Panchakarma - The Relevance and Significance of Panchakarma in Contemporary Medical Practice (Part-I)

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I remember asking a pertinent question to a medical scientist and a dear friend, way back in 1995. He earned name and fame among the medical fraternity after spending two decades of his professional life in the US. The question I had asked him was, "What is your understanding of contemporary Ayurveda practice?"

Without blinking an eye, he retorted, "Oh, it's all about Placebo, Palliation and Panchakarma." He continued to pinpoint how Ayurveda doctors he had met in India and in different parts of the world, prefer to use purgation as a common medical intervention.

I tried to explain that a few patients found such treatment particularly effective. To which he had a hearty laugh and said, "To a person with a hammer everything is a nail."

His sarcastic response was palpable. Yet, I was happy that he knew something about Panchakarma, although it was superficial. This gave me an opportunity to educate him about the relevance of Ayurveda. I drew his attention to the spectacular advances in the past few decades, which prove that Ayurvedic medicine is scientific.

Five thousand years ago, sages recorded, more than 4000 symptoms and over 60000 formulations based on geographical availability. The classical texts of Ayurveda, written by sages, mention about defining, observing, categorising and naming diseases, with therapeutic interventions, with the hope that all these would allow future generations to stay healthy.

The classical texts, I informed him, state how to record a patient's medical history, doctor's instincts, and ask about a patient's ancestors, willingness and participation, findings from the physical examination, feeling the contours of patient's pulse, past experiences, rumours, folklore, behaviour, gossips, and how each of these influences the diagnostic ability, weighing the evidences and the inferences, rather than playing with probability.

Each and every diagnostic challenge in medicine was observed and documented vividly 5000 years ago. The astonishing feature of Ayurvedic medicine is its ability to use all the information to mount genuine therapeutic intervention against diseases based on rational precepts.

They have recorded by observing the evolution of the diseases and by constructing the models of how diseases occurred and programmed. Such is the rock solid foundation of medicine laid 5000 years ago.

My friend was mesmerised with the crash-course. His perception towards Ayurveda changed at that very moment. I told him that this is just the tip of the iceberg. Since then he keeps referring many cases to Ayurveda physicians.

The emergence of Ayurveda colleges in cities and towns laid the foundation for greater public interest. People started to look at Ayurveda as an effective alternative medicine. The sudden surge in public demand enabled Ayurveda colleges to incorporate speciality Ayurveda practices, not just advising people to pop pills or gulp decoctions.

That's how panchakarma as an Ayurvedic form of treatment began to percolate in the minds of the people. In fact, extensive researches show, the large quantity of oil that flowed down during panchakarma treatment has enormous therapeutic benefits in reversing hundreds of diseases.

In the early 1990s the word panchakarma was only known to Ayurveda doctors and a negligible percentage of the population. There was neither demand nor awareness in most part of the country, except in Southern India. There were a handful of Ayurveda colleges which practiced panchakarma. The professor

in-charge of the panchakarma department was looked upon as a celebrity among students, even if the professor were to be extremely serious in nature.

In the mid-1990s the Maharashtra Government opened the floodgates by permitting two dozen Ayurveda colleges in the state. Karnataka followed suit. This inspired other states. Yet they did not embrace it in a big way.

"Diseases will not recur if panchakarma treatment is adopted in a patient" propounded Charaka. He devoted several chapters on panchakarma. Yet, the practice of panchakarma declined between 17th to 19th century due to lack of training and the advent of herb-mineral preparations.

It was only towards the end of the 19th century panchakarma came back into prominence. It was the effort of Keraleeya Panchakarma. Arya Vaidya Sala, Kottakal played a significant role in popularising panchakarma treatment in India and abroad. They insisted on equipping physicians with continuous practical knowledge of panchakarma, in the same way a surgeon is trained. This paved the way for the fledgling Kerala Ayurveda tourism.

Astavaidya tradition contributed immensely to popularize this trend. The vaidyas in Kerala ensured to prescribe at least one panchakarma procedure along with oral medication. They believed in the merits of panchakarma and Ayurveda and advocated the holistic nature of Ayurveda. Their untiring efforts made Kerala the undisputed leader of Ayurveda in India. More than 1000 Ayurveda hospitals and resorts have come into existence to uphold the tradition and practices of Ayurveda.

Late Dr. Haridas Sridhar Kasture wrote a book in Hindi on Ayurvediya Panchakarma Vignan in 1970. It was a rare and authentic compilation of data on panchakarma from Ayurvedic texts and from his personal experience. It was published by Shri Baidyanath Ayurved Bhavan, Nagpur. Every Ayurveda student graduated since 1970 would have read this book, considered even today as the Holy Bible of reference in Ayurveda. Dr. Kasture took 12 long years to complete this book with no financial backing. His selfless act and passion for profession stand testimony in every page of the book.

The panchakarma practice was revived by veteran teachers in each state. Credit must be given to a few exceptionally brilliant professors who contributed their expertise and experience to promote this speciality. Their sacrifice and commitment is legendary. It is because of these eminent personalities, people oblivious to this practice, started talking about kati basti, janu basti, vamana, virechana etc. The wave of globalisation and liberalization, gave a fillip to the health industry and Ayurvedic practices in particular. Panchakarma became the 'final word' for purification.

A significant number of doctors began practising Ayurveda in every nook and cranny of India. Resorts wooed customers with Ayurvedic spa, private Ayurveda hospitals attracted patients with panchakarma facility. The sudden boom was also the result of doctors who were proficient in treating many diseases with panchakarma. The public was convinced about the efficacy of panchakarma treatment.

Yet, the business model opened the sluice gate for many doctor-entrepreneurs to start a slew of day care panchakarma centres. More than 5,000 centres mushroomed across India and thrived until 2012. The meteoric rise began to dwindle and only centres that were doctor-centric thrived. Lack of practical knowledge and the huge investment required to establish a state-of-art facility to run the business became an impediment.

However, panchakarma day care centres became the new sunshine industry. Initially people thronged such centres purely for massages. The therapeutic nature was given secondary treatment. But, doctors at these centres continued to promote the therapeutic nature of panchakarma.

The public perception was altered through effective mass communication. Scholarly articles, blogs and testimonials of people who have benefitted from therapeutic panchakarma treatment helped change the perception. Sukha chikitsa (abhyaga and shirodhara) became a sought-after panchakarma procedure. Ayurveda was reintroduced into the national consciousness, like a new religion. The wellness industry accepted Ayurveda as a panacea for detoxification. The stress-filled modern lifestyle needed a soothing therapy in the form of detoxification. Shodhana as it is known, became the saviour, emotionally and commercially.

Detoxification was promoted as the need of the hour through analogies like, "Even a BMW car needs overhauling," "The inner body needs regular cleansing", "Our tissues, organs and the mind need scrubbing regularly". That's exactly what Ayurveda provides. It's nothing lesser than an incredible art.

Panchakarma, over the course of three decades, transformed a mere concept taught at Ayurveda colleges into a powerful tool that catapulted the contemporary practice of Ayurveda. It's heartening to know that panchakarma has gently and steadily massaged the practice into the social, political and personal discourses in India and among the Indian Diaspora living across the globe.

Although panchakarma offers many unique and innovative therapies, I must sound the alarming bell about the bizarre treatments given in certain spas. The spas that claim to offer 4 to 5 therapies in a single day, by pampering a person's banal senses, are just money making quick-fix trends.

What has taken three decades to awaken the consciousness of the public cannot be sedated through such spurious trends. Let us, as guardians of the contemporary practice of Ayurveda, keep the light of Panchakarma burning brighter and brighter. Let us take the responsibility of making this sunshine industry dispel the darkness.