Vamana Karma
This term literally means to expel the vitiated doshas through the oral route and is the pradhan karma of the panchakarma therapy. Vamana or the expelled material may consist of undigested food, kapha, and pitta. Vamana karma is a specific therapy for kaphaja disorders and following are the indications of vamana:

• Nasal discharge
• Acute fever
• Cough
• Tuberculosis
• Asthma
• Indigestion
• Poisoning
• Nausea
• Anorexia
• Obesity
• Sore throat

A variety of vamana drugs are used induce purva karma before vamana as they are suitable in mobilizing the doshas.

Following indicates the effectiveness of vaman: ·

• Maximum elimination of doshas with minimal dose
• Minimization of the disease
• Absence of complications
• Pleasant taste smells and colors

After vamana the loud speech, overeating, continued sitting, too much walking, anger, anxiety, coitus, retention of natural urges should be avoided.

Virechana Karma
Literally meaning the expulsion of doshas through the anal passage, virechana is the specific therapy for pitta dosha disorders. Under the panchkarma therapy virechana karma is the next pradhan karma.

Virechana expels pitta from the amashaya (stomach and upper part of the small intestine) and is neither stressful nor painful and is the easiest procedure, usually unaccompanied by any complication. Following are the indications for virechana: ·

• Fever
• Skin diseases
• Piles
• Splenetic disorders
• Abdominal swellings
• Headaches
• Constipation
• Anorexia
• Asthma
• Cough
• Jaundice gout
• Indigestion
• Gastrointestinal disorders
• Edema

After virechana karma it is advisable to the patient to take plenty of rest and light diet.

Basti Karma
The term basti has been derived from the fact that the Basti yantra (apparatus) used for introducing medicated materials is made up of Basti or animals' urinary bladder. Basti is among the major panchkarma procedures and is used to cure vatic disorders. This remedy is applied to restore the balance of the doshas and has the following effects also:

• Increases weight in emaciated people
• Decreases weight in the obese
• Improves vision
• Prevents aging
• Brings back luster and strength
• For health and longevity

The Basti procedure that is applied through the anus may be Niruha basti.That consists of the use of decoction of appropriate drugs Following are the indications for Niruha Basti:

• Retention of flatus
• Retention of urine
• Retention of stools
• Loss of strength
• Dosha deficiency
• Fever
• Splenetic diseases
• Abdominal swelling and pain
• Headache
• Lumbago
• Heaviness
• Edema
• Stiffness
• Gout
• Piles
• Dysuria

Anuvasana basti
In which oily substances are used. Following are the indications for Anuvasana basti:

• Coarseness
• Increased appetite
• Increase of vata dosha

Following indicates the effectiveness of adequate basti:

• Proper passage of wind and urine
• Proper balance of doshas
• Feeling of lightness in the body
• Pleasant feeling
• Increased appetite and strength

After the remedy of basti the patient must take light diet along with the following activities that are to be avoided after basti, such as:

• Sitting for a long duration
• Standing for it long duration
• Excessive talking
• Travelling
• Sleeping during the day
• Coitus
• Sexual relationship
• Anxiety
• Anger

Sirovirechana Karma
Also known as nasaya it is generally the last step in pradhanakarma of the panchkarma therapy. This refers to the applications of medicines or medicated oils administered through the nasal passage spread throughout the head-and its constituent parts and influence all the doshas and the diseases situated in these parts.

It is referred to as the best and the most specific procedure for diseases related to head (shiro- roga).

Nasya karma prevents the diseases of the eyes, ears, throat, oral cavity and improves the speech, delays aging; and bestows a pleasant oral smell.

Following are the indications for the use of shirovirechana:

• Stiff neck stiff jaw
• Chronic corrhyza
• Tonsillitis
• Cataract
• Headache
• Earache
• Shoulder ache
• Toothache
• Hoarseness of voice
• Stammering
• Alteration of voice

Following are the four types of nasya procedures that can be administered:

• Navana nasya
  It refers to the instilling of the drops of medicated oil in the nose.
  
  
• Auapida nasya
  It refers to the instilling of the juice (extract) of a drug through the nasal passages.
  
  
• Dhamapana nasya and Pradhdmana nasya
  It refers to the inhalation of fine powder (if drugs in the nasal passages with the help of a nadi- yantra. In Dhumanasya medicated fumes are inhaled through the nasal passages and are eliminated through the oral route.
  
  During the nasya procedure, the head should not be excessively flexed or bent, and the patient should be supine.

The patient must avoid following things:

• Speech
• Anger
• Laughing
• Swallowing
• Clearing his throat

Following indicates the effectiveness of adequate nasya:

• Lightness of the body
• Good sleep
• Lightness of the head
• Feeling of pleasure

After the remedy of nasya the patient should avoid cold water, oil, ghee, alcohol, head bath and inhalation of dust and fumes.