Panchakarma therapy to prevent chronic diseases
How This Helps
Health, as defined by the World Health Organization (WHO), is "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."1 Ayurveda which is dated back to 5000 years ago interpreted the definition of health in a similar way. According to Ayurveda health is not only the state of not having disease but the normalcy of Dosha, Dhathu, Agni and Malakriya along with pleasant senses, mind and soul.
We all strive for quality of life rather than the number of years we live. The concept of prevention of disease is given utmost importance in Ayurveda. There is a separate branch of Ayurveda for preventive medicine called as ‘Swastha Vritta’. We all have Vata, Pitta and Kapha in our body. Then why are we all not alike? Our physical features, characters, immunity everything is different from others. The reason for this individuality is the combination of Dosha in each person. Any one, two or three of these doshas are expressed dominantly in a person by birth. This is known as Prakrithi or Constitution. Each of these doshas in a person tends to aggravate daily or seasonally depending on seasonal changes or lifestyle. When a person indulges in diet and regimen which provokes a particular dosha in its aggravated state diseases occur. So how can we keep the doshas, dhathus and other factors under check?
In order to achieve the same Ayurveda has advocated certain regimens and treatment modalities such as Dinacharya, Rutucharya, Vega Adharana, Rasayana–Vajikarana and Panchakarma. Panchakarma is a unique way of cleansing the body and thus keeping the body healthy.2
In the management of lifestyle diseases, Ayurveda offers various regimens including Dinacharya (daily regimen), Ritucharya (seasonal regimen), Panchakarma (five detoxification and bio-purification therapies), and Rasayana (rejuvenation) therapies. The Sadvritta (ideal routines) and Aachara Rasayana (code of conduct) are utmost important to maintain a healthy and happy psychological perspective.3
In this perspective article, I will be explaining the following –
1. What is Panchakarma and the principle behind it.
2. Which are the 5 procedures and how do they help to keep the doshas in check.
3. Moving towards Evidence base about Panchakarma
4. Treatment approach to Lifestyle disorders with Panchakarma
Understanding Panchakarma Therapy
As per Ayurvedic principles improper diet and life style, external factors like changes in atmosphere and weather conditions can result in accumulation of toxins in the body. This accumulation of toxins can create imbalance in the doshas and can result in diseases. The accumulated and aggravated doshas can be pacified in 2 ways.
a) Shamana Chikitsa – In Shamana Chikitsa, the aggravated Doshas are pacified by means of oral medicines. This can be done when the dosha aggravation is minor.
b) Shodhana Chikitsa – When there’s a larger extent of dosha vitiation it is better to get rid of the doshas from the root and Shodhana or Panchakarma is done.
The word ‘Pancha’ in Sanskrit means five and ‘Karma’ means procedure. These five procedures are –
1) Vamana – Therapeutic Emesis
2) Virechana – Therapeutic Purgation
3) Vasti – Therapeutic Enema
4) Nasya – Nasal Errhine
5) Rakta Mokshana – Blood letting
Vamana or Therapeutic Emesis
When the toxins are removed through the upper route (Mouth) by means of administering medicines, it is called as Vamana. Vamana is usually performed when ‘Kapha’ is in imbalance. The ideal season to perform Vamana in preventive aspect is ‘Vasanta Ritu’ or Spring Season.
When there is an aggravation of Kapha dosha in the body you might end up with diseases like Cold, Cough etc. In simple words most of the respiratory ailment are caused when there is a Kapha imbalance.
The prime location of Kapha is chest region and that’s why it is easy to eliminate the aggravated Kapha through oral route by therapeutic emesis. Initially the dosha is forcefully brought from the extremities to the abdomen by means of Purva Karma like Snehana (Internal administration of medicated ghee and Oil Massage) and Swedana (Sudation). Then, Vomiting is induced.
Benefits of Vamana –
- Improves digestion and metabolism
- Restoration of health
- Clarity in sense organs
- Gains strength
- Improves luster and complexion of skin
- Slows down ageing process
- Improves chances of virility, fertility and sexual power
- Improves the quality of life
Virechana or Therapeutic Purgation
Virechana is the administration of purgative medicines for the cleansing of pitta through the lower pathways. The derivatives of Virechana in modern days include Liver detox, colon detox etc.
Virechana is targeted to expel the aggravated Pitta dosha and need to be administered in Sharat Ritu or Autumn season. Since the prime location of Pitta is intestines, eliminating the aggravated Pitta through lower route (Anal route) is easier. To expel the toxins out, initially it is brought to the intestine forcefully from extremities by Snehana (Oleation) and Swedana (Sudation).
It is indicated in Skin diseases where there is an aggravation of Pitta, Abscess, blisters, liver disorders etc.
Benefits of Virechana –
- Regression of diseases
- Clarity of senses
- Clarity in skin and restoration of normal skin complexion
- Proper digestion and metabolic activities
- Lightness of the body
Vasti or Therapeutic enema
Vasti or Enema is mainly administered when there is an aggravation of Vata dosha. It is popularly known as ‘Ardha Chikitsa’ which means Half treatment since it can be adopted in wide range of diseases and once Vasti is done it is similar to the way that half course of the treatment is completed. There are 2 types depending on the medicine used.
a. Anuvasana Vasti – Oil Enema
b. Kashaya Vasti – Decoction enema
When the herbal active principles present in Vamana and Virechana medicines are not digested or destroyed due to the acid in the stomach during metabolism. Herbs are administered through rectal route which can readily be absorbed by the intestine.
Benefits of Vasti –
- Anti-ageing and promotes youthfulness
- Nourishes the eyes
- Prevents greying of hair
- Provides proper nourishment to body and tissues
- Enhances strength and immunity
- Enhances color and complexion
- Promotes health and longevity
Nasya – Nasal errhine
The treatment involves the administration of herbal medicines in to the nostril. It is considered as the ideal treatment for the diseases affecting head and neck region. Synonym of the word Nasya is ‘Navana’.
As per Ayurveda, Nose is considered as the gateway of head.
Time of Administration of Nasya as per Dosha
Kapha rogas - Forenoon
Pitta Rogas - Noon
Vata Rogas - Afternoon
Seasonal Administration of Nasya as per seasons for healthy persons
Sharat Ritu (Autumn season) - Morning
Vasanta Ritu (Spring Season) - Morning
Greeshma Ritu (Summer season) - Evening
Varsha Ritu (Rainy season) – When the sun is visible
Hemana Ritu (Winter season) - Noon
Benefits of Nasya –
- Diseases of head
- Greying hair
- Neck stiffness
- Diseases of Ear
- Diseases affecting eyes
- Good sleep
- Clarity of senses
- Lightness of head and body
Rakta Mokshana – Blood Letting
In Rakta Mokshana, Vitiated blood is eliminated out of the body by the application of leech or by means of puncturing. When there is vitiated blood in the body, there will be various diseases including skin disorders.
Benenfits of RaktaMoksha
- Subsiding of pain
- Clear skin
- Feeling of lightness of the body
It is ideally performed in Sharat ritu or autumn season. The most convenient form of blood letting is Leech therapy.
Research and Clinical studies on the effect of Panchakarma
1. School of Ayurveda in Stockbridge, Massachusetts conducted descriptive study on panchakarma in 2005. Using data gathered from an Ayurvedic treatment program, this study examined the role of psychosocial factors in the process of behavior change and the salutogenic process. This observational study examined associations with participation in the 5-day Ayurvedic cleansing retreat program, Panchakarma. Quality of life, psychosocial, and behavior change measurements were measured longitudinally on 20 female participants.4 The two behavioral measures, the Lifestyle Profile (which measures reported adherence to positive lifestyle practices) and self-efficacy (which measures belief in one’s ability to make positive health changes with these practices), both showed significant improvement at 3 months postintervention. Anxiety decreased significantly at 3 months post-treatment, but not immediately after treatment.
2. Shodhana can be adapted for both types of prevention viz. primary and secondary. Primary, in which the strategies intend to avoid the development of diseases. Secondary, in which the strategies attempt to diagnose and treat an existing disease in its early stage before it results in significant morbidity.5
3. In the management of lifestyle diseases, Ayurveda offers various regimens including Dinacharya (daily regimen), Ritucharya (seasonal regimen), Panchakarma (five detoxification and bio-purification therapies), and Rasayana (rejuvenation) therapies. The Sadvritta (ideal routines) and Aachara Rasayana (code of conduct) are utmost important to maintain a healthy and happy psychological perspective. The inclusive utilization of all these treatment modalities has a great effect on lifestyle disorders.6
The dividing line between preventive medicine and public health practice is far from distinct, as is that between prevention and treatment. The opportunity to combine the “best” of the conventional healthcare system and practices and providers commonly considered to be CAM, and thereby produce better outcomes, measured in terms of symptom relief, functional status, patient satisfaction, and perhaps cost effectiveness. Integrative medicine is necessarily “holistic” in the sense that somatic, emotional, and spiritual health are considered integral to overall health. 7
Proper administration of Panchakarma procedures can be used along with other healthcare practices for successful effects.
Lifestyle disorder is an umbrella term given to all the diseases which arise because of unhealthy lifestyle. Lifestyle diseases, a subset of non-communicable diseases (NCDs) are a result of the way we live, work and go about our everyday lives. Ayurveda provides better solution in the forms of proper dietary management, lifestyle advises, Panchakarma like detoxification and bio-purification procedure and rejuvenation therapies. If the factors involved in pathogenesis of these lifestyle disorders are reviewed on the basis of Ayurveda, the symptoms show Agnidushti (decreased digestive fire), Kaphadushti (Aggravated Kapha), Mansavaha (affecting mind) and Medovahadushti (affecting Medas or channel carrying fat). Life style disorders can be prevented through Panchakarma as it prevents vitiated Kapha, Meda etc. along with stress and strain of mind as well as body.8
1. WHO: https//apps.who.int:aboutwho:en:definition.html.
2. Joshi SS, Praveen BS, Girish KJ: Preventive Panchakarma Journal of Ayurveda and Holistic Medicine | April, 2013 | Vol 1 | Issue 1
3. Chandola H. M. (2012). Lifestyle disorders: Ayurveda with lots of potential for prevention. Ayu, 33(3), 327. doi:10.4103/0974-8520.108814
4. Naidoo, D., Schembri, A., & Cohen, M. (2018). The health impact of residential retreats: a systematic review. BMC complementary and alternative medicine, 18(1), 8. doi:10.1186/s12906-017-2078-4
5. Joshi SS, Praveen BS, Girish KJ. Preventive Panchakarma. Journal of Ayurveda and Holistic Medicine. 2013;1(1):7-11.
6. Menon, M., & Shukla, A. (2017). Understanding hypertension in the light of Ayurveda. Journal of Ayurveda and integrative medicine, 9(4), 302–307. doi:10.1016/j.jaim.2017.10.004
7. NIH. Complementary, alternative, or integrative health: what’s in a name? Washington, DC: USDHHS, NIH. https://nccih.nih.gov/health/whatiscam. Published 2008, updated 2015. Accessed April 20, 2015.
8. TIWARI, Swati; SANJAY, Gupta; KUMAR ALOK, Srivastava. ROLE OF PANCHAKARMA IN PREVENTING LIFESTYLE DISORDERS. Journal of Ayurveda and Integrated Medical Sciences (ISSN 2456-3110);