The definition of Panchakarma
Panchakarma is a Sanskrit word that means "five actions" or "five treatments" (Pancha means five and Karma being action). The Panchakarma is an Ayurvedic five-fold rejuvenation regimen or therapy that is aimed at Shodhana, the eradication of the basic cause of disease and Shamana. Shodhana along with Shamana, the mitigation of the disease and its symptoms, are the two concepts of disease management in Ayurveda.
Panchakarma does not just eliminate disease-causing toxins but also revitalizes the tissues. This is why it is called the rejuvenation therapy.
Two different schools
The word Panchakarma means five actions. According to one school of thought, Panchakarma refers to Nasya (nasal therapy), Vamana (emesis), Virechana (purging) and two kinds of Vasti (therapeutic enema), Nirooha Vasti and Sneha Vasti. Herbal decoctions are used for Nirooha Vasti and herbal oils for Sneha Vasti. The other school, that regards Rakta (blood) also as a Dosha (humour), the vitiation of which can cause diseases, advocated Raktamokshana (bloodletting) as the fifth in the Panchakarma therapies. So the five therapies are Nasya, Vamana, Virechana, Vasti and Raktamokshana. As bloodletting involves medical venesection, it is no longer popular. Leeching, however, is still practised.
Panchakarma and Rejuventaion
Panchakarma will remove the excess doshas and correct imbalances in thas well as eliminate the harmful ama out of your systemthrough the body's own organs and channels of elimination (colon, sweat glands, lungs, bladder, urinary tract, stomach, intestines, etc). Panchakarma purifies the tissues at a very deep level. It involves daily massages and oil baths and is a very pleasurable experience. Ayurveda recommends Panchakarma as a seasonal treatment for maintaining mental and physical hygiene and balance.
Panchakarma is a five-fold therapy; it is highly individualized based on the needs of the individual depending on the Ayurvedic constitutional type, doshic imbalances, age, digestive strength, immune status, and many other factors. Depending on each individual's needs all or only parts of the five therapies are utilized. Specially trained therapists must administer these procedures in a definite sequence for a specified period of time. In addition, although Panchakarma is for the most part a delightful and comfortable therapy, there can be periods of discomfort associated with the profound release of toxins, which does occur. It is therefore essential that a knowledgeable expert who can recognize the signs of properly and improperly administered Panchakarma supervise the therapy. Fortunately these signs were meticulously recorded by the ancient vaidyas.
Like all medical procedures, Panchakarma Therapy always must begin with an initial consultation by a qualified health professional who can determine the individual's prakriti (constitutional type), the nature of the health probl(if any), and the appropriate degree of intensity of the prescribed therapies. There are certain special circumstances in which panchakarma should be administered only with strict medical supervision: recovering drug addiction, alcoholism, hypertension, diabetes, and eating disorders are the most common. Panchakarma may also not be appropriate for individuals who are significantly underweight or physically weak or for persons with inadequately treated (or undiagnosed) hypothyroidism or hypoglycemia. The same is true of persons with cancerous diseases, immune deficiency states, or those recovering from recent surgery. All potential patients, but especially those identified above, should always consult a qualified health professional before initiating any form of detoxification program
The three stages of Panchakarma therapy:
Panchakarma is always performed in three stages
The patient who opts for any one of the five therapies has invariably to undergo all the three stages.
Snehana (oleation / oil therapy) and Swedana (sudation) are the two Purva Karma procedures. Snehana (internal and external oleation) loosens the Amam stuck in various sites of the body and Swedana dilates the channels to facilitate its movement towards the Koshta (alimentary canal).
The Amam that reaches the Koshta is eliminated during the Pradhana Karma (primary treatment).
Diet regimens, restricted bodily exertion and the intake of health-promoting drugs come under the Paschat Karma (post-treatment).
Purvakarma (Pretreatment):
The purvakarma procedures are often under appreciated in the grand scheme of proper administration of Panchakarma.The general purpose of the Poorvakarma Therapies is to begin to loosen, liquefy, and move the vitiated doshas from their abnormal sites in peripheral tissues to the appropriate central site within the alimentary canal. Oil massage and fomentation are administered on the night before the day of Vamana. Prior to the start of Vamana, the patient is asked to drink a specified quantity of ghee or oil until the stool becomes oily, or nausea occurs. If vamana is planned a Kapagenic diet is given during this time to aggravate Kapha. Either during the same time period or for one week subsequently, oil massages are given.
Abhyanga Karma (Oil Massage Treatments)
Of the many methods that are described in Ayurveda for externally oiling the body, the one that is used for this purpose in Poorvakarma is known as Sneha Abhyanga. It is worthwhile to know something of the entymology of this term. Sneha, we may recall, means oil, or unctuousness. Abhyanga is derived from the root ang meaning "movement" and the prefix abhi meaning "into" or "toward". Thus the word "abhyanga" has the meaning of moving energy into the body or, alternatively, moving toxins towards the alimentary canal for elimination.
The main purpose of massaging the body with oil is, like the internal oleation procedure, to encourage the detachment of toxins (including vitiated doshas) from the deeper tissues and the subsequent movement of these toxins back to their origins in the gastrointestinal tract where they can be efficiently eliminated with the help of the main panchakarma (pradhanakarma) procedures. Massage has an obvious added benefit in this regard namely the stimulation of the circulatory systems of the blood and lymph tissues. Abhyanga is traditionally performed by one, two, four, or more therapists simultaneously. We will review a few other important aspects of Abhyanga karma.
Position of the Patient
According to the classic texts, the patient adopts five different positions (or postures) during the course of each massage session. Two of the postures are repeated, making a total of seven postures for each massage. These seven postures are:
In clincal practice, an approximately equal amount of time is given to each position, with perhaps a little more time allocated to the front of the body and the back of the body (positions #2 and #4). The physician may also indicate which positions to emphasize for a given patient. By adopting these simple postures throughout the massage procedure, together with the actual "downward" pressure of the massage being applied by the therapists, the patient is forced to bring into contact with the massage table certain joints and bony areas of the body. These areas are several examples of a group of cutaneous energetic points known as marma sthula, the famous marma points of Ayurveda.
Swedana Karma (Sweat or Fomentation Treatments)
Swedana Karma is simply the group of procedures used to induce sweating. Charaka eloquently tells us that swedana is "whatever relieves stiffness, heaviness, and cold in the body and produces sweat" (CS Su. 22/11). The word swedana is derived from the Sanskrit root word swid meaning "to sweat, perspire; foment; soften". The word sweda refers to the "internal excreta of the body" which is a by-product of meda or fat tissue (CS Ci. 15/18).
Swedana karma is instrumental in helping to liquify the sticky and adherent doshas, which have become lodged in the peripheral tissues. Properly timed, Swedana will soften and melt these toxins sufficiently for the body to efficiently expel thwith the assistance of the pradhanakarmas (main therapies) which then directly follow. Sweating leads the doshas to fluidity, making it easier for it to flow out of the system. It opens up the pores and rids the body of impurities through the sweat glands. There are two principal ways of inducing the sweat: using or not using fire.
Examples of Swedana without fire include:
Plants such as ginger root, castor root, punarnava, barley, sesame, kulattha, black gram, jujube and the drumstick plant all encourage the body to sweat more easily.
Swedana therapies are contraindicated in persons who are pregnant, persons with bleeding disorders, who have used alcohol recently, persons who are very fat or very thin, persons with diarrhea, jaundice, anemia. It is also not recommended for people who are very angry, hateful or jealous. Patients suffering from fainting, dizziness, nausea, fever and similar ailments should also not use this treatment.
Pradhana Karma (Primary treatment):
Vamana (Therapeutic Vomiting)
This treatment is used when there is congestion in the lungs causing repeated attacks of bronchitis, cough, cold or asthma. The objective of the therapy is to induce vomiting to get rid of the mucus causing excess kapha. On the morning of the vamana., kapha aggravating foods such as basmati rice and yogurt with salt is given to further aggravate the kapha. The application of the heat to the chest and back will help liquefy kapha. A drink consisting of madanaphalam, liquorice and honey, or calamus root tea is given to the patient. (Other substances used include salt, and cardamom) Vomiting will either occur spontaneously or is induced by rubbing on the tongue. 4-8 vomiting is the target. After vomiting the patient will feel very comfortable; most of the congestion, wheezing and breathlessness will disappear along with the clearing of the sinus.
Therapeutic vomiting is used for cough, cold, symptoms of asthma, fever, nausea, loss of appetite, anemia, poisoning, skin diseases, diabetes, lymphatic obstruction, chronic indigestion, edema (swelling), epilepsy (between attacks), chronic sinus problems and for repeated attacks of tonsillitis.
Since vata is mainly located in the colon and bones, the medication is administered rectally.
Types of Enemas:
Enemas should not be given to persons suffering from shortness of breath, chronic abdominal pain, bleeding from rectum, cough, diarrhea, severe anemia,the very elderly or to children under 8 years.
Nasya (Nasal administration, Errhine Therapy)
This treatment involves the administation of herbalized oils and liquids into the nostrils. It is useful for treatment of kapha-oriented problems, of ear, eyes, nose and throat disorders such as migraine, sinusitis, catarrh, and bronchitis.
The nose is the gateway to the brain and to consciousness. Prana or vital energy enters the body through breath taken in through the nose. Nasal administration of medication helps to correct the disorders of prana affecting the higher cerebral, sensory and motor functions. Nasya is indicated for dryness of the nose, sinus congestion, hoarseness, migraine headache, neurodegenerative conditions (i.e. multiple sclerosis), convulsions and certain eye and ear problems.
Substances such as calamus powder, gotu kola, onion, garlic, black pepper, cayenne, ginger, ghee oil decoctions are used in Nasya. Nasal medication should not be administered after a bath, food, sex, drinking alcohol, during pregnancy or menstruation.
Rakta Moksha (Blood Letting)
Blood letting is used to eliminate toxins that are absorbed into the bloodstream through the gastrointestinal tract. This process purifies the blood. It is used for disorders such as repeated attacks of skin disorders such as urticaria, rash, eczema, acne, scabies, leucoderma, chronic itching and hives. It is also often effective for enlarged liver and spleen, hemochromatosis, and for gout.
Blood letting, which should only be administered by a qualified physician, is useful to relieve several pitta disorders such as acne and rash. If administered properly, it stimulates the antitoxic substances in the blood stream, thus developing the immune mechanism in the blood system.
Do not administer blood letting in cases of anemia, edema, weakness or to very old and very young persons.
Panchakarma, the rejuvenation therapy expounded in Ayurveda is perhaps the most misunderstood of all the Ayurveda practices. Due to ignorance, it is often perceived as just another systemof oil massage. Oil massage is a part of treatment in Ayurveda. The Sanskrit word for oil massage is Abhyanga. One must understand that this oil massage or Abhyanga is mere a part of Panchakarma therapy. Panchakarma is a holistic rejuvenation therapy and is not just an oil massage, as it is widely believed. It is in Kerala that the rejuvenation therapy of Panchakarma grew and flourished. There are regional variations in therapy procedures and also the equipment used. Practice of this therapy should always be done under the guidance of qualified and competent physicians and trained attendants.
