The treatment plan for a patient is chosen after a detailed case taking, examination, and deliberation by the physician/medical team. Every treatment doesn't suit or is needed by everyone. The optimum therapy, when done rightly, restores the health and preserves the strength of an individual.
Ayurveda affirms the most fruitful result with judicious choices or combinations of the time tested therapies of shodhana (Detoxification), Shamana (Palliative therapies) & Rasayana (Rejuvenation). Sodhana therapies are also known as Panchakarma. These detox treatments require preparative (purva karma) and restorative (paschat karma) before and after it respectively.
All therapies will be accompanied by oral medications as decided by the physicians.
Purvakarma is the first set of actions that are taken ahead of the Panchakarma therapy and may last for three to seven days. At this stage, the body is prepared for eliminative treatment by loosening the toxins and increased doshas in the body.
The cause of diseases is amam, or undigested toxins that get formed in the system due to external factors, and spread to different parts of the body. Through Purvakarma these toxins are channelized and collected for easy removal at the Pradhanakarma stage.
Important Purvakarma techniques regularly used across the Pentads of Panchakarma are Pachana (digestion), Snehana (oleation), and Swedana (sudation). They prepare the body for detoxification and revitalization. Panchakarma treatment is impossible without Purvakarma.
Snehapanam is the oral intake of medicated ghee (clarified butter) made from cow's milk. It is done as a part of Purva karma or preparative procedures before starting the panchakarma therapy or as a stand-alone treatment. The dose of ghee increases gradually from day one until the last day of snehapanam according to prescription. The person is also not allowed to eat anything till the medicinal ghee digests completely in his/her digestive tract. It pools the body with the medicine in the medium of ghee which helps the medicine to reach even to brain tissues.
During the Snehapana days, the food is to be very light and is to be taken only if there is hunger. It is the best preparatory procedure for Panchakarma.
The choice of herbs to be used in the ghee varies with patients so does the number of days of snehapanam and quantity of ghee.
Abhyangam or oil therapy is massaging all over the body with lukewarm oil or on specific areas in a specific rhythm by trained and experienced therapists for 45mins. This helps to soothe the mind, body, and it boosts the immune system and is a good skin tonic. The oil massage is been considered as the Samana (palliative care) as well as the preparative procedure for Panchakarma.
Pizhichil is an intense oil therapy, in which the body is poured over with few liters of medicated oil from a specific height for 1 - 1½Hrs by 4/5 therapists. The patient is made to lie on a wooden Droni. Then pieces of linen dipped in comfortably warm medicated oil are squeezed over the patient’s body from a specific height.
When the warm oil flows and spreads over the body, four masseurs sitting on either side give the patient a gentle massage. This treatment is a combination of oleation and sudation. Additionally, during this, the body will undergo detox and rejuvenation, so the recipient is advised to take maximum rest as they might feel a little tired.
This is effective in diseases connected with the VataDosha and its allied manifestations like spondylosis, hemiplegia, arthritis, back pain, muscular dystrophy, etc. It is been considered one of the best treatments for arthritic and nervine disorders.
Kizhi means poultice in Malayalam (the language of Kerala in South India). In Sanskrit, it is known as PindaSweda. It is a type of swedana (sudation) in which herbal bundles are heated in liquid mediums(mostly) and applied on an area or all over the body for a prolonged time. Kizhi is a technique used in the management of various pain-related conditions affecting the musculoskeletal and neuromuscular systems.
The warmth of the poultices, combined with the active ingredients of the herbs and oils, improves circulation and reduces body stiffness and pain. It is often combined with massage to increase the pain-relieving benefits.
There are many varieties of Kizhi and the name is given based on the ingredients tied within the poultice, eg-Podikizhi, Elakizhi, Ennakizhi, Njavarakizhi, Kadikizhi, Majnalkizhi, NarangaKizhie.t.c. The kind of Kizhi used is chosen according to what is most suitable for your particular condition.
Podikizhi: In podikizhi, the poultice is made with medicinal powders and is used for sudation. Podikkizhi helps in opening up the channels in the body and thereby increases blood circulation. This helps in reducing the inflammations caused by arthritis, muscular spasm, and rheumatism. It is also recommended for relieving stress and body stiffness.
Elakizhi - Is another form of sudation technique in which herbal leaves are freshly collected, chopped, and processed to make a poultice. It is applied either on the whole body or a specific area after anointing the site with oil, which helps in reducing the inflammation and pain.
Dhara when performed all over the body with warm medicated liquids, is a form of sudation. The liquid is frequently warmed and is poured on the entire body from a certain height by 2 or 3 therapists. The procedure is continued for 45 -50 mins. It is usually done to reduce stiffness, pain, swellings etc
Sirodhara - Sirodhara is an oleation therapy for the head. For this, the patient is advised to lie on a special wooden droni with his neck and head comfortably placed. Then a non-stop continuous stream of the prescribed liquid medicine is gently poured on his forehead from a prescribed height through a specially devised apparatus called Dhara vessel for a period of time. Even though medicated oil/ thailam is commonly used for dhara, milk, buttermilk, and decoctions of herb extracts are some of the other fluids used for the same in different clinical conditions.
Dhara is considered to be effective for several diseases like stress-related disorders, sleeplessness, and many degenerative brain and spinal disorders.
Ayurveda believes that the causes of chronic disease are deep-rooted imbalances in the doshas (basic body elements), dhatu (body tissues). These deep-rooted imbalances can be cured with deep cleansing. Panchakarma is five natural methods of deep cleaning which give the body an intensive detox.
These treatments include
1. Vamana - Vamana is therapeutic emesis or medically induced vomiting. After the snehana and swedana, patients are made to consume food items the vitiated Kapha. The next day morning, herbal decoctions are administered to induce vomiting. Usually, Vamanam begins within 30 minutes of ingestion, and the emesis subsides on its own after six to eight such episodes. This process is done in the early mornings and is well supervised by physicians. It is the best treatment for Kapha related diseases as well as chronic skin diseases such as psoriasis.
2. Virechanam - (Purgation) VirechanaChikitsa, or Purgation therapy, is the controlled elimination of toxins from the body using herbal laxatives. It is done after preparative therapies such as snehana and swedana for a week. The patient is administered with natural laxatives in the early morning. The laxative effects start within one and a half during which the patient is not advised to drink a lot of water or sleep. If performed correctly, Virechana does not trigger the usual side effects of diarrhea like weakness and loss of electrolytes.
It helps to flush out body toxins and is effective in Pitta related diseases like gastrointestinal problems and also a vast array of disorders.
3. Nasya - Ayurveda considers the nose as the bridge to reach the brain. The inhalation of medicated oil through the nostrils, eliminating any excess of humors accumulated in the sinus, throat, nose, or head areas. It is the recommended therapy in neurological cases, spinal disorders, disorders related to the head and neck. This is also beneficial in conditions such as sinusitis, migraine, chronic cold, and chest congestion.
The patient’s body is massaged from the shoulders upwards and mild sudation is given. A physician-prescribed dose of Nasya medicine is poured into the nostrils as the patient inhales. During the process, the area around the nose, neck, shoulders, palm, and feet are rubbed. The sputum that gets expelled is to be spitted out.
This is to be continued for a few days.
4. Rakthamoksha - (BLOODLETTING) There are various forms of bloodletting including Leech therapy which is the commonest and most popular. Clinically grown and clean leeches are used on the human body to suck out the vitiated blood which is stagnant under the skin. The leeches sucking out the blood from a region facilitates the flow of oxygenated fresh blood, improving the condition.
5. Vasti (Therapeutic Enema) - Vasthi is a powerful treatment in Ayurveda. It is introducing medicines through the anus and expelling the toxins through the same route. It is of two types.
The post-treatment regimen in Ayurveda consists of a number of procedures tailored to restore the strength of the patient post eliminative therapy and to rejuvenate them. Paschatkarma is as important as the other stages of therapy as the treatment remains incomplete without paschatkarma. Along with providing relief and recovery, preventing the recurrence of the disease is also an important goal of Paschatkarma.
Paschatkarma helps patients reintegrate with the outside world slowly, by making them take ample rest, abstain from overly decadent meals, and follow a strict exercise regimen. Based on body composition, each patient is given a unique combination of chosen therapies with herbal concoctions that aid healing, medical guidance, instructions for the exercise, dietary, and lifestyle changes. If these treatment guidelines are not followed properly, impurities can easily infiltrate the system again.
Ayurveda believes that a knowledgeable physician, caring therapist, and the right medicines can bring about miraculous changes to a receptive patient. The various therapies in Ayurveda are innumerable, but choosing the correct treatments for a person according to his prakrti and vikrti and effectively implementing it with careful planning and strict monitoring is paramount to a complete treatment experience.