Panchakarma

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Ayurveda has two systems of treatment. One is to pacify the aggravated Doshas by using appropriate diet, natural herbs and minerals; and the other is to purify the body, by eliminating the increased Doshas from the body.

For purification of the body five different procedures have been described by the Ayurveda texts. These five procedures are basically known as Panchakarma (etymologically, five actions). But Panchakarma, the purification therapy expounded in Ayurveda is perhaps the most misunderstood of all the Ayurveda practices. Due to ignorance, it is often perceived as just another system of oil massage. Oil massage (Sanskrit: abhyanga) is an important treatment in Ayurveda. While a person may perform massage on his own as part of his daily routine, trained masseurs are required to perform this therapy when it is used for disease management. As part of the treatment, medicated oil is massaged all over the body. A massage that is part of the daily routine lasts for five to fifteen minutes. But when it is performed for treating diseases it may take about 45 minutes.

Treatment massages can be effectively done with two therapists working on either side of the patient who lies on a wooden bed called Droni in Sanskrit. The patient is made to lie on the bed while undergoing the treatment. Since the foot are considered sensitive, special care is to be taken for foot massages. The nerve nodal points (called Marmas in Sanskrit) on the soles of the feet are closely related to certain internal organs. The sole of the right foot is massaged with clockwise movement and the left foot with anti-clockwise strokes.

During the treatment the patient is made to recline in seven standard positions. This begins with the person seated in an upright position, supine or flat on the back, turning to the right side, supine again, turning to the left side, supine once again, and finally sitting as in the beginning, Sometimes the position of lying face down is also adopted.

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. 1

Two different schools

The word Panchakarma means five actions. According to Charaka, 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 of the surgeon Sushruta, 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

The three stages of Panchakarma therapy

Panchakarma is always performed in three stages – Purva Karma (pre-treatment), Pradhana Karma (primary treatment) and Paschat Karma (post-treatment). 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).

The definition of Panchakarma

The Ayurvedic rejuvenation regimen practised today is called Panchakarma – Pancha means ‘five’ and Karma, ‘action’. This five-fold therapy is aimed at Shodhana, the eradication of the basic cause of disease. 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. The process of panchakarma consists of 3 stages. a)Purvakarma b)Pradhanakarma c)Pashchatkarma Purvakarma is done which is the primary steps to be given before the main 5 procedures. It consists of Snehana,Swedana,Abhyanga. Snehana is administering sneha or snigdha dravyas in the form of taila or gritha to the body.The sneha should be acc to the disease with drugs.If sneha is given in a pure form without adding drugs its called Achcha sneha,considered the most effective. Snehana is given in early morning for a maximum of 7 days only. snehana helps by bringing the doshas or toxins to move into alimentary tract from extremities for the easy evacuation(vilayana and uthkleshana of doshas).If snehana is not given before panchakarma,body bends like a thin dry stick by the effect of 5karmas. Swedana is fomentation therapy given to the whole body or a part depending on the disease. steam of medicated drugs is given ie using the fire-saagni sweda. Without using the fire fomentation is done-anagni sweda like sitting under the sun,being in thirst,hunger,covering the body with thick bed sheets,being in a closed dark room. Fomentation covers both dry and sticky materials(snigdha dravyas). Fomentation helps in the liquifaction of doshas. given after Abhyanga-massaging the body.so after the 7th day of oleation,patient is made ready for Vamana etc procedures.

Pradhana karma includes Panchakarma. Paschath karma is adminisering required food for the body after the purifaction of the body,to intensify the agni(digestion power)which will be subsided after Panchakarma. Food given be acc to the degree of purifaction of body.

Panchakarma:charaka samhita commentary..
Panchakarma: Ayurveda's Mantra of Rejuvenation,Book, published by Invis Multimedia in association with Kerala Tourism, 2006, ISBN 81-88698-26-1
Panchakarma: Ayurveda's Mantra of Rejuvenation,DVD, produced by Invis Multimedia in association with Kerala Tourism, 2006, ISBN 81-900985-6-X
Panchakarma Details