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As the name suggest, panchkarma means panch karma i.e. five methods or five operation in ayurvedic medicinal system. These are:

  1. Vaman karma (emetic)
  2. Virechan karma (purgative)
  3. Anuvasan vasti (soothing enema)
  4. Nirooh vasti (cleansing enema)
  5. Nasya karma (nasal purge)

Ayurveda believes that any substance entering in our body has an effect on our body. Thus to clensify the wrong effects in the body by that external substance, panchkarma methods were devised. Panchkarma procedures purify, pacify and remove the cause on any disease. For curing any disease one must purify the effective body system by eliminating the aberrant material from the body. Secondly one must soothe the already effected part. And thirdly one must remove the hetu (cause) of the disease. Panchkarma procedures are so designed that they satisfy the above mentioned three requirements of a physician in eradicating a disease.

Shad upkarmas (six methods of treatment)

Ayurveda has mentioned six upkarmas i.e. six methods of treatment under which all the treatments are performed. These are

  1. Brimhana karma (promoting growth)
  2. Lahghan karma (effecting reduction)
  3. Snehan karma (lubrication)
  4. Rookshan (drying)
  5. Swedan (sweating)
  6. Stambhana (promoting contraction)

According to Charak, the great ancient physician, says the best physician is that who has mastery over in performing methods of Brimhana karma (promoting growth), Lahghan karma (effecting reduction), Snehan karma (lubrication), Rookshan (drying), Swedan (sweating), Stambhana (promoting contraction).

All methods of medical treatment in ayurvedic system of medicine may be classified under one or the other of the following categories mentioned below

  1. Brimhana karma (promoting growth) – promoting growth or encouraging plumpiness in body.
  2. Lahghan karma (effecting reduction) – effecting leanness, it is opposite of brimhana karma
  3. Snehan karma (lubrication) – lubrication or increasing fat or watery content in the body
  4. Rookshan (drying) – promoting dryness, the opposite of the above i.e. removal of the fat or moisture
  5. Swedan (sweating) – promoting sweat or diaphoresis, etc, i.e., encourages the dilatation (vikaaranaam) of all channels and opening in the body
  6. Stambhana (promoting contraction) – promoting contraction (sankochanam) or constriction of the part or the vessels of supply such as arterioles, blood, lymph vessels etc, i.e. the opposite of swedanam.

In a general view all the above method mentions methods can be classified into the first two methods i.e. brimhana and lahghan. As ultimate all the six promotes growth or causes reduction in body. Langahan karma, swedan karma and rookshan karma all comes into one category. And brimhana, Snehan and stambhana come in one category.

On account to the multifarious complex combinations of the three doshas, the medical treatment also may become complicated. However combined, number does not exceed six, just as the number of doshas however combined cannot be transcended their three fold character. These methods of treatment should be performed in a very delicate and balanced manner, so that any excess or deficiency of the six methods or their combinations may be avoided.

The patient is the best judge to know weather the method of treatment is performed correctly or not. The progress in the relief of the sufferings of the patient confirms the utility of the treatment. The patient feels happier if the equilibrium prevails and he feels unhappy the moment equilibrium is disturbed. For instance, if a particular portion of the body is dirty and non oily and if a little lubricant is applied to this, the opposite treatment of drying is given, the patient is sure to feel more discomfort.

As in other system of medicine ayurveda also gives treatment generally consist of supplying the opposite of supplementing the lost element in the body by the effect of the diseased condition.

It may be mentioned here that all the above methods of treatment and operations included in the six categories of the treatment called the shad upkarmas, includes the panchkarma, which constitute mainly, the Langahan part of the six methods. All these process of treatments are included in antaparimarjana (internal cleaning) and bahirparimarjana (external cleaning)

Introduction of panchkarma

As mentioned earlier, term panchkarma literally means five procedures. These are defined in two ways:-

  • Charak includes the following five operations or procedures in panchkarma
  • Nasya karma: it is popularly known as shiroveraechan. Nasya is the administration of medicine either in the liquid or in the powder forms into the nostrils. Its main function is to purify the nasal passage and relieves the congestion in the cranial region. In fact, the administration of nasya karma is considered as a purgative to the head as the term shiroveraechan literally implies.

  • Vaman karma: according to ayurveda, definitions say that it is the procedure in which aggravated doshas of the body are expelled out of the body by oral canal. Vaman or administration of emetics is one of the procedures by which Shodhana (cleansing) of the body is being done. The aim and the objective of performing Vaman karma are different from and more comprehensive than those of administration emetics. It is widely used in eradicating disorders caused by kapha dosha.

  • Virechan karma: it’s the procedure by which aggravated or imbalanced doshas are expelled out of the body through anal region. Virechan means purgative. This is chiefly in disorders caused due to pitta dosha. It helps in cleansing the body from doshas thus helping in providing stability and homeostasis in the body.

  • Nirooh vasti karma: nirooh vasti is commonly known as astthapan vasti. It includes the administration of certain decoctions of specific herbs as enemata for the chief purpose of cleaning the intestine. It is widely used in intestinal colic due to irregular peristalsis (udaavartham) and in constipation (vibhandh).

  • Anuvasan vasti karma: this is also called Snehan vasti. It helps in brimhana (strengthening) of the body hence provides power to the body organs. This is administration of enemata, which is prepared whole solely in oils there fore helps in toning up of organs. Besides cleansing purpose it also helps in relieving disorders caused by vata dosha.

  • Karma in normal terminology means special operations or procedure. The word karma means special act whose main purpose is to expel out the vitiated doshas thus helping in cleaning the body. As understood by name panch karma is five in numbers in which four are Shodhana karma i.e. helps in cleaning the body. These are Vaman, virechan, nasya, and nirooh vasti. There main purpose is to purify body or eliminating the aggravated doshas (vata, pitta and kapha) out of the body or subduing them, there fore they are classified into Langahan karma. The one left is anuvasan vasti which is considers as growth promoter and toner thus helps in lubricating and toning muscles and organs often body. Therefore it is characterized into samana karma, a soothing treatment: although its main purpose is also to eliminate or check a premier dosha i.e. vata hence included in brimhana chikitsa (treatment).

Rakta mokshana as a panchkarma

Maharishi Charak has mentioned the above mentioned five karmas but Maharishi Sushurut has considered rakta mokshana karma in panchkarma therapy and has included anuvasan vasti and nirooh vasti under vasti karma. Rakta mokshana commonly signifies to venesection or blood letting, to treat disorders caused by aggravated doshas. Maharishi Vagabhatta has accepted and supported this view as mentioned in ashtang hridayam.

One thing is worth mentioning here that Maharishi sushurut has considered four doshas instead of three i.e. vata, pitta, kapha and rakta.

Stambhana karma

Stambhana karma is the method of treatment by which contraction of the part of the body of the constriction of the arteries or other vessels in that part of the body or in the whole body takes place. This is the opposite of swedan karma, whose purpose is to dilate the pores and to lubricate (Snehan), to liquidate (vishyand), to soften (maardava), or to moisten (kleda) the part. Swedanam encourages perspiration. It checks sthambhan (contraction or solidification), heaviness (gauravam) and cold (sheet).

The purpose of stambhana on the other hand is to check movement (sthambhayati yat gatimantham, chalam) by contracting or congealing the opening of the channels.

Things used for causing stambhana

The things used for casing contraction are generally promoting slowness in movement, sheet (cold), mand (slow), soft (mridu), slakshan (glaszy), rookksh (non oily), sooksham (subtle or quickly permeating), dravya (liquid), sthir (steady) and laghu (light).

Soft and cold potters earth, ice, styptic, haemostatic, constipation, anti diuretics (like opium), and anti diaphoretics (like atropine), vaso constrictors (like adrenaline) may all be included under stambhana substances.

Substances which are sweet, bitter and astringent are stmabhak in action.

Person fit for stambhana karma

Those people who have aggravated pitta and presently the same picture as of pitta dominance like buring eyes, having persistent diarrhoea and vomiting. People who are affected by poison, people who sweat excessively or people suffering from similar kind of diseases are considered fit for stambhana karma.

Symptoms for proper stambhana treatment

Following are the symptoms by which application of stambhana karma is recognized: -

  1. The relief by the patient of all the distressing symptoms which he has been previously suffering

  2. The acquisitation of strength which is easily felt by the patient who had a proper stambhana treatment

Symptoms of excessive stambhana treatment

Following are the symptoms presented when a person is over treated by stambhana karma.

  1. black or grey discoloration of the treated part due to excessive venous congestion, necrosis or gangrene
  2. Stupefaction, loss of sensation or heaviness of the part treated.
  3. hurried respiration or excitement
  4. tendency of lock jaw
  5. A feeling of heaviness in heart region.
  6. Constipation.

Method of administrating panchkarma procedures

Panchkarma procedures are considered to as operations, which are to be performed in a sequence designed by ancient rishis and physicians. A pattern as followed by modern surgeons has been taken from ayurvedic medicinal system. It includes three steps. These are:

  1. Purva karma or the pre-operative procedure
  2. Pradhan karma or the main procedure
  3. Paschat karma or the post-operative care

It is very essential that panchkarma procedures are to be followed in proper sequence and an expert guidance is extremely essential as even little bit of carelessness and ignorance in performing the procedures can lead to extreme effects on body. One should also be very cautions in following the pre-operative and post-operative procedures for very good results.

(A) Purvakarmas or the pre-operative procedures

Purva karma means procedures of the karmas which are to be performed before starting with the main procedure. It can be included in the prior preparation of the main procedures which includes preparing patient mentally and physically for the main procedure. It includes three procedures. These are.

  1. Pachan karma
  2. Snehan karma
  3. Swedan karma

(B) Pradhan karma or the main procedure

It includes the main treatment to be given to the patient. It is most essential step in curing the patients from the disease. It includes all the panchkarma procedures. These are:

  1. Vaman karma
  2. Virechan karma
  3. Vasti karma
  4. Shiroveraechan karma
  5. Rakta mokshana

(C) Paschat karma or the post-operative care

Post operative care is one in which certain precautions are to be taken to get the full benefit of the main procedure. It also includes management and maintenance after recovery period by lifestyle management and diet management or by giving some herbal supplements. These includes following procedures.

  1. sansarjan karma
  2. rasayan adi prayogam
  3. shaman chikitsa