Ayurveda is believed as the oldest treatment method in the world originating from Vedas documented around 5000 years ago and currently practicing in India and many countries of the Indian subcontinent. Ayurvedic healthcare system is based on the holistic concept that health and wellness depend on the delicate balance between the mind, body, and spirit. Ayurveda is assigned as a subsidiary Veda(upaveda) of Atharvaveda. Plants are used for preparing medicines. Animal products such as milk, ghee, liver, bone marrow, and gallstones are also used in certain preparations. In addition, fats are prescribed both for consumption and for external use. Metallic and mineral preparations with purified sulphur, arsenic, lead, copper sulphate and gold, are also explained. The branch of Ayurveda that deals with metallic and mineral preparations is called Rasa shastra. Nowadays Ayurveda has become very popular among the tourist especially foreigners. Patients from all over the world are coming here for Ayurveda treatment.
The basis of ayurvedic treatment is maintaining the health of a healthy person and pacifying the diseased. The panchabhautic theory and the tridosha theory are the main basements for the same. These concepts form the main foundation to understand the physiology, pathology and pharmacokinetics to organise the treatment procedures. A disequilibrium among the three doshas (Vata, Pitta, Kapha) direct towards the condition of uneasiness or disease to the body, which can be on the other hand understood through the concept of panchamahabhutas (the subtle constituents of the whole universe).
The literal meaning of Ayurveda is 'Science of Life'. Ayurveda aims to keep structural and functional entities in a state of equilibrium, which signifies good health (Swasthya). The system is passed through traditionally from master to disciples orally. The disciples used to stay in master's house, and such an educational system was known as 'Gurukula sampradaya’. Now this traditional knowledge has been improved through scientific research and is taught in various Ayurveda Colleges in Kerala. A graduate doctor in Ayurveda, takes 5 years of courses at college besides six months of internship and is considered on par with Doctor of Modern Medicine.
Mainly two methods have been explained for curing the diseases.
By using medicines and other measures, the imbalanced and vitiated doshas such as "Vata", "Pitta" and "Kapha" (Doshas) are brought to a balanced state, thus curing the disease.
This includes the panchakarma procedures such as Vamana, Virechanam, Vasti, Nasyam and Rakta mokshanam. Snehana (oleation therapy) and Swedana (sudation therapy) are the two Poorvakarma (post-operative procedures) done prior to all the panchakarmas according to the condition of the patient. The poorvakarma causes detachment of the doshas adhered to the dhatus and helps in the easy expulsion of the doshas without causing any damages to the involved dhatus. These therapies are very significant as with these treatments not only the disease is cured but also prevent their relapse.
Ayurveda is all about the science of holistic healing and it involves a complete plan to achieve the perfect health for all individuals. Even though it originated thousands of years ago, Ayurveda is equally pertinent in the current scientific world. And Kerala has played a vital role in keeping the magic of Ayurveda alive. Ayurvedic health packages are an integral part of tourist activities carried out in the state. Another aspect about the important role of Ayurveda in Kerala is that Kerala’s fair climate and richness in resources make it the perfect destination for a soothing Ayurvedic massage and other traditional treatment procedures here. Ayurveda emphasizes preventative and healing therapies along with various methods of purification and rejuvenation. Ayurveda is more than a mere healing system, it is a science and art of appropriate living which helps to achieve longevity. It can also guide every individual in the prevention of disease and long-term maintenance of health. To achieve this balanced state of body, mind and consciousness, Ayurveda prescribes Panchakarma Therapy for the cleansing of body.
Snehapana brings about an internal oleation of the body which pacifies the aggravated vata dosha; lubricates and softens the doshas. It improves digestion, regularizes bowels, improves the strength and complexion and prevents premature ageing.Mode of Snehana (oleation) may be broadly classified into: - a) Abhyantara Snehana (Internal oleation), b) Bahya snehana (External Oleation). Abhyantara snehana is the practice of intake (Snehapana) of different types of fat (sneha) such as ghee(ghrita), oil (taila), muscle fat (vasa) and bone marrow fat (majja sneham), in different methods and doses, in accordance with the condition and need. The internal oleation (snehana) starts to act within the system from inside to out, as and when the ingested fat is digested while the external oleation (snehana) starts acting from the outside-in, making sure that all the dhatus get nourished with oleation (snehana).
Abhyangam is one among the bahya-snehana (external oleation) method, considered under the dinacharya (daily-routine) to be practiced or good to be habituated daily without lapse other than during the contra indicated conditions. The procedure abhyanga is being utilised both as therapeutic as well as preventive purpose with great results. The practice is adopted for healing, relaxation and treating various diseases. Abhyanga means massaging the body with any of the Sneha dravya (fat) in the same direction of the hair follicles. Ayurveda advocates the practice of abhyanga daily and especially over shiras (the head), sravana (the ears) and pada (feet). It improves the skin tone and strength especially by setting up a protective barrier against microbial invasion as lipids(fat) play an essential role in the formation and maintenance of both the permeability and antimicrobial barriers. Abhyanga help improve lipid metabolism with in the skin layers. The practice of abhyanga provides a shield of insulation to the body there by making it less prone from getting dry. Abhyangam or oil massage makes the body strong and resistant to the wear and tear caused by stressful and strenuous jobs. The thermoregulatory mechanism is found to be well maintained by the practice of abhyanga especially shiro abhyanga (head oil massage), nourishes the body with sound sleep.
Kaya means the whole body; sekam means showering or sprinkling the whole body with medicated luke warm oil or decoction. In case of pizhichil the sekam is with sneha dravya /oil medium. Kaya sekam is one method under Pariseka swedam, since here a mild abhyangam is followed by the sprinkling of luke warm with simultaneous soft massages, brings an effect of sudation. Although the therapy is a beautiful combination of snehana(oleation) and swedana (sudation). Dhara is synonymous to sekam or kaya sekam. Kaya sekam help in providing an unparalleled relief from stiffness, dryness, pain etc.
The word pichu means a thick swab or a cotton pad. The treatment procedure of oleation of a part of the body with a pichu soaked in oil or any of the fat medium is known as the “sneha pichu”. At the time of Swedana karma, as a purvakarma a small sneha pichu is placed on the vertex of the head. Pichu application is one among the classification of murdhni taila. The treatment procedure is found to be very beneficial in dermatological conditions of the scalp as well as psychological disorders. Clinically it is more significant especially in painful conditions or ulcerations over the scalp etc, as the process does not involve any massaging steps.
Shiro vasti is the most intensive and potent type among the Murdha taila, in which the medicated oil is poured and retained over the head with the help of a cap fixed for a prescribed period according to the disease condition.
Massaging the feet especially giving care to the soles of the feet either with medicated or plain oil is referred to as pada abhyanga. This help reduces or remove the coarseness, dryness over the soles of the feet, stiffness over the joint, fatigue, numbness of feet etc. Makes the feet strong without losing the normal softness and smoothness. Pada abhyanga improves the clarity of vision, sleep, pacifies the aggravated vata dosha. Daily practice of pada abhyanga help prevent diseases like sciatica, cracked heels, varicose vein and weakness or pain in the associated ligaments and muscles. According to reflexology experts, the reflex zones mapped out over the feet and hands represents different organs or tissue groups of the body. Massaging those specific reflex points over the soles can in turn stimulate the respective organs or areas for health and therapeutic purposes.
Swedana (sudation) is a process of inducing sweating by means of different modes of heat
application, for therapeutic use generally followed by Snehana.
Generally, snehana and swedana constitute the poorvakarmas (pre-operative procedures) to all panchakarma. However, both the procedures are prescribed as single therapies according to the therapeutic need in different modes.
Nadi is a channel or a tube. Steam is directed through a tube and is applied to the affected area locally. Nadi sweda is a kind of local administration of steam fomentation after an oil massaging or abhyanga. Being moist heat, it penetrates well into the deeper tissues. Generally, it is done for about 10 – 20 minutes. Helps soften the tissue and produce sweat. The vapours dilate and soften the channels of the body allowing the expulsion of impurities easily. Herbal steam specific to the ailment or vitiated dosha is administered which help opens the pores, allowing detachment of the adhesions, dislodgement towards the alimentary canal making it easier to be expelled through the nearest excretory orifice. Also helpful in cases of stiffness over joints or any part of the body.
A kind of sudation in which medicated steam is administered to the patient’s whole body, except over the head, in a steam chamber for a certain period to get perspiration. It removes stiffness, heaviness and coldness from the body. Here, steam is applied to the whole body. A steam cabinet or steam tent are examples of bashpa sweda. In the steam chamber, the patient either sits or lies down. Steam can be given for about 15 – 45 minutes or according to disease and patient condition. As a pre-operative procedure, abhyanga may be done for 20-30 minutes, before the procedure of bashpa sweda. At the end of the procedure, patient may come out of the chamber and the sweat is wiped off with a dry towel. According to the physician’s suggestion, bath is advised with luke warm water.
Shashtika shali pinda sweda also known as Njavara kizhi is a Kerala specialty of treatment in which the whole body or any specific part is made to perspire by the application of heated medicinal rice (Njavara or the shashtika shali) puddings externally in the form of boluses tied up in a cotton cloth. Kizhi, the Malayalam word for poultice is another special Ayurvedic treatments. There are various types of kizhi. It’s a type of pinda sweda, where pinda means a poultice, when it is prepared of njavara rice (a type of rice also known as shashtika shali), the poultice is known as njavara kizhi (Malayalam) or “shashtika shali pinda sweda”. When the poultice is made of medicinal powder, called as “choorna pinda swedam” or when herbal leaves are used, it is termed as “Ela kizhi” (Malayalam) or “patra potala pinda swedam”. The Njavara rice is boiled and medicated then wrapped in hand-size cotton bags. In the massage program, the kizhi (boluses of njavara made into a handheld bag or medicated powder) is dipped in warm decoctions. This makes the body of the person perspire and this method provides direct nourishment to soft tissues near the skin. The therapy can last for up to an hour a day and continues for 14 days. Persons suffering from joint pains, rheumatism, bad cholesterol, weak and underdeveloped limbs, and certain skin disorders can take an appropriate kizhi therapy.
Upanaha sweda is one type of Swedana (sudation) in which generally group of medicinal powders or raw herbs prescribed in accordance with the dosha condition and patient condition are pasted together with suitable medium like medicated oil, milk, curd, buttermilk, fermented gruel or vinegar and applied over the affected area covered and bandaged with cloth or leather. The upanaham bandaged in the morning hours will be removed in the evening and vice versa. After removing the paste by gently sponging with cotton plug soaked in luke warm water, gently massage with luke warm oil. Generally, leaves of plants that are Vatahara (that which pacifies vata dosha) are used to cover the applied medicinal paste before bandaging.
A sudation (swedana) method through stream pouring or showering decoctions made of medicines over the affected part of the body part locally or over the whole body covered with a cotton cloth simultaneously from both the sides of the patient in a rhythmic manner. The medicinal preparation may be various decoctions, mixed with or without milk, medicated oil etc according to the patient condition, disease condition and the involved dosha. The liquid medicinal preparations are poured with specially designed vessels for conducting dhara or pariseka such as kumbha (small earthen pots), varshanika (a watering can with perforations to make sprinkling effect), pranadi (tubes) etc.
Avagaha sweda is a type of Swedana (sudation) in which the patient is made to sit/ lie immersed in a tub containing medicated decoction for a certain period to give fomentation to the affected parts of the body or as a whole.
Vamana is a treatment procedure of inducing vomiting sensation in cases of patients with kapha dosha vitiation as it acts as a bio-cleansing measure meant for the elimination of doshas (especially kapha dosha) accumulated in the upper gastro intestinal tract by inducing vomiting with the administration of emetics. It is told in the classical ayurvedic texts that Vamana is the main treatment procedure to pacify the vitiated kapha dosha. Certain diseases originate because of accumulation/ vitiation of phlegm/ Kapha. Hence, the elimination of the excessive vitiated kapha dosha will help prevent and cure such diseases.
Virechana is a therapeutic procedure that bring the desired levels of purgation with the administration of different kinds of virechana medicines, according to the disease condition as well as patient condition. Generally, all modes purificatory methods in the branch of Panchakarma are conducted after the pre-operatory procedures such as the snehana (oleation) and swedana (sudation). Since, virechana therapy is a kind of medicated purificatory method of purgation therapy in which the purgation initiates with the digestion of the medicines given to induce virechana, the ingredients of the medicinal preparations generally include hepatoprotective drugs too. Hence, they are efficient in cleansing the body from excess pitta dosha accumulation, purifying blood and rectifying any metabolic errors. Virechana karma primarily concentrates on the excessively accumulated vitiated pitta dosha noticed from certain symptomatic representations, complaints of the patients etc.
Vast karma is the procedure by which a mixture of various medicines in suspension form are administered to the rectum per anal region or genitourinary tract using Vasti yantra. It is the most important procedure among Panchakarma procedures and the most appropriate remedial measure to pacify the vitiated Vata dosha. According to the nature of medicine used, two types of enemas are:
The treatment procedure of administering medicines through the nostrils is called Nasya. Nasya is indicated mainly in aggravated and accumulated doshas especially the kapha dosha above the shoulder region. Along with drug selection, its route of administration frames an outline for the whole treatment. It is already clinically understood that the delicate mucosal layers of the nasal passages and the eustachian tubes of the ears require minimum lubrication to stay healthy, balanced and protected especially in the colder climates. Dry sinuses are easily irritated by pollutants, pollens and dry air etc.
Rakta Mokshanam is the procedure of bloodletting by several means depending on the dosha-roga- rogi principles of Ayurveda shastra. The treatment procedure comes under the purificatory treatments (shodhana therapy). Blood, being a connective tissue leads to various serious health issues on getting vitiated with the accumulated doshas. Hence, in chronic conditions internal medications may not be enough to pacify the doshas circulating the whole body. In such situations the different means of bloodletting are employed accordingly.
Dhumapana is a preventive as well as a curative procedure involving the smoking of a wick prepared with medicated pastes, inhaled through the nostrils and exhaled through the mouth. It is practiced in kapha and vata dosha predominant diseases affecting head and neck regions. It is strictly contra- indicated in conditions with pitta dosha aggravation and after virechana karma. Its also done as a post- operative procedure as in vamana etc.
Gandoosha dharana is a treatment procedure wherein the patient holds the liquid medicine in the mouth, to its full, for a specific time period. The word Gandoosha itself means filling the mouth. Gandoosha is the procedure of holding any liquid in the mouth to its full capacity without any movement inside. Oral health can be related to the general health condition of a person. Hence various regimens are discussed among the dinacharya (daily regimens).
Shirolepana is a procedure of application of paste of medicines over the scalp of the head for a specific period. The procedure is usually done after removing hair. The head of the patient is to be shaved and medicated oil applied over the body and scalp. Patient must sit comfortably in a chair and a band is to be tied around his head. Thereafter paste should be applied on his head with a thickness of 3 inches, considering the band as the boundary. At the vertex, a pichu soaked in an appropriate taila is poured into it. Lotus leaves are to be covered over the applied paste covering the head and tied around the head. After one hour, lotus leaves and the paste should be removed.
Mukhalepa is an effective skin care treatment in which appropriate and specific combination of herbal mixture pastes with appropriate medium is applied over the face and kept for some time according to the skin condition as well as climatic condition. Practice of mukhalepa help in the nourishment of the skin and aid in skin cleansing and make it soft and clear. Mukhalepa also helps to increase the elasticity of the skin and thereby prevents the ageing of the skin, avoids wrinkles on the face, and gives a good skin tone.
Kati vasti is a procedure of retaining comfortably warm medicated oil in the low back region (lumbosacral region) for a specific period. Keeping the medicated oil for specific period on the affected area help nourish the nerves, muscles and joints in the region. The warm oil provides a passive fomentation which in turn alleviates the pain also.
Similarly, when retaining warm medicated oil on specific area near the nape including the upper back
is referred to as Greeva vasti, when at the portion chest, its known as Uro vasti, and similarly when at
the knees, termed as Janu vasti.
Here also the boundaries made to hold the oil at the sites are prepared with the dough from black gram powder. The patient must lie down in supine position for the procedures uro vasti and janu vasti and in prone position for doing greeva vasti. Medicated oil is be filled in it and retained for 30 to 40 minutes or according to the patient condition and disease condition. After the specified time, the oil is to be removed with the help of cotton gauze. The patient is to be advised to take rest. Usually the procedure is done for 7days.
The local treatment procedures of the eyes (netra) are explained under Netra Kriya Kalpam which constitutes various minor treatment procedures (kriya) performed with certain specific formulations (kalpana). The drugs in various formulations are administered locally through kriya kalpa starts acting like a topical administration and help pacify the symptoms due to many immediate changes by rectifying the locally accumulated dosha.
Procedure of slowly pouring medicated liquid over the closed eyes.
Procedure of instilling a few drops of medicines to the open eye, from a height of 3-4cm
The pastes of the required medicines are packed in thick cotton cloth & are kept closely tied over the eye lids, without causing much difficulty to the patient.
It is the application of medicated paste to the outer surface of the eye lids excepting the eye lashes.
Application of medicine to the internal surface of lid margin in its full length from the medial side to the lateral side with a specific probe for using anjanam (anjana shalaka).
In this process, the unctuous (oily) substance is kept held in the orbital area for a specific time with special arrangements.
Indications and procedure are almost like tarpanam but the medicine preparation is specific. i.e., the medicine is (swarasa/ juice) extracted by steam-baking the drug covered with mud.