Dosha, dhaathu and mala are regarded as the basic components of human body, and their imbalance results in various kinds of diseases. The objectives of the treatment, according to the principles of Ayurveda science, is to reinatate the equilibrium or homeostasis of doshas and dhaathus in the event of their disturbance. Medicaments and Panchakarma are administered logically to revive the equilibrium of doshas and dhaathus in order to regain health.

The probability of exacerbation of disease is minimal in cases managed with proper elimination of Shodhana therapy. Hence Aacharya Charaka elucidates the superiority of sodhana chikitsa over the other treatment methods. These treatment procedures are not only advised in dieses, but they can be performed prophylactically in specific season in healthy individuals also.

Ayurveda treatment

Ayurveda treatment aims at the evacuation of malas or waste products from the human body through a set of elimination procedures , which in turn eradicates the disease. The elimination therapy is assisted by internal medicines and dietetics. This most significant line of treatment is referred to as Samshodhana in reputed Ayurvedic treatises like Chakra Samhitha.


The Aacharyas of Ayurveda refers the terminology Samshodhana for five very important elimination methods –Vamana, Virechana, Anuvaasana, Nirooha and Nasya. These procedures are otherwise known as Panchakarma, among Vaidyas and the common public.Despite Panchakarma, being a branch of Kayachikitsa, it is availed in all eight branches of Ayurveda mainly as purification and detoxification measures.

History of Panchakarma in Brief


Shodhana Chikitsa

The descriptions about Shodhana chikitsa can be found in all the authentic Ayurveda classics like charaka Samhitha and Sushrutha samhitha,which date back to two thousand five hundred years. The significance of Panchakarma is emphasised wherever the principles of treatment for serious and chronic disease are mentioned. Panchakarma is mandatory for treating chronic as well as difficult to cure diseases in order to fetch long term relief. Superiority and efficacy of Shodhana chikitsa over Shamana chikitsa is corroborated in both Brhuthrayee and Laghuthrayee groups of text books of Ayurveda.


Science of Panchakarma

Fortunately the extreme southern region of India, particularly Kerala, excels in perfoming the art and science of Panchakarma to cure several chronic diseases exclusively following the Vagbhata style of treatments, as elaborated in Ashtaangahrudaya. Vaidyas all over Kerala, at large, comply with the methodology of Pamchakarma in their undiluted from and pass on the goodness of Ayurveda to the ailing community. Lot of institutions under the state and the Central Governments contribute in disseminating the knowledge and skill of Panchakarma among Ayurveda aspirants.



In the medieval period, the popularity in the therapeutic usage and the quality of Panchakarma had diminished considerably in our country due to various reasons including foreign invasions. Despite northern India, which is proximal to Himalayas, being regarded as the domain of intellectuals like Dhanwanthari, Sushrutha and Agnivesha, unfortunately, genuine and scientific pamchakarma had declined even there in the course of time.



Lack of proper knowledge of panchakarma among the Physicians consequently has created a multitude of fake Panchakarma institutions and massage parlours all over the country, run mostly by unqualified persons who are commercially motivated. This problem can be solved only by empowering the Physicians with the scientific knowledge and skill of Panchakarma.

The Concept of Panchakarma

Panchakarma is basically a group of bio cleaning procedures which purify various systems and evacuates the cumulated toxic metabolites from human body. This in turn maintains normal functioning of tissue, sense organs and mind. It enhances digestion, metabolism and immunity of the body; there by retaring the ageing process. Panchakarma procedures render the human body suitable for the rejuvenation therapy for promotive health as well as for therapeutic regimen.

Different Schools of Panchakarma

The generally accepted classification of Panchakarma is in accordance with the school of Charaka who had specialised in internal medicines. It includes Vamana, Virechana, Anuvaasana, Nirooha and Nasya. Whereas, the school of Sushrutha specialised in surgery includes Raktha moksha among Panchakarma by clubbing Nirooha Basti and Anuvaasana Basti as a single entity.

Raktha Mokshana

According to Sushrutha’s school, there are multiple diseases occurring due to the vitiation of blood, and hence Rakstha has been considered as the fourth closha. In order to eliminate the vitiated Raktha, Raktha mokshana has been designed by Sushrutha and included as a Panchakarma. The physicians in kerala at large follow Charaka’s school of classification. Nevertheless, they perform Raktha mokshana in deserving cases.


The term Panchakarma is derived from the combination of two words Pancha and Karmma, which means five procedures. Panchakarma forms the line of treatment which effectively eliminates vitiated morbid doshas and dhaathus of human body, by the application of prescribed medicines through different routes of administration,subsequent to specific preparatory methods.

Poorva karma and their mechanism of actions

The below mentioned five karma are called Pradhaana karma or the main evacuation procedures which are preceded by certain preparatory measures in order to render the vitiated doshas suitable for elimination. They are snehana and swedana therapies.

Poorva karma are specifically intended to aggravate and bring the vitiated doshas from different parts of the body, especially the extremities. These preparative measures facilitate the traction of morbid doshas from periphery to the alimentary canal by increasing the fluidity of doshas and dilation of srothas leading to the alimentary canal.

After the satisfactory application of pre-therapy measures, the displaced doshas are eliminated either through oordhwa marga or through Adhomarga.

Pradhaana karma (Classification of Panchakarma)

Vamana (Emesis)

The oral drug administered induces emesis and eliminates the vitiated and morbid doshasb from the stomach.

Virechana (Purgation)

Here the oral drug administered induces purgation and purifies the alimentary canal.

Anuvasana Basti

Medicated oil is administered in the required dose through the anal canal.

Nirooha Basti

Mixure of medicines is to applied as enema in which decoction is a major ingredient which expels the vitiated dosha and cleans the intenstines.


Medicine as liquids or powder expel the vitiated doshas from nasal cvity and then pacifies the doshas of head.

Pashchaath Karma

This mainly includes dietary regimen, proper lifestyle and some minor procedures like Dhoomapaana, Kabala etc.

The Kerala specialities of Panchakarma- Main features

As discussed earlier, through the system of Ayurveda had deteriorated all over India in the medieval period, this science to a larger extend survives in its pure form in Kerala. The presence of Vaidyas meticulously following the fundamentls of Ayurveda enabled the inheritance of genuine Ayurveda as a medical science as well as a philosophy of life. The vaidyas by their empirical knowledge had developed unique Panchakarma procedures. The improvised versions of Poorva Karma namely Pizhichil, Thalapothichil, Navara, Pichu, etc. Had evolved as discrete treatment methods in Panchakarma which are nowadays termed as Kerala specialities. Navarakizhi in Ayurveda has become world famous and is very effective in treating muscular diseases like muscular dystrophy.

The ancient vaidyas of Kerala formulated several yogas prepared out of medicinal plants growing in the unique eco climate conditions of Kerala. These were complied in Malayalam texts like Chikitsamanjary, Prayogasamuchayam, Sahasrayoga, etc. Yogas like Kethakeemooladi thaila, Raasanaadi thaila,etc. Are belonging to this group. Another interesting feature of Ayurveda practices of Kerala is the logical use of large number of classical yogas, single or in combination, in specific conditions of diseases.

Benefits of Panchakarma in Brief

  • The vitiated doshas are evacuated from the body mainly through alimen tary tract in the last stages of Panchakarma therapy. Panchakarma from the main stream of sodhana chikitsa- the chances of reoccurrence of diseases can be minimised by the appilication of Sodhana chikitsa rather than opting Shamana chikitsa which imparts only temporary relief by pacifying the doshas.
  • The digestive power and metabolism are enhanced.
  • Normalcy of doshas and dhaathus brings about normal health.
  • Proper Shodhana chikitsa periodically prevents recurrent diseases by enhancing immunity.
  • The sense organs and their faculties are preserved by retarding the ageing process.
  • Shodhana chikitsa with proper regimen rejuvenates the body system.
  • Strength, vigour and virility are boosted.
  • In brief the administrative of Vamana cures Kapha and allied disorders, Virechana cures pittha and allied diseases and Basti cures Vaatha and related ailments. Nasya is specified for various diseases of the head.