The treatment of ayurveda can be divided as brumhan (anabolic) and langhanam (catabolic). The langhanam is again subdivided into shamanam and shodhanam . Purification therapy is a unique feature of ayurveda by which the complete cure and non-recurrence of disease is made possible. The functional components (doshas – vatha, pitha & kapha) move all around the body through the channels of circulation to do the normal physiological activities. The disease is the result of imbalance in the quantity and quality of the doshas. During the disease process, the unbalanced doshas get lodged in the weak parts of the channels of circulation and produce the disease symptoms. If the channels of circulation are pure and healthy, even the aggravated doshas cannot locate anywhere and produce disease.

Ayurveda offers two measures in the management of a disease:

1. Pacifying therapy: (samanam – curative) – In which the unbalanced doshas are pacified with in the body itself. As this therapy doesn’t cleanse the channels of circulation, there is the possibility of reprovocation when exposed to similar causative factors. This therapy is suited in conditions in which there is not much vitiation of the doshas.

2. Purification therapy (shodhana – eliminative): – It is aimed at the complete expulsion of the unbalanced doshas and the purification of the channels of circulation. As the channels are cleansed and strengthened by this process, the chance of recurrence is nil. Purification therapy can be implemented not only for curing diseases but to maintain health. No other systems of medicine can offer such an effective treatment measure. So we can proudly declare our superiority of ayurveda to any other systems on account of its purification therapy.

Shamana means oral medication by using the most specific drugs in different formulations chosen according to the specific stage of disease that is to be determined after classic ayurvedic diagnosis. The classic ayurvedic diagnosis is made by assessing the signs and symptoms with the ayurvedic parameters dealt in classic ayurvedic literatures like madhavanidanam etc. After getting relief and cure from the disease one has to undergo the specific shodhana (panchakarma) instructed treatment principles to prevent the reoccurrence of the previous diseases (getting immuned) and also to rectify some of the complications that may still exist within the body even after curing the disease by the indicated oral medication.

Superiority of eliminative therapy

permanent cure
absence of relapse
immunity enhancement
additional benefits are;
- complications are also prevented
- free radical quenching
- prevent iatrogenic complications
- retards premature ageing process.

‘pancha karma therapy’ is implemented in five ways.

1. enema therapy: – it is best for vatha imbalance.
2. purgation therapy: – best for pitha imbalance.
3. emesis therapy: – for kapha imbalance.
4. nasal drops: – for all diseases above the neck.
5. blood letting – best for removing blood impurities.

Stages of treatment

first stage: This includes the external and internal application oils followed with fomentation or sudation. by this the unbalanced doshas lodged in the weak parts of the channels are liquefied and loosened.
Pachana
Dipana
Snehana
Swedana

Main or second stage: In this stage the loosened and liquefied doshas are expelled out of the body by the appropriate purifactory procedure.
vamana
virechana
anuvasana
asthapana
nasya
rakthamokshan

Post therapy: This includes the regimens to be practiced after the purification. This is mainly intended to augment the digestive fire.
dhumapana
kabala graham
gandusha
sansarjana karma
use of samana oushadha
rasayana aushadi.

Pathphysiology

sanchayam – accumulation
prakopam – aggravation
prasaram – dissemination
sthanasamsrayam – localization
vyakthi – manifestation
bhedam – disrupted complication.

By panchakarma
1). rechanalisation
- removing obstruction
- liquefying static doshas
2). natural mobility of dosha
3). rehabiliting doshas to koshta.
4). rehabilitation of dhadhu parinamum.
5). enhancement of absorption and metabolism.

Advantage of panchakarma

• purifies the entire system
• diseases are uprooted and can be eradicated with no reoccurrence
• improves performance of agni including dhathwagni
• acquires the vyadhikshamatwa(immunity)
• repairs the structural and functional damage of body caused by the diseases.
• tendency as vitiation and mitigation of doshas (even though it is natural) can be normalized.
• srothas (channels of body fluids) becomes clear and this activates the transport of rasadhathu and there by enriches its inherent preenanakarma [rejuvenation].
• koshta (elementary tract) becomes clear and thus koshtangas becomes activated and thereby felicitates co- ordination.
• activates ekadasha indriyas.
• gives absolute and quick relief from chronic diseases.
• purifies navadwara

Disadvantages

1. if physicians logic is irrelevant or not in time, it causes harmful effects.
2. if physicians could not discriminate sama – nirama stages, the rasa part of dhathus, which are essentially required, will be lost like a we get juice out of an unripend mango by squeezing it. – thus body spoils.
3. if samsarjana kriya and other post operative procedures are not properly done – it causes impairment of agni and iatrogenic complications also .

If we do poorvakarma in sama avastha – it causes discomforts caused by shakhagatha amam – hence it can be considered as an eligibility test to do panchakarma by assessing presence of ama upon anupashayam. If we get upasayam panchakarmas can be done.