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Preparatory/Preliminary Procedures (Poorvakarma)Before the administration of actual bio-purificatory therapy, there is a need to prepare the body in prescribed methods to encourage the body to let go of the toxins.Preparatory procedures include: -Deepana (Kindling of digestive fire)-Pachana (Digestion)-Snehana (Oleation)-Swedana (Sudation)Deepana & Pachana do kindling of fire and digestion of metabolic toxins respectively. Ghee or oil is given daily for three to seven days. Snehana loosens the toxins & helps in the separation of toxins from tissues. It also makes the superficial and deep tissues soft and supple. Swedana is sudation or sweating and is given for 1 to 3 days after the massage. Swedana liquefies the toxins and helps in the movement of toxins into the gastrointestinal tract. After three to seven days of Snehana, massage, and sudation the Dosha (bio-humors) is liquefied and brought to GIT. Then specific Panchakarma therapy is administered according to the involvement of bio-humor.Snehana Karma: Medicated oil and medicated ghee are administered internally and externally in various methods such as Sneha Panam, Abhyanga Massage, Sirodhara, Shirobasti, Pizhichil, etc.Swedana Karma: The methods adopted are Njavarakizhi, Elakizhi, Choorna sweda, Steam bath, hot herbal bath, etc.As we know, Dosha and Mala actively participate in physiological functions. Whenever due to some etiology, the Dosha deranges from their normal function they become hazardous to the body and it becomes necessary to either correct them or eliminate them. Panchakarma measures are adopted to eliminate them from the body but it is not as simple as it sounds. As the Dosha is operational at the macro as well as a micro-level of the body functions, they are present in each cell of the body and resultant pathology is also impregnated at the cellular level. It is not possible to eliminate the Dosha without proper loosening and separating them from the cells and tissues. Purification measures adopted without proper loosening, agglomerating and channelizing of the Dosha may be a failure and can also harm the healthy tissue. Before the performance of bio-purification, it is necessary to make a patient biologically ready to expel the accumulated morbid material and this process is known as Purvakarma.The purpose of Purvakarma is to loosen the morbid Dosha and toxins to agglomerate the fragmented Dosha for the ease of removal to channelize them into gastro-intestinal tract or nasopharynx (as per the site of disease) to facilitate their removal from natural routs and to strengthen the body to withstand the stress of Panchakarma therapy.

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