By – Dr JV Hebbar
Virechana therapy is a type of Panchakarma treatment. Here, person is made to undergo controlled purgation for a specific amount of time. It is designed to flush out body toxins. Liver detox, colon detox etc. procedures that are quite famous now-a-days are derivatives of Virechana therapy.
Purpose of Virechana
Virechana treatment is targeted to expel increased Pitta Dosha out of the body. When Pitta dosha gets increased, it causes certain types of diseases – such as abscess, liver disorders, gastritis etc. If the extent of Pitta increased is less, then oral medicines can be given to suppress it. But if it has increased to a large extent and if it has moved from its natural place to other places, then it needs to be expelled out of the body. By expelling it out, the disease gets cured, often completely. Since Pitta is situated at the level of intestines, expelling it from the anal route is very easy. Hence, Virechana treatment is designed. To expel it out, first the Pitta Dosha needs to be forcefully brought from the extremities and different organs into the intestines, and then purgation is induced, to expel it out completely.
Effect on Tridosha
Virechan treatment is indicated in;
High Pitta conditions – like skin disorders, blisters, abscess, liver disorders etc.
Pitta associated with Kapha, where Pitta is the dominant Dosha, as in certain types of vomiting, acid peptic disorders etc.
Pitta associated with Vata, as in case of gout.
Persons suitable for Virechana
Diseases requiring purgation therapy are-
Tumors of the abdomen,
Piles – Often people suffering with piles suffer with constipation. Hence, Virechana therapy helps to correct bowel movements and aids in treating piles, indirectly. Also, as per Ayurveda, liver and Pitta are related with blood vessel health. As piles is related with blood vessels, Virechana treatment relieves piles
Anemia, non healing wounds, ulcers, Abscess, blisters, freckles, discolored patch on face, Jaundice, liver disease, Disease of the spleen, Splenomegaly, chronic fever, ascites – these diseases have Pitta Dosha involvement.
Poisoning, Chronic poisoning
pain in the large intestine,
Diseases of male and female urogenital system
Gout, bleeding disorders of upper parts of the body (such as nasal bleeding)
Diseases of blood vitiation,
GERD, stomach acid and gases causes burning pain in my throat
Virechana for diabetes
Virechana for diabetes treatment: Diabetic patients need good blood vessel care. They also need quick wound healing. Hence, Virechana plays a very important role in them. Also, burning sensation in palms and feet, which occurs as a complication of diabetes, has Pitta involvement, which can be very well treated with Virechana treatment.
Urinary tract disorders
Goiter, tumor, fibroid
cough, cold of Pitta origin,
chronic respiratory tract disease, Asthma
vitiated breast milk
indigestion, Anorexia, lack of taste, obesity
eruption of pimples, urticaria, itching
lack of inclination for work, lack of co-ordination in sense organs,
laziness, Fatigue, Weakness,
foul smell of the body,
sleeplessness or excessive sleep,
drowsiness, weak sense organs,
impediment to intelligence,
loss of strength and complexion in spite of the intake of nutritious diet.
Contra indication for Virechana
Fever of recent origin
Poor digestive activity,
Bleeding disease of lower part of the body (such as bleeding per rectum
wounds, Ulcers of the rectum
Who have been administered decoction enema,
Persons who naturally have hard bowel movement,
who have undergone excess of Oleation treatment
emaciated person – because, purgation involves water loss, which is not ideal for a person who is already debilitated.
Preparation before Virechana
Before Virechan treatment:
Before Virecahan, in most of the cases, person has to undergo Vamana therapy – vomiting treatment.
After Vamana treatment, the patient is made to undergo specific diet regimen called Samsarjana, then after, again oleation treatment (wherein ghee is administered for a few days) is administered. It called as Snehakarma or oleation therapy – click to read more. After that three days of oil massage and sweating treatment is administered. Then Virechana is administered.
Virechana Vidhi- Purgation therapy procedure –
On the day of Virechana treament, If the patient has weak digestion strength (Mandagni), coated feeling in the gut, and if the digestion symptoms of previous food are not seen, then the patient is made to fast for a few hours.
The patient is ensured of good sleep in the last night.
In the morning, after Kapha time has lapsed (after around 9 – 10 am) Virechana drug is given. The kind and quantity of purgation medicine should be determining the nature of his Kostha (alimentary tract, bowels)
A person with Mrudukoshta (soft intestines), even milk will induce purgation.
For a person with Krurakoshta, (hard bowels, intestines), even Trivrit (a purgative herb) might cause purgation with great difficulty.
For Pitta disease, astringent and sweet herbs should be used for purgation.
For Kapha disease, pungent herbs should be given for purgation.
For Vata, drugs with unctuous, oily, hot and salt tasting herbs are used.
The difference in the variation of Dosha, medicinal drugs, location, time strength, body diet wholesomeness, mind, constitution and age should be kept in view while administering this therapy.
Types of Virechana
Types of Virechana based on medicine administered:
Based on the Doshas involved, there can be two types of Virechana –
Snigdha Virechana – Snigdha means oily, here, castor oil alone or castor oil along with Haritaki fruit powder is administered. It is given where, Pitta dosha is associated with Vata Dosha.
Rooksha Virechana – It is used when Pitta dosha is associated with Kapha Dosha. The most commonly used purgation medicine is Trivrit lehyam – 20 – 30 grams.
Or a simple paste of Trivrit (Operculina turpethum ) in a dose of 12 grams is administered.
If bouts of purgation do not commence, he should drink hot water and his abdomen should be fomented with warmed with palms of the hand.
Medicine for Virechana
Personalization of medicine for Virechana:
Person who is weak, who has great amount of increased Doshas develops purgation on his own – without consuming purgative Drug; he should be treated with foods which are purgative.
Persons who are weak, who have undergone purification therapy previously, who have little amount of imbalanced Doshas, who are emaciated and whose nature of the alimentary tract is not known should be given mild purgative drug in a small dose; It is better given in small doses often;
Person who have weak digestion strength, Krura koshta – hard bowels (hard natured alimentary tract), should be administered ghee processed with Kshara and Lavana (Alkalis and salts), to Augment his digestive capacity and Vanquish Kapha and Vata; afterwards he should be given purification therapies.
In persons who are dry, who have great increase of Vata, who have hard bowels, who do exercise regularly and who have strong digestion strength, the purgative drug gets digested without producing purgation; for them, an enema should be given first and then oily purgative drug such as castor oil should be given; or the faeces should be removed first by using a strong rectal suppository made from fruits; the Doshas thus initiated in their movement, the purgative drug expels them easily.
Persons who are suffering from poison , Abhighata (Trauma), Pitika (skin eruption), Kushta – skin diseases, Shopha (inflammation), Visarpa- herpes, Kamala (Jaundice), Anaemia and Diabetes, should be given the purgative therapy without too much of Snehana (oleation. Mild oleation itself is sufficient for them. All of them should be given fatty purgatives – such as castor oil, those who have had oleation earlier should be given dry- non- fatty purgatives.
Normal and abnormal bouts of purgation
Heenayoga – less purgation – 10 bouts of purgation or 384 grams of fecal material
Madhyamayoga – normal purgation – 20 bouts – 768 grams of fecal material
Atiyoga – excessive purgation – 30 bouts. – 1,536 grams of fecal material.
Samyak Virechana Lakshana
Signs and symptoms of proper Virechana treatment (purgation) – Samyak Virechana Lakshana –
lightness of the body
tiredness of sense organs
Regression of diseases,
Feeling of clarity in heart,
feeling of clarity in skin, restoration of normal skin complexion,
timely hunger and thirst
Timely initiation of natural urges. – like defecation, urination etc.
clarity in intellect, sense faculties and mind,
Movement of Vata in proper direction in the body, no bloating or fullness of abdomen.
proper digestion and metabolic activities.
At the end of proper purgation, Kapha – thick frothy materials will be expelled out. This indicates that the Virechana treatment has been successfully completed.
Virechana Heena Lakshana
Signs and symptoms of inadequate purgation – Virechana Heena Yoga Lakshana –
Person starts to spit frequently
chest discomfort, lack of clarity
nausea, feeling of increase (overflowing) of Kapha and Pitta
bloating, feeling of distention
anorexia, lack of taste
vomiting, weakness, lack of lightness
stiffness of hip and thighs
sense organ tiredness,
stiffness, itching, rhinitis
Obstruction of Vata
Discomfort in the region of the heart and abdomen,
anorexia, Too much of Kapha and Pitta increase in the intestines (because they are not properly thrown out of the body) or expulsion of Doshas coming out through the mouth,
burning sensation, skin eruptions, blocking of flatus and constipation
Management: If, on the day of consuming the purgative drug, the patient responds poorly, he should be allowed to take his food on that day and the purgative drugs administered again on the next day;
Virechana Atiyoga Lakshana
Signs and symptoms of excessive purgation – Virechana Atiyoga Lakshana –
Excretion of feces, Pitta, Kapha and Vata.
Excretion of liquid through anus, resembling a mix of water from blood, fat and muscle tissue.
Excretion of black colored blood without Shleshma (Kapha) and Pitta.
The patient will be afflicted with thirst and he may faint due to vitiated Vata.
After the elimination of faeces, Pitta, Kapha and vata in Succeeding order, there will be elimination of watery material which does not contain Kapha or Pitta, which is white, black or slightly red in color, resembling the water in which meat has been washed or resembling a piece of fat;
prolapse of the rectum, thirst, giddiness Sunken eyes and diseases caused by excess of vomiting- will appear.
After Virechana treatment:
After the therapy has been well-administered, the hands, feet and face of the patient should be washed with warm water
The patient should be consoled.
He should then enter into a room which is not exposed to the wind and should lie down there.
Activities to avoid
The patient should abstain from the following for the whole day –
Sitting at one place for long time,
Walking long distances,
Anger and grief,
Exposure to sun, dew and stormy wind,
Indulging in sexual intercourse,
Waking up at night, avoiding sleep
sleeping during day time,
foods with opposite qualities, wrong food combinations and
Foods that may cause indigestion,
Intake of diet exclusively having one taste, intake of diet deficient in nutritive value, or heavy or irregularly mixed up
Suppression or forcible initiation of natural urges.
Diet regimen after Virechana treatment
It is also called as Samsarjana Krama. Soon after purgation, the digestive capacity of the patient is very low. Hence, all of a sudden regular diet cannot be introduced. In stead, liquid diet should be started and gradually turning to solids.
In the same evening or the next day after virechana, patient should take bath in lukewarm water.
He should be given like- warm gruel (Manda) prepared with well cooked old rice. The gruel should be very thin. This is to be given with due regard to the power of digestion, for three meal-times.
For the fourth meal- time, gruel prepared with rice (Vilepi), well-cooked, warm and devoid of oil / ghee and salt altogether or with oil / ghee and salt in small quantity is to be given. Warm water is to be taken after the intake of gruel.
The same type of diet is to be continued for the fifth and sixth meal-times.
For the seventh meal-time again, well-cooked porridge (odana) prepared with the same type of rice of two Prasruta along with a very thin green gram soup (Mudga yusha), added with oil / ghee and salt in small quantity is to be given.
Warm water should be taken after the intake of the porridge. The same diet is to be repeated for the eight and ninth meal-times. For the tenth meal-time, thin meat-soup (Mamsarasa) prepared with water and salt should be given. Warm water is to be taken after this.
This is again to be repeated for the eleventh and twelfth meal times. Thereafter, the patient should take food having different tastes and he should start taking his normal diet from the seventh night.
Another method of Samsarjana
Persons who have had the maximum, medium and minimum purificatory therapies, should consume
Peya- thin Gruel,
Vilepi- thick Gruel,
Akruta Yusa- soup not processed with fat, salt, sours etc.
Krutayusa- Soup processed with fat, salt and Sours and
Rasa- meat juice- in Successive order, for three, two and one Annakala- time of meal respectively.
Eating periods = Anna Kala.
Each day has two anna kala. – morning and evening.
If the maximum vomiting bouts were observed (Ati Yoga), Then, the patient should take Peya, Vilepi, Akruta Yusha, Kruta Yusha and Mamsarasa – three eating periods (Annakala) each. The patient will not have any food except these. Likewise, for the medium vomiting bouts, the number of eating periods Is two each and for lesser bouts (Heena Yoga), the number of eating periods (Anna kala) is one each.
Benefits of Samsarjana Karma
Just as a spark of fire after being fed by grass, powder of dry cow dung etc, gets augmented gradually and becomes great, steady, and capable of burning everything, similarly, the internal digestion fire, by the Samsarjana regimen, in the patient who has undergone virechana karma, gains strength.
Virechana for normal person
For people with Pitta body type – who sweat a lot, who have redness in palm, feet, who are short tempered etc, they should undergo Virechana therapy, quite regularly.
Even for other normal people, during autumn season, when Pitta gets aggravated naturally, due to seasonal factors, Virechana treatment is administered.
Can Virechana treatment be given without doing Vamana?
Usually Virechana is done following Vamana. But in pure Pitta imbalance disorders and when the patient’s Agni – digestion strength is strong, Virechana can be given without Vamana.
After Snehapana, during the rest period, can head bath be taken?
If head massage is done, then head bath (hair wash) can be done.
By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Virechana means therapeutic purgation. It is a part of Panchakarma cleansing therapies. Virechana targets expulsion of morbid pitta or pitta predominant doshas from the body. But it is said that the purgation therapy should be given until the kapha is eliminated in the feces. If purgation is the best remedy for pitta and if we are administering it to expel excess pitta from the body or to effectively treat the pitta predominant disease then why should we look for kapha to get expelled at the end of purgation therapy?
Read – Virechana Therapy – Right Method, Side Effects, Management
Kaphanta means ending with kapha. Kaphanta Virechana means purgation should be administered until kapha is seen in the feces. When kapha is seen in the feces, the purgation therapy should be stopped immediately. Therefore the sight of kapha is a sign of completion of emesis therapy successfully. It is also an indication to the physician that no more purgation should be administered.
To understand this we shall first understand the regional anatomy of the doshas.
Kapha, Pitta and Vata are located above the navel, in the region of the navel and below the navel respectively. So, kapha is located in the upper portion, pitta in the middle portion and vata in the lower portion of the body. The zone of pitta is thus located between the kapha region above it and vata region below it. We need to remember that these doshas are located everywhere in the body and the mentioned anatomical regions are their regions of predominance.
Amashaya which means stomach is said to be the seat of both kapha and pitta. But the term can be used to include the upper part of the intestine also. Amashaya can be divided into Urdhwa Amashaya i.e. the upper region of stomach which is the anatomical stomach and Adho Amashaya i.e. the region below the anatomical stomach i.e. the upper part of small intestine. Thus kapha is predominantly present in the upper part of the stomach and pitta in its lower part.
When purgation therapy is administered the pitta in the stomach / intestine are pushed downwards due to the effect of the medicine and is expelled through the anal route. Once pitta has been totally expelled, the kapha located in the upper stomach is pulled downwards due to the effect of purgation medicine. When this kapha is seen in the feces, the purgation is said to be completed and pitta is said to be expelled totally. Therefore the physician should carefully observe for the appearance of kapha in the feces towards the end of purgation therapy.
Read – 37 Ayurveda Home Remedies For Diarrhea And Dysentery
How to know that kapha is coming down through the feces at the end of purgation?
In therapeutic purgation urine, feces, pitta, purgation medicine, kapha and vata are eliminated in that order. Only when they are eliminated in this order it will be considered as signs of properly done purgation therapy.
In purgation, only the sight of kapha at the end is desired, but not the complete evacuation of kapha. If kapha is expelled in excess at the end of purgation or when purgation is not stopped at the sight of kapha many complications will arise and may prove threat to life.
Kapha will be seen as mucus or mucoid material being expelled at the end of the purgation. The patient may experience slimy things coming out of his anus.
Read – Kapha Increase Symptoms – Kapha Vruddhi Lakshana
Is expulsion of kapha the ultimate sign of comprehensive purgation?
Purgation is said to be comprehensive and fruitful if kapha is seen at the end of the purgation. Along with this, the number of bouts and quantity of purged material should be in accordance to the type of purgation administered i.e. major cleansing, moderate cleansing or minor cleansing. Also signs of proper purgation should be present.
|Shuddhi – type of cleansing||Signs of cleansing|
|Maniki – quantity of vomited material||Vaigiki – number of bouts of emesis||Laingiki – symptoms of proper emesis (common for all types of cleansing)||Antiki – dosha seen at the end of emesis|
|1. Pradhana – major cleansing||4 prastha – 2592 grams||30 bouts||Timely expulsion of doshas Expulsion of feces, pitta, purgation medicine, kapha and vata in that order Purification of channels and sense organs Lightness of body Kindling of digestive fire Suppression / cure of diseases for which purgation was administered Downward movement of vata Absence of signs of incomplete evacuation or excessive evacuation||Kaphanta – expulsion of kapha at the end of purgation|
|2. Madhyama – moderate cleansing||3 prastha – 1944 grams||20 bouts||Kaphanta – expulsion of kapha at the end of purgation|
|3. Avara / Jaghanya – minor cleansing||2 prastha – 1296 grams||10 bouts||Kaphanta – expulsion of kapha at the end of purgation|