Panchakarmas (पञ्चकर्माणि)

Panchakarmas are speciality treatments in Ayurveda. This term Panchakarmas suggests 5 different procedures collectively. These procedures are grouped under Shodhana chikitsa (detoxifying therapies) in Ayurveda wherein the excessively vitiated and doshas aggravated beyond certain level are eliminated out through the nearest external orifice of the shariram. Vamana, Virechanam, Basti, Nasyam and Raktamokshanam are these 5 procedures collective known as Panchakarmas.

Introduction

Chikitsa in Ayurveda is classified in various types on the basis of various criterias. One of the classification classifies chikitsa in Shodhdana and Shamana types. Doshas are believd to be the disease pathology initiating components. When those are aggravated various methods are employed to pacify them and re-establish their equilibrium with the use of herbs, diet, lifestyle management and certain other methods. However, this is possible and beneficial only when te aggravation of doshas is mild to moderate. In certain conditions, the pathology is such that doshas are excessively vitiated and aggravated severly. In such cases, it is advisable to eliminate excessively aggravated doshas out of the body so as to get considerable relief and even prevent recurrance. In such situations, Shodhana chikitsa is considered in the form of one or more Panchakarmas. Not all 5 procedures are incorporated simultaneously.

Definition

The term 'Panchakarma' is composed of two parts. 'Pancha' and 'Karma'.

Pancha - 5 in number

Karmas - Therapeutic procedures

5 types of therapeutic procedures.

Panchakarmas : 5 types of Panchakrmas

Five therapeutic measures are used for the elimination of vitiated Doshas, therefore Shodhana is also called as Panchakarma (five fold therapy). The five measures are Vamana (emesis therapy), Virechana (purgation therapy), Anuvasana Basti (oily enema therapy), Asthapana or Niruha Basti (decoction enema therapy) and Shirovirecana (nasal insufflation therapy). Some of the Ayurvedic authors consider Anuvasana and Asthapana Basti as one and include Raktamoksana (blood letting) in Panchakarma. In this way, in their opinion, Shodhana methods are Vamana, Virechana, Basti, Shirovirechana, and Raktamokshana (blood letting).

Vamana Karma is specific for elimination of vitiated Kapha, Virecana for vitiated Pitta and Basti is best for the elimination of vitiated Vāta.

Vamana

Vamana is considered best for the elimination of morbid and increased Kapha, and thus for curing the disorders of Kapha. It eliminates the Doṣa through stomach by vomiting and should generally be given after performing Snehana and Svedana.

Virechana

Purgation therapy is a specific process for elimination of pitta dosha. PT procedure involves elimination of pitta dominating dosas and toxins of the body through the rectal route.

Basti

The medicine given through enema is called Basti. It is the best treatment for the elimination of morbid Vāta. This therapy may also be used for the promotion of the health as it provides happiness, long life, strength, digestive power, intelligence, voice and colour. It is free from risks, hence it can be administered at all ages. It draws out unwanted faeces, mucus, bile, flatus and urine, imparts firmness, enriches semen and gives body strength.

Basti is of two types

1. Asthapana Basti - The Basti in which the preparation containing only decoction of the drug is given through Basti is known as Nirūha (Asthapana ) Basti.
2. Anuvasana Basti - The Basti in which the preparation containing fat is given is called Anuvasana Basti

Nasyam

It is also known as Shirovirachanam. This procedure is specifically employed to eliminate excessively vitiated doshas situated in head and neck. It is the procedure of giving medicine through the nose. The doshas come out through nose and mouth.

Raktamokshanam

Raktmokshanam is the procedure through which vitiated blood along-with other dosha like pitta are eliminated out by puncturing a Sira (blood vessel) selected on the basis of disease and affected area. It is conducted using various tools like using leeches, various cupping tools

Steps in Panchakarmas

Two accessory measures carried out before (Purva) and after (Pashchat) performing the Panchakarma may also be considered as the part of Panchakarma therapy. The use of Snehana and Svedana before starting the Panchakarma is necessary. These two measures are collectively known as Pūrva Karma. After the Panchakarma the patient is gradually allowed to his normal routines of diet and duties and it is called as Pashchat Karma. Dietary regime prescribed after Panchakarma is also known as Samsarjana Krama.

Poorva-karmas (Preparatory methods)

• Pachanam or Rukshanam
• Snehanam
• Swedanam

Pradhana-karmas (Main procedures)

Vamana, Virechana, Basti, Nasyam and Raktamokshanam are the main procedures known as pradhana karmas.

Pashchat-karmas (Post Panchakarma diet regimen)

Samsarjan krama

One should avoid excessive sitting, standing, talking, riding, driving etc., day-sleep, sexual intercourse, suppression of natural urges, indulgence in cold things, sun exposure, heat, worry, anger, untimely food etc.

After the elimination of the dosha by any one measure the Panchakarma, for improving digestion and assimilation and also for regaining strength and vitality, pashchat-karma is indicated. In pashchat-karma, the steps of gradual dieting have been mentioned. For taking the patient to his normal diet, the diet should begin with Peya, then Vilepi, Krta Yusha, Akruta Yusha, Mamsa-Rasa with the increase in quantity and quality gradually, this process is known as Samsarjana Krama.

It is to be worth mentioning here that Pancha Karma described in Ayurveda is not merely emesis, purgation or enema but it is a complete therapy for the various disorders. It is an important line of treatment in which the diseases are cured by elimination of doshas from the body. However for the success of the therapy the contraindications of each Karma should be borne in mind so that complications or side effects may not occur.