Navarakizhi or Shashtika Shali Pinda Sweda is a form of sweat inducing massage treatment. It is used to improve muscle strength, rejuvenate and re-energize body. Here, milk and rice are mainly used.
Milk is a well known nutrient to us, so is rice. They form a part of our daily diet. But in this write-up we shall see how these 2 food products are used for treatment purposes, not when taken internally but when applied externally.
The main ingredient in this Kizhi is Navara rice that’s why named Navarakizhi. Navara is a medicinal variety of rice from Kerala which is harvested in 60 days and is used exclusively for treatments in Ayurveda. The Navara rice is cooked in a mixture of cow’s milk and herbal decoctions and tied in the poultice.
Kizhi means poultice in Malayalam (the language of Kerala in South India). In Sanskrit, it is known as Pinda Sweda. There are many varieties of Kizhi in Ayurveda and the name is given based on the ingredients tied within the poultice.
Though it is a sweating form of treatment, often, the term massage is associated with this treatment because sweating is used by massaging.
1. Purvakarma (Pre-treatment procedures): This includes –
▪︎ Preparation of the patient:
The patient is thoroughly examined. The Prakriti (basic constitution) and Vikriti (details of morbidity) are documented in detail. The disease is also examined. After careful assessment, it is decided if Navarakizhi or Shashtika Shali Pinda Sweda is suitable to the disease and diseased or not. The treatment line-up, materials and medicines which need to be used are enlisted.
▪︎ Preparation for the treatment:
Materials needed for the navarakizhi treatment are collected beforehand. They are:
• Shashtika Shali – A special type of rice harvested in 60 days
• Balamula – Roots of Sida Cordifolia
• Big vessels – to prepare Kashayam and to cook rice in processed milk
• Sterile clothes to tie the boluses
• Thicker threads to tie the cloth into bolus after placing leaves in it
• Induction plate for heating
• Sterile napkins or tissue papers for wiping
• For Abhyanga (massage) – Taila (medicated oil), Ghee (medicated ghee) or both suitable to the disease and diseased are collected and stored beforehand. Some effective oils used for Abhyanga are
• For Shiro-Abhyanga (Head Massage): Ksheerabala Taila, Chandanabala Lakshadi Tailam, Shatavari Tailam, Lakshadi Tailam etc
• For Sharira Abhyanga (body massage): Sahacharadi Taila, Ksheerabala Taila, Chandanabala Lakshadi Tailam, Dhanwantara Tailam, Mahanarayana Tailam, Balashwagandhadi Tailam.
• Amalaki churna (fine powder of Indian gooseberry)
• Bandage clothes
• Sterile clothes or sponges to sponge out after treatment
▪︎ Preparation of the Medicine:
Bala mula (roots of Sida cordifolia) is taken in a quantity of 12 pala (576 grams)
The roots should be washed with sterile water thoroughly so as to remove the dirt, mud and dust from them
The roots should then be cut into small pieces
The roots should now be put in a vessel consisting of water in the quantity of 12 prastha (768 tola=9216 grams of water)
The contents are boiled until 3 prastha of liquid (192 tola=2304 grams) remains i.e. ¼ of the taken content should remain
The solid part is filtered out
The Bala kwatha (decoction of bala) is prepared now
The Kashaya is divided into 2 equal parts i.e. each part weighing 96 tola(1152 grams)
To one part of Kashayam, equal portion of milk is added (96tola kashayam + 96 tola milk = 192 tola=2304 grams)
In this mixture of Kashayam and milk, Shashtika Shali (Shashtika rice) is added in a quantity of ½ prastha (32 tola=384grams) and cooked thoroughly
Once the rice is cooked properly, it is grinded into soft mass
8 pieces of sterile clothes cut into dimensions of 18×18 inches each are spread over a table
The cooked rice is divided into 8 equal portions. Each portion is put on once cloth piece each. The clothes are tied into boluses, tightly bound at their upper free ends with thick and strong threads such that the four ends of the cloth are bound with an elevation so as to form hand grips. These hand grips help us to hold the boluses while using them for treatment.
The other half of the Kashaya which had been kept apart is added with equal quantity of milk and kept on mild flame of the stove. The above said 8 boluses consisting of Shashtika Shali are dipped in the hot processed milk
▪︎ Abhyangam (oil massage):
The patient is made to sleep on the table made and meant for conducting massage. Holy hymns are recited and the almighty is worshiped for the welfare of the patient and success of the treatment in terms of providing good relief to him or her.
Massage is an essential part of Shashtika Shali Pinda Sweda. First of all a head massage is given with one of the above said oils. Later a full body massage is given with one of the above mentioned oils. Overall the massage is done for 30-40 minutes.
▪︎ Amalaki Tala-dharana:
A small pre-treatment procedure called Amalaki Tala-dharana is done compulsorily after massage.
On the previous day of Pinda Sweda, Amalaki Churna (powder of Emblica officinalis) 10 tola (120 grams) in quantity is boiled and processed in 20 tola (240 grams) of buttermilk. When being processed it gains semisolid consistency, the contents are grinded and made into a soft mass. It is kept in a cool place for cooling.
This paste is used for Tala Dharana. Tala Dharana means applying the paste on the crown of the head and tie a bandage cloth around it to keep it in position such that the knot occupies the place near the ear.
To do this, a small compartment / cabin with elevated walls is constructed with the paste of Amalaki so as to cover a small area on the crown of the scalp. The space within the wall of the cabin is filled with coolant oils like Chandanabala Lakshadi Tailam etc. Over this, leaf of a plant having a capacity of alleviating Vata like leaf of Nirgundi (Vitex negundo), Eranda Patra (castor leaf) etc is placed. A bandage cloth is wrapped around the construction and the knot is tied near the ear.
Shashtika Shali Pinda Sweda or Navarakizhi is a procedure which includes application of heat to the body of the patient for more than 1 hour. The head might affect the brain and sense organs in due process. To protect these organs, Amalaki Tala Dharana is done. This provides a coolant effect on the body and mind of the patient.
If Tala-dharana is not done, pitta gets aggravated due to heat and the aggravated Pitta causes symptoms like giddiness, burning sensation, feeling of darkness in front of the eyes, fainting etc.
When doing Shashtika Shali Pinda Sweda for a part of the body like low back or lower limb or upper limb or shoulder, we need not tie the Tala-dharana since the heat will be provided for a portion of the body and for a short time.
2. Pradhana Karma (Actual Njavarakizhi massage therapy procedure)
We need at least 4 attendants or masseurs to carry on the treatment in a synchronized and uninterrupted way on either side of the patient. The rubbing or stroking of the Pinda or boluses on both sides of the body (left and right) should be done in a rhythmic way by all the 4 masseurs. They should be trained in such a way that they should be able to efficiently carry out the treatment procedure. 2 masseurs should stand on one side of the patient and the other 2 on other side. We need a 5th person as helper (can have 2 helpers too) who should be standing near the stove on which the vessel consisting of medicated milk along with the dipped Pinda’s (boluses) is kept for constant heating on a mild flame. They will be supplying the boluses dipped in the heated medicated milk to the masseurs. As and when the boluses lose temperature, the masseurs return them to the helpers and in turn receive the other boluses kept in the heated milk. This method is conducted for the prescribed duration without interruption. Care should be taken that neither the bolus nor the body of the patient gets cold at any point of the treatment. This is possible only with a cyclic synchronizing between the main masseurs and the helpers in terms of how they keep changing and exchanging the boluses so as to maintain the heat throughout the treatment procedure. The masseurs should not only be skilled but also should be compassionate towards the patient.
The 7 postures of doing Shashtika Shali Pinda Sweda are, patient in –
• Sitting posture
• Sleeping by facing the roof (supine position)
• Sleeping in left lateral position (towards left)
• Sleeping on tummy (prone position or face downwards)
• Sleeping in right lateral position (towards right)
• Sleeping back by facing the roof
• Sitting posture
The treatment procedure is carried out for 10-15 minutes in each posture. Thus the time duration of the treatment ranges from 70-105 minutes. By the time we finish off this procedure, the patient would be sweating, which gives a sign to stop the treatment. At the same time, the medicine (processed milk) kept on the stove too would have been exhausted.
3. Paschat Karma (Post-treatment procedures)
• After the procedure, the boluses are opened. The rice in the boluses is rubbed gently over the body of the patient for 10-15 minutes. After this, the rice is wiped out with the help of tissue or sterile cloth. Traditionally the leaves of coconut tree or castor plant can also be used to wipe off the remnants on the patient’s body.
• The Tala-dharana is slowly removed; the construction of Amalaki and the containing oil are also removed. The head should be wiped off with a sterile cloth.
• Sponging should be given with a sponge or sterile cloth dipped in hot water so as to remove the oil from the body and head. This is followed by hot water shower.
• Alternatively, a light massage is once again given after the procedure followed by hot water shower. Patient is advised to take a refreshing hot water bath after going home or after a few hours if the patient is being handled as in-patient
• Nitya Virechana – Daily metered dose of purgation with purgative decoctions or oils like Gandharvahastadi Kashayam, Gandharvahastadi Eranda tailam, Nimbamritadi Eranda Tailam etc can be administered if a small amount of detoxification is essential on a daily basis or if morbid Dosha’s need to be tackled (optional and strictly based on the decision of the doctor)
• Discharge – The patient is discharged on daily basis (out-patient) or after the course has been completed (in-patient) after giving proper lifestyle and diet advices along with suitable medicines (oral). The patient is also advised to undergo the treatment twice or thrice in a year.
Duration of the course –
The number of days of Navarakizhi treatment varies from 7-21 days depending on the nature and intensity of the disease.
• Shashti shali pind sweda helps in preventing the degeneration of joint tissues
• Navarakizhi provides lightness within the joints, soft tissues, and muscles by inducement sweat
• Navarakizhi corrects morbidity related to Vata and pitta doshas
• Shashti shali pind sweda enhances flexibility and movement of joints
• Navarakizhi also has an extraordinary relaxing and analgesic effect.
• Navarakizhi enhances color and complexion by up blood circulation within the skin
• The navarakizhi treatment is also used in painful and or degenerative conditions like Osteoarthritis, Myalgia, GB Syndrome, Fibromyalgia, various types of Neuro-muscular and Musculoskeletal diseases.