Pancha Karma
Ayurveda offers unique therapeutic measures that heal mild and chronic diseases. Even diseases that are believed to be incurable by modern medicine have been healed. Stories abound of people being carried into panchakarma centers, and a few weeks later, walking out on their own two feet, healthy and rejuvenated. ayurveda is not based on magic; rather, it is based on understanding medical principles and the six stages of illnes. The most deeply seated toxins that cause disease are heavy and sticky, lodging in the deepest tisue layers. Pancha Karma permanently eliminates these toxins from the body, allowing healing and restoration of the tisues, channels, digestion, and mental functions.
Six therapies are used in panchakarma. These are divided into two categories:
Toning or nourishing (Brihmana or Samtarpana), and
2) Reducing or detoxifying —those that cause lightnes. Langhana or Apartarpana Brihmana tones because it uses therapies that promote earth and water elements, while langhana lightens by using ether, air, and fire elements to reduce. Illnes is relieved as doshas become balanced through these therapies.
The six major therapeutic categories are either toning or reducing in nature.
1. Reducing (langhana or lightening) the body, making it light.
2. Nourishing (Brihmana or expanding) the body by adding corpulence.
3. Drying (rukshana) or producing roughnes in the body.
4. Oleation (snehana) or applying oil to the body creates softnes, fluidity, and moistnes.
5. Sudation (svedhana) or sweating, removes stiffnes, heavines, and coldnes.
6. Astringent (stambhana) balances the flow (slow or fast) of bodily fluids (e.g., diarrhea, bleeding, etc.), and prevents mobility.
The therapeutic measures involved for each category primarily include herbs, foods, internal and external application of oils; fasting, and exercise.
Below are listed the respective therapeutic measures,
1. Lightening (langhana)—light, hot, sharp, non-slimy, rough, subtle, dry, fluid, hard.
Two forms of lightening exist: strong (shodhana) and mild (shamana). shodhana expels the doshas out of the body through decoction enema, emesis,
purgation of the body and head, and by bloodletting. shamana is a palliative approach that, rather than expel the doshas, merely normalizes them through seven approaches.
1) Digestive, carminative herbs,
2) Hunger-producing herbs,
3) Avoidance of food,
4) Avoidance of drink,
5) Physical exercise,
6) Sunbathing,
7) Exposure to wind.
Palliative therapy is used by people with diabetes, poor digestion, exces watery conditions (e.g., congestion, overweight), toxic buildup (ama), and fevers. These measures are also used for stiff
thighs, skin diseases, herpes, abscess, spleen, head, throat and eye problems; and are provided to people during the cold season (shishira—mid-Jan. to mid-March).
Pitta and Kapha disorders follow shodhana (strong) therapies of purgation and emesis. Symptoms include the presence of toxins, obesity, fever, vomiting or nausea, diarrhea, heart disease, constipation, heavines, and exces belching. People with moderate symptoms of weight gain and medium strength are first given digestive herbs like ginger, cardamom, or cinnamon. Persons who need to boost their appetites are also given hunger producing herbs like bibhitaki and guggul. Once the person is strengthened and digestion is improved, then both groups of herbs are administered, along with the other purificatory therapies, for a more thorough detoxification. Those people who are only mildly overweight, and of medium strength, and those who have medium strength and have dosha excess, are advised to control their thirst and hunger. For people who are weak and ill, and are not yet able to withstand the stronger therapies, mild therapies are initially suggested (i.e., sun and wind bathing and mild exercise). Excess use of reduction therapies cause joint pain, body aches, cough, dry mouth, thirst, loss of appetite, anorexia, weakened hearing, and sight. Further disorders include mental instability, exces fasting, a desire to enter dark places, emaciation, weakened digestion and depleted strength. Other imbalances are giddines, cough, indigestion, insomnia, depletion of life sap (ojas) and semen; hunger, fever, delirium, and belching. Additional disorders include pain in the head, calves, thighs, shoulders, ribs, fatigue,
vomiting, constipation, and difficult breathing.
2. Nourishing (b^iμhaòa)—heavy, cold, soft, unctuous, thick, bulky, slimy, sluggish, stable, smooth. This is also a shamana (palliative) therapy because it alleviates and/or mitigates both Vayu and Vayu/Pitta imbalances. This is mostly applied to the very weak or those with Vayu exceses. Included here are the very young, very old, emaciated, people suffering from lung injury, those experiencing grief, strain, drynes, excesive emision of semen or exces travel. Nourishing therapies may be given to everyone in the summer, depending upon the condition of their health. Nourishing therapies include bathing, oil massage, oil enema, sleep, nutritive enemas, warm milk with whole sugar, almonds, tahini, organic dairy, and ghee. Excessive use of nourishing therapies causes obesity, congestion, difficulty breathing, heart problems, diabetes, fever, enlarged abdomen, fistula in- ano, and ama. Other developments include skin disorders, cough, fainting, dysuria, poor digestion, and scrofula (TB of the neck lymph nodes). Further, if toxins are in the body, they should be eliminated before toning. To counter excesive use of nourishing therapies, antidotes include les sleep and the herbs guduchi, guggul, shilajit, amalaki, vidanga, trikatu, and chitrak, with honey.
3. Drying (rukshana)—rough light, dry, sharp, hot, stable, non-slimy, hard. Herbs and foods having pungent, bitter, and astringent tastes produce drynes. Usually, this therapy is applied when there are Kapha exceses and obstructions in the srotas (channels). These therapies are also used with major diseases involving the heart, urinary bladder, spastic thighs, gout, urinary disorders.
Excesive use of drying therapies causes the same symptoms as excesive langhana therapies.
4. Oleation (snehana)—these qualities are liquid, subtle, fluid, unctuous, slimy, heavy, cold, sluggish, and soft. Medicated oils are used. Therapy lasts for 3 to 7 days.
5. Fomentation (svedhana)— these properties are hot, sharp, fluid, unctuous, rough, subtle, liquid, stable, and heavy. Sweating techniques such as warm water, poultice, and steam; and medicated lotions are used.
6. Astringent (stambhana)— qualities include cold, sluggish, soft, smooth, rough, subtle, liquid, stable, light VK+. Although this approach seems similar to lightening, astringents are used more for Pitta exceses, while lightening may be required for any dosha. Indications for using this therapy include exces Pitta, blackish complexion, bradycardia (les than 60 heart beats per minute), alkali, diarrhea, vomiting, poisoning, and perspiration. Excesive use of astringents develops stiffnes, anxiety, stiff jaw, cardiac arrest, constipation, cracked skin, dry mouth, thirst, and decreased appetite. Other conditions include memory loss, an increase of upward-moving Vayu and malaise.
All therapies fall into one of two categories, nourishing (santarpana), and depleting (apartarpana). Generally speaking, Kapha doshas need reducing or depleting therapy to reduce earth and water excesses (toxic Pittas need a milder form of detoxification). Kaphas also need nourishing therapies for the ether, air, and fire elements of Vayu and Pitta. In fact, each dosha may need some form of detoxification, depending upon its condition. It is a unique insight into the ayurvedic system that healing requires the removal of the toxins through one of the various reduction therapies.
Then a nurturing therapy to build healthy new cells and tisues follows. To nourish before detoxifying would be adding to the preexisting toxins. In other words, nourishing therapies would only nourish the toxic condition. Only after toxins are removed can one begin to rebuild their system.
Reduce – then Tone: Most people can use some degree of reducing, whether it is with herbs, fasts, sweating, etc., purifying the body, and preparing it for toning.
When Not to Reduce: Some people, who are already weakened by illnes—or the very old or very young—become even weaker through reduction. In these cases, a combination of the two methods is employed so the person’s strength is not depleted completely. Reducing and toning are used especially for long term therapies.
Exces application of nourishing or depleting will cause diseases of the opposite nature. Generally, being too thin is better than being too heavy because gaining weight is easier than losing it.
Pañcha Karma (five actions) returns toxins to their sites of origin to be properly eliminated. This differs from most other healing systems that mainly flush the various organs or body systems regardles if the toxins are present. Once the toxins are removed from the organs and systems, no method exists to remove them from the body gently. Thus, many healers tell clients that they will feel bad for a few days as they detoxify, then they will feel better. With pañcha karma, the detoxification proces happens without discomfort or withdrawal symptoms, and the body is completely rid of toxins.
Pañcha karma consists of five cleansing aspects: emesis, purgation, medicated enemas, medicated nasal oils, and toxic bloodletting. These therapies are employed for acute diseases as well. For example, emesis (vomiting therapy) may be used during acute asthma attacks, obesity, and acute Kapha disorders. As mentioned before, the person needs to be strong before undertaking pañcha karma because these reducing therapies temporarily weaken the system. Additionally, pañcha karma is used to prevent the accumulation of the humors, or as a seasonal health maintenance and a longevity/rejuvenation program. What is unique about this ayurvedic approach is that it is used not only for healing but also for prevention and rejuvenation (longevity). Enemas that include tonics and nutritive herbs are also used in supplementation therapy, as they build tisues rather than reduce humors. Thus, pañcha karma offers various therapies that may be used in various ways, depending upon the person, disease, season, culture, etc. The milder therapies may be used seasonally in self-healing, prevention, and rejuvenation.
Therapeutic Vomitng (Vamana)
Of all the five pañcha karma therapies, this is the most dangerous; one can strain to vomit and damage the nerve reflexes. With proper guidance, one learns the method for oneself or consults a qualified pañcha karma specialist. It is done regularly to cleanse the stomach and remove ama (toxins) and mucus from the nadis (channels) and chest. It is used for relieving recent fever, diarrhea, pulmonary TB, and all lung conditions, skin diseases (e.g., eczema, psoriasis, leukoderma), diabetes mellitus, goiter, tumors, cough, asthma, and difficult breathing. Vamana is also useful for nausea, herpes, head and sinus diseases, allergies, chronic colds, rhinitis, rheumatic diseases, arthritis, viral disorders (e.g., herpes zoster), insanity, parasites (filariasis), bleeding of a downward nature, and exces salivation. It helps heal hemorrhoids, anorexia, cervical adenitis, edema, epilepsy, confusion, absceses, and sore throats.
Vamana helps heal obesity, ear discharge, epiglottis, uvulitis, stiff neck, acute fever, Kapha fever, and nasal discharge. It is also useful for indigestion, gastroenteritis, alasaka, poison, chemical burn, and diseases due to bad breast milk. When vomiting or heart diseases are due to Kapha, then vamana is also used (but never when Pitta causes these two diseases— as per the below caution).
Purgation (Virechana)
This is the simplest method of pañcha karma and has the most easily observed effects. It is an excellent method to heal various conditions, including abdominal tumors, hemorrhoids, smallpox, patches of skin discoloration on the face, jaundice, chronic fevers, and enlarged abdomen. Virechana heals poisoning, vomiting, spleen diseases, absceses, blindnes, cataracts and other eye problems, colon pain, and colitis. It further heals vaginal diseases, diseases of the semen, intestinal parasites, ulcers, gout, bleeding diseases in the upward direction, blood toxins and diseases,
suppresion of urine, and obstructed feces. Purgatives eliminate exces Pitta from its site in the liver, gall bladder, and small intestine (it does not deal with the large intestine). The bitter purgatives like rhubarb, senna, or aloe also clean the liver and gall bladder, decongest bile and remove obstructions to its flow. They are preferred for Pitta and liver disorders (e.g., gall stones). Because this cleansing weakens the digestive fire, it is not always recommended for Vayu doshas. Kapha doshas, however, benefit from this therapy, as they have exces bile, congestion, fat, or phlegm. It also helps constipation, old fevers, acute diarrhea, dysentery, food poisoning, kidney stones, boils, carbuncles, exces bile, or toxic blood conditions.
Enema (Basti)
Enema is half of the medicinal therapy, or even the complete treatment. Charak- Sid. Ch. 1 verse 39 Basti therapy is primarily used for Vayu excesses, either alone, or as the predominant dosha deranged. Basti is the Sanskrit name for urinary bladder. Originally the bladders of larger animals, like buffaloes and goats, were used as enema bags. The colon is related to all other organs and tissues, so by cleansing and toning the colon, the entire body is healed and rejuvenated. The colon is the main organ that absorbs nutrients. A healthy, functioning colon is imperative for proper assimilation of nutrients. Basti is unlike Western enemas or colonics. Enemas only cleanse the rectum and sigmoid colon (only the lower eight to ten inches of the colon) causing an evacuating effect. Colonics remove feces blocks but may weaken the mucous membranes and dry the colon. This further imbalances Vayu’s normal elimination process. Basti, however, treats the entire length of the colon from the ileocecal valve to the anus. Not only is feces flushed from the system but also ama is removed from the tissues. Furthermore, a balanced and healthy colon function is restored as tissues and organs are rebuilt. General Benefits: Basti is useful for many disorders including chronic constipation, sciatica, lower back pain, arthritis, gout, and rheumatism. It also heals numerous neurological disorders like Parkinson’s, MS, muscular dystrophy, paraplegia, hemiplegia, poliomyelitis, osteoporosis, and muscle and nerve atrophy. Further, basti helps with mental conditions such as Alzheimer’s, epilepsy, mental retardation, and sensory disorders.
Nasal Therapy or Snuff (Nasya)
Ayurveda suggests that the nose is the gateway to the head. Thus, nasal herb therapy is used for healing diseases of the throat, neck, head, and senses (e.g., ears, nose, eyes, etc.). Nasya is also used for toning and strengthening these areas. Nasya is useful in relieving stiffness in the head, neck arteries, throat, and jaw obstructions, coryza, uvulitis, tonsillitis, cornea, vision and eyelid disorders, migraines, disorders of the neck, shoulders, ears, nose, mouth, head, cranium, and scapula. It helps facial paralysis, convulsions, goiter, pain, tingling sensation, loose teeth, tumors, hoarse voice, speech disorders, and Vayu disorders of the mind, head, neck, and throat. Nasya is also helpful in head diseases caused by Kapha (e.g., stiffness, numbness, heaviness). Saturating nasyas are recommended for Vayu disorders (e.g., facial paralysis, trembling head). Pacifying nasyas are useful for internal bleeding and other Pitta head and neck disorders. Snuff is suggested three times daily in the rainy, autumn, and spring seasons when there are no clouds in the sky. Snuff is said to improve vision, smell, and hearing; keep hair from graying and falling out;
prevent stiff neck, headache, and lockjaw. It is also said that snuff relieves chronic rhinitis and head tumors. The veins, joints, ligaments, and tendons of the skull gain greater strength. The face becomes cheerful and well developed; the voice becomes more melodious. Nasya herbs include Bala, Vidanga, Bilwa and musta. They are made into an oil decoction with various other ingredients.
Blood-letting (Rakta Moksha)
(Therapeutic toxic blood-letting) involves releasing toxic blood from various body sites, although mainly from the back. At first, blood should be dark or purplish. When it turns bright red, therapy is complete. Two to 8 ounces is the general amount of blood released. Sometimes various sensitive sites require only a prick to relieve problems. For example, at the eyebrow, a prick relieves headaches and eye inflammation. This process is no longer used in India as often as it once was. In some countries, a professional license is required to practice this therapy. Blood-letting is useful when wishing for immediate results with Pitta disorders such as skin, liver, spleen, and conditions like gout, headaches, and hypertension. Late summer through early fall is the best time for this procedure.
Precautions: Rakta moksha is not used on babies, the elderly, during pregnancy or menstruation, or with anemia, edema, leukemia, bleeding, or cirrhosis.