Journal of Yoga & Physical Therapy
Open Access
ISSN: 2157-7595
+44 1478 350008
ISSN: 2157-7595
+44 1478 350008
Review Article - (2023)Volume 13, Issue 4
According to Hata Yoga Pradipika, there are six purificatory procedures (Shatkarma) namely Dhauti, Basti, Neti, Trataka, Nauli and Kapala Bhati which purifies the physical body and specially indicated in increased Kapha and Medo Dhatu condition. Increased Kapha and Medo Dhatu obstruct the srotases which interrupt the flow of Prana (vital energy) and difficult to perform yoga practices especially Pranayama, so these Shatkarmas are usually performed before practicing Pranayama. Dhauti technique gives the best possible wash to the digestive system and controls the functioning of Agni, stops the formation Ama and helps in reduction of accumulation of Kapha and Medas thus leads to prevention of condition of Kapha vitiated conditions like obesity, bronchial asthma and other respiratory tract diseases. In this article a research synthesis has been done from all possible sources to gather the qualitative data regarding effect of Shatkarma and Hrid Dhauti in prevention as well as management of Kapha disorders.
Shatkarma; Kapha; Meda; Dhatu; Obesity; Dhauti
There are three biological humors in the body namely Kapha (mucus), Pitta (bile) and Vata (wind). In Yoga and Ayurveda, they are called Tridosha. A balanced proportion of these three facilitates body functions, but if there is an excess of one and a shortage of another, then ailments will develop. Before commencing pranayama, any imbalance in the Doshas should be removed-excess body fat should be reduced, mucus blocking the respiratory tract should be removed, gas in the stomach and intestines eliminated, etc. In Hatha Yoga, there are six particular practices which were specifically designed for this purpose. They are called Shatkarma, shat is 'six', and karma is 'action'. These techniques regulate the production of the Doshas [1].
Aim of Hata Yoga
If the Doshas are already balanced there is no need to practice the Shatkarma. However, they should be learned, simply so the Sadhaka will know how to practice them if they are needed. If they are practiced unnecessarily, as a part of one's daily Sadhana, they will not be so effective when genuinely required. Just as you would not have your tonsils or appendix removed if they were functioning perfectly, similarly, the Shatkarma are really only for those people who have disturbances or imbalances in the Doshas. In the Hahta Yoga Pradipika the first thing we see is that Swatmarama does not worry at all about self-control and selfdiscipline in the form of Yama and Niyama. The order here is very different. He begins by saying that you should first purify the whole body-the stomach, intestines, nervous system and other systems. Therefore, Shatkarma comes first, i.e., Neti, Dhauti, Basti, Kapaala Bhati, Trataka and Nauli. Hahta yoga begins with these practices. However, Shatkarma alone does not constitute the whole of hatha yoga. After Shatkarma one should practice asana and pranayama. Self-control and self-discipline should start with the body. That is much easier. Asana is discipline; Pranayama is discipline; Kumbhaka (retention of breath) is self-control.
Shatkarma
The purification is acquired by the regular practice of six practices [2]. There are six purificatory procedures-Dhauti, Basti, Neti, Trataka, Nauli and Kapalbhati; these are called as Shatkarma or the six cleansing processes. Hatha Yoga is famous for these six cleansing techniques. Although only six in number, each has a variety of practices.
Dhauti, stands first, literally it means washing or cleansing, which is of four kinds. According to the Gheranda Samhita they are called Antardhauti (internal washing), Danta Dhauti (cleaning the teeth) Hrid Dhauti, (cleaning the heart) and Moola Shodhana (rectal cleaning).
Antar Dhauti is divided into four practices: Vatasara Dhautiexpelling air through the anus, Varisara Dhauti- evacuating a large quantity of water through the bowels, Vahnisara Dhautirapid expansion/contraction of the abdomen, Bahishkrita Dhauti- washing the rectum with the hands.
Hrid Dhauti is divided into three practices: Danda Dhautiinserting a soft banana stem into the stomach, Vastra Dhautiswallowing a long thin strip of cloth, Vamanaa Dhautiregurgitating the contents of the stomach. The last practice of Dhauti-Moola Shodhana can be performed in two ways. It is done either by inserting a turmeric root or the middle finger into the anus.
The second karma, Basti is divided into two parts: Jala (water) Basti and Sthala (dry) Basti. In Jala Basti, sucking the water into the large intestine through the anus and then expel it. In Sthala Basti, sucking air into the large intestine.
The third karma, Neti, has four practices: Jala (water) Neti, passing warm saline water through the nose, Sutra (thread) Neti, passing a soft thread through the nose, Ghrita (ghee) Neti, passing clarified butter through the nose, Dugdha (milk) Neti, passing milk through the nose.
The fourth karma is Trataka, which is steady and continuous gazing at a point of concentration. It has two practices Antar (internal) and Bahir (external) Trataka.
The fifth karma is Nauli, in which isolating and churning the abdominal muscles. It has three practices. When the muscles are isolated to the right it is Dakshina Nauli, to the left, Vama Nauli and in the middle it is Madhyama Nauli.
The last karma is Kapalabhati, which has three practices: Vatkrama Kapalbhati, which is similar to Bhastrika Pranayama, Vyutkrama Kapalbhati, sucking water in through the nose and expelling it through the mouth, Sheetkrama Kapalbhati, sucking water in through the mouth and expelling through the nose. These six fundamental cleansing techniques are the most important aspects of Hata Yoga and are the original Hata Yoga. However, today asana and pranayama are more widely known and few people are now proficient in the Shatkarma. These Shatkarma which effect purification of the body are secret. They have manifold, wondrous results and are held in high esteem by eminent yogis. The Shatkarma are said to be secret practices as one must be personally instructed to do them and taught how to perform them and how often, according to individual need. For this a qualified and experienced teacher is essential. Those who sincerely want to learn the Shatkarma will have to find a guru of hatha yoga and they will have to search well because few teachers are expert in Shatkarma.
Hrid-Dhauti (Purification of heart)
Hrid Dhauti, according to the Gherand Samhita, is of three kinds–Danda Dhauti, Vamanaa Dhauti and Vastra Dhauti [3].
Danda Dhauti: The first practice is Danda Dhauti . Although a soft banana stem is traditionally used, the Gheranda Samhita advises that a sugarcane stick or a turmeric root can be used. Either of any thrust slowly into oesophagus and then draw it out slowly. It expels Kapha, Pitta and other impurities [4]. Today, some people use a thin catheter as a substitute.
Vamanaa Dhauti: Vamanaa Dhauti or Vyaghra Kriya is the second practice of Hrid Dhauti [5]. Vamana is 'to vomit', Vyaghra is 'tiger'. Just as a tiger regurgitates its food a couple of hours after eating, in this practice vomiting the food from the stomach three hours after a meal. If it is difficult, one can drink a glass or two of warm saline water and then tickle the back of the throat with the first two fingers to induce vomiting. Traditionally, after performing this practice a sweet milk rice pudding should be eaten. Kunjal kriya is almost identical to Vyaghra Kriya except it is performed on an empty stomach. One can drink two to four glasses of warm saline water and vomit it out. There are no dietary restrictions afterwards [6].
After meals one should drink water up to the throat, then look upwards for a while and vomit it out. This technique is known also as Kunjala, or the gesture of the elephant. The gesture of the elephant means filling your stomach with large quantity of lukewarm water, and then vomits it out without effort.
Benefits of Vamanaa Dhauti are practice of this every day cures diseases of Kapha and pitta [7]. This Vamanaa Dhauti can be practiced in three ways.
Kunjal Kriya : Prepare about two liters of luke warm saline water, by adding one teaspoon of salt per liter water. Stand near a sink or toilet, or outside in a garden, drink at least six glasses of saline water as quickly as possible, until stomach is full, the vomiting urge comes automatically. Bend forward, keeping the trunk horizontally, open the mouth and place the middle and index fingers of the right hand, towards the back of the tongue. This induces the water to gush out from stomach. When water gush stops again repeat the same process, until entire stomach is empty.
Indications of Kunjal Kriya are Kapha disorders, hyperacidity, indigestion, obesity, bronchitis, asthma, cough, cold, bad breath.
Contra-indications of Kunjal Kriya are hernia, high blood pressure, heart disease, stroke, acute peptic ulcers, and diabetes with eye problems. Acharya Vagabhata in Sutrasthana 14/11 suggests that the main aim of treatment of Sthaulya is to balance the aggravated Kapha, Vata to reduce the increased Medo Dhatu. This can better achieve through Kunjalkriya or Vamana Dhauti karma. In human body majority of disease are caused by Ama Dusti. The process of Vamana Dhauti karma mainly acts on Amashaya and Annavaha Srotas. Vamana Dhauti neutralizes the acid balance in stomach thus helpful in counteracting Tivra Jatharagni. This help in reducing the excessive hunger and thirst intern the obesity. Luke warm water pacifies Vata, salt help in liquification of Achadita and Avalipta Dhatugata Ama. Dhatugata Ama is expelled and as a result Dhatvagnimandya is rectified or homeostasis is established, resulting in proper metabolism process. On account of proper logical and rational application of Vamana Dhauti, Samana Vayu in Amashaya regains in normal physiological power causing adequate Annavivechana (assimilation) and Munchana (excretion). Hence the proper formation and expulsion of mala occurs with the help of another Vayu. This ultimately causes agenesis of all Dhatus restricting generation of Medo Dhatu.
Vyaghra Kriya : This is practiced while there is undigested or partially digested food, as compared to empty stomach. The process is same as Kunjal Kriya. This process prevents burdening of intestines with excessive or undigested food.
Gaja Karani Kriya : Drink at least 6 glasses of luke warm saline water till stomach is full, stand with the legs apart, bend forwards and place the hands-on respective knees. Relax the entire body, open the mouth and breath in slowly, making ‘ah’ sound from throat, meanwhile contract upper part of abdomen. At the end of inhalation retain compression of abdomen and exhale on correct method, the water gushes out in a steady stream. This process is practiced in empty stomach. This is known by the name Gajakarani in Hatayoga Pradipika [8]. One has to stimulate Apăna Vayu from downward to upward direction up to Kantha Nala (Sankhini Nadi) and expel the contents of stomach by the thorough practice of this process, it is possible to control all the Nadis, by practitioner of Hata Yoga. It improves digestion helps in hyperacidity of the stomach. Hence beneficial in gastric, hyperacidity and ulcer [9]. By this process, Kapha, Pitta and Kleda are expelled out and cures all kinds of heart diseases. Abdominal gases are relieved. Uropepsin is found increased by Dhautis, more significant by Vastra Dhauti. Hence Dhautis can be used as substitute or adjunct to therapy. Beneficial in asthma, eczema and other allergic to disorders.
Vastra Dhauti: A strip of wet cloth, four angula wide (i.e. seven to eight centimeters) and fifteen handspans (i.e. one and a half metres) in length is slowly swallowed and then taken out, as instructed by the guru. This is known as Vastra Dhauti. The practice described here is actually Vastra Dhauti. Vastra means 'cloth'. This practice must only be performed under expert guidance and in full accordance with the instructions given. The cloth should be finely woven cotton which is unused and clean. Synthetic material should definitely not be used. The cloth must also be trimmed neatly so that no loose threads fray on the sides. It should be no wider than the tongue or it will fold as it passes down the throat, and should be at least one meter in length and no more than a meter and a half.
Benefits of Vastra Dhauti are, it cures abdominal diseases (Gulma), fever, splenomegaly, skin diseases and diseases of Kapha and pitta [10]. If practiced regularly he will be endowed with health, strength and nourishment. It is also beneficial for asthma and bronchitis, stomach ulcers, skin problems and indigestion.
Shatkarma create harmony between the two major Pranic flows, Ida and Pingala, thereby attaining physical and mental purification and balance. They produce the following effects activating and revitalizing the organs, toning up their functions, desensitization, and development of deep internal awareness. The combination of all the practices of Dhauti cleans the entire digestive tract and respiratory tract. It removes excess and old bile, mucus and toxins and restores the natural balance of the body's chemical composition, thus alleviating ailments caused by such imbalances. The various practices help remove infectious bacteria from the mouth, nose, eyes ears, throat, stomach, intestines and anus. The results are a reduction of excess fatty tissue and relief from flatulence, constipation, poor digestion and loss of appetite [11]. Vamana Dhauti karma technique helps in cleansing the digestive system from the stomach to the mouth, preventing indigestion, obtaining the best possible assimilation of nutrients into the body as well as eliminating other digestive ailments, and through this way it can reduce obesity and related disorders [12].
The Vamana Dhauti karma technique gives the best possible wash to the digestive system from the stomach to the mouth. As such it helps remove all diseases of this region which are the result of a build-up of toxins or general impurities. It also helps to eradicate bad breath, the accumulation of phlegm in the throat and sore throats. Kunjal Kriya cannot change your food habits and certainly cannot remove mental and emotional tension. However, it can help to keep the stomach in good order by washing it clean of impurities. The salt water also reduces the secretion of acid from the glands in the stomach. These in general are rendered more efficient thus allowing better digestion of food. All these are important factors in preventing indigestion, obtaining the best possible assimilation of nutrients into the body as well as eliminating other digestive ailments, and through this way it can reduce obesity and related disorders.
Laghu Shankha Prakshalana (LSP) also reduces the bile acid pool resulting in reduced fat and thus it can help to reduce weight [13].
Yoga based colon cleansing have beneficial effects immediately after the practice in patients with chronic low back pain [14].
Sharma et al. [15], stated the Kriyas or purificatory exercises, help eliminate excess mucus, toxins, and impurities from the body. Shatkarmas are not simply physical cleansing exercises, rather utilize specific bodily dynamics, evolutionary life functions, energetic and psychic mechanics in order to remove emotional, mental, and energetic blockages and hindrances. Dhauti karma alleviates the Kapha disorders, hyperacidity, indigestion, obesity, bronchitis, asthma, cough, cold, bad breath and others digestive problems. Enhance Agni, luster, nourishes body, prevent and promote healthy state of body. Therefore, Shatkarma are beneficial for promotion of health as well as prevention of diseases.
Verma et al., concluded that the practice of Kunjal Kriya can helps the people suffering from obesity and to manage obesity in corporate world.
Pokhriyal, study says-Shatkarma practice showed a significant reduction on their serum glucose level and serum cholesterol level. In this pre-post research study a package of Shatkarma techniques (Kapalbhati-daily, Jalaneti-twice in a week, Vamana Dhauti-once in a week) 90 days.
In a study conducted by Kamathya Kumar, impact of the practice of Shatkarma showed a significance reduction on their serum glucose and serum cholesterol level.
Laghu Shankhaprakshalana Kriya can be used safely to clear the bowel in patients with mild to moderate essential hypertension. Here, in our case this Kriya of LSP acts as a deep stimulation for the autonomic nervous system. When the participant lies down in Shavasana after LSP, he enters into a state of still deeper relaxation which leads to parasympathetic dominance and thereby reduction in BP.
Garg, studies concluded that regular practice of Shankhaprakshalana and asana does reduce blood sugar levels, the blood pressure, weight, the rate of progression to the complications, and the severity of the complications.
Pokhriyal, concluded that Laghu Shankhaprakshalana also reduces the bile acid pool, resulting in reduced fat (both triglyceride and cholesterol) absorption for the next several days (Malshe) and thus it can help to reduce weight.
Patients having cough with expectoration were taught Dhauties in the order of Vaman, Danda and Vastra Dhauti. Vamana and Danda Dhauties helped to remove mucoid secretions and acid water from the stomach thus bringing down the amount of expectoration in the longer run. Vastra Dhauti further helped the removal of excessive mucus from the stomach and stimulating the digestive juices. It is postulated that the massaging action of Vastra-Dhauti influences the pepsin secretion and through it, by feedback mechanism, stimulate the adrenocorticoid activity. For chronic constipation and indigestion, Shankhaprakshalana was given once a week. This Kriya washes the whole of the gastro-intestinal tract and stimulates digestion. For effective removal of sputum from the lungs stress was given on Kapalabhati Kriya, concluded that spinal flexibility was found better after LSP than BST (Back pain Special Technique) sessions in a self as control study on 40 in-patients between 25 and 70 years with Chronic Low Back Pain (CLBP).
Guruprasad, study on-Shatkarma beneficial for diabetes, relieves flatulence, constipation. It counteracts the bowel malfunctioning that cause a decrease in the natural cleansing of the intestine due to low grade food, a sedentary life style, and gradual organic brake down. This is treatment for vitiated pitta and Vata Dosha hence by performing Laghu Shankaprakshalana will get control over Vata and Pitta, Sayyad, studies-Yogasanas and Shatkriya for symptomatic management, accepting balanced diet for weight management. Practice of Laghu Shanka Prakshalana (LSP) among obese individuals had an effect on regulating the serum cholesterol, triglycerides, high density lipoprotein, and low-density lipoprotein. It also helps to reduce the body weight and waist hip ratio as well. A study conducted by Shelke et al., on evaluation of efficacy of Kunjal Kriya (Gajakarani) in the management of obesity. It was summarized that Kunjal Kriya (a type of Antardhauti) alleviates the Kapha Dosha and increased Medo Dhatu in obese individuals and controls the obesity. The above evidences support the indications of Shatkarma like Kapha and Medo conditions by Hathayoga Pradeepika.
Hatha Yoga Pradipika recommended practice of Shatkarma for purification of physical body. Purification of physical body is a prerequisite for practice of asana and pranayama. Hatha Yoga Pradipika specially indicated Shatkarma in the conditions of increased Kapha and Medo Dhatu which leads to morbid conditions like obesity, hyperlipidemia, and respiratory tract infections such as bronchial asthma etc. The practice of Dhauti especially Hrid Dhauti is a boon to Kapha disorders as understood by this literary review and also found that the practice of Shatkarma is safe when practiced under the guidance of a trained guru and has role in health and disease.
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Citation: Nimmi AN, Reddy SP , Surendra A (2023) Shatkarma: A Boon to Kapha Disorders Whole System Research to Hrid Dhauti. J Yoga Phys The. 13:398.
Received: 19-Nov-2023, Manuscript No. JYPT-23-28083; Editor assigned: 21-Nov-2023, Pre QC No. JYPT-23-28083 (PQ) ; Reviewed: 05-Dec-2023, QC No. JYPT-23-28083; Revised: 12-Dec-2023, Manuscript No. JYPT-23-28083 (R); Published: 20-Dec-2023 , DOI: 10.35248/2157-7595.23.13.398
Copyright: © 2023 Nimmi AN, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.