Ayurvedic Treatments: Types and How They Differ

In the Ashtanga Hridaya treatment is divided into two broad kinds. The first lightens the body, the second nourishes it. Lightening, in turn, is of two sorts: shodhana — cleansing, when excess dosha is eliminated from the body — and shamana — pacification, when it is balanced without elimination, through diet, routine and remedies.

This gives a simple rule for treatments. Cleansing actions — vomiting, purgation, medicated enemas, nasal cleansing — belong to shodhana and form the core of panchakarma; it is shodhana that people loosely call an Ayurvedic detox, although it does not promise to “flush out toxins”. Almost everything else a person sees in a clinic — external oil, sweating, pouring treatments — works either as preparation for cleansing or as a gentle part of the plan in its own right.

So the same abhyanga can precede cleansing in one case and stand alone in the plan in another. What decides this is not the name of the treatment but the prescription.

The second preparatory action is swedana, sudation or sweating. The Charaka Samhita devotes a separate chapter to it, listing sweating with fire — steam, hot poultices, pouring warm decoctions — and without fire, such as a warm room, the sun or physical exercise.

In a clinic three kinds are most common.

• Kizhi — hot bundles of leaves, powders or cooked rice are applied to the body with rhythmic movements. Several kinds are distinguished by their filling: leaves, powder, njavara rice.
• Steam box — the person sits or lies in a wooden cabinet with the head outside, and steam from a herbal decoction is directed at the body.
• Local steam — steam from a tube is directed at one spot, such as a joint.

Sweating follows oil rather than replacing it. The dry powder rub — udvartana — stands apart: there is no oil in it, and it is chosen when oil does not suit the person.

A separate group is treatments for the sense organs. The Charaka Samhita places some of them in daily care and describes others as therapeutic.

• Oil pulling — oil is held in the mouth or swished between the teeth. The Ashtanga Hridaya distinguishes two techniques: holding the mouth full without moving the liquid, and swishing a small amount. More in the article on dinacharya.
• Oil in the ears — a few drops of warm oil; in a clinic this is karna purana, when the oil is held in the ear for a set time.
• Netra tarpana — walls of dough are placed around the eyes and filled with ghee; the person opens and closes their eyes in this “pool”. It is described in the Ashtanga Hridaya together with the related treatment putapaka.
• Nasya — oil or powder administered through the nose. The texts allow a few drops of oil as daily care, but strong nasya is one of the cleansing actions of panchakarma and is carried out by a doctor.

Even simple home techniques do not suit everyone. Nose drops and oil pulling are not given to children or to anyone who has difficulty controlling swallowing.

In Ayurveda a treatment is chosen not from a price list but for the person. The doctor looks at prakriti — the inborn constitution — and the current state, digestion, age, strength and the season. These determine the oil, temperature, pressure, duration and order of treatments.

Hence a few signs that distinguish a genuine Ayurvedic treatment from a treatment with an Ayurvedic name:

• before the treatment you are asked how you feel and about contraindications;
• the oil is chosen, not one for everyone;
• treatments come as a course and in a set order, not singly and at random;
• cleansing procedures are not offered without a doctor.

External treatments — oil and sweating — also translate to the spa on the same condition: the therapist is trained and knows when a treatment must not be done. What can and cannot go on a spa menu is covered in Ayurvedic treatments in the spa.