The three stages of panchakarma therapy
Snehana (oleation/oil therapy) and swedana (sudation) are the two
purva karma procedures. Snehana (internal oleation and external oleation)
loosens the ama (toxins) stuck in various sites of the body and swedana
dilates the channels to facilitate its movement towards the alimentary
canal. The ama (toxins) that reaches the alimentary canal is eliminated
during the panchakarma (primary treatment).
Panchakarma or the shodhana therapy is always performed in three
stages-purva karma (pre-treatment), pradhana karma (primary treatment)
and paschat karma (post treatment). The patient who intends to undergo
all the three stages.
Diet regimens, restricted bodily exertion and the intake of health
promoting drugs etc. come under the paschatkarma (post treatment).
Disease management in ayurveda
Shamana and shodhana are the two concepts of disease management
in ayurveda. Shamana means elimination and shamana methods mitigate
the disease and its symptoms. Shodhana means elimination and shodhana
methods aim at the elimination of the basic cause of disease.
Panchakarma and rejuvenation
The word ‘panchakarma’ means ‘five-actions’.
This is a five- pronged method of treatment designed for shodhana,
the expulsion of disease causing toxins (ama). Panchakarma is intended
not only for the elimination of toxins but also for the replenshiment
of the tissues. Often tonics are prescribed after panchakarma to
rebuild the organism and rejuvenate the patient.
Snehana (oil therapy)
‘sneha’ means oil. ‘snehana’ is the term
used for oleation or the application of oil. Oil may be administered
either internally or externally. Application of herbal oil in either
way saturates the body and loosens up the glutinous ama (toxin)
that has accumulated in the tissues/dhatus. Vegetable oils, ghee
(clarified butter), animals fats and fat from bone marrow are used
for certain diseases.
Snehapanam (abyyantara snehana)
In snehapanam, a presequisite in panchakarma, tikta ghritam or
ghee infused with herbs is orally administered to the patient for
a specific period. This ghee is made from clarified butter (obtained
from cow’s milk) from which the protein content has been removed.
It is then cooked with various herbs. Snehapanam is done in the
morning after attending to the calls of nature, on an empty stomach.
The health, age, dosha condition and digestive capacity of the patient
need to be taken into consideration when determining the dosage.
The treatment lasts between five and seven days depending on the
condition of the patient and the illness being treated.
‘abhyanga’, means oil massage. While a person may
perform abhyanga on his own as part of his daily routine, trained
masseurs are required to perform this therapy when it is used for
disease management. In abhyanga, medicated oil is massaged all over
the body. The abhyanga that is part of the daily routine lasts for
five to fifteen minutes where as that which is performed for treating
diseases may take 45 minutes.
Massages in abhyanga is done on the patient who lies on the droni.
The droni is the wooden bed. Padabhyanga or feet massage is done.
The marmas or vital points on the soles of the feet are closely
related with certain internal organs.
Podikkizhi is a method of therapeutic sweating. The body is fomented
thoroughly with linen bags (kizhis) containing drugs in powdered
form. Horsegram, blackgram, sesame seeds and curative ingredients
are powdered and tied up in bundles. As moderate heat is required
to sweat the body, the kizhis have to be warmed up by heating them
in a pan smeared with castor or neem oil to prevent the kizhis from
Navarakkizhi, involves fomentation of the body with a bolus of
cooked rice. Shastika or navara, a particular kind of rice known
for its nutritional valve, is cooked in milk and a herbal decoction
made of sida rhombifoila.
‘pizhichil’ and sarvangadhara are technically the same.
Pizhichil means squeezing. Here warm medicated oil is squeezed over
the patients body from a piece of cloth that is periodically dippe
in a vessel containing the oil.
Dhara is the pouring of warm medicated oil or a herbal decoction
over the body.
An infusion prepared from the cereals (dhanyam) and vinegar (amlam)
obtained from citrus fruits is called as dhanyamlam. Navara rice,
horse gram, millet, sliced citrus fruits, dried ginger and so on
are bundled separately in pieces of linen and then immersed in a
large pot containing water. The water is then boiled for a specific
period during which the extracts mix with water to make vinegar.
A dhara treatment with this liquid is called dhanyamladhara.
Dhara with medicated milk is called
Extracts of herbs that possess preventive and curative properties
are used for netradhara. A stream of herbal extract is gently poured
into the eyes of the patient who lies on the droni.
‘avagaha’ means immersion. Avagaha sweda is sweating
Bashpasweda (steam sudation) is a type of sudation therapy. Here,
herbal steam is applied evenly to the entire body.
Pradhana karma therapies
The nostrils are the entrance to the head and the effect of the
drugs administered through the nostrils spreads and alleviates the
illness thereby protecting the upper as well as the lower regions
of the human body.
The administration of herbal oils, decoctions and powders through
the nostrils is called nasya. The therapy is used not merely as
a nasal decongestant but also to cure many serious ailments like
loss of consciousness, stupor, insomnia, hysteria, hemiplegia, and
Vamana is a process of drug-induced vomiting to expel mainly the
vitiated kapha dosha from the body. Purvakarma procedures like oleation
and sweating are essential for this therapy.
Oleation, internal as well as external, liquefies the ama (toxins)
trapped deep in the dhatus (tissues).
Sudation dilates the bodys subtle channels and allows the liquefied
ama (toxins) to move to the gastro-intestinal tract. When the body
is thus prepared properly, emesis becomes painless and effortless.
Vamana is an effective treatment for chronic colds, bronchial asthama,
arthritis, and certain skin diseases. However, the therapy is not
recommended for pregnant women, the elderly and the weak, and those
suffering from certain diseases of the heart and liver.
Virechana or purgation therapy facilitates the elimination of vitiated
pitta from the body.
Virechana acts on the main domain of pitta dosha-the stomach,
the small intestine.
Vasti is the most important of the therapies in panchakarma. It
involves the introduction of herbal oils and decoctions into the
colon through the rectum.
Of the three humours, only vata, the prime abode of which is the
large intestine (colon), has the power of mobility. When its movement
is affected, the functions of the other two humours are alos adversely
affected. The herbal fluid is allowed to remain in the colon for
a specific period for proper absorption. When it is let out, toxins
from the tissues are eliminated along the faecal matter.
Vasti is not recommended for patients suffering from diarrhea, asthama,
piles or diabetes.
The central portion of the body is called, ‘kati’.. vasti
implies a container. Kativasti is an effective therapy for katishula
(low backache/ lumbago).
For the severe conditions of sciatica and osteo-arthritis of the hip,
a disease condition characterized by severe pain radiating down the
Nertavasti is a treatment for the eyes. A receptacle is built around
the eyes with black gram dough for the retention of the medicated
ghee (ghritam) used in the therapy.
This treatment is prescribed for disorders like facial paralysis,
cataract, deafness, earache, insomnia and other diseases that afflict
the cranial nerves.
The treatment is for ailments affecting the region above the neck,
especially due to disrupted vata dosha. Pichu is used to treat some
ailments of the cranial nerves.
Urovasti is administered to the chest to treat pain in the sternum.
As in kativasti, a small receptacle is made on the chest with black
gram paste. Oil is poured into this and allowed to remain there
for some time.
An ‘upanahasweda’, or poultice is a local application
of a medicinal paste to treat pain associated with swelling.
A medicinal paste is prepared out of various substances. Seeds having
anti-inflammatory and pain reducing properties are ground in herbal
oils or herbs are cooked with grains like wheat or navara rice to
make the paste.
A moderately thick layer of the hot paste is applied to the affected
part. Often the area is then bandaged with cloth or leaves.
Medicinal paste applied on the crown or forehead is called talam.
Covering of the head with medicinal paste is known as talapotichil.
It is an important treatment for minor and major diseases that afflict
Karnapooranam literally means filling the ears.
Lepana is the external application of medicinal paste on the body
where pain associated with inflammatory condition persists. The
ingredients of the paste vary according to the nature of the ailment.
Udvartana means to elevate or to promote. The name is attributed
to the treatments ability to improve the body’s condition.
Rejuvenation and Kudipraveshika
Ayurveda is the science of longetivity. Rasayana chikitsa (rejuvenative
therapy) and vajeekarana chikitsa (virilization therapy) constitute
two parts of ashtanga (eight parts) of ayurveda. According to ayurveda,
any person who undergoes a course of rejuvenation and virilization
can be transformed into a healthy youth. .