Panchakarma - Complete Detoxification and Cleansing

Panchakarma means "five actions" or "five treatments". This process is used to clean the body of toxic materials left by disease and poor nutrition. This fivefold therapy is aimed at Shodhana, the eradication of the basic cause of disease. Normally the body has the innate ability to efficiently process and remove these waste materials, including the vitiated doshas. However due to one's repeated dietary indiscretions, poor exercise patterns, lifestyle, and genetic predisposition the digestive enzymes, metabolic co-factors, hormones, and agnis which regulate the body's internal homeostasis become disorganized. This can lead to the accumulation and spread of toxins throughout the physiology resulting in disease.

Panchakarma will remove the excess doshas and correct imbalances in them as well as eliminate the harmful 'ama' [foul-smelling, sticky, harmful waste matter] out of our system through the body's own organs and channels of elimination (colon, sweat glands, lungs, bladder, urinary tract, stomach, intestines, etc).

According to Charaka, the five actions are;

• Nasya (nasal therapy)
• Vamana (emesis or vomiting)
• Virechana (purging)
• Two kinds of Vasti (therapeutic enema)- Nirooha Vasti and Sneha Vasti.

According to Sushruta;

• Vamana
• Virechana
• Nasya
• Basti
• Raktamoskshana.

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.

Three stages of treatment -

• Purva Karma (pre-treatment) 
• Pradhana Karma (primary treatment)
• Paschat Karma (post-treatment

Pre treatment [Purva karma] -

 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.

During Purva karma, Sneha [taila or gritha] prepared with herbs is given in the early morning for a maximum of seven days in specific diseases. If sneha is given in a pure form without adding herbs its called Achcha sneha, and is considered the most effective.

Oil massage and fomentation are also administered. Fomentation covers both dry and sticky materials (snigdha dravyas). It is said to help in the liquifaction of doshas; it is given after Abhyanga or massaging the body, so after the seventh day of oleation, the patient is made ready for Vamana and other procedures.

Therapeutic Vomiting [Vamana] -

 Vamana removes Kapha toxins collected in the body and the respiratory tract. On the morning of the vamana., kapha aggravating foods such as basmati rice and yogurt with salt is given to further aggravate the kapha. And then the emetic drug is given. Vomiting will either occur spontaneously or is induced by rubbing on the tongue. 4-8 vomiting is the target

Benefits of Vamana: Bronchial Asthma, Chronic Allergies, Hay Fever, Vitiligo, Psoriasis, Hyperacidity, Chronic Indigestion Nasal Congestion, Edema, Obesity, Psychological disorders, Skin disorders.

After vomiting the patient will feel very comfortable; most of the congestion, wheezing and breathlessness will disappear along with the clearing of the sinus.

Purgation Therapy [Virechana] -

 Virechana is the cleansing of the pitta and the purification of the blood toxins. Virechan cleanses the sweat glands, small intestine, colon, kidneys, stomach, liver and spleen.Generally, it is administered three days after the Vamana treatment. 

Benefits of Virechana: Skin diseases, chronic fever, piles, abdominal tumors, worms, gout, jaundice, gastrointestinal problems, constipation and irritable bowel syndrome. 

Enema or Colonic Irrigation [Vasti] -

 This treatment is used to promote elimination of the loosened Vata dosha out through the rectum.

Types of Enemas:

1. Nirhua Basti (Decoction Enema) - mainly herbal decoction and small amounts of oil
2. Anuvasana Basti (Oil Enema) - mainly warm oils with small amounts of herbal decoction
3. Brihmana Basti (Nutrititive Enema) - warm milk, meat broth, bone marrow soup, etc.

This procedure is usually applied for 8 to 30 days, based on the medical condition of a person.

Benefits of Vasti: constipation, distention, chronic fever, the common cold, sexual disorders, kidney stones, heart pain, vomiting, backache, neck pain and hyperacidity, vata disorders as sciatica, arthritis, rheumatism, neurodegenerative conditions, and gout.

Nose Cleaning [Nasya] -

This treatment is the administation of herbalized oils and liquids into the nostrils to cleanse accumulated Kapha toxins from the head and neck region.

Benifits od Nasya: Dryness of the nose, sinus congestion, hoarseness, migraine headache, neurodegenerative conditions (i.e. multiple sclerosis), convulsions and certain eye and ear problems

Blood Letting [Raktamokshana] -

It is used to eliminate toxins that are absorbed into the bloodstream through the gastrointestinal tract. This process purifies the blood.

Benifits of Raktamokshana: Urticaria, rash, eczema, acne, scabies, leucoderma, chronic itching and hives. It is also often effective for enlarged liver and spleen, hemochromatosis, and for gout.

After treatment [Paschat Karma]-  

Dietary regimens, restricted bodily exertion and the intake of herbs believed to promote health come under the Paschat Karma (post-treatment). Paschatkarma is administering required food for the body after the purification of the body, to intensify the agni (digestion power) which will subside after Panchakarma.

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 problem (if any), and the appropriate degree of intensity of the prescribed therapies. These procedures must be administered by specially trained therapists in a definite sequence for a specified period of time.

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.

Dr. Indunil Weerarathne