Ayurvedic Guide to Virechana Therapy

Virechan –Part A
• Presented By –
• Prof.Dr.R.R.Deshpande
• (M.D in Ayurvdic Medicine & M.D. in
Ayurvedic Physiology)
• www.ayurvedicfriend.com
• Mobile – 922 68 10 630
• professordeshpande@gmail.com
9/23/2018 1Prof.Dr.R.R.Deshpande

Thanks
• For Contribution in preparing contents
• Dr. Sachin Sarpotdar
• Dr. Mayura Jadhav
9/23/2018 Prof.Dr.R.R.Deshpande 2

Contents of PPT
• 1) Introduction of Virechan
• 2) Causes of Pitta Vitiation
• 3) Pitta & Rakta –Relation ( Ashraya –Ashrayi)
• 4) Virechan –Indications
• 5) Virechan – Contraindications
• 6) Virechan –Benefits

Virechana (Therapeutic Purgation )
• Introduction ---
• This is more accepted Panchakarma or cleansing
process ,than Vaman
• It literally means medicated purgation
• It eliminates the metabolic toxins through anal canal
• Although it is mainly recommended for eliminating
the vitiated Pitta it is used for Kapha & Vata as well

Causes of Pitta Vitiation
• Pitta is Bioenergy ,responsible for all sorts of
Metabolic activities
• Pitta is having qualities like Fire ,heat ,hot,
sharp, light
• Pitta get vitiated due to excess eating of
Pungent, sour & salty food ,Excessive spicy
food like pickles, chatni, chilly sauces , citrus
fruits like lemon, oranges etc.

Causes of Pitta Vitiation
• Preservative containing foods -- like sauces,
pack foods etc., curd, sour butter milk, fish
• Sun exposure
• Prolonged fasting
• Late night work
• Chemical exposure can also provoke Pitta
• Anger, grief, fear like emotions also makes
Pitta imbalance

Pitta & Rakta – Close Link
• Most important thing is Pitta & Rakta dhatu
are closely related with each other
• So vitiated Pitta makes impure blood
• Impure blood is the chief cause of many skin
disorders
• So Virechana is strongly recommend in many
skin disorders


Virechana - Indications
• Diseases created due to Pitta Prakop & Rakta
dushti
• Digestive tract problems like nausea,
hyperacidity, fatty liver, ascites, jaundice,
worm infestations
• Respiratory conditions like bronchial asthma,
cough, nasal discharge
• Joint disorders like Amavata(RA), Gout ( Vata Rakta)

• Virechana is used to purify the blood hence is
used in Skin diseases like Acne, eczema,
allergic dermatitis, urticaria, skin
pigmentation, psoriasis etc.
• Virechan is indicated in anemia, recurrent
headache, acidity as vitiated pitta is the main
cause of all of these
•

• Ayurveda says Pakshaghate Virechanam & for
Udar or Ascites patient ,Nityam Enam
Virechayet !!
• Surgical conditions like- Fistula-in-ano,
Hemorrhoids, Inguinal hernia, Malignant
tumors, thyroid swelling etc.
• It is used in female infertility, before
Rejuvenation therapy & also to treat sexual
problems in males

Virechana – Contra-Indications
• As like Vaman ,virechan also cause water loss
• So debility or weakness ,due to any reason is
contraindication for Virechana
• Pregnancy, Old age, Children
• Very thin or very fat people
• Severe weakness, Dehydrated patient

Virechana – Contra-Indications
• Acute fever
• Diarrhea & Dysentery
• Heart Diseases
• Post natal period
• Ulceration in the anus
• Undiagnosed GI bleeding
• Cystocele, prolapsed uterus

Virechan Benefits
• After a successful virechana , digestion improves,
appetite increases, abdominal bloating and
heaviness disappear
• The mind feels calm and clear, skin inflammation
clears and the body feels clean, strong and vital
• Virechana therapy promotes metabolism and
assimilation by stimulating  the digestive fires of all
the tissues (dhatus) i.e  Dhatwagni while
simultaneously cleanses  waste products and burns
ama.

Virechan Benefits
• It is excellent for all Pitta-related disorders such as-
malabsorption, acne, dermatitis, psoriasis, eczema,
leprosy, leucoderma, hyperacidity, colitis, urticaria,
hemorrhoids, headaches, migraine and allergies
• It also reduces excessive body heat and acidity,
deeply cleanses the blood, liver and bile, promotes
clarity of mind, sharpens the sense organs,
strengthens and rejuvenates bodily tissues and
improves digestion

Virechan Benefits
• It is excellent for persons suffering from gout,
Chronic fever, skin diseases, hematemesis,
anemia, worms, headaches
• Burning eyes, cataracts, Bronchial Asthma,
Jaundice, Epilepsy, Ascites, Disorders of the
bones and joints and Gynecological disorders

In short virechana is beneficial in following way
• It eliminates the morbid Doshas specially Pitta
& secondarily Kapha
• It eliminates the metabolic toxins
• It increases the strength of Agni
• It increases the mental ability
• It improves the functions of sensory and
motor organs
• It increases the longevity

Contents of PPT
• 1) Introduction of Vaman
• 2) Causes of Pitta Vitiation
• 3) Pitta & Rakta –Relation ( Ashraya –Ashrayi)
• 4) Virechan –Indications
• 5) Virechan – Contraindications
• 6) Virechan –Benefits

Virechan –Part B
• Mobile – 922 68 10 630

Contents of PPT
• 1) Pre Treatment of Virechan ( Purva Karma)
• 2) Symptoms of Optimal Snehan or Oiling
• 3) Virechan – Main Procedure ( Pradhan
Karma)
• 4) Advice after Virechan

Virechan Procedure –Pre Treatment
• Snehan & Swedan are called as Purva Karma
• Internal snehan is done for ---
• 3,5 & 7 days till the onset of optimal oleation
symptoms ( Samyak Snigdna Lakshan)
•

• As per the morbidity and diseases, the oil or
ghee are chosen for Internal Snehan.
• Dadimadi Ghee, Yashtimadhu ghee is
preferred in GI disorders like hyperacidity for
Snehan
• Tiktak Ghee, Mahatiktak ghee, Aragvadh ,
Mahatiktak ghee are used in skin diseases for
Snehan

• Vasadi Ghruta is preferred for the bleedong
problem at upper part of body like Epistaxis ,
Haemoptysis

Pre treatment of Virechan
• If the patient is fit for virechan then start
pretreatment i.e. snehana (internal and
external Oleation) and Swedana (fomentation)
• Examination of digestive power can be done
by giving the testing dose of oily substances to
the patient
• This testing dose is termed as ‘Rhasiyasi
matra’ of Snehana

• Time taken by the patient to digest this dose
decides the proper dose. This testing dose is
generally of 50 ml
• So mathematical Equation will be as follows
• If Patient is takes 3 hours for Digestion of 50
Grams ,then How much will be quantity to
Digest in 12 hours ? Answer will be 200 ml .
This will be the last day dose to get Samyak
Snigdha Lakshan
• 9/23/2018 Prof.Dr.R.R.Deshpande 24

• The quantity of sneha to be taken is
increased gradually for 3- 5-7 days in Mrudu,
Madhyam ,Krur Koshtha respectively
• On the next day of Samyak  or adequate
Snehapan i.e  completion of internal oleation,
next  2days-- external oleation and sudation is
given. After 2 days  Virechan  is given with
prior external oleation and sudation.
•

Symptoms of Samyak Snehan
• 1) Sneha Vidwesha ( Nausea of Sneha
Substance)
• 2) Adhastat Sheha Darshan ( Stool becomes
oily)
• 3) Twak Snigdhata ( Skin becomes oily or
shining)

• After the appearance of the symptoms of
proper Oleation ( Samyak Sneha) , internal
Oleation should be stopped
• Give two days break and on the third day one
should go for the process of virechan

• During these two days massage
Abhyanga or Full body oil massage and
fomentation ( Nadi Sweda or Steam box)
should be continued
• During the period of pretreatment
patient should be examined regularly

• The massage is done with oil for two days. For
the external oleation we can use Tila tail,
Sahachar tail, Triphala tail, Balaguduchyadi
oil
• Most of the time tila tail is preferred.
• It is followed by the fomentation in a Steam
box

Main Procedure
• The Virechan drug is given on an empty
stomach with lukewarm water. The cold
water may produce spasmodic abdominal pain
• Usually the Ashwakanchuki Ras ,Icchabhedi
Ras, Narach Ras , Abhayadi modak, Triphala,
Trivritta Leha ( 50 Gm bottle) are used as the
Purgative drugs

Virechan Medicines
• Ashwakanchki Ras (Jayapal 1 part )  is mild
purgative , Icchabhedi is the moderate
purgative(3 part Jayapal), Narach Ras is the
strong  purgative (5 part Jayapal ),
• Trivritta or Nishottar is the main content of
abhayadi modak.
• Jayapal is the main ingredient of  these
purgative combinations

Virechan Medicines Administration
• After having the purgative drugs the patient
should live in a warm room devoid of breeze
• Purgative drug is given at the end of Kapha
period of the morning
• Hence it given around 8-9 am.

Administration of Virechan Medicines
• There is difference of opinion ,about time of
Administration of Virechana drug
• Some give early in the morning at 5 to 6 am
• Some other vaidyas prefer to give in Pitta kala
i.e around 12 noon

How many motions ?
• Different opinions are there about the exact
period of purgative drug administration
• With Icchabhedi Ras, it has been observed
that 10-15 motions take place till 3 -4 pm

Advice –After Virechan
• Patient is advised to take the warm water
during this period to avoid the dehydration.
• Patient is not allowed to lie down till the
process of virechana is going on
• Also he is not allowed to eat anything till
virechana gets complete

Contents of PPT
• 1) Pre Treatment of Virechan ( Purva Karma)
• 2) Symptoms of Optimal Snehan or Oiling
• 3) Virechan – Main Procedure ( Pradhan
Karma)
• 4) Advice after Virechan

Virechan –Part C
• Mobile – 922 68 10 630

Contents of PPT
• 1) Post Regimen after Virechan
• 2) Sansarjankram ( Specific Diet Advice)
• 3) Symptoms of Proper Virechan ( Samyak)
• 4) Symptoms of Less Virechan ( Ayog)
• 5) Symptoms of Excess Virechan ( Ati yog)

Post therapeutic regimen after Virechana
• Take rest in a room devoid of heavy breeze.
Use ‘Sansarjana krama’(Post therapeutic
dietary regimen) for 3-5 or 7 days to improve
digestive power.
• If panchakarmas are to be done, then after
sansarjana krama i.e. at 9th day do Anuvasana
Basti karma and then go for Niruha Basti
Karma

Post-Therapeutic Dietary regimen
• In the diet first three times give only liquid
part of the gruel. (Rice water, Mung soup)
• Then the next three times meal should have
Gruel with little solid portion. (Watery Rice
with Ghee)
• In the next three meal Rice prepared with
(160 Gm Rice) + Green Gram Soup + Rock Salt
+ Ghee
•

Post-Therapeutic Dietary regimen
• Then give Khichadi of Rice & Mung ,followed
by Bajara bhakar ,green leafy vegetables .Then
gradually start normal diet .

Features
• Progressive approach (Shift from light to
normal meal or from liquid to solid diet) is
followed.
• It considers the digestive capacity of an
individual.
• If no other Panchakarma is to be performed,
then after Sansarjana karma patient can start
medicinal therapy i.e Shaman Chikitsa

Symptoms of proper purgation
( Samyak Yog)
• Elimination of stool, Pitta, Kapha and
Vata respectively
• Cleaning of minute body cavities or
channels.
• Lightness in the body
• Increase in digestive power of the
patient

Symptoms of proper purgation
( Samyak Yog)
• Improvement in diseased condition (this
can be observed in due course of time)
by ---
• Reduced relapse rate & also reduced
intensity of symptoms and step down in
health complaints

Symptoms of incomplete purgation
( Ayog)
• Incomplete elimination of impure doshas
• Repeated urge for excretion, but excretion is
incomplete
• Decline in digestive power
• Heaviness
• Coryza ,Drowsiness,Itching
• Vomiting
• Increase in the health complaints

Symptoms of heavy purgation
( Atiyog)
• Symptoms of dehydration ----
• Like excess thirst
• Loss of skin elasticity
• hypovolemic shock with fast & feeble pulse &
drop down of systolic Blood pressure ( In
Shock it may be below 60 mm of Hg)
• Weakness, Tingling, Numbness

Symptoms of heavy purgation
( Atiyog)
• Abdominal pain
• Excretion of watery stool, sometimes
stool may be blood stained
• Burning sensation with penetrating pain
at anus
• Fainting

Contents of PPT
• 1) Post Regimen after Virechan
• 2) Sansarjankram ( Specific Diet Advice)
• 3) Symptoms of Proper Virechan ( Samyak)
• 4) Symptoms of Less Virechan ( Ayog)
• 5) Symptoms of Excess Virechan ( Ati yog)

Virechan –Part D
• Mobile – 922 68 10 630

Contents of PPT
• 1) Pharmacokinetics & Pharmacodynamics
of Virechan Dravyas
• 2) Types of Virechan
• 3) Drug Formulations

Pharmacokinetics & Pharmacodynamics
of Virechan Dravyas
• Ushma (hotness) --- Because of this
quality, impure doshas deeply embedded
in peripheral tissues are liquefied
• Tikshna (sharpness) --- Because of this
quality, the impure doshas which are
sticked to the minute cavities are
scratched out

of Virechan Dravyas
• Sukshma (minuteness) ---
• Because of this quality, the purgative
substance can enter the minute cavities
in the body and be able to perform its
function

of Virechan Dravyas
• Vyavayi ---
• Because of this special type of quality, the
purgative substance need not be digested by
the body
• It is absorbed directly and can perform its
function
• Hence the time duration for starting the action
of the substance is shortened

of Virechan Dravyas
• Vikasi --- This is also a special type of
quality, because of which, the substance
spread all over the body in very short
time duration
• The purgative substances have
domination of prithvi (earth) and apa
(water) mahabhutas

Types of Virechana
• Anulomana – ( Laxative)
• In this type, purgation substance firstly acts on
the waste material
• The waste material (stool) is formed in its
proper form
• After that its constitution is destructed and is
eliminated through the body in semi solid or
liquid form

Anulomana – ( Laxative)
• This process is known as anulomana. It is the
mildest form of virechana.
E.g. Haritaki (performs the function of
anulomana) --Abhyarishta
• Some other examples – Avipattikar churna,
Sukhasarak churna, Trivrutta avaleha, Castor
oil Used in abdominal distension due to gas
or in mild constipation


Sanstrasana
• The purgative substance only scratches the waste
material stick to the wall of intestine and eliminates
through the body
• This process is known as sransana. It is little stronger
than anulomana. Its action is quicker than
anulomana
• Aragwadh (Cassia fistula) performs the function of
sransana -- Aragvadharishta
• This type of virechan is used in the patients with
madhyam koshtha

Bhedana – Mild Purgation
• The purgative substances destruct the rigid
constitution of fully formed waste material
and excrete it in the liquid form
• The process is known as Bhedana
• It is stronger than Sransana
• Kutki (picrorrhiza kurroa) performs the
function of Bhedan

Bhedana – Mild Purgation
• Kutki is the main component of Tab
Arogyavardhini .
• Icchabhedi rasa is the most commonly
used drug for bhedan.It is given in the
patients with krura koshtha
• It is used in Hepatitis, Jaundice

Rechana – Strong Purgation
• The purgative substance destruct the rigid
constitution of waste material (either fully
formed or not) and eliminate it in the liquid
form, is known as Rechana.
• It is the strongest form of the
virechana. Trivruta (Operculina terpethum)
performs the function of rechana. Another
example is Naracharas


Another classification of virechana-

• Snigdha virechana –

• Purgation induced by oily substances is
known as snigdha virechana
• It is used in Jaundice, anemia, Arthritis.
e.g. Erand (Ricinus communis)

Ruksha virechana
• Purgation induced by ----
• Non-oily substances is known as Ruksha
virechana
• Trivrit powder (Operculina terpethum) ,
Abhayadi modak, Icchabhedi rasa

Drug Formulations
• Icchabhedi Ras --- 80 mg with warm
water.
• Erand Taila (Castor oil) ---- 15 ml for
Mrudu Koshtha,25 ml for moderate and
40 ml for Krur Koshtha
• Combination of Trivrit (Operculina
turpethum) & Swarnaparni (Cassia
angustifolia) --- 3-10 Gm

Drug Formulations
• Aragvadh Kapila Vati ---- 250-500 mg
• Narach Ras ---- 60 mg
• Ashwakanchuki Ras- 125 mg
• Abhayadi modak – 60 mg

Contents of PPT
• 1) Pharmacokinetics & Pharmacodynamics
of Virechan Dravyas
• 2) Types of Virechan
• 3) Drug Formulations

Virechan –Part E
• Mobile – 922 68 10 630

Contents of PPT
• 1) Virechan in Clinical Practice
• Worms
• Burn wounds
• Acne Vulgaris ,Urticaria
• 2) Case study

Virechana In Clinical Practice
• 1)  Virechana is used in Amavata(RA) ,reduces
Relapse rate & Intensity of Joint pain
• 2)  Virechana is beneficial in Sciatica
• 3)  In Obesity --- Shodhan like Virechana is
given in the beginning to Detox body .This is
followed by Tripod Management with Diet +
Exercise + Internal Medicines like Triphala
Guggulu or Medohar Guggulu

• 4) In worms – Kampillak is used for this
(AragVadh Kapila Vati or tablets are available)
•
• 5) In Burn wounds ---- Rose powder, dried
grapes, Jeshthamadh, Bahava decocution is
used for this patient. Within the a week period
the wounds heal. Local application of
Shatadhouta Ghee is also used

• 6) Virechan in the acne --- Virechan shows
wonderful result in Acne vulgaris ,which is
most common problem of youngsters .
• Panchatiktak gruta is used for internal oleation
or Snehapan ,prior to Virechana

A Case Study
• A 30 years old male C/O Arthritis
• His RA factor was positive
• It was started after falling down in the
bathroom. Patient was operated
Laminectomy had done. The deformity in the
posture was appeared after the surgery
• He used to take analgesics almost every day to
get rid of his joints pain

A Case Study
• He travelled Kerala twice for specialized
Ayurveda Treatment but got temporary relief
for the short period
• Then he was advised for Virechana
• Dadimadi Ghruta was given for Snehan

A Case Study
• After the optimal Snehan (7-days) the two
days massage with Bala Guduchydai oil was
done for 45 minutes in the evening period.
• Swedan was done after the oil massage

A Case Study
• Icchabhedi Ras (Baidynath) 1 tablet was given
with water; in the morning at 8 am
• He had 12 motions till 4 pm
• He was advised to follow the dietary regimen
for 5 days
• Patient got relief from pain and had not taken
any analgesic tablet in the three months
period

A Case Study
• His weight was also improved
• Overall quality of life ( QOL) was improved
• However it is necessary to monitor the
patient for the next 1-2 years to observe the
relapse

PK 20 –By Prof.Dr.R.R.Deshpande
• Sharing of Knowledge
• FOR
• Propagating Ayurved

Ayurvedic Guide to Virechana Therapy

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