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Rakta Mokshana as a Panchkarma
Maharishi Charak has mentioned the above mentioned five karmas but Maharishi Sushurut has considered rakta mokshana karma in panchkarma therapy and has included anuvasan vasti and nirooh vasti under vasti karma. Rakta mokshana commonly signifies to venesection or blood letting, to treat disorders caused by aggravated doshas. Maharishi Vagabhatta has accepted and supported this view as mentioned in ashtang hridayam.

One thing is worth mentioning here that Maharishi sushurut has considered four doshas instead of three i.e. vata, pitta, kapha and rakta.

Stambhana karma
Stambhana karma is the method of treatment by which contraction of the part of the body of the constriction of the arteries or other vessels in that part of the body or in the whole body takes place. This is the opposite of swedan karma, whose purpose is to dilate the pores and to lubricate (Snehan), to liquidate (vishyand), to soften (maardava), or to moisten (kleda) the part. Swedanam encourages perspiration. It checks sthambhan (contraction or solidification), heaviness (gauravam) and cold (sheet).

The purpose of stambhana on the other hand is to check movement (sthambhayati yat gatimantham, chalam) by contracting or congealing the opening of the channels.

Things used for causing stambhana
The things used for casing contraction are generally promoting slowness in movement, sheet (cold), mand (slow), soft (mridu), slakshan (glaszy), rookksh (non oily), sooksham (subtle or quickly permeating), dravya (liquid), sthir (steady) and laghu (light).

Soft and cold potters earth, ice, styptic, haemostatic, constipation, anti diuretics (like opium), and anti diaphoretics (like atropine), vaso constrictors (like adrenaline) may all be included under stambhana substances.

Substances which are sweet, bitter and astringent are stmabhak in action.

Person fit for stambhana karma
Those people who have aggravated pitta and presently the same picture as of pitta dominance like buring eyes, having persistent diarrhoea and vomiting. People who are affected by poison, people who sweat excessively or people suffering from similar kind of diseases are considered fit for stambhana karma.

Symptoms for proper stambhana treatment
Following are the symptoms by which application of stambhana karma is recognized: -

  1. The relief by the patient of all the distressing symptoms which he has been previously suffering .
  2. The acquisitation of strength which is easily felt by the patient who had a proper stambhana treatment.
Symptoms of excessive stambhana treatment
Following are the symptoms presented when a person is over treated by stambhana karma.
  1. Black or grey discoloration of the treated part due to excessive venous congestion, necrosis or gangrene
    Stupefaction, loss of sensation or heaviness of the part treated.
  2. Hurried respiration or excitement
  3. Tendency of lock jaw
  4. A feeling of heaviness in heart region.
  5. Constipation.

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