Keep the body fluids clean and

pure for a healthy life…….

Virechana
 This Presentation has 2 parts -

1. Principles of Virechana

2. Practice of Virechana with

Standardized Protocol
I. Principles of Virechana
 Sodhana - Purification of
Body

1. Trans membrane

2.Trans dermal
Trans membrane
Trans Dermal Purification

Special treatments of Kerala

Where are the changes in the
patient….???

Doshas
Dooshyas
Srothuses
Agni
Ojus
Where are the changes in the
patient….???

 Cell
 Tissues
 Channels
 Systems…
 Hormones..
 Enzymes..
 Electrolytes
 Body fluids
 Osmosis
 The Therapeutic Profile…..

Virechana is a procedure in which the

prakupita doshas are expelled through
adhomarga by the administration of
medicines through oral route.
 Virechana
Most commonly employed Shodhana
Easiest administration
Least complication
Maximum efficacy
Highly cost effective

Most popular procedure

Medicines are used in different forms
like-

Choorna, Kwadha, Sneha, Lehya etc,

depending on the condition of the
patient.
 Virechana - Indications
Utklishta pitta
Pittasthanagata kapha

Sramsana – Pittam va kaphapittam va

pakwashyagatam

Mridu Samsodhana for vata

Effective in Sannipatha pathologies

Therapeutic targets

 Pitha dosha elimination

 Raktha prasadana

 Vathanulomana

 Agnideepthi
Contra indications - virechana

Ama / Ajeerna

Agnimandhya

Bahukapha
 Indications
Gulma Pkwashaya ruja
Arsha Yoni / sukraroga
Vishpota
Krimi
Vyanga
Kamala / pleeha Vatarakta
Jeernajwara Oordhagaraktapitta
Udara / pleeha
Mootraghata / Shakrithgraha
Chardhi
Vidradhi Kushtha
Thimira / Kacha Prameha
Syandha
 Indications
Gastrointestinal
Genito urinary
Hepato biliary
Dermatological
Metabolic
Auto immune, Chronic infective
Bleeding disorders
Respiratory
Ophthalmic
 Special indications

Pakshaghata

Udara
 Contra indications
Acute pyrexia
Adhogaraktapitta
Gudapaka
Atisara
Shosha
Atisnigdha
Mandagni
Kroora koshtha
Basic criterias before Virechana

 Dosha domination
 Srothodushti type
 Agni status
 Koshta Stage
 Assessment of Koshta
Kroora
Mridu
Madhyama

Samadosha madhyama
Kaphadhika madhyama

Vata kapha
Vata pitta
Classification of Virechana

Mridu virechana

Sukha virechana

Theekshna virechana
 Classification

Snigdha virechana

Rooksha virechana
 VIRECHANA

Classification and model

drugs

Sukha Thrivrit
Mridu Aragvadha
Tikshna Snuhiksira
Snigdha Taila
Ruksha Choorna
 Classification
Anulomana

Sramsana

Bhedana

Rechana
 Anulomana

Paka of Mala
Removal of Banda
Adhonayana

Harithaki
 Sramsana
Semi digested Mala

Separation of slishta mala

Aragwadha
 Bhedana
Bhedana of abdaha, bhadha or
pinditha mala
Adhapathana

Katuki
 Rechana

Draveekarana of vipakwa or
apakwa mala

Thrivrit
 VIRECHANA - Analysis

Anulomana Abhaya Mala paka

Sramsana Aragvadha No paka

Bhedana katuki Breaks

Badha Mala

Rechana Thrivrit Dravikarana

 Poorvakarmas
Snehana
Swedana
Phalamlamushnodaka / Kapha
avridhikara

Time – Shleshmakale gate

Virechana in Vatharaktha-
Practical observations
Patient
Castor oil
50ml Water Vega Output
Milk 50 ml

9.00 AM 100ml 17 1500ml

6.30 AM 600ml 7 <750

Alpa Snehana before virechana
Visha
Abhighatha
Pitaka
Kushta
Sopha
Visarpa
Kamala
Pandu
Meha
 Sleshma Kala

Routine of patient

Season

Appetite
Virechana Oushadha
 Asathmya
 Bheebhatsa
 Dudarsha
 Durgandha

 Highly palatable
Administration of virechana
 Consider Koshta, Kala, Bala
 Oushadha and its mathra
 Peetamatra – Sheetambu sechana
 Antharmukham – Ushnodakam
 Hridya gandha
 Nivatha sukhashyanam – Tanmana
 Alpalpa ushnodaka anukandhayan
 Ushnodaka pana
 VIRECHANA
Promoting the vegas

Ushnambupana

Pani-tapa sweda
 Assessment
 Vaigiki- 30,20,10

 Antiki- kaphanta

 Maniki- 1,2,4 prastha

 Laingiki- sarva, madhya, alpa

lakshana
 Samyak yoga
Samanya lakshana
 (Vata)Mootra, purisha, pitta,
oushdha, kapha (Vata)
 Hrit sudhi
 Kukshilaghava
 Anulomabhava
Avara
Madhyama
Pravara
 Samyak yoga
Characteristic Pravara Madhyama Avara

1 Vega 30 20 10

2 Mana (prasta) 4 3 2

3 Doshantha Kapha Kapha Kapha

4 Lakshana Dosha expulsion, lightness of

umbilicus, wellbeing etc
Ayoga lakshana
 Immediate signs
 Hritkukshi asudhi
 Sleshmapitta utlklesha
 Aruchi, Chardhi, gourava
 Late Signs
 Kandu, kushtha, pitaka, kotha
 Peenasa
 Agnimandhya
 Vathavitmootrarodha
Atiyoga laxana
 Moorcha, Bhrama, Netrapraveshana
 Jeevaadana
 Gudabhramsa
 Thrishna
 Vatavriddha laxana
 VIRECHANA
Paschatkarma

Asvasana
Visrama
Snehachara
Snana
Peyadikrama
Peyadikrama
 Manda (Ending virechana Karma)
 Peya
 Vilepi
 Akrita yoosha
 Krita yoosha
 Akrita mamsarasa
 Krita mamsarasa
 3 or 2 or 1 anna kala
Complications
 Adhmana
 Parikarthika
 Srava
 Hrithgraha
 Gathragraha
 Jeevadana
 Vibhramsha
 Sthambha
 Upadrava
 Klama
II. Practice of Virechana with
Standardized protocol
Standardization
 Standardization of Virechana
Materials

Method

Time of Administration

Assessment
 Materials required

Virechana Oushadha

Anupana Dravya – Honey/Ghee etc

Luke warm water

The Common Virechana drugs –

Avipatti Choorna with honey – 20-40

gm

Bahushala guda
Trivrut lehya 20-40 gm
Manibadra guda

Patolamooladi kwatha – upto 90-180ml

Eranda taila preparations – 25-50 ml

 Pre operative procedures

Samyak Snehana and swedana should be

ensured.

Swedana is done generally in the form of

abhyanga and Ushma sweda for three
days

Food regimen of odana and mudga Yusha

should be followed
On the day of Virechana, the following
things should be ensured before
administering the medicine –

1. Proper sleep in the previous night

2. Proper digestion of previous day’s
food
3. Proper elimination of natural urges
 Time of administration

After sleshma kala,

ie 2 hours after sun
rise.

8-9 am
1. Virechana Oushadha is administered in empty
stomach

2. Proper anupanas like ushnodaka, Madhu, milk,

triphala kashaya, patoladi kashaya, draksha rasa,
ikshu rasa etc. are used.

3.Patient is advised to wash face with cold water

and mouth with Luke warm water and is advised
to smell substances like lemon, cardamom etc to
prevent vomiting .

4. Patient is advised to take rest in the bed and

wait till the urge for defecation occurs.
5.The patient should not force or hold the urge
and should use warm water for all purposes.

6.Whenever he feels thirsty, he should drink

little quantity of warm water sip by sip.

7.Each Vega should be observed keenly and

should be informed to the doctor

8.He can take rest, but shouldn’t sleep in

between the Vegas.

9.Physician should record the vital data of the

patient at regular intervals.
 VIRECHANA
Samyakyoga assessment

Presence of kapha in later vegas

Minimum 10 vegas
Elimination of at least 2 prasta
 Assessment

Patient is observed for the Samyak

Virechana lakshana like

1.Initial expulsion of stools followed by Pitta

(observed as golden yellow colored viscous fluid
with a characteristic bilious odour) and at last
Kapha (mucous)

2.Lightness of the body

3.Subsiding of Vega by itself without causing

excessive weakness
Post- operative procedure

After getting proper appetite,

samsarjana krama should be done as
per suddhi.
 Samsarjanakrama:

Kanji with more water –kanji with

less water – rice with mudga yusha –
if non veg rice with meat soup is
advised for 3/2/1 annakala depending
on suddhi.

Three annakalas are practiced

per day if agnibala is good.
Complication and management:

1.Nausea and vomiting

It may occur at the time of intake of
medicine and during the procedure. To
avoid the feeling of nausea, the patient
is advised to smell lemon.
2.Feeble pulse, Giddiness, Collapse.
Sidhamakaradhwajam with honey and
betel juice, Drakshadi kashaya,
Dhanwantharam gulika can be given in
this condition.
3.Adhmanam- Swedana should be done locally at
abdominal region.

4. Apravruthi of Vega- Ushnajalapana,Swedana.

5.Kandu- Thrikatu with sitha is given

6.Udarasoola- Ushnajalapana, swedana.

Hinguvachadi Choorna can be given if
necessary.

7.Dehydration: Tender coconut water.

Key Links….
 If no vega
Second dose

Leave the day with fasting

Administer Vamana or vasthi as the

condition demands
Virechana after Vamana
14 days gap

Vamana 7 days peyadi 8th day

Prakrithy bhojana 3 days of
snehana 3 days of swedana
virechana
Sadyovirechana

No direct reference

Widely practiced
Nithya virechana
Udara

 Kushtha
Specific Virechana Protocols…
 Treatment Protocol suggested -
Kushta
 Snehapana with Thikthaka/ Aragwadamahathikthaka
ghrutha

 Virechana

 Peyadikrama

 Snehana

 Administration of Jalouka.

 Pitha samana / Kapha samana

 Virechana in Diabetic
Retinopathy

Koshta - Dhathu sodhana

Kledanirharana
Vathnulomatha in Pitha sthana

Thrivrit / Triphala formulations

 Avipathi Choorna
UTI
Amlapitha
Pitha Raktha skin diseases
Liver diseases
Poison
 Trivrit Lehyam

 Hrudyam Virechanam

 Geriatric care

 Pediatric care

 Weak patients
 Old age
 Vatanubandha
Kalyana gulam

 Kaphanubandha
Trivrit Lehyam
 Dasamoolahareethaki

 Anulomana

 Vatakaphahara
 Manibhadragulam

 No oil
 Rooksha
 Vata Kapha hara
 Anulomana

 Arsas
Eranda thaila Preparations

 Nirgundi eranda – LBP

 Eranda Sukumara – Pakwasayavatha

 Nimbamrutherand- Skinn
diseases,Allergy
 Hinguthrigunathaila

 Kaphaja gulma

 Avarana – Obstructive
pathologies
 Mode of Action
Removes the vitiated doshas
Gradual enhancement of metabolic
power
Detoxification
Correction of hormonal
abnormalities…
Correction of circulatory
problems…
 Fluid Replacement in Sodhana

Cellular
Interstitial
Vascular
Serous cavities
Colorectal….
 Samsarjana Chikitsa

Making the GIT fit for further

digestion..
Fluid and Nutritional
supplementation
Nutrients in a natural form
Laghu to Guru Aharas…
Drava to Sthira food….
 Important yoga
 Danthi kalpa
 Patolamooladi kashaya
 Mishrka sneha
 Simple or processed Eranda
 Abhayadi modaka
 Avipathy choorna
 Thriphala choorna
 Thrivrith lehya
Important yoga
Kalyanagula
Hridya virechana
Samasharkara choorna
Abhayachoorna
Danthyrishta
Abhayarishta
Draksha / Aragwadha phalamajja
Senna
 Rasa formulations

Icchhabhedi Rasa

Aswakanchuki Rasa
 Precautions:

The selected medicine should be made

palatable by adding proper adjuvant

Intake of kaphothklesakara ahara should be

avoided on the previous day

Virechanoushadha can be administered in

divided dose within very short duration to
avoid immediate vomiting if necessary.
Time of administration should be
immediately after kaphakala

Indulgence in any other activity should be

strictly avoided like watching TV ,
excessive talking etc.

Intake of excess water should be avoided

Ensure proper subsidence of vega before

administering paschath karma.
 Virechana –Scope of future
Researches…

Assessment of Electrolytes
Assessment of Enzymes and Hormones
Assessment of Neurotransmitters
Assessment on gut movements
Assessment of Osmosis
No ‘ Sanga… ’ Good ‘ Gathi…’