It is a process of therapeutic vomiting (induced), which helps eliminate the toxic or waste matters from the stomach and thoracic cavity. Kapha dominant diseases like severe skin diseases (psoriasis, urticaria); bronchial asthma, mental disorders etc. are selected for this treatment procedure. This process is not suggested for expecting mothers. Normally eight bouts of emesis are followed. The vomiting is stopped when yellow coloration is seen. Then, dhoomapana—inhalation of medicated fumes—is done through a special process. Finally, certain rules have to be followed called paschatkarma that basically implies strict diet regimen. The entire treatment takes 15 days, and requires good attention as well as skilled assistance.
2. Virechana (Purgation)
This eliminates the toxic or waste matters from the intestine. It also cures pitta or pitta-dominated diseases. Poorvakarma or initial process of cleansing like vamana is suggested here. About 20 purges may be seen in this process depending on the patient's health. A mild form of virechana without the poorvakarma, is an integral part of ayurvedic therapy. It is also used for prevention of diseases.
3. Vasti (Enema)
The process of vasti or therapeutic enema is resorted to eliminate toxins from colon, and strengthens the tissues. Two kinds of vastis are followed in ayurveda. Snehavasti is the vasti where medicated oils are used. This is not advised in patients suffering from diabetes, anemia, diarrhea, and obesity. Poorvakarma is required here. Top For kashaya vasti, honey, rock salt, sneham (oils), paste of medicines are required and mixed one by one in the above order. This concoction is taken in an empty stomach. After the process the patient is allowed to take a bath. Diseases like hemiplegia, and disease due to vata are treated by this process. Medicines are selected as per disease and stage.
4. Nasya (Nasal Application of Herbal Medicines)
Nasya is instillation of medicine through nose. It is an important procedure of ayurveda for the treatment of sirorogas or diseases affecting head area. Nasya helps cleanse the head and sinuses. The process is contraindicated in various psychological diseases, asthma and cough. Here, the patient is to inhale lightly warmed oil. Warmed oil is massaged in the patient's neck, shoulder, palm, face and sole before and after the process of nasya. Different timings are indicated for different dosha types. Morning time is prescribed for kapha diseases, noon in pitta diseases and evening in vata diseases.
5. Raktamoksha (Blood-Letting)
The process of letting out the vitiated blood is termed raktamoksha. In this procedure localized impurity or poison from the blood is removed through various methods. Often leech is used to suck out the impure blood from the affected area. Blood-letting is also done to eliminate toxins from the blood stream causing various chronic skin disorders like urticaria, eczema, scabies and leucoderma etc. The method was also effectively used to cure enlarged liver and spleen. There are steps to be followed before doing panchakarma called poorvakarma. One is snehana or oleation where medicated oils are applied internally and externally. Another process called swedana or sudation is actually classified into four types to induce sweating. The purpose of poorvakarma is to liquefy and guide the provoked doshas to the mainstream to facilitate the sodhana or cleansing.