INTRODUCTION TO PANCHAKARMA BY DR VASNATH LAD

by Vasant Lad, BAM&S, MASc

https://www.ayurveda.com/resources/cleansing/introduction-to-panchakarma

Ayurveda emphasizes preventative and healing therapies along with various methods of purification and
rejuvenation. Ayurveda is more than a mere healing system; it is a science and an art of appropriate living that
helps to achieve longevity. It can guide every individual in the proper choice of diet, living habits and exercise
to restore balance in the body, mind and consciousness, thus preventing disease from gaining a foothold in the
system.

According to Ayurveda, every human being is a unique phenomenon of cosmic consciousness, manifested
through the five basic elements—Ether, Air, Fire, Water and Earth. Vata—a combination of ether and air, pitta
—a combination of fire and water, and kapha—a combination of water and earth, are called the tridosha. These
are the three humors or the three organizations of the body, which are also derived from consciousness. Each
individual constitution or psycho-somatic temperament is determined by the relative proportions of these three
doshas at the time of fertilization. When the embryo is formed, the constitution is determined. There are seven
basic constitutions with one or more doshas predominant according to Ayurveda. They are: vata, pitta or kapha
predominant, vata-pitta, pitta- kapha or kapha-vata predominant and vata-pitta-kapha in equal balance, a rare
occurrence.

Every individual constitution has its own unique balance of vata, pitta and kapha (VPK) according to its own
nature. This balance of VPK is the natural order. When this doshic balance is disturbed, it creates imbalance,
which is disorder. Health is order; disease is disorder. Within the body there is a constant interaction between
order and disorder, thus once one understands the nature and structure of disorder, one can re-establish order.
Ayurveda believes that order lies within disorder.

Order is the state of health, as defined by Ayurveda. This exists when the digestive fire (agni) is in a balanced
condition; the bodily humors (vata, pitta and kapha) are in equilibrium, the three waste products (urine, feces
and sweat) are produced and eliminated normally, the seven bodily tissues (rasa, rakta, mamsa, meda, asthi,
majja and shukra/artava) are functioning normally, and the mind, senses and consciousness are working
harmoniously together. When the balance of these systems is disturbed, the disease (disorder) process begins.

The internal environment is governed by vata, pitta and kapha, which are constantly reacting to the external
environment. The wrong diet, habits, lifestyle, incompatible food combinations (e.g., milk and fish, melons
and grain, yogurt and meat or eating cooked honey, etc.), seasonal changes, repressed emotions and stress
factors can all act either together or separately to change the balance of vata, pitta and kapha. According to the
nature of the cause, vata, pitta or kapha undergo aggravation or derangement, which affects the agni (gastric
fire) and produces ama (toxins).

This ama enters the blood stream and is circulated throughout the body, clogging the channels. Retention of
toxins in the blood results in toxemia. This accumulated toxicity, once well established, will slowly affect
prana (vital life energy), ojas (immunity), and tejas (cellular metabolic energy), resulting in disease. This can
be nature’s effort to eliminate toxicity from the body. Every so-called disease is a crisis of ama toxicity. Ama
is the basic internal cause of all disease, due to the aggravated doshas.
 Herein lies the key to the prevention of disease: help the body eliminate the toxins. To stop the further
production of ama, Ayurvedic literature suggests putting the person on a proper diet with appropriate lifestyle,
habits and exercise, and administering a proper cleansing program such as panchakarma. (Although
panchakarma is often thought of as the entire procedure, it really is only one part of a group of therapies
belonging to a class of cleansing procedures called shodana. There is also a group of milder techniques called
shamana for those not strong enough for shodana.)

Purvakarma: Pre-purification Measures

Before the actual operation of purification begins, there is a need to prepare the body with prescribed methods
to encourage it to let go of the toxins. These two procedures are snehan and svedana. Snehan is the oil
massage. Oil is applied to the entire body with a particular type of massage that helps the toxins to move
towards the gastrointestinal tract. Oil massage also makes the superficial and deep tissues soft and supple, thus
helping to remove stress and nourish the nervous system. Snehan is given daily for three to seven days, as
indicated. Svedana is sudation or sweating and is given every day immediately following the snehan. An
herbal concoction may be added to the steam to further loosen the toxins from the individual. Svedana
liquefies the toxins and increases the movement of toxins into the gastrointestinal tract. After three to seven
days of snehan and svedana, the doshas become well “ripened.” A particular panchakarma method is then
given according to the individual’s constitution and disorder, prakruti and vikruti, respectively.

Five Basic Shodanas: Cleansing Methods

 Vamana: therapeutic vomiting or emesis

 Virechan: purgation
 Basti: enema
 Nasya: elimination of toxins through the nose
 Rakta Moksha: detoxification of the blood

Vamana: Emesis Therapy

When there is congestion in the lungs causing repeated attacks of bronchitis, colds, cough or asthma, the
Ayurvedic treatment is therapeutic vomiting, vamana, to eliminate the kapha causing the excess mucus. Often
times this also releases repressed emotions that have been held in the kapha areas of the lungs and stomach
along with the accumulated dosha. Once the mucus is released, the patient will feel instantly relieved. It is
likely that congestion, wheezing and breathlessness will disappear and that the sinuses will become clear.
Therapeutic vomiting is also indicated in chronic asthma, diabetes, chronic cold, lymphatic congestion, chronic
indigestion and edema.

After vamana, resting, fasting, smoking certain herbal cigarettes, and not suppressing natural urges (i.e.,
urination, defecation, gas, sneezing, coughing) is recommended. If vamana is administered properly, the
person should feel relaxation in the lungs, will be able to breathe freely, will have lightness in the chest, clear
thinking, a clear voice, a good appetite, and all symptoms of congestion disappear.

Virechan: Purgation Therapy

When excess bile, pitta, is secreted and accumulated in the gall

bladder, liver and small intestine, it tends to result in rashes, skin inflammation, acne, chronic attacks of fever,
biliary vomiting, nausea and jaundice. Ayurvedic literature suggests in these conditions the administration of
therapeutic purgation or a therapeutic laxative. Purgatives help relieve the excess pitta causing the bile
disturbance in the body. In fact, purgatives can completely cure the problem of excess pitta. When purgatives
are used, the patient should not eat foods that will aggravate the predominant humor or cause the three humors
to become unbalanced.
Basti: Enema Therapy

Vata is a very active principle in pathogenesis (disease). If we can

control vata through the use of basti, we have gone a long way in going to the root cause of the vast majority of
diseases. Vata is the main etiological (causal) factor in the manifestation of diseases. It is the motive force
behind the elimination and retention of feces, urine, bile and other excreta. Vata is mainly located in the large
intestine, but bone tissue (asthi dhatu) is also a site for vata. Hence the medication administered rectally effects
asthi dhatu. The mucus membrane of the colon is related to the outer covering of the bones (periosteum),
which nourishes the bones. Therefore, any medication given rectally goes into the deeper tissues, like bones,
and corrects vata disorders.

Nasya: Nasal Administration

The nose is the doorway to the brain and it is also the doorway to
consciousness. The nasal administration of medication is called nasya. An excess of bodily humors
accumulated in the sinus, throat, nose or head areas is eliminated by means of the nearest possible opening, the
nose.

Prana, life force as nerve energy, enters the body through the breath taken in through the nose. Prana is in the
brain and maintains sensory and motor functions. Prana also governs mental activities, memory, concentration
and intellectual activities. Deranged prana creates defective functioning of all these activities and produces
headaches, convulsions, loss of memory and reduced sensory perception. Thus nasal administration, nasya, is
indicated for prana disorders, sinus congestion, migraine headaches, convulsions and certain eye and ear
problems.

Breathing also can be improved through nasal massage. For this treatment, the little finger is dipped into ghee
and inserted into the nose. The inner walls of the nose are slowly massaged, going as deeply as possible. This
treatment will help to open the emotions. (Nose tissue is tender and for this application the fingernail must be
kept short to avoid injuring the delicate mucus membranes.) Since most people have a deviated nasal septum,
one side of the nose will be easier to penetrate and massage than the other. The finger should not be inserted
forcibly. The massage should proceed by slow penetration, the finger moving first in a clockwise and then
counter-clockwise direction. By this means, the emotions that are blocked in the respiratory tract will be
released. One may use this treatment each morning and evening. In this way, breathing patterns will change as
the emotions are released and the eyesight also will improve.

Rakta Moksha: Traditional Ayurvedic Method for Purification and Cleansing of the Blood

Toxins present in the gastrointestinal tract are absorbed into the

blood and circulated throughout the body. This condition is called toxemia, which is the basic cause of
repeated infections, hypertension and certain other circulatory conditions. This includes repeated attacks of
skin disorders such as urticaria, rashes, herpes, eczema, acne, scabies, leukoderma, chronic itching or hives. In
such conditions, along with internal medication, elimination of the toxins and purification of the blood is
necessary. Rakta moksha is also indicated for cases of enlarged liver, spleen and gout.

Pitta is produced from the disintegrated red blood cells in the liver. So pitta and blood have a very close
relationship. An increase in pitta may go into the blood causing toxicity, and thus many pitta-genic disorders.
Extracting a small amount of blood from a vein relieves the tension created by the pitta-genic toxins in the
blood. Leeches have been used as an alternative to bloodletting. Bloodletting also stimulates the spleen to
produce anti-toxic substances that help to stimulate the immune system. Toxins are neutralized, enabling
radical cures in many blood-borne disorders.

Certain substances such as sugar, salt, yogurt, sour-tasting foods and alcohol are toxic to the blood. In certain
blood disorders these substances should be avoided to keep the blood pure. For rakta moksha treatment other
than bloodletting, there are blood-purifying practices involving herbs, gem therapy or color water therapy. For
any rakta moksha treatment or related alternative treatment, it is beneficial to refrain from yogurt, salt, sugar,
alcohol, marijuana, sour and fermented foods.

Lifestyle and Diet: The Key to Health and Wellness

During any step of panchakarma therapy, traditional Ayurveda recommends certain lifestyle and diet
guidelines.
 It is advised to get plenty of rest during the panchakarma experience and to avoid strenuous exercise, sexual
activity, late nights, loud music, television and other such stimulating experiences. It is also advised to take
particular care to keep warm and away from the wind and to observe one’s thoughts and experiences during
this time.

A mono-diet of kitchari and ghee is recommended, as well as essential restrictions on cold drinks, cold food,
caffeine, white sugar, recreational drugs or alcohol and dairy products—all substances which should not be
resumed (if at all) until sometime after panchakarma is completed. The reason for this diet is that during the
cleansing process the digestive fire (agni) takes a rest. Also, as toxins move back into the gastrointestinal tract,
the power of digestion is further slowed. Kitchari will provide adequate nourishment, is very easy to digest,
nourishes all the tissues of the body, is excellent for de-aging of cells and assists in the detoxification and
cleansing process. Kitchari is a seasoned mixture of rice and mung dal, and is basic to the Ayurvedic way of
life. Basmati rice and mung dal both have the qualities of being sweet and cooling with a sweet aftertaste.
Together they create a balanced food; an excellent protein combination that is tridoshic.

Panchakarma is a very special Ayurvedic operation requiring proper guidance from a highly trained and
skillful Ayurvedic practitioner. This should not be undertaken with information from an article or a book. One
should consult with an Ayurvedic physician, not just someone with a modest amount of training. Panchakarma
is done individually for each person with their specific constitution and specific disorder in mind, thus it
requires close observation and supervision.

2 BASTI
by Vasant Lad, BAM&S, MASc, Ayurvedic Physician

Rectal Administration of Medications

Medications given by enema primarily treat vata dosha, which is the main etiological factor in the
manifestation of diseases. Vata is the force behind the elimination and retention of feces, urine, bile, and other
excreta. Vata is mainly located in the large intestine. Purisha dhara kala, the colon membrane, is related to
asthi dhara kala, the membrane of the bone tissue. Asthi (the bones) are important sites of vata dosha. Hence,
medications given rectally affect all the tissues up to bone tissue.

Administration of Basti

If you intend to self-administer basti, the following guidelines have been suggested:

 Best times for basti are in the early morning or evening (vata times).
 The stomach should be empty; wait at least three hours after eating.
 Make sure the environment is warm, comfortable and clean. An area where you can lie down near a toilet is
best.
 Materials needed include an enema bag or syringe, measuring cup, hotplate or stove, oil and/or herbal
substance, and towels.
 Basti is often administered in two stages: an oil stage and a decoction
stage. In the first stage, five ounces of warm sesame oil is introduced into the rectum and retained for ten
minutes. Then, without expelling the oil, an emulsion of oil and an herbal tea is introduced and retained for
thirty minutes. This mixture consists of five ounces of sesame oil together with sixteen ounces of a tea made
from herbs steeped in hot water and then strained and cooled to body temperature or slightly warmer.

The enema bag may be suspended three feet above your position. After filling the bag with the appropriate
fluid, allow all the air to be expelled from the tube. Lie on the left side, left leg extended and right knee flexed.
Lubricate the tip of the syringe with oil or ghee. Clean and lubricate the anal orifice with oil and check that
there are no hemorrhoids, fissures, or fistulas. Carefully and slowly insert the tip into the rectum and release
the clip allowing all the fluid to enter, then remove the tip. Assume a hands and knees position and elevate the
buttocks, thus relaxing the colon. Firstly tap the colon area from the sigmoid, through the transverse colon, to
the ascending colon and caecum. Then periodically massage the colon in this counterclockwise motion.

When fluid has been retained for the appropriate length of time, sit on the toilet to allow the passage of the
fluid and fecal matter. You may wish to wear a sanitary pad for a few hours following basti in case there is
some seepage of residual oil. It can be good to eat an hour or so after a basti, but only when hungry.

Result of a Normal Basti

 One or two bowel movements, with good cleansing of fecal matter.

 A feeling of lightness in the abdomen and general clarity.

INDICATIONS FOR BASTI CONTRAINDICATIONS FOR BASTI

Constipation
Lumbago or Slipped disk
Diverticulosis
Rakta Vata (gout)
Ama Vata (rheumatism)
Grudrasi (sciatica)
Sandhigata vata (arthritis)
Adhamana (distention and gas)
Apanavruta prana (nervous disorders)
 INDICATIONS FOR BASTI CONTRAINDICATIONS FOR BASTI

Vata headache
Insomnia
Hernia
Tinnitus

3 NASYA
by Vasant Lad, BAM&S, MASc

Nasal Administration of Medications

The nose is the door to consciousness and the pathway to our inner pharmacy. Medications that
are administered via the nasal passages affect the mind, prana vata, tarpaka kapha, sadhaka pitta,
and majja dhatu. Administer nasya on an empty stomach an hour before or after a shower or
exercise. Lie down with the head tilted back and put 5 drops of nasya in each nostril. Sniff
deeply, then remain lying for a minute or so, to allow the nasya to penetrate.

 
 GENERAL INDICATIONS GENERAL CONTRAINDICATIONS

Stiffness or pain of head, neck, or jaw Children (under 7)

Headache and Migraine Old age (over 80)
Sinus pain and congestion Pregnancy
Toothache, loose teeth, receding gums Menstruation
Hoarseness of voice Just before or after shower/bath
Twitching or drooping eyelids Indigestion or full stomach
Tingling sensations on face Diarhhea
Obstruction in throat Hunger or Hypoglycaemia
Uvulitis, Tonsillitis, Laryngitis, Pharyngitis Thirst or Dehydration
Speech disorders and loss of speech Exertion
Bell’s Palsy (facial paralysis) Intoxication
Goiter Physical exercise
Glaucoma Acute fever
Pituitary or space-occupying tumor Grief
Unconsciousness/fainting Just having done purgation or basti
Depleted sexual energy Same time as neti pot nasal cleansing 
Any disorders above clavicle area

Types of Nasya

1) Virechana (cleansing) nasya: dry powers or herbs are blown into the nose. Commonly used
substances include vacha (calamus), brahmi (gotu kola), and jatamamsi.

Specific Indications

Kapha disorders
Headache or heaviness in the head
Cold
Sticky eyes
Runny nose, sinusitis, chronic rhinitis
Hoarseness of the voice due to kapha
Cervical lymph congestion
Attachment, greed, or lust
Adenitis
Bacterial infections
Epilepsy
Skin diseases
 Drowsiness
Parkinsonism

Additional Contraindications
Hunger
Same day as rakta moksha therapy
1 month post-partum
Cough
Asthma
Facial paralysis
Emaciation

2) Bruhana (nutritive) nasya: especially good for vata dosha. Strengthening and tonifying
substances are administered through the nose. Commonly used substances are ghee, salt,
shatavari ghee, ashwagandha ghee, medicated milk, and various oils.

Specific Indications

Vata disorders
Vata-type headache or migraine
Dryness of voice
Dry nose or sinuses
Nervousness, anxiety, fear, negativity
Dizziness or emptiness
Ptosis
Bursitis
Stiffness of the neck
Cervical spondylosis
Insomnia

Additional Contraindications
Kapha disorders

3) Shamana (sedative) nasya: medicated decoctions, teas, the fresh juice of herbs, or medicated
oils specific to the dosha are used. Substances used include brahmi ghee (for pitta), vacha oil (for
kapha or vata), and tikta ghee (for vata or pitta).

Specific Indications

Pitta disorders
Blue patches on skin: infradermal hemorrhage
Alopatheia
Blephritis
Psoriasis
Additional Contraindications

None

4) Navana nasya: decoctions, fresh juices, and oils are mixed together and administered
according to the aggravated dosha. Used for pitta-vata or pitta-kapha disorders. Among the
substances used include brahmi juice (for pitta) and vacha juice (for kapha or vata).

Specific Indications

Aggravated doshas

Additional Contraindications

None

5) Marshya: A little ghee or oil is inserted into the nostrils with the little finger. This, along with
gentle massage, helps to relieve stress and opens the deep tissues. It can be done on a regular
basis or occasionally as desired.

Prati marshya: Marsha done on a daily basis.

Specific Indications

Stress
Dryness

Additional Contraindications

None

NRESOURCES
 Resources Overview

4 PANCHAKARMA HOME CLEANSE

by Vasant Lad, BAM&S, MASc

Dietary Recommendations during Your Home Cleanse

 SEASON AND DOSHA TIME TO DO PK KITCHARI INGREDIENTS TO
MONTHS ADD SPECIFIC TO SEASON

Summer: June, July, Pitta May – June good Add daikon radish, parsley, parsnips, dill,
August period for pitta water cress
cleansing

Fall: September, Vata Aug – Sept good Add sweet potato, carrots, green peas,
October, November period for vata kidney beans, grated horseradish
cleansing

Winter: December, Kapha Nov – Dec good Add ginger, cinnamon, cloves, cardamom,
January, February (accumulation) period for kapha raw onion, black pepper, winter squash
cleansing

Spring: March, April, Kapha Feb – Mar good period Add bitter greens, dandelion greens, leeks
May (provocation) for kapha cleansing

Since we are assessing three doshas and four to six seasons, this chart serves as a guideline. In
more northern climates or higher elevations, the winter period will be longer, accumulating more
kapha dosha, and this chart would work for that. But in say the southwestern US, the summer
and fall seasons would have more impact due to the hotter temperatures and people there would
be more likely to accumulate pitta dosha. Through observation, you can adjust the chart to locate
the change in season for you and then plan your home PK for the transition between the two
seasons.

Special Teas to Enkindle Agni

To help digest your kitchari meals when your agni is low due to PK, drink Agni Tea before meals and CCF
Tea after meals. CCF Tea is equal parts cumin, coriander, and fennel boiled for 5 minutes and strained for tea.
 

Copyright © 2011, Vasant Lad, MASc. All Rights Reserved. Reprinted with permission
from Ayurveda Today, Spring 2011, Vol. 23, No. 4.

5 VIRECHANA
by Vasant Lad, BAM&S, MASc
 Cleansing the Small Intestine
Virechana is the administration of purgative substances for the cleansing of pitta through the lower pathways.
Give virechana 3 days after vamana. If vamana is not indicated for a particular individual, then give virechana.
In either case, it is necessary to first do 3 days of internal oleation, and preferably both snehana (oleation) and
svedana (sweating), which are purva karma. Virechana cleanses blood toxins, the sweat glands, kidneys,
stomach, small intestine, colon, liver, spleen, and rakta vaha srotas.

SUBSTANCES FOR VIRECHANA  

Triphala Aloe Vera

Castor oil Bhumi Amalaki
Senna (Sona mukhi) Black Sesame Seeds
Sat Isabgol (Psyllium Seeds) Salt
Flaxseeds Dandelion root
Prunes Nishottara (Jaipal or Croton seed)
Raisins Yellow Thistle (Suvarnaskshiri)
Bran Kutki (Hellbore)
Cow’s milk Cow’s urine
Cow’s milk and 2 tsp. ghee Mango juice

Indications
Contraindications

Childhood
Old age
Acute fever
Diarrhea
Dehydration
 Debility and Weakness
Emaciation
Bleeding from rectum or lung cavities
Excess snehana or svedana
Foreign body in the stomach
Immediately after vamana or basti
Low agni or indigestion
Prolapsed rectum
Severe, chronic constipation with hard stool
Ulcerative colitis

10+8 AYURVEDA PAREEKSHA

https://www.indianmirror.com/ayurveda/ayurvedic-pareeksha.html

Ayurveda is the science of healthy and diseases free life. It is the knowledge that is abundantly
supplied with guidelines which, if followed scrupulously and regularly, would spare the agony of
diseases. The science of Ayurveda is based on sound principles of diagnosis which requires no
clinical or costly investigations which are beyond reach of the common and less privileged
person.

Ayurvedic science has discovered that a person falls sick only when there is an imbalance and
disproportionate ratio in Vata (air), Kapha (Phelgm) and Pitta (Bile).Sometimes we resort to
conventional methods for the most common and chronic disorders which can be easily
overcome by simple natural ayurvedic herbs without any side effects and they never go only by
the words of the patients but instead do a thorough examination of the body to find out the root
cause of the ailment in the patients. They mainly aim at finding the exact reason behind the
diseases rather than simply trying to suppress the symptoms.
Ayurveda thoroughly analyzes the total condition of a patient's body to find the underlying
symptoms instead of finding methods to suppress the symptoms. Thus to find out the real
source of the diseases ayurveda follows certain tests and examinations which are must. The
tests involved are characterized into three divisions. This is referred as 'rogi pariksha' in
Ayurvedic terms. The examination of the patient in three different stages helps in finding out the
possible reason for the diseases or the ailment in the patient's body. They are
Darsanam
In Darsanam the general characteristics of the patient's body is thoroughly studied by a keen
observation and inspection. During this session factors like age along with the total history of the
patient is recorded and only then it is further preceded.

Sparsanam
Sparsanam proceeds with three different techniques namely Palpation, Percussion and
Auscultation. In this division of examination observation is done by the touch method.

Prasnam
Here the patient is examined by questioning formally about his ailments and the symptoms or
the difficulties he/she is undergoing because of the diseases. This is done mainly to synchronize
or to cross verify the conclusion of the doctor with that of the patients.

Dasavidha & Ashtasthana Pareeksha

Apart from Darsanam, Sparsanam and Prasnam the Ayurvedic Pareeksha involves other
detailed examination to find the various causes behind the diseases. In the Dasavidha &
Ashtasthana Pareeksha there are certain factors which are taken into consideration during the
examination and tests carried out with the patients. The Dasavidha Pareeksha is done keeping
in mind with the fixed ten factors and the Ashtasthana Pareeksha considering eight factors.

Dasavidha Pareeksha

Regarding the structural and functional abnormalities of

Dooshyam
the body

Desham Geographical situation of the place where patient lives

Balam hysical strength

Kalam The season and climatic conditions

Analam The digestive system of the patient

Prakrithi The natural thridosha constitution of the body

 Vayas Age of the patient

Satvam Psychological strength of the patient

Sathmyam General & personal habits of the patient

Aharam Nature of food

Ashtasthana Pareeksha (Eightfold Examination)

Nadi Pulse

Moothram Urine

Malam Faecal matter

Jihwa Tongue taste

Sabdam Voice and speech of the patient

Sparsham Touch,skin and tactile sense

Drik Eyes and vision

Akrithi General body build

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