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The word panchakarma is composed of two words, ‘pancha’ and ‘karma’. Pancha means five and karma means ‘action’<ref>Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, Karman, Page 258</ref>. In this context karma represents therapeutic procedure or treatment given by a physician. Thus, Panchakarma means the five kinds of therapeutic procedures or treatments. This includes therapeutic emesis ([[vamana]]), therapeutic purgation ([[virechana]]), therapeutic enema with decoction (niruha), therapeutic enema with unctuous substances (anuvasana) and trans-nasal drug administration ([[nasya]]). These procedures are intended to maintain equilibrium in body by expelling the excessively aggravated [[dosha]] outside through nearest external route. [Chakrapani on [[Sutra Sthana]] 2/15] [Su.Sa.Chi.33/3]. These are indicated as seasonal regimen for preservation of health and prevention of diseases. [Cha.Sa.[[Sutra Sthana]] 7/45-50]

The word panchakarma is composed of two words, ‘pancha’ and ‘karma’. Pancha means five and karma means ‘action’.<ref>Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, Karman, Page 258</ref>  In this context karma represents therapeutic procedure or treatment given by a physician. Thus, Panchakarma means the five kinds of therapeutic procedures or treatments. This includes therapeutic emesis ([[vamana]]), therapeutic purgation ([[virechana]]), therapeutic enema with decoction (niruha), therapeutic enema with unctuous substances (anuvasana) and trans-nasal drug administration ([[nasya]]). These procedures are intended to maintain equilibrium in body by expelling the excessively aggravated [[dosha]] outside through nearest external route. [Chakrapani on [[Sutra Sthana]] 2/15] [Su.Sa.Chi.33/3]. These are indicated as seasonal regimen for preservation of health and prevention of diseases. [Cha.Sa.[[Sutra Sthana]] 7/45-50]

{{Infobox

{{Infobox

#Therapeutic purgation ([[Virechana]])

#Therapeutic purgation ([[Virechana]])

#Trans nasal drug administration([[Nasya]])

#Trans nasal drug administration([[Nasya]])

#Therapeutic enema with decoction (Niruha[[basti]])

#Therapeutic enema with decoction (Niruha [[basti]])

#Therapeutic enema with unctuous substances (Anuvasana[[basti]])  

#Therapeutic enema with unctuous substances (Anuvasana [[basti]])  

#Bloodletting ([[Raktamoksha]])

#Bloodletting ([[Raktamoksha]])

==Inclusion of bloodletting ([[raktamoksha]]) in panchakarma==

==Inclusion of bloodletting ([[raktamoksha]]) in panchakarma==

There are differences in opinions about inclusion of bloodletting ([[raktamokshana]]) in five purification procedures. The total number remains five only as they combine two types of enema (unctuous and non-unctuous) in single procedure[A.H.Su.14/5]. However, this inclusion is not supported by Charak as it does not fulfill the inclusion criteria with fundamental principles of purification. The reasons are as below:  

There are differences in opinions about inclusion of bloodletting ([[raktamokshana]]) in five purification procedures. The total number remains five only as they combine two types of enema (unctuous and non-unctuous) in single procedure [A.H.Su.14/5]. However, this inclusion is not supported by Charak as it does not fulfill the inclusion criteria with fundamental principles of purification. The reasons are as below:  

#Panchakarma are intended to expel out [[dosha]] only. Blood ([[rakta]]) is a body component under category of [[dhatu]], not [[dosha]].

#Panchakarma are intended to expel out [[dosha]] only. Blood ([[rakta]]) is a body component under category of [[dhatu]], not [[dosha]].

#The principles of purification state to take aggravated [[dosha]] from periphery (shakha) to gut (koshtha) by preparatory procedures. Then the [[dosha]] is removed through nearest external opening of body. In case of bloodletting, the [[dosha]] in periphery are removed through artificial opening created by using some instrument.

#The principles of purification state to take aggravated [[dosha]] from periphery (shakha) to gut (koshtha) by preparatory procedures. Then the [[dosha]] is removed through nearest external opening of body. In case of bloodletting, the [[dosha]] in periphery are removed through artificial opening created by using some instrument.

#Panchakarma procedures are intended towards generalized purification of whole body with additional benefits on mind and senses. However, [[raktamokshan]] mostly shows limited local benefits on purification of [[rakta] [[dhatu]].

#Panchakarma procedures are intended towards generalized purification of whole body with additional benefits on mind and senses. However, [[raktamokshan]] mostly shows limited local benefits on purification of [[rakta dhatu]].

==Principles of Panchakarma==

==Principles of panchakarma ==

The following principles are applied in panchakarma procedures:  

The following principles are applied in panchakarma procedures:  

#The procedure is intended to correct imbalance in body physiology. It shall remove excessively aggravated [[dosha]] and bring them to normal state.  

#The procedure is intended to correct imbalance in body physiology. It shall remove excessively aggravated [[dosha]] and bring them to normal state.  

#The procedure is performed only in a state of excess aggravation (bahu[[dosha]]) and natural tendency to get removed (utklesha) through nearest natural orifice.  

#The procedure is performed only in a state of excess aggravation (bahu [[dosha]]) and natural tendency to get removed (utklesha) through nearest natural orifice.  

#If the [[dosha]] are in dormant state (leena[[dosha]]), then procedure is performed after bringing them to gut (koshtha) from periphery (shakha). The following factors lead to movement of [[dosha]] from periphery to gut. [Cha.Sa.[[Sutra Sthana]] 28/33]

#If the [[dosha]] are in dormant state (leena [[dosha]]), then procedure is performed after bringing them to gut (koshtha) from periphery (shakha). The following factors lead to movement of [[dosha]] from periphery to gut. [Cha.Sa.[[Sutra Sthana]] 28/33]

*Aggravation of [[dosha]] (vriddhi)

*Aggravation of [[dosha]] (vriddhi)

*Pacification of [[vata]] (vayunigraha)

*Pacification of [[vata]] (vayunigraha)

==General protocol for conducting panchakarma==

== General protocol for conducting panchakarma ==

For safe and effective administration, each procedure is conducted in the following three steps:

For safe and effective administration, each procedure is conducted in the following three steps:

#Post therapy regimen (Pashchatkarma)

#Post therapy regimen (Pashchatkarma)

===Preparation of patient(Purvakarma)===

=== Preparation of patient(Purvakarma) ===

This includes the therapies prior to a panchakarma procedure. These are mainly intended for bringing [[dosha]] in gut. The general therapies are as below:  

This includes the therapies prior to a panchakarma procedure. These are mainly intended for bringing [[dosha]] in gut. The general therapies are as below:  

The medicines and time span for these preparatory procedures varies according to type of procedure and biological condition of patient or individual undergoing treatment.  

The medicines and time span for these preparatory procedures varies according to type of procedure and biological condition of patient or individual undergoing treatment.  

===Main procedure(Pradhanakarma)===

===Main procedure (Pradhana karma)===

The main procedure is performed based upon the disease conditions, site of [[dosha]] vitiation and nearest route to expel it. If a healthy person is following these procedures for preservation of health, then the general sequence includes therapeutic emesis, followed by purgation, unctuous enema, enema with decoction, trans-nasal drug administration. For management of disease, one or more procedures are performed till [[dosha]] equilibrium is achieved. Specific parameters based on end-results of [[dosha]] state (antiki), number of episodes (vegiki) and clinical features observed (laingiki) are observed during each procedure to assess efficacy of therapy.

The main procedure is performed based upon the disease conditions, site of [[dosha]] vitiation and nearest route to expel it. If a healthy person is following these procedures for preservation of health, then the general sequence includes therapeutic emesis, followed by purgation, unctuous enema, enema with decoction, trans-nasal drug administration. For management of disease, one or more procedures are performed till [[dosha]] equilibrium is achieved. Specific parameters based on end-results of [[dosha]] state (antiki), number of episodes (vegiki) and clinical features observed (laingiki) are observed during each procedure to assess efficacy of therapy.

===Post therapy regimen(Pashchatkarma)===

===Post therapy regimen(Pashchat karma)===

Specific regimen (samsarjana krama) is indicated after completion of the main procedure. The strength is weakened due to expulsion of [[dosha]] outside. Therefore, in order to regain the strength of body and correct digestion, certain guidelines in diet and lifestyle must be followed.

Specific regimen (samsarjana krama) is indicated after completion of the main procedure. The strength is weakened due to expulsion of [[dosha]] outside. Therefore, in order to regain the strength of body and correct digestion, certain guidelines in diet and lifestyle must be followed.

*Affliction and obstruction of [[Vata]][[dosha]]. [Cha.Sa.[[Sutra Sthana]] 22/19]

*Affliction and obstruction of [[Vata]][[dosha]]. [Cha.Sa.[[Sutra Sthana]] 22/19]

The state of excess aggravation of dosha is observed by following clinical features:  

The state of excess aggravation of dosha is observed by following clinical features:

Indigestion, anorexia, corpulence, anemia, heaviness, exhaustion, eruption of pimples and wheals (bumps or itchy sores), pruritis, sluggishness, indolence, weakness, foul smell of the body, lassitude, precipitation (utklesha) of [[kapha]] and [[pitta]], sleeplessness or excessive drowsiness, impotency, impediment to intelligence, inauspicious dreams, and loss of strength and complexion inspite of taking nourishing diet and correct therapy. [Cha.Sa.[[Sutra Sthana]] 16/13-15]

Indigestion, anorexia, corpulence, anemia, heaviness, exhaustion, eruption of pimples and wheals (bumps or itchy sores), pruritis, sluggishness, indolence, weakness, foul smell of the body, lassitude, precipitation (utklesha) of [[kapha]] and [[pitta]], sleeplessness or excessive drowsiness, impotency, impediment to intelligence, inauspicious dreams, and loss of strength and complexion inspite of taking nourishing diet and correct therapy. [Cha.Sa.[[Sutra Sthana]] 16/13-15]

==More information==

==More information==

[[Apamarga Tanduliya Adhyaya]], [[Snehadhyaya]], [[Swedadhyaya]], [[Upakalpaniya Adhyaya]], [[Chikitsaprabhritiya Adhyaya]], [[Kalpana Siddhi]], [[Panchakarmiya Siddhi]], [[Bastisutriyam Siddhi]], [[Snehavyapat Siddhi]], [[Netrabastivyapat Siddhi]], [[Vamana Virechana Vyapat Siddhi]], [[Bastivyapat Siddhi]], [[Prasrita Yogiyam Siddhi]], [[Trimarmiya Siddhi]], [[Basti Siddhi]], [[Phalamatra Siddhi]], [[Uttar Basti Siddhi]]  

[[Apamarga Tanduliya Adhyaya]],   [[Snehadhyaya]],   [[Swedadhyaya]],   [[Upakalpaniya Adhyaya]],   [[Chikitsaprabhritiya Adhyaya]], [[Kalpana Siddhi]],   [[Panchakarmiya Siddhi]],   [[Bastisutriyam Siddhi]],   [[Snehavyapat Siddhi]],   [[Netrabastivyapat Siddhi]], [[Vamana Virechana Vyapat Siddhi]],   [[Bastivyapat Siddhi]],   [[Prasrita Yogiyam Siddhi]],   [[Trimarmiya Siddhi]],   [[Basti Siddhi]],   [[Phalamatra Siddhi]],   [[Uttar Basti Siddhi]]  

===Related Articles===

===Related Articles===

[[Vamana]]

[[Vamana]] [[Virechana]] [[Basti]]   [[Nasya]]   [[Raktamoksha]]   [[Snehana]] [[Swedana]]

[[Virechana]]  

[[Basti]]

[[Nasya]]

[[Raktamoksha]]  

[[Snehana]]

[[Swedana]]

===List of references===

===List of references===