Childhood is very crucial period where child picks up growth and development with respect to physical, physiological and social aspect.Dosha,dushya and mala present in body are identical to adult but present in lesser quantity in children. The diseases that manifesting adult can also manifest in a child but with a lesser involvement of Dosha and with less intensity.1 Dhatri stanya dushti is the main cause for diseases in Ksheerada avastha. Hence Shodana should be done both in dhatri and Shishu. Acharya Kashyapabeing pediatrician advises Panchakarma therapy from first year of life. However in today’s time it is observed that with a certain set of precautions along with proper drug and dose Panchakarmatherapiescan be administered in Baala.

1. PANCHKARMA IN PEDIATRICS
By
Dr. Arun Chhajer
Asst. Professor
Chhattisgarh Ayurved Medical College
Rajnandgaon, Chhattisgarh

3. Pachana
Prior to panchakarma procedure deepana and
pachana should be done for obtaining
niramavastha of doshas. Hot water boiled with
piece of dry ginger or dry coriander can be used
in paediatric patient, it relieves ama (toxic
accumulation) at the level of koshta (abdomen).
Other common formulations used
for pachana in paediatrics are Agnitundivati,
Sankh vati, Trikatu, Sunthi churna, Panchakola etc

4. SNEHANA
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Snehana is the process of oleation of the body by
using medicated oils and ghee internally and
externally. It is an important preparatory procedure
for Panchakarma. Snehana dravyas are classified in
to four types namely ghrita (ghee), taila (oil),
vasa(fat) and majja (bone marrow). Out of these
ghrita is consideredas the best.

5. Procedure
 Snehapana is given to the patient early in morning in the
prescribed dose.
 The dose of Sneha dravya can be assessed by ascertaining
agni bala (digestive power) of the patient, nature of
disease, condition of the body etc.
 Hrasiyasi matra (digested within two hours) is preferred
inpatient with unknown doshas, agni etc.
 On first day usual dose of sneha dravya (tail or ghrita) is
10 to 20 ml, second day and onwards dose should be
fixed after assessing the time taken to digestion.
 Snehapana continue up to samyaka snigdha
lakshanas(symptoms of desired oleation) are observed
and usually it is obtained within 3 to 7 days.
 After snehan karma patient should advice to take hot
water to enhance the digestion, adequate rest, avoid day
sleep.

6. Sneha Kala –
Mridu koshthi – 3 days
Madhyam koshthi – 5 days
Krura koshthi – 7 days
Sneha Pravicharana – 24
Sneha Matra –(According to acharya Charaka)
Pradhana – digest in a day & night (24 hr)
Madhyam – digest in a day (12 hr)
Heena - digest in half day (6 hr)

7. Example -
Abhyantara Snehana
Ashwagandha ghrita
Samvardhan ghrita
Panchgavya ghrita
Ashtanga ghrita
Brahmi ghrita
Abhaya ghrita etc.
Bahya Snehana (Abhyanga)
Mahanarayan Taila
Bala Taila
Mahamasha Taila
Lakshadi Taila etc.

8. Swedana
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• 8 Types of sweda according to Acharya Kashyapa
are Hasta, Pradeha, Nadi, Prastara, Sankar,
Upnaha, Avagaha and Parisheka. After gradual
disappearance of delicacy and appearance of
toughness the sudation of these children should
be increased.
• Bala taila parisheka sweda is given in newly born
according to Acharya Vagbhata.
• Hasta sweda-upto 4 months of age.
• Pata sweda- up to 6 years
• Pradeha- From Age of 4th month onwards

9. • Among above mentioned types following
swedana are commonly employed in pediatric
practice.
• Pariseka -
Pouring of Ushna kwatha, taila, Ghrita,
dugdha, kanji, gomutra etc liquids over the body
from a specific height is known as Pariseka.
Kayaseka is one of the most important
treatments for vata diseases.
This is generally indicated in paralysis,
hemiplegia, Apatantraka, Antarayama,
Bahyayama.

10. • Avagaha Sveda -
A good sized tub is filled with hot
decoction of vata alleviating drugs, milk, oil, meat
soup or water and uncted patient lies in this.
• Nadi Sweda -
The drugs, flesh of dear or birds, Kanji
(Sour drink), Salt, Oil, Urine and milk etc. as per
need are boiled in a big pot with mouth sealed
with a saucer or another pot having a hole
preferably in Centre, which is fitted with a flexible
pipe either resembling trunk of elephant or bent
at three place. The hot vapor Coming out of this
is used for Sudation.

11. SHASHTIKA SHALI PINDA SWEDA (SANKAR SWEDA)
This is the common method of Swedana used in
paediatric patients in which specific part or whole
body made to perspire by the application of
shashtika shali (a variety of rice) In the form of
pottalis (boluses tied in a cotton cloth).

12. • Procedure
Shashtik shali is cooked with milk and
decoction of Bala moola . This cooked rice is to be kept
in pieces of cloth to make pottalis (boluses tied in a
cotton cloth) . Remaining decoction and milk should
be mixed and heated in low temperature to dip the
boluses for warming the Pottali . After creating
pottalis, patient should be massaged with suitable
warm oil and then warm pottalis gently applied . One
must ensure that the heat of the boluses is a bearable
to the patient by Touching them over the dorsum of
their foot. The procedure takes about half to one hour
.After all procedure, body should be wiped off with dry
soft towels and patient advice to take rest for at least
half an hour and then take a bath with warm water.

13. Vamana
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Vamana is a process in which vitiated Dosha
are expelled through the upper route i,e
mouth.
Administration
Vamana is a treatment of choice for kapha
disorders especially in children who have
predominance of kapha. Mridu sadyo Vaman
is advisable. No purvakarma procedures are
required in infancy and early childhood
required because Bala shareera is snigdha.

14.  For Ksheerapa, vamana is administered when baala is
Tripta with stanya.
 For Ksheerannada, vamana is administered when baala
is Tripta with dudha and peya.
 For Annada, vamanais administered when baala is
Tripta with peya and ghrita.
• Application-
• Ksheerada: Apply vaman drug like madan pushpa,
pippali, saindhav, Madhu over the breast of mother
and after it dries up, wash it and then baby is made to
feed which leads to easy vaman.
• Ksheerannada: Administer madan, vacha along with
breast milk.
• Annada: The decoction of madan, vacha with
Saindhav is given for emesis.

15. Indication of Vamana at different age by various
Acharya
Acharyas Age
Vaideha janaka Infancy
Vriddha Kashyapa 4th or 8th month
Kashyapa 6 yrs
According to Kashyapa Vamana therapy is suitable to
the children only after age of 6 years. He describes it to
be best to use the milder potency drugs in small
quantity for the same.

16. • Pradhana Karma
Based in the assessment of
strength and weakness of children and of the
Dosha, decoction is prepared with fruits of
Madana [ 4 anjali (120ml), 3 anjali (90ml), 2 anjali
(60ml)] and mixed with Honey and Rock salt
which is 1/8th of kwatha, then mixed with either
pippali and sarshapa or Patola, arista and vatsaka
or paste of priyangu and madhuka (3gm) to
induce Vamana.

17. Paschath karma
Post vamana following procedures
are to be done.
• Ushnajala prakshalana and kavala .
• Nidra in Nirvata pradesha .
• Shali prepared with Apamarga / Pippali /
Shirisha.
• Ardraka samskaritha jala for pana.

18. Virechan
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The process in which the elimination of Dosha through
the adhobhaga is known as Virechana.
Except kashyapa acharya all others
mentioned baala as ayogya for virechan.
Medicines for Virechana
1. Pathya mixed with pippali and rock salt.
2. Fruit of Aragwadha treated with milk or soup (meat
soup)
3. Trivruta or Triphala mixed with ghrita, vyosa, rocksalt
4. Gandharva taila is best for unctuous purgation
5. Trivruta, draksha and abhaya mixed either with
decoction of dasamula or meat-soup of wild animals or
decoction of draksha or water of appetizing drugs or
cows urine.

19. • Aragwadha is madhura, mrudu and does not
produce much complication. Aruna variety of
trivrit is best in children as it is mrudu.
• If vibandha and daha are associated then,
Aragwadha phala majja with Draksha is
administered for rechana.
Paschat karma:
Post virechana all the procedures as
mentioned under vamana are to be done.

20. Basti
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The karma in which the medicine is administered
through anal canal reaches up to the nabhi
pradesha, kati pradesha, parsva, kukshi churns the
accumulated Dosha and purisha spreads the
unctuousness all over the body and easily comes
out along with the purisha and Dosha is called
basti.
 Among all therapeutic procedures, basti is
superior because it like nectar in both bala and
aged group.

21. Types of Basti (Classified into many ways):
1.Astthapana / Kashaya / Niruha Vasti -
Decoction based enema
2.Anuvasana / Sneha Vasti/ Matra vasti -
Oil based enema
3.Uttar basti - If above basti given by
genitourinary route then called uttar basti.
Kashyapa acharya classified basti into karma,
kala, yoga, Chaturbhdra Kalpa.

22. Classification of basti According to sankhya
Basti No. of Basti
Karma 24 Anuvasan+ 6 Niruha
Kala 12 Anuvasan+ 3 Niruha
Yoga 5 Anuvasan+ 3 Niruha
Chaturbhadra 12 in number
(4 Sneha + 4 Niruha + 4 Sneha)
Commonly used Basti Yogas:
Madhutailika vasti, Bala guduchyadi vasti, Patolanimbadi vasti,
Vaitarana vasti, mustadi yapana basti, Tikta kshira basti.

23. Dose of Basti as per Acharya Kashyapa
Sneha basti Niruha basti
(3 times of sneha)
Age Matra Matra
Upto 3 year 3 karsha(45ml) 9 Karsh
4-5 year 1 pala(50ml) 3 pala
6-11 year 2 prasruta 6 prasruta
17 year and
above
4 prasruta 12 prasruta
Old age Matra is to be decrease

24. Dose calculation of niruha basti as per
different acharyas
Age in year Acc. To charak & vagbhatta (in Prasruta ) Acc.to kashyap (in ml)
1 ½ 50
2 1 100
3 1½ 150
4 2 200
5 2½ 250
6 3 300
7 3½ 350
8 4 400
9 4½ 450
10 5 500
11 5½ 550
12 6 600
13 7 700

25. Age in year Acc. To charak & vagbhatta (in Prasruta ) Acc.to kashyap (in ml)
14 8 800
15 9 900
16 10 1000
17 11 1100
18 -70 12 1200
> 70 10 1000

26. Basti netra size according to the age
Age Size in
Angula(finger)
Increment
per year
Size of the
proximal
opening
1-6 yrs 6 ---- Mudgavahi
7-12 yrs 8 1/3 Kalayvahi
13 – 20 yrs 12 1/2 Kolasthivahi

27. Nasya
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Nasya karma is a therapeutic measure where the
medicated oil, kwatha, svarasa, churna etc are
administered through nose to eliminate the vitiated
Dosha situated in sira for the treatment of
Urdhvajatrugata vikaras.
Types of Nasya: Kashyapa mentioned two types of
nasya; namely Brihana (Purana) nasya and Karshana
(Shodhana) nasya .
Marsha nasya cannot be given below 7 years and after
80 years of age.

28. • In Infants (Kashyapa)
Kaphaja disorders– katu taila with Ghrita and
saindava (2 – 3 drops).
• In Older Children
Kaphavataja disorders – Prishnaparni, pippali,
Apamarga, Ardraka Swarasa, Madhu.
 Specially to breast fed children, mustard oil
or Ghrita mixed with rock salt should be used.
Two or three drops should be instilled in each
nostrils following which the nostrils should be
closed with finger for a short while. With this
shleshma disease of child gets cured.

29. Medicine: Panchendriyavardhan taila,
dhanvantara taila, anu taila, shadbindu taila,
shunthi churna for pradhamana nashya.
Paschaat karma
Sukhoshna jala Kaval
Dhumapana.

30. Rakta- mokshan
Siravyadha variety of raktmokshan is
contraindicated throughout the childhood
period till 16 years. However Jalauka variety of
bloodletting is mentioned and suitable for
children.

31. THANK
YOU…