Several millennia ago great seers in India cognized techniques for cleansing the body in such a way as to alleviate many forms of pain and suffering. These  techniques have been grouped together as a potent strategy for curing disease and for preventing onset of disease, as well. By now all of you know about the governing principles of physiology—vata, pitta, and kapha. In other articles we have described their modus operandi, so to speak, so we won’t repeat that here. We have shared that the physiology gets out of balance for many reasons—mental, emotional, physical—including the way we live, the food we eat chronically, the climate, and the way we feel, as examples. We have shared that one way to know the principle of motion—called vata is to notice the presence of gas, bloating, flatus and so on. Vata is like the wind and when we see this principle in the body then we infer that vata is in excess—too high. Pitta is bile, hydrochloric acid, enzymes, even hormones and when we feel burning sensation, see pimples or rash then again we infer that pitta is too abundant in the body. When we have stuffiness, feel heavy, dull, lethargic, our rings are tight and so on then kapha—the fluids of the body--is inferred to be in excess. The ancient rishis cognized that we could help rid the body of these unwanted factors—vata, pitta, kapha, and re-establish better functioning by doing some special elimination techniques. Collectively they are called panchakarma in Sanskrit or “5 actions.”  Briefly, we will consider each of the five techniques.


Basti—This Sanskrit word literally means “ bladder” or “bag” as in the urinary bladder of an animal. In ancient days animal bladders were used for the purpose of holding fluids. This term is symbolic of the technique which involves introducing fluids into the rectum—medicated enemas. The ancients have described many types of basti but there are two main categories—eliminative and uncting (herbalized decoctions and concoctions). Collectively, experts say they are 80% of the treatment of vata disorders. The model of Ayurveda holds that in the case of each governing principle, when it is too abundant in its source location, it tends to spread around the body and disrupt physiology. The lymphatics and circulatory system are the gross pathways for the movement of these factors. Interestingly, if we can empty out the primary site then the excess around the body will move back to its home site.  The colon is the home of or the principle site of vata. If we can eliminate vata from the colon then we get rid of the gas, bloating and the many, many symptoms associated with vata in this organ and around the body. Parkinson’s, Alzheimer’s, and arthritis are a few of the serious manifestations of chronic vata imbalance.  “Eliminating” vata from the colon involves many factors, however. For example, if digestion is weak then gas may form in the GI tract. If the colon is dry or sticky from toxicity (ama) then elimination might be sluggish—leading to gas-forming putrefaction of feces. The nervous system governs peristalsis and this may contribute to putrefaction or weak digestion through emotions, lifestyle and so on. So enemas have many targets and functions--cleansing, toning, lubricating, improving absorption, by the herbs being absorbed--balancing the nervous system and other parts of the physiology, even as treatment for areas far away as vata type asthma and headaches. The restoration of proper colon functions, such as elimination and absorption is crucial to health. Poor elimination, whether at the cell, the tissue, or in the GI tract is the root cause of disease. Please be aware that everyone is not necessarily a candidate for enema.


Virecana—This Sanskrit term, deals with elimination through purgation. Here that which is to be eliminated is excess pitta substances in the GI tract. As noted above these substances have many expressions but they are collectively considered to be hot and irritating. They produce many symptoms and signs including inflammations, ulceration, bleeding and even Multiple Sclerosis. So virecana, with such substances as castor oil, senna, pau d’arco, aloe, etc., causes the body to quickly eliminate pitta substances from their primary site-- stomach and small intestines. The substance chosen must consider existing conditions such as bleeding, diarrhea, constipation, and many others too numerable to list here.


Vamana—This word means therapeutic vomiting. Emetics are usually high in fire and air elements (according to panca mahabhautika siddhanta—5 element theory) although salt water and licorice tea are commonly used for this purpose. This is the treatment of choice for kapha imbalances. Those imbalances are characterized by excess fluid in the body and express as hypertension, obesity, asthma, congestive heart failure, and diabetes to name a few. We have noted in cases of kapha hypertension that vomiting can immediately reduce the systolic and diastolic blood pressure readings by 10 & 5 points, respectively. This treatment, too, has numerous contraindications, too numerous to list here. And there are important complications, which might arise if not properly administered.


Raktamoksha—this term means “liberation of blood” as in bloodletting. The blood tissue is a favored site of pitta substances—blood is typically sour. And as we stated above pitta circulates through the body from the digestive tract via the blood or circulatory system. Traditionally, there are many ways to release blood including--venesection, leeches, animal horns (suction)--but in the US the best way is to just donate blood at your local blood bank. For many centuries in the West bloodletting was a main treatment for many diseases indicating “hot blood.” When the concept of blood as circulating tissue emerged then this technique fell into desuetude and even became medical heresy. Interestingly, the Ayurvedic clinicians of old relied upon this treatment for gout, cerebral hemorrhage, stroke, gangrene, and many other conditions. Even in the West this treatment with leeches has found its way back into several thousands of operations annually. Surgeons have discovered that accidental amputations have better chances of healing when leeches are employed. Old age and severe debility are important contraindications among many.


Nasya—This term relates to the nasal administration of substances. As in the above techniques, there are many forms and types—eliminative, nourishing, consolidating, palliative and so on. Herbalized liquids are common substances but smoke or other materials are used, too. Mostly, this technique aims to improve vata functioning in the head as this is a principle site of vata. But the other two governors of physiology—pitta and kapha—are also amenable to treatment with nasal administration. Commonly, people have congestion or post-nasal drip and related complications, which one would think of addressing through the nose. But equally as important is the fact that our olfactory nerve endings in the nasal cavities are exposed. They terminate in the limbic area of the brain, which is associated with our emotions. Thus it is that we can bring balance to our emotions and subsequently to our physiology by using nasya techniques. Tinitis, neck stiffness, headaches, insomnia, fear, worry and others are some of the indications for nasya. The very young should not do nasya.


Thus we have described the five techniques—2 types enema, purgation, vomiting, blood letting, and nasal administration--which comprise the strategies in Ayurveda for eliminating excess functional factors of physiology. As stated above, when we eliminate them from their principle sites, from which they spread into the general circulation, it is as if we create a vacuum which brings the excess from the extremities back to their home in the GI tract. Of course, we need to employ some other measures to enhance the elimination process. For example, drugs from plant, mineral, and metal origins have a major role to play. And traditionally, we apply uncting measures to the whole body—ghee, sesame oil, for example—inside and out, before, during, and after. And we apply heat and massage to excite these excess factors and to liquefy sticky toxins—to get them moving. The body’s own elimination channels will do the task of ridding the wastes and toxins and excess physiological components. These techniques comprise the ancient system of cure and prevention, when applied timely and appropriately, (regularly at the change of seasons), and in conjunction with proper diet, lifestyle, spiritual practices, etc. Not every person is a candidate for panchakarma as it is very depleting. The very weak should do rejuvenating and balancing measures first. When strong enough then do panchakarma. Those having high ama or toxicity (sticky, physiology-impairing substances) are not good candidates either as the toxins impede the release of substances from the body. Also, because oleation is part of panchakarma and the oily is sticky, too. We do ama-burning and digestion-building techniques first then panchakarma.  Not every disease can be cured for many reasons but it is felt that this is the most powerful health-promoting strategy Ayurveda has for the body.


 © Copyright 1999 Michael S. Dick All Rights Reserved