All About Panchakarma

Words: Dr Nidhi M RATHOD

The goal of Ayurveda is to maintain health as well as prevent and treat disease. Ayurveda describes a myriad of therapeutic formulations, lifestyle, diagnostic and detoxification measures, etc., for the management and treatment of various health disorders.

Panchakarma is one of the detoxification measures used widely in Ayurveda for the prevention and treatment of disease, or illness.

Panchakarma therapy as a sodhana measure helps to eliminate the doshas.

Panchakarma is performed at a specific time for a particular duration, while taking into consideration seasonal variations. The consideration of dietary and life style measures, before and after therapy, is, likewise, just as important.

Importance Of Kala In Panchakarma 

Kala [time] has a great role in Ayurveda with reference to the usage of remedies, application of purification measures, manufacturing of drugs, disease severity and preventive approaches, etc.

Kala is a constant factor for the parinama of events and activities; everything is affected by kala. Charaka categorises kala into two elements: nithyaka and avasthika. Nithyaka kala is divided into uttarayana and dakshinayana. Uttarayana is classified as shishira, vasantha, greeshma, dakshinayana, etc. 

Panchakarma chikitsa helps to remove kupita vata, pitta and kapha — it is apparent that kala greatly affects one’s response to therapy.

Dinacharya, ritucharya, dosha kala, avasthapaka kala and dhathu poshana kala, etc., should be considered too, while performing chikitsa for therapeutic purposes. Panchakarma removes upasthita dosha only after the consideration of the kala of therapy and also the matra of medicines. The success of shamsodhana chikitsa depends greatly upon the proper assessment of kalaadi bhavas. The shamsodhana chikitsa, when not performed according to kala, may cause peeda and other detrimental effects.

Vamana is therapeutic emesis which expels toxins through vomiting. The late spring, or early summer, is considered best for vamana, since it corresponds to the kapha-provoking period. Vamana should be performed after sunrise [early morning].

Virechana means therapeutic purgation — it eliminates the morbid pitta from the anal route by defaecation. According to ashtanga hridayam, the best time for purgation is late morning [9:00am], since this is the time when the kapha-provoking period ends and Pitta becomes dominant.

Basti therapy is used for eliminating vayu, along with the morbid doshas — this therapy is referred to as medicated enema. It should be performed according to disease severity during daytime and in accordance with the duration of therapy.

Nasya means application of medicines through the nostrils — this is used for treating diseases of the throat, head and neck, etc. Nasya should be performed in the early morning and before meals. Nasya should be performed on an empty stomach; it should be avoided in overcast conditions.

Raktamokshana is the blood purification measure [therapeutic bloodletting technique] — the therapy is primarily used for skin and other diseases, where impure blood plays a role in disease pathogenesis. Bloodletting is good for pitta disorders, like gout. This therapy should be performed in late summer.

Recommended Kala Of Sequential Panchakarma

  • Virechana may be done 15 days after vamana
  • Niruha basti may be done 15 days after virechana
  • Anuvasana is recommended after niruha basti
  • Anuvasana basti may be done after virechana
  • Panchakarma may be completed by the 120th day in case of pravara matra/uttama matra shodana
  • Panchakarma should be completed by the 85th day in case of madhyamasodhana
  • Panchakarma should be completed by the 59th day in avarasodhana.

Seasonal Considerations Of Samshodhana Chikitsa

  • Vamana is recommended in vasanta ritu
  • Virechana is recommended in sarad ritu
  • Basti chikitsa is recommended in pravrita ritu.

Importance Of Pathya-Apathya In Panchakarma

The dietetic and behavioural conduct which should be followed before, during, and after panchakarma therapy are considered as pathya-apathya of panchakarma. The consideration of these factors offers maximum health benefits of therapy. Snehapana is the prime pathya to be performed. Purvakarma, ushna and agnivardhak aahara are advised in the ‘digestion’ of snehana.

Anabhyshandi aahara is advocated during swedhana. It helps to prevent shrotoavrodh; it also channelises movement of the morbid doshas to their exit points. Mardana, ushnajala and snana, etc., are advised as pathya viharas. Vyayama is not recommended during swedana to avoid possible complications.

Pathya & Apathya In Various Modalities Of Panchakarma

  • Kaphotkleshaa aahara, ksheer, dadhi and tila, etc., are advised before vamana; it helps in utklesha of kaphadosha
  • Bahya snehapana and swedana karma are recommended for proper movement of doshas
  • Laghu ahaara [langhna] may be advised during virechana karma
  • Mamsa rasa is advised during basti karma for vata disorders
  • Ksheera should be used during basti karma for pitta disorders
  • Yusha should be used during basti karma for kapha disorders
  • Ushna jalapana and laghu ahaara are recommended in nasya karma.

Ayurveda describes samsarjana karma as essential conduct to be followed during vamana and virechana — this involves ahaara-vihara under the heading of peyadikrama and tarpanadi karma

  • Laja, saktu and mamsa rasa, etc., pacify the vitiated agni during the sodhana The [apathya] factors which are to be avoided during sodhana are ucchabashna, ajeerna, adhyasana, aatyasana, dwivaswapana, maithanau, ahitbhojana, etc
  • The pathya and apathya in panchakarma require the consideration of agni, avastha, dosha, doshavastha, dhatu and vyadhiavastha, etc
  • Panchakarma with pathya-apathya offers several health benefits in several pathological conditions. It also preserves general health and maintains synchronisation with natural harmony. One should avoid chinta, krodha, shoka, ratri jagrana and dukha shaiya, , during panchakarma therapy for improved treatment outcomes
  • Pathya brings the vitiated doshas to their normal state — one must, therefore, follow the healthy way of daily and dietary regimens to derive optimal therapeutic effects of sodhana

Conclusion

Panchakarma is a unique therapy of Ayurveda used for kaya shodhana and to detoxifying the whole body. Panchakarma therapy, when performed at the right time, or appropriate kala, ensures the success of the treatment plan. Consideration of rules of pathya and apathya during sodhana therapy maintains normal body functions; it also enhances the effects of the sodhana procedure.

The panchakarma therapy must be performed after consideration of kala, ahaara and vihara. The kala plays an important role in promoting therapeutic values of panchakarma. Panchakarma pacifies the doshas, boosts agni and potentiates dhatus, when performed at the appropriate kala, while following the rules of pathya and apathya. The effects of panchakarma therapy depends primarily upon the kala of therapy, ahaara and vihara, no less. Pathya and apathya should be considered, in their whole essence, also extent, while performing panchakarma therapy.

Dr NIDHI M RATHOD, BAMS, MD [Ayurveda], is Associate Professor, Department of Panchakarma, Shree O H Nazar Ayurveda Medical College, Surat, Gujarat, India. This article [Importance of Kala Vichar, Pathya and Apathya in Panchakarma] was first published in Himalayan Journal of Health Sciences, Vol 7, # 3, October 2022, pp 31-33, under a Creative Commons Attribution-NonCommercial 4.0 International License.

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