Concept of shodhana

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1. CONCEPT OF SHODHANA PRESENTER : DR. SAYANTAN BERA 2 nd YEAR P.G. SCHOLAR DEPARTMENT OF PANCHAKARMA D.G.M.A.M.C. GADAG

2. वस्तु निर्देश् प्रस्तावना व्युत्पत्ति निरुक्ति शोधन महत्व शोधन गुण शोधन लाभ शोधन काल स्वस्थ्य शोधन & दोषानुसार शोधन शोधन वृक्ष शोधन योग्य शोधन अयोग्य वर्ज्य विषय दुर्वल पुरुष शोधन शोधनोत्तर चिकित्सा शोधन अतियोग प्रतिकार

3. CONT... CRITERIA TO SELECT A PATIENT FOR SHODHANA IMPORTANCE OF PURVA KARMA BEFORE SODHANA IMPORTANCE OF PASCHAT KARMA AFTER SODHANA PROBABLE MODE OF ACTION OF SHODHANA PROCEDURES DIFFERENCE BETWEEN SHODHANA &PANCHAKARMA DISCUSSION CONCLUSION

4. प्रस्तावना चिकित्सा: याभिः क्रियाभिर्जायन्ते शरीरे धातवः समाः । सा चिकित्सा विकाराणां कर्म तद्भिषजां स्मृतम् ॥ (च.सू-१६/३४) The procedure by which Dhatus are brought into equilibrium condition is termed as Chikitsa.

5. CONT... In a broader sense Chikitsa is divided into two category – 1. Shodhana 2. Shamana

6. CONT... शोधन: शोधनं यत् कुपितान् दोषान् निःसार्य बहिः रोगोशमनं करोति ॥ (अ.सं,सू-इन्दु -१/३७) Shodhana is the method of eliminating the vitiated doshas from the body to pacify the disease.

7. CONT... शमन: न शोधयति न द्वेष्टि समान् दोषांस्तथोद्धतान् । समीकरोति विषमाच्शमनं तद्यथा अमृता ॥ (श.पू-४/२) The drug which brings the normalcy of doshas without elimination & aggravation is known as Shamana .

8. व्युत्पत्ति शोधन = शुध् + णिच् + ल्युट् (शब्दकल्पम) शुध् = शौच ( Clean) Shodhana is derived from ‘ Shudh ’ (clean)

9. निरुक्ति यदिरयेद्बहिर्दोषान् पञ्चधा शोधनञ्च तत् । निरूह वमनं कायशिररेको आस्रविस्रुति ॥ (अ.हृ,सू-१४/६ ) Sodhana is the procedure by which doshas (vitiated) are expelled out from the body. There are 5 types of Shodhana - Niruha , Vamana , Kaya reka , Shiro reka & Asra visruti .

10. CONT... यदौषधं वातादिनन्तः स्थितान् वहिरीरयेत क्षिपेत् तत् शोधनम् । तच्च पञ्चधा, पन्चविधम् । (अरुणदत्त) By which procedure vitiated Vatadi doshas are removed from body is known as Shodhana .

11. CONT... स्थानाद्वहिर्नयेदुर्ध्वमधो वा मलसञ्चयम् देहसंशोधनं तत्साद्देवदालि फलं यथा ॥ (शा. पू – ४/८) The procedure which detaches the accumulation of Mala from their respective places & expel upwards or downwards, is known as Samshodhana . eg – Devadali .

12. CONT... --------- प्रकुपित स्थानात् मलसञ्चयं दोषादीनां सस्थानात उर्ध्वमधो वा वहिर्नयेत् वहि: करोति तद्देहे शरीरे शोधनं कथितम् । (दीपिका,आढ्मल) The Prakupita Dosha leads to Mala sanchaya (accumulated in their respective places), by administering or giving the Shodhana therapy,the accumulated Malas expells out & by this process Sharir shuddhi takes place

13. शोधन महत्व ( WHY शोधन IS BEST?) दोषाकदाचित् कूप्यन्ति जिता लङ्घनपाचनैः । जिता संशोधनर्येतु न तेषां पुनरुद्भव: ॥ (च.सू-१६/२०) दोषाकदाचित् कूप्यन्ति जिता लङ्घनपाचनैः । ये तु संशोधनैः शुद्धा न तेषां पुनरुद्भवः ॥ (अ.स,सू-५/२४) (अ.हृ,सू-४/२६)

14. CONT... The doshas which have been mitigated by Langhana & Pachana , are likely to aggravate once again. But those doshas conquered by Shodhana therapy will never increase again.

15. CONT... समूलंदोषापहारकत्वं संशोधनस्य, लङ्घन पाचनयोस्तु दोषापहरत्वे सत्यपि न संशोधनवत्- दोषहन्तृत्वमित्याह – दोषा इत्यादि । (चक्रपणि दत्त)

16. CONT... The main root cause which is treated by Shodhana , never occurs again. By Langhana , Pachana also the doshas can be treated but sometimes the may aggravated.

17. CONT... ये पूनः संशोधनैः शुद्धस्तेषां न पुनरुद्भव: - उत्थानं न भवति । (अरूनदत्त) Doshas which are expelled out by Shodhana karma will not aggravate again.

18. शोधन गुण मलापहं रोगहरं वलवर्णप्रसादनम । पित्वा संशोधनं सम्यगायुषा युज्यते चिरम् ॥ (च.सू - १५/२२) Elimination of mala Complete cure of disease Increase strength Increase complexion of skin To get long life

19. शोधन लाभ वुद्धिप्रसादं वलमिन्द्रियाणां धातुस्थिरत्वं ज्वलनस्यदीप्तिम् । चिराच्चपाकं वयसः करोति संशोधनंसम्यगुपास्यमानम् ॥ (अ.हृ,सू- १८/६०)

20. CONT... If the shodhana therapies are taken properly, then these benefits are achieving – Increase intelligence Strengthen the sense organs Stability of the tissues Increase digestive power Increase longevity

21. CONT... एवं विशुद्धकोष्ठस्य कायाग्निरभिवर्धते । व्यधयस्चोपशम्यन्ति प्रकृतिश्चनुवर्तते ॥ इन्द्रियाणि मनोबुद्धिर्वर्णाश्चास्य प्रसीदति । वलं पुष्टिरपथ्यं च वृषता चास्य जायते ।। जरां कृच्छ्रेण लभते चिरं जीवत्यनामयः । तस्मात्संशोधनं काले युक्तियुक्तं पिबेन्नरः ॥ (च.सू-१६/१७)

22. CONT... If anyone take the proper sodhana therapy in proper time, then should get these – Elimination of vitiated dosha from Kostha Increase digestive power Curing disease Restoring the normal health

23. CONT... Strengthen the sense organs Nourishes of mind, intelligence & complexion Gaining of strength, nourishment, virility Not affecting by old age & increasing longevity

24. शोधन काल शरत्काले वसन्ते च प्रावृट काले च देहिनाम् । वमनं रेचनं चैव कारयेतु कुशलो भिषक् ॥ (शा. उ. – ३/१) Vamanadi karmas should be done during Sharad , Vasanta or Pravrit rutu .

25. CONT... शीतोद्भवं दोषचयं वसन्ते विशोधयत् ग्रीष्मजमभ्रकाले । घनात्यये वार्षिकमाशु सम्यक् प्राप्नोतिरोगानृतुजान्न जातु ॥ (अ.हृ,सू – ४/३५) The accumulation of dosha arising from Sisir rutu should be expelled out during Vasanta rutu , that arising from Grishma rutu should be expelled out during Abhrakala , that arising from Varsa rutu should be expelled out during Ghanatyaya rutu .

26. CONT... प्रावृट् शुचिनभौ ज्ञेयौ शरदुर्जसहौ पुनः । तपस्यच्च मधुश्चैव वसन्तः शोधनं प्रति ॥ एतनृतन विकल्प्यैवं दद्यात् संशोधनं भिषक् । स्वस्थवृत्तमभिप्रेत्य व्याधौव्यधिवशेन तु ॥ (च. सि – ६/५,६)

27. CONT... Pravrit – Suchi ( ashad ) & Nabha ( shravana ) Sharad – Urja ( kartika ) & Saha ( margasirsha ) Vasanta – Tapasya ( phalguna ) & Madhu ( chaitra )

28. CONT... These three seasons are suitable for the administration of Shodhana therapies. After determining the exact months constituting these above mentioned seasons, the Bhishak should give the appropriate Shodhana therapy to a healthy person. However for a patient, the appropriateness of the time determined on the basis of the nature of the vyadhi .

29. स्वस्थ्य शोधन & दोषानुसार शोधन प्रावृट्काले वातविकाराः घनात्यकाले पित्तविकाराः । घना मेषाः तेषां अत्यय निनाशो यस्मिन् काले स घनत्ययः शरत्कालः । वसन्तदिनेषु वसन्त दिवसेषु श्लेष्माविकाराः प्रादुर्भबन्तिः । ततस्तस्मात् कारणात् शरीरसंशुद्धिः शरीर- संशोधनं वमनादिभि पञ्चभिः स्यात् भबेत् । तत्र बस्तिदानं वातरोगोपशमार्थं क्रियते । शरत्काले विरेचनं पित्तरोगशमनार्थम् । मधुवासरेषु वसन्तदिनेषु वमनं श्लेष्मरोगोपशमार्थं क्रियत इति । (तिसटाचार्य)

30. शोधन वृक्ष अथापरे त्रयो वृक्षाः पृथग्ये फलमुलिभिः । स्नुह्यर्काश्मन्तकास्तेषामिदं कर्म पृथक् पृथक् ॥ वमने अश्मन्तकं विद्यात् स्नुहीक्षीरं विरेचने । क्षीरमर्कस्य विज्ञेयं वमने सविरेचने ॥ इमांस्त्रीनपरान् वृक्षानाहुर्येषां हितास्त्वचः । पूतीकः कृष्णगन्धा च तिल्वकश्च तथा तरु: ॥ विरेचने प्रयोक्तव्यः पूतीकस्तिल्वकस्तथा । कृष्णगन्धा परिसर्पे शोथेष्वर्श:सु चोच्यते ॥ दद्रुविद्रधिगण्डेषु कुष्ठेष्वप्यलजीषु च । षड्वृक्षाञ्छोधनानेतानपि विद्याद्विचक्षणः ॥ (च.सू – १/११४-११८)

31. शोधन योग्य अविपाक अरुचिः स्थौल्यं पण्डुता गौरवं क्लमः । पिडकाकोठकण्डूनां संभवो अरतिरेव च ॥ आलस्यश्रमदौर्बल्यं दौर्गन्ध्यमवसादकः । श्लेष्मपित्तसमुत्क्लेशो निद्रानाश अतिनिद्रता ॥ तन्द्रा क्लैब्यमबुद्धित्वमशस्तस्वप्नदर्शनम् । बलवर्णप्रणाशश्च तृप्यतो बृंहणैरपि ।। बहुदोषस्य लिङ्गानि तस्मै संशोधनं हितम् । उर्ध्वं चैवानुलोमं च यथादोषं यथाबलम् ॥ (च. सू – १६/१३-१६)

32. शोधन अयोग्य चण्डः साहसिको भीरुः कृतघ्नो व्याग्र एव च । सद्राजभिषजां द्वेष्टाताद्विष्टः शोकपीडितः ॥ यादृश्छिको मुमूर्षच्च विहीनः करणैश्च यः । वैरी वैद्यविदग्धच्च श्रद्धाहीनः सुशङ्कित: ॥ भिषजामविधेयश्च न उपक्रम्या भिषग्विदा । एतानुपचरन् वैद्यो बहून् दोषान्वाप्नयात् ॥ एभ्या अन्ये समुपक्रम्या नराः सर्वरुपक्रमैः । अवस्थां प्रविभज्येषां वर्ज्य कार्य च वक्षते ॥ (च. सि – २/४-७)

33. वर्ज्य विषय अष्ट महादोष : उच्चैर्भाष्यं रथक्षोभमतिचंक्रमणासने । अजीर्णोहित भोज्ये च दिवास्वप्न समैथुनम् ॥ (च.सि – १२/१०) Some factors have the harmful effect to human body. These factors should be avoided for healthy persons as well as diseased person. So these factors also be avoided after Shodhana therapy .

34. उच्चैर्भाष्य ( loud speech) – causes pain in upper part of the body रथक्षोभ (riding wooden cart) – causes pain all over the body अतिचंक्रमण ( traveling long way) – causes pain in lower part of the body अति आसन (constant sitting) – causes pain middle part of the body अजीर्ण भोजन (indigestion) – formation of ama अहित भोजन (unwholesome food) – aggravates different Doshas दिवास्वप्न (sleep during daytime) – increased kapha मैथुनम् (sexual intercourse) – kshaya of the body

35. अत्यासनस्थानवचांसि यान । स्वप्नदिवा मैथुनवेगरोधन् ॥ शीतोपचारातपशोकरोषांस्त्यजेदकालाहितभोजनं च । (च. सि – १/५४)

36. अजीर्ण मैथुनं यान उच्चैर्भाष्यं दिवाशयम् । अतिचंक्रमणास्थानमसात्म्यादि च वर्जयेत् ॥ (का.सं.सि – ५/४)

37. दुर्वल पुरुष शोधन दुर्बलस्य दोषानल्पानल्पान् पुनः पुनः । हरेत् प्रभुतानल्पांस्तु शमयेत प्रच्युतानपि ॥ (सु.चि-३३/३७) In a week person, Doshas which are copious & moving should be expelled in a small quantity again and again; & doshas if less, should be mitigated through moving.

38. शोधनोत्तर चिकित्सा भेषजक्षपिते पथ्यमाहारैबृंहणं क्रमात् । शालिषष्टिकगोधूममुद्गमांसघृतादिभि: ॥ हृद्यदीपनभैषज्यसंयोगाद्रुचिपक्तिदैः । साभ्यङ्गोद्वर्तनस्नाननिरुहस्नेहबस्तिभिः ॥ (अ.हृ.सू -४/२८,२९)

39. CRITERIA TO SELECT A PATIENT FOR SHODHANA समीक्ष्य दोषौषधदेशकालसात्म्याग्निसत्त्वादिवयोबलानि । बस्तिः प्रयुक्तो नियतं गुणाय स्यात् सर्वकर्माणि च सिद्धिमन्ति ॥ (च.सि – ३/६)

40. To achieve success in the administration of Shodhana & to obtained the desired effects, Shodhana should be administered keeping in view the factors like the nature of Dosha, Oushadha , Desha , Kaala , Satmya , Agni, Sattva ; & the vaya and bala of the patient. In Bahu Doshavastha Shodhana therapy should administered.

41. IMPORTANCE OF पूर्वकर्म IN शोधन प्राक् पाचनं स्नेहविधिस्ततच्च स्वेदस्ततः स्याद्वमनं विरेकः । निरुहणान्वासनवस्तिकर्म नस्यक्रमश्चेति भिषग्वराणाम् ॥ (चिकित्साकालिका)

42. येषां नस्यं विधातव्यं वस्तिश्चैव हि देहिनाम् । शोधनीयाश्च ये केचित् पूर्वं स्वेद्यास्तु ते मताः ॥ (सु.चि-३३/१७) Person who are to be administered Nasya , Basti adi Shodhan therapies, for them Swedadi purva karma should be done before Shodhana .

43. स्नेहस्वेदावनभ्यस्य यस्तु संशोधनं पिबेत् । दारु शुष्कमिवानामे देहस्तस्य विशीर्यते ॥ स्नेहस्वेदप्रचलिता रसैः स्निग्धैरूदीरिताः । दोषाः कोष्ठगता जन्तोः सुखा हर्तुं विशोधनै: ॥ (सु.चि – ३३/४६,४७)

44. Those who are not given Snehana & Swedana before Shodhana therapy, their body destroyed just as a dry piece of wood when made to bend. Doshas which are made to move by Snehana & Swedana therapy, increased by the use of Snigdha rasa & which have come into kostha are easy to expelled out by Shodhana therapies.

45. शाखागतस्यापि दोषस्य कोष्ठानयनहेतु: स्नेहः , स्वेदः कोष्ठमागतस्य सुखेन प्रवृत्तिकरश्चेति दर्शयन्नाह – स्नेहस्वेद- प्रचलिता इत्यादि । (डल्हण) Before Shodhana therapy Snehana & Swedana Should be given. It helps to bring the Doshas from Shakha to Kosth a .

46. स्नेहमग्रे प्रयुञ्जीत ततः स्वेदमनन्तरम् । स्नेहस्वेदोपपन्न्स्य संशोधनमथेतरत् ॥ (च.सु – १३/९९) Snehana therapy is required to be administerd first, then the swedana therapy is to be applied. Finally the Shodhana therapy is to be administerd after the administration of of Snehana & swedana .

47. IMPORTANCE OF PASCHAT KARMA AFTER SODHANA शोधनेन दोषक्षय तथा धातुक्षय प्रतिकार भेषजक्षपिते पथ्यमाहारैरेव वृंहणम् । घृतमांसरसक्षीरहृद्ययुषोपशंहितैः ॥ अभ्यङ्गोत्सादनैः स्नानैर्निरूहैः सानुवासनैः । तथ स लभते शर्म युज्यते चायुषा चिरम् ॥ (च.सू -१६/२३)

48. PROBABLE MODE OF ACTION OF SHODHANA PROCEDURES

49. वमन AYURVEDIC CONCEPT ( च.क – १/५) Vamaka drugs possessing the properties like Usna , Tiksna , Suksma , Vyavayi , Vikasi and with their ‘ Swavirya ’ Move to ‘ Hridaya ’

50. From there, through various ‘ Dhamanis ’ lead to micro and macro channels in the body Act over the vitiated complexes in the body ( i ) With ' Agneya Property' - liquify the complexes (ii) With ' Tiksna property' - Break them down into several particles

51. Liquefied matter then glides through various unctuous or smooth channels towards Kostha Enter ' Amasaya ' and then stimulated by ' Udana Vayu “ Having the dominance of 'Agni' and ' Vayu ' elements in the constitution along with self d i sposition ( Prabhava )

52. Move in upward direction towards oral cavity Expelled to outside through it VAMANA

53. PROBABLE MODERN CONCEPT Upper GIT Electrical Stimuli for Psychic Stimuli when full of contents administration of drugs direct stimulation Over distended & CTZ stimulation Stimulates Over excitable hypothalamus Stimulates Vomiting center

54. Automatic motor reaction Motor impulses are transmitted from vomiting centre through 5 th ,7 th ,9 th ,10 th ,12 th Cranial nerves Spinal nerves Upper GIT Diaphragm & abdominal muscles Initiates VOMITING

55. विरेचन AYURVEDIC CONCEPT ( च.क – १/५) Virechaka drugs possessing the properties like Usna , Tiksna , Suksma , Vyavayi , Vikasi and with their ‘ Swavirya ’ Move to ‘ Hrdaya ’

56. From there, through various ‘ Dhamanis ’ lead to micro and macro channels in the body Act over the vitiated complexes in the body ( i ) With ' Agneya Property' - liquify the complexes (ii) With ' Tiksna property' - Break them down into several particles

57. Liquefied matter then glides through various unctuous or smooth channels towards Kostha Enter ' Amasaya ' and then stimulated by ' Udana Vayu “ Having the dominance of ‘ Prithivi ' and ‘ Jala ' mahabhuta in the constitution along with self d i sposition ( Prabhava )

58. Move downwards directions towards Anus (due to Sara guna ) Expelled to outside through it Virechana

59. PROBABLE MODERN CONCEPT Ingestion of Virechana drug Irritation of gastric mucosa Sensory signal goes to defecation centre in Medulla oblongata Motor response from defecation center Through ganglionic plexus Through vagus

60. Increased peristalsis Secretion of various enzymes from ...............................Gall bladder, pancreas,bruner’s gland Reduced absorption .................. Fluid accumulationin the gut Increased hydrostatic pressure

61. Irritation of sacral & lumber plexus Relaxation of ileo caecal & anal sphincters Virechana

62. बस्ति AYURVEDIC CONCEPT POSITION – According to Parashara , Guda is the Mula of the body where all the siraas are located. When basti dravyas administered through the guda , it reaches all over the body. Basti should given to the patient lying on left lateral side as as the Grahani & Guda are situated on the left side of the body. ( cha,si - 3/24)

63. 2. PAKVASAYA – (cha. Si-7/64) The given Basti when enters into the pakvasaya , by its virya ,draws the morvid dosha loddged in the entire body from foot to head, just as the sun situated in the sky sucks up the moisture from the earth. (cha. Si-7/64)

64. 3. Grahani – (su,kal-4/40) (su,su-32/12) Basti dravya reaches first to pakvasaya & the to the Grahani . Pakvasaya is the site of purishdhara kala & Grahani is the site of pittadhara kala . Acharya Dalhana says that purishdhara kala & asthi dhara kala is same and pittadhara kala & majja dhara kala is same.So from these we say that basti has direct action on asthi & majja dhatu . Majja is present in the asthi . Also mastulanga is considered as mastaka majja is the seat of vata . So in this way basti is act in CNS.

65. PROBABLE MODERN CONCEPT The mode of action of basti can be understand in the following way – Drug is administered through anal region It gets absorbed in intestinal mucosa & works by 4 mechanism By absorption mechanism By system biology mechanism By neural stimulation mechanism By excretory mechanism

66. absorption mechanism Hyper osmosis takes place From colon cell to lumen Absorption of endotoxins Irritation of Large intestine (due to irrtant property) Elimination

67. system biology mechanism Drug is administered through anal region It gets absorbed in intestinal mucosa Lipid soluble Water soluble Passive diffution Active diffution

68. By these diffusion mechanism the Basti drugs goes to epithelial cell. Then it goes to the capillaries. Then goes to cell after that molecules.

69. neural stimulation mechanism Drug given ENS is stimulated Excites mysentric plexus & sub mucosal plexus Neurotransmitters carries information to CNS CNS acts independently to produce the GUT feeling

70. excretory mechanism The sigmoidal , rectal & anal region of large intestine are considerably better supplied with parasympathetic nerve fibers than other part of intestine. They are mainly stimulating in action & functions especially on defecation reflexes.

71. नस्य AYURVEDIC CONCEPT (अ. स, सू – २९/३) Nasa is the gateway of Shira Drug administerd through the nostrils Drug reaches in Srungataka marma Spreads in the Murdha taking marma of netra , karna , kantha , siramukha

72. Scratches the morbid doshas in supra clavicular region Expels the vitiated dosha from uttamanga

73. PROBABLE MODERN CONCEPT The drug is administered through Nostrils Goes to the nasal cavity It passes through the Crebiform plate (found in nasal cavity floor) It transverse by olfactory neurons of the Receptor cells

74. It excites the middle cephalic fossa It is connected with 3 rd ,4 th ,5 th , 6 th crenial nerves & optic nerve Pituitary gland can also be approached trans nasal route Thus the drug acts on brain

75. रक्त मोक्षण AYURVEDIC CONCEPT Raktaprasadana – This occurs by the stimulation of Yakrit & Pleeha , which r the root of Raktavaha Srotas . When these Organs are corrected, then the whole Raktavaha Srotas get Corrected. Raktamokshana decrease the workload on Raktavaha Srotas & thus the Yakrit & Pleeha . The Sandrata ( prithivi mahabhuta ), Dravata ( jala mahabhuta ) & Pressure ( vayu mahabhuta ) are corrected.

76. Pitta Shodhana – Rakta is the seat of Pitta . So Rakta - mokshana helps in the Shodhana of pitta .

77. PROBABLE MODERN CONCEPT – 1. Reduces the work load on liver & spleen; stimulates the liver & spleen to perform their normal functions; removes the old & damaged blood cells & helps in formation of new blood cells. 2. Reduces blood pressure, so useful in HTN. 3. Reduces the viscosity of blood & thus prevents the thrombus formation, so useful in DVT, thrombo embolism etc.

78. DIFFERENCE BETWEEN SHODHANA & PANCHAKARMA SHODHANA PANCHAKARMA 5 types – Vamana , Virechana, Basti, Nasya , Raktamokshana 5 types – Vamana , Virechana, Anuvasana basti, Niruha Basti, Shirovirechana It is under in Langhana Chikitsa It acts both Langhana & Brumhana

79. DISCUSSION Is there any major difference in efficacy of Classical Shodhana procedures & Modified Shodhana procedures? What are the consequences if proper Shodhana Kala are not Maintain in Acute condition of the patients ?

80. Conclusion Shodhana acts as Preventive, Curative & Health promotive aspects – Preventive aspect : Shodhana therapy ideally suits for those person who is tend to go through a disease. Thus the sufficient prevention is maintained for the occurrence of the pathogenesis.

81. CURATIVE ASPECTS : When the disease has actually taken place to the vital, to break the pathogenesis, the vital mode of treatment is Shodhana therapy

82. HEALTH PROMOTIVE ASPECT : Not only preventive & curative aspects, it also helps in rebuilding the health.

83. THANK YOU