As the name suggest, Panchkarma means Pancha Karma i.e. Five Methods or Five Operation in Ayurvedic Medicinal System. These are:

Purva karmas of Virechan karma

In this process, we prepare our selves to perform the major process i.e. the virechan karma. Following are the points which are to be taken care of before the procedure has to start.

(a) Samagri or the collection

Before performing virechan one must do Snehan, swedan and Vaman karma. It is very important to perform these karmas before the virechan karma otherwise complications may arise.

(b) Rogi pariksha or the investigation of the patient

It should be first adjudged that does patient require virechan karma. If he requires this karma then he should be care fully investigated and his health should be judged on the criteria of desh (place), kaal (time and season), bal (strength), sharir (body), prakruti (nature). Depending on all these conditions it should be decided, that to what degree of and what type of virechan is to be given.

(c) Preparation of the Rogi

1. If the patient has also to be administered with Vaman karma prior to the virechan karma, then after performing Vaman karma, Snehan and swedan is to be performed again.
   
2. After performing Vaman karma sansarjan karma is to be performed in sequence and on the ninth, tenth, eleventh day and twelth day snehpaan (internal lubrication of body) is to be done.
   
3. After performing this one should take rest and then the procedure of virechan is to be performed.
   
4. The person who has to be given virechan must be given fatty stuff like ghee butter etc mixed with meat; rice etc prior 2 to 3 days before virechan karma and then he should be given purgatives.
   
5. Virechan should be performed empty stomach only.
   
6. Person who is to treated should be given psychological encouragement that he will be fine after the procedure is over.

(d) Preparing medicine

• A person who is week, lean and sensitive should be given Mridu virechak (mild purgative)
  
• If a person has the Mridu koshth (mild bowel) he can be given sugarcane juice, milk, ghee, triphala and warm water for performing virechan karma.
  
• If a person has Karoor koshth, he has vata dominance in his grehni (first part of intestine).
  
• It should be determined earlier the condition of koshth (bowel) of the person.

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