Module on “Pizhichil and Kayaseka: Exploring Traditional Ayurvedic Therapie” Talk By- Dr. Rajkala P. Patil

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   Pizhichil and Kayaseka:
Exploring Traditional Ayurvedic Therapie   

   Dr. Rajkala P. Patil   
Head & Associate Professor,
Department of Panchakarma,
Faculty of Ayurveda, IMS, BHU, Varanasi

  Introduction:      

Kayaseka is a traditional Ayurvedic oil application technique that involves the careful and gentle administration of warmed oil to the body or specific areas. This practice is conducted in a systematic and precise manner, following a predetermined method and duration. The term “Kayaseka” can be broken down to “Kaya,” which means body, and “Seka,” which means pouring or administering. It essentially refers to the process of pouring or applying oil to the body.

One of the primary purposes of Kayaseka is to provide oleation, known as “snehana” in Ayurveda. Oleation involves the application of oil to the body, and it is an integral part of many Ayurvedic therapies. The oil is chosen based on the individual’s constitution (dosha), specific health concerns, and the intended therapeutic effect. Through the application of oil, Kayaseka helps nourish and lubricate the tissues, promoting flexibility, relaxation, and overall well-being. The warm oil is believed to penetrate deep into the skin, muscles, and joints, aiding in the removal of toxins and promoting a sense of balance in the body. Simultaneously, Kayaseka also induces sweating, which is referred to as “swedana” in Ayurveda. Sweating is a natural way for the body to eliminate waste products and toxins. By using the warmed oil, Kayaseka helps open the pores of the skin, facilitating the release of impurities through sweat. This dual action of providing oleation and inducing sweating makes Kayaseka a valuable therapeutic technique in Ayurveda.

Pizhichil, on the other hand, is a refined and advanced variation of Kayaseka that was innovatively developed by Keraleeya vaidyas, who are traditional Ayurvedic practitioners from the Kerala region of India. Pizhichil is a specialized and highly regarded therapy in Ayurveda and is often considered a royal treatment due to its unique approach.In Pizhichil, the warm oil is poured and massaged over the entire body in a rhythmic and synchronized manner by skilled therapists. This continuous and controlled flow of oil is performed for a more extended period than traditional Kayaseka. Pizhichil is characterized by the use of a considerable amount of oil, and it is typically administered by two therapists working in unison. Pizhichil retains the fundamental principles of Kayaseka, offering the benefits of oleation and swedana. The prolonged and luxurious nature of Pizhichil provides a deeply relaxing and rejuvenating experience. It is often recommended for conditions related to the nervous system, musculoskeletal disorders, and certain chronic health issues. This therapy is known for its ability to promote mental and physical relaxation, alleviate stress, and enhance overall vitality.

In summary, both Kayaseka and Pizhichil are traditional Ayurvedic therapies that involve the gentle application of warmed oil to the body. While Kayaseka is a general technique that combines oleation and swedana, Pizhichil is a more specialized and elaborate version of this practice, characterized by its use of a larger quantity of oil and a longer duration. Both therapies are used in Ayurveda as synonyms of snigdha sweda done for whole body.

  Indications:    

  1. Neurological Disorders: Kayaseka and Pizhichil is highly effective in the management of neurological conditions. The warm oil, when applied to the body, has a soothing and nourishing effect on the nervous system. It can be beneficial for individuals with conditions such as:
  • Neuropathy: Kayaseka and Pizhichil can help improve nerve function and alleviate symptoms associated with neuropathy, such as numbness, tingling, and pain.
  • Paralysis: It is often used as a part of comprehensive Ayurvedic treatments for individuals with paralysis to enhance muscle tone, circulation, and overall mobility.
  • Multiple Sclerosis (MS): In some cases, Kayaseka and Pizhichil may be recommended as complementary therapy for individuals with MS to alleviate symptoms and promote relaxation.
  1. Prevention of Degenerative Changes: Kayaseka and Pizhichil is not only used for therapeutic purposes but also for preventive healthcare. It can be utilized to prevent degenerative changes in the body, especially in the context of aging. The regular application of warmed oil can help:
  • Maintain Joint Health: By lubricating the joints, Kayaseka and Pizhichil helps reduce the risk of joint stiffness and arthritis.
  • Prevent Muscle Atrophy: It can promote muscle strength and reduce the risk of age-related muscle atrophy.
  • Improve Skin Health: Kayaseka and Pizhichil helps keep the skin supple, reducing the signs of premature aging and dryness.
  • Enhance Overall Vitality: The rejuvenating qualities of the therapy can help individuals maintain their vitality and energy as they age.

Classical reference: Cha.Chi.29/123

These therapeutic procedures are part of the broader Ayurvedic approach to managing Vatarakta, and they are tailored to the specific doshic dominance in each case. Ayurvedic treatments are highly individualized, and the choice of treatment methods, including oil (ghrita) and liquid (amla dravya) applications, depends on the patient’s unique constitution, the nature of the disease,

  • Koshna Sarpi Seka for Vatapradhana Vatarakta:
    “Koshna Sarpi seka” refers to the therapeutic procedure of use of warm ghee (clarified butter) to the whole body. This treatment is specifically recommended for “Vatapradhana vatarakta.”
  • Amla Dravya Seka for VK Pradhaan Vatarakta:
    “Amla Dravya seka” refers to the application of sour substances or acidic liquids to the whole body. This treatment is recommended for “Vata Kapha pradhaan Vatarakta.”

  Clinical Indications of Kayaseka and Pizhichil:   

  • Mostly in all vata-predominant diseases
  • Paralysis
  • Hemiparesis
  • Neurological diseases
  • Spinal injuries
  • Autoimmune diseases
  • Psychological diseases

  Contra-indications of Kayaseka and Pizhichil:   

  • Amavastha of any disease indicated for shodhana
  • Recurrent rhinitis
  • Allergic rhinitis
  • Fever (Pyrexia)
  • Inflamed skin
  • Kaphaja Vikara

  Materials required:  

  • Suitable oil-3 litres
  • Cotton cloth (40 cm x40 cm)- 4
  • Vessels (5 liters) -3
  • Soft towels- 2
  • Oil for talam- 10 ml
  • Rasnadi choorna-5 g
  • Gauze (60 cm) –1
  • Earplugs-2
  • Hot waterbath-1
  • Coconut leaves/tongue cleaners-2
  • Gandharvahastadi kashaya- 90 ml
  • Medicated water- Q.S.
  • Masseurs -2
  • Attendant – 1

  Pre-operative procedure  

  1. Positioning the Patient: The patient is instructed to sit on a “droni,” which is a traditional wooden table or platform used in Ayurvedic therapies. The patient should have their legs extended, meaning their legs are stretched out in front of them. This position is typically adopted for certain treatments where the patient is seated and treated.
  2. Clothing: The patient is advised to wear a minimum amount of clothing. This is often recommended to allow for easy access to the areas of the body that need to be treated. The minimal clothing ensures that the therapeutic substances can be applied directly to the skin without any obstructions.
  3. Application of “Talam” with Oil/Choorna: “Talam” refers to a medicated paste or substance that is applied to the body. This paste can be a combination of various herbs and oils or other ingredients, and it is selected based on the specific therapeutic requirements of the patient. The “Talam” is applied along with a suitable oil or “choorna” (powder). The choice of oil or powder, as well as the composition of the “Talam,” is determined by the Ayurvedic practitioner, taking into consideration the patient’s health condition and the desired therapeutic effects.
  4. Karnapoorana: “Karnapoorana” involves the application of medicated substances or oils to the ears. It is a common practice in Ayurveda and can be beneficial for various health issues, including ear-related conditions and general relaxation.
  5. Gauze Tied Around the Head: A piece of gauze or cloth is tied around the patient’s head above the eyebrows. It can help prevent any substances applied to the head from dripping down onto the face or into the eyes.
  6. Ears Plugged with Cotton: The patient’s ears are plugged with cotton. This is done to prevent the entry of any substances into the ear canal, and it can also provide a sense of comfort and relaxation during the treatment.
  7. Mild Abhyanga (Oil Application): A mild abhyanga or oil application is performed on the patient’s entire body. This oil application is typically gentle and can help in preparing the body for further treatments.

  Procedure  

Heating the Oil: The first step involves heating the oil in a vessel. To maintain the appropriate temperature, the vessel is typically placed in a hot water bath. This method allows for controlled and gradual heating, preventing the oil from becoming too hot and ensuring it remains within the ideal temperature range of 42°C to 45°C. This warm temperature is crucial for the oil to be comfortable and effective in its application.

Application Technique: Masseurs use cloth pieces, held in one hand, to gently squeeze the warm oil onto the recipient’s body. This technique allows for a controlled and consistent flow of oil. The masseurs typically use their thumb to control the flow, with the thumb facing downward. The choice of cloth pieces and the control of the flow are essential for ensuring the even distribution of oil and for adapting to the recipient’s specific condition.

Seven Positions:
The Seka process is carried out in seven specific positions:

  1. Sitting
  2. Supine (lying on the back)
  3. Right lateral (lying on the right side)
  4. Returning to the supine position
  5. Left lateral (lying on the left side)
  6. Returning to the supine position
  7. Sitting

Each position has its unique significance and therapeutic benefits, and the order of these positions may vary based on the specific treatment.

Prone Position: While the primary seven positions are mentioned, the text also notes that the prone (belly-down) position can be adopted if necessary.

Collecting Excess Oil: During the seka process, excess oil may flow out and can be collected for later use. This is done to minimize waste and ensure that the warm oil continues to be available for the treatment.

Gentle Massage: After the oil is streamed or poured onto the body, a gentle massage is administered along the path of the flowing oil. This massage enhances the therapeutic effects of the seka treatment, promoting relaxation, improved circulation, and the absorption of the warm oil into the skin and underlying tissues.

Note:
Since the medicated oil is quite expensive, it’s advisable to extend its use over several days, ensuring that it remains effective.

  1. Use the same medicated oil for three consecutive days, removing any sediments each day.
  2. To preserve the oil, ensure that all moisture is removed.
  3. Add a small quantity of fresh oil to the existing batch to maintain its volume.
  4. On the fourth day, switch to a fresh batch of oil and use it for the following two days.
  5. On the seventh day, both the initial batch and the second batch of oil can be combined and used together.
  6. Kayaseka can also utilize a kernel for the application. In this method, the oil is filled into the kernel and then poured onto the body. Before application, it’s essential to check the oil’s temperature by pouring a small amount onto the therapist’s own hand to ensure it’s comfortable and safe for the recipient.
  7. It’s worth noting that modern equipment with automated temperature control is currently under development, making the process even more convenient and precise.

  Height of Dhara:  

  • Dhara for head- 3 inches/ 4 fingers from head above
  • Dhara for other parts of the body- 9 inches (12 finger space) from the body
  • Pouring from too low height or too short a period may worsen the condition of the patient

Selection of Sneha- according to Dharakalpa:

  • Vata Dosha- Tila Taila
  • Pitta Dosha- Ghrita
  • Kapha Dosha- Tila taila
  • Rakta dosha- Ghrita
  • Vata+Pitta +Rakta- Ghrita + Taila in equal part
  • Vata+Kapha+Rakta- ½ part Ghrita+ 1-part Tila taila

Period for Changing the liquids:

  • Milk- Every day
  • Dhanymla- 3 days
  • Oil- 3 days (7th day – both oils first and second half should be mixed and used for dhara)

A. Taila According to Dosha:

  1. For Vata Dosha:
    Prabhanjan Vimardana Taila
    Vatashanai Taila
    Dhanvantar Taila
    Narayana Taila
    Maha Narayana Taila
    Dashamula Taila
    Nirgundi Taila
  2. For Pitta Dosha:
    Kheerbala Taila
    Pinda Taila
    Chandan Bala Lakshadi Taila
    Nalpamaradi Taila
  3. For Kapha Dosha:
    Kottamchukadi Taila
    Sahacharadi Taila
    Dhanwantara Taila
    Saindhvadi Taila

B. According to disease (Specific Health Conditions):

  1. Amavata: Brihat Saindhavadi Taila, Saindhvadi Taila, Narayan Taila
  2. Sandhivata: Mahanarayan Taila, Panchaguna Taila, Dashamula Taila
  3. Kitibha: Ayappal Kera Taila, Eladi Kera Taila, Marichadi Taila
  4. Pakshaghata: Mahamasha Taila, Vishagarbha Taila, Prasharini Taila
  5. Mamsa Kshaya: Bala Taila, Niramisa Masha Taila
  6. Sutika Roga: Ksheerabala Taila, Dhanwantharam Taila
  7. Bala Roga: Vatashani Taila, Chandan Bala Lakshadi Taila

Kashaya decoction for Dhara

  • Vataj disease- Bala decoction, Dashmoola decoction
  • Pittaja Roga- Chandana Phanta, Ushira decoction, coconut water, Milk, Ghrita
  • Kaphaja- Aragwadha Decoction, Musta decoction, Manjisthadi decoction

The post-operative procedure of Kayaseka and Pizhichil:

  1. Oil Removal: After the treatment or surgery, any residual oil on the body is wiped off. This is typically done using coconut leaves or tongue cleaners. This step is essential to remove excess oil and any medicated substances that may have been applied during the treatment.
  2. Body Cleansing: To further cleanse the body, a soft towel is used to gently wipe away any remaining traces of oil and residue. This step helps the patient feel clean and comfortable.
  3. Talam Removal: “Talam” typically refers to a medicated paste or substance that may have been applied to the head during the treatment. This talam is removed, and any excess oil or residue on the head is cleaned.
  4. Application of Appropriate Choorna: Following the removal of the talam, an appropriate “choorna,” such as Rasnadi choorna, is applied to the head.
  5. Drinking Gandharvahastadi Kashaya: The patient is provided with a medicinal herbal decoction known as Gandharvahastadi Kashaya to drink. This decoction is typically prescribed to remove the kleda or waste generated in body by liquifying dosha by swedana.
  6. Rest: After consuming the Kashaya, the patient is advised to rest for half an hour. This rest period allows the body to absorb the effects of the treatment and the herbal decoction.
  7. Bathing: Following the rest, the patient is recommended to take a bath. The head bath is done using a decoction of amalaki (Indian gooseberry), which is known for its nourishing and cleansing properties. The body bath is performed using warm water or medicated decoction as per condition of the patient.

Duration:
45 minutes-1 hours for 7, 14 or 21 days.

Time of procedure:
7-11 am or 4-6 pm

Precautions:
1. Temperature should be maintained at the same level throughout the procedure.
2. Stream should be uniform and continuous.

Complications:
1. Fainting- stop the procedure and treat accordingly.
2. Fever-stop the procedure and treat accordingly.
3. Hypotension, Giddiness, Fatigue- treat accordingly.
4. Burns- Shatadhouta Ghrita application

Special references from Dharakalpa
Specifications of Dharatable

Woods of medicinal plants used for Dhara table: The table is made up of woods of medicinal plants like

  • Plaksha (Ficus Lacor),
  • Udumbar (Ficus glomerata),
  • Chandana (Sandalwood),
  • Varuna (Crataeva nurvala),
  • Devadaru (Cedrus deodara),
  • Ashoka (Saraca Asoka),
  • Amra (Mangifera indica),
  • Nimba (Azadirachta Nimba),
  • Bilwa (Aegale Marmelos),
  • Arjuna (Termainalia Arjuna),
  • Khadira (Asia Catechua),
  • Agnimantha (Clerodendrum phlomidis)

Specifications
The foot end of the table consists of an orifice or a tapered opening through which the liquid is poured over the patient’s body and flows down into a collection vessel. This collected liquid can be reheated and reused for the Dhara until the completion of treatment duration.

Head end

Similarly at the head end, there is an elevation for headrest which forms a bridge between an elongated portion of the table meant to accommodate the rest of the body from a small chamber (portion of table) which is extended behind the head end.

Head part

The medicines poured on the head as a part of Shirodhara collects in this chamber and flows back into an orifice or tapered opening at its center a few inches away from the crown of the head and gets collected in another collection pot. This too can be recycled and reused just like the liquid of Sarvanga Dhara is done

Dhara dosha

If dhara is done from very height, fast, slow then it may produce

  • Murccha,
  • Shula, Chardi
  • Raltapitta
  • Jwara (Dharakalpa)

Management of Dharadosha

  1. Gandusha: A therapeutic practice involving mouth rinsing.
  2. Nasya: A nasal administration technique.
  3. Shunthi Kashayapana: Consumption of a ginger-based herbal decoction.
  4. A light evening meal, accompanied by a pepper-infused broth.
  5. On the third day, a basti (enema) treatment combined with saindhava (rock salt).
  6. In contemporary times, fully automated Shirodhara devices are accessible, allowing for precise customization of parameters such as temperature, quantity, drip rate, duration, and oscillation according to the patient’s needs.

  10 multiple-choice questions on Kayaseka, Pizhichil:      

  1. What does the term “Kayaseka” in Ayurveda refer to?
    A. A type of meditation technique
    B. Pouring or administering oil to the body
    C. An herbal drink
    D. A form of yoga
    Answer: b. Pouring or administering oil to the body
  1. What is the primary purpose of Kayaseka in Ayurveda?
    A. Inducing vomiting
    B. Promoting sleep
    C. Providing oleation and inducing sweating
    D. Reducing body weight
    Answer: c. Providing oleation and inducing sweating
  1. What is the key difference between Kayaseka and Pizhichil in Ayurveda?
    A. Pizhichil uses cold oil, while Kayaseka uses warm oil.
    B. Pizhichil involves a rhythmic and synchronized massage.
    C. Kayaseka uses more oil than Pizhichil.
    D. Pizhichil is a meditation technique.
    Answer: b. Pizhichil involves a rhythmic and synchronized massage.
  1. In Ayurveda, what is “Talam” used for in the pre-operative procedure of Kayaseka and Pizhichil?
    A. Body cleansing
    B. Plugging the ears
    C. Applying to the head
    D. Drinking
    Answer: c. Applying to the head
  1. What is the primary reason for removing sediments from the medicated oil used in Kayaseka and Pizhichil?
    A. To enhance the aroma of the oil
    B. To prevent the oil from getting too hot
    C. To ensure the oil remains effective
    D. To add fresh herbs to the oil
    Answer: c. To ensure the oil remains effective
  1. Which dosha type is recommended to use Tila Taila for Kayaseka and Pizhichil in Ayurveda?
    A. Vata Dosha
    B. Pitta Dosha
    C. Kapha Dosha
    D. All dosha types can use it
    Answer: a. Vata Dosha
  1. What time of day is generally recommended for the Kayaseka procedure in Ayurveda?
    A. Late at night
    B. Early morning
    C. Afternoon
    D. Anytime during the day
    Answer: b. Early morning
  1. In Ayurveda, what should be applied to the ears as part of the pre-operative procedure for Kayaseka and Pizhichil?
    A. Oil
    B. Cotton
    C. gauze bandage
    D. Powder
    Answer: b. Cotton
  1. What is the significance of tying gauze around the patient’s head above the eyebrows in Ayurvedic treatments?
    A. To prevent hair from getting oily
    B. To improve vision during the procedure
    C. To prevent substances from dripping onto the face
    D. For decorative purposes
    Answer: c. To prevent substances from dripping onto the face
  1. What is the preferred duration for Kayaseka and Pizhichil procedures in Ayurveda?
    A. 10-15 minutes
    B. 30-45 minutes
    C. 1-2 hours
    D. It varies depending on the patient’s condition
    Answer: b. 30-45 minutes

  References:   

1. Agnivesha, Charaka, Charaka Samhita with commentary of Chakrapani Datta, edited by Vaidya Yadavaji Trikamji Acharya, published by Chaukhamba Krishnadas Academy, Varanasi, Reprint 2010

2. Sushruta, Sushruta Samhita with commentary of Sri Dalhanacharya edited by Aryan Ram Acharya “Kavyatirtha”, published by Chaukhamba Orientalia, Varanasi, Reprint 2009

3. Vagbhata, Ashtanga Hridya with the commentaries Sarvangasundara of Arundatta and Ayurveda Rasayana of Hemadri, edited by Pandit Hari Sadasiva Sastri Paradakara Bhisagacarya; Chaukhamba rientalia, Varanasi, Reprint -2011.

4. Krishna Vaidyan KV, Pillai SG, Editors. Sahastrayogam with Sujanpriya commentary, Chapter 13, Dharakalpa. 26th Edition. Alapuzha; Vidyarambham Publishers, Mullakkal; 2006. pp.472-481

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