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>>