At the heart of a Panchakarma treatment are the five cleansing procedures. These are called Vaman, Virechan, Basti, Nasya, and Raktamokshana. These terms stand for laxative measures, herbal enemas, vomiting therapies, nasal rinsing, and phlebotomy. These procedures help cleanse the gastrointestinal tract, esophagus, respiratory tract, and blood vessels of unwanted substances.
Ayurveda Panchakarma (five actions) actually includes three stages:
1. Preliminary (Palliative) employing oil and sweating methods (Snehana and Svedhana) [often used throughout the year as general maintenance and preventive program]
2. Primary purificatory practices (Panchakarma) use emesis, purgation, enemas, and nasal therapy.
3. Post Panchakarma therapies of rejuvenation and detoxification.
Poorva Karama
Deepana & Pachana
Deepana refers to medications that ignite Agni, the metabolic fire, without necessarily digesting Ama. Pachana drugs, classified as digestives, focus on the digestion of Ama without significantly intensifying Agni.
Snehana
Warm, medicinal oils are applied in large amounts all over the body. Medicated oils like Mahanarayan oil or Sahacharadi oil are used in different people according to the requirement. Essential oils may also be employed according to the doshas. Along with the application of oil, intake of oil or ghee (snehapana) is also recommended. Oils help loosen and liquefy toxins and concerns in the skin and blood (called the outer disease pathway), dislodging and removing the heavy, sticky toxins from the smallest channels. Thus, toxins begin to drain from the central disease pathway (deeper tissues) and start to flow into the GI tract. Secretions are also activated, enabling easier dosha transport of toxins (ama) and wastes (malas) as they return to the GI tract for elimination. Oil lubricates and protects tissues from damage, as ama returns to the GI tract. Finally, since Váyu is responsible for movement, oil lubrication restores proper Váyu functioning, allowing for a proper flow of wastes and toxins to their removal sites.
Svedhana
According to Ashtanga Hridayam, after oleation steam, sweating therapies are employed for effective dislodging and liquefying of toxins and improving digestion. Svedhana causes the body’s channels to widen, enabling ama to easily flow from the tissues back to the GI tract and improve circulation. Heat allows the skin and blood (outer disease pathway) to be cleansed. This relieves, cleanses, and reduces fat tissue and muscle tension. Heat also restores balance to Váyu and Kapha (i.e. removing coldness and stiffness) and reduces the heavy, sticky nature of ama. Once toxins are back in the G.I. tract, they are ready to be completely expelled from the body through Panchakarma therapy.
Pradhana Karma
Panchakarma therapy consists of five cleansing aspects:
1. Emesis (VAMANA)
2. Purgation (VIRECHANA),
3. Medicated enemas (BASTI)
4. Medicated nasal oils (NASYA)
5. Toxic bloodletting (RAKTAMOKSHAN)
Vamana
Vamana is a guided emesis, which expels the accumulated toxins through vomiting. The best time to practice is during late spring or early summer (Kapha provoking time) and close to the full moon when the water element is high, one day after snehana and svedhana, after a good sleep, after food is digested, or after sunrise—6:00 to 9:00 or 10:00 a.m. (Kapha time).
Indications for Vamana
1 Cough, cold.
2 Bronchitis, Asthma, etc.
3 Obesity
4 Infertility
5 Skin diseases like psoriasis, vitiligo, etc.
6 Hypothyroidism
7 Digestive disorders etc.
Virechana
Purgatives eliminate excess Pitta from their site in the liver, gall bladder, and small intestine (it does not deal with the large intestine). The bitter purgatives are used depending on the concern. This purification therapy is preferred for Pitta and liver disorders. According to Ashtanga Hridayam, the time of purgation is after Vamana (emesis), and after 9:00a.m. (the end of the Kapha time of the day). Similar preliminary treatments of Snehana and Svedana are incorporated and post that the therapy is performed.
Indications of Virechana
1. Digestive disorders: Acid reflux, gastritis, irritable bowel syndrome
2. Skin diseases: Psoriasis, eczema, acne, urticaria
3. Liver and gallbladder issues: Hepatitis, jaundice.
4. Metabolic disorders: Diabetes, hyperlipidemia
5. Neurological conditions: Migraine, certain types of headaches
6. Joint disorders: Gout, arthritis
7. Gynecological issues: Menstrual disorders, PCOS
Basti
Medicated Enema is half of the medicinal therapy, or even the complete treatment. Charak- Sid. Ch. 1 verse 39
Basti therapy is primarily used for excess Váyu, either alone, or if the predominant dosha is deranged. Basti is the Sanskrit name for urinary bladder. Originally, the bladders of larger animals, like buffaloes and goats were used as enema bags. The colon is related to all other organs and tissues, so by cleansing and toning the colon, the entire body is healed and rejuvenated. The colon is the main organ that absorbs nutrients. A healthy, functioning colon is imperative for proper assimilation of nutrients.
Indications of Basti
• Basti is very useful in all types of vata disorders
• Constipation
• Lumbago
• Cervical spondylosis
• Lumbar spondylosis
• All types of body pain
• Paralysis
• Neurological disorder
• Osteo arthritis
• Rheumatoid arthritis
• Obesity
• IBS
Nasya
Áyurveda suggests that the nose is the gateway to the head. Thus, nasal herb therapy is used for healing diseases of the throat, neck, head, and senses (e.g., ears, nose, eyes, etc.). Nasya is also used for toning and strengthening these areas. It is known to improve vision, smell, and hearing, prevent greying hair, hair fall, stiff necks, headaches, and lockjaws. Nasyas are taken before meals.
It is recommended to ideally take these nasyas in the morning on an empty stomach and avoid taking them on cloudy days.
Indications of Nasya
• Migraine
• Sinusitis
• Useful for respiratory problems
• Keeps away from the illnesses of eye, ear and nose.
• Prevents premature graying of the hair, skin wrinkling and hair loss, etc.
• Boost up the head's bones, ligaments, tendons and joints.
• Strengthens chest, teeth, jaws and other areas.
Raktamokshana
Therapeutic toxic bloodletting (Raktamokshana) involves releasing toxic blood from various body sites. The impure blood is let out as it causes various skin and body illnesses. 2 to 8 ounces is the general amount of the released. Bloodletting is useful when wishing for immediate results with Pitta disorders such as skin, liver, spleen, and conditions like gout, headaches, and hypertension. Late summer through early fall is the best time for this procedure.
Types of Raktamokshna :
1. Venesection (Sira Vedhana)
2. Horn application (Sringa Avacharana)
3. Gourd application (Alabu Aavacharana)
4. Leech application (Jalauka Avacharana)
5. Scrapping (Pracchanna Karma)
6. Cupping glass application (Ghati Yantra Avacharana)
7. Needle application (Suchi Avacharana)
Indications of Raktsmokshna
• Kushta (skin diseases)
• Karna palli roga (diseases of the ear lobe)
• Shlipada (filariasis)
• Vishadushita Rakta (case of poisoning)
• Visarpa (erysipelas)
• Granthi (cystic lesions)
• Stanya roga (diseases of breast)
• Krimidanta (dental caries)
• Dantapupputa (cystic lesions of gums)
• Galashaluka (inflammatory conditions of throat)
• Oshta roga (lip disorders)
• Arbuda (tissue enlargements)
• Upadamsha (sexually transmitted infections)
• Vidradhi (abscess – all types of vidradhi excluding the one caused due to combined effects of tridosha)
• Gridhrasi (Sciatica)
• Plihodara (Splenomegaly)
Paschat Karma
The Paschatkarma treatment is the post-treatment care, including diet regimen, focused on bringing the patient back into normal diet and lifestyle.
For instance, post emesis Manda, Peya, Vilepi are introduced gradually into the diet. Regular meals are gradually introduced as the digestive fire grows stronger. The general rule of thumb is to eat only when hungry.
Benefits of Panchkarma Therapy
• Purification of the Body and Soul: This therapy is the ultimate solution to get rid of all impurities and toxins from the body and thus purifies the mind, body and soul.
• Basis for Complete Wellbeing: Panchakarma therapy is one of the finest ways to achieve a healthy and stress-free body.
• Balancing the vitiated doshas: As per Ayurveda, doshas are the main governing factors of the human body. It is due to the imbalances in these doshas that our body sometimes responds in an abnormal way, and we fall prey to various kinds of ailments. Panchakarma therapy thus helps to restore the balance between the doshas for proper functioning of the body. It helps to maintain a balance between all the three doshas that are responsible for governing our body.