Panchakarma
Panchakarma means five cleansing procedures, each of which has a different scope of action. Through the employment of these five therapeutic procedures, excessive doshas, the bodily humors, which are the primary cause of disease, are expelled from the body.
Ideally, panchakarma procedures are undergone at least once a year, during the transition of seasons, even by a balanced person for the purpose of health optimization, protecting homeostasis, curbing the aging process and to support longevity.
“śodhanam hi param medhyam śreshtham āyushya vardhanam’’
’’Purification is the greatest promoter of intelligence and the best method for increasing lifespan.”
Ayurveda goes beyond the aim of modern detox modalities. They also strive to purify the body of metabolites and toxins, but panchakarma not only purifies the body, it also resets the physiological forces and intelligence of the body, which allowed for the body to become compromised in the first place. The body realigns with its inherent state of balance, awakening its intelligence and life’s accompanying desire to thrive. The effects of panchakarma trickle through multiple layers of being long after the procedure and often reveal deep insights about personal needs and cause a natural gravitation towards better choices marking a turning point in one's wellbeing. Typically, participants report improved digestion, enhanced immunity, mental clarity, stress reduction, improved sleep, relief of chronic conditions and increased energy and vitality.
“Manaso’pi viśuddhih syāt śodhanāt śarīrake”
“The purification of the body leads to the purification of the mind as well.”
Panchakarma is often seen as a hallmark of Ayurvedic medicine and has gained widespread recognition to assist in the treatment of and recovery from a large number of diseases, provided it is done under the right conditions and with proper application, as well as to support longevity and maintaining health. The procedures of Panchakarma have in their purity been practiced within Ayurveda for thousands of years. Popularly, especially in the western world, the name panchakarma is associated with wellness retreats or spas that have standardized or packaged it, and while these programs have indeed great value in a stressful world, catering to economic and temporal constraints, they can often distort the classical vision of the concept that has been handed down from antiquity. Fundamentally no two panchakarmas are done the same way and each application is precisely tailored to the needs, constitution, age, strength, habits, disease and environment of the patient, contributing to panchakarma’s profound healing potential. For some the need is deep detoxification, for some gentle rejuvenation.
Pacification vs. Purification
Within Ayurveda, there are two main approaches to therapy. Shamana and Shodana. Panchakarma falls into the latter category, shodhana, which means active purification. To clarify, panchakarma is a form of shodhana, but not every shodhana is panchakarma. Its main aim is to pull the dosha, that has been dislodged and excited by the pre-purification preparatory measures, out of the body through the nearest bodily opening by creating a negative pressure in the gastro-intestinal tract. Shodhana therapies aim to completely remove the excess doshas from their sites in the GI tract; the colon, the small intestines and stomach. This prevents the recurrence of a particular illness and removes the cause of it. It takes the skill of a talented clinician to determine whether someone is fit for such a cleansing program.
“Na shodhanādrite rogāh samyag vyapāyinah smrtāh.”
”Without purification (shodhana), diseases cannot be completely eradicated.”
Before any treatment begins one of the things a physician must assess is whether the body is filled with a large amount of āma or not, a term that we can translate as toxins, or undigested particles. When āma is not an issue, and when the person is strong relative to the disease, isn’t elderly, isn’t a child or pregnant, shodhana is indicated.
If there are large amounts of toxins or if the patient is weak, purification is unwise, potentially even enhancing the disease process and shamana; pacification or palliation therapy should be done first. Shamana can be done by means of kindling the digestive fire, metabolizing wastes with herbal medicine, adhering to a particular diet or appropriate form of fasting, exercise, sunbathing and exposure to fresh air or certain therapies and lifestyle adjustments that attribute to these seven main pillars. Shamana pacifies the doshas in their site and re-establishes a person’s constitution, bringing longevity and a quality of consciousness that gives insight helping managing inner life. It is especially beneficial for people that have minimally aggravated dosha, young children, the elderly, debilitated patients, those suffering from chronic illness and others who aren’t strong enough to bear the strain of shodhana.
A proper beginning, middle and end
Like a human life, the seasons and rituals, panchakarma has a clearly defined beginning, middle and end. The actual elimination procedure happens during the climax in the middle and its results are dependent on the preparation measures and post panchakarma measures to which utmost importance is given.
1. Purva karma - preparatory measures
Preparation for panchakarma involves oiling and heating the patient to return the doshas from the limbs to their proper homesites in the GI tract. We can see it as taking the past back to the present. After their return, the doshas are excited by a technique called utkleshana to make them ready to emerge from the body, after which they are then indeed pulled out of the body by one of the five panchakarma methods. Making the dosha excited and ripened, starts with the use of snehana and svedana. Snehana is internal and external application of oil, which lubricates the body inside and out, stimulates the excretion of morbid, unwanted materials separating the dosha from the tissue, who gain greater resilience and elasticity to bear direct purification. Svedana, fomentation, uses heat to induce perspiration, dilating the bodily channels and helps to ripen and liquify, facilitating the journey of the freed doshas back to the GI tract for elimination.
2. Pradhana karma / panchakarma - purification therapy
When the signs of fruition of the previous preparatory steps are observed, one of the five panchakarmas will be selected to move forward to expel the collected doshas and waste products through the nearest bodily opening. Doshas that collect in the stomach are removed through the upper pathway by means of emesis, therapeutic vomiting, vamana. Those in the intestines through purgation, virechana. Those collecting in the bladder or colon are removed by medicated enemas, basti. Doshas collected throughout the hemopoietic system are eliminated through bloodletting, rakta moksha and doshas which collect in the head and or the nervous system through the nose, nasya. There are numerous adjunct therapies that are employed to finetune the process or to remove any residual dosha.
3. Paschat karma - post care measures
The patient is given a pacifying regimen to follow in which diet and herbal medicine for rejuvenation play a central role in protecting the organism until it returns to normal and strengthening the body to encourage it to resist further disease. During panchakarma, bodily energy largely goes to elimination and healing, so digestion becomes fragile. This requires slowly introducing the body to increased consistency and quantity of foods, starting with very easy to digest foods to kindle the tiny spark of the digestive fire and building it up step by step. This is called sansarjana krama. Classically from rice broth, rice porridge, lentil broth, meat broth to kitchari. The length of post care depends on the intensity of the purification therapy and its results, but in general during the week after panchakarma the body and mind are highly impressionable so new habits can be easily formed during this time and the body is quick to manifest their potential. It is vital to protect this vulnerability and to relax, rest and restore in the wake of panchakarma.
“Śuddha dehasya rasāyanam gunavattaram bhavati”
”Rejuvenation therapies (rasayana) are more effective in a purified body.”
