drugs) which are called chakshusya dravya mentioned in our classical treatises. One very basic example here is anjan (medicated collyrium) which is mentioned as chakshushya. It is also called as Netrya (नेत्र्यम्) activity.

केश्यम् ॥ Keshya (promoting hair health)

There are certain set of dravya known as keshya which act to keep hair healthy and promotes good lusture)

वर्ण्यम् ॥ Varnya (Promoting complexion)

Dravyas which act to promote healthy complexion and lusture are varnya dravya.

दीपनम् ॥ Deepan

The dravya which act by kindling the jatharagni(digestive fire) are known as deepan dravya and that process by which it acts is termed as deepana karma.

पाचनम् ॥ Pachana (Digestive)

Pachana means digestive process. The dravya which digests the ama(..) are known as pachana dravya and the process is termed as pachana karma.

अनुलोमनम् ॥ Anuloman

The dravya which removes the morbid dosha through anal route, relieves constipation are known as anulonama dravyas and the process or the karma is termed as anuloman karma.

स्रंसनम् ॥ Sramsana

The dravya which eliminates the digested or undigested food and the adhered doshas through the anal route are sramsana dravyas, and the karma is termed as sramsana karma.

भेदनम् ॥ Bhedana

The dravyas which causes the breakdown of grathit(hardened) mala and removes it through anal route are bhedana dravyas and the process or karma is termed as bhedana karma.

छेदनम् ॥ Chhedana

The dravya which detangles the morbid doshas within themselves are chhedana dravya and that particular action is termed as chedana karma.

लेखनम् ॥ Lekhana

The dravya which causes shoshana(drying up) of dosha and dhatus are lekhana dravya and the action is termed as lekhana karma.

शस्त्रकर्माणि ॥ Shastra Karmas (Activities involved in Surgical procedures)

Shastras are sharp instruments which are used in various surgical procedures.

उत्पाट्यपाट्यसीव्यैष्यलेख्यप्रच्छानकुट्टनम् | छेद्यं भेद्यं व्यधो मन्थो ग्रहो दाहश्च तत्क्रियाः|| (Asht. Hrud. 26.28)

उत्पाटनम् ॥ Utpatana (to extract)

Removal of foreign body or extraction procedure is known as utpatana karma

पाटनम् ॥ Patana (to tear)

The karma which involves cutting or tearing with the help of appropriate shastra is termed as patina.

सीवनम् ॥ Seevana (suturing)

The process of suturing or sealing of a for example wound is termed as seevana karma.

एषणम् ॥ Eshana (probing)

The process of penetrating or probing with the help of a sharp instrument or shastra is termed as eshana karma. (for example, in sinuses, wounds etc)

लेखनम् ॥ Lekhana in surgery (to scrape)

The process which involves scraping

प्रच्छानम् ॥ Prachhan

Scratching, incising, minute puncturing

कुट्टनम् ॥ Kuttana

beating, hitting, pounding

छेदनम् ॥ Chedana

excising, cutting,

भेदनम् ॥ Bhedana

breaking,

व्यधनम् ॥ Vyadhana

Puncturing,

मंथनम् ॥ Manthana

Churning,

ग्रहणम् ॥ Grahana

holding, grasping and

दहनम् ॥ Dahana

burning, cauterizing  are the functions of sharp instruments.