Panchakarma is Ayurveda’s therapeutic purification process that removes metabolic waste (mala) with the intent to restore normal function to the dosas. The word panchakarma comes from two sanskrit words, pancha and karma, and translates as “the five actions.”There are five therapeutic procedures that aim to return the dosas back to their normal state (prakriti). The procedures intentionally aggravate and move the accumulated metabolic waste, which is deeply seated within the cellular level, through the nearest external opening. (Ca. Su. 16/, Ah. Su. 14/)
Metabolic waste accumulates overtime from improperly digested foods caused by improper daily and seasonal habits, food, drink, exercise, and mental stress. Ayurveda believes this metabolic waste accumulates primarily because of low digestive fire (agnimandhya).
Panchakarma is an important part of yearly and seasonal regimen as it removes the aggravated dosa before it can fully manifest as a disease. The principals and process of panchakarma was first introduced in the Caraka Samhita (earliest Ayurvedic text). The main principal with Caraka’s panchakarma is to move the aggravated dosa with the help of preparatory procedures from the periphery (sakha) to the gut (kostha) and expel it through the nearest natural opening.
The inclusion of bloodletting or raktamokshana, was later introduced as one of the five therapies in the Susruta Samhita. Susruta was a surgeon and introduced bloodletting or raktamokshana as one of the five therapies. This process also removes the aggravated dosa but it’s still in the periphery (sakha) and removed through a surgical opening created by the Ayurvedic doctor.
The process for panchakarma has been discussed in all of the ancient Ayurvedic texts. The Caraka Samhita, which is the most important text on internal medicine, gives great detail on the wide use of panchakarma therapy for almost all the major diseases. There are two sections: Kalpa Sthana is the study of formulations used in the therapeutic purification procedures and Siddhi Sthana is the standardization and successful administration of various therapeutic purification procedures.
This stage is the main procedure and is prescribed based upon the disease, site of dosa vitiation and nearest route to expel it. When a healthy person undergoes panchakarma for maintaining good health, the therapies are given in order of vamana, virechana, unctuous basti, decoction basti, and nasya nasal cleansing. For disease management usually one or more procedures are performed until the morbid dosa/s are brought back to a normal state.
When there is congestion in the lungs and symptoms such as chronic bronchitis, colds, coughs or asthma, the Ayurvedic treatment prescribed is typically therapeutic vomiting. This therapy is useful for eliminating excess kapha dosa from its main site the stomach. Vamana is usually administered with three to four glasses of different ingredient such as salt water, milk, sugarcane juice, yashtimadhu phanta and herbal paste to stimulate vomiting.
When excess bile (pitta dosa) accumulates in the gall bladder, liver and small intestine, it tends to produce rashes, acne, chronic fever, nausea, burning sensation, and disorders with inflammation. virechana is generally administered with avipattikar powder, trivrit lehyam, castor oil or triphala in a combination that is appropriate for each person.
The colon is the site for vata dosa and herbal ingredients are prepared in sesame oil and administered into the colon and held for a period of time depending on the recommendations for each person. Basti is one of the most effective healing therapies for vata disorders and usually a series of bastis over a period of time is recommended. Basti’s are useful for constipation, bloating, sexual disorders, backache, sciatica, arthritis, rheumatism, gout, muscle spasms and chronic headaches. Two types of bastis are given during panchakarma, niruha basti is an herbal decoction used as an evacuative enema and anuvasana basti is an herbal oil used as a restorative enema.
The nose is the doorway to the brain and consciousness and the site where prana enters the body. Prana governs sensory and motor functions, memory, concentration, and all intellectual activities. Imbalanced prana creates headaches, convulsions, loss of memory, and reduced sensory perception. The herbal preparations are warmed to body temperature and the eyes are covered with cloth. The tip of the nose is raised and the herbal medicine is administered to each nostril. When the preparation comes to throat, the patient should hold for 10 seconds then spit the contents till the entire medicine is expelled. Nasya therapy brings clarity to the mind, sense organs and restores proper sleep.
There is a specific regimen to follow once the main panchakarma procedures are complete, this stage is called samsarjana krama. Digestive strength is weakened due to the expulsion of dosa and to regain the correct digestive strength there are certain guidelines for foods and lifestyle habits that must be followed. In total there are 28 types of gruels that may be recommended after the main therapies are given. Each gruel has the intention of slowly building up the digestive strength to its normal state and are made from rice or barley with herbs like amalaki, bilva, and ginger. Dhumapana (medicinal herbal smoke) is also administered to help the dosas regain their normal state.Shamana is a process of pacification where the aggravated dosas are slowly pacified over time. This therapy involves kindling the digestive fire to digest some of the accumulated toxins which helps to bring balance to the dosas and dhatus. Shamana differs from panchakarma in that the therapies slowly pacify the accumulated metabolic waste or mala rather than expelling them all at once. There are seven classical therapies for shamana therapy
Shamana is a good temporary solution if the person is unable to take time off from work or other responsibilities. Shamana can be utilized to help the person feel better until they are able or ready for panchakarma. The best possible solution is to consult an Ayurvedic doctor for the best panchakarma treatment plan for each person’s vikruti, age, climate, season and available time.
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