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Virechana concept and practice
1. Page 1
Virechanam
Concept and Practice
Dr Ananth Ram Sharma
MD Panchakarma, (PhD).
Associate Professor
Department of Panchakarma
Amrita School of Ayurveda
Presented at Institute of Management at Government, Kakkanad.
At training program in Panchakarma for medical officers of ISM on
11/06/2013
2. Page 2
Introduction
• Shodhana – Drava Shoshana.
• Procedure of Choice for PITTAJA VIKARA.
• Wide applicability and simplicity
• 40 % of patient in our hospital
14. Page 14
Purgation and Virechana-
Karma
Virechana karmaVirechana karma PurgationPurgation
Have systemic and local
Action
Only local action
Eradication of systemic
disease
No such action
Prior to it assessment of
Kosta, Agni and Doshas
are important
No such assessment were
made
Poorvakarma is essential Poorvakarma is not done
Have the preventive role Not have any preventive
role
17. Page 17
Procedure of Virechana
Karma
PoorvakarmaPoorvakarma
Selection of patient
Examination of patient
Assessment of Koshta & Agni
Deepana – Pachana
Snehana – Swedana
Vishrama kala
18. Page 18
Vamana Before
Virechana?
Decide by
• Roga bala
• Rogi bala
• Avasta of disease
• Condition of Dosha
Eg: In case of kusta if kapha is predominant
then one should go for vamana
19. Page 19
Diet Before Virechana
• Kapha avriddikara
• Snigda drava, ushna ahara
• Mamsa rasa
• Yoosha
• Amla rasa
• Laghu Bhojana
22. Page 22
Matra acc. Classics
• Uttama- 2 pala, Madhyama – 1 Pala, avara – ½ Pala (Bh.Si)
• 1,2,3 Tola is Mentioned for Mridu, Madhyama and Krura (Su.Chi)
Kalpana Hina for
Mridu Koshtha
Madhyama
For Madhyama
Uttama for
Krura
Kwatha 02 Tola 04 Tola 08 Tola
Kalka, Churna, Modaka 01 Tola 02 Tola 04 Tola
Swarasa 01 Tola 02 Tola 04 Tola
Ushnodaka 04 Tola 08 Tola 12 Tola
23. Page 23
Guidelines Followed After
Administration
• Ask the patient not to close the door of toilet
• Hot water gargling
• Have some fragrance
• Intake of water ? Ushna Jala/ Shita Jala
• Vega should not be induced or retained
• Time should be noted
• Keen observation of content of Vega
• Avoid sleep
• Tambula Sevana
• Avoid shitala Vihara
24. Page 24
Practically Encountered
Problem• Chardi soon after giving medicine?
• Chardi after 2-3 hours of administration?
• If virechana won’t happen ?
• If only 2-3 vega observed?
•Aushadha Jeerna Lakshana
•Aushadha Ajeerna Lakshana
•Samyak Shuddhi
•Bala traividyam
•Vyapat
•Shesha Dina
Any intervention only on the following observation
29. Page 29
Samsarjana Krama
Day Annakala Pravara Madhyama Avara
1st Morning - - -
Aft. Noon - - -
Evening Peya Peya Peya
2nd Morning Peya Peya Vilepi
Aft. Noon Peya Vilepi Kruta yusha
Evening Vilepi Vilepi Akrutmamsa rasa
3rd Morning Vilepi Akruta yusha Krita mamsa rasa
Aft. Noon Vilepi Kruta yusha Normal diet
Evening Akruta yusha Akrita mamsa ras or
akrita masha yusha
4th Morning Akrut yusha Krita mamsa rasa
Aft. Noon krut yusha
Evening Akrita Mamsa rasa or Krita yusha
5th Morning AKrita Mamsa rasa or Akrita yush ras
Aft. Noon krita mamsa rasa or krita masha
yusha
Evening Normal diet
30. Page 30
Nutritive Values
K.
Cal
Prot Fat Carb Phos Fe Cal Thim N.
acid
Rib Vit C
Peya
100 gms
94 2.7
gm
2.2
gm
15.8
gm
0.07
gm
0.25
mg
0.11
gm
0.04
gm
0.11
mg
0.12
gm
3.3
mg
Yusha
100 gms
158 5.5
gm
3.6
gm
25.6
gm
- 3.4
mg
0.05
gm
0.04
gm
0.04
mg
0.28
gm
-
31. Page 31
Benefits of Samsarjana
Krama
• Immediate supply of Calories and
Nutrition
• Restoration of digestive power through
specific dietary schedule.
• Absorption and assimilation function of
GIT get increase.
32. Page 32
Pariharya Vishaya
• Speaking loudly.
• Excessive meal.
• Excessive walking.
• Anger and sorrow.
• Sleeplessness.
• Day sleep.
• Incompatible diet.
• With holding natural
urges.
• All these causes GI
upset, further it
will lead to
formation of Ama,
hence aim of
Virechana will fail.
33. Page 33
Nitya Virechana
• Elimination of excessive fluid
• Reliving the constipation
• Acts as diuretic
• Increase of appetite
What may be the scientific reason?
34. Page 34
Virechana as preventive
measure
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• Disease deterrent
• Delay the process of ageing
• Bio purifier
35. Page 35
Virechana as curative
measure
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• Removes the morbid Doshas
• Multiple therapeutic benefit
• Effect on specific disease
36. Page 36
Virechana as Rasayana & Vajikarana Poorva
karma.
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Enhance the drug absorption -
Removing interfering molecules or ions.
Enhancing mucosal blood supply
Altering secretary function
?
37. Page 37
Diminished activity of GI tract
Intestinal villi blunted by many GI disorders due to
ischemic condition
Irritant activity of virechana drug
Re dilate arteriole and correct the blood supply
Increase the parasympathetic activity
Enhances absorption and removes the morbid Doshas
and waste products
Bioavailability of Rasayana and Vajikarana drugs increases
38. Page 38
Mode of Action of Virechana.Mode of Action of Virechana.
39. Page 39
Causes physician induced inflammation
Increased propulsive movement and
irritant properties of virechana Dravya
Increases permeability of the capillaries
Then patient gets Virechana Vega
40. Page 40
Role of inflammation
Hyperemia
Arteriolar
dilatation
Exudation Dilution of
the toxins
42. Page 42
Elimination of
Pitta
Relaxation of sphincter of oddi
Increase uptake of fatty food
Polyunsaturated fatty acid stimulate
oxidation of cholesterol into bile
Cholycytokinin hormone is released
Stimulate gallbladder to contract
43. Page 43
Elimination of Kapha
• Elimination of kapha
•Large intestine chiefly secretes mucous
•Extreme parasympathetic stimulation
secretes large amount of mucous
44. Page 44
Elimination of Waste
Product
1.Interchange of ECF & ICF
2. Some hormones excreted by liver
3. Liver eliminate it through bile
45. Page 45
Summary
• VirechanaVirechana therapy can be used as
Preventive, Curative and Conservative line
of management
• Virechana hold the supremacy over the Pitta
• Careful assessment of Roga – Rogi – Koshta
– Agni — Oushda is essential
• Importance should be given to Samsarjana
Krama that we usually ignore