Panchakarma Therapy

Shekhar Annambhotla BAMS, MD-Ayurved, CMT, RYT

 Panchakarma therapy is considered a

complete, holistic approach to the elimination of the root cause of each and every chronic disease. Today, in the USA, 70% of deaths are due to chronic diseases rather than infectious diseases.

Acharya Charaka emphasized the importance of Panchakarma as Doshah Kadachith Kupyati Jitaa Langhana Pachanaih / Jitaah Samsodhanardhe Tu Na Tesham Punarudbhavaha //
(Charak Sutra Sthana 16-20)

Pancha means FIVE

Karma means actions or procedures Treatments in Ayurveda are classified into two groups:

Shamana Chikitsa (Pacification therapy) Shodhana Chikitsa (Purification therapy)

Pancha

Karma is classified as Shodhana Chikitsa (purification/detoxification procedure)

Shamana: Palliation therapy

Used

to subdue the vitiated or disturbed Doshas, from which any ailments may have arisen Administration of various medicinal herbo-mineral preparations

Shodhana: Purification
If the doshas are vitiated beyond a particular level, they give rise to various endo-toxins (Ama), which have a tendency to be accumulated in the minute channels (Srotas) These endo-toxins (Ama) are beyond the level of pacification and hence they need to be eliminated from the body through Sodhana therapy Ayurveda recommends purification therapy for the majority of chronic diseases

Objective of Pancha Karma

Three major objectives:

Health maintenance Elimination of the disease Prepare for rejuvenation

Health maintenance: (Swasthya Rakshana)

PK is recommended for most individuals, even those who are healthy, as part of regular seasonal regimens The doshas naturally accumulate owing to seasonal changes and can cause disease if they are not timely removed

SEASONAL PANCHAKARMA

In autumn (Vata season), Basti (medicated enema) is recommended to alleviate the normal aggravation of vata caused by the cold wind, dryness of the season In summer (Pitta season), Virechana (induced purgation) is given to remove excess pitta dosha, caused by excessive heat In spring (Kapha season), Vamana (induced emesis) & Nasya (nasal therapy) is performed to remove excess kapha caused by the coolness and dampness of the season

Removing a disease as a whole

In acute diseases, if the vitiated doshas are removed timely, disease progression can be immediately arrested. In chronic diseases, Ama (endo-toxins) adhere to organs and cells; vitiated doshas are first removed by Pancha Karma therapies.

Rejuvenation / Revitalization therapies:

After completion of Pancha Karma, rejuvenation (Rasayana) and revitalization (Vajeekarana) therapies are performed to enhance strengthen tissues

Benefits of Pancha Karma

Strengthens immune system and provides more

resistance to illness Cleansing and rejuvenating therapy for body, mind and consciousness Beneficial effects on overall health, wellness and selfhealing Relives stress from both body and mind Slows aging process Reduces dependence on drugs and medications Eliminates excess Doshas and toxins from cells

 Enhances digestion and metabolism Clears the sense faculties, mind, intelligence and

complexion
Increases strength, nourishes the body Revitalizes the nervous system Restores constitutional balance, improving health

and wellness
Reverses the negative effects of stress on body

and mind, thereby slowing the aging process

Enhances self-reliance, strength, energy, vitality

and mental clarity

 Brings deep relaxation and sense of well-being Implements positive lifestyle changes Vitiated doshas are eliminated through the

alimentary tract Reduced cardiovascular risk factors Reduction in total cholesterol levels: decrease in lipid peroxide levels (LP); increased HDL cholesterol Reduction in diastolic blood pressure Reduced anxiety levels and dioxins

Reduction in levels of toxins such as lead, PCB,

CONTRAINDICATIONS OF PANCHA KARMA

Pregnancy, lactation, extreme obesity,

during menstruation, lympho-sacroma, cancer of lungs, melanoma, hypertension, angina, CCF, emaciation, active HIV or AIDS, or any active infectious disease

Pancha Karma
Classified as Poorva karma - preparatory actions Pradhana karma - main actions Paschath karma - post-therapeutic actions

Poorva karma (Preparatory therapy)

Pachana - Digestive Therapy

Snehana - External & Internal Oleation Therapy Swedana - Sudation / Fomentation Therapy

Digestive Therapy (Pachana)

During digestive therapy, cleansing is

achieved by the ingestion of various herbs and decoctions, which are pungent, bitter in taste and hot in potency, depending upon Ama condition These herbs stimulate the metabolism, activate digestive enzymes, increase peristalsis, improve circulation and enhance mental concentration

 Many of the herbs are anti-parasitic or

antibacterial in activity; some enhance the immune system These herbs are - Trikatu, Triphala, Turmeric, Chitrak, Pippali, Black pepper, Fennel

SNEHANA THERAPY
During Snehana Therapy patients are oleated

externally and internally Ghee or flaxseed oil are ingested, gradually increasing the quantity over a period of 3-7 days, according to an individuals digestive power Simultaneously, oil is applied to the skin using a variety of Ayurvedic massage techniques

 Oleation therapy liquefies the

imbalanced or aggravated doshas and allows the body to maintain healthy tissues, loosens deep rooted toxins within the system, and flushes them out through the skin pores.

Indications Persons who suffer from the following may undergo Pancha Karma: Vata disorders, arthritis, nervous problems, physical strain, psychological problems anxiety, emotional stress, coryza, cough, asthma, hiccough, earache, headache, facial palsy, hemiplegia, sciatica, joint disorders, constipation, spasmodic pains. Contraindications Kapha predominance, adipose or fat tissue, pregnant women, menstruation, ascites, indigestion, anorexia, nausea, during basti, nasya therapy.

SWEDANA THERAPY
Applies heat through various methods including

the use of hot poultice, steam baths, hot showers/baths, sauna, heating stones, covering the body with thick woolen clothes etc. Swedana allows the body to remove endo-toxins (Ama) through opened skin pores Swedana relieves stiffness, soreness, heaviness, coldness in the body

Indications Chronic coryza, asthma, cough, hiccough, headache, pharyngitis, paraplegia, hemiplegia, facial paralysis, arthritis, sciatica, backache, joint disorders, oedema, constipation, urinary obstruction, spasmodic pains, etc. Contraindications Alcoholics, pregnant women, during menstruation, malnourished persons, diabetics, liver disorders, cataract, glaucoma, very old people

PRADHANA KARMA Vamana - Induced vomiting Virechana - Induced purgation Basti - Medicated enema
Kashaya basti - herbal decoction enema Taila basti (matra) - herbal oil enema

Nasya - Nasal medication

VAMANA- Emesis During Vamana, person is advised to drink milk, sugar water, licorice tea, and buttermilk, after which the emetic fruit Randia dumetorum seed (Madanphala) with calamus (Vacha) and licorice (Yastimadhu) is administered to induce vomiting. Vamana purges excess Kapha (mucus) and Pitta from the stomach and all over the body, and purifies the body fluids.

The yellow colored bile with mucus shown

Indications: Helps alleviate asthma, cough, bronchitis, repeated colds, dyspnea, nausea, loss of appetite, sinusitis, skin diseases, obesity, diabetes, and all other Kapha related problems. Contra indications Young children, elderly, debilitated, very weak patients, stomach ulcers, trauma to the lungs, heart disease, abdominal tumors, intestinal obstruction.

VIRECHANA - Purgation Induced by herbal purgatives such as castor oil, triphala, katuki, Abhaya or senna tea to eliminate solid/liquid wastes (feces, urine) from the body Virechana can be given in the morning Observe quantity, times, color, and consistency of waste; blood pressure, pulse, respiration chart maintained.

INDICATIONS Chronic skin disorders, diabetes, fistula, hemorrhoids, ascites, anemia, migraine, asthma, cough, jaundice, edema, gout, liver disorders CONTRA INDICATIONS Anal fissures, ano-rectal bleeding, anorexia, indigestion, fever, alcoholism, weak persons, pregnant women, old age and children.

BENEFITS Allows the body to eliminate Pitta disorders, blood disorders Improves skin conditions, rejuvenate the tissues, abdominal organs Enhances immunity

BASTI ( Medicated enema) Basti means sac or pouch The liquid used for the Basti is either herbal decoction-based (Niruha / Asthapana) or oil based (Anuvasana / Sneha / Matra / Taila) Various medicated enemas are introduced into the large intestine through the rectum with the help of an enema bag.

 Basti serves to cleanse or lubricate the

system and alleviate dryness caused by an excess of Vata Vitiated Vata moves to the intestines and is gently eliminated.

Classification of medicated enemas (Basti) According to the site where they are administered
Rectum Vagina Urethra Wound cavity

According to substance used

Cleansing (Niruha / Asthapana / Kashaya) Oleating (Anuvasana /Taila)

Cleansing Enema (Kashaya Basti) Administered with honey, salt, oil, and herbal (dasamoola etc.,) decoctions. The quantity of the total mixture should be 500 cc depending upon the age, disease and condition of the patient Enema should be given on an empty stomach in the morning. Administered in left-lateral position.

 Medicated contents of cleansing enema are retained in

the intestines a maximum of 45 minutes and allowed to come out along with fecal matter and excess Pitta and Kapha Person can use bed pan or rest near to the bathroom During Kashaya Basti time avoid bath or shower. After cleansing enema, the person should take rest, be given warm herbal tea, and when hungry, should take a nutritive grain soup.

Herbs Dasamoola Bala Guduchi Triphala Ashwagandha Gokshura Kutki Bilva Vacha Fennel Musta Pippali Vidanga

1 person / 2 doses 150 grams 10 grams 10 grams 30 grams 10 grams 5 grams 5 grams 5 grams 5 grams 5 grams 5 grams 5 grams 5 grams

Take 1 part Kashaya Dravya 4 parts of water, reduced to quantity and filter several times.

TOTAL

250 grams

Ingredients Honey

1 person 80 ml

Salt
Sesame oil Kashaya TOTAL

5 grams
120 ml 300 ml 505 ml

INDICATIONS Pain disorders - pain in the abdomen, chest, pelvic region, eyes, ears or legs, headache, cardiac pain, hemiplegia or facial paralysis, arthritis, nervous disorders, amenorrhoea, infertility, obstruction of urine, stools and flatus. CONTRAINDICATIONS Indigestion, obstruction or perforation in the intestines, for very old or debilitated patients, endotoxins (Ama) in the GI tract, diarrhea, vomiting, tuberculosis, ascites, peritonitis, dysentery.

Oil enema (Asthapana / taila basti) Herbal or plain sesame oil is used Generally 100 cc of herbal oil is administered after a meal, preferably during night Because of the small quantity of content, no harm to the person, even if retained in the intestines more than 24 hours Generally the oil is absorbed slowly through the intestines.

INDICATIONS Vata disorders - tissue (wasting and debilitating diseases), nervous exhaustion, sexual debility or low body weight, tuberculosis, diabetes, skin diseases, asthma.
CONTRAINDICATIONS Severe hemorrhoids, excessive Kapha in GI tract, low digestive fire, ascites, excessive anemia, jaundice, obesity, intestinal worms

NASYA- nasal cleansing

The nose is the doorway to the mind and senses,

where Prana or vital energy is absorbed in the process of breathing Involves the cleansing of the nasal passage by the administration of oils, powders, herbal juices, infusions or smoke Massaging the forehead, face, neck with herbal oils; fomentation Oil massage and fomentation loosens toxins in the head

 Liquids administration: head is tilted back and

liquid put into the nostrils After removal of secretions, massage and mild fomentation applied To clear throat of any residual mucous: gargling with warm water with salt or turmeric Inhalation of medicated smoke

Types of Nasya According to action

Purification (Shodhana) to eliminate doshas Palliation (Shamana) to reduce dosha provocation Tonifying (Brimhana) to strengthen Vata

According to substance used

Avapeeda - uses herbal extracts, juices Naavana - instilling milk, oils etc., Dhuma - inhaling smoke of various herbs Virechana - applying medicinal powders into the nose with special apparatus

According to dose:
Pratimarsha - 2 drops in each nostril Marsha - 8 - 32 drops in each nostril

Nasya can eliminate accumulated doshas above the clavicle (ear, nose, eye, throat, head); strengthens the hair and improves mental functions

Indications for liquid Nasya

Vata - pitta disorders of head, ears, eyes, nose,

mouth, dryness of the throat, dental disorders, tonsillitis, facial paralysis, hair loss, graying of hair, allergic and breathing problems

Indications of dry Nasya Kapha related problems in head region, sinusitis, heaviness in the head, epilepsy, loss of voice, excessive congestion,
Rock salt, garlic, dry ginger, calamus, black pepper, turmeric can be used For smoking purpose - guggul, boswellia can used

CONTRAINDICATIONS
Severe digestive disorders, fever, immediately

after physical exertion, pregnant women, children under 5 years.

 A profoundly relaxing program in which a

continuous gentle stream of warm herbal oil/ herbal decoctions / herbal buttermilk is poured over the forehead from a certain height; helps to calm the nervous system, synchronize the right and left hemispheres of the brain, integrates the mind and body Performed for about 30- 45 minutes with one or two therapists

Pizzichill (warm oil bath) A luxurious treatment in which a continuous stream of warm herbal oil is poured over the entire body while two therapists perform massage; a relaxing and deeply cleansing technique to remove deep rooted toxins

GARSHANA Vigorous, dry, full body massage performed with woolen gloves; enlivens the physiology, promotes circulation, pulls the deep rooted impurities from the body

VISHESHA
A deep tissue friction massage performed with

two therapists; loosens and eliminates deep rooted tension

UDVARTANA Full body massage with warm herbal paste performed by two therapists; Drains impurities from the the lymphatics, tissues Stimulates circulation Removes excessive fat or adipose tissue Eliminate impure Kapha dosha Exfoliates the body Strengthen the musculo-skeletal system Brings glow to the skin

NETRA TARPANA
Specialized eye bath that calms, cools and strengthen the optic system; performed with ghee (clarified butter) or herbalized ghee

BENEFITS
Eye strain due to computer & TV screens Refractive errors of the eyes Chronic Conjunctivitis Corneal Ulcer Eye diseases due to aggravation of Vata and Pitta toxins,

Glaucoma, helps in preventing early formation of Cataract

Improper co-ordination and loss of movement of the

eyeballs, Pain and burning sensation in the eyes

Navarakizhi
Rejuvenation technique using a special type of rice (navara rice, which is grown in 60 days) that is cooked, tied into boluses and dipped into an herbal decoction and warm milk, then skillfully massaged simultaneously by four therapists all over the body for one hour after the Abhyanga It is performed 90 minutes with two therapists Benefits Paralytic strokes, anti-aging & rejuvenating, strengthens tissues, body ache, emaciation, debility, hemiplegia, paralysis, osteoarthritis, rheumatoid arthritis

Shiro Pichu

Cotton cloth is soaked in herbalized oil and applied to the head for 45 minutes BENEFITS Facial palsy, headache, chronic insomnia, improves memory, dermatitis of the scalp, dandruff, paralysis, other neurological disorders, skin disorders such as eczema, psoriasis, stress related problems

OTHER TYPES OF BASTI SHIRO BASTI HRUT BASTI KATI BASTI JANU BASTI NABHI BASTI

Hrut Basti, Nabhi Basti

PASHCHAT KARMA
Samsarjana Krama - Special dietetics Rules to follow specific activities:
Diet Regimen

Sansarjana Krama:

Manda - Thin gruel

14

parts water, 1 part rice, boil to cook rice, strain, drink the liquid portion parts water, 1 part rice, boil to cook rice until completely mashed like a thin gruel

Peya - Thick gruel

14

Vilepi - Thick porridge

4

parts water, 1 part rice, cook to become soft

Anna - Solid food

 First three meals: advisable to take a liquid diet of bland,

warm, thin gruel with salt Next three meals: thick gruel - porridge Next three meals: a semisolid kichari (rice lentil dish) with ghee Next three meals: bland meat/vegetable soups with cooked rice Next: continue taking regular meals

DIET REGIMEN Favor

Vegetables:

Fresh dark green leafy vegetables such as spinach, kale, chard, mustard greens, dandelion greens; asparagus, artichoke, fennel (anise), okra, carrots, pumpkin, rutabaga, squash, zucchini, bottle gourd (louki), snake gourd, ridge gourd, broccoli, green beans, celery, cilantro, mint, parsley, oregano, rosemary, thyme, basil
Fruits:

Cooked or stewed apples, pears, raisins, papaya, prunes, dates, figs

Grains: Rice (basmati, white), rice cakes, couscous, quinoa, corn, polenta, wheat Legumes: Yellow moong dal Dairy: Cow's milk, goats milk with spices, ghee, yogurt diluted with water and spices - roasted fennel, cumin, or coriander seed powder Sweeteners: Sucanat, cane sugar, jaggery, turbinado sugar, maple syrup, honey, rice syrup, stevia

Nuts & Seeds: Almonds soaked & peeled; sesame, coconut, small amount of cashews Beverages: Aloe vera juice, papaya juice, mango juice, rice milk, almond milk, soy milk Herbal teas: Ajwan, clove, fennel, ginger (fresh), lemongrass, licorice, saffron, rosehips, peppermint, spearmint, sage, tulasi, hibiscus, lavender, orange peel, green tea

AVOID or REDUCE
Vegetables:

Nightshade vegetables such as potatoes, tomatoes, eggplant, capsicum, chilies; cauliflower, cabbage, Brussels sprouts, garlic, onions
Dairy:

Yogurt, animal protein, cheese (hard/soft)

Processed foods:

Fermented foods, highly processed foods, margarine, leftover, frozen, stale foods, bread leavened with yeast, caffeine, artificial sweeteners, white flour products, refined carbohydrates, carbonated drinks, trans fatty acids, hydrogenated oils, fast foods, food additives, preservatives, allergenic foods particularly one's allergens or MSG foods, spicy food

Condiments:

Chocolate, horseradish, chili pepper, Tabasco, ketchup, mustard, salt (in excess), vinegar, soy sauce, tamari, mayonnaise, gomasio
Beverages:

Coffee, carbonated drinks, alcohol, ice cold drinks, iced tea, lemonade, mixed vegetable juice, V-8 juice, tomato juice

REGIMEN FAVOR

Sipping hot water throughout the day Self oil massage (Abhyanga) Early to bed and early to wake Gentle yoga

Pranayama
Meditation Chanting, singing Gentle movements Walking

AVOID or REDUCE Climate:

Exposure to cold, moist, dry wind, sunlight, rain, snow

Exercise:

Vigorous physical exercise, stress, mental exhaustion, sexual intercourse, loud talking, sleeping during the day, traveling, laughing excessively, standing for a long time, sitting constantly in one place
Habits:

Smoking cigarettes, recreational drugs, suppression of natural urges - flatus, feces, urine, sneeze, thirst, hunger, sleep, cough, breathing on exertion, yawn, tears, vomiting and semen

Emotions:

Repressing feelings, denying one's creative self, engaging in frustrating activities, sadness, boredom, anger, sorrow, pity
Eating habits:

Munching between meals; eating when emotionally upset, while angry, while watching television, reading, talking, standing, or driving; eating too much or too little food, eating at irregular times, overeating, eating without hunger, drinking too much water or ice cold water during, before or after a meal, eating excessively fatty foods and oils, eating a heavy meal at night, drinking milk with a meal

CLINICAL RESULTS

Age distribution of 80 Panchakarma subjects (Table: 1) Age 20 30 years 30 40 years 40 50 years 50 60 years 60 70 years Number of subjects 12 14 28 18 8 Percentage 15 % 17.5 % 35 % 22.5 % 10 %

30 25 20 15 10 5 0 Subjects 20-30 30-40 40-50 50-60 60-70

Gender Distribution of 80 Panchakarma subjects (Table: 2) Gender Male Female Number of subjects Percentage 22 27.5 % 58 72.5 %

60 50 40 30 20 10 0 Subjects Male Female

Deha Prakriti (Physical constitution) Distribution of 80 Panchakarma subjects (Table: 3)

Deha Prakriti Vata Pitta Kapha Vata Pitta Vata Kapha Pitta Vata Pitta Kapha Kapha Vata Kapha Pitta Tridosha Number of subjects 2 1 4 8 11 13 12 16 10 3 Percentage 2.5 % 1.25 % 5% 10 % 13.75 % 16.25 % 15 % 20 % 12.5 % 3.75 %

Deha Prakriti
16 14 12 10 8 6 4 2 0 Subjects Vata Pitta Kapha Vata Pitta Vata Kapha Pitta Vata Pitta Kapha Kapha Vata Kapha Pitta Tridosha

Manasa Prakriti (Psychological constitution) Distribution of 80 Panchakarma (Table: 4)

Manasa Prakriti Satvik Rajasik Tamasik

Number of subjects 12 41 27

Percentage 15 % 51.25 % 33.75 %

45 40 35 30 25 20 15 10 5 0 Subjects Satvik Rajasik Tamasik

Sub Dosha Imbalance Distribution of 80 Panchakarma subjects (Table: 5)

Sub Dosha Prana Vata Udana Vata Samana Vata Apana Vata Vyana Vata Pachaka Pitta Ranjaka Pitta Sadhaka Pitta Alochoaka Pitta Bhrajaka Pitta Kledaka Kapha Avalambaka Kapha Bodhaka Kapha Tarpaka Kapha Sleshaka Kapha Number of subjects 52 24 29 34 15 38 24 59 28 42 32 14 18 12 32 Percentage 65.0% 30.0 % 36.25 % 42.5 % 18.75 % 47.5 % 30.0 % 73.75 % 35 % 52.5 % 40 % 17.5 % 22.5 % 15 % 40 %

60

Prana Udana

50

Samana Apana Vyana

40

Pachaka Ranjaka

30

Sadhaka Alochaka

20

Bhrajaka Kledaka

10

Avalambaka Bodhaka

0 Subjects

Tarpaka Sleshaka

Dhatu (tissue) Imbalance Distribution of 80 Panchakarma subjects (Table: 6)

Dhatu Number of subjects Rasa (Plasma) 48 Rakta (Blood) 29 Mamsa (Muscle) 13 Medas (Adipose tissue) 56 Asthi (Bone) 19 Majja (Bone marrow) 12 Shukra (Reproductive tissue) 24 Percentage 60.0 % 36.25 % 16.25 % 70.0 % 23.75 % 15 % 30 %

Rasa Asthi 60 50 40 30 20 10 0 Subjects

Rakta Majja

Mamsa Shukra

Medas

Agni (digestive fire) Distribution of 80 Panchakarma subjects (Table: 7)

Agni Number of subjects Sama - Balanced 13 Vishama - Irregular 33 Teekshna - Sharp 8 Manda - Dull 26

Percentage 16.25 % 41.25 % 10 % 32.5 %

35 30 25 20 15 10 5 0 Subjects Sama Vishama Tikshna Manda

Koshta (Competence of stomach) Distribution of 80 Panchakarma subjects (Table: 8)

Koshta

Number of subjects

Percentage

Mrudu soft, supple Madhyama - medium Krura rigid, tough

17 25 38

21.25 % 31.25 % 47.5 %

40 35 30 25 20 15 10 5 0 Subjects Mrudu Madhyama Krura

Diet and Pattern of Eating Habits Distribution among 80 Panchakarma subjects (Table: 9)

Diet Number of subjects Vegan 12 Vegetarian including diary 23 Mixed (Veg + Non-Veg) 45 Pattern of eating habits Regular 32 Irregular 48

Percentage 15 % 28.75% 56.25 %

40 % 60 %

45 40 35 30 25 20 15 10 5 0 Subjects
Vegan Vegetarian including diary Mixed (Veg + Non-Veg)

50 45 40 35 30 25 20 15 10 5 0 Subjects

Regular Irregular

Pancha Karma Therapies Distribution among 80 Panchakarma subjects (Table: 10)

Name of Panchakarma Therapies Snehana Abhyanga Vishesha Udvartana Swedana Vamana Virechana Basti Asthapana (Matra) Basti Niruha (Kashaya) Nasya Netra Basti Kati Basti Hrut Basti Nabhi Basti Shiro Basti Shirodhara with Oil (Taila dhara) Shirodhara with Takra (Takra dhara) Shiro Pichu Pizhichil Gandoosha Number of subjects 80 62 65 58 80 12 80 80 48 72 15 21 19 34 11 74 19 25 28 14 Percentage 100.0 % 77.5 % 81.25 % 72.5 % 100.0 % 15.0 % 100.0 % 100.0 % 60.0 % 90.0 % 18.75 % 26.25 23.75 % 42.5 % 13.75 % 92.5 % 23.75 % 31.25 % 35.0 % 17.5 %

80 70 60 50 40 30 20 10 0 Subjects

Snehana Abhyanga Vishesha Udvartana Swedana Vamana Virechana Basti - Matra Basti - Kashaya Nasya Netra Basti Kati Basti Hrut Basti Nabhi Basti Shiro Basti Taila Dhara Takra Dhara Shiro Pichu Pizhichil

Level of Improvement Distribution among 80 Panchakarma subjects (Table: 11)

Health issue Digestion Sleep Constipation Clearance of sinuses Flexibility of joints Physical energy Lightness of body Discomfort / pain Dryness of skin Fatigue Circulation Vision Breathing pattern Cardiovascular endurance Gas, flatulence Complexion Allergy Immune system Physical endurance Strength of spine Allergies Migraine Menstrual pain Backache Overall physical wellness PHYSICAL BENEFITS Complete Marked Moderate (100 %) (75 %) (50%) 32 (40.0) 21 (26.25) 15 (18.75) 15 (18.75) 24 (30.0) 18 (22.5) 37 (46.25) 16 (20.0) 11 (13.75) 12 (15.0) 18 (22.5) 23 (28.75) 17 (21.25) 20 (25.0) 17 (21.25) 22 (27.5) 13 (16.25) 15 (18.75) 12 (15.0) 14 (17.5) 20 (25.0) 22 (27.5) 18 (22.5) 14 (17.5) 51 (63.75) 8 (10.0) 12 (15.0) 28 (35.0) 16 (20.0) 12 (15.0) 18 (22.5) 22 (27.5) 18 (22.5) 12 (15.0) 15 (18.75) 16 (20.0) 14 ((17.5) 15 (18.75) 22 (27.5) 6 (7.5) 15 (18.75) 22 (27.5) 29 (36.25) 17(21.25) 12 (15.0) 21 (26.25) 18 (22.5) 16 (20.0) 20 (25.0) 16 (20.0) 17 (21.25) 16 (20) 22 (27.5) 14 (17.5) 22 (27.5) 12 (15.0) 15 (18.75) 16 (20.0) 15 (18.75) 17 (21.25) 22 (27.5) 16 (20.0) 18 (22.5) 23 (28.75) 18 (22.5) 21 (26.25) 25 (31.25) 16 (20.0) 14 (17.5) 29 (36.25) 17 (21.25) 14 (17.5) 19 (23.75) 20 (25.0) 18 (22.5) Mild (25 %) 8 (10.0) 16 (20.0) 14 (17.5) 16 (20.0) 18 (22.5) 20 (25.0) 22 (27.5) 15 (18.75) 7 (8.75) 15 (18.75) 14 (17.5) 18 (22.5) 16 (20.0) 25 (31.25) 16 (20.0) 13 (16.25) 18 (22.5) 18 (22.5) 17 (21.25) 15 (18.75) 14 (17.5) 13 (16.25) 15 (18.75) 12 (15.0) 14 (17.5) No (0%) 4 (5 .0) 7 (8.75) 2 (2.5) 11 (13.75) 8 (10.0) 10 (12.5) 12 (15.0) 11 (13.75) 2 (2.5) 9 (11.25) 8 (10.0) 19 (23.75) 13 (16.25) 12 (15.0) 6 (7.5) 12 (15.0) 9 (11.25) 10 (12.5) 14 (17.5) 17(21.25) 10 (12.5) 5 (6.25) 10 (12.5) 8 (10.0) 9 (11.25)

60 50 40 30 20 10 0

Digestion Sleep Constipation Sinus clearance Flexibility of joints Physical energy Lightness of body Discomfort / pain Dryness of skin Fatigue Circulation Vison Breathing Cardiovascular Gas, flatulence Complexion Allergy Immune system Physical endurance Strength of spine Allergies Migraine Menstrual pain Backache Overall physical wellness
Complete Moderate No

Duration of Panchakarma Distribution among 80 Panchakarma subjects (Table: 12)

Duration of therapy 5 days 7 days 10 days Number of subjects 48 24 8 Percentage 60.0 % 30.0 % 10.0 %

50 45 40 35 30 25 20 15 10 5 0 Subjects

5 days 7 days 10 days

Overall Improvement in Physical Health Distribution among 80 Panchakarma subjects (Table: 13) Improvement Complete improvement Marked improvement Moderate improvement Mild improvement No improvement Percentage 27.85 % 21.80 % 20.75 % 19.85 % 9.75 %

30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% Percentage

Complete improvement Marked improvement Moderate improvement Mild improvement No improvement

Overall Improvement in Psychological Health Distribution among 80 Panchakarma subjects (Table: 14)
Improvement Complete improvement Marked improvement Moderate improvement Mild improvement No improvement Percentage 24.04 % 20.17 % 23.32 % 19.18 % 13.29 %

30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% Percentage Complete Marked Moderate Mild No

Overall improvement in both physical and psychological health among 80 Panchakarma subjects (Table: 15)

Improvement Complete improvement Marked improvement Moderate improvement Mild improvement No improvement

Percentage 25.94 % 20.98 % 22.03 % 19.5 % 23.04 %

30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% Percentage

Complete improvement Marked improvement Moderate improvement Mild improvement No improvement

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