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             Pradhana karma (main procedure) is the second stage of Panchakarma where the main treatment is given. It includes five types of main operative procedures, which are popularly known as Panchakarma, viz., 
  • Vamana karma (emesis)
  • Virechana karma (purgation)
  • Basti karma (enema)
  • Nasya karma (nasal insufflation)
  • Raktamokshana (blood-letting)
Vamana karma (Emesis therapy) 
             Vamana is the procedure to eliminate the waste product (vitiated dosha) through the upper gastro-intestinal track. It is the cleansing procedure, which expels doshas, particularly the augmented kapha.
Virechana karma (Purgation therapy)
             This karma aims to eliminate doshas that cannot be removed by Vamana karma such as the kidneys, lungs and sweat glands.
             Elimination of vitiated doshas through rectum is called Virecana. It cleanses the small intestine and the organs, which are pitta dominant. For example, the liver and the gall bladder in the mid-zone of the body.
Nasya karma (Nasal insufflation)
             Administration of the drug through nostrils is known as Nasya. karma. 
             It cleanses and opens the channels of the head and improves the oxygenation (prana) which has direct and highly beneficial influence on brain functioning.
Basti karma (Enema therapy)
             Basti karma is the most powerful of the five main procedures of Panchakarma..
             Basti is a type of treatment for augmented VATA dosha. In this type of treatment, medicated decoction and oils are passed through the anus, with the help of specially made basti instruments. Properly administered basti helps to rejuvenate the body, provides strength and long life, and improves the complexion and the voice.
Raktamokshana (Bloodletting) 
             Rakta means blood and mokshan means to remove, so raktamokshana means removing vitiated blood from the body. It is the localized treatment not considering the vitiation of the doshas. 
It is done either by metal instruments or by using leeches or vegetable gourds.



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