Pancha Karma: The Ayurvedic Science of Detoxification and Rejuvenation

Ayurveda, which literally means the knowledge of life is the traditional healing science of India. Viewing disease as the natural end result of living out of harmony with our environment,

Ayurveda emphasizes reestablishing harmony and balance as the means of recreating a state of optimal health in our bodies and minds. While Ayurvedic methods utilize many therapies including herbs, diet, aromatherapy, color therapy, mantras, yoga, meditation and general lifestyle counseling, the most profound of all treatments is that of Pancha Karma.


Pancha Karma is the traditional form of detoxification of the body and mind that facilitates rejuvenation. It has been utilized for thousands of years as a method of staying healthy, young and vital.


"The value of Pancha Karma is that it offers systematic treatment for dislodging and flushing toxins from every cell, using the same organs of elimination that the body naturally employs -- sweat glands, blood vessels, the urinary tract and the intestines."


Pancha Karma is unlike any other detoxification program because it is fundamentally designed to remove a different form of toxin. While many toxins exist in our environment which accumulate and harm our bodies, Ayurvedic Pancha Karma addresses a special toxin called ama which is formed within our own bodies.


Ama is the by-product of inadequate digestion. It has the qualities of stickiness and heaviness. In our bodies it clogs our systems and damages our tissues. It is among the most damaging of forces in our bodies and contributes to disease.

Here is an analogy to help you understand how ama is formed. Imagine that there is a fire inside your stomach. Think of a campfire. If the fire is weak, it cannot burn up the wood put on it. Instead, the wood smolders and begins to smoke. In the end, charred bits are left and the wood is not efficiently turned into ash.


Poor digestive fire, or digestive strength, leads to food being improperly digested. This results in gas, bloating, burning indigestion, or constipation. In addition, a residue of this poorly digested food accumulates in your digestive tract and overflows into your bodily systems. This residue is called ama.


Ayurveda links the occurrence of ama in the body and a weak digestive system to the cause of such chronic conditions such as candida, chronic fatigue syndrome, migraine headaches, chronic respiratory disease and many other conditions. The process of Pancha Karma removes ama and clears the way for the body to re-establish an internal state of balance and harmony.


Ama may be present in the body if there is a coating on the tongue. A normal tongue appears pink throughout, but as ama accumulates in the digestive system, the tongue may appear with a white, yellow, green or gray film over it. In addition, in some cases the body and breath develop a strong odor and the stool becomes dense and sinks to the bottom of the toilet. (According to Ayurveda, the normal stool should float). If you have any of these signs, Pancha Karma treatment may be indicated.


The Process of Pancha Karma


Pancha Karma therapy begins with proper preparation. This includes several days or weeks of a special diet and herbs which begin the process of loosening up the ama and bringing it back to the digestive system for elimination. While the person is eating special foods and taking special herbs, oil and heat therapies are applied. These include the deeply relaxing therapies of Shirodhara, Ayurvedic massage, and Swedana.


Shirodhara is a unique therapy where the client lies down upon a massage table with their eyes covered. Then, a specially prepared warm herbal oil is poured in a thin steady stream through a spicket directly onto the forehead and sixth chakra. This blissful therapy purifies the mind, alleviates anxiety, reduces headaches and expands awareness. Shirodhara can be administered by itself or as part of a Pancha Karma regime.


During Ayurvedic massage two practitioners perform a choreographed hand dance upon the body. Using oils blended with special herbs, this form of massage specifically loosens up the ama stored in the tissues so that it can move back to the digestive system. Not only is it cleansing, but it is deeply relaxing. Ayurvedic massage can be administered by itself or as a part of Pancha Karma.


Swedana is a full-body steam therapy. Special herbs are fused into the steam and together the heat and herbs dilate the channel systems of the body allowing the stored ama to move back into the digestive system.


Once all of the ama is back in the digestive system, the next phase is to eliminate it from the body. This is achieved by the administration of a purgative to cleanse the small intestine and herbal enemas to cleanse the colon. A special form of cleansing is applied to the sinuses called nasya. Following the application of oil and heat over the sinuses, the herbal oils are administered directly into the nasal passages. This procedure not only eliminates ama but is helpful in the treatment of chronic allergic sinusitis and sinus headaches.


Rejuvenation

With the body clear of toxins and ama, it is much like a clean slate. Now the internal energy of the body can be rebuilt. The rebuilding process strengthens the digestive system and the immune system and entails taking additional special foods and herbs. These herbs are designed to enhance the strength of immune system and are revered for extending life.


The end result of Pancha Karma is an optimally functioning digestive system and renewed internal energy. After receiving Pancha Karma the mind is light and clear, the body is pure and the energy is high. For many it is a life-changing experience.



Pancha Karma is traditionally used in the healing of many diseases. It is an intensive therapy best performed at a time when the patient has adequate time to rest. Brief Pancha Karma programs last 7 days. This is followed by a period of rejuvenation which can be done at home. Extensive programs can be designed for up to one month.

Introduction

Respiratory Disease will afflict every human being at some time in their life. Whether it’s a cough associated with the common cold or respiratory distress associated with allergies and asthma, respiratory challenges are a constant source of irritation and misery for the afflicted.

Classical Ayurvedic Medicine categorizes respiratory challenges into two main categories. These are Kasa (cough) and Swasa ( dyspnea or difficulty breathing). From an understanding of ayurvedic knowledge, common conditions such as the common cold, asthma and bronchitis can be understood and managed. This article address the condition of kasa (cough).

Kasa (Cough)

In the Allopathic medicine, Cough are understood to be the result of either infection or irritation of the bronchial tissue and are known as bronchitis. Infectious bronchitis commonly accompanies the common cold but may occur separately and may or may not be associated with fever. Cough may be dry or productive. Irritative bronchitis is usually the result of pollutants, smoke, or chemicals and may have an allergic component.

Samprapti (Pathology)

Kasa occurs when apana vayu is obstructed resulting in an increase in upward motion. Vitiation of udana vayu propels the air upward and out of the body. Vata may however lodge in the chest, back, or head resulting in pain and repeated coughing.

All disease has its physicial origins in the digestive system. This is the site of accumulation and aggrevation of the doshas. Kasa begins with vitiation of apana vayu in the purishavaha srota (large intestine). Vata eventually overflows into circulation (raktavaha srota) and relocates to the pranavaha srota (respiratory system.) Additional doshas may mix with vata or become dominant in the pathology.

Purvarupa (Prodomal symptoms)

Cough are often preceeded by symptoms of the common cold such as a sore throat, and a decrease in appetite. Proper early management of the prodromal symptoms can prevent the onset of bronchitis.


Types of Kasa

Kasa (cough) is of five types; vata, pitta, kapha, ksataja and ksaya. Those of a vata, pitta and kapha nature represent different doshic manifestations of a cough. Ksataja type are due to chest injuries while ksaya type is due to disease that results in wasting of the bodily tissues such as tuberculosis.


Rupa (symptoms)

Cough due to vitiation of vata are called “vataja kasa”. They present as a dry cough with little mucous production. While small amounts of hard mucous may occasionally accompany a cough, the condition is for the most part dry. Examination of the mucous reveals it to be gray in color and ununctuous (not very sticky). The cough may be accompanied by a loss of voice and severe chest pain. The frequency of the cough is episodic and may occur in fits.

Cough due to pitta vitiation are called “pittaja kasa”. They present with a greater amount of mucous. Examination of the mucous reveals a yellow color and possible blood within the mucous giving it a “rusty” appearance. This latter appearance indicates that the infection has penetrated deeper in the respiratory system as is seen in pneumonia. Pittaja kasa is accompanied by fever. The cough is more continuous than that of vata type.

Cough due to kapha vitiation are called “kaphaja kasa.” They present with the greatest amount of mucous. Examination of the mucous reveals a cloudy, white color and the mucous is thick and sticky. The condition is often accompanied by a runny nose, nausea, and vomiting. Actual pain in the chest and head is mild. Kaphaja kasa is not associated with fever. Coughing is continuous.



Comparative Rupa (symptomatology) of Vataja, Pittaja and Kaphaja Kasa
Vataja Pittaja Kaphaja
Minimal mucous, hard mucous, grey in color Moderate mucous, sticky, yellow in color Large amounts of mucous, sticky, cloudy and white in color


Cough due to trauma, called “ksataja kasa” reveal a combination of symptoms related to vata and pitta types. Sputum may be red, yellow or black indicating infection and bleeding. While the mucous is abundant, it is ununctuous. Fever is probable and there may be joint pains as well. Due to trauma, blood may simulatanously appear in the urine. Cough due to trauma are described as resembling the cooing of a pigeon.

Cough due to ksaya occur with wasting disease such as tuberculosis. Tuberculosis is called “rajayaksmadi” literally the “kind of diseases” in the Ayurvedic literature. The condition results in a drying up and loss of tissue (ksaya). While vata dosha plays the most important role in this condition, the condition is sannipattika in nature (due to the vitiation of all three doshas).


Chikitsa: Treatment and Management

The management of kasa (cough) requires an understanding of the state of the patients agni, ama, and ojas as well as an appreciation of the doshic pathology present. In addition to treatment at the site of relocation in the pranavaha srota (respiratory system), treatment should also be directed toward the mahavaha srota (digestive system) as this is the physical root of the condition and the raktavaha srota (circulatory system) as the pathway of overflow.


Management of Vataja Kasa

The management of vataja kasa, at the site of relocation focuses on the application of oils and heat to the pranavaha srota (respiratory system). Sesame oil massaged into the chest followed by fomentation is recommended. Fomentation may be performed simply using hot water bottles, a heating pad or locally applied steam as in nadi svedana. Popular cough relieving herbs from India include kantakari (solanum xanthocarpum; VK-P+) and vamsa rochana (bamboo manna; VP-K+) . These are commonly used and may be prepared as ghrita (medicated ghee). Popular herbs used in the West include licorice (glycyrrhiza glabra; VP-K+) and wild cherry bark (prunis virginiana, prunia serotina; VP-K+).
Care of the digestive system requires dietary modification and the use of anuvasana basti (oil enema) or niruha basti (decoction enema). The diet, though nourishing should be taken in small quantities at first until the agni becomes strong. Nourishing soups are most beneficial. Patients should receive plenty of rest.

For both vataja and pittaja kasa, the classical formulation, Sitopaladi churna is commonly used. It may also be prepared in warm water or with honey. Sitopaladi churna is a combination of many herbs and spices with vamsa rochana as the chief herb in the formulation.


Management of Pittaja Kasa

The management of pittaja kasa, at the site of relocation focuses on herbal therapies. Oil and heat are not recommended. Medicated ghrita (ghee) may be prepared with cough relieving, expectorant herbs such as vamsa rochana (bamboo manna; VP-K+) and vasa (adhatoda vasica; PK- V+). Western herbal alternatives include licorice (VP-K+), mullein (verbascum thapus; PK-V+) and wild cherry bark (prunis virginiana, prunia serotina; VP-

K+). The classical Indian formulation, sitopaladi churna may also be used.
Virechana performed early in the condition is most beneficial to allieviate pitta at its root. The diet should emphasize a greater amount of the bitter taste as the bitter taste is cooling and purifies the rasa and rakta dhatu helping to destroy the infection. The diet should be light and and consist of easy to digest foods until improvement is noted. Stronger antimicrobial bitter herbs may be given to accompany the cooling, cough reducing herbs. These include kutki (Gentiana kuroo; PK- V+) and neem (Azadirachta indica; PK-V+) as well as well as Western alternatives such as goldenseal (Hydrastis Canadensis; PK-V+) and echinecea (Echinecea augustifolia, echinecea purpura; PK-V+). Patients should receive plenty of rest.



Management of Kaphaja Kasa

In the management of kaphaja kasa, treatment focuses on strong purification and may include vamana, virechana and niruha basti. Nasya is also recommended to purify the nasal passages and sinuses. An important herb from India is kantakari (solanum xanthocarpum; VK-P+). Kantakari alleviates cough and is a bronchodilator. Kantakari is one of the herbs in the famous ten roots formulation, dashmoola. Along with kantakari, additional herbs may be added to formulations such as vidanaga (embelia ribes; KV-P+) and chitrak (plumbago zeylancia; K-VP+). Dry, expectorant herbs may also be added to formulation or prepared for inhalation. Clove (caryophyllus aromatica) and bayberry (myrica nagi, myrica sapida, myrica cerifera) are commonly prepared in cigarette form or simply burned and inhaled. Western herbs that are beneficial include elecampane (inula helinum), eucalyptus (eucalyptus globulis) and black pepper (piper nigrum).

The diet of patients with kaphaja kasa should be very light and patients may fast for several days according to their strength. The diet emphasizes the pungent taste to support drying the lung tissues. Patients who are not experiencing great fatigue should remain active but should not overly exert themselves.



Managing Cough due to trauma requires referral to a medical specialist as the lung may be punctured. Until medical care can be administered, patients should take hemostatic herbs such as the Indian herbs manjishta and praval pisthi . Patients should also stay well hydrated.

Cough associated with wasting disease are difficult to treat and careful management is required. Weak patients usually require tonification to combat weight loss and increase strength. Medicated ghees with demulcent herbs such as bala rejuvenate the body and support repair of respiratory tissues. The dosage of the herbs is dependent upon the state of the patient’s agni. Anuvasana basti should also be administered to improve strength and can be prepared with nourishing herbs such as bala and ashwaganda in a sesame oil base. The diet should be nourishing. Meat and bone soups may be required to prevent continued weight loss.

Vegetarian patients may object, however they are strongly recommended if the patients life is in danger. The quantity of food taken should be proportional to the bodies abililty to digest it. Hence, dipanas to strengthen agni are required.


Sadhyasadhyata (Prognosis)

Doshic disturbances resulting in kasa are relatively easy to treat with vataja considered the easiest and kaphaja the most difficult. Those of mixed dosha pathology such as ksataja type are more difficult. Ksaya kasa is the most difficult of all. Ayurvedic texts state that kasa of any kind, if not treated properly can progress to ksaya type.