Therapeutic Insights into Nadi Swedana: Traditional Practice and Modern Perspectives

Introduction

Nadi Swedana (sudation using a pipe-like instrument [SAT-I112]) is a specialized, widely practiced, and effective method of Swedana Karma (sudation therapy) as described in Ayurvedic texts. Various Āchāryas have elaborated on different types of Swedana Karma, with Āchārya Charaka categorizing it into two primary forms: Sāgni Sweda (thermal) and Niragni Sweda (non-thermal) in Sūtrasthāna 14th chapter [1]. Sāgni Sweda is further divided into thirteen subtypes, while Niragni Sweda encompasses ten subtypes [2]. Here, ‘Sweda’ and ‘Swedana’ are used interchangeably.

It is tabulated as [3]:

Table no 1 : Types of Sweda

Acharya Sushruta divided Swedana Karma into four basic categories as in 32^nd  chapter of Chikitsasthana :

1. Tapasweda (direct warmth)
2. Ushmasweda (steam)
3. Upanahasweda (poultice)
4. Dravasweda (warm liquid)

Nadi Swedana is the most frequently utilized method of Swedana Karma. Therefore, a comprehensive understanding of the procedure, as outlined in various Ayurvedic classics, is essential. This article aims to explore the theoretical foundation, practical applications, and significance of Nadi Swedana, while also highlighting the latest modifications implemented in daily practice.

Materials and methods

A comprehensive search was conducted using the terms ‘Nadi Swedana’, ‘Pipe Sudation’ in PubMed and Google Scholar database from 2024/10/15 to 2025/5/7. Studies were screened based on relevance, clinical significance and methodological rigor.  Additionally, various classical texts, including Charaka Samhita, Sushruta Samhita, Astanga Samgraha, Kashyapa Samhita, Bhela Samhita, Sharangdhara Samhita, and Bhavaprakash Nighantu, were thoroughly studied.

Nadi Swedana in Different Classics

1.1 Nadi Swedana in Charaka Samhita

Āchārya Charaka has explained Nadi Swedana as follows:

Nadisweda Dravya (Charaka Sutrasthāna 14/29–33) [4]

• Vātaja Vikāra: In Nadi Swedana, a wise physician should make use of the flesh of domestic, wet-landed and aquatic animals, milk, the head of a goat, the trunk, bile and blood of a hog, unctuous articles, sesame, and rice in the right manner considering the season, after they are well decocted.
• Kaphaja Vikāra: The kettle sudation should be carried out by decocting Varuṇa (Crateva nurvala), Guḍūcī (Tinospora cordifolia), Eraṇḍa (Ricinus communis), Śigru (Moringa oleifera), Mūlaka (Raphanus sativus), Sarṣapa (Brassica napus), leaves of Vāsaka (Justicia adhatoda), Tuga (Bambusa bambos), Karañja (Pongamia pinnata), leaves of Arka (Calotropis gigantea), Pippala (Ficus religiosa), Śobhanjana (a variety of Śigru), Sahacara (Barleria prionitis), Jātipuṣpaka (Jasminum sambac), Tulasi (Ocimum sanctum), Rāmatulasi (Ocimum gratissimum) in water.
• Vāta-Kaphaja Vikāra:

Ajavāyana (Trachyspermum ammi), Pañcamūla, whey, urine, sour gruel, and unctuous articles should be used in kettle sudation.

Nadisweda Kalpana (Charaka Sutrasthāna 14/43) [5]

Above mentioned articles indicated in sudation that are plant-based (the fruit, root, leaves, buds, etc.) or animal-based (the carved flesh and the head of the birds and beasts of hot potency) are mixed together with sour, salt and unctuous articles like urine, milk, etc. They are decocted in a pot after closing the lid tightly to prevent the steam from escaping. A tube of the shape of an elephant’s trunk is made with the leaves of either bamboo or the leaves of Karañja or Arka. Its length should be one Vyāma (6 feet) or half Vyāma (3 feet), considering 72 inches to be the height of the patient [6].

At the proximal end, the circumference should be a fourth part of a Vyāma (22.86 cm), while at the distal end, eight parts of Vyāma, and the entire length of the tube is bent twice or thrice and covered with leaves that alleviate Vāta. The patient who has undergone Abhyanga (oil massage) with Vāta-hara oils is then subjected to sudation from this apparatus. Because of the bends, the force of steam is minimized, protecting the skin from irritation and allowing for smooth sweating. This method of sudation is called steam kettle sudation.

1.2 Nadi Swedana in Sushruta Samhita

In a similar manner, the Sushruta Samhitā provides a description of Nadi Swedana under the section on Ushma Sweda (Sushruta Chikitsāsthāna 32/5–7) [7].
        In steam sudation, besides red-hot lumps of earthenware, stone, brick, or iron being sprinkled with water or sour liquid, a small pot filled with meat juice, milk, curd, Sneha [there are four types of Sneha mentioned in Ayurveda—Ghṛta (ghee), Taila (oil), Vāsa (muscle fat), Majjā (bone marrow)], sour gruel, and a decoction of tender leaves of plants that alleviate Vāta is taken, and another pot is kept upside down, and their joint is sealed.
A hole is made in the side of the upper vessel in which a tube resembling an elephant’s trunk, measuring one Vyāma or half a Vyāma, curved at three points, made of matting grasses is inserted, and steam is passed through that for fomentation.

This sudation should be applied to the patient with Vātika disorders who is well massaged and covered with heavy clothes in a comfortable position. This is easy, spreads through the entire body, and doesn’t produce any discomfort.

1.3 Nadi Swedana in Ashtanga Sangraha

The drugs are boiled in a vessel placed over fire, above which an inverted pot having a hole on the side (equal to that of its mouth) is attached, and the joint is sealed tightly (with red soil-mud) [8]. On the side hole of the upper pot, a hollow pipe is arranged, which can be made from the reed of Sara, hollow arrow, bamboo shoot, or from the leaves of Karañja or Kiliñja, resembling the trunk of an elephant with a length of one or one and a half Vyāma, and a circumference of one-fourth or one-eighth Vyāma, with openings on both ends and two or three bends. It is covered by the leaves of plants that alleviate Vāta. The leaves (covering the ends) should have holes (to let the steam come out).

The steam from this pipe is applied over the body part, after proper oil massage, in a comfortable sitting position. Since the steam is not rushing straight (due to the bends in the pipe), its speed and intensity are restricted, causing perspiration without burning the skin. This is called Nadi Swedana.

Vyāma is the length between the tips of fingers of both hands when stretched, standardized now to 6 feet.

1.4 Nadi Swedana in Kashyapa Samhita

Veṃsa, Muñja, and Nala etc., should be used to give Nadi Sweda (pipe-sudation) in a wind-protected place and after covering the part with cloth, as per requirement and comfort [9].

1.5 Nadi Swedana in Sharangadhara Samhita

The method of Nadi Swedana involves using a pot with a hole near its neck. A metal tube or reed, about two Hasta in length and Śatāṅguli in width with a small opening, is attached to this hole [11]. Vātahara decoction or juice is placed in the pot, which is then covered with a lid and boiled until steam emerges from the tube. The person undergoing treatment receives an oil massage and is positioned comfortably on a cot with a thick blanket covering them. The steam from the pot is directed toward the patient from below the cot or seat until they perspire sufficiently, at which point the treatment is concluded [10].

1.6 Nadi Swedana in Current Practice

Devices like the All-in-One Panchakarma Table, Steam Bath Generator, Portable Steam Cabin, Steam Gun, and Nadiswedana Yantra represent modern adaptations of Nadi Swedana [11]. These tools feature specialized nozzles designed to prevent direct contact between steam droplets and the patient’s skin, while safe-holding sponges are incorporated to protect therapists from heat or burns.

In current clinical practice, the All-in-One Panchakarma technique is the preferred choice for most practitioners due to its versatility. While other devices are also effective, they are often less favored due to their high cost, maintenance needs, and limited availability.
Standard operating protocols for Nadi Swedana are also followed to ensure safety and effectiveness.

Importance of Nadi Swedana

Nadi Swedana has heat transfer effects on targeted areas. Heat application reduces pain, increases blood flow, enhances capillary permeability, improves nerve conduction, and increases collagen extensibility—all of which are the result of vasodilation induced by heat therapy [12]. These mechanisms collectively contribute to the alleviation of pain and stiffness.

When administered following oleation (Snehana), fomentation helps regulate Vāta, aiding in the elimination of Puriṣa (faeces), Mūtra (urine), and Retasa (semen). The analogy of bending dry pieces of wood through oleation and fomentation underscores the significant benefits of Swedana [13].

1.9 Indications of Nadi Swedana [14][15][16]

While looking into the indicated diseases for Swedana  karma in Brihat Trayee, diseases fit for Swedana are – Ardita, Pakshaghata, Sarvanga Vata, Ekanga Vata, Khalli, Vinamika, Vepathu, Supti etc. Gridhrasi, Manyasthambha, Parshva Graha, Pristha Graha, Kati Graha, Kukshi Graha, Pada-Janu-Uru-Jangha Graha/Ruk, Aaharita Sharia, Anupdrava Mooda Garbha, Asmari. Sheeta. Pratishyaya, Kasa, Hikka, Shwasa, Karna Shola, Gala Graha, Swara Bheda, Mutraghata, Mutrakrichra, Vriddhi, Kshvathu, Vatakantaka, Hanu Graha, Arsha, Bhagandara. Heaviness of body,distention of abdomen, constipation, Jrumbhaa, Amadosha, patient fit for Panchasodhana as Vamana, Virechana, Vasti, Nasya and Raktamokshan. Mostly Vataj and Vata Kaphaj Vyadhis are indicated for Swedana except some exceptions as Arsha.

1.10 Contraindications of Nadi Swedana [17][18][19]

Dagdha, Vishapeeta, Madyapeeta, Trishita, Nidranasha, Chhardi, Raktapitta, Hridaya Rogas, Pregnant, Atisara, Madhumeha, Pitta Prakriti, Ruksha body, who consumes more Kashaya Rasa, Vodagdhaguda, Bhrsthaguda, Shranta, Nasta Sangna, Sthula, Pittameha, Kshudita, Kopi, Soka, Jaundice, Udara, Urakshata, Vatarakta,Durbala, Suskadeha, Ojaksheya, Timira, Pandu, Ajeerna. 

1.11 Mode of action of Nadi Swedana [3][14]

Sthambhaghna: Swedana relieves heaviness and stiffness (stambhaghna). Sthamba is caused when Rukshaguna of Samana Vayu absorbs Snigdhata of Sleshaka Kapha. Swedana  being Snigdha and Ushna (~hot) does Srotosuddhi and Amapachana relieving Stambha.

Gauravagna: When Apyaghataka of body comes out of the body during Swedana , it reduces Guruta of the body. It also stimulates the nerves and muscles so lightness is achieved.

Sheetghna: Swedana being Ushna  (~hot) itself reduces the Sheeta property of body.

Swedakarakta: Rise in temperature is the primary stimulus for induction of perspiration. It is the natural response of body at regulating and cooling the body temperature [20]. Sweda (~Sweat) is a type of mala relating to Dhatwagni and Bhutagni (metabolism) which means it carries away the metabolic wastes. Due to Ushna and Tikshna Guna of Swedana Dravya, microcirculatory channels are penetrated and sweat glands are activated. Therefore, Snighda Dosha in the Srotas (paths) are directed towards the skin due to their Sara Guna and are excreted through micropores of skin in form of sweat thus promoting the Swedana.

Discussion

In Ayurveda, Swedana occurs due to Sukshma Medapaka. (figure-1)