How Panchakarma works ?

 Panchakarma is Ayurveda's most powerful tool for returning the body and mind to their natural state of health and harmony. Its not just a Spa program or a general purgation therapy. It’s a very individualistic approach based on the body-type and the clinical signs the patients shows . It involves mainly three steps . First step is called as Purvakarma (Preparatory treatments ), Pradhanakarma( Main treatment) and third Paschyathkarma ( Post-operative / Rejuvenative treatment) .

 

First step involves Snehana ( oilation ) and Swedhana ( Fomentation) . Snehana is done both internally by taking medicated Ghee and externally with the help of massage . Snehana followed by Swedhana that involves Fomentation with which the adhered toxins will be brought to the near by exits and channels either gastrointestinal tract , skin pores , or through Urinary system .

Second step – Pradhanakarma have the five treatments that includes

1)Vamana: Therapeutic emesis for excess Kapha (e.g., congestion, allergies).

2)Virechana: Purgation therapy for excess Pitta (e.g., inflammation, skin conditions).

3) Basti: Herbalized medicated enemas, considered the most important for balancing Vata (e.g., anxiety, arthritis, constipation).

4)Nasya: Administration of herbal oils through the nasal passages to cleanse the head region (e.g., sinusitis, migraines).

 5)Raktamokshana: Bloodletting (rarely used today in its classical form) for blood-borne toxins.

 

The third step is Paschatkarma (Post-Treatment Phase): Often the most crucial, this is a gradual period of recovery and rejuvenation. A specific diet, herbal regimens, and lifestyle guidelines are followed to "reset" the digestion, nourish the newly cleansed tissues, and solidify the benefits.

 

What are toxins ?

In simple terms, it refers to substances—both from outside and inside the body—that can cause harm if they accumulate beyond the body's ability to neutralise and eliminate them. Ayurveda call it as “Ama” .

It can be Metabolic Waste (Produced Inside the Body like Urea,Ammonia, Billirubin etc ), Environmental & Dietary Toxins (Coming from Outside- Like heavy metals ,Persistent organic pollutants, food additives ,Herbicides,etc..) , Gut derived toxins like Lipopolysacharides (Bacterial endotoxins).

Most of these toxins after getting accumulated for a long time will trigger inflammatory responses that will hamper our system and leads to different diseases.  This process of accumulation of toxins mainly happen  with fat soluble toxins because water soluble toxins can be easily removed from the body through urine, sweat or through the anus . Fat soluble toxins escapes from this detoxification cycle and absorbed into the blood from the digestive system and carried to different part of our body and store into adipose tissues(fat tissue) . Its extremely difficult for our body to bring these toxins back. So,it will keep on accumulating and leads to different diseases. Ayurveda call these “Ama” as equal as Visha (Poison) . This can cause a wide range of diseases like a simple allergic response to some severe inflammatory diseases. In our contemporary lifestyle, we are consuming such toxins through our daily meals, we may not be able to follow systematic eating habits, we are living in a sedentary lifestyle, our sleep cycle may be irregular, may have high stress job or other personal matters, all these things are playing the role in our body’s detoxification mechanism in a harmful way. So, if our digestive system misses the first round of detoxification as a part of our normal digestion and let the toxins in, then it starts the cycle of this vicious toxicity.

 

Can we bring these toxins back to the exit routes to eliminate it ?  

Yes … But its difficult… Why ? In order to do that , we have to break these fats in which the toxins are adhered. Its called Lipolysis. But the problem is that the body initiate Lipolysis only when there is high calorific deficit or Energy demand.  Exercise, Sauna ,all these are helpful in this way to initiate the lipolysis that can bring back these toxins . But these toxins will not come to our gastrointestinal tract directly . We don’t have such a physiological channel ,instead ,it will go to our master chemist of  Detoxification – The Liver . Liver has a three staged mechanism to make fat soluble toxins into water soluble toxins and then it will expel through Bile. Once the bile is secreted to our intestine, then we can easily remove these toxins through our Anal route. 

Liver is not the only organ that have the ability to convert Fat soluble toxins into water-soluble toxins . Other organs like Lungs , Kidneys , Gut with the help of some specialised bacterias ,can also do this conversion in a limited manner .

 

How Ayurvedic Panchakarma works..?

First of all ,I repeat,  Panchakarma is not just a Spa Programe or Just an act of drinking some fruit-Vegetable Juices to proclaim yourself as Detoxified. As mentioned before,  It starts with Snehapana ( Intake of ghee in empty stomach).  Just like we all know that our body depends primarily on Carbohydrate metabolism for its energy demand, Not Fat metabolism though the fat gives 2.25 times more energy than carbohydrates per unit mass . Intake of Medicated Ghee on empty stomach and waiting till extreme hunger comes is actually a kind of Metabolic Shock to the body . This will initiate a signal that the system has to make use of the fats . The first response due to that signal will be from none other than liver by increased secretion of bile to the Gastrointestinal tract . Remember ,Bile is a medium through which the already converted water-soluble toxins get released into the intestine for its removal..

 

There is one important question here.  How did the accumulated fatty toxins (Ama) from different parts of our body reach the Liver? ?  The answer is the reason why we do Abhyanga (Massage) and Steambath. That’s why these two procedures are integral to all the other provedures of Panchakarma.  Abhyanga and steam bath  will stimulate  Lipolysis ( breakdown of fats) that drive these toxins to blood by activating Systemic circulation as well as Lymphatic circulation. Once the blood detects the toxins with the help of chemo receptors , all these Toxic blood will rush to our master chemist -Liver. Liver will detoxify it and gives it to the Intestine.  Once the toxins reach intestine, we can remove it by creating forceful lower peristalsis with multiple spells of Vasti and Virechana. The similar action will initiate in lungs also that will cause excess mucous secretion as an act of toxin expulsion.  These Toxins we can expel through another  Panchakarma procedures called Nasya (Nasal drops ) or through Vamana(Emesis) if the excess mucous comes from stomach or upper respiratory tract level.  Still there will be some toxins that bypassed our detox Net that may still circulate in the blood stream.  Before it get accumulated to some part of the body along with fats,  we have to remove some quantity of blood from the body carefully from the areas where there us more chance of blood pooling, Eg;Legs. A portion of water soluble toxins will be also removed through sweat during the course of the course of the procedure.   

 

After the procedure , our body will be definitely tired.  Its digestive fire might have diminished. There will slight weight loss.  But, these are not problematic signs. These are ideal signs of efficient  Panchakarma.  Next step is to give some restorations or rejuvenative medicines with proper diet recommendations so that the body will bounce back to its normalcy with more power, enthusiasm and Happiness. 

Abhyanga (Ayurvedic Oil massage)

 

According to Ayurveda , the Sneha(oils) are fundamental part of the human body. The word “Sneha” mentioned in this context is not simply the literal fats, but  can be interpreted as moisture content, Sebum , Synovial fluids, mucous secretions from glands , Myelin sheath of nerve, Phospholipid layers of cell membranes, Cerebrospinal fluids, and Adipose tissues . If we start loosing this oily factor, the body will function like an engine without lubricants . Friction thus created will be developed as different diseases ,starting from a rough skin to some severe degenerative conditions. So, Ayurveda suggests two ways to meet up the body demand for such sneha. One by consuming medicated fats and second by a procedure called Abhyanga .

 

The magic of Abhyanga lies in its multi-faceted action:

1. Nourishes the Skin: The warm oil penetrates deep into the dermis, combating dryness, improving skin tone and elasticity, and slowing the signs of aging. It’s the original, chemical-free moisturizer.

2. Calms the Nervous System: The rhythmic, self-directed strokes send direct signals of safety and care to the brain. This downregulates the stress response (fight-or-flight) and activates the rest-and-digest (parasympathetic) system.

3. Enhances Circulation & Detoxification: The massage stimulates blood and lymph flow, helping to nourish tissues and flush out metabolic wastes more efficiently.

4. Lubricates the Joints: The oil seeps into the subtle channels (srotas), including those around the joints, promoting flexibility and ease of movement—a boon for stiff, modern bodies.

5. Grounds the Mind & Emotions: In Ayurveda, the skin is linked to the sense of touch and the element of earth. The firm, grounding touch of self-massage is profoundly stabilizing for a racing mind (Vata) and soothing for fiery emotions (Pitta).

 

Whether you seek relief from anxiety, deeper sleep, softer skin, or simply a moment of unwavering peace, the ancient wisdom of Abhyanga awaits…

Doshas in Ayurveda, its balance ,imbalance and Management

  

The word ‘dosas’ is derived from the sanksrit root “ Dhush Vaikruthye” ,meaning that which is susceptible to vitiation. Description about Dosas are qualitative and functional and hence can not be quantitativelydetermined.  They are three in number ,namely Vata,Pitta ,and Kapha. The state of equilibrium of these dosas results in good health and disequilibrium will lead to diseases.  

 

A person‘s dosas are understood by the fundamental qualities they poses. Qualities of Vata dosa Dryness, Lightness, Cool, Rough, Subtle , and Mobility.  Qualities of Pitta dosas are Unctuous, Sharp, Hot , Foetid, Flowing , and Liquidity . Kapha dosa constitutes the qualities like Heaviness, Slowness, Fineness, Stickiness, and Stability.  When these qualities are seen in our body with respect to the physical as well as physiological levels, we assume the dosas and its disbalances . 

 

There are certain signs that are visible in general when a person has got some disbalance of their dosas. Increase of Vata will cause Emaciation, black discolouration, desire for heat , tremor, abdominal distention, constipation, lack of sleep ,sensory disturbances,  incoherent talks, giddiness , and sadness . Increase of Pitta will lead to discolouration of stool, urine ,eyes and skin . It also causes excessive hunger, thirst ,burning sensation, and insomnia . Increased Kapha causes dyspepsia, hyper salivation, heaviness, laziness , pallor, coldness, laxity of organs, dyspnoea , cough, excessive sleep.  Dosas will also decrease than normal and shows another set of complaints.  Vata in its decreased state causes weakness of motor functions of the body. It makes the speech feeble , decrease the body movements, loss of consciousness,  and also leads to the increase of kapha. Decrease of Pitta causes weakness of digestion ,cold feeling , and loss of body complexion. Decrease of kapha produces Giddiness, empty feeling in the joints and palpitation. Understanding these changes in different bodily systems will give the clue about dosas that worked under the pathogenesis.  The diseases will be always have the disbalance of more than one dosas in more than one systems . So, the treatment should be in a way that one approach should never be self contradictory to each other in terms of dosas.  

 

 

 

General line of Treatment. 

 

For Vata dosha disbalance ,the following treatments are mentioned in Ashtangahrydhaya un general . 

 

1.External Snehana (Abhyanga): Anointing the body with warm, Vata-pacifying oils like sesame oil.

· Internal Snehana (Snehapana): Drinking medicated fats, especially ghee (ghrita), which is considered the best substance for pacifying Vata due to its penetrating and unctuous qualities.

 

 

 

2. Swedana (Fomentation/Sudation /Steam Therapy)

 

This is used after oleation to counter the cold quality of Vata. Heat is applied to the body to loosen toxins and soothe Vata-related pain and stiffness.

 

· It involves various methods of applying steam or heat, such as steam boxes, poultices, or sitting in a warm room.

 

3. Vasti (Medicated Enema)

 

This is stated as the most important therapy for Vatadisorders. The colon is considered the main seat of Vata, and Basti directly targets it.

 

· Anuvasana Basti (Oil Enema): An enema with medicated oils. This is highly nourishing and is the primary pacifying therapy for Vata.

· Niruha/Asthapana Basti (Decoction Enema): An enema with herbal decoctions. This cleanses the colon of excess Vata while also providing nourishment.

 

. Dietary Guidelines.

The diet should embody the opposite qualities of Vata.

· Taste Preference: Sweet ,Sour,and Salty tastes pacify Vata.

· Food Qualities: Warm, moist, well-cooked, and unctuous foods.

· Examples: Warm milk, cream, butter, ghee, nuts, seeds, whole grains like rice and wheat, root vegetables, and sweet ripe fruits.

 

 

Main Treatment Modalities for Pitta Imbalance

 

1..Virechana (Therapeutic Purgation)

This is considered the primary and most important treatment (Shodhana) for Pitta.

As Pitta primarily resides in the small intestine, its main seat, Virechana uses mild purgatives to gently flush out excess Pitta and toxins (ama) directly from the gastrointestinal tract, clearing the channels of its heat and acidity.

· Herbs Used: Avipattikar churna, Triphala, Nishottar, Trivrit leha. Etc.

 

2. Snehana (Oleation) & Swedana (Fomemtation/Steam therapy ) - with Caution

 

· “Snehana”: While oleation is primary for Vata, for Pitta it is done with cooling oils like coconut oil or olive oil, and only in minimal amounts as a preparatory step for Virechana. Internal oleation with ghee is highly valued because ghee is cooling and acts as a vehicle to carry Pitta-pacifying herbs deep into the tissues.

· Swedana: Sweating therapy is generally avoided or used minimally for pure Pitta conditions because heat aggravates Pitta. If used, it is a very mild, short sweat to open the channels before Virechana.

 

3. Tikta Ksheera Basti (Medicated Enema with Bitter Herbs)

While Basti is the main treatment for Vata, certain types are used for Pitta. Enemas prepared with decoctions of bitter herbs (like neem, patola) and milk (ksheera) have a strong cooling and pacifying effect on the system, especially when Pitta is located in the lower GI tract.

 

4. Dietary Recommendations

This is a critical pillar of Pitta management.

Taste Preference: Sweet, Bitter, and Astringent, tastes pacify Pitta.

· Tastes to Avoid: Sour,Salty, and Pungent tastes, as they are heating.

· Food Qualities: Cool or warm (not hot), dry or moderately oily, and heavy.

· Favorable Foods: Sweet fruits (grapes, melons, mangoes, sweet ripe oranges), vegetables (cucumber, zucchini, broccoli, leafy greens), whole grains (barley, rice, oats), dairy (unsalted butter, ghee, milk), and legumes (mung beans).

· Foods to Avoid: Hot spices, fermented foods, vinegar, alcohol, fried foods, excessive salt, and sour foods like yogurt and citrus fruits.

 

 

Main Treatment Modalities for Kapha Imbalance are , 

 

1. Vamana (Therapeutic Emesis)

This is considered the primary and most important purification treatment for Kapha.

 

In principle,  Kapha primarily resides in the stomach and lungs. Vamana uses emetic herbs to directly and forcefully expel excess Kapha and toxins (ama) from the upper gastrointestinal tract and respiratory system. It clears congestion and heaviness from the core.

· Herbs Used: Madanaphala (Randia dumetorum), Yashtimadhu (Licorice), and salt with honey water etc.

 

2. Nasya (Nasal Administration of Medication)

 

· This is a key treatment for Kapha disorders in the head, such as sinus congestion, headaches, and lethargy. For Kapha, stimulating and drying nasal therapies are used, often with powders (pradhamana nasya) or sharp medicated oils.

· Herbs Used: Vacha (Calamus), Pippali (Long Pepper), Maricha (Black Pepper) etc 

 

3. Rookshana (/Udwarthanam Drying Therapy)

 

This is a general principle applied throughout Kaphatreatment. It involves therapies that absorb moisture and reduce oiliness.

 

· Dry Massage (Udvartana): Massaging the body with dry herbal powders (e.g., chickpea flour, triphalapowder) instead of oil. This is excellent for countering Kapha's oiliness and heaviness, and it helps manage weight.

· Physical Activity: Exercise is a form of rookshana as it creates internal heat and dries moisture (sweat).

 

4. Swedana (Fomentation/Sudation Therapy)

 

· Unlike for Pitta, Swedana is highly recommended for Kapha to counter its cold quality. Strong, penetrating heat helps to liquefy and mobilise stagnant Kapha, making it easier to eliminate.

· Types: General steam (bashpa sweda) or intense sweating therapies are used.

 

5. Dietary Recommendations.

 

This is a critical pillar of Kapha management.

 

· Taste Preference: Pungent, Bitter ,and Astringent tastes pacify Kapha.

· Tastes to Avoid: Sweet, Sour ,and Salty tastes, as they are heavy, moist, and increase Kapha.

· Food Qualities: Light, dry, and hot.

· Favourable Foods: Light grains (barley, corn, millet), legumes, most vegetables (especially leafy greens, broccoli, cauliflower), pungent spices (ginger, black pepper, chili, turmeric), honey (the only recommended sweetener), and light fruits like apples and pears.

· Foods to Avoid: Heavy or moist foods like dairy (especially cheese and yogurt), wheat, sweet fruits (like bananas and dates), fatty or fried foods, and excessive meat.

 

 

These are just a general introduction to the treatment protocols of Ayurveda.  Most of the diseases have disbalances of all the three doshas in various systems in the body.  So, its important to consider all the aspects, otherwise the treatment will be counter productive.  Systematic balancing can be achieved only by following a personalised treatment plan from a qualified ayurvedic physician.