Panchakarma

Panchakarma is a term most mistaken among European people. It is really 5 main treatments, by which viciated doshas are expelled from the body. They include Vamana (induced vomiting) Virechanam (Purgation) Asthapanam (enema with decoction) Anuvasanam (enema with oil) and Nasyam (Nasal application of oil).According to another school, both the enemas are included under commontitle 'Vasti' and 5th one is Rakta-moksham (Blood letting).

Oleation of the body and steam bath are performed before Vamana (induced vomiting) Vire-chana (Purgation) etc. The viciated doshas, waste materials and toxins are expelled by panchakarma. But for the convenience of the complete expulsion they are collected at particular sites by these pre-panchakarma process called 'Sneh-apanam (oleation) and Swedanam (Steam bath). There are particular, prescribed procedures and steps by which these are carried out .

Panchakarma and kerala
Kerala is a small state situated at the south west of India. This state has a very unique cultural background and has a special nature that it won't accept anything as such. If anything new comes, it will sow the seeds of that in its own soil and cultivate with its own water and air and then will reap the results and that will be used. This happened in the case of ayurveda also. Apart from all over India, Kerala has a special method of treatment .Though the lessons and texts studied are same, the system of treatment is entirely different and far more effective as well. These special methods of treatments which can be included in the pre and post-panchakarma procedures are 'Sarvanga snehadhara /Pizhichi (oil bath), Shashtikapinda-swedam (rice bundle massage), Patrapodalaswedam (leaf bundle massage) Sirodhara (head bath).

Post-Treatment Procedures
Panchakarma therapy can be likened to a surgical operation in which the pre-operative and post-operative procedures are of critical importance. Without the preparatory procedures of snehana and swedana, internal cleansing is superficial and does not remove the basis of disease. Once the toxins and waste products are eliminated from the astrointesrinal tract by nasya, vamana, virechana and nirooha bastis, both the digestive agni and the dhatus must have the opportunity to rebuild themselves.

The set of procedures that follow the main eliminative treatments of Panchakarma and assist this rebuilding process are called, collectively, Paschatkarma. They assure the re-establishment of healthy metabolic function and immunity. If these post- procedures are neglected, digestion does not normalize. Weak digestion generates new ama and the tissues continue to receive toxic material instead of nutritive, strengthening substances. The body then finds it difficult to re-establish its natural immune function and is more likely to fall ill again.

While the digestive fires are rekindling, it is important to respect the somewhat ulnerable state of the physiology. Energy resources are not at their full capacity and, as a result, we cannot do as much as we will be able to do once the dhatus are rebuilt and up to speed. It is therefore crucial for the success of Panchakarma that the patient follow a regulated diet and lifestyle immediately after treatment. Two aspects of the post-procedures - samsara-Jana krama and dinacharya-rise the system to a much higher efficiency level than it had before. A third aspect of Paschat karma,bcalled rasayana therapy, is not technically part of Panchakarma, but is particularly helpful in rejuvenating the dhatus.

Samsarajana krama: Graduated Diet
Digestion is the first aspect of the physiology that needs to be reconstructed. The Panchakarma treatments dramatically affect the digestive process because the G-I tract provides the primary route for the_elimiDatiQn of toxins .The digestive fire is weakened by the process of ama being drawn back into the digestive tract and expelled from the body.

Since faulty digestion creates the potential for illness to arise in the first place, special attention is given to strengthening digestion at the conclusion of Panchakarma. This assures that the dhatus are nourished, immunity is re-established, and health is maintained.

Samsarajana krama constitutes the primary post-treatment procedure for digestion. This term literally means "a graded administration of diet." It consists of a specially prepared diet designed to re-establish full digestive capacity and prevent the formation of new ama.

Charaka uses the following example to show the similarity between digestive agni and fire. If someone wants to kindle a fire Zcan consume a large quantity of dense wood, he must begin I a spark and some blades of dry grass. Once the grass is burning, small splinters and twigs can be added, then small branches and finally heavy logs. Once the logs are burning, the fire-can consume any wood added to it. If, however, a log is added to the first spark and the few blades of burning grass, it extinguishes the fire.

In the same way, food is the fuel that ignites our activities. If, at the end of the main procedures, the food we ingest is too heavy for our exhausted digestive fires to manage, then little or none of that food will be metabolized and transformed into usable nutritive substances. It all becomes ama and the disease process starts a new. This is an unpleasant thought, but luckily it is a situation that is completely avoidable through correct administration of diet.

The diet given to the patient immediately after Panchakarma consists of nutritive and easily digested preparations office and split yellow mung dal (lentil). The diet is tructured in stages, going from more liquid preparations to increasingly solid ones. It begins with easily digestible rice water, and eventually incorporates dal. These stages of digestibility are called manda, peya, vilepi, odana, yusha and kichari. Once this regimen has nurtured our digestive fire back to health, as signaled by a strong, consistent appetite, the person can return to a normal diet.

Manda: Rice Water
Manda, meaning "liquid," is the first meal after vamana or virechana. It is normally taken when the appetite returns, which for most people is about four hours after completing these procedures. Manda is mainly just the water in which basmati rice was boiled. It should be eaten lukewarm with a little ghee and a pinch of black salt (saindhava). It might seem absurd to give only rice water after these major procedures, but the importance of going slowly at this time, due to depleted digestive capacity, cannot be emphasized enough.

Peya: Rice Soup
The patient takes the next meal, called peya, two to three hours later. Peya means "soup" and is traditionally made with eight parts water to one part rice. The rice is cooked until it is very soft, so that it has the consistency of a thin, light porridge.

Purvakarma: Preparing for Panchakarma
Panchakarma's five main procedures are designed to eliminate ama and restore health to the dhatus, but they can only achieve this goal if the body is ready to let go of the accumulated toxins stored deep within its structures. Without proper preparation, these treatments would remove only the ama available in the gastrointestinal tract and would have little or no impact on the ama lodged in the dhatus.

The man whose boils disappeared after purgation, only to see them recur, offers a case in point. The castor oil removed only the pitta-associated ama which had accumulated in the G-I tract. Why wasn't all of it brought out? It has to do with ama's heavy and sticky quality. Once it lodges in the deeper structures of the 4ha-tus, it's grasp is tenacious. The shamana or palliative therapy used by the man was just not capable of addressing this condition.

However, Panchakarma permanently eliminated the cause of the boils because it was able to remove the accumulated ama that had become stuck in his dhatus. In addition, it restored his doshic function, normalized his digestion and elimination, and dispelled the potential for future diseases related to pitta disorders and ama.

The preparatory procedures of panchakarma
The set of procedures which Ayurveda prescribes to facilitate the removal of ama and toxins from the tissues is collectively called Purvakarma. Purva means "before" and karma mean "actions." These treatments help to loosen ama and move it out of the deep structures nuo the G-I tract, where Panchakarmas main I therapies can then eliminate it. The two most important processes used to prepare the system for cleansing are snehana and swedana.

Snehana and swedana are essential to the success of Panchakarma's deep cleansing. In addition to these, Purvakarma utilizes several other dosha-specific, adjunct therapies. Proper administration of the preparatory procedures of snehana and swedana is essential to the success of Panchakarma therapy. Without suitable and sufficient oleation and heating of the body, the main procedures of Panchakarma will not achieve deep cleansing

Snehana: Oleation
'-(Snehana, the first step of Purvakarma, saturates the body with herbal and medicated oils. The saturation takes two form: bahya snehana or external oleation, where medicated oils are vigorously massaged into the body; and abyantar snehana or internal oleation where medicated oils are ingested. Snehana uses four types of oleaginous substances: vegetable oils (taila), clarified butter(ghee) animal fats (vasa) and fat from bone marrow (majja). The oils used match the need of the patient.

Sesame oil (til) is the primary vegetable oil used for external application. It is sweet, bitter and astringent in taste, warming in action and easily penetrates and nourishes the skin. It soothes and reduces the effects of excess vata without aggravating kapha and promotes stability and strength. Sesame and all other oils used in snehana are prepared with herbal decoctions to enhance their effectiveness for individual patients.

Herbalized ghee, or tikta ghrita, the main substance used for internal oleation, is made by processing butter to remove all its milk solids, proteins and water and then cooking it with numerous prescribed herbs. By itself, ghee has remarkable properties as a nutritive and medicinal substance. Its effect on the body is quite different from that of butter, and research has demonstrated that it does not tend to elevate cholesterol levels. It contains the least saturated fat of any fatty substance. In proper amounts, ghee increases the strength of the digestive agms, while decreasing the heat and inflammation due to excess pitta. It reduces excess acidity both in the digestive tract and in the tissues, pacifies vata and softens and lubricates the tissues and joints. Ghee's amazing penetrating qualities make it the most effective substance for internal lubrication. It spreads thoroughly, making it easy for all the tissues to absorb. It carries the therapeutic qualities of the other herbal substances without losing its capacity to increase digestive fire and promote secretions.

Snehana also makes use of animal fat (vasa) and bone marrow fat (majja) for internal oleation. However, these oils are heavy and difficult to digest, and they can produce excess kapha and ama if a patient's digestive agni is weak. Their use is indicated only for specific disorders such as leukemia and several other types of cancer, as well as certain degenerative disease conditions like myopathy. In general, snehana employs substances with the properties of fluidity and oiliness, which can penetrate even the finest tissues of the body and promote secretions. Each of these properties has a specific effect, but in combination they fulfill five important purposes:

1. They induce the dhatus to give up their accumulated toxins.
2. They enhance the secretions through which the doshas transport ama and malas to the gastrointestinal tract for elimination.