Panchakarma literally means "five therapies". These five therapeutic
means of eliminating toxins from the body are Vaman (emesis), Virechan
(purgation), Nasya(nasal insufflation), Basti (enema) and Raktamoskshana
(blood-letting by using leech and different instruments). This fivefold
therapy is aimed at Shodhana i.e., the eradication of the basic cause
of disease and later to achieve Shamana which means the mitigation of
the disease and its symptoms.
Panchakarma is essentially applicable to all cases covering a
wide range of preventive, curative and promotive conditions. Panchakarma
is advocated in a healthy person to combat seasonal imbalance of
tridosha. Ayurveda describes that the disorders treated with this mode
of therapy do not recur while those treated with other palliative
methods might re-appear. These measures are preceded by oleation therapy
(snehana) and sudation therapy (svedana) and are followed by special
diet recommendations (samsarjana karma).
Emesis has been claimed as the best treatment for diseases of
Kapha, purgation for diseases of pitta and enema for diseases of vata.
Classically panchakarma therapy is prescribed and practiced through
following schedule viz., (1) Preparatory measures orpurva karma, (2) The
principal measures or pradhana karma (3) Post therapy measures of
paschat karma.
Purvakarma (preparatory measures)
Before the administration of panchakarma therapy, the patient is
prepared suitably with the administration of fat (oils and clarified
butter) i.e. snehana or oleation therapy and sweating measures i.e.
Swedana or sudation therapy as preparatory measures.Panchakarma therapy
should not be undertaken without purva karma otherwise it fails to
eliminate the dosha situated in the tissues. The administration of fat
therapy renders the body soft and disintegrates the accumulated dosha
and sweating therapy melts thedosha stagnated in the subtle channels of
circulation. At this stage administration of panchakarma measures
eliminates the dosha out of the body easily and effectively through
respective pathways.
ii Snehana-Administrationof preparations
containing fat to a patient for a limited period to get the desired
clinical effect is called Snehana (Oleation). Fat influences
abnormalvata, renders the body soft and clears the accumulated wastes
which have obstructed the body channels. Further the regular use of fats
has been considered beneficial for the proper digestion, cleansing of
the bowel, the promotion of body strength and integrity of senses and
the prevention of aging in the aged besides several other beneficial
effects of oleation. Fat preparations can be administered through
different kinds of foods, as enema, massage etc. according to the
feasibility. The fats may be used singly or may be mixed with other
drugs. Fat may be administered before, during or after food according to
the disease.
iii Swedana-Making a person to sweat, with or
without heat, is called Swedana(Sudation). Generally the sudation
therapy should be undertaken after the oleation therapy. It is
considered that the sweating therapy melts the waste products of
metabolism, stagnated in the subtle channels of circulation which have
been disintegrated by the fat therapy51. Two types of measures are
employed for sweating, (1) using external heat (Sagni sweda) and (2)
Without direct application of heat (Niragni sweda) by using practices
like indulgence in strenuous physical labour, staying in a closed room,
covering oneself with thick clothes, hunger, administration of different
kinds of alcoholic beverages, by covering the body with leather,
wrestling and walking in the sun and other measures which may generate
heat and sweating52. Care should be taken while performing swedana of
certain parts of the body such as groin, eyes, testes and precardial
region.
iv Pradhana Karma (Main procedures)
After preparing the patient with snehana (oleation) and swedana
(sudation) the patient is subjected to the main measures of panchakarma -
Vaman (emesis), Virechan(purgation), Nasya (nasal insufflation), Basti
(enema) and Raktamoskshana (blood-letting by using leech and different
instruments).
v Vamana (Emesis therapy)-Vamana is the
procedure of eliminating waste products of the body through the upper
passage by vomiting. Emesis is the therapy of choice in diseases of
kapha dosha. It is specially indicated in the fever of recent origin,
cough, cold, bronchial asthma, elephantiasis, diabetes, bleeding through
lower channels, nausea, diarrhoea, loss of appetite, poisoning,
stomatitis, anemia, mental diseases, epilepsy, erysipelas,
lymphadenopathy etc. Emesis therapy is contraindicated in the patients
if they are child, very old, debilitated and hungry and also in trauma
of lungs, sprue, bleeding or upper channels, anuria, enlargement of
spleen, abdominal tumours and abdominal diseases etc. A subjective
feeling of cleanliness of the heart, chest, head etc., lightness in the
body, timely passing of urine stool etc. are the features of well
administered emesis therapy.
vi Virechana (Purgation therapy)-Virechana or
purgation therapy is a systemic therapy for the diseases of pitta dosha.
Purgation therapy is indicated in diseases of skin, fever, diabetes,
bleeding of upper channels like mouth, nose etc., diseases of
gastrointestinal tract, piles, abdominal tumour, enlargement of spleen,
anuria, helmenthiasis, erysipelas, gout, vaginal diseases,
fistula-in-ano, tumour, glandular swelling, anemia, jaundice, loss of
appetite etc. It is contraindicated in children and old patients and
also in diseases like bleeding of lower channels, pregnancy, fever of
recent origin, indigestion, lymphadenitis, weakness, debility, diarrhea
etc. Feeling of cleanliness in the channels and sense organs, lightness
in the body and increase of appetite etc. are the symptoms of well
administered Virechana karma.
vii Basti (Enema)-Medication administered by the
enema to get desired therapeutic effects is known as basti (enema)
therapy. According to the Ayurveda vata is the main morbid factor in the
causation of disease pertaining to tissue and organs in the body
andbasti (enemata) therapy is the best treatment of excessive excited
vata, therefore, bastikarma is considered half the treatment of all the
diseases described in Ayurveda. This therapy is also very useful as a
health promoting measure. It is beneficial for old as well as for the
young and there are no notable hazards in this therapy. It cures all
kinds of diseases due to its varied pharmacodynamics and various kinds
of drugs used in its preparations. Enemata therapy is of two types viz.
Oily enema (Anuvasana basti) and Decoction enema (Niruha basti).
viii Nasya (Nasal insufflation)-Nasya is a
process by which drug is administered through the nostrils. It is useful
in all the diseases manifesting above the neck (urdhwajatru gata)
because it eliminates toxins through the nostril. On the basis of its
therapeutic action and the way of administration it is classified in to
many types likevirechana nasya (cleansing nasya) , brumhana nasya
(nutritive) shamana nasya(pecifying) , navana nasya (decoction nasya)
marsha nasya (ghee or oil), pratimarshya(daily oil nasya) etc.
ix Raktamoskshana (Blood-letting)-Rakta Mokshana
or blood letting is one of thepanchakarma developed by Susrutha as a
specialized technique. Here a small amount of venous blood is extracted
by using either sharp instrument or specialised equipment or leech. It
is helpful in relieving diseases of pitta origin, blood born and chronic
skin diseases.
Paschata Karma (Post Panchkarma Procedure Management):
The procedures like internal intake of sneha in high dosage
followed by the purificatory therapy is definitely going to create some
sort of impairment in function of digestive power temporarily. So,
immediately the subject is not allowed to come back to his normal diet
patter. In order to bring back the agni (digestive fire) to normal
state some specific diet patterns are followed after the main procedure.
This is known as Sansarjan krama; in which initially easily digestible
liquid dominant diet is given with gradual introduction of salt,
pepper, mustard, oil etc.
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