विरेचयेत्त्रिर्द्विरथैकशो वा बलं समीक्ष्य त्रिविधं मलानाम्| उरःशिरोलाघवमिन्द्रियाच्छ्यं स्रोतोविशुद्धिश्च भवेद्विशुद्धे||५१||
After ascertaining the strength of the three types of dosha he should be given shirovirechana (errhine) therapy, once, twice or thrice. Appropriately administered shirovirechana gives rise to lightening of the chest and head, clarity of the senses and cleansing of the micro channels of the body. Inappropriate administration leads to adhesion of sticky material in the throat, heaviness of the head and ptyalism.
गलोपलेपः शिरसो गुरुत्वं निष्ठीवनं चाप्यथ दुर्विरिक्ते| शिरोक्षिशङ्खश्रवणार्तितोदावत्यर्थशुद्धे तिमिरं च पश्येत्||५२||
Excessive administration of shirovirechana causes cutting and aching pain in head, eyes, temples, ears and leads to fainting. Excessive administration hazards should be treated with demulcent drinks and medications which are soft and liquid in nature.
For the management of conditions arising out of inappropriate administration of shirovirechana the patient should be given oleation therapy and thereafter strong shirovirechana should be administered. In this manner the Panchakarma therapies are described to ensure happiness in both patient and healthy persons by promoting their strength and longevity and also curing the diseases.
The interval between two courses of any basti etc. (cleansing therapy) should be double the period required for administration of that therapy.[Factors to be avoided during Panchakarma] During cleansing therapies one should avoid excessive sitting, standing, speaking and riding,
शीतोपचारातपशोकरोषांस्त्यजेदकालाहितभोजनं च| बद्धे प्रणीते विषमं च नेत्रे मार्गे तथाऽर्शःकफविड्विबद्धे ||५५||
sleep during day time, sexual intercourse, suppression of natural urges, cooling regimens, exposure to sun, grief, anger and intake of untimely and unwholesome food. Factors responsible for inhibiting enema to enter smoothly: • If nozzle is clogged or inserted obliquely • If rectal passage is blocked by piles, mucus or hard stool