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Panchakarma Therapy in Ayurveda

Panchakarma is the scientific system of cleansing and revitalization and an important part of Ayurvedic treatment.  It is a curative as well as preventative therapy with purifying and rejuvenating procedures. It is a highly effective way to address the root cause of disease. It has been practiced in India for thousands of years to maintain health and youthfulness.

In the ancient Ayurvedic text, Charaka Saṃhitā, it describes a wide use of Panchakarma therapies for almost all major diseases. It states, one who undergoes rejuvenation therapy has an increased life-span with enhanced power of retention, increased intellect, maintains and develops positive health in healthy individuals and youthfulness is maintained (signs of old age are less). It can cure certain diseases or reduce the recurrence of disease, improves digestion, stamina and immunity, improves the functions of sensory and motor organs and enhances complexion.

In Ayurveda, maintenance of a healthy body depends on the balance of the three doshas (humours), seven dhatus (bodily tissues) and three malas (waste products). Any disturbance in the function of these will create an imbalance in the body and cause disease. Improper lifestyle and food habits, continuous stress and strain, and accumulation of toxins, weaken and damage the cells in the body and slowly break down the body’s natural resistance capacity and impair its ability to cleanse efficiently. This is where Panchakarma can be very helpful.

Purification Treatments in Ayurveda Consist of Two Main Types.

  1.  Shaman Chikitsa – where certain medicinal herbal-mineral preparations are given to subdue the vitiated doshas (humours).
  2. Shodhan Chikitsa or cleansing therapy – Panchakarma Chikitsa, which consists of five types of main therapies. This is undertaken when the vitiated doshas and accumulated toxins are beyond the level of pacification and therefore need to be eliminated by a nearby route from the body in order to restore balance to the system.

Before Panchakarma can be undertaken, an Ayurvedic physician will check whether the patient’s body and mind, state of disease, general health condition and age, are suitable to tolerate the procedures—panchakarma is contraindicated in childhood, emaciation, old age, pregnancy and certain heart conditions etc. Panchakarma treatment should only be administered by an Ayurvedic physician who has undergone a post-graduate specialization in Panchakarma Therapy.

Traditionally, Panchakarma treatment is carried out in residence under the close supervision of an Ayurvedic panchakarma specialist. Treatment duration varies from 7 to 28 days, depending on the condition. Complete rest and quiet is required whilst undergoing treatment to relax the mind and body—distractions that are over stimulating in nature, like watching television and excess talking etc., are avoided at that time.

Out of the five Panchakarma procedures, only the particular actions suitable for the patient’s condition and constitution are applied. If appropriate, additional rejuvenation therapies may be advised, like shirodhara, shirobasti, netrabasti, katibasti, hrudbasti, nabhibasti, yonidhavan, yonipichu etc. Some of these procedures can be given outside the main Panchakarma treatment for their palliative and nutritive effects. Once the cleansing or detoxification of the channels in the body is complete, any prescribed Rasayanas or rejuvenation formulas are more easily absorbed by the body.

The Three Parts to the Process of Panchakarma:

  1. Poorvakarma = preparation phase before treatment
  2. Pradhankarma = main treatment
  3. Pashchatkarma = regimen to be followed after treatment.
    Certain dietary changes are advised to support the detoxification and cleansing processes.


Poorvakarma – Preparation Phase for Panchakarma

Before Panchakarma, the following pre-purification measures (Oleation and Sweating) are undertaken to prepare the body for cleansing. These treatments loosen the toxins and move them out of the deep structures into the gastrointestinal tract or trunk area, where they can be easily removed by the main panchakarma therapies:

1) Snehan—oleation. Can be done in two ways, internally and externally. External snehan is where
a particular oil is selected for each individual, like ghee, sesame, mustard, almond, or other special
medicated oil, and is applied over the body. Snehan softens the skin, relieves stress, lubricates and
protects the body tissue from damage while toxins are removed, improves appetite, promotes
secretions allowing toxins to move to GI tract and rejuvenates the tissues.
Internal snehan is the consumption of a prescribed quantity of ghee or oil. It helps to soften the
dosha for elimination and is done before Vamana and Virechana.

2) Swedana—sudation or sweating. The application of heat or steam to the body, given after
snehan. Sweating softens the body and loosens the doshas or toxins by dilating the channels
(srotases) allowing for easier elimination. Herbs are added to the steam to further liquefy and
increase movement of toxins in the body.
Swedana is beneficial for rigidity or spasmodic pain in the back, waist, flanks, sciatica,
heaviness in the body, facial paralysis, headache etc. It is contraindicated in pregnancy, diabetes,
diarrhoea, anaemia, ascites and indigestion.

The 5 Main Kriyas (Actions) in Panchakarma:

  1. Vamana – emesis
  2. Virechana – purgative
  3. Basti – medicated enema
  4. Nasya – nasal drops
  5. Raktamokshana – bloodletting


Description of the 5 Panchakarma Procedures:

Vamana (Emesis) – a process where the upsurged dosha is expelled through the mouth. Emetic substances are used to expel sticky, heavy, oily impurities and toxic wastes from the tissues in the body. It is useful for all chronic ailments of kapha, like bronchial congestion, cough, cold, asthma, sinus, skin diseases, fever, diabetes, allergies, glandular swelling and rheumatic disease, arthritis etc. It is contraindicated for those who are very weak, young children and conditions like heart disease, acute abdominal conditions and worms. Vamana is often recommended in the spring season when there is a natural increase of kapha dosha in the body.

Virechana (Purgative) – particular herbs are given to induce the purging process in a downward direction. It is useful for the elimination and cleansing of Pitta and the purification of blood. Virechana cleanses the small intestine, liver, gallbladder and pancreas. It is helpful for conditions like skin diseases, boils, gynaecological disorders, urinary retention, hemorrhoids, worms, gout, hyperacidity, constipation, ascites, jaundice, chronic headaches, acid peptic disease, allergies and so on. It is not recommended for weak individuals or when there is poor appetite or fever etc.

Basti (Medicated Enema) – one of the main procedures for Panchakarma and useful for disorders caused by vata. As Vata controls movement in the body, it plays a major role in the disease process—both nutrients and toxins are moved around the body by vata, if any imbalance occurs it can cause disease. Vata dosha is predominantly located in the colon and bones, the treatment involves taking the excess vata out of the body through the rectum with different decoctions and medicated oils. When Basti is administered, along with other Panchakarma procedures, it can purify, not only the colon, but deals with toxins from all over the body. Basti promotes good secretions in the colon and rebuilds body tissues.

Different Types of Basti:

Nirooha Basti – mainly a decoction of medicinal herbs with a small amount of fat is used. It is helpful for conditions like hyperacidity, heart disease, gout, diabetes, dysuria (painful or difficult urination), metrorrhagia (abnormal bleeding from the womb).
It is contraindicated for weak people, or conditions like diarrhoea, dysentery, cough, asthma, vomiting, abdominal distention and piles.

Anuvasana Basti – contains mainly fats with a small amount of a decoction of herbs. It is indicated when there is constipation, gout, distended abdomen, diarrhoea, cold, amenorrhoea  (abnormal absence of menstruation), kidney stone and various other diseases caused by vata imbalance, like arthritis, spondylitis etc.
It is not recommended in conditions like anaemia, jaundice, worms, common cold, fever and splenomegaly (abnormal enlargement of spleen).
It can be done in different seasons, but is best undertaken during the rainy seasons where vata dosha is naturally increased.

Nasya (Nasal Drops) – is an inhalation therapy where medications in the form of powder, oil, ghee, juice or decoction (depending on the condition), are administered through the nose. It is helpful for diseases of the ear, nose, throat and head. It removes excess bodily humours in these areas and is very effective for chronic rhinitis, convulsions, migraine, chronic headache, hiccoughs, cervical spondylosis, epilepsy, skin disorders, sore throat etc.  It improves breathing and strengthens the function of the senses – ears, nose eyes, throat and tongue.

Raktamokshama (Blood letting) – an effective treatment to purify blood and neutralize accumulated pitta, or toxins of blood borne diseases. The procedure involves taking a small quantity of blood out of the veins mainly by venesection, Jalauka leeches, or sometimes using the horn of an animal or an instrument prepared from a dried bottle gourd. Bloodletting is an effective treatment for mainly pitta or blood disorders. It is very beneficial for skin diseases and diseases of spleen and liver.

Healthy individuals can undertake raktamokshama treatment at more regular intervals as a preventative for some blood related disorders – this treatment is contraindicated in conditions like anaemia, oedema, pregnancy and ascites.