Dr.

GK 1
Dr.GK 3
Cell – Life and Disease starts from
here…..
From Balance to Imbalance….

Dr.GK 4
 LIFE…
• Life is a collection of events….

• Let us make it Colorful

though healthy body and
mind…

• Let us think about Ayurveda

• May we start the journey

through Panchakarma…

Dr.GK 5
Clinical Exploration of
Panchakarma

Dr. P. K. V. Anand MD
MD - Kayachikitsa
Assistant professor
Dept of Samhitha & Sidhantha
Vaidyaratnam Ayurveda College
Thaikkattussery, Ollur,Thrissur.
pkvanand@gmail.com
 Ayurvedic Treatment
• TWO DOMAINS

• Samana

• Sodhana

• Panchakarmas are the methods of

BIOPURIFICATION
Dr.GK 7
 Samana Sodhana

Removes doshas from

Pacifies doshas locally
body

Comparitively of Effect lasts for long.

temporary action. Done in prabhoota
Done in alpa dosha & dosha & pravara bala.
alpa bala.

Does not interfere much Normalises dhathu

with dhathoos Dr.GK functions. 8
Effects Of Elimination Therapies
 Sodhana – Order of events
• Poorvakarma

• Pradhanakarma
- Panchakarmas

• Paschatkarma
Dr.GK 10
 Poorvakarmas
• Pre operative
procedures

• Snehana and Swedana

• Must before
Sodhanakarma
Dr.GK 11
 Snehana
• Internal
administration

• External
Administration

Dr.GK 12
 Swedana
• Agneya and Anagneya

• Ekanga and Sarvanga

• Ruksha and Snigdha

Dr.GK 13
 Kerala Special Treatments

• They are the combinations

of Snehana and Swedana
• They are the modified
therapeutic procedures
• They can be done as
poorvakarmas and Samana
chikitsa in specific
conditions

Dr.GK 14
 Panchakarmas – Purification
methods
• FIVE in number

• 1. Vamana – Emesis
• 2. Virechana – Purgation
• 3. Vasthi – Medicated enema
• 4. Nasya - Nasal drug administration
• 5. Rakthamoksha – Blood letting (Leech
therapy)
Dr.GK 15
 Why Panchakarmas…???

• The real pathogenesis breaker….

• Long standing effects….

• Less chance of recurrence….

Dr.GK 16
 Where are the changes in the
patient….???
• Doshas
• Dooshyas
• Srothuses
• Agni
• Ojus

Dr.GK 17
 Where are the changes in the
patient….???
• Cell
• Tissues
• Channels
• Systems…
• Hormones..
• Enzymes..
• Electrolytes
• Body fluids
• Osmosis
Dr.GK 18
Vamana

Dr.GK 19
Water nourishes the nature… And
keeps it clean by removing the
wastes……

Dr.GK 20
 The Therapeutic profile…..

Vamana is the therapeutic

procedure where forceful
expulsion of vitiated doshas
occurs through mouth following
administration of
Vamanoushadhi…..

Dr.GK 21
 Therapeutic targets

• Kapha dosha elimination

• Srothosodhana

• Dhathusudhi

• Agnideepthi
Dr.GK 22
 Common Conditions Where
Vamana is Practiced
• Skin diseases - Psoriasis, Urticaria, Eczema,
Allergy, Acne…..

• Bronchial Asthma

• Depression, Anxiety neurosis

• Hypothyroidism

Dr.GK 23
Dr.GK 24
 Mechanism of Action- Vamana

• Central emesis- By stimulating the vomiting

centre situated in Medulla

• Reflex emesis- irritation of the gastric

mucosa stimulates the Vomiting centre
through Vagus and sympathetic pathways

Probably both actions can be seen with the

Vamanoushadhi
Dr.GK 25
Here are the cases…

Dr.GK 26
Vamana in Bronchial Asthma
Vamana in Bronchial Asthma

Dr.GK 28
Vamana in Psoriasis
Vamana in Psoriasis

Dr.GK 30
 Therapeutic goals…
• Useful in –

• Obstructive pathologies

• Immune challenges

• Allergic states
Dr.GK 31
Virechana
Keep the body fluids clean and
pure for a healthy life…….

Dr.GK 33
 The Therapeutic profile…..
• Virechana is a procedure in which the
prakupita doshas are expelled through
adhomarga by the administration of
medicines through oral route.

• Medicines are used in different forms

like choorna, Kwadha, Sneha, Lehya
etc, depending on the condition of the
patient.
Dr.GK 34
 Therapeutic targets

• Pitha dosha elimination

• Raktha prasadana

• Vathanulomana

• Agnideepthi
Dr.GK 35
 Common Conditions Where
Virechana is Practiced

• Inflammatory skin diseases

• Ascitis
• Diseases of lower GIT
• Neurological diseases
• LBP
• Allergic/Toxic states…

Dr.GK 36
The Common Virechana drugs –
Avipatti Choorna with honey – 20-40 gm

Bahushala guda
Trivrut lehya 20-40 gm
Manibadra guda

Patolamooladi kwatha – upto 90-180ml

Eranda taila preparations – 25-50 ml

Dr.GK 37
 Mode of Action
• Removes the vitiated doshas
• Gradual enhancement of
metabolic power
• Detoxification
• Correction of hormonal
abnormalities…
• Correction of circulatory
problems…

Dr.GK 38
Nasya
Dr.GK 39
 A drop too has it’s effect……
One which is medicated will have
more….

Dr.GK 40
Nasya - Therapeutic Profile
This is a
procedure wherein
medicaments are
instilled into nasal
cavity to expel
doshas pertaining to
Uthamanga

Dr.GK 41
 Key Point
• Fix your Clinical
target…
• Options are –
• Purification
• Nourishment
• Stimulation
• Strengthening…
Dr.GK 42
 Nasya - Practical Indications
• Cervical Spondylitis
• Frozen Shoulder
• Hemiplegia
• Facial Palsy
• Seizure diseases
• Mental diseases
• Head aches
• ENT conditions….
Dr.GK 43
 NASYA – Drugs of Choice

• Ardita – Dhanwantharam
Avarthi

• Ksheerabala Avarthi

• Karpasasthyai

Dr.GK 44
 Head Ache - Pathologies

Ksheerabala Avarthis

Varanadi ksheeraghrita

Shadbinduthaila

Dr.GK 45
 Nasal Pathologies
• Anutaila

• Surasadi

• Thulasikalka

Dr.GK 46
 Epistaxis

• Durvasvarasa
• Swarasa of Dadima
Pushpa
• Swarasa of Amrasthi

Dr.GK 47
Apasmara -
Dronapushpi swarasa

Visha, Moha-
Vilwadi gulika

Dr.GK 48
 Vyanga – Cosmetic Issues

Kumkumadi taila

Dr.GK 49
 Some more examples….

• Hair Problems –
Bhringaraja swarasa

• Premature greying –
Nimba thaila

Dr.GK 50
 Nasya – Mental Health

Depression

Lasuna swarasa
Vacha
+Hingu
Vacha
+Jatamamsi

Dr.GK 51
 Nasapana…???

• In Aphasia, Facial Palsy etc

• Mashathmagupthadi kzm
• Mashabaladi kzm
• Done with syringe
• Maximum 80ml in both nostrils
• Same poorvakarmadis as Nasya
Dr.GK 52
 Pharmaco kinetics
• Routes of Action –

• Nasal mucosa- Kapha

• Nasal Vascular - Pitha
compartment
• Olfactory filaments- Vatha

Dr.GK 53
 Mode of Action

• Stimulation of vital
centers
• Nourishing the tissues
• Clearing the channels
• Removes the congestion
• Correcting the neuro-
vascular anomalies Dr.GK 54
 Researches - Transnasal drug
delivery to brain
• Absorption through nasal mucosa is
quite rapid
• An aerosol containing a biologically
active ingredient can make it more
faster…
• Avoiding the problems met by blood
brain barrier…
• Avoidance of enzymatic inactivation,
low pH, hepatic extraction, chemical
degradation etc..

Dr.GK 55
Effect of Nasya in Kamala

Dr.GK 56
When Uthamanga gets fire –
You need a Nasal Shower…..

Dr.GK 57
Vasthi
Dr.GK 58
 Vasthi- Therapeutic Profile

The word Vasthi is named so

because the vasthi or the urinary
bladder is used to inject the
medicinal material into the rectum,
urethra and vagina.

Dr.GK 59
 Therapeutic targets

• Pakwasayagatha vatha
spectrum

• Vatha domination

• Deep seated pathologies

Dr.GK 60
 Three fold utility of Vasthi

• Utklesana – Excitation of dosha

• Purification - Elimination of dosha

• Samana – Pacification of dosha

Dr.GK 61
Vatha Vs Asthi
 Vasthi Yogas
• Vaitharana vasthi

• Saindava – 15 gm
• Jaggery -30 gm
• Tamarind -60 gm
• Thaila -120 ml
• Milk or
Gomoothra – 240 ml

• Indications- Amavatha,Kateegraha
Dr.GK 63
Dr.GK 64
 Pichavasthi
• Milk decoction of Salmali vrinda - 240
ml

• Dadimadi or Charngeryadi ghritha – 120

ml

• Indication - Ulcerative
Dr.GK
colitis 65
Dr.GK 66
 Madhuthailika Vasthi
• Honey – 4 Palas
• Thaila – 4 Palas
• Erandamoola kwadha – 9.5 Palas
• Misi kalkka – ½ Pala
• Saindava - 1 Karsha

• Indications - RA
Dr.GK 67
 Rajayapana Vasthi
• Mustha,pata - 18 drugs
8 madana phala - Decoction in milk 650 ml
• Mamsarasa – 100 ml
• Saindava - 15 gm
• Ghee – 100 ml
• Honey -100 ml
• Kalkka – 30 gm

• Infertility,impotency,extrapyaramidal
disorders A
Dr.GK 68
 Mashathmagupthadi Yapana Vasthi
• Masha,Athmaguptha + Milk 600 ml- Ksheerapaka
Bala,Aswagandha
Saindava - 15gm
Mahamashathaila -120ml
Honey -120ml
Rasnadasamoola ghritha -120ml
Kalka-Masha,athmagupta…. -25gm

PARKINSONISM

Dr.GK 69
Dr.GK 70
 Thiktha Ksheeravasthi in
Osteoporosis

Gugguluthikthaka Ksheera + Ksheera -120ml

Honey -120ml
Kethakimooladithailam -120ml
Gugguluthikthaka ghritha -120ml
Snehavasthi with Lakshadi mezhukupaka-120ml

Dr.GK 71
 Rooksha Vasthi
• Amruthotharam
Kashayam -
300 ml

• Shaddharana choorna
-30gm

• Amavatha
Dr.GK 72
Dr.GK 73
Yogavasthi with Rasnasapthakam
kashayam
• Makshika - 15gm
• Saindava -12gm
• Dhanwantharam thaila -240ml
• Sathahwa kalka -30gm
• Rasnasapthakam kashayam -300 ml

• Kadeegraha
Dr.GK 74
 Mechanism of Action
• Intestinal movements
• Intestinal Absorption
• Intestinal Secretion
• Gut brain – Brain relation
• Regulatory peptides
• Intestinal bacterial flora

Dr.GK 75
Rakthamoksha

Dr.GK 76
When Rakthamoksha..?

• Seat of doshas in Sakha

• Preferably after sodhana

• Other treatments bring

Anupasaya

Dr.GK 77
 Raktha dushti Vs Inflammation

• Vascular and Cellular events of

inflammation
• -Transient vasoconstriction
• -Persistent progressive Vasodilatation
• -Increased local hydrostatic pressure
• -Stasis of circulation
• -Leucocytic margination
Dr.GK 78
Inflammation - Pitha
predominant Sannipatha
condition

Healing - Kapha oriented

Repair process

Dr.GK 79
Jaloukaavacharana - Stages

Dr.GK 80
 Multifactorial effect….

• Blood clot is removed

• Local circulation is improved
• Clearance of wastes
• Venous return is increased
• Speed up the repair process

Dr.GK 81
Components of medicinal leech saliva that exert
effects in the host's body are:

• Hirudin - Inhibits blood coagulation by binding to

thrombin

• Calin - Inhibits blood coagulation by inhibiting

collagen- mediated platelet aggregation

• Destabilase - Dissolves fibrin. Thrombolytic effects

Dr.GK 82
• Bdellins - Anti-inflammatory. Inhibits
trypsin, plasmin, acrosin

• Hyaluronidase - Increases interstitial

viscosity. Antibiotic

• Tryptase inhibitor - Inhibits proteolytic

enzymes of host mast cells
Dr.GK 83
• Carboxypeptidase A inhibitors - Increases
the inflow of blood at the bite site

• Histaminelike substances - Vasodilator.

Increases the inflow of blood at the bite
site
• Acetylcholine - Vasodilator

• Anesthetics substance - Anesthetic

Dr.GK 84
 Mode of action

Vathasonitha -

• Pitharakthaprasadana
• Vathanulomana
• Checks the inflammation
• Improves circulation
• Venous diseases and
thrombosis Dr.GK 85
 Kushta
• Normalizing Twak sara

• Preventing sakhagathi of
doshas

• Bhrajaka pitha prasadana

• Kledaharana Dr.GK 86
Jaloukaavacharana – different
cases

Dr.GK 87
 Triple level action
Raktha- Rakthavaha
Pitha srothus-
Kapha

Rakthagathi - Vatha
Dr.GK 88
Let them drink for OUR
Health….

Dr.GK 89
 Panchakarma – The ultimate
benefits
Dhathus are nourished better
through clear srothuses….

Sara of all dhathus are

enhanced…

Ojus is kept away from

Vyapathas….
Dr.GK 90
No ‘ Sanga… ’ Good ‘ Gathi…’
Relax and Refresh till the
next module…..