1. Prof. R. H. Singh
Distinguished Emeritus Professor
Banaras Hindu University
April 15, 2013
Principles and Practice of
Pancakarma Therapy

2. Holistic Approach Reductionist Approach
Body-Mind-Spirit Integrative Non-Integrative
Life and Health Oriented Disease Oriented
Patient Centric Disease Centric
Diet& Life style Oriented Drug, Surgery Oriented
Pro nature and personailsed Not necessarily
Biotherapy &Green Pharmacy Chemotherapy
High Safety Frequently Unsafe
Efficacy Soft & Nutraceutical Sharp, highly selective
Cost effective Unsustainable high cost
Quality Assurance Low Better
Ayurvedic Medicine Modern Medicine
The Main Distinctions

3. 1. Nidana Parivarjan
2. Samprapti Vighatana
(A) Bio-purification by Panca Karma
(B) Bio-balancing Care by :
1.Drug
2. Diet
3. Life Style Management
Principles of TreatmentPrinciples of Treatment

4. Pancha Karma Therapy is a special therapeutic
procedure popularly practiced in Ayurveda for
biopurification of the body with rejuvenative effect.
It is the composite nomenclature of Five kinds of
treatments designed for trans-membrane visceral
and cellular purification, as well as transdermal
purification of the body. Panca Karma is essentially
the therapeutic technology of Samsodhana.
What is Pancha Karma

5. 1. Promotive & Preventive Health care
To promote health of a healthy and to tackle the
Tridoṣic rhythms in different seasons
2. Rejuvenative Health care
as an integral pre-requisite of Rasayana Therapy
and Kayakalpa
3. Curative Management
To irradicate the disease by cleansing the diseased
channels in chronoic diseases
4. Rehabilitative Health care
To suppress a disease process and to
rehabilitate the patient
Scope of Sodhan TherapyScope of Sodhan Therapy

6. Routine Preventive Application of SodhanRoutine Preventive Application of Sodhan
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Vasanta rituVasanta ritu Kapha prakopaKapha prakopa VamanaVamana
Sarad rituSarad ritu Pitta prakopaPitta prakopa VirechanaVirechana
Varsha rituVarsha ritu Vata prakopaVata prakopa VastiVasti

7. 1. Purva Karma :
● Fasting, Appetisers, Digestants
● Oleation and Massage
● Sudation and Sweating
2. Pradhāna Karma :
1) Vamana = Emesis
2) Virecana = Purgation
3) Anuvāsana = Oleus Enema
4) Āsthāpana = Decoction Enema
5) Nasya = Erhines
3. Paścāta Karma : Post therapy dietetics
Classical Pancakarma Therapy

8. 1. Dhārā Krama = Sequential streamline
medicated liquid pouring over the head.
2. Pin a Swedaḍ = Medicated bolus Fomentation
and Massage.
3. Anna Lepa = Application of Medicated pastes.
4. Śirolepa = Application of Medicated pastes
over the head.
5. Kāya Seka = Oil bath therapy.
Traditional Keraliya Panca KarmaTraditional Keraliya Panca Karma

9. 1. Exhaustion of toxins by Langhan,
Deepan, Pachan.
2. Snehan, Swedan, Abhyanga.
3. Drastic expelsion by major
karmas like emesis, purgation,
enemata , errhine, blood letting.
Purification
Tans-membrane
Trans-dermal
Internal
External
Mechanism of Bio-purification in Samshodan

10. Why Purva Karma
1.To promote Agni, the biofire
2.To exhaust Ama, the morbid Dosa in situ
3.To mobilize the Dosas from Sakha to Kosth
4.To soften the body parts and to render the
cells and tissues more washable

11. Biology of Snehan, Swedan and Abhyanga
 Fluid Mosaic Model of Cell Membrane with abundance
of dynamic lipid components facilitating dissolution of
toxins and their transport to and from the cells.
Local and systemic administration of fats seem to
expand the transport surface.
The subsequent Abhyanga and Sweda (massage and
fomentation) further activate the cleansing process.

12. 1. Absolute (in days)
2. Relative (in quality)
◊ Skip a meal
◊ Reduce the quantity
◊ Alter the quality, taking easy digestibles
◊ Reducing Fat and Protein
◊ Semisolid and liquid diet
◊ Taking warm food
Langhana or Fasting

13. Therapeutic Massage

14. Kāyasáke

15. Traditional Pinḍsweda (Rice Bolus Massage)

16. Medicinal Bolus for Pinḍa Sweda
Raw coarse rice is cooked in a mixture of cow milk
and herbal decoctions forming a Payasam. 4-8 Payas
bolus 200g each tied in cloth pieces and kept dipped
separately in a bowl of warm mixture of milk and
decoction. The warm bolus is used to massage the
pre-oleated whole body of the patient for 30-40
minutes followed by open rubbing of the Paysam on
the body further followed by warm water bath.

17. 1. Physical Massage Effect / Pressure effect
2. Heat Effect on muscles, vessels and viscera
3. Medicinal Effect of the bolus material :
a) Soothing and softening effect
b) Hydration of the skin
c) Nourishing effect
4. Bio-Purification - transdermal
Pin a Sweda Effectḍ

18. 1. It permits transfer of heat and vital energy.
2. It renders the body compact and well formed,
accelerates blood circulation affording
adequate blood and oxygen to entire body.
3. It mobilises unwanted incompatible products
of body and release them to be excreted. This
also relieves local pain and inflammation.
4. It promotes elasticity and functional ability of
nerves, tendons and muscles affording
softness of the body.
5. Prevents stiffness & sclerosis of blood vessels.
Impact of Abhyanga and Massage

19. Anatomical Considerations in Abhyanga and Sweda
Skin layers Vital Components Function Treatment Impact
Epidermis
Keratocytes,
Melanocytes
Surface protect,
Skin Complexion
1. Cytostabilisation
2. Moisturisation
3. Allergy control
Dermis
Blood Vessels,
Nerves,
Lymphatics
Mast cells
Fibroblasts
Bio-Support
Histamin,
Collagen fibers
4. Skin Glow
5. Vascular effect
6. Lymphatic drain
7. Neurostability
Subdermis Subcutaneous
fat
Cushion
Function
8. Skin elasticity
9. Adipose Balance.

20. 1. In relation to heart and circulation
2. In relation to the origin and insertion of muscles
3. Lymphatic flow
4. Vital parts, joints / abdomen / eyes
5. Direction of hairs on skin
6. Degree and distribution of subcutaneous fat
Guidelines for choosing direction, duration, force
and pressure application in Massage Therapy

21. ŚIRODHĀRĀ TREATMENT

22. 1. Vivrational effect in the head affording
synchronised augmentation of circulation.
2. Synchronisation of the neuronic functions
and impulses.
3. Meditative effect.
4. Relaxation Response.
5. Medicinal effect of Dhara materials
Dhārā Effect

23. EFFECT OF SIRODHARA & NASYA ON PAIN SCORE BY VISUAL
ANALOGUE SCALE IN PATIENTS OF CHRONIC DAILY HEADACHE
Groups Mean ± SD of VAS Scores Paired t
BT AT Difference
Sirodhara t = 4.91
(n = 18) 5.22 ± 1.26 3.72 ± 1.12 1. 50 ± 1.29 p<0.001
Nasya
(n = 10) 5.10 ± 1.37 3.80 ± 0.78 1.30±1.27 t = 3.23
p<0.02

24. Indication : For Routine Biopurification
All Kaphaja Diseases
Therapeutic use in Asthma and Allergy
Procedure : Purva Karma 5-7 days
Basal Assessment
Assurance
To drink milk or sugar cane juice 2-3 litres
Administer Emetic single dose :
Madanphala 6-12g + Vacā 3-5g +
Rock salt 5-10g + Honey 20ml
Wait for Vamana for 10 Minutes.
Result : Massive Emesis with Kapha, Mucus, Histamine.
Measure the vomitus and analyse.
Vamana or Therapeutic Emesis

25. Preparatory Monitoring before Vamana (Therapeutic Emesis)

26. Histamine Dialysis Through Vamana
Mean ± SD 0.495 0.400 0.282
(n=20) ± 0.234 ± 0.206 ± 0.136
t - 0.94 2.55
p - >0.05 <0.05
Before Vaman After Vaman
Just After After 1 Month
Mean Total Histamine Estimated In Vomitus 315.31 µgm
Mean Total Histamine Reduction In Blood 332.50 µgm
Blood Histamine in µgm/ml

27. 5.32
3.55
6
4
2
0
2.4
1.6
0.8
0
D-XYLOSEEXCRETIONG.PER5HRS
BEFORE AFTER DIFFERENCE
SAMSHODHANA P < 0.001
MEANDIFFERENCE
Improved Gut Absorption Pattern
After Samshodhana Karma

28.  Allergy & Asthma
 Arthritis & allied conditions
 Disorders of Skin
 Residual Paralysis
 CNS degenerative diseases
 Obesity and lipid disorders
 Diabetes mellitus
 Disorders of fertility
 Chronic Headaches
 Stress and Residual Psychoses
 For Healthy Aging
 Rehabilitative
Major Chronic Diseases Potentially Treatable
With Panchakarma Therapy

29. CONCLUSION
Sanśodhana Biopurification effect envisaged through Pancakarma is
an unique therapeutic concept in Ayurveda.
It purifies the milieu-interior through biomembrane system allowing
spontaneous restoration of normalcy, followed by self-recovery from
disease, improved bioavailability of medications administered and
their easy elimination reducing the chances of cumulative side
effects.
Besides biopurificatory effect various procedures also produce
rehabilitative and Physiotherapeutic impact.
Procedures are safe and have evidence of efficacy.
There is need of developing indicators for evaluating the efficacy and
safety of different procedures and their standardization.

32. Ayurveda
Ayurveda (Ayu=Life + Veda=Science), the ancient Science
of Life is the main-stream traditional system of Medicine
officially practiced in India for thousands of years. It has
now been updated and strengthened with scientific research
and development. Because of its unique pronature holistic
approach and safe Green Pharmacy, now Ayurveda is being
accepted enthusiastically world-over.
The Historicity of Ayurveda goes back to ancient Vedas
and its original knowledge is available today through Two
sets (Three books in each) of authentic classic texts -
1. Brihattrayi (Pre-Christian Era)
2. Laghuttrayi (Medieval Period)

33. Surya
Pitta
Teja
Energy
Oja Biology Prana
Kapha Ecology Vata
Jala Vayu
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34. Health is the state of equilibrium of Dosas,
Agnis, Dhatus, Malas and body functions along
with spiritual, sensorial and mental well-being.
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Definition of Health in Ayurveda

35. Concept of Disease
1. Sahaja Diseases – Genetic & hereditary
2. Acquired Diseases
Loka Purusha Vaishamya
Errors of Kala, Buddhi & Indriyartha
Depletion of Agni
Srotodusti
Dosha Vaishamya
Dhatu Vaishamya
Ama
Vyadhi

36. The all-pervading structure of the channel
function ie. Srotas is the membrane-
system lining the big hollow organs,
micro-tubular structures and covering
each Cell. The integrity of this membrane
system is vital for inner transport which is
inherently challenged by divergent wear
and tear activities and hence it needs
periodical cleansing by Samsodhana..
SROTAMSI AS THE BIOTRANSPORT SYSTEM