Due to poorely managed life style and unhealthy dietary habits over a period of time, the potency of digestive fire decreases and the food is not properly digested. As a result the undigested food mixed with the gastric juice turns toxic and is the reason behind all diseases as per Ayurveda. This toxic material called Ama can accumulate in any tissue channel or organ system and can cause disease in the respective organ.

Panchakarma itself means 'Five actions'. These five actions aim at cleansing or detoxifying the body by removing the ama . Traditionally, there are five Shodhana (cleansing) procedures given in a prescribed order. The two major texts vary in their listing of procedures. Charaka records the following five: vamana (therapeutic vomiting), virechana (purgation), niruha (cleansing enema), anuvasana (oil enema) and nasya (herbal nose drops). Shusruta provides a similar list: vamana, virechana and nasya, but both enemas are grouped under vasti and his fifth treatment is raktamokshana (bloodletting).

Not all five procedures are always utilized. Just as Ayurveda has always been a treatment modality based on the needs and circumstances of the individual, so has panchakarma always been an individual process. Therapies are chosen based on a person's innate constitution, strengths and weaknesses, imbalances, emotional state and even the season of the year. The digestive capacity of the individual is also considered.

The panchakarmas are intense treatments, done under the supervision of a qualified practitioner and require proper preparation. The poorvakarmas (preparatory practices) include: dietary changes; internal oleation (drinking oil or ghee) to liquefy toxins; abhyanga (oil massage) to mobilize toxins and dislodge excess doshas; and svedana (fomentation) to mobilize toxins from the system towards the alimentary canal. As soon as the toxins reach the alimentary canal they can be taken out by either therapeutic vomiting or purgation.

Yet poorvakarmas are not merely preparatory; they are powerful therapeutic techniques in themselves as they remove toxins, pacify the doshas and relieve stress.

Another thing to keep in mind, is that following an individually recommended diet is crucial to the success of panchakarma -before, during and after the process - first to support the cleansing procedures and then to rebuild the body. Since agni, the digestive fire responsible for the breakdown of food, is usually dampened while burning toxins, rejuvenation (paschatakarma), the final step in the panchakarma process, is necessary to rebuild the body's strength and rekindle agni. Just as asana is completed with savasana, shodhana or cleansing is completed with rejuvenation.

Classical Ayurveda recommended a course of panchakarma once  a year. But that is an overwhelming commitment in our modern lives. A shorter course of treatment or a supervised dip in the healing waters of poorvakarma can release stress and create essential therapeutic shifts in our lives.