Panchakarma Practices:
The Five Clinical Actions in Ayurveda

In addition to the use of herbs, lifestyle and diet, Ayurveda also employs a very complex and in-depth system of detoxification, removing the excesses of doshas, from their sites of accumulations.

In short, these areas are:

Vata (Gas) in the Large Intestine or Colon and Lower Body

Pitta (Bile) in the Small Intestine and Liver

Kapha (Phlegm) in the Head, Stomach and Lungs / Chest

In order to do this, the system of Panchakarma, meaning “Five Actions” was developed in India, by a series of clinical methods, as follows:


Nasya – Nasal Therapies, which aim at reducing Kapha / phlegm in the head. This is by snuffing pungent powders such as ginger, calamus or medicated oils such as Anu Taila, a special oil for removing phlegm and kapha in the sinuses.

Vamana – Emetic therapy, which aims at removing Kapha from Lungs / Stomach. Often decoctions for this include liquorice teas, and also strict diets or kichari (a bland dish of rice).

Virechana –Purgation therapy, which aims at removing Pitta / bile from the large intestine. This is done via potent formulas such as Avipattikar, known for reducing Pitta, and also Castor Oil (Eranda Taila).

Basti – Enema therapy, which aims at removing Vata from the site of the Colon, where it causes problems to the lower body and joints. It is of two kinds, according to Ayurvedic Seer Charaka – Sneha (Oil) and Kashaya (Medicated Decoction) – forming, according to him, the “Five Actions”, less the last, which is according to Sushruta (who classifies basti as one type alone), the Ayurvedic physician:

Raktamoksha – Therapeutic blood-letting, removing Pitta from the blood and thus from the kidneys and liver, helping in disorders such as skin diseases. It is often done with leeches (jalauka chikitsa), or by making small incisions / pricks in veins.



In addition to these, Ayurvedic Therapists employ “Purvakarma” or Preliminary Therapies, such as Snehana (Oleation) and also Swedana (Sudation) therapies – especially for Vata type people and disorders, which help dislodge the accumulated doshas from their sites of accumulation.

Accumulated and excess doshas are called Ama (toxins) in Ayurveda, which are built up in areas respective to both their sites of accumulation, and also where they have settled in the body (tissues, joints, channel systems etc).

Panchakarma itself is known as Shodhana therapy – meaning “Cleansing”.

Afterwards, clients undergo Rasayana therapies – rejuvenation therapies, which help to restore vitality to the body, after the severe shock it can undergo with Shodhana – or cleansing actions of Panchakarma.

Here, tonic herbs as Ashwagandha (Winter Cherry) and Rasayana formulas or confections, known as Avalehas are often given to restore the body’s vitality and also tissue. Especially in debilitated Vata type people.

In addition, Diet and Lifestyle form the aspect of Shamana – palliative therapies in Ayurveda, and form an important part of those undergoing Panchakarma – strict diets, lifestyles and even exercise regimes, as part of their treatments. Lifestyle Advice in the West today, in Ayurveda, is mainly Shamana or palliative / pacifying.

Such therapies include:

Abhyanga – Ayurvedic Massage. This is of local areas and the full body (sarvanga) for preventing aging of the body and skin.

Murdha Taila – Head oil / oleation (snehana). This is done by Shirobasti (holding oils in the head region by a leather cap) or Pichu (cloth soaked in oil on the head), Abhyanga (massage)

Pischu is good for falling of hairs and cracking of the skin, whereas Shirobasti or keeping oils on the head by a leather cap etc. is useful when there is facial palsy, insomnia, dryness of nose and mouth, as also blindness also, as said in the ancient texts.

Shirodhara – Pouring of medicated warm oil in the forehead for psychological disorders, especially insomnia and stress.

Another form known as Takradhara is also done, using decoction of Amalaki and  (Indian gooseberry) and buttermilk for varuous disorders also, such as psoriasis, arthritis, diabetes, eye and ear diseases as well as premature greying of the hair, stress and headaches.

Shamana Nasya – Palliative nasal therapies, such as those done in winter time to remove excess build-up of kapha or phlegm (two drops per nostril, per day).

Such oils as Anu Taila (discussed elsewhere) can be used for this.

Kevala and Gandhusha – Retention of medicated oils and decoctions in the mouth, in case of mouth ulcers, oral disorders, toothache and for strengthening gums in general.

For this, one can use sesame paste mixed with water or sesame oil for Vata disorders (tingling feeling, shaky teeth, dry mouth); ghee (clarified butter) or milk for Pitta disorders as ulcers or burns, and honey for Kapha disorders as excess phlegm.

Liquids should be warm for Vata and Kapha and cool for Pitta.

It is said that disorders of the ears, nose, mouth, neck and head are helped by this.

Dhumapana – Medicated Smoking. Relieving congestion in the head and sinuses, and often done after Nasya or nasal therapies. Resins such as Guggul are used here, which help in reducing kapha or phlegm.

Karnapurana – Holding medicated oils in the ears, for ringing in the ears, loss of hearing, neck ache and tooth ache.

Common oils for this is Kshara Taila, Garlic Oil and Vachalasunadi, which help reduce congestion in the ears and clear them, as well as keep the ears healthy.

One can warm oil, fill ear cavity with oil and then place a bung of cotton wool inside to prevent oil from spilling out, and do the same for the reverse.

Netra Kriyas – Eye therapies, such as holding ghee (clarified butter) and decoctions of the Ayurvedic substance Triphala in and over the eye for inflammation and lack of sight, as also various collyriums / pastes and juices used for the same

Localised Bastis – Retention of medicated oils in dough-wells, such as on the knee, neck and lower back, in cases of severe pain, sciatica, pain in the joints etc.

There are many such treatments, which are often passed-off as being Panchakarma in the West, however are only palliative treatments and therapies – although can also form part of more complex Panchakarma therapies themselves.

It is useful to know about these methods also, as if one chooses to undergo them in India, you will have a better picture of what they aim at, and what therapies are available to you.

Whilst some of these methods may seem old-fashioned and far-fetched, they are actually very useful in curing many diseases.

For example – Raktamoksha or blood-letting is very effective in severe diseases of the skin, such as Leucomerma / Vetiligo, Psoriasis etc.

Basti or therapeutic enemas have many uses, including for arthritic conditions, and are often done along with therapies such as hot bolus-bag massages, for relief of pain in joints, limbs, as also paralysis and strokes also.

On that note, some special oils such as Ksheerabala and Bhunaga Tailas are used for nasal therapies (nasya) for the same, helping reduce Vata in the head and mind, which causes strokes, paralysis and loss of sensation, and also speech problems in stroke victims.

It is hence helpful to know what varieties of treatments are available in Ayurveda, and also their scope of healing, which we often do not hear about in the West