Ghee, Enemas, and Nasal Oils

What I learned from a two week Panchakarma cleanse in Nepal

I’m trying something new! This week, I’ve recorded an audio version of the essay below (excuse the lingering nasal congestion). Let me know if you like it and I should continue including audio versions of essays I share.

“Are you really going to drink that?,” J., a bubbly divorcée from Wisconsin, asked me as I stared down a glass of melted butter.

After my yoga teacher training, I stayed in Kathmandu to dive deeper into a practice that’s often seen as complementary to yoga — Ayurveda. A holistic system of traditional medicine, Ayurveda originated in India and is often integrated into modern healthcare systems across South Asia. In other parts of the world, it’s considered alternative medicine.

I’m generally not a fan of alternative medicine (or anything that hasn’t been peer reviewed, tbh), but something pulled me to give Ayurveda a chance — perhaps the brilliant Ayurveda doctor who taught our anatomy class, or the influence that Ayurvedic principles had on our food, our meditation, our yoga practice. If I wanted to truly know yoga, I had to know Ayurveda.

So 48 hours after I graduated with my yoga teacher certification, I started a 2-week Ayurveda treatment; specifically, a Panchakarma cleanse. Panchakarma, literally translated as “five actions,” is a cornerstone of the Ayurveda health system, with healthy patients undergoing the comprehensive detoxification process about once a year.

Traditionally, the five treatments — each targeting a different imbalance — were:

1. Vamana: controlled vomiting, balancing Kapha, or the water element;

2. Virechana: administration of herbal laxatives, balancing Pitta, or the fire element;

3. Basti: enemas with medicated oils or herbal mixtures, balancing Vata, or the air element;

4. Nasya: nasal administration of herbal oils and powders, also balancing Vata;

5. Rakta Mokshana: blood-letting, for total detoxification, but not used anymore.

The three dosas and how they present in the body. (Healthy Directions)

Don’t worry, I didn’t do all five. Here’s how it went.

Note: This issue might be a little TMI for some; if you’re not painfully curious, you can always skip to the conclusion.

Initial Consultation

My first meeting with my Ayurveda doctor, she took my wrist, felt my pulse for an awkward length of time, and said, “wow, you’re really unbalanced.” Curious to see if she was a snake oil salesman, I asked, “hmm… how?”

She diagnosed my dosha as Vata-Pitta (or Air-Fire), with imbalances in both. This came with symptoms like dry skin, bloating, high anxiety, irregular appetite, trouble concentrating, and a few other symptoms that were… actually true. Intrigue and skepticism battled in my brain; is this uncanny, or are these just the symptoms of every burnt-out westerner that walks into an Ayurveda clinic?

My doctor then provided me with my treatment plan: I should never again eat foods that are dry, cold, spicy, or fermented; and for the next two weeks I would undergo virechana, basti, and nasya to balance me out.

Virechana

“Are you really going to drink that?,” J., a bubbly divorcée from Wisconsin, asked me as I stared down a glass of melted butter.

My Virechana treatment started with drinking increasing amounts of ghee, or clarified butter, every morning until… well, until it came out the other end. Ghee is believed to draw out toxins accumulated throughout my body, bringing them right to my digestive tract to be flushed out over the next two weeks.

The doctor had warned me that drinking ghee is the worst part of Panchakarma. On Day 1, I chugged 40ml of ghee — unpleasant, but bearable. By Day 4, the staff put 160ml — a full glass — of melted ghee in front of me. The day before, I hadn’t eaten a thing besides the 1,080 calories in my glass of ghee (something about drinking a glass of butter just kills your appetite for the rest of the day). Luckily, Day 4 was my last day.

The morning of Day 5, I was given a herbal laxative — the most repulsive cup of tea I’ve ever consumed in my life (on par with drinking ayahuasca). Virechana marked the first treatment that would purge toxins from my body.

“Make sure you go between 7 and 27 times,” my nurse said. Too many times, and they’d give me medicine to make it stop; too few, and I’d have to drink more of this devil’s tea. I had never felt so determined.

After 5 days of digestive turmoil, I was allocated two days to recover. My appetite did not return, which was fine, because all I was allowed to eat for those two days was kitchari, a tasteless mix of rice and mung beans.

Basti

After five days of virechana and two days of rest, I started basti treatments — medicated enemas, twice a day, for 7 days.

Never in my life did I ever think I would get an enema — why would I do that to myself??? — but when I had looked into research on Ayurveda, basti had been one of the most studied treatments (see this NIH study, or this one). So naturally, it was the one I was most excited for.

My technician always administered my basti treatments after a Abhyanga massage and some time in the steam room. It was an attempt to relax me, in addition to mobilizing toxins to start making their way out of me. So after an hour of trying to let go while also telling myself, how can I relax when I know what’s happening next?!, I’d turn to my left side, stretch out my right leg, and get pronged in the *you know what.*

After the prong, you hold the herbal concoction for 30-45 minutes. Each day the amount is increased by 100ml — from 500ml to 1200ml. My first day, I chatted lightly with my technician while waiting for 45 minutes to pass. This is supposed to be hard?, I joked. Oh, how naive I was. By Day 5, was crying, screaming, and squeezing my technician’s hand as she stroked my hair. I sprint to the bathroom at 28 minutes because, well, time is a construct and that was good enough.

As uncomfortable as the experience was, I loved basti. The rumors were true — basti left me feeling lighter (thank you, clean colon), less bloated, and even, as some friends pointed out, with healthier looking skin. One of Basti’s biggest benefits is enhanced digestion and nutrition absorption, as well as detoxification. In Ayurvedic medicine, it primarily targets Vata imbalance, which causes dryness in the skin, joints, and other parts of the body. So it made sense; more nutrients, more moisture, less toxins, better skin.

Nasya

Nasya is supposed to be a deeply relaxing process in which the technician drops medicated oils through your nasal passages; these oils are meant to support brain health, improve emotional balance, and detoxify the head and neck region. It was the one my technician was most excited to give me, so much that I added an extra day to complete it. “This will be so good for you,” she had gushed.

My nasya experience started with trying not to choke on the smoke of burning holy basil, followed by trying to not burn off my nose as I breathed in medicated steam, and then trying to control post-nasal drip as what I can only describe as very spicy oil was deposited into my nostrils. Not as relaxing as I hoped.

In the end, I lost about 3kg from my Panchakarma cleanse. Over a month after I completed my cleanse, my skin still looks better, my bloating subsided, my energy increased. Even more so, I’m increasingly conscious about what I’m putting into my body, because — well — I saw it all come out.

Ayurveda earned my respect, and with that so did other alternative healing techniques. I didn’t have to believe the reasons they were supposed to work, but I could notice that, through correlation or causation, things happened. Ayurvedic medicine said that my Vata imbalance, for example, caused too much ‘air’ in my body; brain flighty, tummy bloated, skin dry. Basti corrects ‘Vata imbalance,’ and, for some incredible reason, addressed this seemingly random group of symptoms. It promoted internal rehydration, which showed up in my skin; it hydrated and cleaned out my colon, which reduced bloating; and perhaps because of its impact on my gut microbiome — which were only now learning has significant influence over mental health — it treated my anxiety.

I’m still following a somewhat Ayurvedic diet. After a few days, I noticed that my diet recommendations (no dry, cold, spicy, or fermented foods) pushed me towards meals that had always made feel better anyway. I still take a series of herbal supplements recommended by another Ayurvedic doctor, because they were right about Ashwagandha after all, so shouldn’t I try some others? I’ll stay open to considering alternative medicine, not because I’m convinced that Ayurveda has it 100% correct, but because I’ve started to become curious about unexplained connections and medical interventions we haven’t proven yet.

There's just too much we don’t know.

I’m curious: What practices and beliefs do you have a healthy level of skepticism about? Are there any that you believe wholeheartedly?

What I’m Up To

One of my favorite Substack articles this week was from

Carrington Epperson

, who talked about the sometimes damning advice to “step outside your comfort zone.” Even though I’ve done exactly that this past year, I’m cautious about shouting this often-heard advice. To leave your comfort zone, you must first have one.

Comfort Zone