The basic tenet of Ayurveda involves treating the patient in two way – Sodhana (Purification) and Samana (Pacification). The Sodhana involves relieving the body of various aggravated Dosha by dismissing them through body orifices, Samana involves intake of herbs, applying oil, poultices, massages, etc. and ameliorating the aggravated Dosha without dispelling them. Panchakarma comprises the process of purification. Panchakarma is considered a stepwise process beginning from the initial preparatory procedures (Purvakarma), moving unto the main procedures where you actually relieve the Doshas (Pradhankarma) and then finally into the stage of recovery (Paschatkarma).

The preparatory procedures basically involve prepping the body to undergo the onerous task of purification.

These Includes:

1. Digestive juice stimulants (Dipana),
2. Digestant (Pachana),
3. Oleation (Snehana), and
4. Sudation (Swedana).

Dipana is the process for stimulation of the digestive juices and fire (Jatharagni) using medicines; Pachana involves intake of digestants. Then is the process of internal as well as external oleation – essentially ingesting medicated oil or ghee and also applying it externally. The process is known as Snehana. The process of Snehana goes hand in hand with the process of Swedana (Sudation). Any preparation is usually administered for 3 to 7 days, depending on the age, disease and the condition of the patient.

The preparatory procedures are followed by Pradhankarma or the main procedures of Panchakarma. Panchakarma is composed of two Sanskrit words Pancha – Five and Karma – Actions. Various acharyas have iterated these five actions to be of five different types, but the three procedures of Vamana (emesis therapy), Virechana (purgation therapy) and Vasti (enema therapy) have fallen under common consensus of all the Acharyas. Vamana involves emptying out the contents of the stomach including Kapha and Pitta Dosha. It helps to remove toxins from the upper part of your body. Virechana involves elimination of Pitta and toxins of the body through the rectal route. Vasti is the process where decoction, pastes, and oil is introduced into the large intestine through the rectum with the help of enema apparatus. Vamana is recommended for Kapha illness, Virechana for Pitta illness and Vasti for the Vata illness.

According to Acharya Charak, the five procedures falling under the Panchakarma is Vamana, Virechana, Anuvasana vasti (oil used in Enema), Asthapana vasti (decoction used in enema) and Shirovirechana / Nasya. Susruta prescribed Vamana, Virechana, Vasti, Nasya and Raksta mokshana. Nasya or errhines is when you place heated oil or powder of herbal medicines inside your nostrils and then they are expelled out through the mouth. The procedure is beneficial for the diseases of the head. Rakta mokshana is similar to the process of bloodletting. It may be by application of leeches or suction and is a good procedure for removal of intoxicated Rakta (Blood). These five procedures may be done chronologically or concomitantly or singly.

The Paschatkarma involves the reviving of the subjugated Doshas to their normalcy by using up of light food and herbs that promote the physiological balance.

The beneficial contribution of Panchakarma therapy is that it removes the toxins from the body and provides purification of the body at two levels: the gross level, where various organs and systems of the

body are thoroughly cleansed (e.g. gastrointestinal tract, chest, cardiovascular system, etc.); and the cellular level, where purification and cleansing of the body is produced at the level of cells. Panchakarma holistically helps the body back to normalcy; starts rejuvenation and revitalization of all body tissues even at spiritual level; potentiates the pharmacological actions of various drugs and medicines administered after Panchakarma; removes waste products, toxins, and stagnant Doshas; and potentiates physiological functions of all the body systems. Panchakarma not only is a prerequisite for all the therapeutic procedures and medications but also has a full therapeutic role in promoting preventive, curative, and rehabilitative procedures. If properly performed, Panchakarma does not produce any serious complications. If any minor complications are produced, they are easily manageable.

It is important that the full procedure of Panchakarma is done under proper guidance. There are always chances of unwanted complications and a person need to have keen senses and intuition to identify those eccentricities and care the person accordingly to help progress the therapy to a proper conclusion.