Panchakarma therapy dr.r.h.singh

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  • 1. Prof. R. H. SinghDistinguished Emeritus ProfessorBanaras Hindu UniversityApril 15, 2013Principles and Practice ofPancakarma Therapy
  • 2. Holistic Approach Reductionist ApproachBody-Mind-Spirit Integrative Non-IntegrativeLife and Health Oriented Disease OrientedPatient Centric Disease CentricDiet& Life style Oriented Drug, Surgery OrientedPro nature and personailsed Not necessarilyBiotherapy &Green Pharmacy ChemotherapyHigh Safety Frequently UnsafeEfficacy Soft & Nutraceutical Sharp, highly selectiveCost effective Unsustainable high costQuality Assurance Low BetterAyurvedic Medicine Modern MedicineThe Main Distinctions
  • 3. 1. Nidana Parivarjan2. Samprapti Vighatana(A) Bio-purification by Panca Karma(B) Bio-balancing Care by :1.Drug2. Diet3. Life Style ManagementPrinciples of TreatmentPrinciples of Treatment
  • 4. Pancha Karma Therapy is a special therapeuticprocedure popularly practiced in Ayurveda forbiopurification of the body with rejuvenative effect.It is the composite nomenclature of Five kinds oftreatments designed for trans-membrane visceraland cellular purification, as well as transdermalpurification of the body. Panca Karma is essentiallythe therapeutic technology of Samsodhana.What is Pancha Karma
  • 5. 1. Promotive & Preventive Health careTo promote health of a healthy and to tackle theTridoṣic rhythms in different seasons2. Rejuvenative Health careas an integral pre-requisite of Rasayana Therapyand Kayakalpa3. Curative ManagementTo irradicate the disease by cleansing the diseasedchannels in chronoic diseases4. Rehabilitative Health careTo suppress a disease process and torehabilitate the patientScope of Sodhan TherapyScope of Sodhan Therapy
  • 6. Routine Preventive Application of SodhanRoutine Preventive Application of Sodhangjsn~ olUrs ys"ek.ka fiRra kjfngjsn~ olUrs ys"ek.ka fiRra kjfnfugZjsr~ AfugZjsr~ Ao"kkZlq ok;aq izkfXodkj leqPNª;kr~ AAo"kkZlq ok;aq izkfXodkj leqPNª;kr~ AAlqñlwñ 6%38lqñlwñ 6%38Vasanta rituVasanta ritu Kapha prakopaKapha prakopa VamanaVamanaSarad rituSarad ritu Pitta prakopaPitta prakopa VirechanaVirechanaVarsha rituVarsha ritu Vata prakopaVata prakopa VastiVasti
  • 7. 1. Purva Karma :● Fasting, Appetisers, Digestants● Oleation and Massage● Sudation and Sweating2. Pradhāna Karma :1) Vamana = Emesis2) Virecana = Purgation3) Anuvāsana = Oleus Enema4) Āsthāpana = Decoction Enema5) Nasya = Erhines3. Paścāta Karma : Post therapy dieteticsClassical Pancakarma Therapy
  • 8. 1. Dhārā Krama = Sequential streamlinemedicated liquid pouring over the head.2. Pin a Swedaḍ = Medicated bolus Fomentationand Massage.3. Anna Lepa = Application of Medicated pastes.4. Śirolepa = Application of Medicated pastesover the head.5. Kāya Seka = Oil bath therapy.Traditional Keraliya Panca KarmaTraditional Keraliya Panca Karma
  • 9. 1. Exhaustion of toxins by Langhan,Deepan, Pachan.2. Snehan, Swedan, Abhyanga.3. Drastic expelsion by majorkarmas like emesis, purgation,enemata , errhine, blood letting.PurificationTans-membraneTrans-dermalInternalExternalMechanism of Bio-purification in Samshodan
  • 10. Why Purva Karma1.To promote Agni, the biofire2.To exhaust Ama, the morbid Dosa in situ3.To mobilize the Dosas from Sakha to Kosth4.To soften the body parts and to render thecells and tissues more washable
  • 11. Biology of Snehan, Swedan and Abhyanga Fluid Mosaic Model of Cell Membrane with abundanceof dynamic lipid components facilitating dissolution oftoxins and their transport to and from the cells.Local and systemic administration of fats seem toexpand the transport surface.The subsequent Abhyanga and Sweda (massage andfomentation) further activate the cleansing process.
  • 12. 1. Absolute (in days)2. Relative (in quality)◊ Skip a meal◊ Reduce the quantity◊ Alter the quality, taking easy digestibles◊ Reducing Fat and Protein◊ Semisolid and liquid diet◊ Taking warm foodLanghana or Fasting
  • 13. Therapeutic Massage
  • 14. Kāyasáke
  • 15. Traditional Pinḍsweda (Rice Bolus Massage)
  • 16. Medicinal Bolus for Pinḍa SwedaRaw coarse rice is cooked in a mixture of cow milkand herbal decoctions forming a Payasam. 4-8 Payasbolus 200g each tied in cloth pieces and kept dippedseparately in a bowl of warm mixture of milk anddecoction. The warm bolus is used to massage thepre-oleated whole body of the patient for 30-40minutes followed by open rubbing of the Paysam onthe body further followed by warm water bath.
  • 17. 1. Physical Massage Effect / Pressure effect2. Heat Effect on muscles, vessels and viscera3. Medicinal Effect of the bolus material :a) Soothing and softening effectb) Hydration of the skinc) Nourishing effect4. Bio-Purification - transdermalPin a Sweda Effectḍ
  • 18. 1. It permits transfer of heat and vital energy.2. It renders the body compact and well formed,accelerates blood circulation affordingadequate blood and oxygen to entire body.3. It mobilises unwanted incompatible productsof body and release them to be excreted. Thisalso relieves local pain and inflammation.4. It promotes elasticity and functional ability ofnerves, tendons and muscles affordingsoftness of the body.5. Prevents stiffness & sclerosis of blood vessels.Impact of Abhyanga and Massage
  • 19. Anatomical Considerations in Abhyanga and SwedaSkin layers Vital Components Function Treatment ImpactEpidermisKeratocytes,MelanocytesSurface protect,Skin Complexion1. Cytostabilisation2. Moisturisation3. Allergy controlDermisBlood Vessels,Nerves,LymphaticsMast cellsFibroblastsBio-SupportHistamin,Collagen fibers4. Skin Glow5. Vascular effect6. Lymphatic drain7. NeurostabilitySubdermis SubcutaneousfatCushionFunction8. Skin elasticity9. Adipose Balance.
  • 20. 1. In relation to heart and circulation2. In relation to the origin and insertion of muscles3. Lymphatic flow4. Vital parts, joints / abdomen / eyes5. Direction of hairs on skin6. Degree and distribution of subcutaneous fatGuidelines for choosing direction, duration, forceand pressure application in Massage Therapy
  • 21. ŚIRODHĀRĀ TREATMENT
  • 22. 1. Vivrational effect in the head affordingsynchronised augmentation of circulation.2. Synchronisation of the neuronic functionsand impulses.3. Meditative effect.4. Relaxation Response.5. Medicinal effect of Dhara materialsDhārā Effect
  • 23. EFFECT OF SIRODHARA & NASYA ON PAIN SCORE BY VISUALANALOGUE SCALE IN PATIENTS OF CHRONIC DAILY HEADACHEGroups Mean ± SD of VAS Scores Paired tBT AT DifferenceSirodhara t = 4.91(n = 18) 5.22 ± 1.26 3.72 ± 1.12 1. 50 ± 1.29 p<0.001Nasya(n = 10) 5.10 ± 1.37 3.80 ± 0.78 1.30±1.27 t = 3.23p<0.02
  • 24. Indication : For Routine BiopurificationAll Kaphaja DiseasesTherapeutic use in Asthma and AllergyProcedure : Purva Karma 5-7 daysBasal AssessmentAssuranceTo drink milk or sugar cane juice 2-3 litresAdminister Emetic single dose :Madanphala 6-12g + Vacā 3-5g +Rock salt 5-10g + Honey 20mlWait for Vamana for 10 Minutes.Result : Massive Emesis with Kapha, Mucus, Histamine.Measure the vomitus and analyse.Vamana or Therapeutic Emesis
  • 25. Preparatory Monitoring before Vamana (Therapeutic Emesis)
  • 26. Histamine Dialysis Through VamanaMean ± SD 0.495 0.400 0.282(n=20) ± 0.234 ± 0.206 ± 0.136t - 0.94 2.55p - >0.05 <0.05Before Vaman After VamanJust After After 1 MonthMean Total Histamine Estimated In Vomitus 315.31 µgmMean Total Histamine Reduction In Blood 332.50 µgmBlood Histamine in µgm/ml
  • 27. 5.323.5564202.41.60.80D-XYLOSEEXCRETIONG.PER5HRSBEFORE AFTER DIFFERENCESAMSHODHANA P < 0.001MEANDIFFERENCEImproved Gut Absorption PatternAfter Samshodhana Karma
  • 28.  Allergy & Asthma Arthritis & allied conditions Disorders of Skin Residual Paralysis CNS degenerative diseases Obesity and lipid disorders Diabetes mellitus Disorders of fertility Chronic Headaches Stress and Residual Psychoses For Healthy Aging RehabilitativeMajor Chronic Diseases Potentially TreatableWith Panchakarma Therapy
  • 29. CONCLUSIONSanśodhana Biopurification effect envisaged through Pancakarma isan unique therapeutic concept in Ayurveda.It purifies the milieu-interior through biomembrane system allowingspontaneous restoration of normalcy, followed by self-recovery fromdisease, improved bioavailability of medications administered andtheir easy elimination reducing the chances of cumulative sideeffects.Besides biopurificatory effect various procedures also producerehabilitative and Physiotherapeutic impact.Procedures are safe and have evidence of efficacy.There is need of developing indicators for evaluating the efficacy andsafety of different procedures and their standardization.
  • 30. AyurvedaAyurveda (Ayu=Life + Veda=Science), the ancient Scienceof Life is the main-stream traditional system of Medicineofficially practiced in India for thousands of years. It hasnow been updated and strengthened with scientific researchand development. Because of its unique pronature holisticapproach and safe Green Pharmacy, now Ayurveda is beingaccepted enthusiastically world-over.The Historicity of Ayurveda goes back to ancient Vedasand its original knowledge is available today through Twosets (Three books in each) of authentic classic texts -1. Brihattrayi (Pre-Christian Era)2. Laghuttrayi (Medieval Period)
  • 31. SuryaPittaTejaEnergyOja Biology PranaKapha Ecology VataJala Vayu{ksiS% lkselw;kZfuyk ;Fkk A èkkj;fUr txísga dQfiRrkfuykLr
  • 32. Health is the state of equilibrium of Dosas,Agnis, Dhatus, Malas and body functions alongwith spiritual, sensorial and mental well-being.lenks"k% lekfXup le/kkrq eyfØ;%lékResfUnz;euk% LoLFk bR;fHk/kh;rs& lqñ lwñ 15%Definition of Health in Ayurveda
  • 33. Concept of Disease1. Sahaja Diseases – Genetic & hereditary2. Acquired DiseasesLoka Purusha VaishamyaErrors of Kala, Buddhi & IndriyarthaDepletion of AgniSrotodustiDosha VaishamyaDhatu VaishamyaAmaVyadhi
  • 34. The all-pervading structure of the channelfunction ie. Srotas is the membrane-system lining the big hollow organs,micro-tubular structures and coveringeach Cell. The integrity of this membranesystem is vital for inner transport which isinherently challenged by divergent wearand tear activities and hence it needsperiodical cleansing by Samsodhana..SROTAMSI AS THE BIOTRANSPORT SYSTEM