PANCHAKARMA

India is fast becoming a hub for medical tourism. People fro west prefer Indian hospitals for surgery, as the cost here is less prohibitive than in the western countries. The waiting period to avail the medical facilities that their government provides is too long often ranging from 3 to 6 months for a minor operation. All this has further contributed to the inflow of tourists seeking medical aid in India. Indian doctors are abreast of the technology without losing touch with humanity. Also since time immemorial India is renowned for its hospitality.

Substantial number of tourists also comes here to get rid of their chronic health problems or to simply rejuvenate their body and mind through Ayurveda and spirituality, both of which go hand in hand. Many allied therapies like yoga, crystals, chanting of mantras also form part of Ayurveda. However the most significant part of Ayurveda is the preventive medicines. To maintain the health of a healthy individual, Ayurveda has in great detail explained the daily regime one needs to follow and also the variations to be made in the same depending on the season, place where a person resides and his or her constitution. In case a person is unable to follow this regime either through ignorance or due to lack of control on his or her mind and falls ill, then a variety of therapies are prescribed for an individual depending on their constitution.

The greatest gift to mankind is Ayurvedic panchkarma or the five procedures described in Ayurveda to establish equilibrium between the various doshas. Ayurveda believes that imbalance of dosha is the root cause of all the disease. Panchkarma help to set this equilibrium again.

However it may prove to be a boon or a bane depending on whether it is done scientifically or not. Since we are discussing the benefits of Ayurvedic therapy for the sick and healthy individuals it would be apt to describe the panchkarma procedures briefly before we proceed to the rejuvenation therapy. Also it is a norm to detoxify the body before rejuvenating it as this helps to augment the benefits of rejuvenation therapy. The best method to detoxify the body is through panchkarma.

Panchkarma as the name suggests is a group of five therapies. The therapies described by different school of thoughts vary slightly but for our convenience we would consider the following widely accepted ones.
Vaman: Detoxification of the body by inducing emesis (vomiting) is known as vaman. It is important to differentiate vaman and vomiting. Vomiting could be a result of some pathology in body e.g. indigestion, hyperacidity, raised intracranial pressure, or diseases of internal ear etc. However any kind of vomiting could be labeled as vaman. Vaman is therapeutic vomiting induced in patient to treat various diseases or as a preventive medicine to prohibit occurrence of diseases. All the panchakarma are preceded by certain procedure known as ‘purvakarma’. These are to be carried out properly in order to avoid complications that panchkarma may cause. Vaman is particularly helpful in treating disorders caused by vitiated kapha and up to certain extent those caused by vitiated pitta. Thorax, upper part of stomach and head are considered to be predominant areas of kapha. Healthy kapha bring about the function of lubrication in body and prevents wear and tear of its tissues. However if there is imbalance of cough it may lead to various problems such as cold, cough, asthma, etc. To eliminate problems like these and various other problems like obesity, hysteria, skin diseases, anemia, indigestion, some diseases affecting ear, nose, throat and eyes etc., vaman is induced. Patients unfit for vaman are patients suffering form haemoptysis, heart diseases, gout, anuria, piles, diseases affecting the vision like retinal detachment, tumors, pregnant women, very weak individuals, etc. are advised not to undergo this therapy. Most of the procedure involved in panchkarma have to be followed by certain other treatments like ‘gandush’, ‘dhoompan’ etc. Also a stringent diet regime has to be followed for 3-7 days after the procedure. However, describing all the procedure n elaborate details along with the preceding and succeeding procedures is beyond the scope of this article.

Virechan: Induction of purgation to treat various ailments caused by vitiated pitta. The predominant area of pitta in the body is the duodenum and liver. The procedure of virechan can cleanse the whole alimentary canal and is comparatively safe. For very delicate and weak persons mild form of virechan may be given using raisins, milk, etc. An ailing person who is capable of and in need of stronger purgative may be given seeds of cotton tiglium, pichrorrhiza kurroa etc. Formulations containing these herbs are available in market and generally used to induce purgation. The diseases in which purgation is helpful are various skin diseases, splenic disorders, ascites, hepatitis, haemorrhoids, fissures etc. Again it is important to carry out purvakarma like oleation and fomentation before the virechan is given. Dietary restrictions have also to be observed for a few days before and after panchkarma. These precautions have to be followed before all the procedures and hence it is implied that they will be carried out in all the panchkarmas.

Basti: It is the most potent of the five procedures. It gains importance from the fact that it is used to treat vitiated vata. Vata is responsible for most of the diseases. Although vitiated kapha and pitta are also responsible for diseased states, these doshas need help from vata to carry out functions (physiological as well as pathological) in our body.

Secondly, basti can carry out seemingly opposite functions such as slimming down or putting on weight or it may be used to treat consumption and also to treat loose motions depending on the medications used. Basti can be safely given to infants as well as geriatric patients. Hence some ancient masters regarded basti as a complete treatment in itself. Basti literally means bladder. In olden days animal bladders were cleaned, processed and used for giving medicated enemas to the patients. This procedure of giving medicated enemas is known as basti. The predominant site of vata dosha is the colon and hence giving medicines via rectum is the closest and the fastest route to treat different ailments. Commonly used substances are decoctions, herbal oils and medicated milk. These are used to treat various acute or chronic ailments like constipation, diarrhea, lumbago, sciatica, paralysis, failure to gain weight, obesity, infertility, sexual problems, renal calculi etc.

Basti is classified into many categories depending on the substance used for the basti, route used for administration of drugs, or the function that the procedure carries out. However the three main categories of basti are:
1. Niruha basti also known as aasthapan basti: In this mainly decoctions are used to treat the patient and these are administered via the rectal route. This type is contraindicated in haemorroids (piles), intestinal perforation, ascies, and diarrhea especially where the patient has fever and other toxic symptoms, skin disease etc.
2. Anuvasan basti: Oil, either plain or medicated, is mainly used in this procedure. However animal fat, ghee and bone marrow of various animals may be used in some cases. This is comparatively easy to give and may be given to most in varying proportions. The only contraindications are indigestion, obesity, diabetes, and person who sleeps during the day.
3. Uttar basti: This is given not via rectal route but through the urethra or vagina and after administering niruha basti. Medicated oils, decoction etc. may be used for uttar basti.
Nasya: a relatively simpler yet beneficial procedure. Nasya means administration of drugs through the nasal route. These drugs could be either extract of juices of various plants, medicated oils, dried powders of different herbs etc. It is mainly used to treat the diseases affliction head. Done systematically it is helpful in treating premature graying of hair or hair fall, sinusitis, allergic rhinitis, migraine, cluster headaches, fractures afflicted on upper limbs etc. Regular use helps improve vision and hearing capacity of an individual. Only contraindications for nasya are a person who has acute attack of cold, asthma, etc. pregnant ladies or women who have delivered recently, a person who has recently undergone vaman, virechan or basti (less than 15 days ago), or any individual who has just had a heavy meal, or head bath, alcohol, diet rich in fat etc.

Raktamokshan: This is a procedure in which impure blood is removed from the body of patient by various means. It may be done using venesection or leeches. Leech therapy gives instant results in reducing pain in patients of rheumatoid arthritis, infections, joint disease etc. It is also easier to be carried out as compared to venesection. After determining whether the patient is fit for the procedure, only precaution one might need to take while using the leeches is to determine whether they are poisonous or not. Ayurvedic texts have elaborately described the kind of leeches as regards to their colour, length etc. that can be used for the procedure. In many European countries this procedure is already in use. Although, they discard leeches after single use, it is possible to re-use the leeches after treating them with turmeric and salt immediately after use. This treatment induces vomiting in leeches and the impure blood they have sucked from a patient’s body is thus removed. After ensuring that the leeches are free from the toxic blood, they are rested in clean water for a period of 15 days and then re-used. Venesection is rather skillful procedure and needs expertise. The vein to be punctured is determined by the ailment that a person is suffering from. In olden days hollow horn or pumpkin was used to withdraw blood after venesection. However presently doctors use syringe for the same. This method is useful in treating skin problems like psoriasis, erysipelas, herpes, gout, benign tumours, abscesses etc. However this procedure should never be implemented in persons with bleeding disorders, pregnant women or in women who have just delivered a baby, a person having jaundice as one of the symptoms, persons suffering from paralysis, piles, anemia, dropsy, tetany etc.


Although panchkarma helps fat and complete detoxification of the body, it may prove to be cumbersome for a person who is either too delicate of ignorant of its benefits. Such persons who need to rejuvenate their bodies may detoxify them through fasting followed by detoxifying diet of fresh fruits and vegetables or their juices, milk, honey etc. and then proceed for rejuvenation. It is every person’s dream to stay youthful, healthy, and full of vigor and vitality. This basic need of mankind was observed by the ancient masters and hence two branches of Ayurveda developed to cater to this need. These are rasayan and vajikaran. The former deals with retaining the youth and health while the latter deals in improving the fertility and sexuality of mankind. Although with changing times it is not possible to follow everything described to Ayurveda completely as many ancient herbs are extinct now and so are the animals. Also population and population have risen exponentially. However even now with right kind of diet and lifestyle these benefits can be reaped up to a large extent. Long and healthy life, boost in memory, glowing complexion, erect posture, regaining control over one’s mind, improving sexual life, enhancing vision, hearing power, olfactory senses and voice quality are just some of the benefits a person may experience with regular rejuvenation therapy. However, good habits have to be formed consciously like observing right kind of diet and lifestyle.

After ensuring that the body is free from toxins, many procedures can be adopted depending on the person’s needs and physician judgment. These have been improvised over a period of time. Some of them have been listed below.

Abhyanga: In layman’s language it means massage. Now the common question, which pops up, is how often should one take massage? The answer to which is everyday. Application of oil and its slow absorption in the body through massage helps lubricate the skin and joints, tones muscles, improves the texture of hair, relaxes mind, helps fight insomnia. Although due to constraint in time it may not be possible for everyone to go to the spa or ayurvedic centre daily for a massage in that case just heat sufficient oil in a water bath and apply and massage it on the body till it is absorbed. If even doing this is not possible then just apply ail to head, soles of feet and ear daily. While ayurvedic massage does not provide a complete therapeutic cure, it does provide nutrients to various tissues of the body and helps excrete the toxins from the body by facilitating the circulation. Marma chiktista is a specialized form of massage, which deals with 107 vital points of the body. These points are known as ‘marma’. This treatment is useful in treating musculoskeletal ailments caused due to trauma or accidents. It is the treatment that works on the extremely sensitive vital points of the body (the 107 ‘marmas’). However this is practiced few centers only. In north Kerala massage is given by foot. This form of massage is inspired by the local martial art known as ‘kalarippayttu’.

Udvartanam: In obese patients instead of oil herbal powders are used for massage. This is known as ‘udvartanam’. It is also helpful in reducing swelling of joints in conditions like gout, rheumatoid arthritis etc. In udvartanam massage is done in direction opposite to the direction of growth of hair. However this massage may cause irritation and allergies in certain skin types. In such cases some modifications or change in herbs may be necessary.

Swedanam: Oil massage is generally followed by fomentation. This fomentation can be given using various methods. The commonest form of giving fomentation is by introducing a person to steam chamber. Entire body is inside the chamber except for the head. Inside the chamber steam from boiling herbal decoctions is emitted. This kind of fomentation however is contraindicated for diabetic patients, pregnant women, and hypertensive patients. Direct steam should never be given on eyes, groins and chest. If steam has to be concentrated on one area of problem like joints then decoction is made in a vessel with small mouth and the steam emitted is given on the affected area with the help of a tube. This is known as ‘nadisweda’. Sometimes the steam is given with the help of various leaves of plants that are treated with oil and lemon. This form is known as ‘patrapottali sweda’ (patra=leaves, pottali=poultice). In Kerala this procedure is known as ‘elakizhi’. Similarly a variety of rice known as ‘shashtik shali’ is cooked in herbal decoction and milk. A poultice is then made from this rice and dipped in the same warm decoction and used for massage and fomentation. This helps in all the disorders where muscle wasting or muscular atrophy is present e.g. paralysis, muscular dystrophy, etc. this is known as ‘shashtik shali pinda sweda’ and in Kerala it is known as njavarakizhi’.

Dhara: Dhara is dropping of fluid (either medicated oils or milk, or buttermilk or decoctions etc.) of certain temperature and from certain height for defined period of time. If this dhara is done on head then it is known as ‘shirodhara’. Shirodhara is helpful in treatment of psychological problems such as anxiety neurosis, depression, and insomnia and for slowing age related mental illnesses like dementia. If instead of head whole body is given dhara then it is known as ‘kayasekam’. It is known as ‘pizhichil’ in Kerala. It is used to treat paralysis, rheumatic disorders, spondylosis etc. Kayasekam is given simultaneously with massage.

Tarpan: This procedure is used to enhance the vision and treat some disorders affecting eyes. Small well-like structures are made using dough, made from black gram, along the orbit of eyes. Oil or decoction at certain temperature is dropped in to these wells and the person undergoing the treatment is asked to gently keep on blinking while the fluid is still there. This is followed by washing the eyes with decoction of ‘triphala’.

Lepam: To remove minor flaws in the skin and for glowing complexion, various packs are applied to the skin. These packs are known as lepam. Lepam usually is done after proper detoxification and lubrication of the body. The ingredients used in lepam are usually the blood purifying and natural bleaching agents like sariva, manjishtha, neem, haldi, arjun, lodhra etc. these may be changed as required depending on the skin type.

Yoga: Following the various principle of yoga helps gain control over ones’ mind and body. If yogic principles are followed regularly along with yogic postures (asana) and mudras then one gets enormous flexibility and will power. Yoga is also known to cure minor health ailments like lower backache, menstrual cramps, chronic headaches etc. It is also help in controlling asthma, diabetes, blood pressure etc. For further reference in yoga refer the previous and subsequent editions of these editions of this magazine.

Apart from the above- mentioned treatments, which are mainly followed in most of the ayurvedic centers, there are many others smaller ones that may be carried out by some centers. Modern equipments are also used nowadays for their convenience and hygiene e.g. sterilizers, massagers to concentrate more on one area etc. Some times other alternative therapies may also be used like acupressure, aromatherapy, etc. along with these treatments.

It is needless to mention how refreshed one might feel after these treatments. Anybody who has had a good massage will know what wonders it does to your body and mind.

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