Panchakarma is one of the most popular treatments in Ayurveda even common public recognize. It is popularized with the name of Panchakarma centres, Keraliya Panchakarma treatments etc. People commonly misunderstand Panchakarma as a massage treatment or any other kind of spa treatment. But in originality Panchakarma hold a larger significance and have a deeper insight in disease management.
“Doshah kadachit Kupyanti Jita Langhana pachanaih Jitah Samsodhanairye tu na tesham punarudbhavah“
Acharya Charaka stressed the importance of Panchakarma can actually prevent disease. Above shloka explains mind-body balance is achieved by pacifying the imbalance through reductive approach and enhancing digestion from time to time. An Ayurvedic Panchakarma treatment not only manages the imbalances temporarily but also prevents the recurrence of imbalance.
“Doshah Ksheena brmhiyatvyaah, Kupitaaha prashamaiyatvyaah, Vriddah nihartharvyaah, Samaah paripaalyaa iti siddantah”
As per the view of Acharya Susruta treatment protocol should be in such a manner that Ksheena (lowered) doshas are to be nourished, Kupita (Aggravated) doshas should be brought to normalcy, Vriddha (Excited) doshas should be expelled whereas doshas in equilibrium(Samaah) should be maintained as they are to lead a healthy life.
Panchakarma literally means “FIVE ACTIONS”.
It is a type of Samshodhana Chikitsa (Bio-cleansing Therapy) which treats, cleanses and rejuvenates body, mind, soul by 5 treatment techniques namely
- Vamana (Medicated Emesis)
- Virechana (Medicated Purgation)
- Basti (Medicated Enema)
- Nasya (Medicated instillition of Nasal Drops)
- Rakta Mokshana (Blood Letting)
BENEFITS - Due to its effective therapeutic and cleansing actions are known for boosting up the rejuvenating effect on body. Following benefits are observed
- Complete purification of body.
- Expulsion of Toxins.
- Enhanced or improved Metabolism.
- Increased Digestive fire.
- Clearance of blocked channels (Strotas).
- Rejuvenation of tissues.
- Boosts Immunity.
- Relieves Stress.
- Relaxing effect to mind and body.
The procedure of Panchakarma is divided into following segments:
It is a preparatory procedure required before main procedure making an individual to get the fruitful benefits of Pradhana karma. It includes procedures like Deepana (Appetiser), Pachana (Carminative), Snehana and Swedana.
Out of above described procedures Snehana (Oleation) and Swedana (Sudation) karma actually fit to the criteria of Poorvakarma.
As per the view of Acharyas, performing Deepana and Pachana karma (Correcting the digestive fire) is to relieve the effects of any existing AMA (the undigested food).
- SNEHANA KARMA (OLEATION THERAPY)- Snehana or Oleation means Administering of medicated ghee or oil or fat or bone marrow in an individual with an intention of undergoing Panchakarma therapy. The term snehana is coined because of its ability to induce the qualities of sneha likely to be sneha (oiliness), Vishyandha (Liquefaction), Mardavam (Smoothness), Kleda (Moistness) etc.
Substances used for Snehana karma are Ghee (Ghrita), Oil (Taila), Vasa (Animal Muscle Fat), Majja (Bone Marrow). Amongst all Cow Ghee is the ideal one for performing snehana karma.
This procedure is performed after assessing the considerable factors to be eligible for undergoing Snehana karma and planned accordingly the quantity, time period, koshta etc for attaining Sneha siddhi lakshanas. (Complete benefits)
|Based on Prakriti, Strength of individual, Digestive capacity dosage of Sneha dravya ranges from minimum of 30ml to 180 ml and can extend accordingly with properly checking for Sneha siddhi Lakshanas.||A minimum time period of 3days to a maximum of 7 days is considered as brief time period.||Persons undergoing Swedana therapy, roughness of skin, diseases of vata, vitiation, depleted blood and semen, metabolic disorders, infertility, arthritis etc|
The main aim of performing snehapana is to completely saturate the body cells with medicated fat and to mobilize the toxins from the cellular levels thereby eliminating it through the main procedures like vamana or Virechana.
SWEDANA KARMA/ SUDATION THERAPY
Swedana refers to sweating or sweating therapy is a process to induce sweating by external means. Swedana to an individual is performed after oleation therapy either internally (internal consumption of sneha dravyas) or externally (Application of sneha dravyas to external body surface likewise in massage).
TIME PERIOD of swedana karma – Till appearance of sweating on forehead
AIM - Liquefaction of sticky and adherent doshas situated in the deeper tissues.
CLASSIFICATION OF SWEDANA KARMA
Based on medium used for swedana it is of 4 types
- Tapa sweda- Fomentation
- Upanaha sweda- Poultice.
- Ushma sweda –
- Drava sweda- Pouring of warm
|TAPA SWEDA (Dry Heat)||UPANAHA SWEDA (Poultice)||USHMA SWEDA (Steam Bath)||DRAVA SWEDA (Tub Bath)|
|It is performed by touching affected part of body with heated cloth, metal plate, palm of hand, using sand and salt in Pottali etc||Upanaha sweda is performed by application heat by poultice (Paste of medicated drugs).||Steam of the hot substance is directed towards the body part.||Medicated liquid should be filled in a pot, jug with spout, or a tube and poured slowly and steadily over the painful part covered with cloth.|
BENEFITS - Swedana karma is performed to liquefy the sticky and adherent doshas present deeply in dhatus (Tissues). Sweating achieved brings down the excess body heat, helps in relieving stiffness, opens up pores of skin to expel impurities in an effective manner, helps in obese conditions. Swedana stimulates nerve endings and promotes muscle strength.
After performing proper poorva karma and attainment of samyak lakshanas (Complete Symptoms) of snehana and swedana, pradhana karma is planned to an individual according to the disease suffering and signs & symptoms presented.
Pradhana Karma includes procedures
- Vamana- Aggravated kapha conditions.
- Virechana- Pitta disorders.
- Basti- Vata Problems.
- Nasya- Urdhwa jaturgata (For the diseases above the clavicle).
- Rakta mokshana- conditions with vitiated Blood.
VAMANA KARMA / EMESIS THERAPY
Though doshas are present all over the body but their dominant regions differ making them their home region. Likewise kapha dosha makes the region of chest as its natural dwelling place. When vitiated it should be cleared from that region to maintain normalcy. Vamana karma is indicated in aggravated kapha conditions.
Vamana therapy refers to a natural way of inducing emesis or vomiting in aggravated kapha conditions. Since natural place of kapha is the chest region expulsion of aggravated kapha dosha through oral route becomes easier as it is the nearest route of exit.
BENEFITS OF VAMANA
Vitiated kapha dosa is expelled out there by culminating the morbidity to a greater extent. Digestion power and metabolim is enhanced. Sense organs and skin become clear. Strength, nourishment and immunity are improved.
The process of vamana is indicated among the following:
|INDICATIONS||CONTRA – INDICATIONS.|
|Aggravation kapha, Aggravated kapha with pitta, Fever of recent origin, cold, cough, Asthma, Chronic respiratory disorder, Indigestion, Heaviness of body, Skin diseases with itching and burning, thyroid disorders, obesity, PCOD, Kapha disorders affecting neck, ear, nose, eyes and throat etc..||Persons with low vitiation of kapha, pregnant women, who has not undergone poorvakarma, with heart diseases, Spleen enlargement, upward movement of vata, blindness etc..|
VIRECHANA KARMA/ PURGATION THERAPY
A Panchakarma procedure where the vitiated or morbid doshas is expelled out through anal route or the act of expelling doshas through Adhobhaga (Guda marga or anal route) is referred to as Virechana karma.
In condition where the vitiation of pitta is beyond the control of palliative treatment virechana karma becomes ideal choice of treatment to bring the normalcy and maintain equilibrium of doshas.
Based on the involvement of doshas virechana is of following
- Snigdha Virechana- Pitta dosha associated with vata dosa.
- Rooksha Virechana- Pitta dosha associated with kapha dosa.
Indications and Contra Indications of virechana karma
Virechana is indicated in aggravated pitta conditions observed in diseases of skin, liver etc.
|Persons suffering from tumors in abdomen, Piles, Anemia, Non healing wounds, Ulcers, Abscess, Jaundice, GERD, Problems related urogenital system, Skin diseases, infertility, menstrual disorders etc..||Fever of recent origin, Poor digestive capacity, Bleeding per rectum, ulcers of rectum, Hard bowel movement, Emaciation etc…..|
Agni is the main reason for maintaining the health of an individual. After performing the Shodhana karmas the strength of Agni is diminished. Acharyas proposed a special diet regimen or schedule called Samsarjana krama to regain the strength of agni.
Samsarjana krama is a special diet prescribed to the patient who has undergone shodhana (Pradhana karma) chikitsa till he starts taking normal diet. Due to expulsion of vata (Flatus), purisha (Faeces), mutra (Urine), kapha (Phlegm) and pitta by shodhana karmas there is loss of weight, weakness, decrease in Agni therefore a diet is planned to regain the lost strength of the patient. This diet schedule is followed for 3-7 days depending on the level of purification.
BASTI KARMA / ENEMA THERAPY
Basti or vasti is one among the five panchakarma procedures which has both preventive and curative aspects and indicated in vata disorders. Vasti is described as ‘Ardha chikitsa’ as it helps in proper maintainence of health by putting check to vata which is the causative factor for most diseases.
Basti or vasti is the process of administering the medicated drugs through anal route or urethral or vaginal.
Routes of administration
Different routes of administering medicated drugs are selected based on the type of disease reported
- Anal route- General route of administration of basti dravya in all cases of vitiated vata disorders.
- Urethral route- Vasti is also given through Mutramarga to treat uro- genital disorders.
- Vaginal route- This route is also called ‘Apathyamarga’ to treat abnormalities of female reproductive system.
- Vrana – Injecting of medicated dravya into vrana (Wound) which help in cleaning and healing of wounds and ulsers.
Uro-genital route of administration of vasti dravya is referred to as Uttaravasthi which is to be performed carefully with lesser quantities.
Purpose of vasti
As per the classical texts vata constitutes to majority number of diseases, Vasti plays a key role in mitigating the vitiated vata. Properly performed vasti acts as controls premature ageing, Enhances nourishment to the body, provides longevity.
Constituents of Vasti and the number of days are decided based on the strength of the patient and disease.
|Persons affected with Paralysis, emaciation, worm infestation, colic pain, Atrophy, skin disorders, RA, Gout arthritis, strengthening of reproductive system improves fertility etc.||Indigestion, Emaciated conditions, Person with feeling of hunger and anger, cold and cough, Ascites, intestinal perforation.|
“NAASA HI SHIRASO DWAARAM”
Nostrils or Nasal passages serve as gateway to brain which serve as quickest route of drug administration. Nasya karma is indicated in Urdwajatrugata rogas i.e. disorders above the clavicle (shoulder). Nasya karma is instillation or inhalation of medicated drugs though nasal pathways or Nostrils. It is also called as Shirovirechana or shirovireka- as it causes virechana (elimination) of impurities in head.
Murdha virechana - The synonym of head is Murdha hence named as Murdha virechana.
MODE OF ACTION
As stated earlier Nose is the gateway to Head, Drugs administered through nose reaches the Sringataka Marma of the head which is a Sira Marma formed by the Siras of Nasa, Netra, Kantha and shrotra and purifies them by expelling the morbid doshas. The irritating effect in the head is a additional to research carried out as irritation increases blood circulation.
Advantages of Nasal Pathway Drug Administration
- Drug Degradation is absent.
- Hepatic First pass Mechanism is absent.
- Rapid drug absoption.
- Quick onset of action.
- Better Bio-availability for smaller drug molecules.
- Convenient route when compared with par-enteral routes.
Indications: Paralysis, cervical pain, frozen shoulder, hair fall, migraine, sinusitis, allergic rhinitis, hormonal imbalances, infertility, gynaec disorders, eye disorders, ear problems etc.
RAKTA MOKSHANA/ BLOOD LETTING THERAPY
Rakta is referred to as the root (Originating and Supplying factor) as various life activities are dependent on it like:
- Carries oxygen to all the internal organs there by preventing Necrosis.
- Carries nutrients from digested food material.
- Formation of blood clots to prevent blood loss during injuries.
- Regulation of body temperature.
- Transport of waste materials to kidneys for cleansing.
- Carries Glucose to brain which is the only food supplement keeping us conscious etc and many other countless contributions for proper functioning of body.
Rakta (Blood) mokshana is an important para-surgical procedure indicated for management of disorders caused due to vitiation of rakta. It is important line of management of Rakta pradoshaja vikaras which does not get subsided after getting treated with other purification procedures.
Types – Based on the usage of instrument for blood-letting technique, Raktamokshana is classified accordingly
|Sl. No||Type of Raktamokshana|
|1.||Shastra (with sharp instruments)
|2.||Anushastra (Without sharp instruments)
Out of all the types, Siravedha and Jalauka are most used blood-letting techniques widely used in practice and indicated in conditions of skin diseases, Elephantiasis, Toxic conditions of blood, Swelling, Arthritis, Herpes etc. Rakta mokshana and Siravyadha are considered as half treatment in shalya like that of Basti in Kaya Chikitsa.
Ayurveda defined health as not only the state of not having disease but the state of normalcy of dosha (3), dhatu (7), Agni(13) and malakriya (3) also including the presence of Prasanna Atma (Soul), Indriya (Sense organs) and Manas (Mind). Health is attained and maintained by following hygienic practices and undergoing periodical natural detoxification methods.
Ayurveda focuses to establish a balance of Tridosas and advocated certain regimens like Dinacharya (daily regimen), Rutucharya (seasonal regimen), Vega Adharana (Non-Suppression of Urges) and treatment modalities like Rasayana (Immunomodulators), Vajikarana (Rejuvenation) and Panchakarma (Bio-Cleansing methods). Panchakarma stands out to be a perfect treatment technique which is a natural detoxification method of cleansing the body.
The process of filling or retaining oil on the surface of head with the help of a cap is known to be Shiro basti. Depending on the dosha involved oil is duration is maintained.
Indications - Neurological ailments, Chronic headaches, Migraine, Deafness, Facial Paralysis, Paralysis etc.
- Stimulates the nerve impulses in the brain.
- Promotes sleep, reduces anxiety and depression.
- Nourishes the roots of hair.
- Provides nourishment to the nerves.
A small cotton piece or swab is dipped in the medicated oil and kept on the anterior frontanella is known as Shiro pichu. Indicated in disorders of Shiro rogas, Pakshaghata, Vata roga, falling of hairs,
split ends of hair etc.
- Strength to sense organs and hair.
- Provides smoothening effect to the nerves and brain
- Pacifies the vata.
- Controls premature graying and hairfall.
Continous pouring of medicated liquid in a systematic manner on the fore head or scalp using dhara yantra is known as Shiro- dhara.
Based on the liquid used for Dhara, it is of many types
- Taila Dhara- Taila (Oil).
- Takra Dhara- Takra (Butter milk).
- Kashaya Dhara – Kashaya (Decoction).
- Ksheera Dhara – Ksheera (Milk).
- Jala Dhara – Water.
Indications: Anxiety, Stress, Depression, Diabetes, Scalp Psoriasis, Psoriasis,
Autism spectrum disorders, Migraine, hairfall etc.
A relaxing treatment where fermented liquid prepared from cereals and herbal ingredients is poured on to the body in a rhythmic manner and massaged simultaneously.
Indications - Rheumatic diseases, Vata dosha disorders, Paralysis, Arthritis, Insomnia, High blood pressure, Depression, Muscular aches and dislocated or stiff joints.
- Ideal therapy for Vata imbalance.
- Relieves body pains, inflammations and stiffness.
- Helps in detoxification and rejuvenation.
- Improves blood circulation.
- Improves overall physical and mental health.
Akshi Tarpana is a process of filling eyes with medicated oil or ghee in a compartment made out of wet flour of black gram around the eyes for a certain perid of time. The word Tarpana refers “to nourish”. Akshi tarpana on whole is referred to as nourishment to eyes.
Indications - Dryness, trauma, vata, pitta disorders of eyes, Falling of eyelashes, blurriness of vision, Neural disorders of eye etc.
Benefits - Clarity of vision, strength to muscles and nerves of eyes.
Application of medicaments in the form of paste (medicated herbs) into conjuctival fornices with an applicator (Shalaka) is referred to as Anjana. It is a process that can be performed on regular basis.
Indications - Localization of doshas in eyes, Defects in vision, inflammatory conditions.
Benefits - Increases vision, Provides lightness and prevents excess Lacrimation.
Gandusha generally means gargle. It is done with the help of medicated liquids or oil.
Indications - Disorders of teeth, gums, lips and oral cavity, headache, diseases of ear, eye and throat, excessive salivation, dryness of mouth, nausea.
Inhalation of medicated smoke or vapor through nose or mouth is defined as Dhoomapana.
Indications - Sinusitis, Recurrent Upper respiratory tract infections, Allergic rhinitis etc.
Benefits - Lightness of chest, throat, head. Clarity of mind and sense organs.
The procedure of filling oil/ medicated liquid into ears for a prescribed time is known as karnapurana.
Benefits - Ear disease of vata origin will be subsided. Reduces the Stiffness of the neck and jaws, relieves the difficulty in hearing loud sounds and deafness. Reduces giddiness and vertigo problems.
Greeva basti is a pain relieving treatment in where medicated warm oil is made to pool over the area of neck or nape of neck in compartment made using wet flour of black gram covering the cervical region. Greeva basti is indicated in Cervical spondylosis, Cervical disc lesion, vertigo, Numbness of hands, Frozen shoulder etc.
- Relieves burden of stress and congestion in nerves, bones, muscles of neck and shoulders.
- Improves flexibility and brings smooth movement.
- Improves circulation around neck and shoulder region.
- Relieves pain and stiffness.
Meru in Sanskrit refers to Spine. Merudanda basti is performed by pouring medicated warm oils over the spine in a boundary made out of flour of black gram for stipulated time based on the complaints of the individual.
Indications - Indicated in conditions of back pain who are subjected to sedentary work habits, Spinal muscle fatigue, Degenerative vertebral disease, Spinal disc herniation, Spondylitis, Prolapsed disc etc..
Kati Basti is a traditional Ayurvedic treatment used for lower backache and disorders of lumbosacral region, slip disc, Sciatica, Lumbar Spondylosis. Kati Basti is a procedure of retaining warm medicated oil in sacral or lumbar region within a specially designed compartment like structure from wet flour of black gram.
The healing properties of medicated oils help in
- Provides hydration to the discs.
- Building strong muscle and connective tissues.
- Lubricate the joints.
- Reduces the inflammation in the disc spaces and nerves.
Knee joint is referred to as Janu. Janu Basti is the procedure of retaining medicated oils on and around the region of knee joint.
Indications – Osteoarthritis, Knee pain, Rheumatism, Osteoporosis etc.
- Strengthens muscles, joints of knee.
- Prevents degenerative changes.
- Improves movement of knee joint.
- Reduces swelling.
- Increases weight bearing capacity.
It is also referred to as chakra basti/umbilical basti/ navel basti where a round shaped ring like structure of required measurements is prepared from dough of black gram flour and placed over umbilicus area in supine position and filled with lukewarm medicated oils.
Benefits - Strengthens power of digestion. Facilitate release of deep seated emotions, acts on solar plexus.
The process of applying medicated ghee or oil to feet and massaging for a specific duration is known as Pada Abhyanga (Foot Massage).
Benefits - Removes dryness, stiffness, tiredness. Improves sleep and vision, provides relaxation to the whole body.
SHASHTIKA SHALI PINDA SWEDA
A type of localised or whole body massage performed with bolus of boiled shashtika shali (Cereals) with Milk.
PATRA POTTALI PINDA SVEDA
Patra Pottali refers to Patra (leaves) made in to a Pottali (Bundle). Medicinal herbs which have effect on aggravated vata- kapha are selected and swedana is performed. The prepared Patra pottali is heated in the selected oils and applied throughout body with mild pressure.
Indications - Pain management, Stiffness, inflammation, frozen shoulder, neuro-muscle pain, cervical pain, back pain, sciatica etc.
Benefits - Good for all the vata rogas, provides nourishment, increases the muscle power and tone, and reduces the pain and inflammation.
It is a rejuvenation treatment where the individual is applied with lukewarm herbal oil all over the body in rhythmic way continuously for 60-90mins in all conventional 7 massage positions for 7-10 days.
Benefits - It improves circulation, metabolism and restores health.
Upanaha sweda is performed by application of heat by poultice (Paste of medicated drugs) and tied with bandage of cloth or leaves.
Indications - Swelling around wounds and ulcers.
Lepa is the form of a paste of herbal drugs. Lepa is a type of topical application to the skin and considered to be of cosmetic value.
Indications - Wounds, inflammations, ezcema, tumour, all types of joint pains etc.
Benefits - Reduces inflammation, burning sensation and pain, pacifies aggravated tridosha.
- Udwartana is a full body massage using herbal powder or paste performed inrhythmic manner.
- Udgarshana is a full body massage using herbal powder or paste without oil.
- Udsadana is a powdered massage with oil.
Indications - Diabetic Neuropathy, Obesity, Paralysis, Skin care, Indigestion.
- Helps in losing weight.
- Improves skin complexion.
- Relieves stress and induce relaxation.
- Stimulates fat metabolism.
- Reduces and balance vata and kapha.