Dr.GK

Dr.GK

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

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

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

Dr.GK

Effects Of Elimination Therapies

Sodhana – Order of events Poorvakarma Pradhanakarma- Panchakarmas Paschatkarma Dr.GK

Poorvakarmas Pre operative procedures Snehana and Swedana Must before Sodhanakarma Dr.GK

Snehana Internal administration External Administration Dr.GK

Swedana Agneya and Anagneya Ekanga and Sarvanga Ruksha and Snigdha Dr.GK

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

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

Why Panchakarmas…??? The real pathogenesis breaker…. Long standing effects…. Less chance of recurrence…. Dr.GK

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

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

Vamana Dr.GK

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

The Therapeutic profile….. Vamana is the therapeutic procedure where forceful expulsion of vitiated doshas occurs through mouth following administration of Vamanoushadhi….. Dr.GK

Therapeutic targets Kapha dosha elimination Srothosodhana Dhathusudhi Agnideepthi Dr.GK

Common Conditions Where Vamana is Practiced Skin diseases - Psoriasis, Urticaria, Eczema, Allergy, Acne….. Bronchial Asthma Depression, Anxiety neurosis Hypothyroidism Dr.GK

Dr.GK

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

Here are the cases… Dr.GK

Vamana in Bronchial Asthma

Vamana in Bronchial Asthma Dr.GK

Vamana in Psoriasis

Vamana in Psoriasis Dr.GK

Therapeutic goals… Useful in – Obstructive pathologies Immune challenges Allergic states Dr.GK

Virechana

Keep the body fluids clean and pure for a healthy life……. Dr.GK

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

Therapeutic targets Pitha dosha elimination Raktha prasadana Vathanulomana Agnideepthi Dr.GK

Common Conditions Where Virechana is Practiced Inflammatory skin diseases Ascitis Diseases of lower GIT Neurological diseases LBP Allergic/Toxic states… Dr.GK

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

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

Nasya Dr.GK

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

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

Key Point Fix your Clinical target… Options are – Purification Nourishment Stimulation Strengthening… Dr.GK

Nasya - Practical Indications Cervical Spondylitis Frozen Shoulder Hemiplegia Facial Palsy Seizure diseases Mental diseases Head aches ENT conditions…. Dr.GK

NASYA – Drugs of Choice Ardita – Dhanwantharam Avarthi Ksheerabala Avarthi Karpasasthyai Dr.GK

Head Ache - Pathologies Ksheerabala Avarthis Varanadi ksheeraghrita Shadbinduthaila Dr.GK

Nasal Pathologies Anutaila Surasadi Thulasikalka Dr.GK

Epistaxis Durvasvarasa Swarasa of Dadima Pushpa Swarasa of Amrasthi Dr.GK

Apasmara - Dronapushpi swarasa Visha, Moha- Vilwadi gulika Dr.GK

Vyanga – Cosmetic Issues Kumkumadi taila Dr.GK

Some more examples…. Hair Problems – Bhringaraja swarasa Premature greying – Nimba thaila Dr.GK

Nasya – Mental Health Depression Lasuna swarasa Vacha +Hingu Vacha +Jatamamsi Dr.GK

Nasapana…??? In Aphasia, Facial Palsy etc Mashathmagupthadi kzm Mashabaladi kzm Done with syringe Maximum 80ml in both nostrils Same poorvakarmadis as Nasya Dr.GK

Pharmaco kinetics Routes of Action – Nasal mucosa - Kapha Nasal Vascular - Pitha compartment Olfactory filaments- Vatha Dr.GK

Mode of Action Stimulation of vital centers Nourishing the tissues Clearing the channels Removes the congestion Correcting the neuro-vascular anomalies Dr.GK

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

Effect of Nasya in Kamala Dr.GK

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

Vasthi Dr.GK

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

Therapeutic targets Pakwasayagatha vatha spectrum Vatha domination Deep seated pathologies Dr.GK

Three fold utility of Vasthi Utklesana – Excitation of dosha Purification - Elimination of dosha Samana – Pacification of dosha Dr.GK

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

Dr.GK

Pichavasthi Milk decoction of Salmali vrinda - 240 ml Dadimadi or Charngeryadi ghritha – 120 ml Indication - Ulcerative colitis Dr.GK

Dr.GK

Madhuthailika Vasthi Honey – 4 Palas Thaila – 4 Palas Erandamoola kwadha – 9.5 Palas Misi kalkka – ½ Pala Saindava - 1 Karsha Indications - RA Dr.GK

Rajayapana Vasthi Infertility,impotency,extrapyaramidal disorders A 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

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

Dr.GK

Thiktha Ksheeravasthi in Osteoporosis Gugguluthikthaka Ksheera + Ksheera -120ml Honey -120ml Kethakimooladithailam -120ml Gugguluthikthaka ghritha -120ml Snehavasthi with Lakshadi mezhukupaka-120ml Dr.GK

Rooksha Vasthi Amruthotharam Kashayam - 300 ml Shaddharana choorna -30gm Amavatha Dr.GK

Dr.GK

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

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

Rakthamoksha Dr.GK

When Rakthamoksha..? Seat of doshas in Sakha Preferably after sodhana Other treatments bring Anupasaya Dr.GK

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

Inflammation - Pitha predominant Sannipatha condition Healing - Kapha oriented Repair process Dr.GK

Jaloukaavacharana - Stages Dr.GK

Multifactorial effect…. Blood clot is removed Local circulation is improved Clearance of wastes Venous return is increased Speed up the repair process Dr.GK

Hirudin - Inhibits blood coagulation by binding to thrombin 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

Bdellins - Anti-inflammatory. Inhibits trypsin, plasmin, acrosin Hyaluronidase - Increases interstitial viscosity. Antibiotic Tryptase inhibitor - Inhibits proteolytic enzymes of host mast cells Dr.GK

Acetylcholine - Vasodilator Anesthetics substance - Anesthetic 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

Mode of action Vathasonitha - Pitharakthaprasadana Vathanulomana Checks the inflammation Improves circulation Venous diseases and thrombosis Dr.GK

Kushta Normalizing Twak sara Preventing sakhagathi of doshas Bhrajaka pitha prasadana Kledaharana Dr.GK

Jaloukaavacharana – different cases Dr.GK

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

Let them drink for OUR Health…. Dr.GK

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

No ‘ Sanga… ’ Good ‘ Gathi…’

Relax and Refresh till the next module…..