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 Ayurvedic Medicine: An Introduction to Panchakarma  
 
Ayurveda emphasizes preventative and healing therapies along with various methods of purification and rejuvenation. Ayurveda is more than a mere healing system, it is a science and an art of appropriate living which helps to achieve longevity. It can guide every individual in the proper choice of diet, living habits and exercise to restore balance in the body, mind and consciousness, thus preventing disease from gaining a foothold in the system.

According to Ayurveda, every human being is a unique phenomenon (manifested through the five basic elements - ether, air, fire, water and earth) of cosmic consciousness. Vata (ether plus air), pitta (fire plus water) and kapha (water plus earth) are called the tridosha, meaning the three humors or the three organizations of the body, which are also derived from consciousness. Every individual psycho-somatic temperament or constitution is determined by these three doshas at the time of fertilization. When the embryo is formed the constitution is determined. There are seven basic constitutions according to Ayurveda: vata, pitta, kapha, vata-pitta, pitta-kapha, kapha-vata and vata-pitta-kapha. Every individual constitution has its own unique balance of V-P-K according to its own nature. The balance of V-P-K is the natural order, thus when this doshic balance is disturbed, it creates imbalance, which is disorder. Health is order; disease is disorder. Within the body there is a constant interaction between order and disorder, thus once one understands the nature and structure of disorder, one can re-establish order. Ayurveda believes that order lies within disorder.

Order is the state of health, as defined by Ayurveda, which exists when the digestive fire (agni) is in a balanced condition; the bodily humors (vata, pitta and kapha) are in equilibrium, the three waste products (urine, feces and sweat) are produced and eliminated normally, the seven bodily tissues (rasa, rakta, mamsa, meda, asthi, majja and shukra) are functioning normally, and the mind, senses and consciousness are working harmoniously together. When the balance of these systems is disturbed the disease (disorder) process begins.

The internal environment is governed by V-P-K, which is constantly reacting to the external environment. The wrong diet, habits, lifestyle, incompatible food combinations (e.g. milk and fish, melons and grain, yogurt and meat or cooked honey etc.), seasonal changes, repressed emotions and stress factors can all act either together or separately to change the balance of V-P-K. According to the nature of the cause, either vata, pitta or kapha undergo aggravation or derangement which affects the agni (gastric fire), and produces ama (toxins). This ama enters the blood stream and is circulated throughout the body, clogging the channels. Retention of toxins in the blood results in toxemia. This accumulated toxicity, once well established, will slowly affect prana (vital life energy), ojas (immunity), and tejas (cell metabolic energy) and result in disease. This can be nature's effort at eliminating the toxicity from the body. Every so-called disease is a crisis of ama toxicity. Ama is the basic internal cause of all disease, due to the aggravated doshas.

Herein lies the key to the prevention of disease: help the body eliminate the toxins. To stop the further production of ama Ayurvedic literature suggests putting the person on a proper diet with appropriate lifestyle, habits and exercise, and administering a proper cleansing program such as panchakarma.

[Although panchakarma is often thought of as the entire procedure, it really is only one part of a group of therapies belonging to a class of cleansing procedures called shodan. There is also a group of milder techniques called shaman for those not strong enough for shodan.]

Purvakarma: Pre-purification Measures
Before the actual operation of purification begins, there is a need to prepare the body in prescribed methods to encourage the body to let go of the toxins. The two procedures are snehan and swedan. Snehan is the oil massage. Oil is applied to the entire body with a particular type of massage which helps the toxins to move towards the gastro-intestinal tract. Oil massage also makes the superficial and deep tissues soft and supple, thus helping to remove stress and to nourish the nervous system. Snehan is given daily for three to seven days, as indicated. Swedan is sudation or sweating and is given every day immediately following the snehan. An herbal concoction may be added to the steam to further loosen the toxins from the individual. Swedan liquifies the toxins and increases the movement of toxins into the gastro-intestinal tract. After three to seven days of snehan and swedan, the doshas become well "ripened." A particular panchakarma method is then given according to the individual's constitution and disorder, prakruti and vikruti, respectively.

Five Basic Shodhans: Cleansing Methods

1) Vaman: therapeutic vomiting or emesis
2) Virechan: purgation
3) Basti: enema
4) Nasya: elimination of toxins through the nose
5) Raktalmoksha: detoxification of the blood

Vaman: Emesis Therapy
When there is congestion in the lungs causing repeated attacks of bronchitis, colds, cough or asthma, the Ayurvedic treatment is therapeutic vomiting, vaman, to eliminate the kapha causing the excess mucus. First, after the snehan and swedan, three to four glasses of licorice or salt water is administered, then vomiting is stimulated by rubbing the tongue which triggers the vomiting center through the gag reflex. Often times this also releases repressed emotions which have been held in the kapha areas of the lungs and stomach along with the accumulated dosha. One may alternatively take two to three glasses of salt water which will also aggravate kapha and then rub the tongue to induce vomiting. Once the mucus is released the patient will feel instantly relieved. It is likely that congestion, wheezing and breathlessness will disappear and that the sinuses will become clear. Therapeutic vomiting is also indicated in chronic asthma, diabetes, chronic cold, lymphatic congestion, chronic indigestion and edema.

Before vaman is administered, oil massage and fomentation are recommended on the night before the day of vaman. One to three days prior to vaman, the person should drink one cup of recommended oil two to three times a day until the stool becomes oily, or until he or she feels nauseated. The person should also eat a kaphagenic diet to aggravate kapha in the system. Vaman should be given early in the morning (kapha time). The person should eat basmati rice and yogurt with much salt early in the morning, which will further aggravate kapha in the stomach. The application of heat to the chest and back will liquify the kapha. The person should sit calmly on a knee-high chair and drink the concoction of licorice and honey, or salt water. This emesis preparation is measured and recorded before being drunk, so that at a later time the amount of vomitus from the decoction can be determined. After drinking the decoction the person should feel nauseated. He should then rub the tongue to induce vomiting, continuing until bile comes out in the vomitus. The degree of success in this treatment is determined by: 1) the number of vomitings (8 is maximum, 6 medium, 4 minimum), and 2) the quantity of vomitus (1 quart maximum, 1 1/2 pints medium, 1 pint minimum).

Emetic Substances: madan-emetic nut, madhuka-yastimadhu-licorice, neem-bitter leaf, bimbi, kutaj-kurchi- conessi bark, murva-clematis, triloba-devdaru-deodar, Cedrus deodara, Salt, NaCl, ela-cardamom, nux vomica.

After vaman, resting, fasting, smoking certain herbal cigarettes, and not suppressing natural urges (i.e. urination, defecation, gas, sneezing, coughing) is recommended. If vaman is administered properly, the person should feel relaxation in the lungs, will be able to breathe freely, will have lightness in the chest, clear thinking, clear voice, a good appetite, and all symptoms of congestion disappear.

After practicing vaman in the morning, the person should fast until 5 pm, then eat kitchari with ghee. He or she can drink cumin, coriander, ginger, fennel tea (equal portions). Steep in hot water and drink with one tsp. honey. Or he can drink honey lime tea, using one tsp. honey and one tsp. lime juice to one cup of hot water.

Indications for Vaman:

  • used for all kapha type disorders
  • good for pitta headache, dizziness, and nausea
  • will help to release blocked emotions
  • respiratory congestion
  • bronchitis
  • chronic cold
  • sinus congestion
  • kaphagenic asthma

    Contra-Indications for Vaman:

  • below the age of 12 or over age 65
  • menstruation
  • pre-menstrual period (one week prior)
  • pregnancy
  • emaciation
  • delicate or sensitive person with too much fear, grief or anxiety
  • hypoglycemia
  • vata prakruti
  • vata diseases
  • heart diseases
  • during vata season
  • acute fever
  • diarrhea
  • obesity

    Virechan: Purgation Therapy
    When excess bile, pitta, is secreted and accumulated in the gall bladder, liver and small intestine, it tends to result in rashes, skin inflammation, acne, chronic attacks of fever, biliary vomiting, nausea and jaundice. Ayurvedic literature suggests in these conditions the administration of therapeutic purgation or a therapeutic laxative. Virechan is facilitated with senna leaves, flax seeds, psyllium husks or triphala in a combination that is appropriate for the individual person.

    Senna leaf tea is a mild laxative, but in people of vata constitution, this tea might create griping pain, since its action aggravates peristaltic movement in the large intestine.

    An effective laxative for vata or pitta constitutions is a glass of hot milk to which two teaspoons of ghee have been added. This laxative, taken at bedtime will help to relieve the excess pitta causing the bile disturbance in the body. In fact, purgatives can completely cure the problem of excess pitta.

    When purgatives are used, it is important to check the diet. The patient should not eat foods that will aggravate the predominant humor or cause the three humors to become unbalanced.

    Virechan Substances: Senna, prune, bran, flaxseed husk, dandelion root, psyllium seed, cow's milk, salt, castor oil, raisins, mango juice, triphala.

    Indications for Virechan:

  • allergic rash
  • skin inflammation
  • acne, dermatitis, eczema
  • chronic fever
  • ascites
  • biliary vomiting
  • jaundice
  • urinary disorder
  • enlargement of the spleen
  • internal worms
  • burning sensation in the eyes
  • inflammation of the eyes
  • conjunctivitis
  • gout

    Contra-Indications for Virechan:

  • low agni
  • acute fever
  • diarrhea
  • severe constipation
  • bleeding from rectum or lung cavities
  • foreign body in the stomach
  • after enema
  • emaciation or weakness
  • prolapsed rectum
  • alcoholism
  • dehydration
  • childhood
  • old age
  • ulcerative colitis

    Basti: Enema Therapy
    Vata's predominant site is the colon. Ayurvedic basti involves the introduction into the rectum of herbal concoctions of sesame oil, and certain herbal preparations in a liquid medium. Basti, is the most effective treatment of vata disorders, although many enemas over a prescribed period of time are usually required. It relieves constipation, distention, chronic fever, cold, sexual disorders, kidney stones, heart pain, backache, sciatica and other pains in the joints. Many other vata disorders such as arthritis, rheumatism, gout, muscle spasms and headaches may also be treated with basti.

    Vata is a very active principle in pathogenesis. If we can control vata through the use of basti, we have gone a long way in going to the root cause of the vast majority of diseases.

    Vata is the main etiological factor in the manifestation of diseases. It is the motive force behind the elimination and retention of feces, urine, bile and other excreta. Vata is mainly located in the large intestine, but bone tissue (asthi dhatu) is also a site for vata. Hence the medication administered rectally effects asthi dhatu. The mucus membrane of the colon is related to the outer covering of the bones (periosteum), which nourishes the bones. Therefore, any medication given rectally goes into the deeper tissues, like bones, and corrects vata disorders.

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     About The Author
    Dr.Vasant Lad Vasant Lad is an Ayurvedic Physician and Executive Director of the Ayurvedic Institute. Dr. Lad brings a wealth of classroom and practical experience to the United States. A native of India, he served for three years as......more
     
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