Panchakarma literally translates to "five therapies." This group of ayurvedic therapies is performed periodically, generally once or twice a year, as a means tio dislodge deep-seated impurities that lead to systemic disorders. Panchakarma is performed as a preventive measure for the healthy and as a treatment modality for the unwell.

The five therapies that constitute traditional panchakarma are vamana (emesis), virechana (purgation), basti (enema), nasya (nasal drops), and raktamokshana (bloodletting). Today's panchakarma treatments offer a blend of some of these therapies, and should be performed under the supervision of an ayurvedic physician by trained ayurvedic technicians.

A full-fledged panchakarma treatment occurs in three phases: poorva karma or the preparation phase, pradhana karma or the treatment phase, and pashchata karma or the post-therapy routine. Each phase is considered critical for a good outcome, and not paying attention to the preparation or the aftercare can not only detract from the effectiveness of the routine but can be counterproductive in some cases. Performed correctly, panchakarma is an effective rejuvenator of mind, body and spirit.

The Preparatory Phase

Just as the healthiest seedlings come from a well-prepared soil bed, panchakarma cleansing treatments are most effective when the physiology has been prepared thoroughly. In the preparation phase, modalities such as snehana (oleation therapy) and swedana (steam therapy) are used to break down gross impurities and open up all the pores of the body.

Snehana, or the anointing of the body with oil, is done both internally and externally, via diet, enemas and massage. Internal oil therapy can take the form of intake of vegetable oils or ghee (clarified butter) under the supervision of your ayurvedic physician for three to seven days. Abhyanga is the traditional warm-oil ayurvedic full-body massage, often performed by two technicians working in synchrony. Herb-infused massage oils are massaged into the entire body in order to improve circulation, release impurities clogging the lymphatic system, and dislodge embedded impurities in the joints. Shirodhara is a special massage wherein a stream of warm oil is poured in a stream over the forehead, and is deeply relaxing and calming to the entire physiology.

Swedana is steam therapy, and follows oleation. Individualized herbal steam baths are designed to perform in-depth purification of cells and tissues.

In this preparatory phase, diet is modified to be light and cleansing, consisting mainly of easily-digested whole grains and cooked vegetables. Activity is modified to include winding down from intense work or stressful activity, introduction of deep breathing and light exercise and periods of silence and meditation.

The Purification Phase

Emesis and bloodletting are not generally included in panchakarma programs offered today.

Emesis, or induced vomiting, is used to cleanse the body of excess kapha dosha. Preparations made with rock salt and/or honey is used as a vehicle for vamana therapy, which is considered useful in restoring balance to the respiratory system and the chest area of the body.

Virechana or purgation therapy is mainly used to reduce excess pitta in the physiology, and certain types of kapha and vata aggravation. Laxatives, mild purgatives, and strong purgatives are used, depending on an individual's needs.

Basti, or enema therapy, is the treatment used to restore balance to vata dosha. When administered correctly, basti helps rejuvenate the system. Basti can be an oil-based preparation, or a decoction of herbs.

Raktamokshana, or bloodletting, is used in blood-related diseases.

Nasya therapy consists of the use of nasal drops in order to purify the area above the collar bones. Medicated oils or drops are administered to loosen impurities and to restore balance. This treatment is especially effective to restore sinus health and respiratory system health and function.

During the cleansing period, individuals follow a strict diet, consisting sometimes of a monodiet of khichari - a soupy porridge made with moong dal and rice, and herbal teas designed to help the process of internal purification.

Aftercare Phase

After the cleansing period, the physiology should be gradually restored to a regular diet and normal lifestyle. Solid foods should be introduced very gradually, and all food should be cooked to facilitate easier digestion. Jarring the physiology should be avoided.

Physician-supervised panchakarma is available in hundreds of ayurvedic rejuvenation centers worldwide. Dr. Vasant Lad's Ayurveda Center in Albuquerque (NewMexico), Dr. John Douillard's LifeSpa in Boulder (Colorado), and The Raj in Fairfield (Iowa) are some rejuvenation centers that offer panchakarma treatments.