Panchakarma

In Ayurveda , Pancha Karma therapy is considered a complete, holistic approach to the elimination of the root cause of each and every chronic disease. Today, in the USA, 70% of deaths are due to chronic diseases rather than infectious diseases. Acharya Charaka has described that imbalances in Doshas can be pacified by Shamana therapies (palliation methods), such as administration of herbo-mineral supplements, lifestyle changes, adopting fasting, etc., but deep rooted imbalances in Doshas can be completely eliminated by the administration of Shodhana therapies (purification methods), such as Pancha Karma, including – Vamana, Virechana, Niruha Basti, Anuvasana Basti and Nasya.

Acharya Charaka emphasized the importance of Panchakarma as –
“Doshah Kadachith Kupyati Jitaa Langhana Pachanaih /
Jitaah Samsodhanardhe Tu Na Tesham Punarudbhavaha” // (Charak Sutra Sthana 16-20)

The vitiated doshas are pacified by fasting and by taking digestive herbo-mineral compound preparations, but when the imbalances of doshas are stronger and deep seated, only through sodhana -- purification therapies -- can doshic imbalances be removed from their deep roots. The analogy has been narrated here as the unwanted weeds and trees can be completely destroyed by removing them from their roots, but by cutting the branches, the weeds and trees will regrow and become stronger than the earlier disease.

During the purification and detoxification therapy, the balanced dhatus are eliminated along with the vitiated doshas; hence, one should remember to provide a nourishing diet with ghee, milk, and vegetable soups to maintain proper energy. During panchakarma therapy, the impurities dislodge from the cells and are flushed from the body.

Candidates for Panchakarma include those who show signs and symptoms of indigestion, anorexia (lack of enthusiasm of meals), obesity , anemia, heaviness, excessive mental and physical exhaustion, acne, pimples and urticaria, pruritus, lack of inclination for work, laziness, fatigue, weakness, foul odor of the body, lassitude, excessive production of kapha and pitta doshas, sleeplessness or excessive sleep, drowsiness, impotency, lack of intelligence, lack of clarity of mind and senses, inauspicious dreams, impaired energy and strength, and loss of complexion, even though they may be taking a nourishing diet .

Advantages of Panchakarma therapy include the following: The vitiated Doshas are eliminated from the body through the gastrointestinal system, digestion is improved, and metabolism is increased. Overall health is restored, the sensory faculties are improved, and intelligence and complexion become clearer.
Seasonal Panchakarma program –
• Late autumn to winter (approximately October to February) – predominance of Vata Dosha, the importance is given to Basti (colon cleansing, restorative) therapies.
• Midsummer to early autumn (approximately July to October) – the predominance of Pitta Dosha, it is important to administer Virechana (purging) therapies.
• Spring to early summer (approximately March to June) – predominance of Kapha Dosha, the importance is given to Vamana (therapeutic emesis) and Nasya therapy.

The following Panchakarma Therapies were adopted –
Poorva Karma (preparatory therapy)
• Ama pachana (administration of herbal preparations for about 1-2 weeks)
• Snehana –Bahya (external oleation) – self-massage with herbalized oil and internal oleation (abhyantara snehana) with ghee
• Swedana – Sweating / sudation / fomentation therapy
Digestive (Ama pachana) tea –prepared with
• Cumin – 1 part, Ginger – ½ part, Fennel – 1 part, Cardamom – ½ part, Cinnamon – ½ part – 6 cups water boil for 5 minutes / drink several times a day.
• Trikatu – 1-2 tablets / 3 times daily
Digestive and deep rooted Ama reduction –
• For Vata Prakriti persons – a combination of Chitrak – 1 part, Haritaki – ½ part, Fennel – 1 part,
• For Pitta Prakriti persons – a combination of Avipathikara churna – 1 part, Triphala – 1 part, Licorice -1 part, Fennel -1 part, Coriander -1 part
• For Kapha Prakriti persons – a combination of Chitrak -1 part, Musta -1 part, Ginger - ½ part, Licorice -1 part, Trikatu - ½ part
Snehana – Oleation
• Internal oleation – Administered ghee 2, 4, and 6 teaspoons, respectively, for three consecutive days. People who are intolerant to ghee were administered flaxseed oil in the same quantities with warm milk, soy milk or rice milk.
• External oleation –Clients were advised to self-massage regularly with Ojas Rejuvenation oil.
Swedana
• The candidates were put in the steam tent to provide complete sweating, providing Amalaki Kalka (paste of Phyllanthus emblica with rose water) or coconut oil to protect excess heat to brain (Mastishka)
Pradhana Karma (Main actions) –
Vamana (therapeutic emesis) –
• It is highly recommend in imbalanced Kapha Dosha. For candidates who are strong, Vamana Therapy with Madanaphala (Randia dumatorum) fruit powder – 2 parts, Vacha (Acorus calmamus) root powder – 1 part and Saindhava Lavana (Mineral salt) - 1 part, mixed with honey was administered early in the morning on an empty stomach. After 15-20 minutes, candidates were given Yastimadhu Jala (Licorice water) - 8-10 oz to drink.
Virechana (therapeutic purgation) –
• This therapy is recommended for imbalanced Pitta Dosha and removes excess pitta through increasing bowel movements. The purgative therapy was administered with castor oil and TriDosha cleanse capsule – a combination of Triphala, Haritaki, Cascaria, and Sonamukhi.
Basti Therapy (both Kashaya and Matra Basti) –
• Basti therapy is administered on alternative days for 5, 7, or 10 days according to the duration of Panchakarma therapy. For Kashaya basti, different herbs were used for preparing Kashaya. We followed a specific method of mixing Kashaya basti substance – “Makshikam Lavanam Tailam Kalkam Kwatham” – In this procedure first taking honey, mineral salt, sesame oil and kashaya are given. In some specific cases, we have used Kalka churna.
• For Matra basti, we administered Ashwagandha Bala oil, sesame oil or specific therapeutic oils for specific disease conditions.

Nasya Karma –
• According to doshic imbalances, Rechana (eliminative) nasya was provided. In some cases, we also provided Ardraka swarasa (fresh ginger juice) with jaggary to eliminate excess Kapha Dosha from sinuses and nasal passages.Other supportive Panchakarma therapies –
• Netra Basti (eye therapies), Kati Basti (lumbar therapy), Hrit Basti (Heart therapy), Nabhi Basti (Naval therapy), Shiro Basti, Shiro Dhara, Shiro Pichu, and other therapies were provided as needed.

Panchakarma ResultsTables showing distribution of 80 subjects of Panchakarma therapy

Age distribution of 80 Panchakarma subjects (Table: 1)

Age Number of subjects Percentage
20 – 30 years 12 15 %
30 – 40 years 14 17.5 %
40 – 50 years 28 35 %
50 – 60 years 18 22.5 %
60 – 70 years 8 10 %

Gender distribution of 80 Panchakarma subjects (Table: 2)

Gender Number of subjects Percentage
Male 22 28 %
Female 58 72 %

Deha Prakriti (Physical constitution) Distribution of 80 Panchakarma subjects (Table: 3)

Deha Prakriti Number of subjects Percentage
Vata 2 2.5 %
Pitta 1 1.25 %
Kapha 4 5 %
Vata Pitta 8 10 %
Vata Kapha 11 13.75 %
Pitta Vata 13 16.25 %
Pitta Kapha 12 15 %
Kapha Vata 16 20 %
Kapha Pitta 10 12.5 %
Tridosha 3 3.75 %

Manasa Prakriti (Psychological constitution) Distribution of 80 Panchakarma (Table: 4)

Manasa Prakriti Number of subjects Percentage
Satvik 12 15 %Rajasik 41 51.25 %
Tamasik 27 33.75 %

Sub Dosha Imbalance Distribution of 80 Panchakarma subjects (Table: 5)

Sub Dosha Number of subjects Percentage
Prana Vata 52 65.0%
Udana Vata 24 30.0 %
Samana Vata 29 36.25 %
Apana Vata 34 42.5 %
Vyana Vata 15 18.75 %
Pachaka Pitta 38 47.5 %
Ranjaka Pitta 24 30.0 %
Sadhaka Pitta 59 73.75 %
Alochoaka Pitta 28 35 %
Bhrajaka Pitta 42 52.5 %
Kledaka Kapha 32 40 %
Avalambaka Kapha 14 17.5 %
Bodhaka Kapha 18 22.5 %
Tarpaka Kapha 12 15 %
Sleshaka Kapha 32 40 %

Dhatu (tissue) Imbalance Distribution of 80 Panchakarma subjects (Table: 6)

Dhatu Number of subjects Percentage
Rasa (Plasma) 48 60.0 %
Rakta (Blood) 29 36.25 %
Mamsa (Muscle) 13 16.25 %
Medas (Adipose tissue) 56 70.0 %
Asthi (Bone) 19 23.75 %
Majja (Bone marrow) 12 15 %
Shukra (Reproductive tissue) 24 30 %

Agni (digestive fire) Distribution of 80 Panchakarma subjects (Table: 7)

Agni Number of subjects Percentage
Sama - Balanced 13 16.25 %
Vishama - Irregular 33 41.25 %
Teekshna - Sharp 8 10 %
Manda - Dull 26 32.5 %

Koshta (Competence of stomach) Distribution of 80 Panchakarma subjects (Table: 8)

Koshta Number of subjects Percentage
Mrudu – soft, supple 17 21.25 %Madhyama - medium 25 31.25 %
Krura – rigid, tough 38 47.5 %

Diet and Pattern of Eating Habits Distribution among 80 Panchakarma subjects (Table: 9)

Diet Number of subjects Percentage
Vegan 12 15 %
Vegetarian including diary 23 28.75
Mixed (Veg + Non-Veg) 45 56.25 %
Pattern of eating habits
Regular 32 40 %
Irregular 48 60 %

Pancha Karma Therapies Distribution among 80 Panchakarma subjects (Table: 10)

Name of Panchakarma Therapies Number of subjects Percentage
Snehana 80 100.0 %
Abhyanga 62 77.5 %
Vishesha 65 81.25 %
Udvartana 58 72.5 %
Swedana 80 100.0 %
Vamana 12 15.0 %
Virechana 80 100.0 %
Basti – Asthapana (Matra) 80 100.0 %
Basti – Niruha (Kashaya) 48 60.0 %
Nasya 72 90.0 %
Netra Basti 15 18.75 %
Kati Basti 21 26.25
Hrut Basti 19 23.75 %
Nabhi Basti 34 42.5 %
Shiro Basti 11 13.75 %
Shirodhara with Oil (Taila dhara) 74 92.5 %
Shirodhara with Takra (Takra dhara) 19 23.75 %
Shiro Pichu 25 31.25 %
Pizhichil 28 35.0 %
Gandoosha 14 17.5 %

Level of Improvement Distribution among 80 Panchakarma subjects (Table: 11)

PHYSICAL BENEFITS
Health issue Complete improvement (100 %) Marked improvement (75 %) Moderate improvement
(50%) Mild improvement
(25 %) No improvement
(0%)
Digestion 32 (40.0) 21 (26.25) 15 (18.75 ) 8 (10.0) 4 (5 .0)
Sleep 15 (18.75) 24 (30.0) 18 (22.5) 16 (20.0) 7 (8.75)
Constipation 37 (46.25) 16 (20.0) 11 (13.75) 14 (17.5) 2 (2.5)
Clearance of
sinuses 12 (15.0) 18 (22.5) 23 (28.75) 16 (20.0) 11 (13.75)
Flexibility of
joints 17 (21.25) 20 (25.0) 17 (21.25) 18 (22.5) 8 (10.0)
Physical energy 22 (27.5) 13 (16.25) 15 (18.75) 20 (25.0) 10 (12.5)
Lightness of
body 12 (15.0) 14 (17.5) 20 (25.0) 22 (27.5) 12 (15.0)
Discomfort / pain 22 (27.5) 18 (22.5) 14 (17.5) 15 (18.75) 11 (13.75)
Dryness of skin 51 (63.75) 8 (10.0) 12 (15.0) 7 (8.75) 2 (2.5)
Fatigue 28 (35.0) 16 (20.0) 12 (15.0) 15 (18.75) 9 (11.25)
Circulation 18 (22.5) 22 (27.5) 18 (22.5) 14 (17.5) 8 (10.0)
Vision 12 (15.0) 15 (18.75) 16 (20.0) 18 (22.5) 19 (23.75)
Breathing pattern 14 ((17.5) 15 (18.75) 22 (27.5) 16 (20.0) 13 (16.25)
Cardiovascular
endurance 6 (7.5) 15 (18.75) 22 (27.5) 25 (31.25) 12 (15.0)
Gas, flatulence 29 (36.25) 17(21.25) 12 (15.0) 16 (20.0) 6 (7.5)
Complexion 21 (26.25) 18 (22.5) 16 (20.0) 13 (16.25) 12 (15.0)
Allergy 20 (25.0) 16 (20.0) 17 (21.25) 18 (22.5) 9 (11.25)
Immune system 16 (20) 22 (27.5) 14 (17.5) 18 (22.5) 10 (12.5)
Physical
endurance 22 (27.5) 12 (15.0) 15 (18.75) 17 (21.25) 14 (17.5)
Strength of spine 16 (20.0) 15 (18.75) 17 (21.25) 15 (18.75) 17(21.25)
Allergies 22 (27.5) 16 (20.0) 18 (22.5) 14 (17.5) 10 (12.5)
Migraine 23 (28.75) 18 (22.5) 21 (26.25) 13 (16.25) 5 (6.25)
Menstrual pain 25 (31.25) 16 (20.0) 14 (17.5) 15 (18.75) 10 (12.5)
Backache 29 (36.25) 17 (21.25) 14 (17.5) 12 (15.0) 8 (10.0)
Overall physical
wellness 19 (23.75) 20 (25.0) 18 (22.5) 14 (17.5) 9 (11.25)

PSYCHOLOGICAL BENEFITS
Clarity of mind 26 (32.5) 16 (20.0) 18 (22.5) 12 (15.0) 8 (10.0)
Self awareness 15 (18.75) 26 (32.5) 18 (22.5) 13 (16.25) 8 (10.0)
Thought process 12 (15.0) 17 (15.0) 22 (27.5) 19 (23.75) 10 (12.5)
Mental energy 21 (26.25) 14 (17.5) 19 (23.75) 18 (22.5) 8 (10.0)
Meditation 19 (23.75) 17 (21.25) 18 (22.5) 19 (23.75) 7 (8.75)
Memory 12 (15.0) 26 (32.5) 16 (20.0) 14 (17.5) 12 (15.0)
Deep relaxation 21 (26.25) 16 (20.0) 21 (26.25) 15 (18.75) 7 (8.75)
Chronic stress 27 (33.75) 15 (18.75) 16 (20.0) 14 (17.5) 8 (10.0)
Relationship
with others 10 (12.5) 16 (20.0) 15 (18.75) 18 (22.5) 21 (26.25)
Connectedness of
mind, body, spirit 24 (30.0) 14 (17.5) 12 (15.0) 16 (20.0) 14 (17.5)
Inner harmony 26 (32.5) 15 (18.75) 16 (20.0) 11 (13.75) 12 (15.0)
Mental fatigue 29 (36.25) 14 (17.5) 17 (21.25) 12 (15.0) 8 (10.0)
Calmness of
mind 21 (26.25) 18 (22.5) 16 (20.0) 14 (17.5) 11 (13.75)
Creativity 18 (22.5) 14 (17.5) 19 (23.75) 16 (20.0) 13 (16.25)
Mental stamina 22 (27.5) 18 (22.5) 14 (17.5) 14 (17.5) 12 (15.0)
Self confidence 18 (22.5) 12 (15.0) 18 (22.5) 17 (21.25) 15 (18.75)
Positivity 22 (27.5) 14 (17.5) 16 (20.0) 12 (15.0) 16 (20.0)
Mental alertness 16 (20.0) 18 (22.5) 13 (16.25) 16 (20.0) 17 (21.25)
Concentration 19 (23.75) 15 (18.75) 16 (20.0) 18 (22.5) 12 (15.0)
Overall
mental wellness 21 (26.25) 16 (20.0) 18 (22.5) 12 (15.0) 13 (16.25)

Figures in parenthesis indicate percentage.

Duration of Panchakarma Distribution among 80 Panchakarma subjects (Table: 12)

Duration of therapy Number of subjects Percentage
5 days 48 60.0 %7 days 24 30.0 %
10 days 8 10.0 %

Overall Improvement in Physical Health Distribution among 80 Panchakarma subjects (Table: 13)

Improvement Physical Health Percentage
Complete improvement 27.85 %
Marked improvement 21.80 %
Moderate improvement 20.75 %
Mild improvement 19.85 %
No improvement 9.75 %

Overall Improvement in Psychological Health Distribution among 80Panchakarma subjects (Table: 14)

Improvement Psychological Health Percentage
Complete improvement 24.04 %
Marked improvement 20.17 %
Moderate improvement 23.32 %
Mild improvement 19.18 %
No improvement 13.29 %

Overall improvement in both physical and psychological health among 80Panchakarma subjects (Table: 15)

Improvement Psychological Health Percentage
Complete improvement 25.94 %
Marked improvement 20.98 %
Moderate improvement 22.03 %
Mild improvement 19.5 %
No improvement 23.04 %

Conclusion and Summary:
The highest number of subjects (35%) to undertake Panchakarma therapy in the present clinical study fell in the 40-50 years age group (Table 1). More females participated in the Panchakarma therapy (72%) as compared to male subjects (Table 2). In the present clinical study, 20% of subjects were Kapha Vata Deha Prakriti (Table 3) and 51% were Rajasik Manasa Prakriti (Table 4). 73% of subjects had Sadhaka Pitta imbalances, and 65% had Prana Vata imbalances noted in the pulses of subjects (Table 5). In the present clinical study, 70% of subjects had Medo Dhatu vitiation, and 60% has Rasa Dhatu (60%) vitiation (Table 6). We observed 41% of subjects with Vishama Agni, as depicted in Table 7 and also observed that 37% had Krura Koshta as mentioned in Table 8. Regarding diet – a mixture (non-vegetarian and vegetarian) is represented in the present clinical study (56%), and their eating habits are irregular (60%) (Table 9). Different Panchakarma and allied therapies were provided for the subjects, according to their individual needs (Table 10). Regarding their symptoms, large numbers of subjects were completely relieved of their symptoms – dryness of skin (63%), constipation (46%), digestion (40%), in physical symptoms and in psychological symptoms – chronic stress (33%) and mental fatigue (36%) (Table 11). A large number of subjects (60%) underwent only 5-day Panchakarma therapy, whereas only 10% subjects have undergone 10-day Panchakarma therapy (Table 12). If more subjects were to undergo 10, 14 or 21 days of Panchakarma therapy, we may expect a greater percentage of subjects to note complete relief from symptoms. We found about 27% complete improvement in physical symptoms and about 24% complete improvement in psychological symptoms (Tables 13 & 14). Approximately 25 % of subjects noted complete overall improvement, while 23% noted no overall improvement in their health issues. (Table 15)