According to the Charaka Samhita, the body normally uses three routes to eliminate waste products and toxins: the mouth, anus, and pores of the skin. The three doshas act as the vehicle which carries ama either upward, downward, or out through the periphery. Through dosha gati, the doshas move these impurities from the deep structures to the G-I tract and from the G-I tract to the body’s three main outlets. Panchakarma curative and rejuvenating power lies in its ability to utilize and stimulate the natural movement of the doshas to eliminate ama.
Panchakarmas Related to Direction of Elimination of Ama
- Vamana Karma Nasya Karma – Upward Movement Kapha Dosha Zone
- Virechana Karma – Downward Movement Pitta Dosha “Zone
- Basti Karma – Downward Movement Vata Dosha Zone
- Raktamokshana Karma– Peripheral Movement Through Blood Vessels
Vamana and nasya, two of the five karmas, take place in the upper or kapha zone of the body and use the upward movement of the doshas to remove ama. Toxins associated with kapha are primarily but not exclusively deposited throughout the upper part of the body. Twice a day, during the kapha-dommawt periods, doshic action draws kapha-related toxins into the hollow structure of the stomach from the denser tissues. Because this is where kaphic ama naturally collects, Panchakarma uses vamana or therapeutic vomiting to eliminate them. This is because the mouth offers the easiest and most direct way to discharge these particular types of toxins.
Nasya, or shirovirechana, is a procedure used to assist vamana in dislodging ama and excess kapha from the throat, nose, sinuses and other organs in the region of the head and neck. Nasya is the introduction of medicated substances into the nose. This process stimulates secretions which help eliminate kapha-related toxins from this area. The treatment’s primary effect is to improve the connection between the senses and their organs of perception by opening the shrotas or channels through which the sensory information flows.
Virechana and basti use pitta and vata doshas downward movement to remove related toxins and waste materials from the system. Virechana works on the pitta zone of the body, whose major organs are the small intestine and liver. Basti cleanses the vata area, whose focal point is the large intestine. Ama associated with pitta and vata gets discharged from the body through the rectum because of its proximity and accessibility to these organs.
Virechana clears the body and particularly the pitta zone of excess pitta and pitta-related ama which naturally accumulates there during the pitta times of day. Basti therapy introduces medicated substances into the colon through the anus to stimulate the expulsion of vata-related ama which amasses during the vata times. The last of the five major eliminative procedures, raktamok-shana, removespitta-te\ated toxins from the blood.
These five treatments constitute Panchakarma’s main purificatory treatments.