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An Introduction to Panchakarma

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An Introduction to Panchakarma An Introduction to Panchakarma Presenter : Dr. Praerna Bhargav Chair Person : Dr. Kishore R K Research Associate Research Officer (Ayurveda) DST – SATYAM Project RARIMD, CCRAS, Bengaluru OVERVIEW Panchakarma in Ayurvedic Classics Pathogenesis of disease Ayurvedic Principles of Treatment Fundamental Principle behind Panchakarma What is Panchakarma? Objectives of Panchakarma Steps in Panchakarma Purvakarma Pradhankarma Paschatkarma Major Precautions in Panchakarma Importance of Panchakarma Benefits of Panchakarma Research findings Panchakarma in Ayurvedic Classics Charaka Samhita Sushruta Samhita Ashtanga Hrudaya Ashtanga Sangraha Pathogenesis of disease Every disease is related to an imbalance of the doshas. Other coherent factors are: The disturbance of the biological fires (agnis) The formation and accumulation of undigested nutrients(ama), Obstruction of the body channels (srotorodha) Disturbed assimilation in the tissues (vitiated doshas). Ayurvedic Principles of treatment Nidana Parivarjana – Preventing the cause Samprapti Vighatan - Shodhana - Bio-purification by Panchakarma Shamana - Bio-balancing care by Aushadhi - Medicine Aahara – Dietary regime Vihara – Life style modification (Ashtanga Sangrah Sutra Sthana 16-20) Fundamental Principle Behind Panchkarma Concept of Jatharagani and Ama Body as Yajnya Kunda Cow’s Ghee as the Carrier: Bio- permeable Importance of Cleansing the srotas (Subtle channels) – Koshta –shakhagat srotas Removing impurities from tissues without surgery What is Panchakarma? Panchakarma Pancha means five and karma means actions or treatments So Panchakarma is a special therapeutic procedure in Ayurveda, involving five types of evacuating treatment which leads to detoxification of the body and strengthening of the immune system, thus, restoring balance and well-being with resultant rejuvenation. Objectives of Panchakarma Three major objectives: Swasthya Rakshana - Health maintenance Roga nivarana – Elimination of the disease Prepare for rejuvenation (Charak Sutra Sthana 7-47,48) Swasthya Rakshana - Health Maintenance Recommended even for healthy individuals, as part of regular seasonal regimens as doshas naturally accumulate owing to seasonal changes and can cause disease if not removed timely. (Charak Sutra Sthana 7-46) Dosha aggravation rhythm cycle VATA ↑ VATA KAPHA ↓ PITTA↑ Varsha Sharad PITTA Hemant KAPHA VATA ↓ Shishira Vasant Grishma KAPHA ↑ PITTA ↓ Roga Nivarana – Elimination of the disease When the doshas are vitiated beyond a certain level, they give rise to various endo-toxins (Ama), which have a tendency to be accumulated in the minute channels (Srotas). When such condition is beyond the level of pacification and do not respond well to medications then they need to be eliminated from the body through Shodhana therapy. Rasayana & Vajikarana – Rejuvenation/Revitalization Therapy Panchakarma procedures prepares the body to respond well to Rasayana (Rejuvenation) and Vajeekarana (revitalization) therapies which helps to strengthen various body tissues and delays degenerative processes. (Charak Sutra Sthana 7-48,49) Steps of Panchakarma Purva Pradhan Paschata karma Karma karma Vamana Samsarajana Deepana Karma – Diet Regimen Virechana Pachana Rasayanadi Karma – Nasya Rejuvenation Snehana therapy Basti Shamana Swedana Karma – Raktamokshana Pacification Purva Karma – Preparatory procedure These are the preparatory procedures that help the body discard the toxins present in tissues and GI tract. It includes following procedures: Deepana & Pachana - Digestive Therapy Snehana - External & Internal Oleation Therapy Swedana - Sudation / Fomentation Therapy Significance of Purva Karma These preparatory procedures help by : Ignition & promotion of digestive fire Loosening of deep rooted toxins & softening of the body parts (Ca.Si. 1;7) Liquefaction and mobilization of aggravated doshas from shakha (periphery) to koshtha (GI tract) (Ca.Si. 1;7) Snehana - Svedana Indications Contraindications • Vata disorders - paraplegia, • Alcohol abuse hemiplegia, facial paralysis, • Pregnancy arthritis, sciatica, backache, joint • Menstruation, disorders, constipation, colicky • Malnourished persons pains, spasmodic pains, • Gastrointestinal disorders • Oedema, • Obesity • Dysuria, • Comatose pt • Heaviness of the body • Tuberculosis • Respiratory disorders - Chronic coryza. Asthma, Cough, Hiccup • Diabetes • Headache • Very old people, • Pharyngitis • Pitta prakriti /pitta disorders Properties of appropriate Snehana - Svedana Properties of Samyak Snehana- vatanulaeMy< dIÝaei¶vRcR> iõGxms<htm!, madRv< iõGxta ca¼e iõGxanamupjayte. (Charak Sutra Sthana 13-48) Evacuation of flatus, increase of digestive fire, unctuous and soft stool, supple and soft body, oily skin Properties of Samyak Svedana- zItzUlVyuprme StMÉgaErvin¢he, s<jate madRve Svede SvednadivritmRta. (Charak Sutra Sthana 14-13) Relief from coldness, stiffness, heaviness and pain, induces sweating and softness of the body. Pradhana Karma – Main Procedure Vamana - Induced vomiting Virechana - Induced purgation Basti - Medicated enema Aasthaapan basti - herbal decoction enema Anuvasana basti - herbal oil enema Nasya - Nasal medication Raktamokshana – Blood letting Effects of Panchakarma on dosha Procedure Dosha Vaman For Kapha dosha Virechan For Pitta dosha Basti For Vata dosha For Kapha dosha Nasya in head For Rakta and Raktamokshana Pitta dosha Vamana - Therapeutic emesis Procedure –2-3 litres of either milk/ sugar water/ licorice tea/ buttermilk to drink followed by emetic dose usually comprising of Randia dumetorum seed (Madanphala) with calamus (Vacha) and pinch of rock salt mixed with honey. Wait period of 45 mins Vegas start Removes excessive Kapha and accumulated toxins from upper GI tract and the respiratory system Vamana - Therapeutic emesis Indications Contraindications • Respiratory disorders - Asthma, • Young children Cough, Bronchitis, repeated colds • Pregnancy Pharyngitis • Elderly • Kapha disorders • Malnourished persons • Dyspnoea • Debilitated • Nausea • Stomach ulcers • Anorexia • Severe lung/heart disease • Sinusitis • Abdominal tumors • Skin diseases • Intestinal obstruction • Obesity • Splenic disorders • Diabetes • Psychological disorders Properties of appropriate Vamana kale àv&iÄrnitmhtI Vywa ywa³m< dae;hr[< Svy< cavSwanimit yaegl][ain ÉviNt. (Charak Sutra Sthana 15-13) Timely disposition of vegas, not causing much discomfort, evacuation of doshas in proper sequence and termination of the vegas on its own after proper detoxification ipÄaNtimò< vmn< (Charak Siddhi Sthana 1-14) Sign of perfect emesis with expulsion of pitta According to the disposition of number of vegas, purification can be of three types: Type of Shuddhi Number of vegas Quantity of waste Heena 4 768 gm Madhya 6 1152 gm Pradhana 8 1536 gm Virechana – Therapeutic purgation Procedure – After purvakarma the person is made to ingest any of the herbal purgatives such as eranda taila/ triphala/ katuki/ Abhaya/ senna to eliminate solid/liquid wastes (feces, urine) from the body After 30 – 45 mins vegas start Removes excessive pitta and toxins accumulated in liver and gall bladder from lower GI tract Purifies blood Virechana – Therapeutic purgation Indications Contraindications • Chronic skin disorders • Anal fissures • Diabetes • Ano rectal bleeding • Ano-rectal disorders - Fistula, • Anorexia Haemorrhoids • Malnourished persons • GI disorders – Ascites, liver • Debilitated disorders, indigestion, • Elderly constipation • Pregnancy • Anaemia • Children • Migraine • Fever • Jaundice • Alcoholic • Oedema • Gout * Quantity, counts, color and consistency of waste emitted should be observed. Also blood pressure, pulse, respiration should be tracked for both Vamana and Virechana Therapies. Properties of appropriate Virechana daEbRLy< la"v< GlainVyaRxInam[uta éic>, ùÖ[Rzuix> ]uÄ&:[a kale vegàvtRnm!. buÏIiNÔymn> zuixmaRétSynulaemta, sMyiGvir´il¼ain kaya¶eínuvtRnm!. (Charak Sutra Sthana 16- 5,6) Weakness, lightness and tiredness of body, subsidence of disease, finding taste in food, purification of the heart and improved complexion, feeling of hunger and thirst, timely disposition of vegas, clarity of thoughts, intellect, senses, channelization of vata and improved bio fire. k)aNt< c ivrek> (Charak Siddhi Sthana 1-14) Sign of perfect purgation with expulsion of kapha Type of Shuddhi Number of vegas Quantity of waste Heena 10 1536 gm Madhya 20 2304 gm Pradhana 30 3072 gm Basti – Medicated enema “Basti” means sac or pouch Various medicated enemas are used for inducing into the large intestine through rectum (basti) using an enema bag (basti) Cleanses or lubricate the system and alleviate dryness caused by an excess of Vata It is also considered as the mother of all Panchakarma treatments as it cleanses the accumulated toxins from all the 3 doshas : Vata, Pitta and Kapha, through the colon. Types of Basti Based on liquid used for enema, basti is of 2 types – Niruha / Asthapana basti (Herbal decoction based - Cleansing ) Anuvasana / Sneha / Matra / Taila (oil based - Oleation) Based on site of administration, basti can be of several types – Guda basti Uttara basti Shiro basti Hrut basti Kati basti Nabhi basti Jaanu basti Aasthaapana Basti Procedure – Enema comprises of honey, salt, oil, and herbal decoction and is administered on an empty stomach in the morning. Quantity - 500 cc (age, disease, condition) Position - left-lateral lying down Wait period - medicated contents are retained in the intestines for a maximum of 45 minutes and
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