According to Ayurveda, health is not defined as being disease-free. It is the state of normalcy of the three doshas – Vata, Pitta, and Kapha. Vata (ether and air) governs movement, Pitta (fire and water) governs transformation and digestion, and Kapha (water and earth) governs structure and stability.

These doshas keep the human body, mind, and emotions in balance. A disease is manifested when the delicate balance between the doshas is disturbed. An Ayurvedic cleanse draws out the toxins from the body, also drawing out excess vata, pitta, and kapha from the tissues into the digestive tract in order to eliminate them. This, in turn, unblocks the channels and restores balance. This cleanse is known as Panchakarma, which literally means five actions or procedures.

The name refers to five distinct purification procedures, each directed at a different dosha, and each requiring medical preparation and supervision. Panchakarma is never the five procedures alone. It is preceded by Purva Karma — Snehana (oleation) and Swedana (sudation) — and followed by Paschat Karma, a graded return to normal diet called Samsarjana Krama. It is a method of cleansing the body of all unwanted waste after lubricating the body. This treatment is highly beneficial as it includes preventive and curative actions for various diseases.

The complete process of Panchakarma involves the following three steps:

1. Poorva Karma

This is a preparatory procedure required before the main treatment, to soften the tissues so that the lipid-soluble toxins deposited into them are liquefied and flow back into the digestive tract. From here, they can be eliminated. This treatment prepares the patient mentally and physically for the main procedure of Panchakarma.

It involves three procedures:

Pachan Karma – improves digestion with herbs and fasting so that the patient can digest the ghee (clarified butter) which is provided to liquefy the fat-soluble toxins.
Snehan Karma – medicated ghee is given to the patient in increasing doses in order to aggravate and liquefy the fat-soluble toxins deposited in the deep tissues.
Swedan Karma – a full body steam bath is given to the patient thereby opening up the body channels and allowing the heat to liquefy the toxins further. This facilitates their movement from the tissues to the digestive tract.

2. Pradhan Karma

This is the Panchakarma, a five-step procedure which is highly individualized depending on the needs, age, digestive strength, immune system, and other factors. This intense Panchakarma procedure can only be done under the guidance of an Ayurvedic practitioner.

The five karmas to cleanse the complete body are:

Vamanam (therapeutic emesis) – targets kapha. It is defined as a "procedure in which Doshas (waste products or toxins) are eliminated through upper channels i.e. mouth". A supervised, medically induced emesis clearing the stomach and upper airway. Published protocols exclude anyone with hypertension, diabetes, renal disease, peptic ulcer, jaundice, acute infection or dehydration.
Virechanam (therapeutic purgation) – targets pitta. Medicated purgatives clear the small intestine. In a published trial the whole sequence ran: deepana-pachana (digestive herbs) 2-3 days, snehana (oil loading) 3-7 days, external therapies 3 days, then the purgation itself, then samsarjana krama (staged re-feeding) 3-7 days — roughly 11 to 20 days end to end for one of the five procedures.
Basti (medicated enema) – targets vata. Given in two alternating forms: niruha (decoction-based) and anuvasana (oil-based). The typical Kala Basti schedule is 16 applications: 6 Niruha and 10 Anuvasana.
Nasyam (nasal administration) – medicated oil, ghee or powder given through the nostrils, for conditions above the collarbone: head, sinuses, throat, eyes, ears.
Raktamokshana (therapeutic bloodletting) — removal of a controlled quantity of blood, for conditions attributed to vitiated blood and pitta. Done by leech application, vein puncture or cupping.

3. Paschaat Karma

This is a post-therapy dietary regime to restore the body’s digestive and absorptive capacity to its normal state. It includes rejuvenating treatments, lifestyle management, diet management, and intake of herbal supplements.

It includes the following procedures:

Sansarjan Karma – food therapy after detoxification, which aims at gradually increasing the patient’s diet from liquids to semi-solids to a normal diet.
Rasayan Adi Prayogam – a rejuvenating rasayan therapy which aids in increasing natural immunity and enhancing your general well-being.
Shaman Chikitsa – a pacification therapy with herbs and lifestyle management.

It is important to note that a Panchakarma procedure is designed specifically for an individual after a thorough physical examination and pulse diagnosis. Hence, there is no universal package for everybody. Traditional Panchakarma is delivered over a minimum of two weeks and more usually four, in a retreat or hospital setting.

Who Needs Panchakarma?

It is recommended to do a regular detox to flush out toxins and free radicals from the body. Detox can help in alleviating fatigue, digestive problems, skin disorders, headaches and other health issues. It also helps in boosting energy, improving mental clarity and getting rid of stress. Ayurveda therapies like Abhyangam, Shiroabhyanga, Padabhyanga, and Shirodhara help improve the body's overall balance and health, thus strengthening the body's ability to absorb nutrients and eliminate toxins. Detoxification is a safe and natural way to maintain a healthy lifestyle. With the help of programs such as detox programs, pain management, anxiety management and weight management, your body can be restored to a state of balance and harmony.

Panchakarma Side Effects and Who Should Avoid It

Common side effects of Panchakarma include fatigue, malaise, headaches, congestion, and general illness. An initial increase in the symptoms may also occur as a side effect. It is also important to note that as Panchakarma seeks to release stored emotional problems, some patients can experience mental disturbances and depression during the course of treatment.

Because these are active purification procedures, published clinical protocols screen participants out rather than in. A Vamana study excluded anyone with hypertension, diabetes, renal disease, peptic ulcer, jaundice, acute infection or dehydration. Then: pregnancy, children and the elderly, and anyone on prescription medication should be assessed by a physician first.

Panchakarma treatments should only be performed by qualified and experienced Ayurvedic practitioners.

References

Gupta B, Mahapatra SC, Makhija R, Kumar A, Jirankalgikar NM, Padhi MM, Devalla RB. "Physiological and biochemical changes with Vamana procedure." Ayu. 2012;33(3):348-355. doi:10.4103/0974-8520.108821
Shukla G, Bhatted SK, Dave AR, Shukla VD. "Efficacy of Virechana and Basti Karma with Shamana therapy in the management of essential hypertension: A comparative study." Ayu. 2013;34(1):70-76. doi:10.4103/0974-8520.115455
Conboy LA, Edshteyn I, Garivaltis H. "Ayurveda and Panchakarma: Measuring the Effects of a Holistic Health Intervention." ScientificWorldJournal. 2009;9:272-280.
http://vikaspedia.in/health/ayush/ayurveda-1/panchakarma#section-2
https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/panchakarma

Glossary

Abhyanga / Abhyangam = warm-oil massage over the whole body
Shiroabhyangam / Shiro Abhyanga = head and scalp oil massage
Padabhyanga / Padabhyangam = foot massage
Shirodhara = a steady stream of warm oil poured across the forehead
Sweda / Swedana = sweating brought on deliberately as part of the treatment
Snehana = oiling the body, inside and out
Vasti / Basti = a ring of dough that holds warm oil on one spot; in Panchakarma the same word means a medicated enema
Dosha = one of the three functional types Ayurveda uses to classify imbalance
Vata = the dosha associated with movement
Pitta = the dosha associated with heat and digestion
Kapha = the dosha associated with structure and fluid
Panchakarma = a five-procedure cleansing programme
Vamana = therapeutic vomiting
Virechana = purgation
Raktamokshana = bloodletting
Purva Karma = the preparation phase before the main procedure
Deepana / Pachana = herbs that stimulate appetite and digestion
Ghee / Ghrita = clarified butter
Sudation = sweating
Oleation = oiling

Hands pouring oil onto another person’s back with a flower on their ear

Annalepam (Medicated Rice Therapy)

Annalepam therapy is an Ayurvedic treatment where rice is directly applied to an individual’s body. This treatment is used for vata and pitta disorders, rakta (blood) problems such as contamination, and inflammatory and degenerative diseases.

A woman lying on her stomach with her hands folded below her head and 2 hands putting a pair of poultices on her back

The Benefits of Practicing Ayurveda

Ayurveda is based on the principle that to achieve and maintain health over the course of your life, you must re-balancing emotions, improve diet, practice yoga and “pranayama” (breathing exercises), and make lifestyle adjustments.

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