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Panchakarma
Panchakarma-the detoxification process- is a comprehensive system of knowledge and practices to purify the body of toxins and restore it to balance with natural law.
As more and more people are falling prey to the adverse effects of stress, there are more and more complaints of diseases like poor digestion, lack of sleep, allergies, chronic fatigue, cancer, heart diseases, diabetes, osteoporosis etc. All these diseases are complex disorders that accumulate over a lifetime.
The most deeply seated toxins that causes diseases are heavy and sticky, lodging tissue layer. Panchakarma permanently eliminates these toxins from the body, allowing healing permanently of tissues, channels, digestion and mental functions.
In Ayurveda, the treatment is broadly divided into two categories: Shodhana and Shamana. Curing the disease by cleaning out the impurities is called Shodhana chikitsa, which is the principle of Panchakarma. It involves the clearing of vitiated doshas (vata, pitta and kapha) which cause the disease and thereby the restoration of equilibrium of doshas.
Panchakarma includes the following five purification therapies:
Vamana (emesis), Virechana (purgation), Basti (enema), Nasya (nasal insufflation) and Raktamokshana (blood-letting).
In this module, we have provided an in depth information about Panchakarma for our users' benefit. The details of pre-procedures, main procedures like vamana, virechana, nasya, basti, raktamokshana and post-procedures have been provided.
The five purification measures
Panchakarma is a type of treatment in Ayurveda, which means five actions, where pancha means five and karma means actions. By five actions or purification measures, the body is purified of specific vitiated doshas and ama (undigested food products), which form as a result of metabolic processes. Each process has a specific action to bring about a specific imbalanced dosha in balanced state and thus preventing further disorders.
Panchakarma constitutes the foremost sodhana chikitsa or purification therapy as it reverses the disease mechanisms, which carry toxic waste products from the digestive tract into the tissues of the body. It is designed to draw ama (undigested food products) out of the dhatus (body tissues), return it to the digestive tract and expel it from the body.
Importance of shodhana therapy
Doshas do at times get aggravated after treating them with fasting and digestive drugs. But there is no chance of relapsation, if we treat the vitiated doshas by means of elimination therapy.
So, shodhana therapy is definitely superior to palliative measures.
Panchakarma consists of the following five purification therapies:
Vamana or emesis therapy
Virechana or purgation therapy
Vasti or enema therapy
Nasya or nasal insufflation
Raktamokshana or bloodletting
Aims and objectives of Panchakarma
Panchakarma aims to remove the ailments of a diseased person, maintain positive health in a healthy individual and obtain extra-ordinary qualities like Rasayana (rejuvenation therapy) and Vajeekarana.
Panchakarma in diseased persons:
Panchakarma is equivalent to the medicinal treatment given to the patient. Some diseases respond to Panchakarma treatment better than the medicines given to them.
Panchakarma in healthy persons:
Diseases cannot invade the lives of people who follow the daily and seasonal regime (dincharya and ritucharya). Therefore, most of the people are adopting these therapeutic techniques in their daily routine.
The Process
The three stages of Panchakarma
Panchakarma is a three-phased process consisting of:
Poorva karma (Pre-procedure)
It is the first phase of Panchakarma, which comprises of essential preliminary procedures like preparation of the patient, preparation of the medicines and the equipments necessary for the further procedures.
The purpose of poorva karma is to unload stored toxins i.e. to loosen the ama and move it out of deep structures into the gastro-intestinal tract, to be further eliminated by the Panchakarma.
Any attempt to administer Panchakarma without proper preparation of patient may not give the desired response and may also harm the body.
Pradhana karma (Main procedure)
Pradhana karma (main procedure) is the second stage of Panchakarma, which consists of the actual administration of the five purification therapies. These five therapies are popularly known as Panchakarma, viz., vamana (emesis), virechana (purgation), basti (enema), nasya (nasal insufflation) and raktamokshana (blood-letting).
Paschat karma (Post-procedure)
This is the last phase of Panchakarma, which is carried out after the main purification process and assures the restoration of digestive enzymes. The post procedures are designed to nourish, strengthen and balance the newly cleansed dhatus. It describes the measures employed after the main treatment, such as diet, medicines and daily routine.
Note
These procedures must be performed under strict medical supervision and advice.
Poorvakarma
Poorva karma includes the preparatory measures like snehana (oleation) and swedana (fomentation) before the main specific treatment.
According to the Ayurvedic principles, the Panchakarma should not be used until after the administration of oleation and fomentation, which make the body soft and disintegrate the morbid doshas.
Poorvakarma is of three types:
Pachana karma
Sneha karma
Sweda karma
Pachana karma (Digestion therapy)
Before going to proceed for main therapeutic procedures, pachana karma is essential to digest the undigested substances by means of Deepana and Pachana drugs like, peya (liquid), choorna (powder), quatha etc.
Sneha karma (Oleation therapy)
Through this process, the body becomes oily and soft. It softens the vitiated doshas. In this therapy, oil is administered through different types of foods, enema or massage.
Digestion improvement, soft stools,lightness of the body and lack of desire for oily substances are the signs of properly administered oleation.
Sveda karma (Sudation therapy)
Procedure to cause perspiration is known as svedana vidhi (sudation therapy). It promotes the penetration of snehana inside the body. Due to svedana, toxins are expelled in form of sweat.
It is a therapy, which removes the stiffness, heaviness, coldness and inflammation of the body.
This process liquefies vitiated doshas to bring them in the kostha. After the oleation therapy, the patient should be administered fomentation.
Snehana (Oelation Therapy)
Snehana is the pre-procedure of panchakarma therapy. It makes the body oily and soft. It softens the vitiated doshas.
Procedure
It can be done in two ways: externally (bahya snehana) and internally (abhyantara snehana).
In external oleation, massage is done with oily substances and medicated herbs.
In internal oleation, unctuous substances are taken internally.
Benefits
It increases digestive power.
There is a feeling of lightness in the body.
Skin becomes smooth.
Improves circulation.
Speeds up the elimination of waste products.
Relieves fatigue.
Improves the eyesight.
Induces sleep.
Reduces ageing.
Gives the strength to the joints.
Bahya snehana
Bahya snehan is external application of oil or medicated pastes. It can be given to healthy as well as unhealthy persons to maintain positive health.
It is done by various methods
By massaging the body gently in the downward direction after applying the oil or medicated pastes.
In the opposite direction of hair follicles with high pressure or normal pressure.
By applying the pressure with the help of foot.
Pouring of medicated oils, decoctions, and milk in a systematic way.
Holding the liquid drugs in buccal cavity for a specific time without moving the drug. Anointing the head with medicated oil.
By keeping medicated ghee on the eyeballs for a specific period.
By filling the ears with medicated oil.
Indication of Oleation therapy
Oleation therapy, in general, is prescribed for those:
who are to be given fomentation or elimination therapy.
whose skin is rough.
suffering from diseases due to the vitiation of vata.
who indulge in physical exercise, wine and women.
who suffer from mental strain.
suffering from neurological disorders and eye diseases.
It is also given to old persons, children and debilitated persons.
Period required for administration
The maximum period required for administration of oleation therapy is seven days.
Minimum Period required is three days.
Signs and symptoms
Signs and symptoms of proper oleation
Good digestive power.
Unctuous and soft stools.
Softness and smoothness of the body.
Feeling of lightness in the body.
Signs and symptoms of over oleation
Paleness.
Heaviness.
Dullness.
Undigested condition of stools.
Drowsiness.
Anorexia.
Nausea.
Aversion to take food.
Passing stools many times.
Discharges from the mouth, nose and rectum.
Treatment of over oleation
Usnodaka (warm water) is the first treatment for over oleation.
Vamana (emaciation) and svedana (sudation) could be given.
Pippali, Triphala and madhu (honey) should be given for over oleation.
Signs and symptoms of under oleation
Dry stools.
The vata not becoming regulated.
Weak digestive power.
Roughness and dryness of limbs.
Burning sensation in the chest.
Weakness.
Roughness of the skin.
Treatment of under oleation
For the treatment of under oleation, unctuous substances should be given to the patient.
Oleation should be repeated.
Pre-oleation management
A day preceding to the administration of oleation therapy, one should take food in proper quantity.
The food should be liquid, hot and anabhisyandi (that does not obstruct the channel of circulation).
It should neither be too unctuous nor a mixture of two opposite qualities (hot and cold).
Oleation before elimination (Samshodhana)
Regarding the elimination (samshodhana) type of oleation therapy, it should be administered when the food taken in the preceding night has been well digested.
Elimination type of oleation therapy is to be administered in the morning hours when the food taken in the preceding night is well digested.
The main object behind the elimination therapy is to excite the doshas in the body.
Oleation before alleviation (Samsamana)
When hungry, one should take alleviation (samsamana) type of oleation therapy during lunch hours.
The alleviation type of the therapy suppresses the doshas.
If the alleviation type of oleation therapy is administered in the morning when there is no intensity of appetite, the unctuous substance will not get digested and it will adhere to the lumen of the intestine. This will excite the doshas, rather than suppress them. Therefore, alleviation type of oleation therapy should be administered during lunch hours.
Dosage of Oelation
The classification of dosage of the snehana (oleation therapy) is based on the period of digestion of the unctuous substance.
Maximum dose: The quantities, which take 24 hours for their digestion.
Moderate dose: The quantities, which take 12 hours for their digestion.
Minimum dose: The quantities, which take six hours for their digestion.
Who should take the maximum dose?
The following people should take the maximum dose of oleation:
People who are in the habit of taking adequate quantity of unctuous substances.
People having resistance to hunger and thirst with strong power of digestion.
Those suffering from abdominal tumour, insanity, dysuria, snake bite and visarpa (skin diseases characterised by an acute spread).
People who have problem of hard stools.
Benefits of maximum dose intake
If properly administered, it alleviates all ailments instantaneously; it eliminates the doshas.
It pervades all the systems of the body.
It strengthens and rejuvenates the body, sense organs and mind.
Who should take the moderate dose?
People suffering from eruptions.
People suffering from boils, pimples, itching, papules and obstinate skin diseases including leprosy.
People suffering from obstinate urinary disorders and gouts (vatarakta).
Those who cannot eat much.
Those who are of relaxed bowels.
People with moderate strength.
Benefits of moderate dose intake
It requires the least precautions.
It stimulates libido and gives strength.
This is least harmful and can be continuously administered for a long time.
Svedana (Sudation)
Procedure to cause perspiration is known as sudation therapy. It liquefies vitiated doshas and brings them in the koshtha (alimentary canal).
It promotes the penetration of oil inside the body. Due to svedana, toxins are expelled in form of sweat.
It removes the stiffness, heaviness, coldness and inflammation of the body.
After the oleation therapy, the patient should be administered fomentation.
Procedure
Sudation should be done in a room devoid of heavy breeze.
The patient should have been lubricated both internally and externally.
It should be done after the digestion of food.
It should be either mild, moderate or heavy depending upon the disease, the land (habitat) and the season.
Benefits
Causes softness and brilliance of the skin.
Sudation therapy increases the digestive capacity.
It also increases the desire to eat and cleanliness of the orifices.
It removes laziness and stupor.
It makes the stiffened joints move quickly.
If administered after oleation, fomentation brings vata under control and thereby facilitates the elimination of faeces, urine and semen.
The doshas which have been lubricated and localized in the alimentary tract, in the various tissues and channels, in the extremities and bones get liquefied by sudation therapy and are brought into the alimentary tract to be eliminated (out of the body) by appropriate purification therapies.
Importance of sudation
Even when dry pieces of wood bend by means of application of oleation and sudation, then how can living beings not be benefited.
Specificity of sudation
Sudation is considered efficacious.
Sudation should be well medicated which is neither too hot nor too mild.
It should be applied to the proper region with due consideration of the disease, season and vitality of the patient.
Indication of Svedana (Sudation)
Sudation is done in following conditions
Pratisyaya (Coryza)
Cough (kasa)
Hiccup (hikka)
Dyspnea (swasa)
Heaviness of the body (angagraha)
Earache (karna sula)
Neck pain and headache (manya sula and sira sula)
Hoarseness of voice (swar bheda)
Spasmodic obstruction in the throat (gala graha)
Paralysis of the face (ardita)
Paralysis of one limb (ekanga ghata)
Paralysis of whole body (sarvanga ghata)
In flexures of the body (vinamaka)
Distension of the abdomen (koshtha anaha)
Constipation (vibandha)
Suppression of urine (mutra ghata)
Uijrmbhaka (pendiculation)
Stiffness of sides (prasva graha)
Stiffness of back (prustha graha)
Stiffness of waiste (kati graha)
Stiffness of abdomen (kukshi graha)
Sciatica (grudhrasi)
Dysuria (mutrakrucha)
Enlargement of scrotum (undaki vridhi)
Pain and stiffness of feet (pad graha)
Pain and stiffness of knee (janu graha)
Oedema (sotha)
Neuralgia of upper and lower extremities (khalli)
Excessive heaviness and numbness
Contra-indication of Svedana (Sudation)
The following people should not take the fomentation therapy
The pregnant women.
People who have taken too much astringent and alcohol.
Those suffering from hemothermia (raktapitta) and diarrhoea.
People who have paittika type of obstinate urinary disorder, especially diabetes mellitus.
People who have inflammation and prolapse of the rectum.
Those having paittika constitution and dry skin.
Those who are fatigued, unconscious, fatty, thirsty and hungry.
The person who is angry and excited.
Those suffering from jaundice and abdominal diseases.
Those who are weak and dried up.
And whose ojas has been reduced.
Contra-indicated body parts for fomentation
Fomentation should not be administered over:
Testicles
Heart
Eyes
Even if it is very necessary to administer, it should be of mild type.
Over groins it should be moderate.
Signs and Symptoms
Sometimes the sudation is not given properly i.e. the over or insufficient sudation is given. There are signs and symptoms to make out whether the process is insufficient, proper or over done.
The signs and symptoms of proper sudation (Samyaga svedana)
Sudation is to be administered until there is
Complete recovery from cold,
Colic pain, stiffness and heaviness of the body, and tenderness and sweating appear.
The signs and symptoms of over sudation (Atisvedana)
Aggravation of pitta.
Fainting and prostration of body.
Thirst and burning sensation.
Weakness of the voice and limbs.
The signs and symptoms of insufficient sudation
Coldness and pain are not relieved.
Patient feels stiffness and heaviness.
Roughness of the body.
Treatment
The sudation should be continued till the patient gets proper symptoms.
Degrees and Qualities of Svedana (Sudation)
Depending upon the type of disease, different types of sudation are prescribed. Drugs to be used for fomentation are unctuous or nonunctuous, depending upon the nature of the disease to be treated.
If the disease is of serious type, the season is very cold and the body of the patient is very strong, then strong sudation is prescribed.
If the disease is mild, the season is moderately cold and the body is weak, then mild fomentation is prescribed.
If all are of moderate nature, then moderate sudation is prescribed.
In diseases caused by vata, combined with kapha, vata alone or kapha alone, the sudation to be applied should be prepared from drugs of unctuous and coarse qualities, unctuous quality alone or coarse quality alone, respectively.
If the vata is accumulated in amashaya (stomach), then the sudation with drugs having coarse qualities should precede the prescribed sudation for vata.
On the other hand, if kapha is accumulated in the pakvasaya (colon), sudation with drugs having unctuous qualities should precede the prescribed fomentation for kapha.
Pradhana karma (main procedure)
Pradhana karma (main procedure) is the second stage of Panchakarma where the main treatment is given. It includes five types of main operative procedures, which are popularly known as Panchakarma,
Vamana karma (emesis)
Virechana karma (purgation)
Basti karma (enema)
Nasya karma (nasal insufflation)
Raktamokshana (blood-letting)
Vamana karma (Emesis therapy)
Vamana is the procedure to eliminate the waste product (vitiated dosha) through the upper gastro-intestinal track. It is the cleansing procedure, which expels doshas, particularly the augmented kapha.
Virechana karma (Purgation therapy)
This karma aims to eliminate doshas that cannot be removed by Vamana karma such as the kidneys, lungs and sweat glands.
Elimination of vitiated doshas through rectum is called Virecana. It cleanses the small intestine and the organs, which are pitta dominant. For example, the liver and the gall bladder in the mid-zone of the body.
Nasya karma (Nasal insufflation)
Administration of the drug through nostrils is known as Nasya. karma.
It cleanses and opens the channels of the head and improves the oxygenation (prana) which has direct and highly beneficial influence on brain functioning.
Basti karma (Enema therapy)
Basti karma is the most powerful of the five main procedures of Panchakarma..
Basti is a type of treatment for augmented VATA dosha. In this type of treatment, medicated decoction and oils are passed through the anus, with the help of specially made basti instruments. Properly administered basti helps to rejuvenate the body, provides strength and long life, and improves the complexion and the voice.
Raktamokshana (Bloodletting)
Rakta means blood and mokshan means to remove, so raktamokshana means removing vitiated blood from the body. It is the localized treatment not considering the vitiation of the doshas.
It is done either by metal instruments or by using leeches or vegetable gourds.
Vamana (Emesis) Therapy
Vamana is the procedure to eliminate the waste product (vitiated dosha) through the upper gastro-intestinal track. It is the cleansing procedure, which expels doshas, particularly the augmented kapha.
By this treatment, vitiated kapha dosha is totally eliminated from its roots (stomach) through the mouth.
Due to the total removal of vitiated dosha, chances of reoccurrence of the disease becomes remote.
Principles of Therapeutic Emesis Therapy
Due to oleation, the vitiated dosha becomes soft.
Due to sudation, these doshas get liquefied.
These liquefied doshas enter into the minute channels.
Action of emetic drugs :
o Ushna quality: Liquefies the doshas.
o Tikshna, vyavi and vikashi: Allows the drug to penetrate deep into the body for breaking down the vitiated dosha, so that it can enter the minute channels and come out.
From these minute channels, liquefied dosha reach in the kosthas (abdominal cavity: stomach).
From there, the dosha is forced out of the body from the mouth.
Indications of Vamana (Emesis) Therapy
Poisoning
Indigestion
Acute fever
Tuberculosis
Diarrhea
Bleeding rectum
Cholera
State of colic with constipation
Salivation
Poor digestion
Insanity
Epilepsy
Bronchitis
Asthma
Diabetes
Skin diseases
Anorexia
Anaemia
Stomatitis
Obesity
Rhinitis
Pharyngitis
Tonsillitis
Kapha dominant diseases
Contra indications of Vamana (Emesis) Therapy
Heart disease
Malnourished
Children
Old persons
Debilitated person
Pregnancy
Vomiting
Urine retention
Tuberculosis
Thirst
Hunger
Headache
Virechana Karma (Purgation Therapy)
This karma aims to eliminate doshas that cannot be removed by Vamana karma such as the kidneys, lungs and sweat glands.
Elimination of vitiated doshas through rectum is called Virechana. It cleanses the small intestine and the organs, which are pitta dominant. For example, the liver and the gall bladder in the mid-zone of the body.
It may be given three days after emesis therapy, or given directly when emesis is not indicated. But it must be practiced only after Poorva karma has been administerd.
The drugs used for virechana karma (purgation therapy) vitiate the doshas and bring them into the koshta (abdomen). From there, they are expelled through rectum.
Purgative drugs are dominant in earth and water elements and have downward movement.
The synonyms of virechana are rechan and praskandhan.
Following are the diseases for which Virechana karma can be given
Fever
Skin diseases
Haematemesis
Epistaxis
Fistula
Haemorrhoids
Splenic disorders
Tumors
Goiters
Lymphadenitis
Artificial poisoning
Cholera
Retention of urine
Worm infestation
Anaemia
Headache
Burning eyes
Lacrimation
Asthma
Jaundice
Cough
Rhinitis
Epilepsy
Insanity
Gout
Gynaecological disorders
Seminal disorders
Ascitis
Anasarca
Elephantiasis
Leprosy
Diabetes
Inguinal swelling
Intestinal torpor
Cardiac disorders
Rheumatic conditions
Anorexia
Vomiting
Purgative drugs
Qualities of purgative drugs
Ushna (hot).
Tikshana (pungent).
Sukshma (minute).
Vyavayi (penetrating agent).
Vikasi (tissue destructive agent).
Purgative drugs have the dominancy of Prithvi (Earth) and Jala (Water) mahabhutas.
Herbs used
Shyama (Operculina turpethum)(Black).
Trivrit (Operculina turpethum)(Red).
Chaturangala (Cassia fistula).
Tilvaka (Symplocus racemosa).
Sudha (Euphorbia nerifolia).
Saptala (Acacia sinuta).
Sankhini (Clitoria ternatia).
Danti (Baliospermum axillare).
Dravanti (Croton tiglium).
Contra indications of Virechana (Purgation Therapy)
Delicate persons
Anal injury
Prolapse rectum
Bleeding per vagina, urethra and rectum
Fasting
After niruha basti
Indigestion
Acute fever
Injury
Excessive oleation
Excessive dryness
Emaciation
Children
Old persons
Weak persons
Tired persons
Excessive coitus
Excessive study
Over exercise
Pregnancy
Tuberculosis
Diarrhoea
Just after meal or drinking water.
Intestinal obstruction
Perforation
Miscarriage
Alcoholic
Basti karma (Enema Therapy)
Basti karma is the most powerful of the five main procedures of Panchakarma. The literal meaning of basti is bladder.
It expels the vitiated doshas rapidly and easily from the body and also causes reducing as well as nourishing the body very fastly. In ancient times, bladders of various animals were used to administer this procedure.
Basti is a type of treatment for augmented VATA dosha. In this type of treatment, medicated decoction and oils are passed through the anus, with the help of specially made basti instruments. This procedure pulls out the vitiated doshas, especially vayu from pakvashaya i.e. the lower gastro-intestinal tract.
Properly administered basti helps to rejuvenate the body, provides strength and long life, and improves the complexion and the voice.
Frequency
Classification of basti (enema) on basis of frequency and duration
On basis of frequency and duration, basti is classified into three parts which are as follows:
1) Karma basti
It comprises a month- long treatment and is given to people who have vata- dominant constitutions and disorders.
It begins with anuwasan basti and alternates with niruha basti for 25 consecutive days, i.e. 12-12 alternate asthapana anuvasana basti.
The 30-day program ends with five days of anuwasan basti.
Therefore, total 30 number of basti should be given in a course.
2) Kala basti
It lasts for 15 days and is used mainly for patients with pitta-dominant constitutions and vata disorders.
It starts with anuwasan basti, which then alternates with niruha basti for 10 or 12 days and concludes with three or five days of anuwasan basti i.e. total 11 niruha and anuvasan basti are given alternately.
Therefore, total 15 basti should be given in a course.
3) Yoga basti
It is given for eight days and usually suits kapha patients with vata diseases.
It first gives anuwasan basti, and alternates three times with niruha basti i.e. three asthapana anuvasan basti alternately.
It concludes with two days of anuwasan basti.
Therefore, total eight basti should be given in a course.
Function
Classification of basti (enema) on basis of function
1) Shodhana basti (cleansing enema)
It cleanses and detoxifies the body.
It is divided into strong treatment that penetrates in to deeper dhatus and mild treatment, which work on the superficial level of dhatus.
2) Utkleshana basti
It means promoting secretions in the colon.
It promotes the liquefaction of ama and mala (waste products) in the colon.
It helps the colon expel them. Similar to western enemas, this basti increases colonic peristalsis, producing rapid elimination of the faeces.
3) Shamana basti
It is palliative.
It restores dosha performance, reduces symptoms and allows the patient to feel better.
In cases of rectal bleeding or dysentery, the immediate objective is to stop the symptoms.
For example, pichha basti, which uses astringent herbs, shrinks the capillaries or srotas and stops the bleeding or peristalsis, ending the symptoms.
4) Lekhana basti
Lekhana means scraping agent.
It means strong and penetrating. It resembles sodhana basti, but is stronger in its effects and generally much larger in volume.
It is particularly useful for kapha and meda dhatu disorders, where excess fatty substances have accumulated. The accumulated substances need to be eliminated, as in obesity and arteriosclerosis.
5) Bruhan basti
Bruhan means nourishment.
Highly nutritious substances are used to balance and strengthen the dhatus and their metabolism, and increase the body's resistance to infectious diseases.
Anuwasan provides the prime example of bruhan.
There are nutritive basti also, like ksheer basti (enema of milk), medicated decoction of fresh, whole milk.
These enemas are very effective in regenerating the dhatus and are specifically used to tone the muscles (mamsa) and reduce atrophy and emaciation.
In addition, there are bruhan basti, which use honey, ghee, or the juices from meat, bone marrow and herbs, which have a highly nutritive value.
6) Snehana basti
It is prepared only from oleated substances, but is larger in volume.
Due to its size, it has a greater lubricating effect on both the colon and the body in general.
It has a strongly pacifying influence on vata and is particularly useful in cracking of joints and for those who have very dry skin or who are emaciated.
Site of administration
Classification of basti (enema) on basis of site of administration
1) The first major classification refers to the administration site and the primary organs receiving treatment
Pakwashaya gata basti: Medicated liquids sent through the anus and rectum into the colon.
Uttara basti: Medicated liquids sent through the vagina and cervix to cleanse and nourish the uterus.
Mutrashaya gata basti: Medicated liquids introduced into the penis and urethra to treat the male genital and urinary organs.
Vranagata basti: Cleansing and medicated liquids used to irrigate and heal abscesses or wounds.
2) Four types of external basti are classified according to their site of administration
Netra basti or netra tarpana :
o In this type of basti, medicated ghee is applied to the eyes.
o A dam constructed around the eye sockets, made of the dough from black gram flour, contains the ghee.
o Netra basti is highly nourishing for the eyes; it removes eyestrain and improves vision.
Katti basti :
o Katti basti means medicine retained on the lower back.
o In this type, medicated oils are applied in a container of black gram dough built around the lumbosacral area.
o This form of external basti particularly benefits muscle spasm and rigidity of the lower spine and strengthens the bone tissue in that area.
Uro basti :
o Uro basti means medicine retained on the chest and heart region.
o It uses medicated oils in a container constructed of black gram dough around the heart region.
o It reduces pain in the sternum area and strengthens the heart.
Shiro basti :
o Shiro basti is administered on the head region through the use of a specialized leather container resembling a hat. This type of basti improves the functioning of prana vayu and revitalizes sensory functioning.
o It also promotes kapha secretions in the para-nasal sinus zone, which reduces vascular congestion in the brain.
o Shiro basti is extremely useful in shiraha shoola (headaches), mansa rog (schizophrenia, obsessive-compulsive disorders, memory loss, disorientation) and adhimantha (glaucoma) and sinus headaches.
Drugs
Classification of basti (enema) on the basis of drugs
On the basis of drugs, basti is classified into two types which are as follows
1) Niruha basti (Cleansing basti)
Niruha, which means that which gets eliminated," cleanses toxins from the dhatus (tissues) and removes naturally accumulated malas from the colon.
Niruha basti is given in a series of treatment over a period of several days.
The first day of this basti treatment cleanses the colon of ama and mala.
The second day of niruha balances and nourishes vata, producing increased mental calm and clarity.
Because the vata zone has now been cleared, the third day pulls out ama and toxins from the pitta zone. This balances and nourishes pitta function and, in turn, purifies and strengthens both rasa and rakta.
On the fourth and fifth days of administration, toxins get pulled out of the kapha area.
On the sixth and seventh day, the basti benefits reach the deeper dhatus, asthi (bone) and majja (bone marrow), and the eighth day works on shukra (semen or ovum).
2) Anuwasan basti (Nourishing basti)
It is of three types: Sneha basti, Anuvasan basti, Matra basti.
The basti, which remains in the body for a while is called as anuvasan basti.
Anuwasan basti is usually administered after a cleansing course of niruha basti to ensure that vata dosha is operating properly.
They not only restore health to the colon, but also lubricate and nourish all the dhatus.
This counteracts the debilitating influence of ama and toxins on the tissues and helps in restoring them to normality, which is the primary purpose of anuwasan basti.
Indications of Basti
Basti therapy is advised for all types of diseases for all doshas and for all the stages of the disease, but in some cases like when in obstruction due to meda (fat) and kapha there is increase in vata rather then giving anuvasan basti, niruh basti is useful. The indications for anuvasan basti are same.
In the following diseases asthapana basti can be given
Paralysis
Hemiplegia
Paraplegia
Obstruction of vayu, feces and urine
Fever
Tuberculosis
Fissures
Coryza
Gout
Piles
Dysuria
Amla pitta
Pain in head, ear, heart
Backache
Diseases of vata
Contra - indications of Basti
Following are the contra indications for asthapana as well as anuvasan basti:
Anorexia
Increased kapha character
After oleation
In the case of vitiation of doshas
Tired by travelling
Very weak
Hungry and thirsty
After consumption of food
Immediately after other therapies
In emotionally disturbed state
Unconscious
Breathlessness
Cough
Hiccoughs
Imperforated anus
Ascites
Diabetes
Leprosy
Piles
Anemia
Fatness
In children and old aged person.
In seventh month of pregnancy.
Nasya karma (Nasal Insufflation)
Administration of the drug through nostrils is known as Nasya karma. Navana and Nastah are the synonyms of Nasya karma.
Nose is the gateway of the head. So, systematically performed Nasya karma cures almost all the diseases of the head easily. It cleanses and opens the channels of the head and improves the oxygenation (prana) which has a direct and highly beneficial influence on brain functioning.
Indications for nasya or nasal administration
Stiffness in the head, neck, teeth and jaw
Chronic coryza
Uvulitis
Tonsilitis
Seminal disorders
Cataract
Diseases of the eye lid
Hemicranial
Shoulder pain
Diseases of mouth, nose, ear, eye and head
Facial Paralysis
Hysteria
Tetanus
Hoarseness of voice
Aphonia
Stammering
Tooth ache and other tooth disorders
Nasya should not be given to infants, pregnant women, and elderly people above 80 yrs of age.
Avapidana Nasya
Nasya karma or nasal administration is of five types: navana, avapidana, dhmapana, dhuma and marsa or pratimarsa nasya.
The process of nasal administration of fresh juice obtained from the leaves containing tikshna guna is known as avapidana nasya. It is of two types:
Stambhana
Sodhana
Indications
Murcha (fainting)
Sanyasa (coma)
Moha
Apatantraka
Apasmara (epilepsy)
Shirovedana (headache)
Psychic disorders
Throat diseases
Insomnia
Dosage
In each nostril :
Uttama matra (Maximum quantity) : 8 drops
Madhyama matra (Medium quantity) : 6 drops
Hraswa matra (Minimum quantity) : 4 drops
Dhmapana Nasya
Nasya karma or nasal administration is of five types: navana, avapidana, dhmapana, dhuma and marsa or pratimarsa nasya.
Blowing medicated powders into the nostrils is called dhmapana nasya or prdhamana nasya.
Indications
Unmada (Insanity)
Apasmara (Epilepsy)
Atatwabhinivesa
Kaphaj shiroroga
Dosage
Dose is 120 mg.
Dhuma Nasya
Nasya karma or nasal administration is of five types: navana, avapidana, dhmapana, dhuma and marsa or pratimarsa nasya.
The process of inhaling medicated fumes through the nostrils and expelling through mouth with the help of a dhuma yantra is known as dhuma nasya
.
It is of three types:
Prayogika
Vairechinika
Snehika.
Indications
Shiroroga
Nasal diseases
Eye diseases
Dhuma yantra
Dhuma yantra consists of two parts:
Dhuma netra
Dhuma varti
Dhuma netra
Dhuma netra can be prepared with the metals, viz. gold, silver, copper etc.
It has the circumference of a thumb at the base and of little finger at the tip.
The hole near the tip is of the size of a pea.
The length of :
o prayogika dhuma netra is 48 inches.
o snehika dhuma netra is 32 inches.
o vairechinika dhuma netra is 24 inches.
Dhuma varti
Soak a stick of any herbal stem of 12 inches length in water overnight.
Roll a cloth piece of nine inches and apply the paste of drugs, according to the condition of the disease and then dry it well.
In this way, paste is to be applied for five times.
Remove the stick from the cloth and dhuma varti is ready.
Arrange it to dhuma netra and after applying ghee and medicated fumes, inhale through the nostrils.
The fumes inhaled through the nostrils should be expelled through the mouth and those inhaled through the mouth also should be expelled through mouth only.
Note
The fumes should never be expelled through the nostrils; otherwise disease of the eyesight may arise.
Navana Nasya
Nasya karma or nasal administration is of five types: navana, avapidana, dhmapana, dhuma and marsa or pratimarsa nasya.
Administration of medicated oil into the nostrils with the help of cotton or dropper is called navana nasya. It gives strength to the neck and shoulders and improves eye-sight. It is of two types:
Snehana
Sodhana
Dosage
In each nostril:
Uttama matra (Maximum quantity): 32 drops
Madhyam matra (Medium quantity): 16 drops
Hraswa matra (Minimum quantity): 8 drops
Marsa / Pratimarsa Nasya
Nasya karma or nasal administration is of five types: navana, avapidana, dhmapana, dhuma and marsa or pratimarsa nasya.
A finger dipped in medicated oil or ghee is applied inside nostrils. This procedure is called marsa or pratimarsa nasya. It is of two types:
Uttama Sneha
Virechana
Indications
Krumi (maggots) in head.
Strengthening.
Premature graying of hair.
Dosage
Uttam matra (Maximum quantity): 10 drops
Madhyama matra (Medium quantity): 8 drops
Hraswa matra (Minimum quantity): 6 drops
Note
It can be administered without any hesitation as the dose of pratimarsa is only 2 drops.
Raktamokshana (Bloddletting)
Rakta means blood and mokshan means to remove, so raktamokshana means removing vitiated blood from the body. It is the localized treatment not considering the vitiation of the doshas. It is an important therapy in shalya tantra (surgery) as is basti (medicated enema) in kayachikitsa (medicine).
Extraction of vitiated blood from the body by using Sastras and Anusastras is known as Raktamokshana. Kusta, Visarpa, Slipada etc. are some of the diseases caused due to the vitiation of blood.
It is done either by metal instruments or by using leeches or vegetable gourds.
Indications
Following are the diseases for which Raktamokshana can be given:
Skin diseases
Herpes
Jaundice
Ulcers
Gout
Piles
Abscess
Leucoderma
Syncope
Eczema
Types of Raktamokshana
Raktamokshan has two types:
1) Shastra prayoga
Pracchana: Pracchana is indicated to drain the accumulated blood from a particular point.
Sira vedhana: Venepuncture is devised whenever vitiated blood circulates in the body.
2) Anushastra prayoga
Jalouka prayoga: Deep-seated blood can be extracted with the help of leech application. It is better to extract blood vitiated by pitta by means of leech application.
Sringa: To extract the blood vitiated by vata, sringa or horn is indicated.
Alabu: Blood vitiated by kapha can be extracted by Alabu as it consists of tikshna and ushna gunas.
Ghati yantra: To drain the vitiated blood, which has settled in different layers of the skin, ghati yantra is useful.
Precautions
The following precautions should be followed for raktamokshana:
Never give incision to the contra indicated where the proximal part is not tied, where the veins are not bulged and also in the transverse direction.
Venesection is not advised in mid summer, winter and rainy season.
Should not be done in healthy individuals.
Required equipment, instruments and other essential drugs and antidotes should be collected before starting the therapy.
Contraindication of Raktamokshana
Immediately after oral administration of oil.
Immediately after performing any Shodhana Therapy.
Pregnant women.
Postnatal period.
Chronic jaundice.
Impotency.
Below 16 years and above 70 years of age.
Haemorrhage
Excessive oleation.
Without sudation.
Paralysis, diarrhoea, vomiting, dyspnoea, cough, ascitis, piles, anaemia, anasarca, etc.
When venesection is conducted to the contra indicated persons, either no bleeding or excessive bleeding occurs.
But in case of an emergency, venesection can be done for the above persons also.
Paschat karma
The third stage of Panchakarma is Paschat karma i.e., the adoption of rehabilitative measures after the main treatment. It describes the measures employed after the main treatment, such as diet, medicines and daily routine.
It is of three types:
Samsarjana Karma
Rasayanadi Karma
Samana Prayoga
Samsarjana Krama
Restoration of digestive power by advocating specific diet after completion of Sodhana Therapy is known as Samsarjana krama.
Rasayanadi Karma
Administration of Rasayana and Vajeekarana drugs after Elimination Therapy is known as Rasayanadi karma.
Samana Prayoga
Administration of medicines required to treat the particular disease after the process of elimination is called Samana Prayoga.
After care
The following regime is to be followed during the course of oleation therapy for the same number of days, even after the completion of the course.
Use only warm water for drinking and bathing.
Celibacy should be maintained.
Avoid :
o Suppressing the natural urges.
o Speaking loudly.
o Anger and anxiety.
o Exposure to sunlight and cold breeze.
o Traveling long distances by vehicle or by walk.
o Contact with smoke and dust etc.
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