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An Introduction to Panchakarma

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Purvakarma: Pre-purification Measures


Five Basic Shodhans: Cleansing Methods

1) Vaman: therapeutic vomiting or emesis
2) Virechan: purgation
3) Basti: enema
4) Nasya: elimination of toxins through the nose
5) Raktalmoksha: detoxification of the blood

Vaman: Emesis Therapy





Indications for Vaman:

used for all kapha type disorders
good for pitta headache, dizziness, and nausea
will help to release blocked emotions
respiratory congestion
chronic cold
sinus congestion
kaphagenic asthma

Contra-Indications for Vaman:

below the age of 12 or over age 65
pre-menstrual period (one week prior)
delicate or sensitive person with too much fear, grief or anxiety
vata prakruti
vata diseases
heart diseases
during vata season
acute fever

Virechan: Purgation Therapy





Virechan Substances: Senna, prune, bran, flaxseed husk, dandelion root, psyllium seed, cow’s milk, salt, castor oil, raisins, mango juice, triphala.

Indications for Virechan:

allergic rash
skin inflammation
acne, dermatitis, eczema
chronic fever
biliary vomiting
urinary disorder
enlargement of the spleen
internal worms
burning sensation in the eyes
inflammation of the eyes

Contra-Indications for Virechan:

low agni
acute fever
severe constipation
bleeding from rectum or lung cavities
foreign body in the stomach
after enema
emaciation or weakness
prolapsed rectum
old age
ulcerative colitis

Basti: Enema Therapy




There are eight main types of basti, according to traditional texts, each with their own indications and contra-indications as listed below.

1. Anuvasana (oil enema) is used in pure vata disorders and when a person is having excess hunger or dryness related to vata imbalances.

2. Niruha-Asthapana (decoction enema) is used, among other conditions, for evacuation of vata, nervous diseases, gastro-intestinal vata conditions, gout, certain fever conditions, unconsciousness, certain urinary conditions, appetite, pain, hyperacidity and heart diseases.

3. Uttara Basti (through the urethra with men or vagina with women) is used for selected semen and ovulation disorders and for some problems involving painful urination or bladder infections. This is not to be used for someone with diabetes.

4. Matra Basti (daily oil enema) is used by someone emaciated by overwork or too much exercise, too much heavy lifting, walking too long of a distance, too much sexual activity or someone with chronic vata disorders. It does not need to be accompanied by any strict dietary restriction or daily routine and can be administered, in the appropriate cases, in all seasons. It gives strength, promotes weight and helps elimination of waste products.

5. Karma Basti (schedule of 30 bastis),

6. Kala Basti (schedule of 15 bastis; 10 oil + 5 decoction)

7. Yoga Basti (schedule of 8 bastis; 5 oil + 3 decoction).

In karma, kala and yoga bastis, it is better to give both types of basti in combination and not the oil and decoction separately. The conditions under which these are recommended are too detailed to be able to list in this article. In general, the indications and contra-indications that apply to basti also apply here.

8. Bruhana Basti (nutritional enema) is used for providing deep nutrition in select conditions. Traditionally, highly nutritive substances have been used, such as warm milk, meat broth, bone marrow soup and herbs like shatavari or ashwagandha.

General Indications for Basti:

low back ache
nervous disorders
vata headache
muscular atrophy
General Contra-Indications for Basti (include but are not limited to the following):
Enema therapy should not be used if the patient is suffering from diarrhea, bleeding of the rectum, chronic indigestion, breathlessness, diabetes, fever, emaciation, severe anaemia, pulmonary tuberculosis, old age or for children below the age of seven years.



There are six main types of nasya, as listed below.





5. Marshya Nasya (ghee or oil nasya)


Substances Used in Nasya: brahmi, ginger, ghee oils, decoctions, onion, garlic, Piper longum, black pepper, curry pepper, rose, jasmine, mogra flowers and henna.

Indications for Nasya:

emotional imbalances
stiffness in the neck & shoulders
dryness of the nose
sinus congestion
migraine headache

Contra-Indications for Nasya:

sinus infections
after sex, bathing, eating or drinking of alcohol
should not be used below 7 years or over 80 years of age
Raktamoksha: Traditional Ayurvedic Method for Purification and Cleansing of the Blood
Toxins present in the gastro-intestinal 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. Raktamoksha 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 pittagenic disorders.

Extracting a small amount of blood from a vein relieves the tension created by the pittagenic toxins in the blood. Bloodletting also stimulates the spleen to produce antitoxic substances which helps to stimulate the immune system. Toxins are neutralized enabling radical cures in many blood born disorders.

Bloodletting is contraindicated in cases of anaemia, edema, extreme weakness, diabetes and in children and elderly persons. It is also an illegal procedure within the United States.

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. Burdock root tea, sandalwood, saffron, manjista, guduchi, rose and lotus are herbs that help to purify the blood. Turmeric, goldenseal, pomegranate juice, neem, oranges, beets and raisins can also be beneficial for blood disorders.

For raktamoksha treatment other than blood-letting, there are blood-purifying practices involving herbs, gem therapy or color water therapy.

For blood purifying therapy look for substances that are bitter and astringent and have blood thinning properties. Burdock root tea is the best blood purifier. For blood carried disorders such as allergy, rash or acne the patient should take a milk laxative and the next evening begin burdock root tea therapy. The tea is made from one teaspoon of powder in one cup of hot water. If taken every night, the action of the herb will begin to purify the blood.

Beneficial gems and crystals are pearl, coral, amethyst, rose quartz and jade.

In the practice of colored water therapy, red should be used in vata disorders, blue for pitta and purple for kapha.

For any raktamoksha treatment or related alternative treatment it is beneficial to refrain from yogurt, salt, sugar, alcohol, marijuana, sour and fermented foods.

Indications for Raktamoksha:

chronic itching
enlarged liver or spleen

Contra-Indications for Raktamoksha:

young children
old age
during pregnancy
during menstruation

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 some time 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, nourishes all the tissues of the body, is very easy to digest, 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, that is an excellent protein combination and 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 just from information in this article. 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. It is also done to best advantage, although not always, at the junctional period between two seasons, thus helping a person to prepare their internal environment for the oncoming season.

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