The Ancient Cleanse That Will Kick Your Ass

Panchakarma—an intense Ayurvedic cleanse—is not about about instant gratification.

Nov 28 2016, 10:00pm

Photo: Gizmo / Getty Images

"You keep your feet." The driver delivers this command while pointing at my ankles. I have no idea what he means. Before I can inquire, our car skids by a temple elephant and my eyes divert to the road. We're in Southern India, navigating a tangle of country lanes through the black Keralan night. Finally, a few rose-colored stuccoed buildings come into sight, shaded by silhouetted palms. Lo and behold, the Ayurvedic clinic where I'll be voluntarily interned for the next month and a half.

With the preeminence of yoga in the postindustrial world, it is little wonder that Ayurveda—the so-called "Science of Perfect Health"—has become next to catch on. Ancient Indian medicine relies on Hindu cosmology, guided by the principle that the building blocks of the universe—fire, water and air—also make up our own bodies. In Hindu pujas, the elements, deified as gods, are honored each day. So too are the elements inside us meant to be kept in check.

Panchakarma is the body's total purification in a system of steps, lasting on average 28 days (plus recovery time). Detoxes include vomit therapy, blood-letting (some clinics still use leeches), oil enemas, herbal purgatives (laxatives), and a week's ingestion of hot, medicated ghee, or clarified butter. Clinics in the US offer modified therapies, and Ayurvedic massages have long been staples of Western spas. But the longer (and grislier) clinical treatments—mostly illegal stateside—are only now enjoying a surge in popularity as more and more health-seekers head east.

Peter Francyk, 50, a Salt Lake City-based yoga instructor, has done panchakarma at least ten times. "The first few times, it was very subtle," he says. "After a decade, at least, of 24/7 constant pain" due to a spinal injury, eventually he noticed that his neck "wasn't hurting anymore." He credits the treatments.

"If body strength is high and disease rate is low, Ayurveda will make [the body] manageable," explains Girish Kumar, a doctor based in Bangalore. He likens panchakarma, which he describes as eliminating naturally occurring metabolic toxins from the body, to taking a car in for regular service. "You need to change the filter, the tires," he tells me. "Same thing in the body."

Very few randomized clinical trials on Ayurveda have been performed, and in many parts of the world the method remains seen as a wellness treatment, rather than an illness remedy. But herbs used in panchakarma (the classic Sanskrit texts highlight 700 recommended plants) have been shown to slow the growth of cancer cells. And knee therapies, one of the few Ayurvedic treatments to be evaluated, have been found effective for osteoarthritis.

During my stay at the clinic, I live like an extinct species of diva, roused in time for my massage, then oiled and bathed and instructed to rest as I wait for silver trays bearing fresh vegetarian meals. Were it not for the daily horror of chugging ghee, I might think myself on vacation. The medicated butter is succeeded by three sessions sweating in acrid steam inside a kind of a vertical coffin, reminiscent of a prop in a Victorian sideshow. "We're loosening up those toxins, those deposits, from the deeper tissues," explains Claudia Welch, doctor and author of two bestselling books about Ayurveda. "In the next stage, we eliminate them."

Every day for nine days, two therapists pour gooey, caramel-colored oil all over my body, sprawled lengthwise across a wooden table and outfitted with a grease-soaked paper loincloth, a hollow stab at modesty. Often, I nod off. Once, bizarrely, I cry.

"We become very malleable during panchakarma," Welch tells me. "Not only in body but in spirit and mind. It's a very vulnerable time." Treatments can cause "hormonal stimulation," explains doctor and researcher Sumit Ashok Kusarkar, which "with the social-moral setup of that individual can cause an emotional response."

Partway through my stay, Usha, my massage therapist, asks how I slept. 

"Not so good," I say. I had dreamt of an asteroid spinning round and round the horizon, and woke right before it crashed. 


"Fine, fine," she smiles, radiant in a crisp white sari, hair gleaming. 

"Do you always sleep well?" 

"Yesss," she beams.

In Ayurveda, one element predominates our being, sculpting our personalities and appearances, honing potential defects. Serene and prone to weight gain? Must be kapha (water). Pitta (fire) drives mental acuity and rash tempers, while vatas of the world—my brethren!—are lanky, spacey, insomniacs (air).

When balanced, only our best qualities reign.

One night, outside the yoga hall, a Polish girl with fiery Little Mermaid hair recounts her sister's long battle with breast cancer. 

"We're talking about death," says another patient—a Ukrainian Krishna devotee—looping an imaginary noose around her neck and rolling out her tongue. This strikes me as a little insensitive. But no one is fazed. 

"This is just the body!" the redhead cries, grand and defiant. "The soul lives on...forever!"

Not all patients share the same fervent piousness, and their skepticism extends to their treatment. "I hope this shit works," one sighs, hair turbaned in an oily cloth. Luckily for the skeptics, panchakarma "doesn't require faith in Ayurveda for it to work," Francyk tells me.

Though perilously complex, Ayurvedic treatments hinge on a clear philosophy, grounded in thousands of years of medical trial and error. "The whole point of existence is transportation," explains Kusarkar. "Assimilation, absorption, excretion…when this mechanism is hampered, disease occurs. Panchakarma tries to correct this."

The latter "elimination" phase of my stay is less ghastly than anticipated. Last year, someone had to be sent to the emergency room for an I/V drip, but for me, herbal purgatives are mercifully anti-climactic. Those final couple weeks are blissful. Every morning, I'm slathered in curdled milk and pounded with hot, herb-filled poultices (Navarakizhi). Fragrant oils are dripped back and forth across my forehead as I flicker in and out of consciousness (Shirodhara).

Whether it's the tropical idyll, all the herbal medicines I'm being fed, or the therapies themselves, I do start to feel pretty fantastic. In between treatments I lounge on the lawn, sipping from fresh coconuts. Or I count the frogs in the clinic pond. As days melt together, I begin to relive the languorous thrill of childhood summers.

But it's not a quick fix. I emerge from weeks of treatment more chrysalis than butterfly. "You look like a corpse," a friend laughs. Maybe. But I feel like a newborn. (Literally; I have not fetched food for myself or taken an unaided bath since I admitted myself into the clinic.)

"Subjects may feel worse on the way to feeling better," a report in Scientific World Journal rather tentatively suggests. Or, as Francyk puts it, "It's not like a spa, where you come, and 'Oh, it's nice, now I feel fantastic.' It's like getting off the surgery table."

Eventually, I begin to feel the effects of my system reboot, overtaking fears that I've permanently debilitated my health. I sleep better, get fewer migraines, and feel generally more resilient than before.

Panchakarma isn't about instant gratification. But if 5,000 years of Indian medicine have taught us anything, it's to play the long game.