Pañcakarma includes specially designed five procedures of internal purification. Āyurveda treatment comprises of two major treatment principles i.e., Samśodhana and Samśamana cikitsā. Pañcakarma is basically a bio purificatory method intended to eliminate the toxic elements from the body and thereby maintains equilibrium of doṣas.The word Pañcakarma is made out of two words, Pañca and Karma.

• Pañca – Five
• Karma – कर्मलक्षणं बह्वितिकर्तव्यतायोगिदोषनिर्हरणशक्तिज्यायस्त्वम् (Cha. Su. 2/15 Ṭīkā)

Here Pañca is saṅkhyā prādhānya and Karma refers to the procedure which has multiple and broad-spectrum action and having the capacity to eliminate the vitiated doṣas.

स्नेहस्वेदादि द्वार शरीरस्य उत्क्लिष्ट दोषाणां यथा आसन्न मार्गेण बहिर्निर्हरण कर्त्रुत्वं संशमनं कर्त्रुत्वं पञ्चकर्मत्वं॥ (Mu. Dvi)

Pañcakarma is a procedure in which the Utkliṣṭa Doṣas are expelled out through the nearest route after Snehana and Svedana. It is followed by Śamana therapy.

The term Pañcakarma has been used for the first time in Caraka Samhita Sūtrasthāna Apamārga Taṇḍulīyam Adhyāya.

तान्युपस्थितदोषाणांस्नेहस्वेदोपपादनैः|

पञ्चकर्माणि कुर्वीत मात्राकालौ विचारयन्||१५||

(Cha. Su. 2/15)

After attainingupasthita doṣavasthā by Snehana and Svedana, a physician should administer the Pañcakarma paying due regard to the dose and time.

Here Chakrapani explains the meaning of upasthita doṣas.

उपस्थितदोषाणामिति शाखां त्यक्त्वा कोष्ठगमनेन तथा लीनत्वपरित्यागेन प्रधानावस्थाप्राप्तदोषाणाम्

(Cha. Su. 2/15 Ṭīkā)

Doṣas which have left the periphery (śākhā) and moving towards koṣṭha, which have lost līnatva (deep seated or adherence) and attained pradhāna avasthā (attained the qualities to be expelled) are known as upasthita doṣas namely,

1. Vamana
2. Virecana
3. Nirūha basti
4. Anuvāsana basti
5. Nasya

Pañcakarma is useful in all the Aṣṭāṅgas of Āyurveda. Pañcakarma is not only meant for śodhana, but also a measure for laṅghana, bṛṃhaṇa, lekhana and śamana. Even though a person stays healthy, there is a seasonal deposition of some amount of doṣas which may lead to disease in future. Season wise Pañcakarma is effective in preventing these diseases. In the present era where people are more affected with stress, anxiety, allergies, improper digestion, lifestyle diseases. By clearing the body from toxins, Pañcakarma is effective in revitalizing body as well as mind. Thus, pañcakarma procedures are widely used in a preventive, promotive and curative aspect.

Śārṅgadhara explains Pañcakarma as[i]

• Vamana
• Recana
• Nasya
• Nirooha Vasti
• Anuvāsana Vasti

Pañcakarma can act both as Laṅghana and Bṛṃhaṇa. Anuvāsana Basti acts as Bṛṃhaṇa. Nirooha Vasti and Nasya has Bṛṃhaṇa type also.

According to Aṣṭaṅga Hṛdaya Pañcaśodhana is explained as

यदीरयेद्वहिर्दोषान् पञ्चधा शोधनं च तत्|

निरूहो वमनं कायशिरोरेकोऽस्रविस्रुतिः||५||[ii]

Śodhana is the procedure by which vitiated doṣas are expelled out from the body. There are 5 types of Śodhana – Nirooha Vasti, Vamana, Kāyareka or Virecana, Śiroreka or Nasya and Raktamokṣa. Śodhana comes under Laṅghana Cikitsā.

[i] Sha. Sam. U 8/63

[ii] A.H. Su 14/4

Importance in Dinacaryā

In Dinacaryā various procedures like Snehana, Abhyaṅga, Udvartana, Śiro abhyaṅga, Pratimarśa Nasya, Padābhyaṅga etc… are told which helps in promotion of the health in Svastha persons. Pratimarśa Nasya has been told in different Kāla in a day. Similarly,dhūma has been also told. By regularly following all these procedures the person becomes Svastha, Balavān and Sudṛḍha.

Importance in Ṛtucharya and Śodhana according to ṛtu

The doṣas get accumulated in the body gradually over ṛtus which should be eliminated for keeping the body Svastha. Ācāryas have specified elimination or Śodhana of doṣas in specific ṛtus like in Prāvṛṭ ṛtu Vasti should be administered to normalise the aggravated Vāta, similarly in Śarad ṛtu, Virecana should be done to normalise the aggravated Pitta and in Vasanta ṛtu Vamana should be done to eliminate the aggravated Kapha.

अत्युष्णवर्षशीता हि ग्रीष्मवर्षाहिमागमाः|

तदन्तरे प्रावृडाद्यास्तेषां साधारणास्त्रयः||४||

प्रावृट् शुचिनभौ ज्ञेयौ शरदूर्जसहौ पुनः|
तपस्यश्च मधुश्चैव वसन्तः शोधनं प्रति||५||
एतानृतून् विकल्प्यैवं दद्यात् संशोधनं भिषक्|
स्वस्थवृत्तमभिप्रेत्य व्याधौ व्याधिवशेन तु||६||[iii]

Grīṣma (Summer), Varṣa (Rainy Season) and himāgama or Hemanta (Winter) are charecterized by excessive heat, rain and cold respectively. The three intervening seasons viz, prāvṛṭ (the period between summer and rainy season), Śarat or Autumn (the period between rainy season and winter) and Vasanta or spring (the period between winter and summer) are of general nature. The months composing the three seasons of general nature are as follows;

The above mentioned three seasons are suitable for the administration of elimination therapies.

After determining the exact months constituting the above-mentioned seasons, the physician should give appropriate elimination therapies to a healthy person. However, for a patient, the appropriateness of the time (season) should be determined on the basis of the nature of the diseases.

आत्ययिके पुनः कर्मणि काममृतुं विकल्प्य कृत्रिमगुणोपधानेन यथर्तुगुणविपरीतेन भेषजं संयोगसंस्कारप्रमाणविकल्पेनोपपाद्य प्रमाणवीर्यसमं कृत्वा ततः प्रयोजयेदुत्तमेन यत्नेनावहितः||१२७|| [iv]

Caraka in Vimana Sthāna says in emergency conditions Pañcakarma can be done in any season by creating artificial environment and by administering the drug which has been potentiated by combining with other drugs.

Importance in Vegadhāraṇajanya Roga

Ācāryas have specified the use of Pañcakarma procedures and Bāhya karmas in the treatment of Vegadhāraṇajanya Roga. In Mūtravegadhāraṇajanya Roga treatment procedures like Avagāha Sveda, Abhyaṅga, Vasti karma and in Purīṣavegadhāraṇajanya Roga Avagāha Sveda, Vasti karma, Varti Prayoga etc. are told.

Importance in Rasāyana and Vājīkaraṇa

It has been told that before doing Rasāyana and Vājīkaraṇa the body should be purified by Śodhana Karma. If the body is not clean then the Auṣadha administered will not give the desired effects.

In this regard a similie has been told, If you want to dye a cloth you have to wash it properly first and then colour it. Otherwise, it becomes dirtier and more useless. Similarly, if you want to rejuvenate the body first remove dirt (Vitiated doṣas – Body toxins etc..) from the body by means of Pañcakarma therapy.

[iii] Cha. Si 6/4

[iv] Cha. Vi 8/128

There are three methods of treatment told for the removal of diseases according to Caraka in Vimana sthāna – Śodhana, Śamana and Nidāna parivarjana

संशोधनं संशमनं निदानस्य च वर्जनम्|

एतावद्भिषजा कार्यं रोगे रोगे यथाविधि||३०||[v]

Ācāryas have told that in different kinds of Roga the treatment should be finalised only after assessing prakṛti of the patient, Sara, Bala, Vaya, Satva, Sātmya and Jaṭharāgni. The diseases which are cured by Śodhana does not re- occur again. In Prameha, Kuṣṭha, Pandu, Vāta Vyādhi, Vātarakta, Rājayakṣma, Manovikara different procedures like Vamana, Virecana, Vasti, Nasya, Raktamokṣa etc. are told. Further the detailed Pañcakarma procedures are elaborated in their respective Cikitsādhikāra.

[v] Cha. Vi 7/30