Panchakarma
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Ayurvedic
Medicine |
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Prakriti /
Constitution
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Ayurvedic
Medicine |
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Panchakarma
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Ayurvedic
Medicine |
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Basics
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Panchakarma-the detoxification process- is a comprehensive system of
knowledge and practices to purify the body of toxins and restore it to
balance with natural law.
As more and more people are falling prey to the adverse effects of
stress, there are more and more complaints of diseases like poor
digestion, lack of sleep,
allergies,
chronic fatigue, cancer, heart
diseases, diabetes,
osteoporosis etc. All these diseases are complex
disorders that accumulate over a lifetime.
The most deeply seated toxins that causes diseases are heavy and sticky,
lodging tissue layer. Panchakarma permanently eliminates these toxins
from the body, allowing healing permanently of tissues, channels,
digestion and mental functions.
In Ayurveda, the treatment is broadly divided into two categories:
Shodhana and Shamana. Curing the disease by cleaning out the impurities
is called Shodhana chikitsa, which is the principle of Panchakarma. It
involves the clearing of vitiated
doshas (vata,
pitta and
kapha) which
cause the disease and thereby the restoration of equilibrium of
doshas.
Panchakarma includes the following five purification therapies:
Vamana (emesis), Virechana (purgation), Basti (enema), Nasya (nasal
insufflation) and Raktamokshana (blood-letting).
In this module, we have provided an in depth information about
Panchakarma for our users' benefit. The details of pre-procedures, main
procedures like vamana, virechana, nasya, basti, raktamokshana and
post-procedures have been provided.
The five purification measures
Panchakarma is a type of treatment in Ayurveda, which means five
actions, where pancha means five and karma means actions. By five
actions or purification measures, the body is purified of specific
vitiated doshas and ama (undigested food products), which form as a
result of metabolic processes. Each process has a specific action to
bring about a specific imbalanced
dosha in balanced state and thus
preventing further disorders.
Panchakarma constitutes the foremost sodhana chikitsa or purification
therapy as it reverses the disease mechanisms, which carry toxic waste
products from the digestive tract into the tissues of the body. It is
designed to draw ama (undigested food products) out of the dhatus (body
tissues), return it to the digestive tract and expel it from the body.
Importance of shodhana therapy
Doshas do at times get aggravated after treating them with fasting and
digestive drugs. But there is no chance of relapsation, if we treat the
vitiated doshas by means of elimination therapy.
So, shodhana therapy is definitely superior to palliative measures.
Panchakarma consists of the following five purification therapies:
The Process
The three stages of
Panchakarma
Panchakarma is a three-phased process consisting of:
Poorva karma (Pre-procedure)
It is the first phase of
Panchakarma, which comprises of essential
preliminary procedures like preparation of the patient, preparation of
the medicines and the equipments necessary for the further procedures.
The purpose of poorva karma is to unload stored toxins i.e. to loosen
the ama and move it out of deep structures into the gastro-intestinal
tract, to be further eliminated by the Panchakarma.
Any attempt to administer
Panchakarma without proper preparation of
patient may not give the desired response and may also harm the body.
Pradhana karma (Main procedure)
Pradhana karma (main procedure) is the second stage of Panchakarma,
which consists of the actual administration of the five purification
therapies. These five therapies are popularly known as
Panchakarma,
viz., vamana (emesis), virechana (purgation), basti (enema), nasya
(nasal insufflation) and raktamokshana (blood-letting).
Paschat karma (Post-procedure)
This is the last phase of
Panchakarma, which is carried out after the
main purification process and assures the restoration of digestive
enzymes. The post procedures are designed to nourish, strengthen and
balance the newly cleansed dhatus. It describes the measures employed
after the main treatment, such as diet, medicines and daily routine.
Note
These procedures must be performed under strict medical supervision and
advice.
Poorvakarma
Poorva karma includes the preparatory measures like snehana (oleation)
and Svedana (fomentation) before the main specific treatment.
According to the Ayurvedic principles, the
Panchakarma should not be
used until after the administration of oleation and fomentation, which
make the body soft and disintegrate the morbid
doshas.
Poorvakarma is of three types:
Pachana karma
Sneha karma
Sweda karma
- Pachana karma (Digestion therapy)
Before going to proceed for main therapeutic procedures, pachana karma
is essential to digest the undigested substances by means of Deepana and
Pachana drugs like, peya (liquid), choorna (powder), quatha etc.
Sneha karma (Oleation therapy)
Through this process, the body becomes oily and soft. It softens the
vitiated doshas. In this therapy, oil is administered through different
types of foods, enema or massage.
Digestion improvement, soft stools, lightness of the body and lack of
desire for oily substances are the signs of properly administered
oleation.
Sveda karma (Sudation therapy)
Procedure to cause perspiration is known as svedana vidhi (sudation
therapy). It promotes the penetration of snehana inside the body. Due to
svedana, toxins are expelled in form of sweat.
It is a therapy, which removes the stiffness, heaviness, coldness and
inflammation of the body.
This process liquefies vitiated
doshas to bring them in the kostha.
After the oleation therapy, the patient should be administered
fomentation.
- Snehana (Oelation Therapy)
Snehana is the pre-procedure of
panchakarma therapy. It makes the body
oily and soft. It softens the vitiated
doshas.
Procedure
It can be done in two ways: externally (bahya snehana) and internally
(abhyantara snehana).
In external oleation, massage is done with oily substances and
medicated herbs.
In internal oleation, unctuous substances are taken internally.
Benefits
It increases digestive power.
There is a feeling of lightness in the body.
Skin becomes smooth.
Improves circulation.
Speeds up the elimination of waste products.
Relieves
fatigue.
Improves the eyesight.
Induces sleep.
Reduces ageing.
Gives the strength to the joints.
Bahya snehana
Bahya snehan is external application of oil or medicated pastes. It can
be given to healthy as well as unhealthy persons to maintain positive
health.
It is done by various methods
By massaging the body gently in the downward direction after applying
the oil or medicated pastes.
In the opposite direction of hair follicles with high pressure or
normal pressure.
By applying the pressure with the help of foot.
Pouring of medicated oils, decoctions, and milk in a systematic way.
Holding the liquid drugs in buccal cavity for a specific time without
moving the drug. Anointing the head with medicated oil.
By keeping medicated ghee on the eyeballs for a specific period.
By filling the ears with medicated oil.
Indication of Oleation therapy
Oleation therapy, in general, is prescribed for those:
who are to be given fomentation or elimination therapy.
whose skin is rough.
suffering from diseases due to the vitiation of
vata.
who indulge in physical exercise, wine and women.
who suffer from mental strain.
suffering from neurological disorders and eye diseases.
It is also given to old persons, children and debilitated persons.
Period required for administration
The maximum period required for administration of oleation therapy is
seven days.
Minimum Period required is three days.
Signs and symptoms
Signs and symptoms of proper oleation
Good digestive power.
Unctuous and soft stools.
Softness and smoothness of the body.
Feeling of lightness in the body.
Signs and symptoms of over oleation
Paleness.
Heaviness.
Dullness.
Undigested condition of stools.
Drowsiness.
Anorexia.
Nausea.
Aversion to take food.
Passing stools many times.
Discharges from the mouth, nose and rectum.
Treatment of over oleation
Usnodaka (warm water) is the first treatment for over oleation.
Vamana (emaciation) and svedana (sudation) could be given.
Pippali, Triphala and madhu (honey) should be given for over oleation.
Signs and symptoms of under oleation
Dry stools.
The
vata not becoming regulated.
Weak digestive power.
Roughness and dryness of limbs.
Burning sensation in the chest.
Weakness.
Roughness of the skin.
Treatment of under oleation
For the treatment of under oleation, unctuous substances should be
given to the patient.
Oleation should be repeated.
Pre-oleation management
A day preceding to the administration of oleation therapy, one should
take food in proper quantity.
The food should be liquid, hot and anabhisyandi (that does not
obstruct the channel of circulation).
It should neither be too unctuous nor a mixture of two opposite
qualities (hot and cold).
Oleation before elimination (Samshodhana)
Regarding the elimination (samshodhana) type of oleation therapy, it
should be administered when the food taken in the preceding night has
been well digested.
Elimination type of oleation therapy is to be administered in the
morning hours when the food taken in the preceding night is well
digested.
The main object behind the elimination therapy is to excite the
doshas
in the body.
Oleation before alleviation (Samsamana)
When hungry, one should take alleviation (samsamana) type of oleation
therapy during lunch hours.
The alleviation type of the therapy suppresses the
doshas.
If the alleviation type of oleation therapy is administered in the
morning when there is no intensity of appetite, the unctuous substance
will not get digested and it will adhere to the lumen of the intestine.
This will excite the doshas, rather than suppress them. Therefore,
alleviation type of oleation therapy should be administered during lunch hours.
Dosage of Oelation
The classification of dosage of the snehana (oleation therapy) is based
on the period of digestion of the unctuous substance.
Maximum dose: The quantities, which take 24 hours for their digestion.
Moderate dose: The quantities, which take 12 hours for their
digestion.
Minimum dose: The quantities, which take six hours for their
digestion.
Who should take the maximum dose?
The following people should take the maximum dose of oleation:
People who are in the habit of taking adequate quantity of unctuous
substances.
People having resistance to hunger and thirst with strong power of
digestion.
Those suffering from abdominal tumor, insanity, dysuria, snake bite
and visarpa (skin diseases characterized by an acute spread).
People who have problem of hard stools.
Benefits of maximum dose intake
If properly administered, it alleviates all ailments instantaneously;
it eliminates the doshas.
It pervades all the systems of the body.
It strengthens and rejuvenates the body, sense organs and mind.
Who should take the moderate dose?
People suffering from eruptions.
People suffering from
boils, pimples, itching, papules and obstinate
skin diseases including leprosy.
People suffering from obstinate urinary disorders and
gouts
(vatarakta).
Those who cannot eat much.
Those who are of relaxed bowels.
People with moderate strength.
Benefits of moderate dose intake
It requires the least precautions.
It stimulates libido and gives strength.
This is least harmful and can be continuously administered for a long
time.
Svedana (Sudation)
Procedure to cause perspiration is known as sudation therapy. It
liquefies vitiated doshas and brings them in the koshtha (alimentary
canal).
It promotes the penetration of oil inside the body. Due to svedana,
toxins are expelled in form of sweat.
It removes the stiffness, heaviness, coldness and inflammation of the
body.
After the oleation therapy, the patient should be administered
fomentation.
Procedure
Sudation should be done in a room devoid of heavy breeze.
The patient should have been lubricated both internally and
externally.
It should be done after the digestion of food.
It should be either mild, moderate or heavy depending upon the
disease, the land (habitat) and the season.
Benefits
Causes softness and brilliance of the skin.
Sudation therapy increases the digestive capacity.
It also increases the desire to eat and cleanliness of the orifices.
It removes laziness and stupor.
It makes the stiffened joints move quickly.
If administered after oleation, fomentation brings
vata under control
and thereby facilitates the elimination of faeces, urine and semen.
The
doshas which have been lubricated and localized in the alimentary
tract, in the various tissues and channels, in the extremities and bones
get liquefied by sudation therapy and are brought into the alimentary
tract to be eliminated (out of the body) by appropriate purification
therapies.
Importance of sudation
Even when dry pieces of wood bend by means of application of oleation
and sudation, then how can living beings not be benefited.
Specificity of sudation
Sudation is considered efficacious.
Sudation should be well medicated which is neither too hot nor too
mild.
It should be applied to the proper region with due consideration of
the disease, season and vitality of the patient.
Indication of Svedana (Sudation)
Sudation is done in following conditions
Pratisyaya (Coryza)
Cough (kasa)
Hiccup (hikka)
Dyspnea (swasa)
Heaviness of the body (angagraha)
Earache (karna sula)
Neck pain and
Headache (manya sula and sira sula)
Hoarseness of voice (swar bheda)
Spasmodic obstruction in the throat (gala graha)
Paralysis of the face (ardita)
Paralysis of one limb (ekanga ghata)
Paralysis of whole body (sarvanga ghata)
In flexures of the body (vinamaka)
Distension of the abdomen (koshtha anaha)
Constipation (vibandha)
Suppression of urine (mutra ghata)
Uijrmbhaka (pendiculation)
Stiffness of sides (prasva graha)
Stiffness of back (prustha graha)
Stiffness of waiste (kati graha)
Stiffness of abdomen (kukshi graha)
Sciatica (grudhrasi)
Dysuria (mutrakrucha)
Enlargement of scrotum (undaki vridhi)
Pain and stiffness of feet (pad graha)
Pain and stiffness of knee (janu graha)
edema (sotha)
Neuralgia of upper and lower extremities (khalli)
Excessive heaviness and numbness
Contra-indication of Svedana (Sudation)
The following people should not take the fomentation therapy
The pregnant women.
People who have taken too much astringent and
alcohol.
Those suffering from hemothermia (raktapitta) and
diarrhea.
People who have paittika type of obstinate urinary disorder,
especially diabetes mellitus.
People who have inflammation and prolapse of the rectum.
Those having paittika constitution and dry skin.
Those who are fatigued, unconscious, fatty, thirsty and hungry.
The person who is angry and excited.
Those suffering from
jaundice and abdominal diseases.
Those who are weak and dried up.
And whose ojas has been reduced.
Contra-indicated body parts for fomentation
Fomentation should not be administered over:
Testicles
Heart
Eyes
Even if it is very necessary to administer, it should be of mild type.
Over groins it should be moderate.
Signs and Symptoms
Sometimes the sudation is not given properly i.e. the over or
insufficient sudation is given. There are signs and symptoms to make out
whether the process is insufficient, proper or over done.
The signs and symptoms of proper sudation (Samyaga svedana)
Sudation is to be administered until there is
Complete recovery from
Cold,
Colic pain, stiffness and heaviness of the body, and tenderness and
sweating appear.
The signs and symptoms of over sudation (Atisvedana)
Aggravation of
Pitta.
Fainting and prostration of body.
Thirst and burning sensation.
Weakness of the voice and limbs.
The signs and symptoms of insufficient sudation
Coldness and pain are not relieved.
Patient feels stiffness and heaviness.
Roughness of the body.
Treatment
The sudation should be continued till the patient gets proper symptoms.
Degrees and Qualities of Svedana (Sudation)
Depending upon the type of disease, different types of sudation are
prescribed. Drugs to be used for fomentation are unctuous or
nonunctuous, depending upon the nature of the disease to be treated.
If the disease is of serious type, the season is very cold and the
body of the patient is very strong, then strong sudation is prescribed.
If the disease is mild, the season is moderately cold and the body is
weak, then mild fomentation is prescribed.
If all are of moderate nature, then moderate sudation is prescribed.
In diseases caused by
vata, combined with
kapha,
vata alone or
kapha
alone, the sudation to be applied should be prepared from drugs of
unctuous and coarse qualities, unctuous quality alone or coarse quality
alone, respectively.
If the vata is accumulated in amashaya (stomach), then the sudation
with drugs having coarse qualities should precede the prescribed
sudation for vata.
On the other hand, if
kapha is accumulated in the pakvasaya (colon),
sudation with drugs having unctuous qualities should precede the
prescribed fomentation for
kapha.
Pradhana karma (main procedure)
Pradhana karma (main procedure) is the second stage of Panchakarma where
the main treatment is given. It includes five types of main operative
procedures, which are popularly known as
Panchakarma,
Vamana karma (emesis)
Virechana karma (purgation)
Basti karma (enema)
Nasya karma (nasal insufflation)
Raktamokshana (blood-letting)
Vamana karma (Emesis therapy)
Vamana is the procedure to eliminate the waste product (vitiated
dosha)
through the upper gastro-intestinal track. It is the cleansing
procedure, which expels doshas, particularly the augmented
kapha.
Virechana karma (Purgation therapy)
This karma aims to eliminate
doshas that cannot be removed by Vamana
karma such as the kidneys, lungs and sweat glands.
Elimination of vitiated doshas through rectum is called Virecana. It
cleanses the small intestine and the organs, which are pitta dominant.
For example, the liver and the gall bladder in the mid-zone of the body.
Nasya karma (Nasal insufflation)
Administration of the drug through nostrils is known as Nasya. karma.
It cleanses and opens the channels of the head and improves the
oxygenation (prana) which has direct and highly beneficial influence on
brain functioning.
Basti karma (Enema therapy)
Basti karma is the most powerful of the five main procedures of
Panchakarma.
Basti is a type of treatment for augmented
vata dosha. In this type of
treatment, medicated decoction and oils are passed through the anus,
with the help of specially made basti instruments. Properly administered
basti helps to rejuvenate the body, provides strength and long life, and
improves the complexion and the voice.
Raktamokshana (Bloodletting)
Rakta means blood and mokshan means to remove, so raktamokshana means
removing vitiated blood from the body. It is the localized treatment not
considering the vitiation of the doshas.
It is done either by metal instruments or by using leeches or vegetable
gourds.
Vamana (Emesis) Therapy
Vamana is the procedure to eliminate the waste product (vitiated
dosha)
through the upper gastro-intestinal track. It is the cleansing
procedure, which expels doshas, particularly the augmented
kapha.
By this treatment, vitiated kapha dosha is totally eliminated from its
roots (stomach) through the mouth.
Due to the total removal of vitiated
dosha, chances of reoccurrence of
the disease becomes remote.
Principles of Therapeutic Emesis Therapy
Due to oleation, the vitiated
dosha becomes soft.
Due to sudation, these doshas get liquefied.
These liquefied doshas enter into the minute channels.
Action of emetic drugs:
o Ushna quality: Liquefies the doshas.
o Tikshna, vyavi and vikashi: Allows the drug to penetrate deep into the
body for breaking down the vitiated dosha, so that it can enter the
minute channels and come out.
From these minute channels, liquefied
dosha reach in the kosthas
(abdominal cavity: stomach).
From there, the dosha is forced out of the body from the mouth.
Indications of Vamana (Emesis) Therapy
Poisoning
Indigestion
Acute
fever
Tuberculosis
Diarrhea
Bleeding rectum
Cholera
State of
Colic with
constipation
Salivation
Poor digestion
Insanity
Epilepsy
Bronchitis
Asthma
Diabetes
Skin diseases
Anorexia
Anemia
Stomatitis
Obesity
Rhinitis
Pharyngitis
Tonsillitis
kapha dominant diseases
Contra indications of Vamana (Emesis) Therapy
Heart disease
Malnourished
Children
Old persons
Debilitated person
Pregnancy
vomiting
Urine retention
Tuberculosis
Thirst
Hunger
Headache
Virechana Karma (Purgation Therapy)
This karma aims to eliminate
doshas that cannot be removed by Vamana
karma such as the kidneys, lungs and sweat glands.
Elimination of vitiated doshas through rectum is called
Virechana. It
cleanses the small intestine and the organs, which are pitta dominant.
For example, the liver and the gall bladder in the mid-zone of the body.
It may be given three days after emesis therapy, or given directly when
emesis is not indicated. But it must be practiced only after Purvakarma has been
administered.
The drugs used for virechana karma (purgation therapy) vitiate the
doshas and bring them into the koshta (abdomen). From there, they are
expelled through rectum.
Purgative drugs are dominant in earth and water elements and have
downward movement.
The synonyms of virechana are rechan and praskandhan.
Following are the diseases for which
Virechana karma can be given
fever
Skin diseases
Haematemesis
Epistaxis
Fistula
Hemorrhoids
Splenic disorders
Tumors
Goiters
Lymphadenitis
Artificial poisoning
Cholera
Retention of urine
Worm infestation
Anemia
Headache
Burning eyes
Lacrimation
Asthma
Jaundice
Cough
Rhinitis
Epilepsy
Insanity
gout
Gynecological disorders
Seminal disorders
Ascitis
Anasarca
Elephantiasis
Leprosy
Diabetes
Inguinal swelling
Intestinal torpor
Cardiac disorders
Rheumatic conditions
Anorexia
vomiting
Purgative drugs
Qualities of purgative drugs
Ushna (hot).
Tikshana (pungent).
Sukshma (minute).
Vyavayi (penetrating agent).
Vikasi (tissue destructive agent).
Purgative drugs have the dominancy of Prithvi (Earth) and Jala (Water)
mahabhutas.
Herbs used
Shyama (Operculina turpethum)(Black).
Trivrit (Operculina turpethum)(Red).
Chaturangala (Cassia fistula).
Tilvaka (Symplocus racemosa).
Sudha (Euphorbia nerifolia).
Saptala (Acacia sinuta).
Sankhini (Clitoria ternatia).
Danti (Baliospermum axillare).
Dravanti (Croton tiglium).
Contra indications of Virechana (Purgation Therapy)
Delicate persons
Anal injury
Prolapse rectum
Bleeding per vagina, urethra and rectum
Fasting
After niruha basti
Indigestion
Acute
fever
Injury
Excessive oleation
Excessive dryness
Emaciation
Children
Old persons
Weak persons
Tired persons
Excessive coitus
Excessive study
Over exercise
Pregnancy
Tuberculosis
Diarrhea
Just after meal or drinking water.
Intestinal obstruction
Perforation
Miscarriage
Alcohol
addiction
Basti karma (Enema Therapy)
Basti karma is the most powerful of the five main procedures of
Panchakarma. The literal meaning of basti is bladder.
It expels the vitiated doshas rapidly and easily from the body and also
causes reducing as well as nourishing the body very fastly. In ancient
times, bladders of various animals were used to administer this
procedure.
Basti is a type of treatment for augmented
vata
dosha. In this type of
treatment, medicated decoction and oils are passed through the anus,
with the help of specially made basti instruments. This procedure pulls
out the vitiated doshas, especially vayu from pakvashaya i.e. the lower
gastro-intestinal tract.
Properly administered basti helps to rejuvenate the body, provides
strength and long life, and improves the complexion and the voice.
Frequency
Classification of basti (enema) on basis of frequency and duration
On basis of frequency and duration, basti is classified into three parts
which are as follows:
1) Karma basti
It comprises a month- long treatment and is given to people who have
vata- dominant
constitutions and disorders.
It begins with anuwasan basti and alternates with niruha basti for 25
consecutive days, i.e. 12-12 alternate asthapana anuvasana basti.
The 30-day program ends with five days of anuwasan basti.
Therefore, total 30 number of basti should be given in a course.
2) Kala basti
It lasts for 15 days and is used mainly for patients with
Pitta-dominant
constitutions and
vata disorders.
It starts with anuwasan basti, which then alternates with niruha basti
for 10 or 12 days and concludes with three or five days of anuwasan
basti i.e. total 11 niruha and anuvasan basti are given alternately.
Therefore, total 15 basti should be given in a course.
3) Yoga basti
It is given for eight days and usually suits
kapha patients with
vata
diseases.
It first gives anuwasan basti, and alternates three times with niruha
basti i.e. three asthapana anuvasan basti alternately.
It concludes with two days of anuwasan basti.
Therefore, total eight basti should be given in a course.
Function
Classification of basti (enema) on basis of function
1) Shodhana basti (cleansing enema)
It cleanses and detoxifies the body.
It is divided into strong treatment that penetrates in to deeper
dhatus and mild treatment, which work on the superficial level of
dhatus.
2) Utkleshana basti
It means promoting secretions in the colon.
It promotes the liquefaction of ama and mala (waste products) in the
colon.
It helps the colon expel them. Similar to western enemas, this basti
increases colonic peristalsis, producing rapid elimination of the
faeces.
3) Shamana basti
It is palliative.
It restores dosha performance, reduces symptoms and allows the patient
to feel better.
In cases of rectal bleeding or dysentery, the immediate objective is
to stop the symptoms.
For example, pichha basti, which uses astringent herbs, shrinks the
capillaries or srotas and stops the bleeding or peristalsis, ending the
symptoms.
4) Lekhana basti
Lekhana means scraping agent.
It means strong and penetrating. It resembles sodhana basti, but is
stronger in its effects and generally much larger in volume.
It is particularly useful for
kapha
and meda dhatu disorders, where
excess fatty substances have accumulated. The accumulated substances
need to be eliminated, as in
Obesity and
atherosclerosis.
5) Bruhan basti
Bruhan means nourishment.
Highly nutritious substances are used to balance and strengthen the
dhatus and their
metabolism, and increase the body's resistance to
infectious diseases.
Anuwasan provides the prime example of bruhan.
There are nutritive basti also, like ksheer basti (enema of milk),
medicated decoction of fresh, whole milk.
These enemas are very effective in regenerating the dhatus and are
specifically used to tone the muscles (mamsa) and reduce atrophy and
emaciation.
In addition, there are bruhan basti, which use honey, ghee, or the
juices from meat, bone marrow and herbs, which have a highly nutritive
value.
6) Snehana basti
It is prepared only from oleated substances, but is larger in volume.
Due to its size, it has a greater lubricating effect on both the colon
and the body in general.
It has a strongly pacifying influence on
vata
and is particularly
useful in cracking of joints and for those who have very dry skin or who
are emaciated.
Site of administration
Classification of basti (enema) on basis of site of administration
1) The first major classification refers to the administration site and
the primary organs receiving treatment
Pakwashaya gata basti: Medicated liquids sent through the anus and
rectum into the colon.
Uttara basti: Medicated liquids sent through the vagina and cervix to
cleanse and nourish the uterus.
Mutrashaya gata basti: Medicated liquids introduced into the penis and
urethra to treat the male genital and urinary organs.
Vranagata basti: Cleansing and medicated liquids used to irrigate and
heal abscesses or wounds.
2) Four types of external basti are classified according to their site
of administration
Netra basti or netra tarpana:
o In this type of basti, medicated ghee is applied to the eyes.
o A dam constructed around the eye sockets, made of the dough from black
gram flour, contains the ghee.
o Netra basti is highly nourishing for the eyes; it removes eyestrain
and improves vision.
Katti basti:
o Katti basti means medicine retained on the lower back.
o In this type, medicated oils are applied in a container of black gram
dough built around the lumbosacral area.
o This form of external basti particularly benefits muscle spasm and
rigidity of the lower spine and strengthens the bone tissue in that
area.
Uro basti:
o Uro basti means medicine retained on the chest and heart region.
o It uses medicated oils in a container constructed of black gram dough
around the heart region.
o It reduces pain in the sternum area and strengthens the heart.
Shiro basti:
o Shiro basti is administered on the head region through the use of a
specialized leather container resembling a hat. This type of basti
improves the functioning of prana vayu and revitalizes sensory
functioning.
o It also promotes
kapha secretions in the para-nasal sinus zone, which
reduces vascular congestion in the brain.
o Shiro basti is extremely useful in shiraha schoola (headaches), mansa
rog (schizophrenia,
obsessive-compulsive disorders, memory loss,
disorientation) and adhimantha (glaucoma) and sinus Headaches.
Drugs
Classification of basti (enema) on the basis of drugs
On the basis of drugs, basti is classified into two types which are as
follows
1) Niruha basti (Cleansing basti)
Niruha, which means that which gets eliminated," cleanses toxins from
the dhatus (tissues) and removes naturally accumulated malas from the
colon.
Niruha basti is given in a series of treatment over a period of
several days.
The first day of this basti treatment cleanses the colon of ama and
mala.
The second day of niruha balances and nourishes
vata, producing
increased mental calm and clarity.
Because the
vata zone has now been cleared, the third day pulls out ama and toxins from the
Pitta zone. This balances and nourishes
Pitta
function and, in turn, purifies and strengthens both rasa and rakta.
On the fourth and fifth days of administration, toxins get pulled out
of the
kapha
area.
On the sixth and seventh day, the basti benefits reach the deeper
dhatus, asthi (bone) and majja (bone marrow), and the eighth day works
on shukra (semen or ovum).
2) Anuwasan basti (Nourishing basti)
It is of three types: Sneha basti, Anuvasan basti, Matra basti.
The basti, which remains in the body for a while is called as anuvasan
basti.
Anuwasan basti is usually administered after a cleansing course of
niruha basti to ensure that
vata
dosha is operating properly.
They not only restore health to the colon, but also lubricate and
nourish all the dhatus.
This counteracts the debilitating influence of ama and toxins on the
tissues and helps in restoring them to normality, which is the primary
purpose of anuwasan basti.
Indications of Basti
Basti therapy is advised for all types of diseases for all
doshas and
for all the stages of the disease, but in some cases like when in
obstruction due to meda (fat) and
kapha
there is increase in
vata rather
then giving anuvasan basti, niruh basti is useful. The indications for
anuvasan basti are same.
In the following diseases asthapana basti can be given
Paralysis
Hemiplegia
Paraplegia
Obstruction of vayu, feces and urine
fever
Tuberculosis
Fissures
Coryza
gout
Piles
Dysuria
Amla
Pitta
Pain in head, ear, heart
backache
Diseases of
vata
Contra - indications of Basti
Following are the contra indications for asthapana as well as anuvasan
basti:
Anorexia
Increased
kapha
character
After oleation
In the case of vitiation of
doshas
Tired by traveling
Very weak
Hungry and thirsty
After consumption of food
Immediately after other therapies
In emotionally disturbed state
Unconscious
Breathlessness
Cough
Hiccoughs
Imperforated anus
Ascites
Diabetes
Leprosy
Piles
Anemia
Fatness
In children and old aged person.
In seventh month of pregnancy.
Nasya karma (Nasal Insufflation)
Administration of the drug through nostrils is known as Nasya karma.
Navana and Nastah are the synonyms of Nasya karma.
Nose is the gateway of the head. So, systematically performed Nasya
karma cures almost all the diseases of the head easily. It cleanses and
opens the channels of the head and improves the oxygenation (prana)
which has a direct and highly beneficial influence on brain functioning.
Indications for nasya or nasal administration
Stiffness in the head, neck, teeth and jaw
Chronic coryza
Uvulitis
Tonsilitis
Seminal disorders
Cataract
Diseases of the eye lid
Hemicranial
Shoulder pain
Diseases of mouth, nose, ear, eye and head
Facial Paralysis
Hysteria
Tetanus
Hoarseness of voice
Aphonia
Stammering
Tooth ache and other tooth disorders
Nasya should not be given to infants, pregnant women, and elderly people
above 80 yrs of age.
Avapidana Nasya
Nasya karma or nasal administration is of five types: navana, avapidana,
dhmapana, dhuma and marsa or pratimarsa nasya.
The process of nasal administration of fresh juice obtained from the
leaves containing tikshna guna is known as avapidana nasya. It is of two
types:
Stambhana
Sodhana
Indications
Murcha (fainting)
Sanyasa (coma)
Moha
Apatantraka
Apasmara (Epilepsy)
Shirovedana (Headache)
Psychic disorders
Throat diseases
Insomnia
Dosage
In each nostril:
Uttama matra (Maximum quantity): 8 drops
Madhyama matra (Medium quantity): 6 drops
Hraswa matra (Minimum quantity): 4 drops
Dhmapana Nasya
Nasya karma or nasal administration is of five types: navana, avapidana,
dhmapana, dhuma and marsa or pratimarsa nasya.
Blowing medicated powders into the nostrils is called dhmapana nasya or
prdhamana nasya.
Indications
Unmada (Insanity)
Apasmara (Epilepsy)
Atatwabhinivesa
kaphaj shiroroga
Dosage
Dose is 120 mg.
Dhuma Nasya
Nasya karma or nasal administration is of five types: navana, avapidana,
dhmapana, dhuma and marsa or pratimarsa nasya.
The process of inhaling medicated fumes through the nostrils and
expelling through mouth with the help of a dhuma yantra is known as
dhuma nasya
.
It is of three types:
Prayogika
Vairechinika
Snehika.
Indications
Shiroroga
Nasal diseases
Eye diseases
Dhuma yantra
Dhuma yantra consists of two parts:
Dhuma netra
Dhuma varti
Dhuma netra
Dhuma netra can be prepared with the metals, viz. gold, silver, copper
etc.
It has the circumference of a thumb at the base and of little finger
at the tip.
The hole near the tip is of the size of a pea.
The length of:
o prayogika dhuma netra is 48 inches.
o snehika dhuma netra is 32 inches.
o vairechinika dhuma netra is 24 inches.
Dhuma varti
Soak a stick of any herbal stem of 12 inches length in water
overnight.
Roll a cloth piece of nine inches and apply the paste of drugs,
according to the condition of the disease and then dry it well.
In this way, paste is to be applied for five times.
Remove the stick from the cloth and dhuma varti is ready.
Arrange it to dhuma netra and after applying ghee and medicated fumes,
inhale through the nostrils.
The fumes inhaled through the nostrils should be expelled through the
mouth and those inhaled through the mouth also should be expelled
through mouth only.
Note
The fumes should never be expelled through the nostrils; otherwise
disease of the eyesight may arise.
Navana Nasya
Nasya karma or nasal administration is of five types: navana, avapidana,
dhmapana, dhuma and marsa or pratimarsa nasya.
Administration of medicated oil into the nostrils with the help of
cotton or dropper is called navana nasya. It gives strength to the neck
and shoulders and improves eye-sight. It is of two types:
Snehana
Sodhana
Dosage
In each nostril:
Uttama matra (Maximum quantity): 32 drops
Madhyam matra (Medium quantity): 16 drops
Hraswa matra (Minimum quantity): 8 drops
Marsa / Pratimarsa Nasya
Nasya karma or nasal administration is of five types: navana, avapidana,
dhmapana, dhuma and marsa or pratimarsa nasya.
A finger dipped in medicated oil or ghee is applied inside nostrils.
This procedure is called marsa or pratimarsa nasya. It is of two types:
Uttama Sneha
Virechana
Indications
Krumi (maggots) in head.
Strengthening.
Premature graying of hair.
Dosage
Uttam matra (Maximum quantity): 10 drops
Madhyama matra (Medium quantity): 8 drops
Hraswa matra (Minimum quantity): 6 drops
Note
It can be administered without any hesitation as the dose of pratimarsa
is only 2 drops.
Raktamokshana (Bloddletting)
Rakta means blood and mokshan means to remove, so raktamokshana means
removing vitiated blood from the body. It is the localized treatment not
considering the vitiation of the doshas. It is an important therapy in
shalya tantra (surgery) as is basti (medicated enema) in kayachikitsa
(medicine).
Extraction of vitiated blood from the body by using Sastras and
Anusastras is known as Raktamokshana. Kusta, Visarpa, Slipada etc. are
some of the diseases caused due to the vitiation of blood.
It is done either by metal instruments or by using leeches or vegetable
gourds.
Indications
Following are the diseases for which Raktamokshana can be given:
Skin diseases
Herpes
Jaundice
Ulcers
gout
Piles
Abscess
Leucoderma
Syncope
Eczema
Types of Raktamokshana
Raktamokshan has two types:
1) Shastra prayoga
Pracchana: Pracchana is indicated to drain the accumulated blood from
a particular point.
Sira vedhana: Venepuncture is devised whenever vitiated blood
circulates in the body.
2) Anushastra prayoga
Jalouka prayoga: Deep-seated blood can be extracted with the help of
leech application. It is better to extract blood vitiated by
Pitta
by
means of leech application.
Sringa: To extract the blood vitiated by vata, sringa or horn is
indicated.
Alabu: Blood vitiated by kapha can be extracted by Alabu as it
consists of tikshna and ushna gunas.
Ghati yantra: To drain the vitiated blood, which has settled in
different layers of the skin, ghati yantra is useful.
Precautions
The following precautions should be followed for raktamokshana:
Never give incision to the contra indicated where the proximal part is
not tied, where the veins are not bulged and also in the transverse
direction.
Venesection is not advised in mid summer, winter and rainy season.
Should not be done in healthy individuals.
Required equipment, instruments and other essential drugs and
antidotes should be collected before starting the therapy.
Contraindication of Raktamokshana
Immediately after oral administration of oil.
Immediately after performing any Shodhana Therapy.
Pregnant women.
Postnatal period.
Chronic jaundice.
Impotency.
Below 16 years and above 70 years of age.
Haemorrhage
Excessive oleation.
Without sudation.
Paralysis,
diarrhea,
vomiting, dyspnoea, cough, ascitis, piles,
anaemia, anasarca, etc.
When venesection is conducted to the contra indicated persons, either no
bleeding or excessive bleeding occurs.
But in case of an emergency, venesection can be done for the above
persons also.
Paschat karma
The third stage of
Panchakarma is Paschat karma i.e., the adoption of
rehabilitative measures after the main treatment. It describes the
measures employed after the main treatment, such as diet, medicines and
daily routine.
It is of three types:
Samsarjana Karma
Rasayanadi Karma
Samana Prayoga
Samsarjana Krama
Restoration of digestive power by advocating specific diet after
completion of Sodhana Therapy is known as Samsarjana krama.
Rasayanadi Karma
Administration of Rasayana and Vajeekarana drugs after Elimination
Therapy is known as Rasayanadi karma.
Samana Prayoga
Administration of medicines required to treat the particular disease
after the process of elimination is called Samana Prayoga.
After care
The following regime is to be followed during the course of oleation
therapy for the same number of days, even after the completion of the
course.
Use only warm water for drinking and bathing.
Celibacy should be maintained.
Avoid:
o Suppressing the natural urges.
o Speaking loudly.
o Anger and
Anxiety.
o Exposure to sunlight and cold breeze.
o Traveling long distances by vehicle or by walk.
o Contact with smoke and dust etc.
Panchakarma
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