The Sanskrit term Panchkarma translates five therapeutic procedures. Pancha refers to the number five, and the karma refers to the therapy that brings about homeostasis by way of evacuation of accumulated morbid dosha. These Panchkarma procedures are carried out in a three sequential steps. These steps are named as purva-karma, pradhana-karma and paschat-karma meaning preliminary procedures, primary procedures and follow-up procedures respectively.

Purva-karma (preliminary procedure)

For the easy, proper and effective administration of the Shodhana-karma (cleansing- process), it is essential to prepare the client by specific therapeutic procedures. To set an ideal stage for Shodhana (cleansing) the client is subjected to certain upa-karma or therapies. These preliminary procedures are referred by the name Purva-karma. Pachan-chikitsa, Snehana and Swedana therapies are enumerated as Purva-karma.


1. Pachan chikitsa

Optimal functioning of digestive system and gastrointestinal tract is needed for the effective administration of further therapies. This optimal functioning is achieved by the employment of Pachan chikitsa prior to the administration of any of further Shodhana (cleansing) procedure. Therefore Pachan chikitsa is categorized as one among the Purva-karma (preliminary procedures). As this Pachan chikitsa involves augmenting the functioning of agni (digestive fire).

Pachan chikitsa refers to the oral administration of certain medicines that augments and assists the process of digestion, thus ensuring the optimal state of gastrointestinal tract. Thereby one can expect proper digestion and assimilation of the drugs administration as well as the desired results from the Shodhana (cleansing) procedures that follow.


2. Snehana

The word Snehana simply refers to imparting greasiness. The therapeutic procedure by which greasiness is imparted to body using different kinds of fat is called as Snehana. Certain forms of fat like oil or ghee is administered internally or applied externally to add oiliness to body. The drugs used in preparation of the medicated oil for external use as massage have got its own therapeutic effect. Added to this massage that follow the oil application increases the blood circulation, improves the process of clearing the toxic substances from the tissues, also releases the stiffness in the muscles and cures pain.


3. Swedana

Introduction of sweating for the therapeutic purpose is referred by the name Swedana in Panchkarma. This may be used either for the promotion of health or for curing the illness. By definition the procedure that alleviates the stiffness of the body, relieves sense of heaviness, and cures feeling of cold is called as Swedana.

Pradhana-karma (primary procedure)

Following the Purva-karma the client is then subjected to actual Shodhana or evacuation procedure, that are also the primary procedures which include Vamana, Virechana, Basti and Nasya. These evacuation procedures are referred as Pradhana-karma.

Vamana

Vamana is the unique procedure of eliminating the dosha from the body through the oral route by way of inducing vomiting. Kapha-dosha, the third among the three doshas is best eliminated by this procedure. The forcible expulsion of undigested Pitta and Kapha through the upper root is known as Vamana by definition.

Virechana

Evacuation of the fecal matter and other accumulation of dosha in the lower gastrointestinal tract through the anal route are known as Virechana. Expulsion of the waste from the body is the verbal meaning of the word Virechana. In particular elimination of dosha by way of inducing purgation is referred by the name Virechana.

Basti

The administration of the liquid medicine through the rectal route is referred by name Basti. Basti is said to have edge over any other Shodhana procedure. It is found to be the most useful procedure as it is indicated in maximum number of the diseases. It is general notion that enema is administered with the purpose of evacuating the bowel. But in Ayurveda, this procedure is prescribed as a route of drug administration.

Basti, an Ayurvedic enema, involves the introduction in to the rectum of herbal concoctions and certain herbal preparations in a liquid medium. Basti is most effective treatment of Vata disorders, although many enemas over a prescribed period of time are usually required. It relieves constipation, distention, chronic fever, cold, sexual-disorders, kidney stones, heart pain, backache, sciatica and other pains in the joints.


4. Nasya

Administration of the medicines through nasal route is known as Nasya. As this is the nearest root, the diseases related to head are best treated by this procedure.

Pashchat-karma (follow-up procedure)

Shodhana procedures, are likely to cause debility in clients. And even there occurs impaired functioning of the gastrointestinal tract. Hence following the Pradhana-karma, it is required to restore the physical strength as well as optimum functioning of the gastrointestinal tract. This is achieved by specific diet regimen. Even complete rest is advised for several days following the Shodhana-karma. These follow ups of the client in regards to dietary or behavioral regimen is considered as Paschat- karma.