In patients suffering from bahudoshavastha, or even in healthy persons to negate the deleterious influence of different seasons, all the shodhana procedures may have to be carried out in a single client. But all these shodhana procedures can not be administered simultaneously, rather carried out sequentially one after the other. Each shodhana procedure includes unique purvakarma, pradhanakarma and pashchatkarma and it requires certain duration for completion. Thus the whole course of Panchakarma, involving all the procedures carried out in a sequential order of vamana, virechana, basti and nasya karma, takes about 129 days for completion. The same is elaborated in following lines.
To begin with the course the client is subjected to vamana karma. For this initial client is treated with snehana karma by oral administration of medicated or plain ghee for about 7 days. Abhyanga followed by bashpa sveda is carried out on 8th day. On the 8th day evening, the client is asked to take specific food that provokes kapha dosha. And this is essential for the easy expulsion of kapha dosha during the vamana karma. On the 9th day of the course in the morning, the client is subjected to vamana karma. Vamana karma is followed by samsarjana krama for next 7 days. This completes 16 days procedure of vamana karma.
Vamana karma is then followed by virechana course. After the samsarjana krama of vamana karma there should be a rest for one day. Or to say rest is observed on 17th day of the complete Panchakarma course. During the next 3 days i.e. on 18th, 19th, and 20th days of the course oral administration of medicated or plain ghee is carried out for the second time with the purpose of snehana chikitsa. This is followed by 3 days of kapha reducing diet. Warm liquid food that does not aggravate kapha dosha is preferred on 21st, 22nd and 23rd days of the course. On the 24th day of the Panchakarma course, the client is subjected to virechana karma. This day is the exactly 15th day from the date of vamana karma. Virechana karma is followed by samsarjana krama for the next 7 days i.e. from 25th to 31st day of the Panchakarma course. This completes the virechana procedure.
The course of basti karma follows the virechana karma. Basti karma may be carried out in courses of 30 days or even of 8 days depending upon the requirement. Usually, 30 days course of basti karma is opted to achieve the maximum amount of shodhana. Following the samsarjana krama of virechana procedures rest for one day is allowed i.e. on 32nd day of the full Panchakarma course. From 33
From 33rd day to 62nd day of the Panchakarma course the course of basti karma is carried out. This includes the administration of both anuvasana basti and asthapana basti. The course of basti karma should be followed by 60 days of the rest period or pariharya kala. (The stipulated peried of rest for the course of basti karma is double the number of days of basti karma. In the course of basti, basti is administered for 30 days and hence rest period should be of 60 days. 16 days is the duration of kala basti, and therefore there should be a rest of 32 days. Yoga basti is for 8 days and accordingly, the rest period is 16 days). In this way, this completes 122 days of complete Panchakarma course.
Basti course is followed by the course of nasya karma. The course of nasya karma usually involves 7 days and is administered from 123rd day to 129th day of the whole Panchakarma course. In this fashion, the whole course of Panchakarma is completed in 129 days.
If raktamokshana has to be done, it is carried out on the 130th day of the course. In case raktamokshana to be carried out after the snehana karma, then from 130th day onwards, snehapana is carried out for seven days up to 136th day. This is followed by one sitting of abhyanga and svedana on the 138th day. Raktamokshana is then conducted on the 138th day of the full course of Panchakarma.
Though in the foregoing, 129 days are calculated for the whole course of Panchakarma, excluding raktamokshana there may be variations in the total number of days required for the whole course in an individual case. This is because the maximum duration of snehana is for 7days and is considered in the above elaboration of the course of Panchakarma. But in a given case snehana may be terminated before the completion of seven days, depending upon the appearance of symptoms of proper snehana. Accordingly, there will be a reduction in the total duration of Panchakarma course. Secondly, the above said planning is for the maximum amount of shodhana. In any given client, for different reasons moderate or minimum amount of shodhana may have to be carried out and that will also shorten the total duration of Panchakarma procedures.
When moderate amount of shodhana is planned, to begin with, the client is subjected to snehapana for a maximum period of five days. Abhyanga and svedana are done on the 6th day and is followed by vamana karma on the 8th day. Vamana karma is then followed by samsarjana krama for the next seven days up to 14th day. 15th day is the rest day.
As a part of virechana karma the client is treated with snehapana for three days from 16th to 18th day of the course. During the next three days i.e. on 19th, 20th and 21st day of the course client is advised to take kapha alleviating diet virechana karma is then administered on the 22nd day. During the next seven days up to 29th day of the course samsarjana krama is followed to complete the course of virechana karma.
30th day will be the rest day. Virechana karma is then followed by the administration of kala basti course of 16 days from 31st day to 46th day. Since, 16 days is the course of kala basti, the pariharya kala would be of 32 days. Thus including this pariharya kala the basti karma will be completed by 78th day.
Following the basti karma the nasya karma is done during the next five days from 79th to 83rd day.
After the rest on 84th day raktamokshana is done on 85th day to complete the course of moderate shodhana.
In the course of minimal shodhana, snehapana is administered during the initial three days of the course. On the fourth day abhyanga and svedana are done. On the fifth day of the course the vamana karma is administered. This is then followed by samsarjana krama of seven days. Thus vamana karma is completed by 12days
13th day is the rest day.
On the next 14th, 15th and 16th day, the client is subjected to the second course of snehapana as a part of virechana karma. During the next three days up to 19th day kapha alleviating food is given. On the 20th day the client is subjected to virechana karma. Following this during the next 7days, up to 28th day samsarjana krama is advised to complete the course of virechana karma.
28th day is the rest day.
From 29th onwards the course of basti karma is started. Thus from 29th onwards up to 36th day, the client is treated with basti karma. This is followed by the pariharya kala of 16days. In this way the course of basti karma is completed by 52nd day.
Basti karma is followed by nasya karma for three days on 53rd, 54th and 55th day.
56th day is the rest day.
Raktamokshana is carried out on 58th day to complete the whole course of Panchakarma with minimal shodhana.
In a nut shell, depending upon the physical strength of the client or the amount of dosha vitiation, maximum, moderate or minimal amount of shodhana may be carried out. When the maximum amount of shodhana has to be done, it takes about 129 or 138 days to complete course. The moderate shodhana will be completed in 85 days. Like wise, minimum shodhana can be achieved in 57 days. Maximum amount of shodhana is referred as pravara shodhana, moderate amount of shodhana is known as madhyama shodhana and minimum amount of shodhana is called by the name avara shodhana.