Essentials of Practical Panchakarma Therapy

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Dr. Vasant C. Patil graduated from SVM Ayurvedic College, Ilkal affiliated to RGUHS, Bangalore. He completed M.D. (Panchakarma) in August 2006 from Institute for Post Graduate Teaching & Research in Ayurveda (IPGTRA), Gujrat Ayurved University, Jamnagar. He is well versed in Classical & Keraliya Panchakarma. He is practicing Ayurveda since 2001 and engaged in teaching since 2006. He is also director of Atreya Ayurveda foundation, which is engaged in healthcare and publication. He is also the managing director of Atreya Ayurveda and Panchakarma centre.

He published 15 papers in research journals & 5 articles in magazines. Author also reviewed more than 40 articles of Peer Reviewed International Journals. Currently he is working as editor-in-Chief for Journal of Ayurveda and Holistic Medicine (JAHM).

Recipient of 2nd prize in an essay competition on "Rationale behind Panchakarma Therapy" organized by Punarnava Ayurveda, Mahabalipuram (2006).

Recipient of Ist prize in an essay competition on "Bahirparimarjana Cikitsa" organized by Dr. Ishwara Reddy Memorial Trust, at Bellary (2007).

Aurveda deals with the preventive and curative aspects of health. It comes under the classification of Traditional Medicine (TM) as per the specifications of W.H.O and is in the process of acquiring international recognition. Globalization has brought opportunities for exploitation of the global market for traditional medicine and its practitioners. Traditional Medicines have an annual share of millions of dollars in the world market. Ayurveda can definitely claim a good share of it, if it meets international standards.

Ayurveda is broadly divided into 8 branches, namely

1. Kayachikitsa - Medicine

2. Balachikitsa or Koumarabhritya - Pediatrics

3. Bhootavidya or Grahavidya - Diagnosis & Treatment of diseases caused by evil spirits or supernatural forces

4. Shalakya Tantra - Diagnosis & Treatment of ENT, head and neck

5. Shalya Tantra - Surgery

6. Agadatantra - Toxicology

7. Rasayana Tantra - Rejuvenation Therapy

8. Vajikarana Tantra - Aphrodisiac Therapy

Panchakarma a specialty of Kayachikitsa (Medicine) presents a unique approach of Ayurveda with specially designed five procedures of internal purification of the body through the nearest possible route. Such purification allows the biological system to return to homeostasis and to rejuvenate rapidly and also facilitates the desired pharmacokinetic effect of medicines administered thereafter. Panchakarma provides a comprehensive therapy role as a promotive, preventive, curative & rehabilitative procedure.

Revival of interest in Ayurveda has provided drift to medical tourism in the country. There has been a phenomenal increase in the demand for specialized therapies of Ayurveda, particularly Panchakarma, not only for treatment of diseases but also for preventive & promotive health care. As a result, many health centers and tourist resorts providing Panchakarma therapy have come up in the country.

Panchakarma is not merely bio-purificatory therapy as it is understood, but also has wider range of therapeutics such as replenishing, depleting, rejuvenating therapies etc.

Besides their application in the treatment of the disease, they are also used as preparatory measures before institution of surgery and also before administration of rejuvenation therapy, virility therapy, and palliative medicines. But Panchakarma, the purification therapy expounded in Ayurveda is perhaps the most misunderstood of all the Ayurveda practices. Due to ignorance, it is often perceived as just another system of oil massage.

Panchakarma is always performed in three stages preparatory/pre-operative procedure, main/operative procedure and post-operative procedure. The patient who opts for any one of the five therapies has to invariably undergo all the three stages.

The order of therapy according to their priority is: Pachana, Snehana & Svedana, which can be termed as pre-operative procedures. Main/Primary procedures include: emesis therapy, purgation therapy, enema therapy, errhine therapy and blood letting therapy. Post-operative procedures include: dietatic regimen, rejuvination etc therapy, & administration of palliative medicine.

Panchakarma does not just eliminate disease-causing toxins but also revitalizes the tissues. Hence it is called as rejuvenation therapy.

In today's world more and more people are falling victim to the adverse effects of stress and anxiety, which is leading to diseases like improper digestion, lack of sleep, allergies, heart diseases, diabetes, chronic fatigue, cancer, osteoporosis etc. These diseases are caused mainly due to deeply seated toxins. Panchakarma eliminates these toxins from the body, allowing permanent healing of tissues, channels, digestion, and mental functions.

Panchakarma is not only good for alleviating disease but is also a useful therapy in maintaining excellent health. Ayurveda advises to undergo Panchakarma during seasonal changes to purify the body, improve the digestion and to improve the metabolic processes.

If the Dosha (bio-humors) are vitiated beyond a particular level, they give rise to various endotoxins, which have a tendency to be accumulated in the minute channels. These are beyond the level of pacification and hence need to be eliminated or removed from the body. In such cases the bio-purificatory therapy is indicated.

Definition

Pancha means 'five' and Karma means 'action', so Panchakarma means "five actions"

Preparatory/Preliminary Procedures (Poorvakarma)

Before the administration of actual bio-purificatory therapy, there is a need to prepare the body in prescribed methods to encourage the body to let go of the toxins. Preparatory procedures which includes:

1. Deepana (Kindling of digestive fire)

2. Pachana (Digestion)

3. Snehana (Oleation)

4. Svedana (Sudation)

Deepana & Pachana does kindling of fire and digestion of metabolic toxins respectively. Ghee or oil is given daily for three to seven days. Snehana lossens the toxins & helps in separation of toxins from tissues. Also makes the superficial and deep tissues soft and supple. Svedana is sudation or sweating and is given for 1 to 3 days after massage. Svedana liquefies the toxins and helps in the movement of toxins into the gastro-intestinal tract. After three to seven days of Snehana, massage and sudation the Dosha (bio-humors) are liquefied and brought to GIT. Then specific Panchakarma therapy is administered according to the involvement of bio-humor.

Panchakarma (Five Major Bio-Purification Therapies)

1. Vamana (Therapeutic vomiting or emesis)

2. Virechana (Purgation)

3. Basti (Therapeutic Enema)

4. Nasya (Elimination of toxins through the nose/errhine therapy)

5. Raktamokshana (Blood letting) Vamana (Emesis Therapy)

When there is congestion in the lungs causing repeated attacks of bronchitis, colds, cough or asthma, the Ayurvedic treatment is therapeutic vomiting, to eliminate the Kapha. Therapeutic vomiting is mainly indicated in chronic asthma, chronic sinusitis, skin diseases involving upper part of body, diabetes, chronic cold, lymphatic congestion, chronic indigestion, and edema.

Virechana (Purgation Therapy)

When excess Pitta is accumulated in the gall bladder, liver, and small intestine, it tends to result in rashes, skin inflammation, acne, chronic recurrent fever, biliary vomiting, nausea, and jaundice. Ayurvedic literature suggests in these conditions the administration of therapeutic purgation.

Basti (Therapeutic Enema)

Vata is a main factor involved in pathogenesis (disease). If one can control Vata through the use of Basti, then it is easier to treat the root cause of the vast majority of diseases. Vata is the motive force behind the elimination and retention of feces, urine, bile and other excreta. Vata is mainly located in the large intestine, but bone tissue (Asthi Dhatu) is also a site for Vata. Hence the medication administered rectally effects Asthi Dhatu. The mucus membrane of the colon is related to the bone tissue. Therefore, any medication given rectally goes into the deeper tissues, like bones, and pacifies Vata disorders.

Ayurvedic Basti involves the introduction of herbal concoctions of sesame oil, and certain herbal preparations in a liquid medium into the rectum. Basti is the most effective treatment in Vata disorders. It relieves constipation, distention, chronic fever, cold, sexual disorders, kidney stones, heart pain, backache, sciatica and other pains in the joints. Many other Vata disorders such as arthritis, rheumatism, gout, muscle spasms and headaches may also be treated with Basti.

Nasya (Errhine therapy)

The nose is the gateway to the brain. The nasal administration of medication is called Nasya. An excess of bio-humors accumulated in the sinus, throat, nose, or head areas is eliminated through the nose.

Prana, life force as nerve energy, enters the body through the breath taken in through the nose. Prana is in the brain and maintains sensory and motor functions. Prana also governs mental activities, memory, concentration and intellectual activities. Deranged Prana creates defective functioning of all these activities and produces headaches, convulsions, loss of memory and reduced sensory perception. Thus nasal administration, Nasya is indicated for nervous system disorders, sinus congestion, migraine headaches, convulsions and certain eye and ear problems.

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