The word Panchakarma means five actions. According to one school of thought, Panchakarma refers to Nasya (nasal therapy), Vamana (emesis), Virechana (purging) and two kinds of Vasti (therapeutic enema), Nirooha Vasti and Sneha Vasti. Herbal decoctions are used for Nirooha Vasti and herbal oils for Sneha Vasti.
The other school, that regards Rakta (blood) also as a Dosha (humour), the vitiation of which can cause diseases and health problems advocated Raktamokshana (bloodletting) as the fifth in the Panchakarma therapies. So the five therapies are Nasya, Vamana, Virechana, Vasti and Raktamokshana. As bloodletting involves medical venesection, it is no longer popular. Leeching, however, is still practised.