Panchakarma is elimination of doshas from the body. It is one of the peculiarities of Ayurveda. Since according to Ayurveda, disease is the result of imbalance of doshas, when the increase of dosha is in a large quantity the best way to get cured faster is expelling the doshas out. These procedures (Karmas) are five (Pancha) and hence they are described as Panchakarma i.e. five procedures. These are to be performed not only by the patient for getting them cured but even by healthy persons for maintaining the health. Even this is a pre treatment before rejuvenation (Rasayana) and treatment for virility (vajikarana) also for the best progeny before conception.
Snehana is a lubrication of the body mainly with the use of oil or ghee (clarified butter) . The person is asked to take medicated oil or ghee in increasing quantity till some particular signs and symptoms occur and that much quantity is consumed which takes nearly 12 hours to digest. The person has to be observe some restriction such as drinking only hot water through out the day, no sleep during day time, eating food only when hungry, etc.
Fomentation especially in the form of a steam bath to produce sweating is ‘Swedana. This helps liquefaction of doshas so that they can easily tickle down to alimentary canal. Generally this is performed with external snehana.
Snehana and Svedana are the pre-procedure. Medicated ghee or oil is given orally, in such a quantity, which will require at least 12 hours to get digested. Stream bath is also given simultaneously once or twice a day. Curds and preparations of black gram are given on previous day.
The procedure is done in the early morning period from 7 a.m. to 9.30 a.m. The patient is asked to drink decoction of herbs along with milk or sugarcane juice or alone till the stomach is totally filled and the patient is unable to take more. Vomiting generally starts automatically and then the process of drinking and vomiting continues till the whole Kapha is expelled out.
The person is advised to take rest. Herbal cigarettes are given for smoking after completion of the process. The diet is given in a particular order starting from rice water (rice + 14 times water to be cooked and filtered) to normal food. It may take 3 to 10 days depending on the elimination doshas to come back to normal diet.
The procedure is important for the Vata dosha mainly, but can be used for Kapha and pitta and for all sorts of diseases also. In this procedure enema with herbal decoction, oil, honey and salt is given. Since it has a direct action over the large intestine, which is the main site of Vata dosha, it acts instantaneously. The procedure is especially useful for all kinds of diseases caused by Vata Dosha e.g. back ache, arthritis, dystrophies, multiple sclerosis, muscle wasting etc. The best season for this procedure is the rainy season.
An enema of medicated oil is given as a pre procedure. This is given after meals. This may even get retained in the body and may even get absorbed, depending upon the need of the body. So the procedure of snehana is done by such kind of oil enema, technically called as Sneha-basti or anuvasana -basti. This basti is also given intermittently during the main procedure when a particular course of basti is advised.
It’s an enema of herbs decoction, honey, salt and oil as mentioned earlier. It is to be given empty stomach. It evacuates the bowels immediately.
The person is advised to take warm water bath and then a light meal , preferably with rice. Then again the Sneha Basti can be given on the same day or the second day.
Courses of basti
It is course of 8 bastis comprising one sneha basti initially, 3 decoction bastis (technically called Niruha or asthapana basti) alternatively followed by 3 sneha bastis and one sneha basti in the end. A course of 15 or 30 bastis has also been mentioned in the texts.
This process is instillation of medication into the nostrils. It may be in the forms of a medicated oil / ghee, juice, or even powder. The nose is the door of the head and hence this procedure is useful in various diseases associated with head and neck parts such as sinusitis, migraine, fall of hairs, graying of hairs, head aches, epilepsy etc. There are 3 types of nasya and the ‘shodhana’ type is incorporated in the Panchakarma.
Some dry fomentation with the help of warm cloth is given to the forehead and then the patient is asked to lie down with little head low position. The legs are little lifted up.
Warm medication is instilled in each nostril and the person is asked to inhale deep into the head. He is asked to spit it out, if it comes in the mouth.
Gentle massage with oil is given on the back of the neck, shoulders. Exposure to the cool air is to be avoided. Smoking of the herbal cigarettes is also to be advised to some persons.
Many a times the Rakta (Blood) vitiated by the doshas is the cause of diseases e.g. skin disorder, abscesses, stomatitis, hypertension, herpes, varicose veins, arthritis etc. The procedure here is to let the blood flow out of the body along with doshas. The best season for blood letting is ‘autumn’.
Snehana and svedana as per requirements. The patient is advised to take some food which will aggravate the dosha little bit e.g. curds (Yogurts) preparations from black grams, buttermilk etc.
The bloodletting is now generally done by a prick with a needle. Cubital vein is most suitable to puncture; however the nearest possible vein of the site of the disease is the proper vein. It is punctured and then blood is allowed to flow out using a scalp vein set or is removed by using an injection syringe. When the color of the blood changes and pure blood starts coming out, the procedure is stopped.
Very light diet is advised on the day of the procedure.
Shirodhara is an Ayurvedic treatment which involves slowly pouring liquids over a client’s third eye, which is located in the forehead. It has been used in India for centuries to treat a wide range of conditions.
It is used to treat a range of skin conditions, along with eye problems, stress, insomnia, memory loss, and graying hair. A wide range of liquids can be used, depending on the body type of the patient; oils are common, but milk, buttermilk, and water can be used as well. Frequently, the liquid will be infused with herbs which are tailored to the client.
It is also popularly known as third eye treatment of lord Shiva, a therapeutic Marma head massage with herbal oils is done and herbal oil, medicated milk or herbal decoction is poured in gently and steadily over the forehead in a continuous stream using a special rhythmic swaying movement. This results in a fantastic sense of deep relaxation and inner peace. It works on cerebral system, helps in relaxing the nervous system and balancing the Prana Vayu around the head. It improves the function of five senses, helps in insomnia, stress, anxiety, depression, hair loss, fatigue, imbalance of Vata and makes one calm and fresh. Shirodhara is a purifying and rejuvenating therapy designed to eliminate toxins and mental exhaustion as well as relieve stress and any ill effects on the central nervous system.
Shirodhara is a unique form of ancient therapy of pouring oil on the forehead from a specific height and for a specific period continuously and rythmatically allowing the oil to run through the scalp and into the hair. This is a subtype of Murdha taila which means keeping the medicated oil on the head region. The types of Murdha taila other than Shirodhara are Shiro Abhyanga, Pichu And Shiro Basti. So the concept of shirodhara is mainly concerned with the application of oil though the other liquids are also used for the therapy but they are associated with specific clinical conditions.
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Dr. Vinesh Nagare
M.S. (Gynac.), Diploma in Yoga, Ayurved Vachaspati