Panchakarma therapy to prevent chronic diseases

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.

 

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

– Mindfulness

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 Rasaya.