KERALIYA PANCHAKARMA- TREATMENTS IN AYURVEDA

PANCHAKARMA CHIKITSA/TREATMENTS IN AYURVEDA

Ayurveda treatments comprises of two major parts,Samshodhana Chikitsa (Bio cleansing therapy) and Samshamana Chikitsa (Pacifying Therapy).Samshamana Chikitsa consist of conservative treatment like Langhana,Pachana, drug administration etc.Samshodhana Chikitsa  envisages Pancha karma treatment which is basically a Bio-cleansing regimen indented to eliminate the toxic element from the body and thereby enhances the immunity of the body.Samshodhana Chikitsa is considered superior to Samshamana Chikitsa as the chances for recurrences of the diseases so treated are remote.

Panchakarma increases the acceptability of body to various therapeutic regimens like Rasayana (Rejuvenation) and Vajikarana (Aphrodisiac). Thus Panchakarma therapy is believed to impart radical elimination of diseases causing factors and maintain the equilibrium of  Doshas.

Types :

Five fold measures comprehended as Panchakarma are:

1. Vamana (Therapeutic Emesis)
2. Virechana (Therapeutic Purgation)
3. Anuvasana (Medicated Oil enema)
4. Asthapana (Medicated Decoction Enema)
5. Nasya (Nasal Insufflations) [ref: C.S Kalpa sthana,S.S Chiktsa, A.H. Sutra sthana].

Vagbhata in Ashtanga Hridaya has enumerated five types of Samshodhana are:

1. Niruha
2. Vamana
3. Virechana
4. Nasya
5. Rakthamokshana

Prior to these five Pradhana Karma (main procedure), Poorva Karma (pre operative),and Paschat(post operative) Karma has to be done.some of the Poorva Karma are:

• Pachana and Deepana (correct digestion and Ama condition by using digestive or and appetizer medicines)
• Snehana (oleation) and
• Swedana (Sudation).

After the main procedures, Paschat karma a special diet and life regimen is advocated as post operative measures.Pancha karma therapy plays a definite role in the management of disease especially of neuromuscular, rheumatological and gastro intestinal origin.In addition to this Panchakarma procedures are utilized for the purpose of preservation,maintenance and conservation of health and the promotion of longevity.
Based on Ayurvedic principles and own experiences,the Ayurveda Scholars in South India have modified certain procedures according to Dosha,Prakriti, Kala/season and found them effective.Later these got popularized as Keraliya Panchakarma.some of theses practices are:

• Shashtika shali pinda sweda
• Pizhichil
• Shirovasthi
• Shirodhara
• Shirolepana,etc which will explain later.

These procedures are specialized varieties of Snehana and Swedana which have more nutritive/nourishing effects than bio cleansing or depleting effects.
Before administering of Panchakarma procedures,one must carefully select,assess and prepare the patient explaining all the procedures to be followed.The doses of drugs,vegas/urges and frequency of procedures may vary according to the condition of the patient and severity of the diseases.While undergoing the procedures,it is duty of the physician to asses the patient's strengths,Constitution,age,diseases stage and other relevant factors.(ref A.H.Su)
The Samshodhana Chikitsa of Ayurveda,which include Panchakarma treatment,basically indent to eliminate the toxic elements from the body and thereby enhanced the immunity of the body.The toxic products of the body metabolism can be broadly divided into water soluble,fat soluble and volatile substances.the volatile substances like carbon dioxide can easily be removed from the body through the lung.While there are number of mechanisms available to get rid of the water soluble toxic materials through Kidney,Sweat and other body secretions, removal of fat soluble toxic material is very difficult and only liver can play a small role.Hence it is likely that there would be accumulation of fat soluble toxic products in the body.Liberal use of oil and ghee in various Panchakarma procedures makes it possible to eliminate these toxic products.In modern day medicines ,we can see that molecules moves from higher concentration to lower when separated by a diffusion membrane.The skin and the mucous membrane provide an excellent opportunity for this maneuver.While skin of an average adult provides a surface area of less than 2 sqr mm,the gastro intestinal tract is many meters long with highly permeable mucous membrane.The mucous membrane of the gut has many folds and projections in the form of villi and micro villi,which helps to increase the total exchange area.Various Panchakarma procedures like Vamana,Virechana,and Anuvasana use oil liberally,thereby removing toxic fat soluble waste materials.Prior to the Pradhana Karma,Poorva karma ie,Bahya Snehana (External Oleation) and Sarvanga Swedana(Whole body Sudation) are given to the patient.These procedures further helps in removing toxic materials from the body.Swedana procedures using hot steam increases the local skin blood flow there by enhancing the exchange process.It is known that the fat soluble toxic substances are stored in the body fat.Fat in the body is largely located below the skin and inside abdomen around the mesentry of the gut.During various procedures exposure of skin and gut mucous membrane to a quantity of oil seems to be logical and ideal procedures.repetition of these procedures over several days will largely remove the toxic wastes by concentration gradient.The Ayurvedic medicines added to the oil might give additional benefits.
One of the important features of these procedures is the safety and easiness  by which these can be administered without any major side effects(if done properly). In Ayurveda practice of Panchakarma, Dosha (humoral factors), Prakriti (body constitution), Kala (season), drug availability etc are always prime concern.

Scope of Panchakarma:

 The important aims and objectives are:

1. Curative approach
2. Preventive approach
3. Promotive approach
4. Preparatory approach
5. Vishahara/toxicology etc

By:Dr.Rimin Razak

Ref: practical hand book of panchakarma.