Trividha Karma

Trividham karma-poorva karma pradhankarma paschyatkarmeti || Su.Su. 5/1 

Acharya Dhallana which was the Commentator of Acharya Sushruta has been given explanation above said verse as Snehana, Svedana, Vamana, Asthapana, Anuvasana, Dhupa, Nasya, Kawalagraha, Gandusha, and Deepana, Pachana, Samshamanadi kriya. This is the Chikitsarthvachaka meaning of word Karma. 

Therefore, we will not administer independent karma, and has pre-operative, and post-operative measure should be consider. So, extended Panchakarma procedures i.e. Trividha Karma are as follows- 

(I)Poorvakarma- are three in numbers 1) Pachana, 2) Snehana and 3) Svedana. 

1) Pachana- it is given for Ama. Those medicines are Ama Pachana mentioned in Samhita can be used for Pachana. 

2) Snehana- it is divided into two types Bahya and Abhyanatara. Abhyanatara Snehana is of two categories Vicharana and Acchapeya. Again Sthavara, Jangama are its types. Also, it of so many types according to actions. Vicharana Sneha is Odana, Mansarasa, Yushadi etc. types. 

3) Svedana- firstly it is of two types Anagni and Niragni. Anagni Svedana is subdivided into Vyayama, Ushnasadana, Gurupravarana, Kshudha, Bahupana, Bhaya, Krodha, Upanaha, Aahava (Mushthi Yuddha) and Aatapa. Sagani Svedana is subdivided into Tapa, Upanaha, Ushma and Drava. 

(II)Pradhana Karma- are five in numbers Vamana, Virechana, Basti, Nasya, and Raktamokshana. 

1) Vamana- Procedure of expelling out Doshas through mouth is as called Vamana. According action it is of three types Pravara, Madhya and Avara. 

2) Virechana- Procedure of expelling out Doshas through anus is called as Virechana. Those medicines purifies Mana is known as Virechaka or Rechaka. According to action Virechana is four types Anulomana, Stransana, Bhedana and Rechana. 

3) Basti- The bladder of animals is known as Basti. By the use of bladder medicinal decoction, medicated oils, etc medicines administered through anus into the pakvashaya (large intestine) is called as Basti. According to route viz- through anus into pakvashaya, through vagina and cervix into garbhashaya and through urethra into mootrashaya are three types of Basti. According to type of medicine it is two types Niruha and Anuvasana. Niruha Basti is various types of actions Shodhana, Lekhana, Utkleshana, Bruhana, Shamana, Rasayana, Vajikarana, etc. In Niruha Basti main content is Kwatha or Kashaya so called as Kashaya Basti. Synonym of Niruha is Asthapana. For Basti used Ghrita, Taila etc Sneha. This type of Basti are Sneha, Anuvasana and Matra according quantity of Sneha. Basti given by Uttar marga is called as Uttar Basti. Uttar marga means Uttarvarti to Guda i.e. Medhra or Yoni. Uttar Basti is of two types Niruha and Anuvasana. 

4) Nasya- Drugs administered through nose is called Nasya. Main three types of Nasya are Virechana or Rechana, Bruhana or Tarpana and Shamana. According method of procedure Nasya is five types Navana, Pradhamana, Marsha, Pratimarsha Dhooma and Avapeedana. 

5) Raktamokshana- letting of blood from the body is called as Raktamokshana. Synonym is Raktavisruti. Raktamokshana is of six types Shriga, Jalookavacharana, Alabu, Pracchana, Siramokshana or Siravyadha and Ghatiyantra. 

(III)Paschat Karma- after main procedures body will be in strenuous state, for bringing to normal state those procedure are performed is known as paschat karma. These are three in numbers Sansarjana krama, Rasayanadi krama and Shamana chikitsa. 

1) Sansarjana krama- after Vamanadi procedures clears Agnimandya, but purpose to improve Agnis power, stability and digest heavy food not advise normal food to the patient. Here we advise for Agnibala vardhan Peya, Vilepi, Akruta Yusha, Kruta Yusha, Akruta Mansarasa, Kruta Manasa Rasa, and then normal food. By following slowly slowly this sequence of food is known as Sansarjana krama. 

2) Rasayanadi krama- if Vamanadi procedures are done in the patient as detoxification/ cleansing/purification of the body before starting of Rasayana (Rejuvenation) and Vajikarana (Aphordiastic) treatments, then in paschata karma you advise patient to take these medicines. 

3) Shamana Aoushadhi Prayoga- suppose as per disease condition we have done one of the pradhana karma then we have advise to the patient that take Shamana treatment of that disease in paschata karma.