"Panchakarma"
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Pancha Karma is the cornerstone to Ayurvedic management of
disease. Pancha Karma is the process which gets to the root cause of
the problem and corrects the essential balance of 'Tridosha' in body.
Pancha Karma is not only good for alleviating disease but is also a
useful tool in maintaining excellent health. Ayurveda advises
undergoing Pancha Karma at the seasonal changes to clean the body,
improve the digestion and to improve the metabolic processes.
Panchakarma is a Sanskrit word that means "five actions" or "five
treatments".
This age-old science of purifying the body is an ancient
branch of Ayurveda, The Treatment in Ayurveda consists of two main
types.
One is Shaman Chikitsa, used to subdue the vitiated Doshas, due to
which any ailments may be produced. It is administered by using various
medicinal herbo-mineral preparations.
However, if the Doshas 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 second type of treatment, which is Shodhan Chikitsa
or cleansing therapy, is indicated. Since it consists of the five types
of main therapies, it is known as the Panchakarma Chikitsa.
Panchakarma has been given a special place in all the ancient Ayurvedic
texts. Aacharya Charak, the author of the most important ancient text
on internal medicine, has described a wide use of Panchakarma therapy
for almost all the major diseases. Two separate sections, Kalpa
Sthanam, and Siddhi Sthanam in Charak Samhita describe the details of
special decoctions and other preparations used for Panchakarma therapy.
Panchakarma includes three parts namely:
Poorva Karma (Preparatory Methods)which includes :
Paachan (Digestion)
Snehan (Internal and external oleation)
Swedan (Fomentation)
Pradhan Karma (Main methods)which includes :
Vaman (Induced vomiting)
Virechan (Induced purgation)
Basti (Medicated enema)
Nasya (Nasal medicine)
Rakta Mokshan (Artificial bloodletting)
Pashchat Karma (Post-Therapeutic Measures)which includes :
. This includes Sansarjan Krama (Specific dietetics), DhumaPana
(smoking of medicinal cigars) and some rules to follow specific
activities.
Purvakarma: Pre-purification Measures
Before the actual operation of purification begins, there is a
need to prepare the body in prescribed methods to encourage the body to
let go of the toxins. The two procedures are 'snehan' and 'swedan'.
Snehan is the oil massage. Oil is applied to the entire body with a
particular type of massage which helps the toxins to move towards the
gastro-intestinal tract. Oil massage also makes the superficial and
deep tissues soft and supple. Snehan is given daily for three to seven
days, as indicated. Swedan is sudation or sweating and is given every
day immediately following the snehan. An herbal concoction may be added
to the steam to further loosen the toxins from the individual. Swedan
liquefies the toxins and increases the movement of toxins into the
gastro-intestinal tract. After three to seven days of snehan and
swedan, the doshas become well "ripened". A particular panchakarma
method is then given according to the individual's constitution and
disorder, prakruti and vikruti, respectively.
Panchakarma
Five Basic Shodhans: Cleansing Methods
1) Vaman: therapeutic vomiting or emesis
2) Virechan : purgation
3) Basti: enema
4) Nasya : elimination of toxins through the nose
5) Rakta moksha: detoxification of the blood
Vaman: Emesis Therapy
When there is congestion in the lungs causing repeated attacks
of bronchitis, colds, cough or asthma, the Ayurvedic treatment is
therapeutic vomiting, vaman, to eliminate the kapha causing the excess
mucus. First, after the snehan and swedan, three to four glasses of
licorice or salt water is administered, then vomiting is stimulated by
rubbing the tongue which triggers the vomiting center through the gag
reflex. One may alternatively take two to three glasses of salt water
which will also aggravate kapha and then rub the tongue to induce
vomiting. Once the mucus is released the patient will feel instantly
relieved. It is likely that congestion, wheezing and breathlessness
will disappear and that the sinuses will become clear. Therapeutic
vomiting is also indicated in chronic asthma, diabetes, chronic cold,
lymphatic congestion, chronic indigestion and edema.
Emetic Substances:
madan-emetic nut, madhuka-yastimadhu-licorice, neem-bitter leaf, bimbi,
kutaj-kurchi- conessi bark, murva-clematis, triloba-devdaru-deodar,
Cedrus deodara, Salt, NaCl, ela-cardamom, nux vomica.
Indications for Vaman:
used for all kapha type disorders good for pitta headache, dizziness,
and nausea will help to release blocked emotions respiratory congestion
bronchitis chronic cold sinus congestion kaphagenic asthma
Contra-Indications for Vaman:
below the age of 12 or over age 65 menstruation pre-menstrual period
(one week prior) pregnancy emaciation delicate or sensitive person with
too much fear, grief or anxiety hypoglycemia vata prakruti vata
diseases heart diseases during vata season acute fever diarrhea obesity
Virechan: Purgation Therapy
When excess bile, pitta, is secreted and accumulated in the
gall bladder, liver and small intestine, it tends to result in rashes,
skin inflammation, acne, chronic attacks of fever, biliary vomiting,
nausea and jaundice. Ayurvedic literature suggests in these conditions
the administration of therapeutic purgation or a therapeutic laxative.
Virechan is facilitated with senna leaves, flax seeds, psyllium husks
or triphala in a combination that is appropriate for the individual
person.
Virechan Substances:
Senna, prune, bran, flaxseed husk, dandelion root, psyllium seed, cow's
milk, salt, castor oil, raisins, mango juice, triphala.
Indications for Virechan:
allergic rash skin inflammation acne, dermatitis, eczema chronic fever
ascites biliary vomiting jaundice urinary disorder enlargement of the
spleen internal worms burning sensation in the eyes inflammation of the
eyes conjunctivitis gout
Contra-Indications for Virechan:
low agni acute fever diarrhea severe constipation bleeding from rectum
or lung cavities foreign body in the stomach after enema emaciation or
weakness prolapsed rectum alcoholism dehydration childhood old age
ulcerative colitis
Basti: Enema Therapy
Vata's predominant site is the colon. Ayurvedic basti involves the
introduction into the rectum of herbal concoctions of sesame oil, and
certain herbal preparations in a liquid medium. Basti, is the most
effective treatment of vata disorders, although many enemas over a
prescribed period of time are usually required. 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.
Vata is a very active principle in pathogenesis. If we can control vata
through the use of basti, we have gone a long way in going to the root
cause of the vast majority of diseases.
Vata is the main etiological factor in the manifestation of diseases.
It is the motive force behind the elimination and retention of feces,
urine, bile and other excreta.
There are eight main types of basti, according to traditional texts,
each with their own indications and contra-indications as listed below.
1. Anuvasana (oil enema) is used in pure vata disorders and when a
person is having excess hunger or dryness related to vata imbalances.
2. Niruha-Asthapana (decoction enema) is used, among other conditions,
for evacuation of vata, nervous diseases, gastro-intestinal vata
conditions, gout, certain fever conditions, unconsciousness, certain
urinary conditions, appetite, pain, hyperacidity and heart diseases.
3. Uttara Basti (through the urethra with men or vagina with women) is
used for selected semen and ovulation disorders and for some problems
involving painful urination or bladder infections. This is not to be
used for someone with diabetes.
4. Matra Basti (daily oil enema) is used by someone emaciated by
overwork or too much exercise, too much heavy lifting, walking too long
of a distance, too much sexual activity or someone with chronic vata
disorders. It does not need to be accompanied by any strict dietary
restriction or daily routine and can be administered, in the
appropriate cases, in all seasons. It gives strength, promotes weight
and helps elimination of waste products.
5. Karma Basti (schedule of 30 bastis),
6. Kala Basti (schedule of 15 bastis; 10 oil + 5 decoction)
7. Yoga Basti (schedule of 8 bastis; 5 oil + 3 decoction).
8. Bruhana Basti (nutritional enema) is used for providing deep
nutrition in select conditions. Traditionally, highly nutritive
substances have been used, such as warm milk, meat broth, bone marrow
soup and herbs like shatavari or ashwagandha.
General Indications for Basti:
constipation low back ache gout rheumatism sciatica arthritis nervous
disorders vata headache emaciation muscular atrophy
General Contra-Indications for Basti (include but are not limited to
the following):
Enema therapy should not be used if the patient is suffering from
diarrhea, bleeding of the rectum, chronic indigestion, breathlessness,
diabetes, fever, emaciation, severe anemia, pulmonary tuberculosis, old
age or for children below the age of seven years.
for oil enemas: diabetes, obesity, indigestion, low agni, enlarged
liver or spleen, unconsciousness, tuberculosis and cough.
for decoction enemas: debility, hiccough, hemorrhoids, inflammation of
anus, piles, diarrhea, pregnancy, ascites, diabetes and some conditions
involving painful or difficult breathing.
for nutritional enemas: diabetes, obesity, lymphatic obstruction,
ascites.
for urethra or vaginal enemas: diabetes
Nasya: Nasal Administration
The nose is the doorway to the brain and it is also the
doorway to consciousness. The nasal administration of medication is
called nasya. An excess of bodily humors accumulated in the sinus,
throat, nose or head areas is eliminated by means of the nearest
possible opening, 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 prana disorders,
sinus congestion, migraine headaches, convulsions and certain eye and
ear problems.
There are six main types of nasya, as listed below.
1. Pradhamana (virechan) Nasya (cleansing nasya) uses dry powders
(rather than oils) that are blown into the nose with a tube. Pradhamana
nasya is mainly used for kapha types of diseases involving headaches,
heaviness in the head, cold, nasal congestion, sticky eyes, hoarseness
of voice due to sticky kapha, sinusitis, cervical lymph adenitis,
tumors, worms, some skin diseases, epilepsy, drowsiness, Parkinsonism,
inflammation of the nasal mucosa, attachment, greed and lust.
Traditionally, powders such as brahmi are used.
2. Bruhana Nasya (nutrition nasya) uses ghee, oils, salt, shatavari
ghee, ashwagandha ghee and medicated milk and is used mainly for vata
disorders. It is said to benefit conditions resulting from vata
imbalances such as vata-type headaches, migraine headache, dryness of
voice, dry nose, nervousness, anxiety, fear, dizziness, emptiness,
negativity, heaviness of eyelids, bursitis, stiffness in the neck, dry
sinuses and loss of sense of smell.
3. Shaman Nasya (sedative nasya) is used according to which dosha is
aggravated but mainly for pitta-type disorders such as thinning of
hair, conjunctivitis and ringing in the ears. Generally certain herbal
medicated decoctions, teas and medicated oils are used.
4. Navana Nasya (decoction nasya) is used in vata-pitta or kapha-pitta
disorders and is made from decoctions and oils together.
5. Marshya Nasya (ghee or oil nasya)
6. Prati Marshya (daily oil nasya) This helps to open deep tissues and
can be done every day and at any time to release stress.
Substances Used in Nasya:
brahmi, ginger, ghee oils, decoctions, onion, garlic, Piper longum,
black pepper, curry pepper, rose, jasmine, mogra flowers and henna.
Indications for Nasya:
stress emotional imbalances stiffness in the neck & shoulders dryness
of the nose sinus congestion hoarseness migraine headache convulsions
Contra-Indications for Nasya:
sinus infections pregnancy menstruation after sex, bathing, eating or
drinking of alcohol should not be used below 7 years or over 80 years
of age
Raktamoksha: Traditional Ayurvedic Method for Purification and
Cleansing of the Blood
Toxins present in the gastro-intestinal tract are absorbed
into the blood and circulated throughout the body. This condition is
called toxemia, which is the basic cause of repeated infections,
hypertension and certain other circulatory conditions. This includes
repeated attacks of skin disorders such as urticaria, rashes, herpes,
eczema, acne, leukoderma, chronic itching or hives. In such conditions,
along with internal medication, elimination of the toxins and
purification of the blood is necessary. Raktamoksha is also indicated
for cases of enlarged liver, spleen and gout.
Extracting a small amount of blood from a vein relieves the
tension created by the pittagenic toxins in the blood. Bloodletting
also stimulates the spleen to produce antitoxic substances which helps
to stimulate the immune system. Toxins are neutralized enabling radical
cures in many blood born disorders.
Bloodletting is contraindicated in cases of anemia, edema,
extreme weakness, diabetes and in children and elderly persons.
Indications for Raktamoksha:
urticaria rash acne eczema scabies leukoderma chronic itching hives
enlarged liver or spleen gout
Contra-Indications for Raktamoksha:
anemia edema weakness young children old age during pregnancy during
menstruation