Steps in Panchakarma 
Pretreatment
Therapeutic vomiting (Vamana)
Purgation Therapy (Vireka, Virechan, herbal laxative therapy)
Enema (Basti)
Nasal Administration - Nasya (herbal inhalation therapy)
Blood Letting (Rakta Moksha)
Panchakarma
Panchakarma is a Sanskrit word that means "five
actions" or "five treatments." This is a process
used to clean the body of toxic materials left by disease and poor
nutrition. Ayurveda says that imbalanced doshas create waste matter.
This waste matter is called Ama in Ayurveda. Ama is a foul-smelling,
sticky, noxious substance that needs to be evacuated from the body
as thoroughly as possible.
Panchakarma will stick out the excess doshas (or imbalances
in the dosha) along with the sticky Ama out of your system by means
of the body waste evacuation channels such as sweat glands, urinary
tract, intestines, etc. Panchakarma is, thus, a balancing operation.
It involves daily massages and oil baths and is extremely pleasant
experience. Ayurveda recommends Panchakarma as a seasonal treatment
for toning your mind body system. (This is like a tune up for the
car.)
Steps in Panchakarma
Panchakarma is a five-fold therapy; it is highly personalized
based on the needs of the individual depending on the body type,
dosha imbalances etc. Usually, only parts of the five therapies
are needed.
Pretreatment
Prior to starting Panchakarma, oiling and heating
of the patient is done to bring the excess doshas from the limbs
to their proper reservoirs in the digestive tract, from which they
can be expelled. The doshas are then excited by a procedure called
utkleshana, a therapy that makes the excess dosha anxious to leave
the body. One to three nights prior to the start of Vamana, the
patient is asked to drink one cup of oil two to three times a day
until the stool becomes oily, or he feels nauseated (This treatment
is called oleation or sneehana). Kapagenic diet is given to aggravate
Kapha. On the morning of the Panchakarma, kapha aggravating foods
such as basmati rice and yogurt with salt is given to further aggravate
the kapha. Oil massage and fomentation are administered on the night
before the day of Vamana. The application of the heat to the chest
and back will liquefy kapha.
Therapeutic vomiting (Vamana)
This treatment is used when there is congestion in
the lungs causing repeated attacks of bronchitis, cough, cold or
asthma. The objective of the therapy is to induce vomiting to get
rid of the mucus causing excess kapha. A drink consisting of licorice
and honey, or calamus root tea is given to the patient. (Other substances
used include salt, and cardamom) Vomiting is induced by rubbing
on the tongue. 4-8 vomiting is the target. After vomiting the patient
will feel very comfortable; most of the congestion, wheezing and
breathlessness will disappear along with the clearing of the sinus.
Therapeutic vomiting is used for cough, cold, symptoms
of asthma, fever, nausea, loss of appetite, anemia, poisoning, skin
diseases, diabetes, lymphatic obstruction, chronic indigestion,
edema (swelling), epilepsy (between attacks), chronic sinus problems,
and for repeated attacks of tonsillitis.
Purgation Therapy (Vireka, Virechan, herbal laxative
therapy)
Virechan is the cleansing of the pitta and the purification
of the blood toxins. Generally, it is administered three days after
the Vamana treatment. If Vamana therapy is not needed, Virechan
can be administered directly. Virechan cleanses the sweat glands,
small intestine, colon, kidneys, stomach, liver, and spleen. A number
of fine herbs are used as a laxative. These include senna, prune,
bran, flaxseed husk, dandelion root, psyllium seed, cow's milk,
salt, castor oil, raisins and mango juice. When taking these laxatives,
it is important to adhere to restricted diet. Vireka is used for
treatment of skin diseases, chronic fever, piles, abdominal tumors,
worms, gout, jaundice, gastrointestinal problems, constipation,
and irritable bowel syndrome.
Enema (Basti)
Medicated enemas are used for various specific reasons.
In general, this treatment is used to flush the loosened doshas
out through the intestinal tract. There are over 100 specific enemas
listed in Ayurveda.
Basti involves introducing medicinal substances such
as sesame oil, calamus oil, or other herbal decoctions in a liquid
medium into the rectum. Basti is especially good for vata disorders.
It alleviates constipation, distention, chronic fever, the common
cold, sexual disorders, kidney stones, heart pain, vomiting, backache,
neck pain and hyper acidity. Such vata disorders as sciatica, arthritis,
rheumatism, and gout can also be treated by Basti. There are about
80 vata related disorders in Ayurveda. About 80 percent of them
can be treated with medicated enemas.
Since vata is mainly located in the colon and bones,
the medication is administered rectally.
Type of Enemas:
Oil Enema or Nirhua Basti - 1/2 to 1 cup of warm
sesame oil (for chronic constipation)
Decoction enema or Anuvasana Basti (Herbal enema) - 1/2 cup of gotu
kola or comfrey decoction with 1/2 cup of warm sesame oil
Nutrition Enema - 1 cup of warm milk, 1 cup of meat broth or 1 cup
of bone marrow soup
The enema should not be given to persons suffering
from chronic indigestion, bleeding from rectum, cough, breathlessness,
diarrhea, diabetes, severe anemia, to aged or to children under
7. Don't give decoction enemas to people suffering from acute fever,
diarrhea, cold, paralysis, heart pain, or severe pain in the abdomen.
Nasal Administration Nasya (herbal inhalation therapy)
This treatment involves inhaling vapor from medicinal
herbs that have been infused in boiling water. It is used mostly
to eliminate kapha-oriented problems, of ear, eyes, nose, and throat
disorders such as migraine, sinusitis, catarrh, and bronchitis.
The nose is the gateway to the brain and to consciousness.
Prana, or life energy, enters the body through breath taken in through
the nose. Nasal administration of medication helps to correct the
disorders of prana affecting the higher cerebral, sensory and motor
functions. Nasya is indicated for dryness of the nose, sinus congestion,
hoarseness, migraine headache, convulsions and certain eye and ear
problems.
Types of Nasya
Virechan (cleansing with use of powders or herbs)
Nutritional Nasya (for vata)
Sedative Nasya
Nasya decoctions
Ghee or oil Nasya
Nasal massage
Substances such as calamus powder, gotu kola, onion, garlic, black
pepper, cayenne, ginger, ghee oil decoctions are used in Nasya.
Nasal medication should not be administered after a bath, food,
sex, drinking alcohol, during pregnancy, or menstruation.
Blood Letting (Rakta Moksha)
Blood letting is used to eliminate toxins that are
absorbed into the bloodstream through the gastrointestinal tract.
This process purifies the blood. It is used for disorders such as
repeated attacks of skin disorders such as urticaria, rash, eczema,
acne, scabies, leucoderma, chronic itching, and hives. It was also
found effective for enlarged liver and spleen, and for gout.
Blood letting, which should only be administered by
a qualified physician, is useful to relieve several pitta disorders
such as acne and rash. If administered properly, it stimulates the
antitoxic substances in the blood stream, thus developing the immune
mechanism in the blood system.
Do not administer blood letting in cases of
anemia, edema, weakness or to very old and
very young persons
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