Instructions & Precautions during Panchkarma

General Instructions and Precautions
Sarvang Abhyang & Vashp Swed
Internal Snehan (Internal olietion)
Vaman (vomiting)
Virechan (Purgation)
Vasti (enema treatment)
Shiro Vasti
Karn Pooran (ear treatment)
Akshitarpan (eye treatment)
Pattrapottali Massage
Kati/Katiprisht vasti
Balancing massage
Solar Plexus (navel centre) Treatment
What may be felt during and after Panchkarma?
Post-Panchkarma Instructions and Precautions

General Instructions and Precautions During Panchkarma Therapy

  Always bathe with warm water
  Do not bathe immediately following a treatment or after eating a meal
  Do not sleep during the day (unless feeling weak or unable to sleep at night)
  Do not control natural urges like sneezing, coughing, urination or bowel movement
  Do not talk loudly
  Do not go out either in the hot sun or in the cold wind
  Do not use a very high pillow for sleeping
  Avoid smoky and dusty environments
  Do not eat sour, dry, fried or oily foods
  Do not use narcotics or alcohol during therapy
  Do not fast or overeat
  Do not eat or sleep at sunset
  Eat only from the Ayurveda kitchen
  Do not criticize the food eaten
  Do not eat food brought or served by undesirable persons
  Do not eat stale food, dried ginger or fruits which can stay fresh longer may be taken
  Repeat the Gayatri or other appropriate mantra before eating
  Curds, husked barley, and black gram should not be eaten at night.
  Avoid emotional upsets like anger, frustration, irritation, etc.
  Keep calm and avoid mental stress
  Avoid physical exertion and sexual activity
  Try to meditate on Nature keeping in mind its laws: that a cause will always have an inbuilt and automatic effect, therefore always begin an activity keeping in mind the law of cause and effect.
 Avoid gossip or criticism
 Avoid arrogance, impatience or mental agitation
 Contain anger with serenity, and fear with confidence
 Remain focused on work
 Avoid over rationalizing, or overindulging in intellectual activity
 Maintain peace of mind and calmly govern the senses
 Avoid meaningless discussions
 Avoid over indulgence in sleep, sleeplessness, bathing, drinking (water or wine) or eating
 Promote peace and remain calm in the face of harsh criticism or retaliation
 Treat all human beings as equals.
 Pray for universal peace and happiness

Sarvang Abhyang & Vashp Swed (whole body massage fomentation)

Instructions and Precautions-

  If suffering from hypertension or if there is history of cardio-vascular disease,
varicose veins, fractures or any serious illness, be sure to inform the Doctor
  Do not go for massage immediately after eating a heavy meal
  Light breakfast or food is permissible
  It is essential to wear only ‘langot’ (a brief loin cloth) during the treatment
  Inform the therapist about the tolerance level of the massage pressure
  Before going for steam drink a minimum of 200 ml of water
  The soles of the feet must be absolutely dry to avoid slipping on the oily floor surface.
  Walk to the steam chamber with extra care
  While taking steam treatment, cover the head with a damp towel
  Inform the therapist about your tolerance level to steam
  After completion of treatment, rest for at least 30 minutes
  Try and retain oil in the body for as long as possible (at least for 2 hours)
  Take a shower only if felt necessary but not before a 30 minute rest
  Use only yellow powder (black gram powder) to remove oil from the body
  Avoid soap, body gel or shampoo on the day of massage

Internal Snehan-A preparation for Detoxification

Observational points during Internal Snehan :-

Appetite- normal, diminished or increased
Srool- frequency, smell, consistency and color
Skin- texture --- smooth or dry

Instructions and Precautions-

  Take the prescribed medicated ghee from kitchen
  Timing of ghee or oil administration may be varied, either morning or evening depending upon the season, climate and doshik condition
  Do not eat or drink in the morning before drinking ghee
  Do not take breakfast after drinking ghee
  Ginger may be chewed at the time of drinking ghee to alter the unusual taste of the ghee and to increase the bio-availability of the ghee from the gut
  Take only warm water after drinking the ghee for the entire day and night; a little herbal tea is permissible
  Take lunch only if real hunger persists
  Do not indulge in any heavy physical labor
  Tiredness and emotional upset may occur
  Smoking and sexual activities are strictly prohibited
(neglect of these two activities might lead to improper detoxification and other
  Observe any physical disturbance (nausea, heaviness etc.) and notify the doctor

Vaman (vomiting)

Instructions and Precautions-

  Whole body massage and steam to be given in the morning
  No food or drink to be taken in the morning
 Only water may be taken
  After massage and steam, the main procedure of Vaman starts (between 7 to 9 a.m.)
  Remain calm and quiet and consider the procedure as a betterment of health
  Sit properly on a chair
  Milk or sugarcane juice may be taken in plenty
  After drinking milk/sugarcane juice, liquorice water will be given
  Followed by a paste of “emetic nut” (Randia Spinosa Poir.) and sweet flag (Acorus Calamus Linn) and then a wait of 15 to 45 minutes
  The first symptom is perspiration which indicates that the Dosha have begun the process of loosening up from their position
  Second symptom is distension of abdomen, which indicates that dosha have reached the intestines and stomach
  Nausea, excessive salivation and standing up of hairs indicate the upward movement of dosha toward the mouth
  Patients are instructed to vomit in the vessel kept for the purpose
  The patient may be assisted by two persons on either side to support the forehead and to gently massage the back
  If the vomiting does not begin on time, it may be induced either by pushing the fingers down the throat or by administering a mixture of herbs
  Palpitation and discomfort which may occur should be considered normal
  Do not try to prevent the force of vomiting
  After completion of Vaman, take rest for 45 minutes
  Dhoompan (herbal smoking) may be undertaken to clear throat, mouth and nasal passage of obstruction by residual kapha
  Do not speak loudly
  Do not sleep during the day
  Do not take lunch
  Do not be exposed to the sun and wind
  After 4 p.m. light tea with a light rice snack may be taken
  Dinner should be light (preferably vegetable soup)
  The next morning at breakfast, only liquid khichari (rice broth) from the canteen, but no heavy breakfast, may be taken
  The entire process can lead to a feeling of complete exhaustion and lack of energy, but should be considered as normal reactions
  Normal health is regained after couple of days

Virechan (Purgation)-

Instructions and Precautions-

  No food or drink to be taken in the morning
  Only water and herbal tea may be taken in the morning
  Do not take breakfast or lunch
  Take the prescribed decoction from the canteen (at 9 a.m.)
  Drink warm water and try to balance the body if nausea is felt
  After taking the decoction, drink warm water, and lie on the back, but do not fall asleep
  After one or two hours of taking the decoction, purgation may start. The time span can vary with each person
  Drink warm water all the time – more than desired – after every visit to the toilet, and until the purgation is complete
  Count the number of purgation and check the consistency of the stools, particularly the last one
  Usually the purgation starts around 10:00/11:00 a.m. and should stop by 4 p.m.
  The number of purgation may vary from 6 to 16, depending on individual response and level of dosha
  After 4 p.m. light tea with a light rice snack may be taken
  Dinner should be light (preferably vegetable soup)
  The next morning at breakfast, only liquid khichari (rice broth) from the canteen, but no heavy breakfast may be taken
  During the entire process the high digestive fire might give rise to intolerable hunger, but no solid or heavy food is to be taken that evening at dinner or next morning at breakfast

Vasti (enema treatment)

Instructions and Precautions-

Three types of Ayurvedic Vasti:-
1-Anuvasan vasti (oil enema)
2-Niruh vasti (decoction enema)
3-Matra vasti (low dose oil enema)

  1 & 2 are a set of vasti. Advisable to take them for 8 days, 16 days or 30 days (depending upon illness and Doshik condition)
  Anuvasan vasti (oil enema): administered after lunch
  Niruh vasti (decoction enema): administered in the morning on an empty stomach
  Both enemas: administered after a whole-body massage and steam every day (the patient should be mentally prepared for such treatment)
  Lie on the left side keeping the left leg stretched straight and right leg folded in front during enema (either oil or decoction)
  Lie on the back for 5 minutes after enema
  Lie again on the back with legs bent for 15 to 30 minutes
  Discomfort may be felt during the administration of enema.
(The amount of decoction enema ranges from 400 ml to 800 ml)
  After decoction enema visit the toilet immediately
  After oil enema hold as long as possible. If beyond toleration, visit the toilet
  After completion of vasti, rest for at least 30 minutes.
  Avoid a bath after oil enema


Instructions and Precautions-

  During treatment do not move head
  Inhale liquid through one nostril, and then through the other
  Do not talk or laugh during treatment
  Do not swallow the oil
  Spit it out in the container provided for the purpose
  The oil runs down the throat causing irritation, and burning sensation all over the face
  These symptoms are usual and automatically subside after some time without any adverse effect
  After the treatment is over, lie stretched out on the back and rest for 15 minutes in the resting area
  Do not blow the nose immediately following Nasya
  Do not wash hair during Nasya
  Avoid exposure to cold during the treatment
  Preferably keep the head and neck covered till the therapy is over


Instructions and Precautions-

  For maximum benefit it may be taken for 7 days but never less than 3 days
  The second or third day of the treatment may produce dizziness or mild headache which will automatically subside on the 4th or 5th day
  Do not move head during therapy
  Maintain silence during and after the treatment
  Cover the head after treatment
  Do not wash hair until the Shirodhara treatment has ended
  Take maximum rest after treatment
  Avoid exposure to excessive cold or heat after treatment
  Smoking and sexual activities are strictly prohibited
(neglect might produce restlessness, disturbed sleep, confusion, and irritation)
  Since the treatment works directly on the “agya chakra” (the subtle center between the two eyebrows) any blockage in the channel or old thoughts or past events deep seated in the sub-conscious mind, may come up during treatment.
  Some people may experience emotional upsets and feel depressed. Being aware of the
elimination process will help in understanding the feelings and creating a balance

Shiro Vasti-

Instructions and Precautions-

  Oil will be poured in a special cap on top of your head
  There might be a little burning of the eyes and tears
  After the treatment a mild heaviness might be felt
  Do not move the head from side to side during treatment
  Cover the head afterwards
  Avoid exposure to cold
  Do not wash hair during the treatment

Karn Pooran (ear treatment)

Instructions and Precautions-

  Lie on the back for 15 minutes after Karnpooran
  Ears and head must be covered with a cloth on the day of treatment. This cover must be in addition and over the cotton balls which must remain in the ears overnight
  Remove the cotton balls from the ears the next morning
  Mild drowsiness might be caused by the treatment. This should not be a cause for worry
  Do not expose body to cold winds during treatment
  Do not take any cold items in the diet.

Akshitarpan (eye treatment)

Instructions and Precautions-

  Tension may be felt in the eyes during treatment
  Do not go out into direct sunlight after treatment
  Do not look at bright glowing objects
  Do not look at the sky
  Wear sunglasses on the day of treatment
  Some people may feel irritation in eyes after treatment. (Although rare and usually harmless, the symptom should be brought to the notice of the doctor)
  Do not wash eyes with cold water immediately following the treatment
  Do not face cold and harsh winds
  Do not read and write for a period of time

Pattrapottali Massage-

Instructions and Precautions-

  Inform the Doctor if you are suffering from high blood pressure before start of treatment
  Inform the therapist about tolerance to heat and pressure during the treatment
  Do not take a shower within two hours of the treatment
  Do not get exposed to cold after the treatment
  Do not take the treatment if there is history of bone fractures, varicose veins or eczema
  Take minimum 30-minute rest after treatment


Instructions and Precautions-

 Do not take treatment if there is lot of hair on the body
  Inform the therapist about tolerance of pressure during the treatment
  Do not take shower within two hours of the treatment
  Do not get exposed to cold after the treatment
  Do not take the treatment if there is history of bone fractures, varicose veins or eczema
  Sometimes skin becomes so sensitive that even a soft touch may not be tolerated
  Stop the treatment and inform to the doctor
  In case of any bruise, hyper pigmentation, erythematic plaques or abscess appears on the skin, inform immediately
  Benefits of the treatment is based on individual response
  Take minimum 30-minute rest after treatment


Instructions and Precautions-

  Inform the Doctor if there is history of allergy to sesame oil
  During procedure the treatment tub becomes very slippery so be careful while changing posture
  Inform the therapist about your tolerance to the oil’s temperature during treatment
  Keep your muscles relaxed during the procedure
  Tiredness is a common symptom after treatment
  Light diet should be taken during the treatment
  Heavy exercise and brisk walks should be avoided
  Body becomes very soft if treatment is given for a longer duration, in such cases even simple and mild physical work should be avoided.
  For the maximum benefit of the treatment avoid showering as much as possible
  After the treatment take rest at least for 30 minutes
  Sometimes consistency of stool becomes soft and the frequency of passing stools and
urine may increase

Kati/Katiprisht vasti-

Instructions and Precautions-

  Take light breakfast or meal before treatment because you will have to lay down in prone position (face down) for 45 minutes
  If you have history of fractured spine, disc prolapsed or disc herniation then tell to the
  therapist not to give any pressure over the sensitive area of the spine
  Inform to the Doctor regarding any hypersensitivity after the procedure
  This treatment should be continue for minimum 3 days
  Do not take bath after the procedure
  Back of your body should not be exposed with cold after the treatment
  It is always better to take rest minimum for 30 minute after this procedure

Balancing massage-

Instructions and Precautions-

  There are no specific Instructions and Precautions
  Use soft and comfortable clothes for maximum relaxation during treatment
  Be relaxed and tension free during the entire period of treatment
  There is no need to remove your clothes
  Take rest for 30 minute after treatment

Solar Plexus (navel centre) Treatment-

Instructions and Precautions-

  Take light dinner the evening before
  Do not take breakfast or any food in the morning
  Treatment starts on an empty stomach
  During the treatment a gentle massage with slight pressure around and about the navel center will be given
  A hollow bowl or glass may be pressed around a lit candle or small light upon the navel for about 2-5 minutes to create air suction
  Vacuum will be created by the above method
  Procedure may be repeated 2 to 3 times
  After the above, the big toe will be stretched by the therapist
  Take rest for about 30 minute after the treatment
  Do not exercise, run, travel or bend your body during the entire period of treatment
  Do not carry heavy luggage
  Take very light diet e.g. “Khichari” or fruit juice etc.
  Procedure should be followed for at least 3 days to alleviate the tendency toward frequent shift of energy in the solar plexus

What may be felt during and after Panchkarma:

  Elimination of physical and mental toxins might give rise to various physical and mentalsymptoms, like weakness, dizziness, lethargy, drowsiness, dryness, irritation, digestive upsets, sneezing, restlessness, excitability, anger, emotional upsets, mood swings, recalling old thoughts, actions and events, heightened sexual desire, craving for different tastes, etc. These symptoms disappear automatically.
  Energy levels may vary from day to day since Panchkarma besides being a cleansing process also works at very subtle energy levels
  The energy levels begin to normalize once the entire procedure is complete. It may however take a week or more
  The real benefit from Panchkarma can be perceived after 7 to 15 days.
  Benefits may vary at a personal level depending upon the body’s individual response and the post-Panchkarma routine advised by the physician

Post-Panchkarma Instructions and Precautions -

  After completion of Panchkarma treatment the diet regime should be adhered to for at least 7 days, and thereafter as often as possible
  It is advisable to rest the body for a couple of days before embarking upon a journey after completion of Panchkarma. Do not go trekking or undertake similar strenuous activities too soon
  If a panchkarma diet advised by the physician is not possible, then a diet with plenty of fruit included is desirable
  Avoid mental stress as much as possible after finishing the Panchkarma treatment

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