In Ayurveda, there are two main lines of management of internal diseases. Śamana and Śodhana. The first i.e. Śamana type of management subsides the vitiated Doṣa without eliminating them from the body, while the second i.e. Śodhana type of management eliminates the vitiated Doṣa out of the body. Out of these two varieties of management of internal diseases latter is considered management of choice on the basis of the Non recurrence. It is said “दोषाः कदाचित कुप्यन्ति जिता लंघनपाचनैः”Caraka
Prakopa of Doṣa subsided by relieved by Laṅghana and Pācana i.e. by Śamana treatment, may sometimes recur, but Doṣa eliminated by Śodhana treatment are not likely to cause the disease again.
Five therapeutic measures are used for the elimination of vitiated Doṣa, therefore Śodhana is also called as Pañcakarma (five fold therapy). The five measures are Vamana (emesis therapy), Virecana (purgation therapy), AnuvāsanaBasti (oily enema therapy), Āsthāpana or NirūhaBasti (decoction enema therapy) and Śirovirecana (nasal insufflation therapy). Some of the Āyurvedic authors consider Anuvāsana and ĀsthāpanaBasti as one and include Raktamokṣaṇa (blood letting) in Pañcakarma. In this way, in their opinion, Śodhana methods are Vamana, Virecana, Basti, Śirovirecana, and Raktamokṣaṇa (blood letting).
Two accessory measures carried out before (Pūrva) and after (Paścāta) performing the Pañcakarma may also be considered as the part of Pañcakarma therapy. The use of Snehana and Svedana before starting the Pañcakarma is necessary. These two measures are collectively known as Pūrva Karma. After the Pañcakarma the patient is gradually allowed to his normal routines of diet and duties and it is called as Paścāta Karma. Dietary regime prescribed after Pañcakarma is also known as SaṁsarjanaKrama.
Pañcakarma therapy is used for promotion of health and prevention and cure of the disease. In a particular season, Prakopa of a specific Doṣa occurs and by eliminating it at a appropriate time the diseases of that season can be prevented. Vamana Karma is specific for elimination of vitiated Kapha, Virecana for vitiated Pitta and Basti is best for the elimination of vitiated Vāta.