There are three sequential steps in carrying out Panchakarma treatments in a classical way. They are Purvakarma, Pradhana Karma, and Paschat Karma.

Purvakarma(Preparatory procedure)
For proper and effective administration of Panchakarma, it is essential to prepare the patient before Panchakarma by Deepana – Pachana, Snehana, and Swedana treatments.

• Deepa – Pachana (Herbs to increase digestive fire and to promote digestion) – Oral administration of Deepana – Pachana (Digestive) herbs in the form of powder, tablet, or decoctions help to enhance Agni (Digestive fire) and liquefy Ama (toxic metabolites) so that it can be eliminated from the body by Panchakarma treatments.
• Snehana (Internal and External Oleation) –Snehana is the process of administration of fats internally in the form of medicated ghee and externally in the form of Ayurveda oil massages. Suitable medicated ghee is administered orally in an increasing dose for a period of 3 – 7 days depending upon the severity of the condition and nature of the patient. Snehana helps in the mobilization of the vitiated dosha from the site of morbidity.
• Swedana (Sudation) – After Abhyanga (Therapeutic massage), Swedana is administered. Swedana is the procedure of inducing perspiration by the application of heat to the body. This helps in liquefying the vitiated doshas and bringing them to the gastrointestinal tract from where they are eliminated by various Panchakarma treatments.

Pradhana Karma/Panchakarma therapies (Main detoxification procedures)

• Vaman: Vamana treatment is a medicated emesis therapy that removes Kapha toxins accumulated in the body. According to Ayurveda, psoriasis is caused due to the imbalance of Kapha dosha, which makes Vamana therapy as one of the most effective treatment procedures for psoriasis. The treatment is also prescribed to people with bronchial asthma, gastritis, skin disorders, sinusitis, diabetes, and neurological ailments related to Kapha dosha.
• Virechan: In virechana therapy is defined as the medicated purgation therapy, which cleanses the Pitta and purifies blood, by clearing the toxins from the body. this treatment is a flushing of the whole gastro-intestinal track with herbal laxatives. This powerful treatment quickly reduces body heat (pitta); liver, gallbladder, and colon congestion and helps improve rashes, itching, skin inflammation, and acne while also improving digestion and boosting metabolism, in this method of detoxification and purification, the doshas are removed in the form of feces through the rectum. The purgative medicines given to the patient are heavy in action (and therefore help to bring down the doshas) and have a tendency to produce heat which aims to the eradication of the doshas. Virechana karma is basically a medicated purgation therapy that removes from the body.
• Basti: Basti refers to Enema therapy. Ayurvedic Basti involves injecting herbal substances like oil and decoction in a liquid medium into the intestine. Basti means the urinary bladder. In ancient times, the urinary bladder of animals was used to give enemas. It is prescribed mainly for people with Vata dosha.
  Basti is considered to be one of the most important therapies as it works to keep a check on the Vata Dosha. The Vata dosha is the root cause for a majority of diseases. It also moves the other two Doshas Kapha and Pitta which results in their imbalance. Keeping Vata under control is a proactive measure to keep diseases at bay

Types of Basti

Asthapan Basti
Asthapan Basti or enema therapy is also called Niruhana Basti. This basti helps in removing the doshas (stuck inside the body tissues) in the form of feces. Judging by the form of the disease, properties, and actions of the medicines to be used, time of the day, type of the season, and whether the patient is strong enough to respond to the treatment, this Basti, when given to the patient, purifies all the body pores. More often Aasthapan Vasti is given in the disease of the large intestine and the digestive tract.

Anuvasan Basti
If the roots of the tree are filled with water, it also fills the tree with leaves, flowers, and fruit. Similarly, inside the detoxified and purified body (from which the aggravated doshas have been removed), this particular Basti provides vigor, vitality, and strength to the body. In this method of treatment, medicated oils are given in enemas that lubricate the body tissues. It works by purifying and nourishing the seven dhatus (body tissues) inside the body viz. Rasa, Rakta, Maans, Medha, Asthi, Majjha, and Shukra (Juice, blood, muscle, fat, bone, bone marrow, and semen) dhatus or the body tissues. Furthermore, it helps in holistic healing and thus enhancing the total health of the individual.

UttaraBasti:
Here the enema is administered through the urethra for men and vagina for men. This is not prescribed for people with diabetes.

• Nasya: This treatment is extremely effective in clearing and purging the head area. It is a process by which drug in the form of medicated oil, fresh herbal juice, and herbal powder is administered through the nostrils. If ‘Nasyakarma’ is done properly and regularly it will keep the person’s eye, nose, and ear unimpaired. It also prevents the early graying of hair and beard. Nasya karma will prevent the falling of hair. It will ensure the growth of hair and alleviate diseases like cervical spondylitis, headache, facial paralysis, hemiplegia, diseases of the nose, frozen shoulder, hemicrania, coryza, sinusitis, mental disorders parkinsonism, and skin complaints. Nasya karma will enhance the activity of sense organs and prevent diseases of the head (urdhwanga). It will prevent the early aging process.
• Raktamokshan (Bloodletting) Bloodletting is used to eliminate toxins that are absorbed into the bloodstream through the gastrointestinal tract. This process purifies the blood. It is used for disorders such as repeated attacks of skin disorders such as urticaria, rash, eczema, acne, scabies, leukoderma, chronic itching, and hives. It is also often effective for enlarged liver and spleen, hemochromatosis, and for gout. Raktamokshan is the traditional Ayurvedic method for purification and cleansing of the blood. Toxins present in the gastrointestinal tract are absorbed into the blood and circulated throughout the body.

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