Panchakarma

Life goes on here much the same as ever; some days a million things seem to happen, and other days the time melts away before I'm even fully awake.

This week I've been studying the panchakarma therapy in Ayurveda, which literally translates to "five actions" and is a detoxifying treatment. Classically it goes for 28 days, or 54 (though that's seriously intense), but the center here has developed a 14-day "seasonal" panchakarma course as well, which is only two of the five traditional treatments. Each of them takes a toll on the body and has a deep impact on the mind, which is why they say it flushes out the "mind-body system." Even ayurvedic medicines (herbal, oral) cannot go to the root of a problem without first flushing out the body with panchakarma, which balances all three doshas and prepares the body to receive medicine with cleaner and more sensitive organs, better circulation, and so on. If a person takes medicine--even very strong, or allopathic medicine--it will have only 25-50% efficacy compared to its real potency depending on the presence of toxins in the body.

The five therapies are vamana (induced emesis or vomiting), virecana (induced evacuation or bowel movements), anunasana basti and niruha basti (two kinds of enema; basti literally means "bladder") sirovirecana or nasya (nasal cleansing, but includes ears, nose, throat, etc.), and finally and less commonly raktamokshana (bloodletting). The bloodletting practice was added from a different source specializing in surgeries; the others all came from the same classical text of the Carak Samhita.

Each of the treatments works to balance a specific dosha (vaman-kapha, virecana-pitta, bastis-vata). The therapy course is developed beyond the basic treatments appeals to each individual's specific problem. Each day of treatment includes smooth/external oleation therapies (i.e. abhyanga, cakra therapies, sirodhara, picu) to help the body relax and be at ease. Some of the smooth therapies, such as cakra basti, involve mixing specific herbs and oils that not only are appropriate for the patient's constitution, but also target specific diseases or problems like joint pain.

The amount of preparation that goes into designing one person's program (which is all-encompassing: diet, routine, oils and herbs, etc.) for even a single day is staggering, and on top of that, there are ways the body itself needs to be prepared. The first six days or so of the 28-day treatment are spent preparing the body with smooth therapies, proper diet and routine. Before each of the five panchakarma treatments, three days or so of custom ghee preparations (clarified butter with particular spices and ingredients) is given to the patient. They have very deliberate functions--for example, the ghee preparation before the vamana treatment serves to coat the esophagus to protect it from any damage during the vomiting, and at the same time brings out the mucus and heaviness in the chest and respiratory system that needs to be vomited up.

Though vamana is probably the most intense of the five treatments, the restrictions on who can receive it and the other "karmas" (no elderly, children, weak or fatigued persons, pregnant women, people with fever or infectious disease, esophagus problems, etc.) make it different from many other ayurvedic therapies. A person cannot just schedule a panchakarma treatment; the mandatory consultation first might reveal that the therapies are not appropriate for them. However, most people can receive the basti treatments, which is how the 14-day course evolved. The bastis have their own strong effects, though, which many people might not anticipate.

As always, ayurveda treats the person as a whole; panchakarma therapy is accompanied by consistent counseling and seeks to address the health of the patient through latent memory (which is often cellular memory and thus transformed into physical dysfunction or discomfort). In sirodhara, for example (a smooth therapy in which oil is steadily poured onto the forehead between the eyes), patients often fall asleep or into a kind of relaxed hypnosis, during which they will often cry or "lip" (speak without sound) without realizing it. During the basti (enema) treatments, the intestines are thoroughly flushed out and become intensely sensitive. Because they are packed with nerve endings, there is an immediate and extreme effect on the brain; everything that is ingested and sensed within the body is felt strongly.

As a result of the physiological sensitivity and the psychological effects of this sudden change in consciousness, people often break down emotionally at this point during the treatment course. Everything from depression to extreme agitation can occur. Though a patient would never know it (at least at the clinic I'm studying at), there are multiple doctors (M.D.s) and experienced therapy providers watching the reactions of the patient and using their observations to decide which abhyangas and therapies to use, and which oils and preparations to use in them, to bring up the source of whatever distress has contributed to the patient's disease. No wonder many patients unconsciously react with negative emotions.

From the cases that have been described to me (including current patients at the clinic), the behavior becomes almost childlike, which makes sense--can you imagine the shock to your mind and body if all of a sudden your adult self became as sensitive to the inner and outer environment as when you were a child? Personally, having an enormously heightened sensitivity when I came back from trekking, closely followed by several days of abhyanga therapies, I know it had a significant effect on me--five minutes of bickering with my sister had me in tears, physically feeling the effects of unpleasant conversation.

As a sidenote, after oleation therapies patients are usually given steam to dilate the channels (pores etc.) and let the oils, herbal powders, or whatever was used have direct passage into the main stream of the body. In combination, a full course of treatments aims to have preventive, curative, and promotive effects; it takes measures to boost immunity, increase digestive capacity, and lessen stress. This is whole body and mind rejuvenation, which may sound lovely in a brochure but in actuality can be a very uncomfortable experience. The goal of rejuvenation is not relaxation in the typical American "spa" sense of the word.

Anyhow, I figured it has been a while since I updated with any information on what I've actually been studying (or at all, actually), so this entry should remedy that (no pun intended). There are far too many things to really sum up in a blog entry, but I hope the blog gives at least a small taste of this endlessly interesting body of knowledge--a fraction of a fraction!