Types of Panchakarma Treatments in Ayurveda

Purification Therapy

Panchakarma translates to “the five actions”; pancha means five and karma means action. Panchakarma is the five actions used to cleanse the body of ama or toxins. It is considered the ultimate shodhana chikitsa or purification therapy. This purification therapy removes ama and mala or waste products from the body, mind and spirit. It also restores balance to the dosha.

When ama builds up in the body, we begin to see manifestations of dis-ease. Oftentimes when we’ve entered into the later stages of the disease process, Ayurvedic lifestyle and dietary changes won’t produce the major shifts that the body needs. That is where panchakarma steps in. It purifies the body of any foreign and unhealthy substance, impression or karma that has been lodged in the body/mind.


Causes of Dis-Ease

There are three main causes of dis-ease according to Ayurveda.

  1. Pragya Aparadha: Mistake of the Intellect

  2. Asatymya-Indriyartha-Samyog: Misuse of the Senses

  3. Kala-Parinama: Effect of the Passage of Time

Pragya Apradha or “mistake of the intellect”/“error in wisdom” refers to living and eating in disharmony with the self. This includes overuse of alcohol, smoking cigarettes, eating foods incompatible with our dosha, and focusing on feelings of negativity, hatred and anger.

Asatymya-Indriyartha-Samyog or “misuse of the senses” refers to unwholesome contact of the sense organs with their sense objects. Our sense organs (eyes, ears, nose, tongue, skin) are how we perceive and take in the impressions from the world around us. We can misuse the senses by excessive contact, insufficient contact, or unnatural or wrong contact. This includes listening to harsh sounds, extreme temperatures, exposure to skin irritants, watching violent media, smelling pollution, and tasting unhealthy and chemical-filled foods and drinks.

Kala-Parinam or “effect of the passage of time” refers to the transformations produced by the passage of time. Each dosha is associated with the different seasons; the times of day; and the cycles of life.

  • Vata: fall/autumn season; 2-6am & 2-6pm; older age ~55+

  • Pitta: summer and late-spring seasons; 10am-2pm & 10pm-2am; adolescence through midlife

  • Kapha: winter and early-spring seasons: 6am-10am & 6pm-10pm; childhood


Before one undertakes one or more of the five cleansing actions of panchakarma, they first experience the preliminary procedures of purvakarma. Purvakarma prepares the body, mind and spirit to release the toxins and panchakarma are the actions that remove those toxins. According to the 6 stages of the disease process in Ayurveda, as the dosha become imbalanced, they relocate from their main sites in the digestive tract (vata=colon; pitta=small intestine; kapha=stomach) to the dhatus or tissues. We use purvakarma procedures to loosen the vitiated dosha from the dhatus so that they can move back to their main sites in the digestive tract to then be removed with one or more of the cleansing actions in panchakarma.

Types of Purvakarma Treatments

If you have looked into experiencing panchakarma at an Ayurvedic center, you may have seen a list of luxurious spa treatments. These treatments include snehana or oleation; swedana or therapeutic heat or fomentation; and lifestyle and dietary adjustments.

  • Abhyantar Snehana or internal oleation treatments: this usually includes taking spoonfuls of warm ghee on an empty stomach in increasing amounts leading up to panchakarma

  • Bahya Snehana or external oleation treatments

    • Abhyanga or Ayurvedic oleation therapy, sometimes referred to as Ayurvedic massage; this treatment can be performed by one or two technicians and includes shiroabhyanga or head massage, padabhyanga or foot massage, and full-body abhyanga; it utilizes specially-formulated herbal oils that are balancing to your specific imbalances

    • Udvartana is an herbal dry rub used predominantly for kapha-imbalances and in lieu of abhyanga in a daily treatment schedule

    • Garshana is an exfoliating dry rub used predominately for kapha-imbalances, where a technician uses raw silk gloves and specific strokes

    • Lepanas or herbal mud treatments

    • Shirodhara or third-eye treatment where a stream of warm medicinal oil is poured over the third-eye and forehead

    • Pichu is when a cotton cloth is soaked in herbal oils and placed on areas of the body in need of healing

    • Pishinchhali is a luxurious treatment where warm oils are poured over the oil, bathing the body in body

    • Karna Purna is oleation of the ears

    • External Bastis are when a ring of dough is placed around a specific area of the body and filled with warm, herbal oils

      • Nabhi Basti: belly

      • Hrid Basti: heart

      • Katu Basti: lower back

      • Janu Basti: knee

      • Netra Basti: eyes

      • Kundalini Basti: spine

  • Swedana or Ayurvedic heat therapy

    • Bashpa Swedana or steam bath where steam is applied evenly to the entire body

    • Pindi Swedana is when boluses filled with herbs, decoctions, rice and milk or other healing substances are heated and pressed, rubbed or pounded on the body

    • Drava Swedana or warm decoction bath

    • Nadi Swedana or localized steam application where steam is applied to only specific areas of the body


The Five Actions

Panchakarma utilizes “the five actions” of vamana, virechana, basti, nasya, and rakta moksha to cleanse the body of ama and vitiated dosha.

  • Vamana or emesis therapy: this treatment is predominately used for kapha-imbalances and to remove toxins from the lungs and stomach; this procedure involves taking herbs to induce vomiting; this treatment is rarely performed in the United States and can only usually be experience in an Ayurvedic clinic in India

  • Nasya or cleansing of the head: it is sometimes called shirovirechana or purgation of the head; this treatment is predominately used for kapha-imbalances and to remove toxins from the head; this procedure involves nasal insufflation of medicated powders or medicated oils

  • Virechana or therapeutic purging: this treatment is predominately used for pitta-imbalances and to remove toxins from the small intestines; it involves taking purgatives or laxatives to remove mala, ama and toxins from the body

  • Basti or purification and rejuvenation of the colon: this treatment is predominately used for vata-imbalances and to remove toxins from the colon; it involves using herbal decoction or herbal oil enemas

  • Rakta Moksha or blood-letting therapy: this treatment is predominately used for pitta-imbalances and to remove toxins from the blood; in India it involves placing leeches on the body; this treatment is not practiced here in the United States; however, there are some practitioners who recommend blood donation as an alternate form of this treatment

If you are interested in learning more about the Five Prana Panchakarma program, click here.