Panch Karma

 

SL NO PROCEDURE
1 ABHYANGA
2 AVAGAHA SWEDA
3 CHOORNA PINDA SWEDA (ROOKSHA
4 DHANYAMLA DHARA
5 JAMBEERA PINDA SWEDA
6 JANUVASTHI:
7 KATIVASTHI
8 LEPAM
9 SHIRO ABHYANGA
10 SHIROSEKA
11 ANNALEPA
12 PICHU
13 VALUKASWEDA
14 KASHAYA DHARA
15 .UPANAHA SVEDA
16 DHUMAPANA
17 SHASHTIKA PINDA SWEDA
18 GANDUSHA:
19 NASYA KARMA
20 KAVALA
21 SHIROLEPANA
22 KHSEERA DHUMA
23 NIRUHA BASTI
24 MATRA BASTI
25 KARNAPOORANA
26 ASCHOTANA
27 GRIVA BASTI
28 MAMSA PINDA SWEDA
29 PATRA PINDA SWEDA
30 PRUSHTA BASTI
31 SHIROBASTI
32 SHIRODHARA
33 UDVARTANA
34 VAMANA
35 AKSHI TARPANA: 

 

1. ABHYANGA: Abhyanga is defined as an ayurvedic procedure of application of snehadravyas over body with certain amount of (very mild) pressure in specific directions. It can be applied to the whole body or locally. Many of the prevalent modern massage techniques are the modified forms of abhyanga.
Procedure: Patient should be seated on the droni/table, with leg extended. The oil with Optimum temperature should be applied to head, first in the anterior fontanellae and then the Whole scalp. Then karnabhyanga should be done, Palm and padabhyanga are also done prior to the main process.The oil heated should be applied uniformly by two therapists on both sides of the droni/ table. Start massaging scalp, head and move down to neck, upper back, shoulders, upper arms, forearms & hands; then chest, abdomen, low back, lower limbs. Abhyanga should be done in sitting, supine, right lateral, left lateral positions. Prone position can also be adopted in the case of low back ache. Avoid prone position in patients with chronic diseases of lung, heart, GIT, Upper back should be massaged in upward down direction. Limb joints should be massaged in circular manner and muscles in linear manner. Umbilical region is massaged in circular manner. Supine position:-Upper Limbs, Shoulder & neck, Umbilical region , Lower limbs & region from sternum to flanks are more concentrated. Left lateral:-Back , Lower Limb & Hip are more concentrated. Rt.Lateral:-Back, Right Limb & Hip. If prone:- Mild spinal massage is given. At the end of the procedure the medicine on the body should be wiped off with tissue paper / towels.

2. AVAGAHA SWEDA:The word ‘avagaha’ means to immerse. Avagaha sweda is a type of sudation therapy which is included in Drava sweda, in which the patient is made to sit/lie in a tub containing medicated dravadravya to produce fomentation to the body.
Procedure: The patient should be seated comfortably in the tub containing medicated dravadravya in such a way that his lower part of the body should be submerged above the level of umbilicus. Sarvanga avagaha sweda should be performed submerging the body up to neck. When the temperature of the medicated dravadravya comes down, some amount should be replaced by warm dravadravya, thus keeping the temperature uniform

3.CHOORNA PINDA SWEDA (ROOKSHA):Choorna pinda sweda is one among Rooshma sweda. It isdone with the boluses of various choornas(usually medhika, sarshapa, sathapushpa, jatamansi, atasi etc ). It can be done as snigdha or rooksha according to the condition. In snigdha pinda sweda, oil is applied over the body as well as the pottalis are heated in oil. The potalis can be heated by the steam of boiling drava dravyas like Dhanyamla in specific conditions.
Procedure: The hot pottali should be gently applied over the body, after confirming the temperature by applying pottalies on dorsum of hand of therapist. Just pressing the body with pottali should be done, no need of kneading and massaging with the pottali. Both pottalis are used alternately after reheating to maintain uniform temperature throughout the procedure(Reheating is done either by keeping pottali in vessel or by steam of dhanyamla). Same pottali can be used for three days.For whole body, it should be done for about 30-45 minutes in the 7 positions as in kayaseka. It can be applied locally also. Samyak swinna
lakshanas must be looked for.

4. DHANYAMLA DHARA: It is a type of kayaseka, included under drava sweda. Dhanyamla is included under Sandhana kalpana. It is used in vatarogas, especially with kaphanubandha. Procedure: Warm Dhanyamla is poured with kernels/mugs by two attendants standing on either sides of the droni. The temperature should be warm and which is comfortable to the patient. Dhara should be poured at a medium speed and from a height of 6-12 cm. This is to be
done in the seven positions mentioned in Kayaseka. Can be done hot or cold according to condition. Change dhanyamla after every 2 days.

5.JAMBEERA PINDA SWEDA: The Jambeera pinda sweda is performed with the bolus of Jambeera fruit pieces. This is mainly applied in vatakapha predominant conditions. It is usually done in frozen shoulder,plantar fascitis and traumatic conditions. It is sophahara, rooksha& Theekshna.
Procedure: Abhyanga should be performed with suitable medicated oil. Out of the four pottalis, the two pottalis should be warm and which is comfortable to the patient by keeping on the hot pan containing suitable oil. This pottali should be applied to the patient as per the general procedure for about 30-45 minutes.

6.JANU BASTHI: This is a practical modification of snigdhasweda, where warmed sneha is allowed to stand over knee area for a prescribed period of time. It can be used in Janushoola caused by degenerative joint diseases, but contraindicated in inflammatory conditions.
Procedure: The area of application should be thoroughly cleaned and flour dough should be pasted over the line, marked around knee joint like a ring. It should be then reinforced by pressing and sealed properly by flour paste to avoid leakage of oil. The oil should be warmed over hot water bath, usually warm and comfortable to the patient. The warmed oil should be then poured uniformly into bund constructed up to an extent that oil level stands up to 2 inches above the skin level. It should be allowed to remain there for prescribed time. The temperature of oil must be maintained throughout the procedure by taking some oil out using a cotton and replaced by same amount of warmed oil.

7 .KATIVASTHI: It is a type of local snigdhasweda where warm oil is kept at the katipradesha for a prescribed time. The patient lies in prone position and the katipradesha is encircled with thick black gram paste for retention of the oil. . It acts effectively as it is applied at the site of lesion .This procedure can be performed in other areas like greeva, janu, uras etc. and named accordingly It is a samana procedure.
Procedure: The oil should be warmed over the hot water bath and poured slowly inside the ring. Its temperature must be warm and comfortable to the patient, by replacing a small quantity after reheating. After the prescribed time, oil should be removed with the help of cotton.

8.LEPAM: The tropical application of the herbal paste to the body and keeping it undistuebed for certain period is known as Lepam.
Procedure: Make a paste of required herb or choornam (as per vaidya’s prescription) adding sufficient quantity of liquid/ water. A small quantity of paste is applied to ensure the tolerability of heat. Then this paste is applied over body part to be treated as per vaidya’s advice.

9.SHIRO ABHYANGA:ShiroAbhyanga is defined as smearing the oil to the head followed by massage by specific maneuvers refers to shiro abhyanga.The technique of shiro abhyanga includes smearing the oil to the portions of the scalp above the neck followed by placing specific strokes.

10. SHIROSEKA- Continuous pouring of decotion, oil or other liquids on the forhead and then allowing it to flow over the scalp, using a specific instrument dhara yantra is known as shiroseka.it is also known as shirodhara.
Procedure:Patient should lie in supine position on theDroni with a pillow under the neck and the Shirodhara device is placed over the head. Its height is fixed in such a way that suitably warm oil/ medicated liquids should fall from a height of 8 to 10 cm in a continuous stream of the thickness of a little finger over theforehead. The oil/ liquid poured is recollected and reheated just above the body temperature and again poured in the Dhara Patram. The attendant should move the vessel to both sides of the fore head so that the flow of liquid reaches both sides properly.

11.ANNALEPA:In Annalepana, just as in Shashtika Shali Pinda Sweda, milk processed with medicinal herbs and a special type of rice are combined together to be used as an effective external therapy which is used to provide strength and nutrition to the body tissues, especially bones, muscles and other soft tissues.
Procedure: The grinded rice should now be rubbed against the body of the patient in the procedure of Udwarthana or rubbing from below upwards. The masseurs take the rice from the bowl or vessel in their hands and rub against the body. The rice is rubbed in upward direction (opposite to the direction of body hairs). Two masseurs should take in charge of rubbing and stroking the rice against the body of the patient in a gentle way and cover the lower portion of the body i.e. one masseur should attend the hip, buttock, anterior and posterior portions of thigh, leg, knee, ankle and lumbo-sacral area on the right side and the other masseur on the left side.The other masseur should carry on the procedure simultaneously on the upper portion of the body. One among them should cover the abdomen, chest, sides of the chest, flanks, upper back, neck (nape), shoulder, elbow, wrist and small joints of the hands, arm and forearm of the right side and the other masseur should cover the left side of the body.The treatment should be carried out in a skilful and synchronized way on both left and right sides of upper and lower portions of the body by all the 4 masseurs in an uninterrupted way.The strokes are given from below upwards from the low back area towards the nape of the neck and the masseurs attending the lower portion of the body will give ascending stroke by rubbing the rice from the foot towards the hip covering the whole of lower limb.The strokes are done in a circular and clockwise fashion while covering joints of the body. Similar method is followed while conducting the treatment on the upper limbs. While rubbing the part with the rice in right hand, the masseur can move his left hand over the body part following the direction of the hand rubbing the rice and give a soothing stroke. Circular strokes can be given over the joints and vertical strokes from below upwards on the back and limbs.The application of rice in Annalepana procedure should reach all parts of the body. To achieve this, the procedure should be carried out in all the 7 postures in which Abhyanga (herbal oil massage) is done.

12..PICHU: Pichu is a procedure in a piece of cloth or gauze is folded and dipped in oil or any selected medicine then later kept on the selected part affected.
Procedure :The place which is selected should be given slight abhyanga for 15minutes.Cotton should be dipped in the medicine and then placed over the part selected.

13. VALUKA SWEDA:Application of heat and there by inducing perspiration by using heated pack ofsand is known as valuka sweda..Here in valuka sweda body part is subjected to sudation procedure without prior application of oil.
Procedure The patient should sit comfortably exposing the part to be sudated. The hot pottali should be gently applied over the body, after confirming the temperature. Just pressing the body with pottali is advised; no need of kneading. The pottalis should be used alternately after reheating to maintain uniform temperature throughout the procedure. For whole body, it should be done for about 15-20 minutes in the 7 positions . Same potalis can be used for three days.

14. KASHAYA DHARA: The word ‘kashaya dhara’ means pouring of herbal decoctions or extracts. Kashaya dhara is a type of sudation therapy which is included in Parisheka , in which the patient is made to sit/lie in a table and pouring medicated dravadravya to produce fomentation to the body.
Procedure : Medicine for Kayaseka is to be heated. The temperature of medicinel must be comfortable to the patient. Then piece of cloth is to be dipped in the warm medicinel and squeezed over body with the right hand .Simultaneously gentle massage is done with left hand. The medicine should flow in uniform stream from the thumb facing down wards from a height 12 to 20 cms. or as per the condition of the disease / patient. The process is to be continued in seven positions as given below.
Positions for Kayaseka:
Basically three positions Sitting, Supine and prone are described but practically following seven positions can be followed:
1. Sitting 2. Supine 3. Left lateral 4. Prone 5. Right lateral 6. Supine 7. Sitting

15.UPANAHA SVEDA: The procedure of applying warm herbal paste to the diseased part of the body followed by bandaging.This unique type of swedana therapy is usually preferred for performing the swedana for a limited portion of the body
Procedure:Then the above paste with bearable heat should be applied. The area where the paste is applied should be covered with Eranda patra or other prescribedleaves and bandage to be done with thick cotton cloth.

16. DHUMAPANA: Smoking for the therapeutic purposes using a specially designed instrument orpipe is known by the name Dhumapana. Using a special instrument the herbalpowders are burnt and the smoke emitted is inhaled
Procedure: Patient is made to sit comfortably on a knee highchair. And the lighted dhuma yantra is placed infront on a table. The Patientis asked to suck andthen inhale the dhuma by placing the mouthpiece of the dhumayantra between his lips. Heshould exhale the dhuma only through themouth. This is repeated several times. If anysputum comes it should be spat out in aspittoon. Following this the client is nowasked to suck the dhuma through one of thenostrils and then inhale. While doing so theother nostril is closed with a finger. And then the dhuma must be exhaled throughthe mouth. Dhuma should never be exhaled through the nose and is the rule.After repeating the procedure several times dhumapana is then continuedthrough the other nostril.In case of the prayogika and vairechanika dhumapana the inhalation of the smokemostly through the nostrils is preferred. Inhaling the smoke both through thenostrils as well as mouth is ideal in case of snaihika dhumapana. Contary to thisthe inhalation of smoke only through the mouth is advised in kasaghna and In general the smoke is inhaled three to four times through each nostrils and mouth. Inhalation of the smoke thrice is ideal in prayogika dhumapana. Snaihika dhumapana may be continued till there appear tears in the eyes, Vairecanaika dhumapana is continued for a longer duration till the complete elimination of the dosha.

17. SHASHTIKA PINDA SWEDA : The word ‘PINDA’ means bolus. Pinda sweda refers to the sudation performed by bolus of drugs. Shashtika pinda sweda is performed in ekanga or sarvanga with the bolus of boiled Shashtika shali with Balamoola kwatha and ksheera. The main properties of Shashtika are snigdha, guru, sthira, sheeta and tridoshaghna. Though a sweda karma, it has brimhana guna.

18. GANDUSHA: The procedure of holding oil or decoctions in the buccal cavity for certain period is known as gandusha.Gandusha is indicated in both healthy and diseased persons
Procedure: The patient is made to sit on a knee height chair with arms resting on the armrest and head slightly raised
*The patient is asked to take about 100ml of luke warm sneha/ medicated decoction or the quntity that fills inside the mouth
*The patient is asked to hold the sneha inside the mouth , undisturbed , without gargling for certain period
*After specific period , the patient is allowed to spit out the sneha

19NASYA KARMA: Administration of medicines through nostrilsis called nasya. Nasya is indicated mainly in aggravated and accumulated do shas of head and neck
Procedure: Slightly warm oil should be in stilled in the prescribed dose in each no stril Gentle massage is to be performed on the plantar and Palmarregion, shoulder and back The patient is allowed to spit if patient feels discomfort due too ili n the throat

20. KAVALA- Procedure of holding oil or decoction in the buccal cavity followed by gargling for a certain period is known as kavala-.
Procedure-Oil is heated and the person is asked to take about 100ml of lukewarm oil or as much as he can accommodate in his mouth.The medicine has to be gargled in the mouth until he is comfortable. Later he is asked to spit out the Medicine.

21. SHIROLEPANA:it is a procedure of application of paste of medicines on head for a specific period of time.
Procedure: After shaving head, medicated oil applied over the body and scalp. Patient has to sit comfortably on a chair and Varti is to be tied around his head. Thereafter paste should be applied on his head with a thickness of 3 inches.At the center,a dip is made and taila is poured into it. Lotus leaves are to be covered on the applied paste and tied around the head.

22.. KHSEERA DHUMA:Ksheera dhuma is a modified Svedana procedure, which can be included under Drava Sveda. It is found to be effective especially in diseases pertaining to Urdvajatrugata Roga.
Procedure:Ask the patient to sit comfortably on a stool. Cover the body with blanket. When the vapours take free end of the rubber tube, direct the vapours towards the oleated areas. Continue till sweat appears on the nose, forehead for about 15-20min.
Care should be taken to prevent burns. During the procedure ask the patient to open his mouth widely, protrude his tongue and inhale deeply.
Precautions:
• The temperature of medicine should be tolareble to the patient.
• If the patient feels any discomfort or attains good perspiration at any time during the treatment, the therapy should be stopped.

23. NIRUHA BASTI:Administration of basti predominantly consisting of herbal decoction is known asNiruha basti. The composition of the medicine administered in the form of bastiincludes herbal decoction, medicated oil, honey, rock salt and herbal powder.Among these different ingredients, the concentration of the herbal decoction isrelatively more in comparison to other ingredients. This is the distinctive feature ofthe niruha basti, also known by the name Asthapana basti. Earlier the processedurinary bladder fitted with a nozzle is used to administer the basti, and these daysthe enema can is utilized for the same. The procedure of this therapy is detailed inthe following paragraphs
Procedure:
ADMINISTRATION OF BASTI: The anal orifice of the client is smearedwith oil for lubrication with the help ofcotton wool. The catheter is then gentlyintroduced into the anal canal in thedirection of the client's spine. About 42inches to 6 inches of the catheter isinserted. Now it is time for administrationof the basti. For this the enema can is Elevated considerably, rubber tubing isopened by releasing the kink. The bastidrug flows into the client's rectum easily.At the same time the client is encouraged totake deep breaths. In most of the cases the client excretes the medicines within few minutes ofadministration of basti. Therapist should wait for the evacuation for a maximumperiod of 48 minutes after the administration of the basti. If the basti drug doesnot come out by this period every effort should be made to evacuate the bowel.As soon as the catheter is removedthe therapist should place gentlestrokes on the client's buttocks forabout a minute. Client is then askedto gradually assume the supineposition. To begin with from the leftlateral position he turns to lie downin the prone position, within amoment he then turns to rightlateral position. Staying for a moment in this position finally he turns to assumethe comfortable supine position. In this position he is asked to rub his palmsbriskly against cach other, and at the same time the therapist rubs the clients sole vigorously. Further, the therapist flexes the client's legs at the hip and knee repeatedly several times. Then thc client is asked to raise his legs by flexing the hip several times. This completes the procedure of administration of the asthapanabasti. Client is then allowed to take rest.The client is encouraged to hold the medicine with in the rectum as long aspossible. When there is strong urge for defecation the client is allowed to excrete the medicine
Precautions:Client is then allowed to take rest.The client is encouraged to hold the medicine with in the rectum as long aspossible. When there is strong urge for defecation the client is allowed to excrete the medicines. most of the cases the client excretes the medicines within few minutes ofadministration of basti. Therapist should wait for the evacuation for a maximumperiod of 48 minutes after the administration of the basti.

24. MATRA BASTI:Matra vasti is the method of administration of medicated oil in small dose, which can be given daily and is totally harm less. It is a type of Sneha Vasti and indications are similar to Snehavasti. It can be indicated irrespective of age and no precautionary measures are required. The usual dosage is 60 ml
Procedure:The patient is advised to lie down in left lateral position. Apply little quantity of oil on patient’s anus and catheterof Basti yantra. The catheter is gently inserted into the anal canal up to a specific length and press the syringe piston with uniform pressure. The pressure is continued till only small quantity of
fluid remains in the syringe. Then the catheter is removed gently and thepatient is allowed to lie down on supine position for 15minutes.

25. KARNA POORANA: Putting of medicated Lukewarm oil or ghrita in to the external auditory canal
Procedure: After Abhyanga and swedana around the ear about 3.5ml of Lukewarm medicated oil is dropped into the ear with the help of dropper spoon. The ear pinna may be pulled out little towards the posterior side. Then close the ear by placing the cotton plug. Then same procedure is followed in other ear

26.ASHCHOTANA:The unique therapy of dropping in liquid form on the eyes with the eye’s kept open is known as ASHCHOTANA
- The medicine is gently wiped off with a soft cotton cloth
- The eyes are then subjected to mild fomentation
- A pad of cotton cloth is soaked in warm water and the water is squeezed off
- The moist warm pad of cloth is placed on the closed eyes

27.GRIVA BASTI:Griva basti is the procedure of applying heat to the cervical region by retaining warm medicated oil with in a specially formed frame on this area is known as Griva basti

28 MAMSA PINDA SWEDA:This is a special type of Pinda sweda , and there by the bolus is specially prepared with mamsa (flesh) and fomentation is made with the help of this potali.

29. PATRA PINDA SWEDA: Patra Pinda Sweda refers to the Swedana (sudation) performed by specially prepared bolus of medicinal leaves. In this process leaves of Vatahara drugs are cut into
pieces and fried with rock salt and suitable medicated oil. This hot mixture is tied in cotton cloth as boluses for application over the body.

30.. PRUSHTA BASTI:It is a type of local snigthsweda where warm oil is kept at the prushta pratesha for a prescribed time.