Panchakarma

October 26, 2004

Panchakarma

A healthy body and healthy mind is the aim of all medical systems. Ayurveda is

one such system that prevailed since 5,000 years ago. It was considered the

most advanced and scientifically proven in those days. It still continues to

shine. The present millennium has shown us numerous disorders and we know that

the changes in atmosphere and living conditions are among the causes. This

results in serious disorders like cancer and AIDS. To handle these problems,

Ayurveda shows the correct way. The word Ayurveda is composed of Ayu and Veda.

Ayu means life, which is a proper combination of the body, mind, sense organs

and the soul. Veda means knowledge.

Sudesh Balan Pizhichil, one of the purvakarmas. The Vedas revealed the truth

that all the living and non-living things are a combination of pancha bhoota

(prithvi, ap, thejas, vayu, akasa). Ayurveda also agrees with this principle.

To regulate the living body easily, the acharyas concised the pancha bhootas

into tridoshas (vata, pitta, kapha). These tridoshas are the basic pavement for

all ayurvedic theories. Along with tridoshas, datusamjna, malasamjna are given

to certain constituents for the functioning concept of living things. Datus and

malas are controlled by doshas. Samyavastha (well-being) is the condition when

the doshas are in their natural rhythm. When this rhythm is lost it is called

vaishamya (disease). The former means order, the latter, disorder. Doshas

cannot be identified separately in samyavastha. In diseased condition, the

doshas manifest their particular symptoms. These symptoms denote malfunctioning

of the doshas. The purpose of treatment of all diseases is to keep the doshas in

equilibrium. In Ayurveda there are three steps in treating any diseases, they

are samsodhana - cleansing process, samsamana - palliative measures and

nidanaparivarjana - treating the causes. In Kerala, certain special

Panchakarma procedures are done for purification of the body. This is a model

which shows the process of Sirodhara and Pizhichal, done together. Samsodhanam

is considered a prominent process and should be administered with full care.

Samsodhana is so important because the diseases treated by samsamana may occur

again but those treated by the former will never recur or the chances of

recurrance are very small. Panchakarma is a synonym for samsodhana. Panchakarma

actually is a group of treatments, five in number, all of which are not commonly

practised in all diseases. The panchakarma are vamana, virechana, snehavasti,

kashayavasti and nasya. Vamana is emesis, virechana is purging, vasti is enema,

which of two kinds done with medicated oils and medicated decoctions and are

called snehavasti and kashayavasti respectively. Nasya is instillation of

medicines through nose. Susrutha, the father of surgery, gives stress to

rakthamoksha (blood-letting) as one of the panchakarma, taking the two kinds of

vasti as a single karma. There are certain steps to be followed before doing

panchakarma called poorvakarmas. They are snehana (oleation) and swedana

(sudation). Snehana has to be done by two ways, application of snehadravyas

internally and externally. Swedana is classified into four types to promote

sweat. The purpose of poorvakarma is to liquefy and guide the provoked doshas

to the mainstream to facilitate the sodhana karma. The process of letting out

the vitiated blood is termed Rakthamoksha.This is an illustration of Lord

Dhanwanthri holding a leech in the right hand whichis extensively used in blood

letting. Vamana (Emesis) The first in panchasodhana karma, this process requires

good attention and skilled assistance. It induces expulsion of the stomach

contents through the mouth. Kapha or kapha dominant diseases are selected for

this procedure. Diseases like severe skin diseases (psoriasis, urticaria)

bronchial asthma, mental disorders and so on. This process is not suggested for

pregnant women, the aged, those suffering from cardiac problems and those who

are not very strong. On the previous day, the patient, who has undergone sneha

sweda is given kapha increasing foods. The next morning, after ablutions and a

hot water bath, the patient should be asked to sit in a relaxed manner in an

armchair. Milk is commonly used for this purpose. For those with milk

intolerance, sugarcane juice can be used. The patient has to drink as much as

milk as he can. Then a paste of madana phala (10 gms) along with yashtimadhu

powder (5 gms), vacha (5 gms), rock salt (5 gms) and honey (5 ml) mixed with

milk should be given. Within a short time, the patient will feel nauseous and

starts vomiting. All impure accumulated kapha will come out. Normally eight

bouts are seen. The attenders should hold the patient's forehead and massage

his back and wipe away the sweat. Vomiting is stopped when the pitta or yellow

colouration is seen, which is considered the correct symptom. If the bouts are

less, vomiting should be by irritating the uvula by touching with the figers or

a quill. Then allow the patient to wash his face and fingers with hot water.

Then dhoomapana - inhalation of medicated fumes - is done. The smoke should be

inhaled through one nostil and exhaled through the mouth and the other nostril.

This should be done thrice. Closer view of the image of Lord Dhanwantri

depicting the leech. After this, certain steps have to be necessarily followed

called paschat-karma. These are mainly food restrictions, called samsarjana

kriya. Just after vamana, if the patient is hungry, thin gruel is given. After

ascertaining the digestive power, thick gruel, porridge, porridge with meat

soup are given. The entire treatment takes 15 days. Virechana (Purgation) Pitta

and pitta dominant diseases are cured by this process. By this the vitiated

doshas are made to pass through the anus. Poorvakarma as noted in vamana are

advocated here. Though several drugs are mentioned for virechana, trivrit is

considered the best. Trivrit combinations, like avipathy churna, trivrileha are

used. To give the medicine it should be ascertained whether the last meal has

been digested. Medicine should be given after the kaphakala (about 9 a.m.) - 15

to 25 gms of Avipathy churna mixed with hot water. No food is given till

virechana is over. In proper virechana, the patient passes urine, stool, pitta,

medicine, kapha and vata in order. About 20 purges may be seen. This also

depends on the patient's health. A mild form of virechana is an unavoidable

factor in ayurvedic therapy. It is commonly used to treat various kinds of

ailments in which poorvakarma is not necessary. So virechana is also used for

prevention. The paschat karma followed is similar to that of vamana except that

dhoomapana is not administered. Vasti (Enema) This is a process of injecting

fluid through the anal, urinary or vaginal canal. Vasti or the urinary bladder

of animals is used and hence this term. Today, a bag of polyethene or leather

is used. Vasti is for combating vata and vata dominant diseases. As vasti is

important among the panchakarma, many consider vasti as half the entire range

of treatment and some as the complete range. The equipment for vasti karma

consists of a nozzle and a bag. Nasya as a method of medicinal application was

extant for a long period. The Valmiki Ramayana contains descriptions of Rama and

other warriors who were restored to consciousness by using medicinal herbs as

nasya. The famous physician Jivaka was said to have treated Lord Buddha by

Nasya. Snehavasti is Vasti with unctuous oils. This is not advised in patients

suffering from diabetes, anaemia, diarrohea, obesity, filaria. After

poorvakarma, the patient is advised to take a hot water bath and permitted to

eat a light meal not more than three quarters of usual quantity, a suitable

drink may follow. He should lie down in a cot on his left side (left lateral

position) (i.e.: the left is stretched and right one is folded). The suitable

oil is poured in the vasti bag which is connected with the nozzle. The nozzle

end and anus are soothened with oil and enema is applied. Gentle pressure

should be applied on the bag so that the fluid passes without interruption. The

patient should now lie on his back. Certain methods are adopted to retain the

oil inside the body such as raising the leg. The effectiveness of the vasti is

indicated if the oil stays inside for the intended period and comes out with

all faeces and air. The quantity of oils is one quarter of kashaya vasti (10

ozs) mixed thoroughly with powdered rock salt, satahva (5 gm each), and warmed

suitably before giving. Kashaya vasti Diseases like hemiplegia, IVDP, and

disease due to vata are treated as well. Acute diarrhoea, chest lesions, piles,

hiccups, are contraindicated. For kashaya vasti, honey, rock salt, sneham, paste

of medicines are required and is mixed one by one in the above order. Total

quantity is nearly 40 ozs. An emulsion is made by churning all and warming in a

water bath. This should be taken on an empty stomach at about 10 a.m.

Application is the same as snehavasti. When the bowels are clear the patient is

allowed to take a hot water bath. This should be done after two or three

snehavastis. Sneham, paste of medicines, kashayam noted above are selected as

per disease and stage.

Nasya

Instillation through the nose is called nasya. It is the best and important

procedure for the treatment of sirorogas i.e, sodhana of urdhvanga. Our body is

compared to a tree, its root is the head and extremities are the branches. Head

is also called uttamanga, as it is the seat of manas and panchendriyas, which

gives a unique status of superiority. This is contraindicated in various

manorogas, asthma, cough. Sudesh Balan After suitably warmed oil is applied to

the shoulder and neck of the patient, the patient should lie supine and tip his

head back. Lightly warmed oil is dropped into each nostril. The patient should

inhale deeply. The usual dose is 8 drops but this varies according to the

disease and its nature. The timings are morning in kapha diseases, noon in

pitta diseases and evening in vata diseases. After the nasya, the shoulder,

face, palm and sole of limbs should be massaged briskly for few minutes. The

percolated kapha will be spat. Dhoomapana and gargling with hotwater should be

done afterwards. Nasya should not be done continuously for more than seven

days. Panchakarma should not be administered to those below seven years and

those above 80 years. If it is done properly, healing of the disease treated,

along with clear intelligence, alertness of the senses, stability of the body,

efficacy of digestion and absorption, prolongation of youth are all achieved.

Dr. R. Bharatharajan

Retd. Principal, VPSV Ayurveda College, Kottakal.

October 31, 2004

sir i would be happy if u tell me different oils used in pizichil pinda swed

according to the disease

thanking u

vd sidharth wilson thomas <viltc > wrote: