Panchakarma is being practiced as a preventive measure as well as treatment to cure the illness all over India. The practice of panchakarma was also prevalent in the small state Kerala located in the southern part of the India. Ayurvedic physicians of this part developed this art of healing with some uniqueness.
This exclusive way of practice of panchakarma is now popularly known as Keraleeya panchakarma. This Keraleeya panchakarma though differs in comparison to the practices in other parts of India is solely based on the principles of Ayurveda. The variation in the practice of panchakarma is basically due to the influence of regional suitability in regards to weather and as well as availability of local herbs. Even the names of the procedures are changed due to the influence of the local Malayalam language. In addition to this more emphasis is given to external forms of treatment rather than internal measures like shodhana procedures in Keraleeya panchakarma. Abhyangam, Navarakizhi, Navarateppu, Elakizhi, Podikizhi, Narangakizhi, Pizichil, Dhara, Sirobasti, Talapothichil, Kati basti and Urobasti are unique therapeutic procedures popularly known as Keraleeya panchakarma
Abhyangam-Oil massage: This is a form of bahyasneha (external oleation) in which application of oil to the skin is followed by massage in a direction identical to the orientation of hair. Oil for application is selected according to ones prakriti or illness. Ksheera bala tailam, Sudhabala tailam Nelebringadi oil, Kanjuniaadi oil Eladi oil, Asanailaadi oil are prescribed for abhyangam on the head. Dhanwantaram tailam, Sahacharadi tailam Madhuyashtiadi tailam, Pinda tailam, Prabhanjanam tailam are ideal for body massage. As Kerala tradition, people receive abhyangam twice a week. More particularly males prefer abhyangam on Wednesday as well as Saturday. In contrast to this, females take abhyangam on Tuesday and Friday. It is customary to use Medicated warm water processed with Bala root (Sida cordifolia) or Chandanam (Sandalam album) for bath following abhyangam. After the bath as a regular practice, a teaspoon full of Rasnadi powder is applied on the vertex.
Navarakizhi - Shastika Sali pinda sveda: Inducing perspiration by using heated round packs of rice is referred as Navarakizhi. The whole body below the neck or a portion of the body is subjected to the svedana therapy, and this belongs to the category of agnisveda, as well as snigdha sveda. Rice is boiled in decoction of bala (Sida cordifolia) and milk; this rice is then tied in pieces of cloth to prepare packs. These rice packs are heated in decoction of bala (Sida cordifolia) and milk. Warm rice packs are used to apply heat to the client’s body and there by inducing perspiration. Following Abhyangam and application of Talapothichil the patient receives the navarakizhi. Each part of the body below the neck is subjected to pindasweda by way of momentary touch, pressure touch and pressure touch with squeeze. By the completion of the procedure the paste of rice sticking on the client’s body can be easily scraped out with the free border of the coconut leaflet. Navarakizhi is treatment of proved efficacy in a plethora of vatavyadhi.
Navarateppu-Annalepana: Inducing perspiration by applying the warm paste of rice is referred as annalepana. The whole body below the neck or a portion of the body may be conveniently subjected to the svedana therapy by this procedure, and this belongs to the category of agnisveda, as well as snigdha sveda. In this procedure the rice that grows in 60 days is preferred for carrying out the treatment. The soft thick paste of rice is prepared with milk and decoction of bala (sida cordifolia) well in advance. The client in minimum dress is subjected to sarirabhyanga. This is followed by application of the paste of rice all over the body below the neck; simultaneously the gentle massage is also carried out. After completing the whole application of paste of rice, it is removed by scraping. Oil is once again applied to the whole body and then the client is allowed to take hot water bath. Pakshaghata, sarvangavata and similar other diseases, particularly in children are best treated by navarateppu.
Elakizhi Pachakizhi-Patra pottala sveda: Application of the heat and there by inducing perspiration by using heated pack of specific herbal leaves is known as Elakizhi. The leaves of herbs like eranda, arka, dhattura, Nirgundi, sigru, vasa or karanja etc are commonly used depending upon the requirement and availability. The herbal leaves are cut into small pieces and then is fried in oil to make it plaint. This fried leaves is used for the preparation of packs. Following the abhyanga heat is applied to the body by way of momentary touch as well as pressure touch of heated packs. The procedure is continued for about 30 to 45 minutes. This treatment is proved to be effective in relieving pain and aches of muscles and joints.
Podikizhi-Churna pinda sveda: induction of perspiration by applying heat using heated packs of herbal powder is refereed as podikizhi. Kolakulathaadi Choornam, Satahwaadi Choornam, Kottamchukkadi Choornam are commonly used in this treatment. Podikizhi is effective in diseases due to the morbidity of kapha and vata dosa, pain and swelling in the joints as well as pakshaghata. Depending upon the requirement whole body below the neck or a part of the body may be treated by this procedure. Abhyangam followed by application of the heat with the warm packs of herbal powder for about 30 to 45 minutes is the method of Podikizhi.
Narangakizhi-Jambeera pinda sveda: the unique swedana procedure carried out by applying heat with packs containing fried pieces of lemon and coconut scraping is known by the name narangakizhi. This is a procedure of proven efficacy in diseases characterized by pain and swelling in the joints like apabahuka. About the procedure of Narangakizhi oil is anointed to the body part to be treated, and then heat is applied by momentary as well as pressure touch of the warm packs and is continued for about 30 to 45 minutes.
Sirobasti: Sirobasti is a unique procedure of applying oil to the scalp in the form of bahyasneha. To be more precise, a special hat, preferably made of leather is fixed around the head just above the ear and eyebrow, and the joint between the head and hat is made leak proof. On to this positioned hat lukewarm oil is poured, and is allowed to remain there for a prescribed period. After removing the oil siroabhyanga is carried out as a follow up procedure. This therapeutic procedure of retaining oil on the vertex for a specific period is referred as Sirobasti.
Talapothichil-Taladhara: Application of the herbal paste on the vertex followed by bandaging is known as Talapothichil. This procedure is performed as a preparation of the patient for svedana process. Frequently this is also prescribed as an individual therapeutic procedure in conditions like headache and insomnia. The mixture of butter milk, amalaki and musta is heated to get the herbal paste for treatment. Following siroabhyanga this paste is applied on the hairy areas on the scalp and is properly covered with plantain leaf. Application should be approximately 1/4th of an inch. Before using, the plantain leaf is heated on fire to make it plaint. Alternatively one can use the leaf of lotus plant for the same purpose. Paste and leaf is secured in position by applying bandage on the head. This is the procedure of talapothichil and is removed after about 3 hour.
Kati basti: The procedure of applying heat to the sacral or lumbar region by retaining warm medicated oil with in a specially formed frame on this area is popularly known by the name kati basti and is a localized form of svedana procedure. A frame of black gram paste is made around the sacral region. Warm medicated oil is poured into this frame. This warm oil heats the sacral region inducing perspiration this is followed by massage and fomentation to this part of the body. This is the procedure of kati basti. Quite similar to this, in painful conditions of neck, chest and knee - grivabasti, urobasti and janu basti respectively are effective
Panchakarma translates five eliminatory procedures. In general all upakrama that include shodhana and samana treatment, that include antaparimarjana and bahiparimarjana treatment are collectively referred by the name panchakarma. Mostly bahiparimarjana chikitsa like Abhyangam, Navarakizhi, Navarateppu, Elakizhi, Podikizhi, Narangakizhi, Pizichil, Dhara, Sirobasti, Talapothichil and Kati basti are known by the name Keraleeya panchakarma.
Dr. G. Shrinivasa Acharya is author of the famous book “Panchkarma Illustrated” and contributed in this special issue of Keralite Panchkarma on our special request.