BRITISH MEDICAL STUDENT EXPLORING PANCHKARMA At DAYANAND AYURVEDIC COLLEGE, JALANDHAR In the era of modern medicine where all actions & decisions taken by a medical practioner are purely based on evidences and clinical trials, there also lies a science of ancient wisdom with much more intellect & tremendous potential. Recent years have recorded increased awareness in people regarding their health and the therapies in use. Observing this, I too decided to learn this ancient technique with an inquisitive mind. There is little evidence of why such form of treatment was being used. A form of medicine which when compared to modern day medicine, its treatment techniques and therapy may seem ancient. In the world of constantly developing and improving technology, how traditional forms of treatment can survive, with this curiosity I decided to explore ayurveda and panchkarma at Dayanand Ayurvedic College, Jalandhar and writing my understanding about the same as following.
Ayurveda is known as a holistic form of complementary therapy in the West; however, it is still being widely used in India as a traditional form of medicine. Ayurveda is based on some basic principles such as the theory of panchmahabhootas which states that everything in the universe comprises of five components- aakash, vayu, agni, jala and prithvi which further combine to form the tridoshas, known as vata, pitta and kapha. All three doshas are present in everybody but there are one or two dominant doshas in each individual. These dominant doshas determine the individual's prakriti. As soon as these doshas lose their balance, disease occurs. The Ayurvedic practitioners work to restore equilibrium amongst these.
Panchkarma: It derived from two Sanskrit words 'Panch' means five and 'Karma' means action. So the name denotes five primary procedure of cleaning, which are used to purify the body. It is the deep cleaning process, unique to Ayurveda, that enable the body to release excess Doshas and toxins from it's cells and expel them, which basically denotes detoxification or elimination of toxins from the body. It is a five fold purification therapy in Ayurveda, involving Emesis, Purgation, Enema, Nasal drops and Blood letting. Therapy is preceded by oil and sweating therapies (snehana and swedana respectively).This purification procedure can be completed in 7, 14, 21 or 40 days.
The objectives of panchkarma are to maintain health, treat the disease and rejuvenate the body. It is designed to assist the body with the elimination of both tissue waste and dosha waste in order to allow natural regeneration of vital tissue.
Some of the benefits of panchkarma are an improvement in digestion by improving digestive fire, increase in immunity, body rejuvenation, physical and mental health prevails and ageing is delayed.
Panchkarma constitute the foremost Shodhana Chikitsa. Panchakarma or the Shodhana therapy is always performed in three stages
Preliminary Procedures (Purva Karma) include
• Oelation (Snehana)
• Fomentation (Swedana)
Main Procedures (Pardhana Karma) include
• Emesis (Vamana)
• Purgation (Virechana)
• Nasal (Nasya)
• Bloodletting (Raktamokshana)
Post Procedure (Pashchat Karma) include
Preliminary procedures (Purva Karma)
Preliminary procedures involve snehana and swedana and according to Ayurvedic principles panchkarma should only be administered after the administration of the oleation therapy (snehana) and fomentation therapy (swedana). These procedures make the body soft and disintegrate the morbid doshas so that they can be eliminated more easily from the subtle channels of circulation.
The various methods of snehana are; abhyanga, shiroabhyanga, akshi tarpan, karnapurana, shirodhara, shirobasti, pidicchil, kawala and gandusha and can be administered through different foods, enema and massage. The duration depends on patient's strength and response. These procedures are mainly performed with oil, ghee and various pastes containing fatty substances to alleviate vata and soften the doshas. After snehana has taken effect fomentation or sweating therapy should follow1.
Swedana should be administered in a place free from exposure to excessive wind and to a person whose last meal has been well digested. Swedana liquefies aggravated doshas and brings them to sites from which they are easily expelled out by the main panchkarma procedures. It opens pores in the skin and dilates all the channels in the body. Generally medicated steam is provided to the patient's body as they lay in a steam chamber. Once the preparatory procedures have been applied then the patient can be subjected to panchkarma therapies depending on aliment and physical condition2.
Main procedures (Pradhankarma)
Vamana: Artificial vomiting is induced using herbs like strong teas of locerica, salt, calamus. Doshas are eliminated through the mouth by vomiting. This is the best way to eliminate kapha dosha. This emesis therapy is administered with drugs suitable to the particular disease and conditions of the patient.10% of all diseases are caused by Kapha dosha. Indications for vamana are cough, asthma, chronic rhinitis, skin disorders, anorexia, allergy, mental disorders and to reduce fat.
Virechana (purgation therapy) : This process of elimination is primarily through the anal canal and it is the systemic therapy for elimination of the pitta dosha. Pitta dosha is the cause of 20% of diseases. This is indicated for fever, skin diseases, bleeding from upper channels of the body, piles, worms, gout, vaginal diseases, anal fistulas, anaemia, glandular swellings and loss of appetite. Substances used can be laxatives, mild purgatives or strong purgatives.
Vasti Karma (enema therapy): liquid medicine is administered through the anal route for the treatment for deranged vata.Vata is the pardhana dosh in the body. Many acivities and the function of other dosha are controlled by vata .Vata is the causative factor of 70% diseases. This comprises of anuvasana vasti (oily enema therapy), asthapana vasti (decoction enema therapy) or uttara vasti.
Nasya: Medicine is administered through the nasal route. It extracts vitiated dosha from the head. Medicated oils or powders are put into the nostrils for the treatment of diseases occurring above the collar bone, such as ear, nose, throat, head and teeth. It is effective for sinusitis, migraine and recurrent nasal congestion.
Raktamokshana: Bloodletting from a particular part of the body to extract vitiated pitta and rakat. It is indicated in obstinate skin diseases, gout, some tumours, excessive sleepiness, alopecia, hallucinations. Mildest form is to apply leech to the body after the body has been purified with powder or paste of turmeric and mustard. The leeches then suck the impure blood. Metal instrument are used in more severe cases, such as large abscesses or hepatosplenomegaly.
Post procedures (Paschatkarma)
After the removal of the doshas and internal cleansing with panchkarma, the digestive capabilities must be restored. This is achieved through a properly planned diet and lifestyle changes. Rasayana and vajikarana therapies (rejuvenation and virilification) can further improve the general health of the patient.
Exploring Ayurvedic medicine at Dayanand Ayurvedic College has been a very informative and enlightening experience. Having always been taught medicine on an evidence-based method, it was difficult for me to believe that ayurveda would actually achieve the same success rates as allopathic medicine. My training at Dayanand illustrated the capability of ayurveda and demonstrated the power of traditional Indian healing therapy. Many patients choose Ayurvedic treatment after failed attempts by allopathic medicine and according to the patients, ayurveda has provided them with a better quality of life and cures that they thought they would never achieve.
Over recent years the Western world has started accepting more different cultures and various forms of medicine; hence they realise the choices of treatment available. Panchkarma is a branch of ayurveda which has seen an increase in demand, especially in the UK and USA, but there are some concerns regarding the lack of research in Ayurvedic medicine and the high metal content of some treatment therapies. A firm belief is that ayurveda and panchkarma has a significant potential in the west and is a science which is successfully meeting with the demands of the patients & holds the capacity to raise the bar of medical standards, however its full potential will only be realised once there are more clinical trials to prove its success.