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Background: The principles of treatment in Ayurveda are summarised in a small number of categories: shodhana (purification), shamana (pacification) and nidana parivarjana (avoidance of cause), along with the broader opposition of langhana and brimhana. These are applied with attention to the patient's constitution, strength, season and stage of disease. Objective: To review the classical statement of the principles of treatment, the rationale for and methods of shodhana and shamana, and recent literature on their evaluation and safety. Methods: Classical texts were studied in translation. PubMed was searched in November 2026 for papers on Panchakarma, shodhana, shamana, Rasayana and Ayurvedic treatment principles. Results: The Samhitas state that treatment is of three kinds, directed at purification, pacification and removal of cause. Shodhana comprises five procedures (vamana, virechana, basti, nasya and raktamokshana, with variations), preceded by preparatory procedures (snehana, swedana) and followed by regulated diet. Comparative studies of preparatory procedures and bioavailability enhancers show the application of these principles. The literature on toxicology, metabolic diseases and chronic disease suggests uses of shodhana, but trial quality is variable. Conclusion: The classical principles of treatment form a logical sequence from cause to recovery. Clinical research should incorporate the full sequence, including preparation and post-procedure care, and should record safety and constitution.