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PANCHKARMA SCIENCE




             
 
DESCRIPTION OF PANCHKARMA



AYURVEDA USES TWO MAIN MODALITIES IN THE TREATMENT OF DISEASE, EACH WITH ITS OWN DISTINCT PURPOSE, namely Shamana and Shodhana therapies.

SHAMANA CHIKITSA
(Procedures for Alleviating the Symptoms)

Shamana, which means "to suppress", reduces or eliminates symptoms. Shamana treatments make the patient feel better by suppressing the effects of the body's accumulated ama. When we take aspirin to alleviate headache or muscular pain, we are employing a shamana or palliative type of treatment.

SHODHAN CHIKITSA
(Procedures for Eradicating Disease)

The second means that Ayurveda uses to treat illness is called Shodhana, which literally means "to go away". In this form of treatment, the basis of the disease process is eradicated. Shodhana therapy rids the body of ama and mala and restores balance to the doshas. It is considered superior to Shamana because it not only removes the symptoms of disease but also eliminates their cause.


PANCHKARMA

Panchkarma is one of the unique therapeutic procedure in Ayurveda advocated for the radical elimination of disease causing factors and to maintain the equilibrium of doshas. The five fold measures comprehended by this therapy for internal purification of body system are Vamana (Therapeutic Emesis), Virechana (Therapeutic Purgation), Basti (Therapeutic Enema), RaktaMokshan (Therapeutic withdrawal of Blood), Nasya (Therapeutic cleansing of Sinuses).

It Prevents ageing process and improves memory and functions of sense organs. Panchkarma therapy is very effective in the management of auto-immune disorders, chronic ailments like rheumatoid arthritis, bronchial asthma, G.I.T. disorders and mental diseases.
                    
                    

Panchkarma Procedure

The whole procedure of Panchkarma is divided into 3 steps : Purva Karma, Pradhan Karma and Paschat Karma


PURVA KARMA

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 means "actions". These treatments help to loosen ama and move it out of the deep structures into the G-I tract, where Panchkarma's main therapies can then eliminate it. There are two purvakarmas : Snehana and Swedana

SNEHANA (Therapeutic Oleation)

Snehana, the first step of Purvakarma, saturates the body with herbal and medicated oils. The saturation takes two forms: bahya snehana or external oleation, where medicated oils are vigorously massaged into the body; and abhyantar 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).

OLEAGINOUS SUBSTANCES

SEASAME 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 aggaravting kapha and promotes stability and strength. Seasame and all other herbal oils used in snehana are prepared with herbal decoctions to enhance their effectiveness for individual patients.

HERBALIZED GHEE (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. In proper amounts, Ghee increases the strength of the digestive agnis, while decreasing the heat and inflammation due to excess pita. It reduces excess acidity both in the digestive tract and in the tissues, pacifies vata and softens and lubricates the tissues and joints.

VASA (Animal Fat) and MAJJA (Bone Marrow) are also used in the 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.

TYPES OF SNEHAN

INTERNAL OLEATION (Abhyantar Snehana), consists of taking prescribed amounts of warm, herbal ghee, called tikta ghrita, first thing in the morning and in late afternoon on an empty stomach. The Ayurvedic physician gradually increases the prescribed dosage, depending on the strength of the patient's digestive agni. The patient does not eat until the ghee is digested, which is signaled by the return of appetite.

In preparation for the main eliminative procedures, the patient receives both internal and external oleation each day. These treatments continue for seven days, the time required for the oleaginous substances to reach and saturate all seven dhatus. After the seventh day, oleation becomes counterproductive, as there is nowhere else for the oil to go. If continued, it starts to collapse in the dhatus as saturated fat and depletes the dhatu agnis.

Certain classical signs indicate oleation's completion. When oil has saturated all seven dhatus, the body is well-lubricated, internally and externally. The skin displays a soft and shiny appearance and smells slightly unctuous.

EXTERNAL OLEATION (Bahya Snehana), employs a specific form of massage to apply the herbalized oil to the skin. There is great significance to the strokes used in bahaya snehana, for they match the movements of vata's five different directional functions.

Description of vata's five directional functions :

Prana Vayu, the vata function which moves from the head, mouth and nostrils to the navel, takes prana, or life-force, in the form of air, food and water from the environment into the body. It also controls sensory functioning.

Udana Vayu, flows in the opposite direction, moving from the navel to the mouth, nostrils and head. Udana Vayu eliminates carbon dioxide and various forms of mala, like mucus and saliva, from the kapha zone, and also creates the sounds used in speech.

Samana Vayu, circulates in a clock-wise direction around the navel area. It helps strengthen the digestive agni in the same way that air or wind strokes a fire.

Vyana Vayu, moves from the heart to the periphery and from the periphery back to the heart in a circadian rhythm.

Apana Vayu, travels from the navel to the anus and urethra. Its main function is to eliminate urine, faeces and menstrual discharge. Its also responsible for childbirth.

Both the massage technique and the herbs allow the oil to penetrate deep into the tissues to loosen the grip of the ama.The ama that has formed on the walls of the dhatus shrotas is also loosened, opening up these channels so that ama can be more easily removed from the tissues. Snehana's actual meaning implies kindness, tenderness and love, and true to its meaning, it is a thoroughly soothing and enjoyable experience.

IMPORTANCE OF SNEHANA


1) It Induces the Dhatus to give up their accumulated toxins.

2) It enhances the secretions through which the doshas transport ama and malas to the gastrointestinal tract for elimination.

3) It lubricates and protects the dhatus from damage while ama is being removed.

4) It pacifies and nourishes vata through its unctuous qualities.

5) It removes the obstructions in the shrotas or channels.


SVEDANA (Therapeutic Heat)

The second major aspect of the preparatory procedures of PurvaKarma is called swedana, the theraputic application of heat to the body. Though swedana literally means "sweat", the main purpose of swedana is not to poduce sweat, but to dilate the body's shrotas or channels so that oleation's objective - removing anna from the dhatus - can be easily achieved.
 

Sweat results naturally when the channels widen. In addition, the application of heat also counteracts the coldness of both vata and kapha, reduces the body's stiffnes and heaviness, and counters the slow, heavy and sticky attributes of ama.

As the influence of agni bhuta increases, it begins to soften or melt ama's density. Ama gets liquified and shrinks in volume, making it easier to be carried from the tissues. The heating action of swedana also mobilizes the doshas, which are responsible for transporting these toxic waste materials from the deep tissues to the gastrointestinal tract.

TYPES OF SWEDANA

NADI SWEDA (Penetrating Heat), Nadi, which means "tube", uses steam from an herbal water decoction. Nowadays, this method is facilitated by the use of a pressure cooker and a nylon reinforced plastic hose which eases the steam's application to the body's surface. Nadi is a more penetrating type of wet heat than bashpa, because the steam actively drives the heat and oil deep into the tissues through the pores of the skin.

Although this type of steam treatment is given to the whole body, it focuses on the thick and complex structures of the joints to improve their mobility. Nadi swedana usually lasts for five to seven minutes. Outside the panchkarma process, it can be used with snehana for reducing pain, muscle pain, muscle spasm and rigidity in localized areas. This treatment can be very helpful in the palliative management of backache, inflammation of the spine, hip and knee, and for generalized muscle pain.


BASHPA SWEDA (Steam Heat), the second type of agni swedana, generally folows immediately after nadi swedana is administered. Bashpa literally means "steam" and unlike the more directed form of heat used in nadi swedana, bashpa applies steam evenly to the entire body.

Bashpa sweda uses a sweat box, in which the patient either sits or lies down on his back. Every part of the body is exposed to the heat except the head, as it cannot tolerate high range of temperatures. In fact, a technician continuously places cool compresses on the forehead during the treatment to maintain the head's normal temperature. To avoid dehydration, the patient is given a glass of water before administering bashpa sweda.

These small, one-person steam baths are normally constructed of wood with a thermostat that allows their temperature to be easily controlled. Herbal steam is released into the box according to the needs of the patient. The duration of the treatment is seven to ten minutes, or until sweat begins to bead on the face and forehead.

CONTRA - INDICATIONS :

Though Bashpa sweda is an important preparatory procedure, it is not appropriate for people with heart disease or hypertension, since the heat may cause a rise in heart rate and blood pressure. Individuals with blood disorders, such as anaemia or leukaemia, also cannot tolerate the temperatures used to induce a full body sweat during this treatement.

PRADHAN KARMA

According to the Charak Samhita, the body normally uses three routes to eliminate waste products and toxins: the mouth, anus, and pores of the skin. The three doshas act as the vehicle which carries ama either upward, downward, or out through the periphery. Through dosha gati, the doshas move these impurities from the deep structures to the G-I tract and from the G-I tract to the body's three main outlets. There are five PradhanKarmas : Vamana, Virechana, Basti, RaktaMokshan and Nasya.


                                                        Panchkarmas related to Direction of Elimination of Ama

 
Type of karma
Impact on Dosha
Direction
Vaman Karma
Nasya Karma
Kapha Dosha Zone
Upward Movement
Virechan Karma
Pitta Dosha Zone
Downward Movement
Basti Karma
(Anuvasan and Nirooha)
Vata Dosha Zone
Downward Movement
Raktamokshana Karma
Blood Vessels
Peripheral Movement
 
   
   


VAMANA (Therapeutic Emesis)
 
Vamana take place in the upper or kapha zone of the body and use the upward movement of the doshas to remove ama. Toxins associated with kapha are primarily but not exclusively deposited throughout the upper part of the body. Because this is where kaphic ama naturally collects. Panchkarma uses Vamana or therapeutic emesis to eliminate them.

The emesis procedure used in vamana is quite smooth and painless, with little or no nausea, retching or discomfort. This procedure for discharging excess kapha and kaphic ama was designed to be accomplished with great ease.

The herbs used to produce the emetic effect provide the main keys to successful vamana. These herbs, such as yashti madhu (Licorice) and madan phal (Randia Dymotorum) stimulate the action of agni and vayu buta. They are hot, strong and penetrating. Their action permeates the fine channels in the kapha zone and stirs up and liquifies the ama.

PREPARATION FOR VAMANA:


To prepare for Vamana, Snehana and Swedana is administered for seven days, after which time the patient should show signs of complete internal and external oleation. The night before Vamana is administered, the patient takes food which stimulates kapha - sweet, heavy, cool, sticky, slimy and oily foods including yogurt, milk, bananas and urad dal. They increase the volume in the stomach, and this provides the impetus for kapha associated toxins to be expelled.

Just before going to bed, the patient is given an herb to stimulate stomach secretions which further increase the volume of its contents. This herb called, Vacha has been used by Ayurveda for many years. Its energy is hot and causes the ama in the stomach to thin out. Because heat rises, Vacha works in an upward direction, supporting emesis. Patients receive small doses of less than one gram. After taking Vacha, they consume no additional food or liquid until the vamana procedure is administered.


When patient awakens, the patient urinates and defeacates as usual, but refrains from eating and drinking. An empty stomach stimulates secretions from the surrounding tissues and encourages them to enter the stomach.

ADMINISTRATION OF VAMANA:

Vamana is always given early in the morning, when jala bhuta dominates the external environment and kapha dosha dominates the body's internal environment. Normal doshic activity causes maximum watery and mucous secretions to accumulate in the kapha zone during this time, bringing Kaphic toxins out of dhatus and into the hollow spaces of stomach.

The procedure begins by giving the patient approximately 300 milliliters of a thin, sweet tasting porridge made from wheat and milk. This promotes watery secretions, and again incerases the volume of the stomach's contents. After he eats the porridge, the patient receives an emesis- stimulating herb which contains a strong influence of agni and vayu bhuta. To insure that the emesis is as effortless and comfortable as possible, the patient receives a large quantity of warm licorice tea, prepared as a cold infusion the night before.

The patient is asked to drink as much Licorice tea as possible during vamana to fill the stomach completely. This helps to liquefy the contents, which facilitates their removal. Within a few minutes, the patient feels hot, his stomach churns and he begins to feel the urge to vomit. Salivary secretions fill his mouth and he sponataneously starts vomiting.

INDICATIONS :

It is usually administered only for Kapha related disorders or ama. These include: all lung problems, bronchial asthma, allergies, chronic colds, rhinitis, diabetes mellitus, arteriosclerosis, rheumatic diseases, arthritis and some chronic skin disorders like eczema, psoriasis and leukoderma. It is also beneficial in some viral disorders, like Herpes Zoster.

CONTRA - INDICATIONS :

Vamana therapy is contra-indicated for people who are emaciated or very weak, the elderly who are frail, young children and pregnant woman. People with tuberculosis, pleurisy, collapsed lung, Hepatitis, degenrative or cirrhotic diseases of the liver, severe heart diisease and problems with blood pressure should also not undertake vamana therapy.

VIRECHANA (Therapeutic Purgation)

Virechana use pitta and vata dosha's downward movment to remove related toxins and waste materials from the system. Virechana works on the pitta zone of the body, whose major organs are the small intestine and liver. Ama associated with pitta and vata gets discharged from the body through the rectum because of its proximity and accessibility to these organs.


Virechana works in a downward direction to eliminate pitta related ama and excess pitta in the form of acidic secretions. Since pitta has a close connection with the blood, it also helps remove waste matter and toxicity from the blood. Virechana is a natural, herb - induced purging process which automatically ceases once the accumulated ama and toxins are gone.

PREPARATIONS FOR VIRECHANA :

Snehana and Swedana treatments readies the patient. Full oleation is essential to dislodge the ama and toxins and draw them into the small intestine from the surrounding organs and tissues in the pitta zone.

The meal immediately preceding Virechana includes foods which promote secretions from the organs governed by pitta. Such foods are high in pitta - enhancing qualities - hot, spicy and sour. The purgative is taken when the meal is in the small intestine, in the second stage of prapaka transient digestion. This sour stage of digestion promotes pitta secretions in the mid - zone which supports virechana. On an average, it takes about two and a half hours for food to reach this phase of digestion.

Once the patient has eaten, he should take it easy and refrain from physical or mental activity, which would draw blood and doshic activity away from the gastrointestinal tract and out to the organs and periphery of the body.



ADMINISTRATION OF VIRECHANA :

Virechana's stimulus should be used when pitta's physiological activity peaks, in the hours around noon and midnight, and when agni bhuta is at its height of influence in the environment. Several hours after taking the purgative, the patient feels the need to move his bowels.

Over the next hour, the patient may have four to ten bowel movements. The fecal matter is solid at first, but progressively softens until it is entirely liquid. The patient may feel mild cramping or a burning sensation. The patient avoids liquids, except for some pure water with a little dried sugarcane juice and black salt. The patient should drink a small amount of this or an organic electrolyte mixture after each bowel movement to replenish electrolytes and prevent dehydration.

For successful Virechana, the patient should have at least four to six bowel movements. Otherwise, the procedure should be repeated within few hours. After virechana, the patient is cautioned to keep away from cold drinks or cold baths, because they shrink the shrotas or channels, aggaravate vata and obstruct the flow of energy.
If the whole process goes fine, the patient feels clean, light and strong. Pitta is normalized, along with digestion, assimilation and appetite.

INDICATIONS :

It is good for all types of pitta - related disorders. This includes hyperacidity, colitis, urticaria, acid peptic disease, hemorrhoids, chronic headaches, some types of diabetes, allergies and skin diseases such as acne, dermatitis, psoriasis, eczema, leprosy, leukoderma and lichen planus syndrome. It is also indicated for malabsorption and migraine headaches.

CONTRA - INDICATIONS :

It should not be used on infants, very elderly and in pregnant women.


BASTI (Therapeutic Enema)

Basti one of the most powerful of all the main five procedures of Panchkarma. Charaka, as well as many other Ayurvedic scholars have unanimously praised the features of Basti. Basti like Virechana use pitta and vata dosha's downward movment to remove related toxins and waste materials from the system. Basti cleanses the vata area, whose focal point is the large intestine.

Basti is the introduction of medicated liquids into the colon through the rectum. While it directly effects the colon, its is not a localized or symptomatic treatment. Basti treatments balance and nurture vata dosha. When vata functions normally, it helps bring toxins and waste matter out of the dhatus and eliminates them.

It treats localized symptoms of constipation by promoting evacuation. It clears faeces that have collected in the rectum and sigmoid colon- the last eight to ten inches of the colon.


THERAPEUTIC BENEFITS OF BASTI THERAPY:

Basti therapy is the most effective treatment for disorders arising from abdominal vata. This includes chronic constipation, low back pain, sciatica, rheumatism, gout, arthritis, hemiplegia, poliomyelitis, Alzheimer's disease, Parkinson's Disease, multiple sclerosis and dystrophy and atrophy of nerves and muscles. It benefits epilepsy, mental retardation, and sensory dysfunction.

TYPES OF BASTI THERAPY:


Basti
fulfils many needs, so the type of basti used during Panchkarma varies according to the intended purpose of the treatment. One type of basti eliminates the ama that has gathered in the colon from throughout the body. Another normalizes Vata function.

BASTI CLASSIFIED BY SITE OF ADMINISTRATION :

The first major classification scheme refers to the administration site and the primary organs receiving the treatment. It recognises four areas.

A) Pakwashaya gata Basti : Medicated liquids sent through the anus and rectum into the colon.
   
B) Utara Basti : Medicated liquids sent through the vagina and cervix to cleanse and nourish the uterus.
   
C) Mutrashaya gata Basti : Medicated liquids introduced into the penis and urethhra to treat the male genital and urinary organs.
   
D) Vranagata Basti : Cleansing and medicated liquids used to irrigate and heal abscesses or wounds.

Four types of external Basti are classified according to their site of administration.

1) NETRA BASTI OR NETRA TARPANA

In this, medicated ghee is applied to the eyes. The ghee is contained by a dam constructed around the eye sockets, made of the dough from the black gram flour. Netra basti is highly nourishing for the eyes, removes eye strain and improves the vision.

2) KATTI BASTI

It means "retained on the lower back". It applies medicated oils in a container of black gram dough built around the lumbosacral araea. This form of external basti particularly benefits muscle spasm and rigidity of the lower spine and strengthens the bone tissue in that area.

3) URO BASTI

It means "retained on the chest and heart area". It uses medicated oils in a container - also constructed of black gram dough - around the heart. It reduces pain in the sternum area and strengthens the heart.

4) SHIRO BASTI

It is administered on the head through the use of a specialized leather container resembling a hat. This type of basti improves the functioning of prana vayu and revitalizes sensory functions. It also improves kaphagenic secretions in the pre-nasal sinus zone which reduces vascular congestion in the brain.


BASTI CLASSIFIED BY SITE OF FUNCTION :


While Charaka developed and presented basti therapy in great detail, his knowledge provides general guidelines which allow experienced and well-trained Ayurvedic physicians to adapt treatments to their patient's needs. Following types of basti are decsribed according to their site of function.

1) SHODHANA BASTI

It cleanses and detoxifies. It is divided into two strong treatments which penetrate to the deeper dhatus, and mild treatments, which work on the more superficial level of the dhatus. Nirooha offers the prime example of this form of therapy.


2) UTKLESHANA BASTI

.....meaning "promoting secretions in the colon". It promotes the liquefication of ama and mala in the colon. It helps the colon expel them. Similar to western enema, this basti increases colonic peristalsis, producing rapid elimination of the faeces.


3) SHAMANA BASTI

It is palliative. It restores doshic performance, reduces symptoms and allows the patient to feel better. In cases of rectal bleeding or dysentry, the immediate objective is to stop the bleeding. For example, picha basti, which uses astringent herbs, shrinks the capillaries or shrotas and stops the bleeding or peristalsis, ending the symptoms.

4) LEKHANA BASTI

It is stronger in its effects and generally much larger in volume. Its strong and penetrating. It is particularly useful for kapha and meda dhatu disorders, where excess fatty substances have accumulated that need to be eliminated as in case of obesity and arteriosclerosis.


5) BRUHAN BASTI

It nourishes. Highly nutritious sustances are used to balance and strenghten the dhatus and their metabolism, and increase the body's resistance to infectious diseases.
It's very effective in regenerating the dhatus and are specifically used to tone the muscles and reduce atrophy and emaciation.

6) SNEHANA BASTI

It is similar to anuvasan because it is prepared only from oleated substances, but is larger. Because of its size, it has a greater lubricating effect on both the colon and the body in general. It has a strong pacifying influence on vata and is particularly useful in cracking of joints and for those who have very dry skin or who are emaciated.


7) RASAYANA BASTI

It rejuvenates and can be prepared to rebuild and strengthen either specific dhatus or the whole body.


8) VAJIKARNA BASTI

It treats infertility, it increases virility and fertility and gives vigour and vitality to the body.

9) MATRA BASTI

It can be given any time of the day, and is particularly useful to pacify vata aggravation resulting from travel, exercise or stress.


BASTI CLASSIFIED BY SITE OF FREQUENCY AND DURATION :

Charaka describes three additional classifications which are based on specific treatment regimens : karma basti, kala basti and yoga basti.

1) KARMA BASTI

Karma Basti comprises a month long treatment and is given to people who have vata dominant constitutions and vata related disorders. It begins with anuvasan basti and alternates with nirooha basti for twenty-five consecutive days. The thirty day program ends with five days of anuvasan basti.


2) KALA BASTI

Kala Basti lasts for fifteen days and is used mainly for patients with pitta - dominant constitutions and vata disorders. It starts with an anuvasan basti and alternates with nirooha basti for ten or twelve days and concludes with three or five days of anuvasana basti.

3) YOGA BASTI

Its given for eight days, suits kaphic patients with vata diseases. It first gives anuvasan basti, and alternates three times with nirooha. It concludes with two days of anuvasan.


TYPES OF BASTIS USED IN PANCHKARMA :

Due to the importance of the colon's eliminative and rejuvenating functions, Panchkarma largely employs pakwashaya gata bastis given during this therapy. They are called nirooha and anuwasan basti.

NIROOHA BASTI, which means, "that which gets eliminated", cleanses toxins from the dhatus and removes naturally accumulated malas form the colon. Charaka Samhita has indicated that this Shodhana type of basti is capable of cleansing the entire body. These basti primarily, but not exclusively, use water - based decoctions of purifying herbs. The quantity of liquid administered is approximately 400 ml (1-3/4 cups), though the dosage may vary from individual to individual.

The quantity is always less than in enemas, since the basti's efficacy and specific action is not based on the volume of the liquids, but on the effects of the herbs. In nirooha, or purifying bastis, the liquid is retained in the colon for approximately forty-eight minutes. During this time, some of the ingredients get absorbed and their purifying influence moves throughout the body. The rest gets expelled along along with fecal matter and toxins.

Nirooha Bastis are given in a series of treatments over a period of several days. These bastis, along with the preparatory procedures, allow the cleansing process to reach deeper and deeper into the tissues with each passing day.

The first day of this basti treatment cleanses the colon of ama and mala. The second day of nirooha balances and nourishes vata, producing increased mental calm and clarity. Beacuse the vata zone has now been cleared, the third day pulls out ama and toxins from the pitta zone. This balances and nourishes the pitta function.


On the fourth and fifth days of administration, toxins get pulled out of the kapha area. Kapha resides in two major sites, other than the stomach: mamsa (muscles) and meda (adipose tissue), and this cleansing automatically purifies and strengthens both of them. On the sixth and seventh days, the basti's benefits reach the deeper tissues. This sequential cleansing process stimulates the natural absorptive and eliminative functions of the colon to remove ama and malas from all the tissues of the body.

ANUWASAN BASTI, the second major of the pakwashya gata basti, has as its purpose to nourish the body. It does so through the application of herbalized oils. Oil naturally lubricates and nourishes the dhatus, an effect which is opposite to the drying and wasting influence of excessive vata. Therefore, this class of basti is particularly successsful in the treatment of vata disorders.

Anuwasan Basti are usually administered after a cleansing course of nirooha basti to ensure that vata dosha is operting properly. They not only restore health to the colon, but also lubricate and nourish all the dhatus.

Anuwasan basti refers to "that which is to remain in the body for a while". For this type of basti, it is optimum if it can be retained in the body for a longer period of time in order to have its intended effect. Three to six hours is the ideal retention time. If it is administered, it is best if it can be held overnight.

Bastis are always applied slowly, but Anuwasan should be introduced extremely slowly, ideally a drop at a time. This is particularly important for individuals with irritable bowel syndrome. Slow administration reduces the possiblity that a hyperactive colon will go into a refelxive response and reject the basti, and insures that the bastis's nourishing ingredients will soothe and restore normal function to the colon.


It is prepared in a wide variety of ways, depending on the specific nutritive requirement. They can benefit neuromuscular disorders, in which dhatu is impaired, including muscles, bone, bone marrow, and nerve tissue.

PREPARING FOR BASTI THERAPY :

As with all Panchkarma procedures, proper preparation is crucial for successful basti treatment. First Snehana and Swedana must loosen out ama and open the body's channels so that it can be moved out. This greatly aids the effectiveness of both the cleansing and nourishing bastis. They are always administered immediately after oelation and sudation (heating).

Basti ingerdients are freshly prepared, A typical Anuwasan Basti consists of approximately 60 ml of herbalized sesame oil. Nirooha Basti contain primarily herbal decoctions of water with a small amount of oil. A typical nirooha basti contains 400 ml (1-3/4 cups) of a water decoction of dashmoola, a standard preparation consisting of a mixture of ten different herbal roots, 30 ml of seasame oil, a little honey and a pinch of black salt. The black salt is added to increase secretions in the colon.

BASTI ADMINISTRATION :

To facilitate the movement of the basti fluids from the rectum up through the descending colon, patient always lies on the left side when receving basti. The patient extends his left leg, while bending his right knee and drawing it up towards the chest. This makes the anal opening more accessible to the nurse or physician administering the basti. The patient's head should be supported on a pillow and he should be warm and relaxed.

The basti temperature must be near or at body temperature to increase the body's receptivity to treatment. The decoction is drawn up into a rectal syringe and introduced into the rectum through a thin rubber cartridge. Both the anal opening and the catheter are lubricated to allow easier access. With the permission of the patient, the doctor or nurse introduces the catheter, slowly and gently, about six inches into the rectum while the patient inhales deeply. After the basti, the patient lies on his back and rests for ten to twenty minutes.

Because of its small volume, Anuwasan Basti can be easily retained for a long period of time. However, with nirooha basti, the pateint is more likely to feel the urge to defeacate within forty-five minutes to an hour and in some cases, sooner. In Nirooha, the ama which the doshas drew into the colon is eliminated along with much of the basti fluid and faecal matter.


The time of Basti administration is noted along with the time of each subsequent bowel movement. It is often not possible for the physician to do this, so the patient is instructed to observe and note the frequency, color, consistency, odor and other signs which can show the physician whether ama is present and what type of ama is being eliminated.

TREATMENT REGIMEN :

The Ayurvedic physician always closely monitors the patient's response to basti treatments. He then makes adjustments in the type of basti, its oil and water content, the specicfic herbal decoctions used and the number of bastis which alternate nirooha with anuwasan.

Based on the information presented in the Charaka Samhita, several regimens which alternate herbal water decoctions with oil bastis are employed. The specific regimen depends on the constitution of the patient and the condition of the colon. A nirooha decoction is often applied for two consecutive days and then followed by an oil based anuwasan basti on the third. If there is greater need for cleansing, nirooha bastis can be given for three days, followed by oil on the fourth.


In most cases, this type of treatment schedule, followed for eight to ten days, cleanses ama and mala from the dhatus and assists the rebuilding of dhatu structures. This regimen restores normal balance to the doshas and the dhatus.

It is essential to always end treatment with anuwasan basti. This guarantees that vata is operating properly and that the colon is left lubricated and nourished. When properly administered, basti treatment does not interfere with normal intestinal flora and strenghtens the function of the mucous membranes lining the colon.

Bastis have proven remarkably successful in treating situations that have not responded to any other form of therapy. Their power and efficay as a treatment modality have gone largely unrecognized by modern medicine. When the vital functions of vata dosha are not understood, it is easy to overlook the tremendous absorptive power of the colon. As a consequence, modern medicine has failed to take advantage of the colon as an important route for the administration of medicines and nutrients.


RAKTAMOKSHAN (Therapeutic withdrawal of Blood)

Although Ayurveda favors prevention wherever possible, traumatic invasive surgery is advised in certain acute cases. Sushruta's extensive experience in the examination of blood during the course of surgery enabled him to gain a deep understanding of the relationship of the blood to rakta dhatu, pitta dosha and diseases associated with their toxicity and malfunction.

Sushrut attributed particular importance to the blood because it performed the important job of providing transportation within the body. He noted that when ama or toxins collected, they were circulated throughout the body with the blood. He devised RaktaMokshan as a purification treatment to be used when excess toxins are being carried in the blood to the periphery of the body.

Although Raktamokshan is the most limited of the five major procedures, it provides a rapid and sometimes dramatic reduction of symptoms in certain acute disorders, especially where time is a crucial factor. Rakta Dhatu and Pitta Dosha are closely associated and their functions interrelated. The blood, which represents rakta dhatu, is formed and regulated by the liver, spleen and bone marrow, which perform pitta related work. For this reason, when toxins appear due to excess pitta, they concentrate in the blood.

When excessive pitta related ama exists in the blood, it gets transported to the body's periphery, where it often produces characteristic symptoms like skin inflammation or skin hypersenstivity. Acute symptoms can usually be relieved within a few hours by simply removing a small amount of toxic blood from the affected area. Once ama is gone, rakta metabolism improves, and the blood can perform its job efficiently. When toxins associated with pitta are eliminated, pitta function regains balance.


Raktamokshana successfully treats blood-related diseases, including many types of skin disorders: chronic itching, eczema, urticaria, rashes and leukoderma. It is also indicated for enlarged liver or spleen, gout and some types of headaches and hypertension. Its mostly prescribed during the end of summer and during autumn, when pitta's tend to become aggravated due to agni bhuta's dominance.

ADMINISTRATION OF RAKTAMOKSHANA :

Snehana and Swedana dont have to precede raktamokshana. On the day of treatment, the patient simply lies on a table and a small amount of blood is withdrawn intravenously. In ancient times, several different methods were used, depending on the patient's doshic constitution. This procedure should always be performed under qualified medical supervision. The venipuncture is sealed by medicated gauze and a pressure bandage is applied for a short time. After approximately, one hour, the patient can get up and leave.

The blood is examined for color, smell, consistency, viscosity and clotting characteristics. The specific characteristics of the blood will indicate the quality of function in the pitta zone.

When raktamokshan is contra-indicated but symptoms indicate that the blood is toxic and needs to be cleansed, Ayurveda employs shamana or palliative therapies. These include adjustments in diet, and the use of specific herbs to cleanse the blood. In Ayurveda, the blood is said to be the carrier of ayu, or life, so its condiiton directly influences the four parts of life: atma (soul), manas (mind), indriya (senses) and sharira (body).

NASYA (Therapeutic cleansing of Sinuses)

Nasya or Shirovirechan is a procedure used to assist vamana in dislodging ama and excess kapha from the throat, nose, sinuses and other organs in the region of head and neck. Nasya is the introduction of medicated sustances into the nose. This Process stimulates secretions which help eliminate kapha related toxins from this area. It removes ama and toxins from the nose, larynx, pharynx, mouth, para-nasal sinuses, ears and eyes.

Nasya is indicated in diseases of the head and neck. It is used for dry nasal passages, as well as sinus congestion, common cold, chronic sinusitis, allergies and allergic rhinitis. It relieves chronic vascular headaches, migraine, epilepsy, and has a positive effect on degenrative diseases of the brain and mental retardation. Nasya also helps with eye and ear problems, such as dry, itching and watery eyes, conjuctivitis, glaucoma, hearing loss and tinnitus, as well as loss of the sense of smell.

TYPES OF NASYA :

Traditionally, nasya uses two different classes of substances: medicated oils and medicated powders. According to Charaka, both classes can be utilized for three different purposes.

(i) to promote secretions which dislodge and carry toxins out of the body, called shodhana nasya.

(ii) to create a palliative or soothing effect, called shamana nasya.

(iii) to provide nourishment to the tissues in the region, called bruhan nasya.

Tikshana Shirovirechana is a Shodhana type of hot, pungent, dry and quickly penetrating. They increase secretions which help remove ama from the nose and head. This treatment effectively eliminates headaches, heaviness in the head, nasal congestion and swollen lymph nodes.

Shamana is palliative and nourishing type of nasya, and generally incorporate sweet materials like ghee, sweet herbs or flowers into their formulas. Shamana which means "palliative", helps manage symptoms but does not heal the cause of a condition. For example, when nasal passages are blocked or congested, vacha in a seasame oil base rapidly clears the obstruction and returns the patient to easier breathing. This is particularly useful for people with bronchial asthma. Shamana nasya helps control sneezing and nose bleeds.

Bruhan means "nutritive", is more nourishing than cleansing. It improves sensory functioning and attention deficit disorders, and helps with degenrative brain conditions like Alzheimer's, Epillepsy and mental retardation. The Dosage usually begins with eight drops in each nostril and can increase to fifteen drops. Panchendriya vardhan oil is used for these conditions.

ADMINISTERING NASYA :

Charaka describes a number of ways to administer nasya. The first, avapidana, or "squeezing," drips juices extracted from fresh herbs into the nasal passages. This cleanses and soothes the paranasal sinus. The astringent juices of common grass, for example, can be used to stop a nose bleed. Ayurveda employs avapidana for insomina, headache and anxiety.

The second method of administering nasya is pradhamana, which translates as "forcefully pushing". It has a strong cleansing action and gives immediate relief from dizziness, fainting, severe headaches and dis-orientation.
In this therapy, powdered herbs are blown into the patient's nose through a tube while the patient inhales deeply.

Marsha Nasya and Prati Nasya, or "repeated application", are milder procedures than the previous two ones because they utilize fewer and weaker herbs and are not propelled as deeply into the nasal passages. Marsha Nasya introduces two to four drops of medicated oil into the nostrils every two hours.

In Prati Marsha Nasya, the patient himself applies the medicated oils ferquently during the day. He inserts his little finger into warm oil and gently massages the inside of the nasal passage. In both cases, once the oil has been inserted, the head is tilted back and the patient gently sniffs. This treatment cleans, lubricates and strenghtens the mucous membranes, keeps the nasal passages open, and increases resistance to foreign substances.

PREPARING FOR NASYA THERAPY :

Proper preparation is crucial to all of Panchkarma's elimination procedures, including Nasya. Before the medicated drops or powders are administered, warm herbalized oil is vigorously massaged into the face, focusing on the sinus area. Fomentation, using a hot water bottle wrapped in a hot, moist cloth or towel, is a then applied to the face and neck to dilate the passageways.

After this localized snehana and swednana, the patient has his head tilted back and reeceives herbalized drops in each nostril or powders forcefully blown in. The patient inhales deeply thorugh the nose to bring the herbalized oil up into the nasal passage. To draw the medications more deeply into the passageways, the patient pinches his nostrils closed on the inhale and releases suddenly. He does this quickly, five to ten times per each strong inhale.

If the patient's nasal passages are inflamed because of excess pitta, he may expereince burning from the nasya treatment. This can be alleviated by placing two drops of ghee in each nostril or by placing a cool towel over the face.

For Kapha disorders, cleansing nasya, using hot penetrating substances in oil, should be applied during kapha dominant periods of the early morning or early evening.

After nasya, the patient head will feel lighter and less congested, her mind clear and her senses more acute. She will feel more comfortable and happy.

CONTRA - INDICATIONS :

The cases in which nasya is contraindicated are for infants who are dehydrated, or for those who are experiencing severe panic or anger. It should also not be administered immediately after taking bath. Some caution is advised when giving this therapy to pregnant women.


PASCHAT KARMA

The set of procedures that follow the main eliminative treatments of Panchkarma 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, strenghtening 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 re-kindling, it is important to respect the somewhat vulnerable state of the physiology. Energy resources are not at their full capacity, and as result, we cannot do as much as we will be able to do once the dhatus are rebuilt and up to the speed. It is therefore crucial for the success of Panchkarma that the patient follow a regulated diet and lifestyle immediately after treatment.

There are two procedures of Paschat Karma : Samsarjana Karma and Rasayan Chikitsa

SAMSARJANA KARMA (Graduated Diet)

Samsarjana Karma constitutes the primary post-treatment procedure for digestion. This term iterally 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.

Digestion is the first aspect of physiology that needs to be reconstructed. The Panchkarma treatments dramatically effect the digestive process because the G-I tract provides the primary route for the elimination of the toxins. The digestive fire is weakened by the process of ama being drawn back into the digestive tract and expelled from the body.

The diet given to the patient immediately after Panchkarma consists of nutritive and easily digested preparations of rice and split yellow mung dal (lentill). The diet is structured in stages, going from more liquid preparations to increasingly solid ones. These stages of digestibility are called manda, peya, vilepi, odana, yusha and kichari.

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.

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 consistencyy of a thin, light porridge.

VILEPI : THICK RICE SOUP

Vilepi, or "thick soup", describes the third and fourth meals after vamana or virechana. Vilepi consists of a slightly thicker porridge of soft, cooked rice grains and is made with a ratio of four parts water to one part grain. A little black salt water and dried sugarcane juice can be added for taste. In order to add some strength to the digestive fire, one can lightly saute a little fresh ginger, turmeric, cumin, coriander or fennel in a small amount of ghee and add them to the porridge.

ODANA : COOKED RICE

Odana, which means "cooked rice" and has the consistency of normal, soft, cooked rice, is given as the fifth meal.

YUSHA : MUNG LENTIL SOUP

Dal is added to the sixth meal, which the patient eats on the second day after Virecahan and Vamana. Yusha or "soup mixture", is rice with some yellow mung dal added.

KICHARI : RICA AND DAL MIXTURE

The patient gets kichari for a number of meals. Kichari contains a mixture of basmati rice and spilt yellow mung dal coked together with a pinch of black salt and the sauteed spices. The nourishing food forms the basis of the traditionial purification, recuperation and rejuvenation diets in Panchkarma therapy.

TIPS FOR HEALTHY BODY AND SOUL:

1) Only eat when you have appetite.

2) Do not eat to full capacity. Always leave a little room in your stomach at the end of each meal.

3) Avoid drinking cold liquids with your meals.

4) Eat your main meal at noon time when the environmental agni is strongest, and eat a lighter meal at night.

5) Eat in a calm atmosphere and sit down when you eat.

6) When possible, avoid snacks between meals and avoid eating just before going to bed.

7) Once every week or two, fast or eat lightly to give your digestion a much needed rest.

8) Avoid foods that are deep-fried or are too heavy.

RASAYANA CHIKITSA (Rejuvenation Therapy)

Rasayan Karma does not technically belong to Panchkarma therapy, but forms its own system withnin Ayurvedic System. However, the rasayan therapy increases the effectiveness of Panchkarma's rejuvenating processes. Rasayana actually means "that which increases the essence of each dhatu, starting with rasa".


When people hear about the rejuvenating properties of rasayanas, it is common for them to want to take them immediately, without going through the necessary procedures to make the body receptive to their influence. This will not work for three reasons :

(i) The rasayana are very refined and concentrated herbal and mineral formulas that take strong digestive capacity to metabolize.

(ii) Imbalanced doshic functioning impedes delivery of these substances to the dhatus.

(iii) The ama and mala stored in the dhatus block their ability to asimilate these special compounds.

As a result of these three factors, Rasayana doesn't achieve its desired effect. Digestion must be strenghened, the doshas must be balanced and impurities must be eliminated from the dhatus through Panchkarma therapy in order for the rasayanas to work.

Many herbs and herbal formulas are commonly given after Panchkarma to produce specific effects.

Ashwagandha pacifies and balances vata.

Brahmi and Manjistha pacify pitta.

Ginger, black pepper and Pippali improve the digestive capacity of all the dhatus agnis and pacifies kapha.

Amalki increases sattva, thereby improving the calrity, stillness and positivity of the mind. It also pacifies both pitta and vata.


KERALA PANCHKARMA

Kerala Panchkarma is a special form of Panchkarma developed in the Green state of Kerala and it generally employs some form of Snehan or Swedana, and often address the functions of a particular dosha.


PINDASWEDA

It is the process by which certain medicinal puddings, especially the cooked navara type of rice in the form of boluses tied up in cotton cloth is applied the whole body or a specific part of the body, for a period of 7 to 14 days, It is used in the treatment of neuromuscular disorders, hemiplegia, chronic rheumatic disorders, for rejuvenation, geriatric problems etc.

During Pinda Sveda Ayurveda treatment small linen bags filled with a specially prepared mixture are applied locally to relieve the muscles. An additional major role in this therapy is played by the highly effective herbal oils mixture which are specially selected by the 'Ayurveda doctors' for the parts of the body where the treatment is required. The effect of the herbal extracts is to relieve the pain if there is any and to relax and build up the body tissues of the application area

During Pinda Sveda Ayurveda therapy massaging is done by trained and experienced Ayurveda technicians, using a bag filled with specially medicated special rice which is very useful to remove body pains, improve digestion, cures sclerosis.

The oil massage is often followed by a herbal steam bath with specially selected medicinal herbs. This widens the vessels and thereby assists the de-toxification of the body system. After a gentle massage on the body, specially prepared warm herbal oil is poured over the lower back and kept inside an herbal paste boundary for 50 minutes. The healing properties of herbal oils used for this massage deeply cleans and enriches the blood, builds and maintains strong muscle and connective tissues and lubricates the joints keeping them flexible and pain free.

PIZHICHIL

It is the process by which warm medicated oil is poured on the whole boy in a specific manner with simultaneous gentle massage. It is used in the treatment of various neurological diseases, rheumatic disorders, for rejuvenation, preventing ageing process etc.

Pizhichil is a special form of treatment which is a combination of oil massage and heat treatment. This therapy is also known as treatment for aristocrats as in the olden days the Maharajas or Kings used to have this treatment. A gentle, synchronized massage is carried out under a constant flow of warm herbal oil. This Ayurveda treatment also involves squeezing a cloth soaked in oil over the body. During this treatment the patient is made to sit on a Ayurveda chair specially made for this purpose and the medicated oils are then applied over the head and body.

Ayurveda therapists are all the time present for the observation of the treatment and if needed at the same time the Shriodhara is also undertaken.

A cloth is tied over the forehead of the therapy taken to prevent oil from getting into the eyes. The warm, medicated oil is then poured in a continually flowing single stream, by squeezing a clean cloth dipped in oil over the body. The treatment starts and ends with the patient in a sitting position. In the duration in-between, the patient is made to lie flat while the application of Shirodhara goes on.

This Ayurveda treatment of Pizhichil has been highly valued by all our guests and produces good results in case of joint problems and muscle tension. The duration of Pizhichil is decided by the Ayurveda experts after the body constitution of the individual has been determined.

Pizhichil Treatment increases the blood circulation, nourishes muscles, nerves tissues and sexual ability. Pizhichil Ayurveda treatment is also effective for Paraplegia, Hemiplegia and general debility.

SIROBASTI

It is the process of keeping ceratin amount of medicated lukewarm oil on the head for a prescribed period of time by using a special type of cap without top, fixed properly on the head for the treatment of various neurological disorders, diseases of head, facial palsy etc.

Certain mixture of the lukewarm herbal oils which are prescribed by the Ayurveda Physician according to the individual body type are poured into a cap fitted on the head for 15 to 60 minutes per day according to the patient’s conditions for the advised period.

This treatment is highly effective for mental stress, rejuvenation of sensory organs, facial paralysis, dryness of nostrils, mouth and throat, severe headaches, burning sensation of head and other vata predominant diseases.

SIRODHARA

It is the process by which medicated oil, milk, buttermilk etc. is poured in a continuous stream on the head, especially forehead in a specific manner It is indicated in mental disorders, insomnia and skin diseases. Duration of treatment 7 to 14 days.

Shirodhara is a modern purification and rejuvenating therapy based on an ancient Indian technique.

In Sanskrit language Shirodhara is composed of two words shiro + dhara. Shiro means head and Dhara means flow of warm oil on head. Sesame or another base oil is mixed with a few drops of aromatic essential oil to create the liquid. It is then warmed till a comfortable temperature is reached and the treatment begins. The exact combination of the oils depend on the body constitution and is decided and prescribed by an Ayurveda expert. The patient lies supine on a flat surface with head back and a rolled towel or pillow beneath the neck. A stream of warm oil is poured very slowly onto the center of the forehead (the location of the "third eye") for 30 to 45 minutes followed by gentle scalp massage. The effect is indescribable.

Shirodhara treatment is done in absolute silence. It takes you to deep relaxation and into a balanced state of rest in mind and body. Men and women alike experience it as a high-point of Panchakarma applications of Ayurveda.
Best experienced after a massage, Shirodhara is one of our most popular Ayurveda application taken by Ayurveda lovers.

This therapy is meant for 'Shodhana' (a Sanskrit term). 'Shodhana' or purification therapy is not only meant for elimination of disease-causing toxins present in the body but also to replenish the tissues with nourishment and rejuvenate them. Rejuvenate literally means 'to make young again'.

Shirodhara is a great rejuvenating therapy that gives a healthy face and body glow. In Ayurveda, rejuvenating therapy is the golden path to attain longevity as it is aimed at the preservation of health. Ayurveda says that rasayana or rejuvenating therapy optimises the circulation of nutrients to both body and mind. Shirodhara removes the root cause of the disease and is a rejuvenating therapy at the same time as well.

Shirodhara Ayurveda therapy helps to overcome stress and its ill effects on nervous system. Shirodhara helps to relieve insomnia, stress, tension, anxiety, anger, chronic headaches, rheumatism, hypertension, asthma, hair problems and gives mental relaxation.

The Ayurvedic physician determines the number of days of the treatment for different problems after your body type according to Ayurveda has been determined. With weekly sessions, you will find relief from stress and strain from daily life. To achieve the maximum benefits from the therapy, it is advisable to follow Ayurvedic lifestyle. An Ayurvedic physician decides appropriate foods, exercise, yoga and herbal preparation to optimise the benefits after the therapy
 

SIROLEPANA

It is a procedure in which paste of medicinal herbs / rugs is applied on the scalp for a specified period. It is an effective method of treatment for neurological disorders and mental diseases.













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