All disease processes point to a crisis of ama toxicity in the body. Panchakarma constitutes the foremost shodhana chikitsa, or purification therapy, because it reverses the disease mechanisms which carry toxic waste products from the digestive tract into the tissues of the body.
Panchakarma inverts the movement of ama, which takes place in the third and fourth stages of the disease process. During prasara, the third stage of disease manifestation, ama overruns the site of its initial accumulation in the G-I tract and flows into other areas of the body. During sthana samshraya, the fourth stage, the spreading ama enters and lodges in weak or defective dhatus, where its disruptive influence will eventually produce the final stages of the disease process. Panchakarma is designed to draw ama out of the dhatus, return it to the digestive tract and expel it from the body.
In the case of the man with skin problems mentioned earlier, when he underwent Panchakarma therapy, the cause of his recurring skin eruptions was permanently removed.
The uniqueness of Panchakarma is that it puts the attention on the patient, whereas all other therapies focus on the pathology and its symptoms. Panchakarma therapy recognizes and uses the specific qualities of the patient’s physiological make-up to heal. It does not just treat diseased organs and tissues; it treats and manages the doshas, the biological forces which carry ama back and forth between the digestive tract and the deeper body tissues.
There is a simple elegance to the approach and effectiveness of Panchakarma as a shodhana therapy. It takes advantage of the naturally occurring cycles of doshic migration, and utilizes the active phases of each dosha to draw dosha-speciBc ama out of the dhatus and eliminate it from the body. In this way, Panchakarma differs from every other form of treatment, including all other modes of detoxification and purification.
The name Panchakarma comes from two Sanskrit words: panch, meaning “five,” and karma meaning “action.” The name incorporates the core of the treatment: the five primary actions or procedures which Ayurveda uses to purify the body of everything foreign to it. Each procedure addresses a specific doshic imbalance and the ama which forms as a result.
Panchakarma therapy, however, is more than just these five purificatory and rejuvenative procedures. It is a three stage process in which the five core treatments serve as the focal point. The first phase, called Purvakarma, comprises essential preliminary procedures whose purpose is to prepare the body to unload stored toxins — the purpose of the main or second stage.
The last stage, called Paschatkarma, occurs after the main purification processes. It employs a set of procedures to assure the restoration of strong digestive agni and thorough rejuvenation of the dhatus. These post-procedures are designed to nourish, strengthen and balance the newly cleansed dhatus. They aim to establish a consistently healthy energy level, strengthen the immune system and rebuild the body.
To understand how these procedures achieve such a complete physiological purification, we must have a working knowledge of how the doshas move in the body.