Cleansing Protocols: Panchakarma or Pacification therapies?
GENERAL UNDERSTANDING AND CLARIFICATION OF CLEANSING
Ayurveda emphasizes the importance of cleansing, seasonally and as needed in between. With this day and age of global calamities involving the imbalances amongst the five elements, now, more than ever, managing the doshas through various types of cleansing protocols is a MUST!
It is when the doshas gain momentum and have established themselves that Panchakarma is necessary. Performing panchakarma helps to cut the vitiated doshas at this level, from root. Check HERE for a complimentary article. Ayurveda identifies two general categories (bheda) differentiating between general cleansing (langhana or ‘lightening’ therapies)1. that of a palliative nature known as Shamana Cikitsa (palliative treatment), which serves to reduce, through pacification, the momentum of the doshas but does not excite or expel them, and 2. Shodhana Cikitsa (purificatory treatment) is specifically designed to be very aggressive at expelling the doshas through either all five means of purification therapies PANCHAKARMA or at least a particular one of the five at any given time but that correlates to seasonal appropriateness, and that can occur over a period of a year or years going layer by layer and a slower rate compared to a traditional process that can require a minimum of 46 days in order to go through all five karmas.
शोधनं शमनं चेति द्विधा तत्रापि लङ्घनम्||४||
śōdhanaṁ śamanaṁ cēti dvidhā tatrāpi laṅghanam||4|| AH Su 14/5
Langhana (lightenting therapies) are divided into two categories of shodhana (purification) and shamana (pacifying) treatments.
Benefits of purification therapy as per Caraka Samhita Ca Su 15/22
मलापहं रोगहरं बलवर्णप्रसादनम्| पीत्वा संशोधन सम्यगायुषा युज्यते चिरम्||२२||
malāpahaṁ rōgaharaṁ balavarṇaprasādanam| pītvā saṁśōdhana samyagāyuṣā yujyatē ciram||22||
The benefits of a properly administered purification therapy include elimination of vitiated dosha, alleviation of disease, improvement in strength, complexion and longevity. [22]
Per traditional Ayurveda, Caraka states that pacifying doshas is like a tree that gets cut down but can resprout over time but expelling doshas through purification therapies that remove the root. Caraka Sutrasthana 16/20-21
दोषाः कदाचित् कुप्यन्ति जिता लङ्घनपाचनैः| जिताः संशोधनैर्ये तु न तेषां पुनरुद्भवः||२०||
दोषाणां च द्रुमाणां च मूलेऽनुपहते सति| रोगाणां प्रसवानां च गतानामागतिर्ध्रुवा||२१||
dōṣāḥ kadācit kupyanti jitā laṅghanapācanaiḥ| jitāḥ saṁśōdhanairyē tu na tēṣāṁ punarudbhavaḥ||20||
dōṣāṇāṁ ca drumāṇāṁ ca mūlē'nupahatē sati| rōgāṇāṁ prasavānāṁ ca gatānāmāgatirdhruvā||21||
Morbid dosha relieved by fasting and digestive drugs may sometimes get aggravated again, but those that are evacuated by purification therapies do not recur. Dosha, like plants, if not uprooted completely, would recur or relapse almost certainly. [20-21]
SOME REASONS WHY SOMEONE WOULD CHOOSE PACIFICATION THERAPIES (shamana cikitsa) OVER PURIFICATION THERAPIES (panchakarma) OR VICE VERSA:
-One main reason for choosing shamana versus shodhana is that the protocol can be generally done over a period of time, which may be easier to manage in one’s schedule.
-Another main reason for choosing shamanism versus shodhana is the cost of the protocol(s). Cost is more easily managed by a less aggressive process that requires resources such as a support system in place for panchakarma, especially during the process and on a daily basis, versus shaman, which can be done simply with the Ayurvedic clinician and patient, without support staff, necessarily.
-Another reason for shamana versus shodhana is that for shamana, a patient can come and go for the necessary treatments, but with shodhana, a patient may either stay generally at the facility (if this is an option) or be close by in some cases. Panchakarma could be done from afar, but it is not necessarily considered ideal.
-Additionally, shodhana (panchakarma) is more aggressive and expels the doshas and requires more consideration, planning, and preparation. Not everyone is a candidate, and the ones that are eligible are determined case-by-case, along with whether it is seasonally appropriate. There are rare instances where a panchakarma can be conducted outside of seasonal periods, but this is also determined by the urgency of the case.
-Additionally, there is quite a difference between shamana and shodhana practices. What tends to be confused here in the West is that Panchakarma is a series of spa treatments (oil, steam, shirodhara) and either ending with drinking a special tea or something similar to cause a loose stool, but this is NOT panchakarma. Frankly, panchakarma is a “messy/challenging” process for anyone undergoing the protocol(s) directly and not to be confused with the precursory therapies that tend to involve the oiling and steaming of the body. These latter treatments set the stage for the karmas (any of the five) to be undergone, but they are not the karmas themselves.
HERE ARE SOME OPTIONS AND CATEGORIES OF CONSIDERATION THAT WILL BE SEPARATED INTO TIERS:
Tier 1 (basic cleanse) *This cleanse protocol falls under shamana cikitsa
If you are a new patient and are unable to commit to a lengthy cleanse, then a simple one-day protocol, usually a Sadhya Virecana/purging or Matra Basti/medicated enema, can be put into place at the time of your initial consultation. The details of this will be discussed further around the time of your session, if not a follow-up session. Timing must always be a consideration for any cleanse, especially involving seasonal transitions; along with other factors, and not limited to, such as digestive strength, age, and energy. New Patients click HERE for details.
If you are a pre-existing patient and unable to commit to a lengthy involving cleanse, then a simple one-day protocol, usually a Sadhya Virecana/purging or Matra Basti/medicated enema, can be put into place at the time of a follow-up session. The details of this will be discussed further around the time of your session. Timing must always be a consideration for any cleanse, especially involving seasonal transitions; along with other factors, and not limited to, such as digestive strength, age, and energy.
For either the new or pre-existing patient, on the day of the cleanse itself especially regarding the Sadhya Virecana (purging) an additional fee of $125.00 will be applied and charged based on needing to be “on call” and available this day as a clinician to monitor the progress and prevent any/avoid any complications. This fee is in addition to whether you have enrolled in Package A or Option B of the Basic Plans.
The availability and cost of herbs or formulas are not included in the general cost but are added as needed to the total, determined case-by-case. Some of the herbs/formulas are available in the office, while other herbs/formulas are available through the associated dispensary where the order is placed.
For either the new or pre-existing patient, a particular handout will be provided that contains specific instructions to prepare for the cleanse, conduct the actual cleanse, and the post-cleanse follow-up process; whether for the sadhya virecana or the matra basti.
In some cases, when Matra Basti(s) is/are being considered, this is open to the possibility of a daily event rather than a one-day event. This is determined on a case-by-case basis and to be discussed as needed.
Where the Matra Basti(s) is/are indicated, an additional fee will be applied to the total based on the treatment plan chosen.
For Sadhya Virecana, this is mainly done in the privacy of your own home.
For the Matra Basti, this is done in the privacy of your own home.
Generally, with this basic cleanse process both types of therapies either the sadhya virecana or the matra basti are done at home BUT there is the option to come in for some hands-on sessions that include abhyanga and svedha as determined/requested/needed. Furthermore, there is also the option to cater the protocol to an Abhyanga with svedha, food served, and then administration of a matra basti, consisting of about two hours total, which would be a separate cost, and details could be provided.
Tier 2 (next level more comprehensive) *this cleanse protocol falls under shamana cikitsa
If you are a new patient and are able to commit to a more lengthy cleanse, then there are options for a 3 or 5-day protocol that ends with the 4th or 6th day (not a Sunday, usually) involving usually a Sadhya Virecana/purging or Matra Basti/medicated enema can be put into place at the time of your initial consultation. The details of this will be discussed further around the time of your session, if not a follow-up session. Timing must always be a consideration for any cleanse, especially involving seasonal transitions; along with other factors, and not limited to, such as digestive strength, age, and energy in “a and b.” New Patients click HERE for details.
If you are a pre-existing patient and able to commit to a more lengthy cleanse process, then there are options for a 3 or 5-day protocol that ends with the 4th or 6th day (not a Sunday, usually) involving usually a Sadhya Virecana/purging or Matra Basti/medicated enema that can be put into place at the time of your follow-up session. Timing must always be a consideration for any cleanse, especially involving seasonal transitions, along with other factors, and not limited to, such as digestive strength, age, and energy. The cost and details for the 3 or 5-day series of sessions can be seen below in “a and b.”
For either the new or pre-existing patient, on the day of the cleanse itself especially regarding the Sadhya Virecana (purging) an additional fee of $125.00 will be applied and charged based on needing to be “on call” and available this day as a clinician to monitor the progress and prevent any/avoid any complications. This fee is in addition to whether you have enrolled in Package A or Option B of the Basic Plans. The cost and details for the 3 or 5-day series of sessions can be seen below in “a and b.”
The availability and cost of herbs or formulas are not included in the general cost but are added as needed to the total, determined case-by-case. Some of the herbs/formulas are available in office, while other herbs/formulas are available through the associated dispensary where the order is placed.
For either the new or pre-existing patient, a particular handout for the sadhya virecana will be provided that contains specific instructions to prepare for the cleanse, conduct the actual cleanse, and the post-cleanse follow-up process.
In some cases, when Matra Basti(s) is/are being considered, this is open to the possibility of a daily event rather than a one-day event. This is determined on a case-by-case basis and to be discussed as needed. Some aspects of the protocol may be changed to accommodate this and discussed in detail during your session planning.
Where the Matra Basti(s) is/are indicated, an additional fee will be applied to the total based on the treatment plan chosen.
For Sadhya Virecana, this is mainly done in the privacy of your own home. For the Matra Basti, this is administered in the office but carried on in the privacy of your own home.
“Stacking Treatments” is always a possibility, whether during the cleansing protocols or simply as part of the current plans in place. Stacking Treatments refers to having more than one treatment conducted during any one session, which can range from 1.5 hours to 4 hours on average. The cost for this will vary per treatment.
There is the option for staying in the guest room if desired/needed. The daily rate is $70.00.
Should staying the night be an option, and meals are requested, the daily cost for meals would be an additional $40.00.
a) New Patient: (3 Day)—1-2 hour Consult, 1- 1/2 hour follow-up session, 3 Shirodhara, Abhyanga w/ svedha = $1,350.00
b) New Patient: (5 Day)—1-2 hour Consult, 1 -1/2 hour follow-up session, 5 Shirodhara, Abhyanga w/ svedha = $1,980.00
a) Pre-existing Patient: (3 Day)—3 Shirodhara, Abhyanga w/ Svedha = $1,585.00 *This is due to having already been established as a patient with the needs being understood, including that there tends to be a follow-up session that is usually either part of Package A or Option B.
b) Pre-existing Patient: (5 Day)—5 Shirodhara, Abhyanga w/ Svedha = $2,215.00 *This is due to having already been established as a patient with the needs being understood, including that there tends to be a follow-up session that is usually either part of Package A or Option B.
Tier 3a (traveling to and from home and actual Panchakarma) *This option allows you to commute daily and plan accordingly.
For either a New Patient or Pre-Existing Patient, this is determined on a case-by-case basis. In both cases, a full consultation is required. New Patients click HERE for details. *Not everyone is a candidate for panchakarma.
If you are determined to be eligible, and all logistics are discussed, the treatment protocol and plan will be created.
If you are eligible, and in specific cases or difficult cases, Dr. Antonio will be collaborating with his mentor as per requirements from his previously completed advanced program of Ayurveda.
The cost will be based on five to six days (not on Sunday) and determined by the individualized protocol that will include treatments, food provisions (around $40.00 daily), herbal medicines, and specific formulations that are prepared in packages at the associated dispensary, clinician availability, planning, preparation, and other relevant expenses. The average cost could be around $4,000.00, excluding room and board. You can commute or locate a local Airbnb for accommodations.
This rate does not include stacking treatments. Stacking pertains to adding other treatments during the primary cycle of the karmas implemented during this week.