Ayurvedic doctor Ashutosh Guleri

CLEANSING THROUGH PANCHAKARMA: Interview with Ayurvedic doctor Ashutosh Guleri

Last updated: March 26th, 2019

Alongside the growing interest in Ayurveda has come a growing interest in panchakarma (also spelled panchkarma), the Ayurvedic way to cleanse the body. And as more and more people are going off to do panchakarmas in India or at health centres closer to home there’s a lot of confusion about what is commonly called panchakarma and what an actual classical panchakarma is. I spoke with Dr. Ashutosh Guleri, medical director of Kayakalp, a non-profit Ayurvedic healing centre at the base of the Himalayas in India, to find out what a panchakarma is all about and why you would want to do one.

What do you consider a panchakarma?

Panchakarma is a specific branch of the whole science of Ayurveda. Panchakarma is made up of two words: pancha and karma. Pancha is a Sanskrit word that means five. Karma means action or treatment. So in total five treatments together are called panchakarma. The first of these therapies is vaman, induced vomiting; second Is virechan, induced purgation; third is enema basti; fourth is nasal treatments and fifth is bloodletting.

When all five therapies have been performed one after another then you have done panchakarma. That protocol is still present in Ayurveda and it takes more than three or four months to do the whole panchakarma process.

In classical panchakarma there’s a preparatory process, the execution of the treatment and the dietary regime. In the beginning you’re given internal oils—oils or ghee according to what your nature suggests. After the preparation it takes five to seven days. After the seven days, after your body is thoroughly oilated, then the induction of medicine is given for the purpose of the panchakarma.

For a physician, Ayurveda says that when you take anybody for a panchakarma you have to be very selective in choosing. For panchakarma one has to be mentally very strong.

What’s an alternative?

Uppakarma is site therapy. For example, nowhere in panchakarma is kati basti mentioned. There are five major treatments for deep cleansing but for general health maintenance there are more than 300 treatments called uppakarma—selective treatments.

Can you describe the panchakarma process?

If there’s a generalized disease, which has to do with the gastrointestinal system and related to the skin or any other part like atopic dermatitis, we’ll go with the panchakarma. I’ll be selective, asking what’s the nature of the individual? For example, if a pitta prakriti [fire constitution] is coming with atopic dermatitis I understand that immunity is low.

If I have five treatments, I would select virechan as the one protocol that’s most useful. The second protocol, internal oilation. In internal oilation, which kind of fat would I select: ghee, oil or animal fat? Out of these three which would I select for you to drink? Oil is very pitta itself in nature so if I give it to you it may not have that much effect. So I will select ghee and ask you to drink it. I would start with 30 ml today, maybe 70 tomorrow, maybe 80 after and I would note down how you’re feeling. For example, after oilation I want every single cell of your body to be hydrated with ghee so that it can bind with the toxins. Once it’s done and internal oilation is complete and specific signs are present I’ll ask you to stop drinking the oil and start giving you massage—a thorough application of oil on the skin. I’ve changed the body’s ph now. There’s a higher concentration inside the body’s cells and a lower concentration outside the body’s cells outer layer.

After two days I’ll give you a medicine which again alters the ph. Because of the medicine there will be an osmosis effect: these toxins always tend to travel from higher to lower concentration. So now you will ooze toxins out of the body through the cells’ semi-permeable membrane. The medicine will have a laxative effect—it will purge it. Now, after a whole day of purge comes the dietary regime because you have played with the GI system. You need to restore the movements of the GI tract.

After the purge the digestive fire is completely demolished so we have to reignite. How do we that? Start with minimum food like rice water, clear soup, formed soup, then gradually up to half a chapati and back to the normal diet. That would be the schedule for one treatment out of panchakarma.

I’ve heard that panchakarma is not advisable for some people?

It has to be selective. For example, for a vata/pitta with spinal problems, out of the five treatments, basti enema would do a world of good. Then question how long and when. With functional troubles of the spine, address the functional problems, spinal problems, relax the muscles, strengthen the back and physical body, and then go for panchakarma.

Otherwise, panchakarma is advisable for everyone. But the reason why I’m selective and not advising it for everyone is that out of 10 people I know 9.5 will cheat [on the prescribed diet]. People are not careful with themselves.

Can you tell me about side effects?

Who says alternative medicines do not have any side effects. For example, in naturopathy food is a medicine but who says that food has no allergic reaction or side effect. If you eat in excess you’ll purge it. That’s nothing but a side effect. It’s as good as taking a paracetemol tablet and getting gastritis or eating too much food and getting gastritis. You cannot say allopathy is bad because it has side effects and naturopathy is good because it does not. Both systems have their own implications. One has to be very selective with their treatments—you know what kind of treatments are required and when.

The problem is that people are not careful with themselves. I will start panchakarma with very good enthusiasm. I know it will definitely be effective for them and will add five years of lifespan to their life. But if they cheat, the whole system can have an adverse effect on their body and they won’t understand. Even if they’re counselled on everything they will still not understand. So that’s the only reason why I’m very selective. I would love to do classical panchakarma if they’re sincere with themselves. If they’re doing whatever is advised by the doctor.

In general if someone is looking to book a trip to do a panchakarma, how long would you recommend?

Generally, I recommend 15 days, but everyone’s situation is different.

For those who just want a restful vacation and rejuvenation, what would you recommend?

If you need a break from your hectic schedule, living in this kind of environment [Ayurvedic healing centre] destresses an individual. Stress is a basic factor of all diseases. Diet is the second thing that helps in rejuvenation because you’re taking a break from the normal, rich diet and coming back to the wholistic diet, which is a cleansing diet. Third, all these treatments like massages are increasing the blood circulation in the body. Blood circulation is increasing oxygenation to the body. Oxygenation is the basic thing.

For someone who wants to continue their treatment after a panchakarma, what would you recommend?

Ayurveda’s basic advice is to apply oil on the body every day as a kind of self-massage. It’s a vigorous exercise that will take 10 to 15 minutes. Apply sesame oil on all body parts. It’s self-exerting and is a kind of exercise. Oil helps to strengthen the tissues, creates a coating over the skin, prolongs life and induces sleep. That’s why self application of oil is recommended for everyone. Once a week one can enjoy a professional massage done by someone.

Prefer to cleanse on your own? Check out NATURAL CLEANSE DIET: Eating Ayurvedically with kitchari>>

  1. Thank you Dr. Ashuthosh. I am proud that you have been our student of Panchakarma. However I want to advice you within 15 days Panchakarma can’t be done. That practice will simply becomes commercialization of Panchakarma. As you know after each therapy there is a recovery period of double the days of thereapy itself or atleast 7 days.

    1. Dr. Ashutosh mentioned in the interview that “it takes more than three or four months to do the whole panchakarma process.”

      It seems that the term “panchakarma” has become a generalized term to describe separate panchakarma treatments or at least that’s what I’ve noticed at every treatment centre I’ve seen… they just call it panchakarma but what they’re offering are various treatments that are of a panchakarma nature.

      Ayurvedic literature needs to more clearly define and differentiate the classical panchakarma from what is now commonly called panchakarma, which are just individual treatments rather than the whole process. This was the main point behind doing this interview. There’s such a lack of clarity here.

      The website for his treatment centre refers to “panchakarma treatments” but does not market a “panchakarma” itself, which could be a good way to phrase it, but people will just end up calling it “panchakarma” anyways. After all, Panchakarma has a good name and is easy to market that way so most people do, and unfortunately since most people do call it that people feel they have to as well.

      1. 27-4-2014

        Dear Sir,

        Thanks for your clarification. I agree it has become a fad to quote the work “Panchakarma” and it sells now. But it can also bring bad name to Ayurveda and Panchakarma itself in long run if we practice it wrongly.

        You raise a issue in your response that Ayurvedic literature needs to more clearly define and differentiate the classical panchakarma from what is now commonly called panchakarma, but sir Ayurvedic literature are very clear about these terminologies and there is no confusion in it. The Panchakarmas are “Vamana, Virechana, Basti, Nasya and Raktamokshana” or “Vamana, Virechana, Anuvaasana, Nirroha and Basti”. Where is the clarification. All other things practiced as therepies are to be considered ” Upakramas” they are 2, 6 or 60 of them.

        I hope readers will be able to understand it clearly.

        1. I agree that Ayurveda is very clear about what panchakarma is. I was referring to the present-day literature and marketing materials that are selling it as something other than what it is. It’s unfortunate that it has become this fad. I see the same thing happening with Yoga. People, particularly in the West, are selling asana as Yoga, when in reality they are just selling asana, which is just one of the eight limbs of the whole practice. I cringe when I hear the term “Yoga class” when all they’re doing is getting together for an hour of asana. I wish people just called it what it is: “asana class.” Ultimately, this incorrect terminology has the effect of diluting the true meaning of Yoga and confuses people. The upside is that more people get into the practice in the first place and a percentage of those people will discover the true meaning. The others will gain something as well, just not nearly what they could be getting if they had the real thing.

    2. Dear Dr. Kamath,

      May I ask if and where you practice? I have been to many Ayurvedic doctors who claim to be doing panchakarma, but I’m afraid that I’m seeing little or no results- perhaps I’m even experiencing adverse results to much expense and suffering (internal oliation and dietary restrictions require that one behave like a yogi!) I am disciplined and serious about healing my condition, and also am able to follow an expert doctor’s treatment protocol. However, I am yet to find an expert doctor. Please let me know if you are affiliated with a center; I’d love to know the details,

      Best wishes,
      Miranda

  2. Plz suggest me something on constipation, gases and acidity. Because I hv these three problems at a time.
    plz plz plz plz plz tell me somthing. Because im very fed up.

    1. *Drinking a cup of cold water first thing in the morning, helps.
      *Also, everyone can react different for different food we eat since we are all different, so pls experiment and see which of these food can work the best for you; all of these work for me really good–guaranteed: Carrot, Asparagus, Shitaki mushroom, Beets, Brown Rice, Basmati rice, Sweet Potato, Gobo and Swiss Chard. If really bad, have some penuts and drink cold cup of milk; hopefully, it won’t become the other extreme.
      *whenever I drink green smoothies–vitamix, in a few hours, my body forces me to go to bathroom: these are the ingredients (you may add omit however you want, but these work for me really good as well):
      Water–purified: 1 1/2 C
      Kale: about 1 C
      Broccoli: 1/2 C
      Brussel Sprout: 1 big one or 2 small ones
      Carrot: 1 small organic carrot
      Romaine Lettuce: 2-3 leaves
      Celery: 1/2 C
      Spinach: 1 C
      Swiss Chard: 1/2 C
      Aloe: 1/3 C (1 stem)
      Grape leaves: about 3 leaves
      3 ripe bananas
      Fresh rosemary, Mint and sage: 1 ts of each
      Raw garlic: 1/2 ts
      fresh Ginger: 1 ts
      Green onion: 1/2 root
      Blackberry(any fruit you like): 1/2 C
      peaches, apples: 1/2 C of each
      Sunflower seed: 1TS
      Raisins: 1TS
      Corriander seed, fennel, Chia seed : 1 ts of each
      Flax seed: 1TS
      Cinammon, Tumeric: 1 ts of each

      (if you have any of inside of Honey dew, Cantaloupe, pumpkin, Papaya seeds, you may add as well)

      I hope this help!
      Lord bless you!

      kk 🙂

  3. I’m no doctor so I wouldn’t be in a place to suggest any Ayurvedic remedies, but I’ve found that yoga therapy and a good whole foods vegetarian diet has worked really well for me for digestive issues.

  4. Hi, I would like to find a replacement for ghee because I am a vegan. I usually have vata type issues with my health and have also developed arthritis and dental problems. Both stress related. I typically replace the ghee in my cooking with coconut oil. How doe that compare to ghee for m? Thanks for any advice.

  5. Coconut oil does not do good for Vata types. It’s basically a nourishing oil, but too thin to lubricate the tissues and the Dhatus as mentioned in the texts.

    Sesame oil would be suitable for external application, however in order to lubricate and strengthen the tissues from within – there is nothing better than Ghee.

    Being Vegan is a fad, if you want your body to really heal – you need to give it other fats too.
    Ayurveda is not a purely vegetarian science. There are treatments for high Vata that involve meals/soups with bone marrow in it – as this strengthens the Asthi Dhatu directly.

    There is either a compromise of your philosophy and restrictions being a Vegan or a compromise of your health. You decide.

  6. Being vegan is no fad! It’s an effort to practice equality by treating every living creature as you would do a human.

  7. Dear Doctor,
    I’m a little concerned because I’m currently undergoing a panchakarma but today after the last of seven days of snehapana, my skin condition seems to be worse than ever.
    During the snehapana process I had many loose motions every day, and some emotional stress. I hope that the treatments will still have good effects, but am a worried that my skin condition will even worsen because of this panchakarma. I will start abhyanga and steaming tomorrow, then vamana.. Unfortunately, my first couple weeks here were totally wasted with a bad doctor, so this whole panchakarma is being done in only 14 days.
    Do you have any words of wisdom for me? Is it normal that my very reactive and acne troubled skin would become worse after the snehapana phase of the panchakarma?
    Also, where are you located and do you offer treatments? I have studied some Ayurveda in the past and am very serious about healing. I live in Himachal Pradesh, India, and am a Buddhist nun in the Tibetan tradition.
    Thank you so much, I hope to hear from you ??

    Miranda

  8. Dear Dr. Guleri,
    Thank you for explaining the cleansing process by panchakarma. It is the best detox method not only for the body but also for the mind

  9. Very well written article. It has essential details and pointers for Panchakarma. Many FAQs were answered here. Is panchakarma for everyone? very nicely you mentioned spine problems. Would love surely go through other blogs.

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