There are many methods prescribed by the texts to increase heat in the body, though most are seldom used as a part of Panchakarma therapy. Nevertheless, they have a definite benefit and have been employed as effective swedana or heat treatments since ancient times. They all involve applying heat directly to the body, generally or locally, and can use heated substances which are liquid or solid, wet or dry, oily or watery, hard or soft.
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.
Vamana is one of the least understood of Ayurveda’s five elimination therapies. Most people associate emesis or vomiting with nausea and sickness and are repulsed by it. As some of my patient’s have said, “Just the thought of vomiting makes me vomit!” However, the emesis procedure used in vamana is quite smooth and painless, with little or no nausea, retching or discomfort.
Shirovirechana and nasya are terms that are used interchangeably. In Sanskrit, shiro means “head,” and virechana means “purging.” This procedure purges and rejuvenates the tissues and organs of the head and neck. It introduces medicated oils and powders into the nose, the nearest access and outlet to the organs of the head. It removes ama and toxins from the nose, larynx, pharynx, mouth, para-nasal sinuses, ears and eyes.
Basti therapy is perhaps the most powerful of the five main procedures of Panchakarma. Charaka, as well as many later Ayurvedic scholars, unanimously praise the value of basti. They say that while vamana, nasya and virechana together contribute fifty-percent of the benefits of Panchakarma, basti by itself, provides the other fifty-percent. The literal meaning of Basti is “bladder,” because centuries ago, bladders made of animal skins or organs were used to administer this procedure. Bas carries the meaning, “to stay in place,” and therefore can be understood as “that which is retained or kept inside.”
Basti fulfills many needs, so the type of basti used during Panchakarma varies according to the intended purpose of the treatment. One type of basti eliminates the ama that has gathered in the colon from throughout the body. Another normalizes vata function. If the prime mover is out of balance, everything is out of balance. Once vata has returned to normal functioning, basti therapy is then used to nourish and revitalize the dhatus.
Due to the importance of the colon’s eliminative and rejuvenating functions, Panchakarma largely employs pakwashaya gata bastis. We will now discuss the two main types of pakwashaya gata bastis given during this therapy. They are called nirooha and anuwasan basti. All other bastis, whether based on administrative site or specific purpose, serve only an adjunctive function in Panchakarma.
Preparing for Basti Therapy
As with all Panchakarma purification procedures, proper preparation is crucial for successful basti treatment. First, snehanaand swedana must loosen ama and open the body’s channels so that it can be moved out. This greatly aids the effectiveness of both the cleansing and nourishing bastis. Bastis are always administered immediately after oleation and sudation (heating). Because of these preparatory procedures, the patient feels calm and settled and his shrotas (channels) are dilated. This facilitates the work of the doshas, which is to remove ama from the colon and deliver nutritive substances to the dhatus.
Thousands of years ago, Charaka wrote the oldest and most extensive text of Ayurveda, thoroughly explaining the science of Ayurveda. In this treatise, he also delineated the five karmas or major procedures of vamana, nasya, virechana, cleansing and nourishing bastis for purifying and rejuvenating the body. He is consequently considered to be the father of Ayurvedic internal medicine.
Earlier I gave some examples from my clinical experiences regarding the healing potential of nasya, virechana, vamana and basti. However, treatment of most diseased conditions demands that these procedures be applied in unison in order to eradicate the root cause of the disease. The following case histories address specific conditions: