Panchakarma – Complete Detoxification and Cleansing

Panchakarma literally means “five treatments”, a process which is used to cleanse the toxic materials accumulated inside the body. These therapies are aimed to eradicate the basic cause of diseases – ama (metabolic waste). In general, body has the innate ability to efficiently process and remove these waste materials, including the vitiated doshas. However, due to repeated dietary indiscretions, poor exercise patterns, lifestyle, and genetic predisposition on the digestive enzymes, poor metabolism, hormones, and agni (metabolic fire), the internal homeostasis of the body gets disorganized. This can lead to accumulation and spread of the toxins throughout the systems. Ama is foul-smelling, sticky, harmful waste matter and accumulates in organs and channels such as colon, sweat glands, lungs, bladder, urinary tract, stomach, intestines, etc. This leads to the derangement of doshas and Panchakarma will eliminate the excess doshas and correct the imbalances by digesting and eliminating harmful ama.

In Ayurveda, there are two major treatises: Charaka and Sushruta Samhita.

According to Charaka, the five therapies are;

  • Nasya (nasal therapy)
  • Vamana (therapeutic emesis / vomiting)
  • Virechana (purgation therapy)
  • Two kinds of Vasti (therapeutic enema)- Nirooha Vasti (Decoction Enema) and Sneha Vasti (Oil enema)

According to Sushruta;

  • Vamana (therapeutic emesis / vomiting)
  • Virechana (purgation therapy)
  • Nasya (nasal therapy)
  • Vasti (therapeutic enema)
  • Raktamoskshana (blood letting therapy)

It is highly individualized which means based on the needs of the individual depending on the Ayurvedic constitutional type, doshic imbalances, age, digestive strength, immune status, and many other factors. Depending on each individuals’ needs all or only parts of the five therapies are utilized.

Three stages of treatment –

  • Purva Karma (pre-treatment)
  • Pradhana Karma (primary treatment)
  • Paschat Karma (post-treatment)

Pre-treatment –

 The general purpose of pre-treatment is to loosen, liquefy, and move the vitiated doshas from their abnormal sites in peripheral tissues to the appropriate central site within the alimentary canal.

During the pre-treatment, oil/ ghee prepared with herbs is given in the early morning for a maximum of seven days in specific diseases. If oil is given in a pure form without adding herbs its called Achcha sneha, and is considered the most effective.

Oil massage and fomentation are also administered. Fomentation is said to help in the liquefaction of doshas; it is given after Abhyanga (massage), hence after the seventh day of oleation, the patient is prepared for Vamana and other therapies.

Therapeutic Vomiting [Vamana] –

Vamana eliminates deranged kapha and toxins collected in the body, respiratory tract and the upper gastrointestinal tract. In the morning before treatment., kapha aggravating foods such as basmati rice and yogurt with salt is given to further aggravate the kapha. And then the emetic drug is given. Vomiting will either occur spontaneously or is induced by rubbing the tongue. 4-8 times vomiting is the target.

Beneficial in Bronchial Asthma, Chronic Allergies, Hay Fever, Vitiligo, Psoriasis, Hyperacidity, Chronic Indigestion Nasal Congestion, Edema, Obesity, Psychological disorders, Skin disorders.

After the treatment patient will feel very comfortable; most of the congestion, wheezing and breathlessness will disappear along with clearing of the sinus.

Purgation Therapy [Virechana] –

Virechana is the cleansing of the pitta and the purification of blood toxins. Virechana cleanses the sweat glands, small intestine, colon, kidneys, stomach, liver and spleen. Generally, it is administered three days after the Vamana treatment.

Beneficial in Skin diseases, Chronic fever, Piles, Abdominal tumors, Worms, Gout, Jaundice, Gastrointestinal problems, Constipation and Irritable bowel syndrome.


Enema or Colonic Irrigation [Vasti] –

This treatment is used to promote elimination of the loosened Vata dosha out through the rectum.

Types of Enemas:

  1. Nirhua Basti (Decoction Enema) – mainly herbal decoction and small amounts of oil
  2. Anuvasana Basti (Oil Enema) – mainly warm oils with small amounts of herbal decoction
  3. Brihmana Basti (Nutrititive Enema) – warm milk, meat broth, bone marrow soup, etc.

This procedure is usually applied for 8 to 30 days, based on the condition of the person.

Beneficial in Constipation, Distention, Chronic fever, Common cold, Sexual disorders, Kidney stones, Chest pain, Vomiting, Backache, Neck pain,  Sciatica, Arthritis, Rheumatism, Neuro-degenerative conditions, and Gout.


Nose Cleaning [Nasya] –

Administation of herbal oils and liquids into the nostrils to cleanse accumulated kapha and toxins from the head and neck region.

Benefits of Nasya: Dryness of the nose, Sinus congestion, Hoarseness, Migraine headache, Neurodegenerative conditions (i.e. multiple sclerosis), Convulsions, Eye and ear problems


Blood Letting [Raktamokshana] –

It is used to eliminate toxins that are absorbed into the bloodstream. Hence, this process purifies the blood.

Benefits of Raktamokshana: Urticaria, Eczema, Acne, Scabies, Leucoderma, Chronic itching and hives. It is also often effective for Enlarged liver and spleen, Hemochromatosis, and Gout.


Post therapeutic Process-

Post-therapeutic process is administered after the purification of the body, to intensify the agni (digestion power) which will subside after Panchakarma. Hence, dietary regimens and proper physical exercise along with herbs is recommended to promote health.

Like all the other Ayurvedic therapeutic procedures, Panchakarma should also administered under a qualified Ayurvedic doctor who once determine the individual’s prakriti (constitutional type), nature of the health problem (if any), appropriate degree of intensity of the prescribed therapies, etc.

Panchakarma may not be appropriate for individuals who are significantly underweight, physically weak or inadequately treated (or undiagnosed) hypothyroidism, hypoglycemia. Special cautions should also be taken with cancerous diseases, immune deficiency, or those who are recovering from recent surgery.

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May All Beings be Healthy!
Dr. Indunil Weerarathne

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