Virechana Therapy – Right Method, Side Effects, Management

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.

Stomach and intestine

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
Vomiting
blindness, Cataract
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,
Dysuria, constipation
skin diseases
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
Elephantiasis, Filariasis
Schizophrenia
cough, cold of Pitta origin,
chronic respiratory tract disease, Asthma
nausea, herpes
vitiated breast milk
indigestion, Anorexia, lack of taste, obesity
heaviness
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,
lassitude,
sleeplessness or excessive sleep,
drowsiness, weak sense organs,
impotency,
impediment to intelligence,
loss of strength and complexion in spite of the intake of nutritious diet.

Virechana contraindications

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
diarrhoea, dysentery
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 therapyvomiting 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 procedure

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 –
tiredness, slimness,
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 purgationVirechana 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 –
Speaking aloud,
Excess eating,
Sitting at one place for long time,
Walking long distances,
Anger and grief,
Exposure to sun, dew and stormy wind,
Travelling,
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

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.

Note:
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.

76 thoughts on “Virechana Therapy – Right Method, Side Effects, Management”

  1. I found this article very beneficial as I am undergoing vamana and virechana for psoriasis. It guided me on each and every step.

    Reply
    • What would be a suggested virechana dosage and duration for using
      Castor oil / Trivrit Lehyam / Avipathikara Choornam at the end of a 7day Ghee Snehakarma? Can Avipathikara Choornam be used alone, dosage?

      Reply
      • It depends on many factors, mainly – Koshta – digestion strength of the patient. Some may have purgation with only 5 – 10 grams of Trivrit Lehyam but some may not get even with 30 grams.

        Reply
  2. Thanks for the detailed information! Very, very useful.
    I’ve a few questions:
    -Is one day’s Virechan enough in Vata-Pitta conditions?
    -In usual practice, how many Virechans are given in succession?
    -If more than one Virechanas are given, then are they given on consecutive days?
    -Similarly, in usual practice, how many VamanaKarmas are given in Panchakarma therapy?

    Reply
  3. Hi, I suffer from mild-stark acne, and thouht that doing a virechana would be useful.
    Do you agree or are there other things to do?

    Reply
  4. Thank you doctor. In the end you mentioned for a normal person with Pitta body type they need to undergo regular virechana especially during fall. How often should that person do virechana and which months. Thank you

    Reply
  5. thanks for the useful information.

    How often one can go for virechana? (because psoriasis is reoccurring even after virechana)

    Reply
    • Dear sir, Would advise you to take expert suggestion in this regard. The Ayurvedic physician will assess you and lay down the treatment for you based on the severity of psoriasis, the kostha , bala and Age.

      Reply
  6. Very informative thank you. This week iam taking virechana treatment tomorrow I will be taking 90ml of the medicated ghee and have to go for body massage and the following day I will be taking the leghyam. Can you tell me what kind of massage will be given to me tomrrow. Iam taking this treatment for allergy rashes

    Reply
    • Hi, general full body oil massage (Abhyanga) with skin benefitting oil such as Eladi taila / Manjishtadi taila / Nalpamaradi oil etc may be given to you. The choice of oil rests with the doctor.

      Reply
  7. Namaste Sir, Virechana Treatment should be done under medical supervision only and cannot be done at home.

    Reply
  8. I have an allergy to tomatoes ashwagandha is nightshade and related to tomatoe will this affect me taking the ashwagandha. Thank you

    Reply
    • Hi, unlike other nightshades, root of Ashwagandha is used. Hence, people who have nightshade allergy can take Ashwagandha.

      Reply
  9. Triphala is mild, compared to Trvrit Lehya. Hence, it is best to take it before night, after food
    If the purgative quantity is less, increase the dose of churna at that night.
    If it is more, than kutaja ghanavati tablet – 2 tablets 2 or 3 times a day after food needs to be taken.

    Reply
  10. Sir ,Would the candidate go through the same multiple vegas (10 or more) when the purgative is consumed a night before the virechana day as one would have in the morning of the virechana day ?

    Reply
    • If someone has Mrudukoshta (soft, sensitive colons), milk alone or milk + sweet raisins act as laxative. This can be used once in two days time, as laxative.

      Reply
  11. Hello, I have uterine fibroids and did virechana therapy and the next menses were heavy, purple, thick and had clots. Is this normal?

    Reply
  12. My son has undergone both Vaman and verechan therapy for his skin ailment(eczema). In the process he has lost 15kg weight due to diet restriction. Is it all right?

    Reply
  13. You will have to consult an Ayurveda doctor. Do not self-do Virechana. It can be very dangerous.

    Reply
  14. Im going through virechana therapy today…but i gone through only 3 motions n its stop automatically….is it ok

    Reply
  15. Doctor, for 7 days i drank ghee and other 2 days snehan. Now today drank senna as purgative. But it is not working. I am not able to clean my stomach. Does it mean i need to drink more of senna? I feel hungry though. During ghee drinking time i used to have diarrhea. Thank you!

    Reply
  16. Hi, it is fine to stop at 150 ml.
    Usually protein rich drink is given as an alternative to meat juice.

    Reply
  17. Hi doctor,

    In the course of panchksrma treatment, I was treated with shirodhara for 3 days after that I coul.not go out because of excess heat. When I faced heat, felt dizzy and weak. Doctors gave me aswagandha churns, godanti bhasma, prabal panchamruit, mukhtar sukti bhasma, jahar mohara pisti with panch tikta kwath. Again they are giving me enema and I am feeling better. Instead of shirodhara they gave me takradhara. It is helping but not completely. I can not tolerate heat at all I have excess pitta in my body. What should I do in this case? I did birechan in February. I would like to do proper birechan next time. How should I go for best result? I have burning sensation on my back. Extremely Looking forward to hearing from you. Thank you so much.

    Reply
  18. I have psoriasis.I had undergone vamana and now i am undergoing virechana.vamana had improved my condition.i had oil massage and steaming all days.the diet i am following is normal except to avoid tamarind and curd.will this alone cure psoriasis as i have lesions in 10 -15% of my body?

    Reply
    • Hi, usually Vamana and Virechana treatments, followed by Ayurvedic medicines are very useful. Please go ahead as per your doctor’s advice.

      Reply
  19. I passed through virechana bedore 6 days… 9-10 motions only I did… after virechana day I didn’t go for motion yet… I m on liquid diet for first three days… afterward I started with boiled vegetables… I m worried if virechana improves digestive system so why still no any motion passed away???… is it normally happened or something is wrong sir??

    Reply
  20. Is virechana treatment useful on fibrosis? Can fibroids completely removed or it will only shrink In their sizes..

    Reply
  21. I took uptil 12 tea spoon ghee till day 4, day 5 I felt like vomiting, I couldn’t take more than 3, and I got my periods now which is at least a week in advance why ? And what shall I do now ?

    Reply
  22. Respected Sir,
    I am sharing a link with you. I am sharing it to have your opinion on the liver cleansing method which I think is VIRECHANA with olive oil and the process seems to be rather easy and super safe.Do you find any harm in following this method.https://www.youtube.com/watch?v=LvNzNLkVdOY
    Sir what is “EPSOM SALT” called in Ayurveda ?

    Reply
    • I live in jaipur rajasthan.I a reday to go elsewhere if I can have better places.First preference is obviously jaipur then north india and then south india.

      Reply
  23. How deep seated pitta could this method pull out in your opinion sir ?
    Could we replace olive oil with ghee in this ?

    Reply
    • Castor oil or Trivrit Lehya is used.
      Purgation treatment cannot be done by yourself. Please consult an Ayurveda doctor directly.

      Reply
  24. Hi, the purpose of virechana is to expel out toxins from all parts of body through the gut. The oil massage helps in loosening these toxins and bringing them to the gut.
    Coconut oil is a coolant and does not stimulate movement. Hence, sesame oil based herbal oils are more suited. If they are bad smelling, a pinch of camphor can be added to the oil to make the smell tolerable.

    Reply
  25. Respected Doctor,
    You have mentioned the use of PURGTIVE FOODS if the internal snehan itself starts loose motions. What are those purgative foods that should be taken if the virechan starts at the internal oleation stage ?

    Reply
  26. Can the virechana loose motions be stopped midway through the vegas by some means if the atiyoga symptoms are begining to appear but havenot fully appeared ? Does stopping the warm water drinking stops the vegas ?

    Reply
  27. I have read almost all your articles .All of them are very clear and you have made all efforts to make the language simple for a layman to understand . Kudos to you Doctor .. Happy New Year and God Bless !

    Reply
  28. Namste Sir
    Kya virechna kriya krnese luecodurma thik hota he…
    Aur weight gain ke liye virechna helpful he

    Reply
  29. hi doctor..
    appreciable efforts u r doing sir .. really impressive..
    just wanna know bit about sadhya virechan.

    Reply
  30. Appreciate the kind of effort you have put in to write so many articles. Keep up with the good work God Bless.

    Reply
  31. Hi Doctor,
    You mentioned in the article that vamana has to be followed by virechana. Can virechana be taken alone, without preceding vamana?

    Reply

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