Pradhana Karma (Main procedures)
After preparing the patient with snehana (oleation) and swedana (sudation) the patient is subjected to the main measures of panchakarma - Vaman (emesis), Virechan(purgation), Nasya (nasal insufflation), Basti (enema) and Raktamoskshana (blood-letting by using leech and different instruments).
i Vamana (Emesis therapy) - Vamana is the procedure of eliminating waste products of the body through the upper passage by vomiting. Emesis is the therapy of choice in diseases of kapha dosha. It is specially indicated in the fever of recent origin, cough, cold, bronchial asthma, elephantiasis, diabetes, bleeding through lower channels, nausea, diarrhoea, loss of appetite, poisoning, stomatitis, anemia, mental diseases, epilepsy, erysipelas, lymphadenopathy etc. Emesis therapy is contraindicated in the patients if they are child, very old, debilitated and hungry and also in trauma of lungs, sprue, bleeding or upper channels, anuria, enlargement of spleen, abdominal tumours and abdominal diseases etc. A subjective feeling of cleanliness of the heart, chest, head etc., lightness in the body, timely passing of urine stool etc. are the features of well administered emesis therapy.
ii Virechana (Purgation therapy) - Virechana or purgation therapy is a systemic therapy for the diseases of pitta dosha. Purgation therapy is indicated in diseases of skin, fever, diabetes, bleeding of upper channels like mouth, nose etc., diseases of gastrointestinal tract, piles, abdominal tumour, enlargement of spleen, anuria, helmenthiasis, erysipelas, gout, vaginal diseases, fistula-in-ano, tumour, glandular swelling, anemia, jaundice, loss of appetite etc. It is contraindicated in children and old patients and also in diseases like bleeding of lower channels, pregnancy, fever of recent origin, indigestion, lymphadenitis, weakness, debility, diarrhea etc. Feeling of cleanliness in the channels and sense organs, lightness in the body and increase of appetite etc. are the symptoms of well administered Virechana karma.
iii Basti (Enema) - Medication administered by the enema to get desired therapeutic effects is known as basti (enema) therapy. According to the Ayurveda vata is the main morbid factor in the causation of disease pertaining to tissue and organs in the body andbasti (enemata) therapy is the best treatment of excessive excited vata, therefore, bastikarma is considered half the treatment of all the diseases described in Ayurveda. This therapy is also very useful as a health promoting measure. It is beneficial for old as well as for the young and there are no notable hazards in this therapy. It cures all kinds of diseases due to its varied pharmacodynamics and various kinds of drugs used in its preparations. Enemata therapy is of two types viz. Oily enema (Anuvasana basti) and Decoction enema (Niruha basti).
iv Nasya (Nasal insufflation) - Nasya is a process by which drug is administered through the nostrils. It is useful in all the diseases manifesting above the neck (urdhwajatru gata) because it eliminates toxins through the nostril. On the basis of its therapeutic action and the way of administration it is classified in to many types likevirechana nasya (cleansing nasya) , brumhana nasya (nutritive) shamana nasya(pecifying) , navana nasya (decoction nasya) marsha nasya (ghee or oil), pratimarshya(daily oil nasya) etc.
v Raktamoskshana (Blood-letting) - Rakta Mokshana or blood letting is one of thepanchakarma developed by Susrutha as a specialized technique. Here a small amount of venous blood is extracted by using either sharp instrument or specialised equipment or leech. It is helpful in relieving diseases of pitta origin, blood born and chronic skin diseases.