Virechana 02 varanasi

Virechana in
Panchakarma ‐02
Virechana in Panchakarma -02
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/
Ayurmitra, Nadi Bhishak, Jyotisha Vaidya
Prof KSR Prasad (Technoayurveda)
9290566566/9503227966 / technoayurveda@yahoo.com
Panchakarma CME for Medical Officers from 22‐27 November 2021 @

We learn today …
• Identification of effective
Virechana Drugs.
• Standardization of Virechana
Drugs.
• Assessment of mode of action
of Virechana Drugs.
• Standardization of dose of
Virechana Drugs.
• Differentiate the conditions to
administer Tarpanadi Krama,
Peyadi krama and Rasa
samsarjana krama and its
rational use according to
Desa, Kala and Satmya.
Virechana in Panchakarma - 02

01
Introduction
• One have to choose
wisely the Drug that
not only makes
evacuation of
stomach content but
also the Dosha based
and disease
perspective.
Virechana is defined as
eliminating the body bio
waste especially Pitta
through lower GIT route

01
Importance of Desha
• Jangala – Usually with increased vata dosha
and constipation or hard stools is the result –
so, a regular Anulomana and in disease state
Teekshna Virechana is indicated
• Anupa – is with increased Kapha – so,
Madhyama Virechana is indicated only after
proper vamana karma
• Sadharana – will have normal dosha patterns
– so, based on disease the type of Virechana is
undertaken

01
Importance of Kaala
• Nitya Kala – a normal person as prophylactic
measure or health improvement protocol or in
elderly age and diseases where the body dosha
can not be removed at once (Udara, etc) – a daily
Virechana is indicated from Mrudu to Teekshna
Virechana
• Vyadhi kala – usually in Sanchaya – Prakopa –
Prasara states we can directly eliminate the
Dosha –
– if not Dosha are brought to Koshta with Sneha‐Sweda
and eliminated

01
Importance of Satmya
• When Satmya / habituated Virechana drug
patients require Virechana we need to
undergo with a Teekshana Virechana. One of
such yoga used for Krura Koshta is –
– Abhayadi Modak 1‐2 tab +
– Triphala Churna 2 Tsf +
– Trivrut Avaleha 15gms +
– Eranda Tailam 15 ml

01
Virechana Mode of Action
• All Virechana drugs are with Adhobhaga
haratwa – could be understand as
Hypermobility
– Adhobhaga indicates – Amashaya, Pakwashaya,
Purishashaya, Koshtanga – Yakrut, Pleha, Kloma
• We need to understand the target organ /
type of water soluble mala removed from
rectum along with fat soluble (Snehapana end
product reaching Koshta)

01
Mode of Action
• Under the target –
– 1) Hyper Motility causation in intestines is
through motilin which is generated in stomach
– 2) Osmotic action (Anupravana Bhava) in
intestines to percolate fluids along with biowaste
chemical products (Hydrochloric acid, Urea, uric
acid, etc)
– 3) Specific Pitta elimination – reflective as
reversal of systemic acidosis in which pH of the
body is brought to normal and Acid peptic flora of
stomach is removed to have new layers

01
pH of Blood in Virechana
• Blood acidosis or Low pH can impact body
functions is a warning sign
• Food do not alter pH but the impact over digestive
system or infection can alter ‐ common acids that alter
pH are ‐
– Lactic acid ‐
– Keto acids – Prameha, Madhumeha
– Sulfuric acid,
– Hydrochloric acid,
– Phosphoric acid,
– Carbonic acid are

01
Lactic acidosis
• Lactic acidosis is a medical condition
characterized by the buildup of lactate
(especially L‐lactate) in the body, with
formation of an excessively low pH in the
bloodstream.
– Lactic acidosis occurs when there's too much
lactic acid in your body. Causes can
include chronic alcohol use, heart failure, cancer,
seizures, liver failure, prolonged lack of oxygen,
and low blood sugar. Even prolonged exercise can
lead to lactic acid buildup.

01
ketoacidosis
• Diabetic ketoacidosis is a serious complication
of diabetes that occurs when your body
produces high levels of blood acids called
ketones. The condition develops when your
body can't produce enough insulin.
– Diabetic ketoacidosis (DKA) is a serious condition
that can lead to diabetic coma (passing out for a
long time) or even death. When your cells don't
get the glucose they need for energy, your body
begins to burn fat for energy, which produces
ketones.

01
Sulfuric acid
• In the human body, only the amino acids cysteine
(nonessential) and methionine (essential) contain
sulfur. This means that many proteins containing
them are able to produce small quantities of
sulfuric acid when metabolized.
– The influx of sulfuric acid into the skin is partnered
with the immediate dissociation of its hydrogen ions;
the pH of the affected tissue drops rapidly. In this
highly acidic environment, the surrounding cells die,
leading to coagulation necrosis, eschars (dry, black
tissue) and thrombus forming in the capillaries and
larger blood vessels in the case of second and third‐
degree burns.

01
Hydrochloric acid
• Stomach has hydrochloric acid helps body to
break down, digest, and absorb nutrients
such as protein. It also eliminates bacteria and
viruses in the stomach, protecting your body
from infection.
– Low levels of hydrochloric acid can have a
profound impact on the body's ability to properly
digest and absorb nutrients. Hypochlorhydria is a
condition marked by low levels of stomach acid.
Cause digestive problems, a lack of vitamins, or
stomach infection.

01
Phosphoric acid
• Phosphoric acid is made from the mineral
phosphorus, which is found naturally in the body.
It works with calcium to form strong bones and
teeth. It also helps support kidney function and
the way your body uses and stores energy.
Phosphorus helps your muscles recover after a
hard workout.
– Extra phosphorus causes body changes that pull
calcium out of your bones, making them weak. High
phosphorus and calcium levels also lead to dangerous
calcium deposits in blood vessels, lungs, eyes, and
heart.

01
Carbonic acid
• Carbonic acid is important in the transport of
carbon dioxide in the blood. Carbon dioxide
enters blood in the tissues because its local
partial pressure is greater than its partial
pressure in blood flowing through the tissues.
– In the lungs, carbonic anhydrase reverses the
reaction, turning the carbonic acid back into CO2
to be exhaled. This process also maintains blood
pH by controlling the amount of bicarbonate ions
and protons dissolved in the blood.

01
Indication of Virechana
• Purana Jwara / Doshadhikyata – Draksha Amalaki,
Trivrut Madhu, Triphala Madhu, Aragwadha Dugdha,
Triphaladi Modaka,
• Prameha / madhumeha – Katphala haritaki, Triphala
Kwatha,
• Udara – Nitya Virechana – Snuhi Gomutra, Snuhi
Ksheera, Yakrut Plehari Yog, Abhayarishta, Doshahara
Eranda Taila
• Kushta – Trivrut, Danti, Triphala,
• Pandu – Danti Ghruta, Danti Phala Phamta, Gomutra
Dugdha, Trivrut Swarnaksheeri,
• Gulma – Tilvaka Gruta, Danti Haritaki
• Shotha –Kamsa haritaki, Mutra Virechana,

01
Indication of Virechana
• Urdhwaga Raktapitta – Trivrut Abhaya
• Grahani – Tilvaka Ghruta, Sudha Triphala Kshara,
• Hikka Shwasa – Teekshna Virechana after
Vamana
• Visarpa – Karanja Dugdha, Triphala Trivrut
• Kasa – Trivrut Avaleha
• Unmada – Virechana
• Agnimandya – Sukha Virechana
• Arsha – Sukha Virechana, Pippali Haritaki,

01
Virechana Drug Dynamics
Atyagni Mandagni Samagni
Combustion Indigestion Digestion
– Induction of Hyperperistalsis
‐ Absorption in to circulation
‐ Collection of Bio waste through
Anupravana Bhava
(Pitta – Acidic pH Bio waste)
Dosha Koshtagati
Adhobhaga Dosha Harana
Virechana
Vamana
Adversity Reaction
No Result
Motilin is the hormone that is cyclically
released during the fasted state and is
released by the entero-endocrine cells
(Mo cells) in the upper small intestine.
Motilin stimulates gastric and small
intestine motility, causing undigested food
in these regions to move into the large
intestine.

01
Identification of Virechana Drug
• Sharngadhara – Anulomana, Sramsana,
Bhedana and Virechana classification is based
upon the removal of Dosha after Paka or
without
– Paka is transformation or digestion of the Koshta
contents – Dosha, Mala, etc.
• Virechana is not mere evacuation of intestinal
content by generating hyper motility
• The Drug acts even in else where systems to
drag the metabolic bio‐waste to Koshtanga

01
Anulomana
• The anulomana is a Medicine –
• the Pachana means the process of digestion
• Mala‐Bhedana indicates the bio waste
molecules to break in to smaller and facilitates
& permeate through intestinal wall
• Adhonayet represents the increasing motility
through Motilin production

01
Sransana
• Either Digested or undigested bulk segregation
which is adhesive in Koshta / Intestines is
removed through recum is Sransana
Virechana
– This much more to remove only abdominal
content

01
Bhedana
• The digested food of past getting Pindikrita
either because of lack of water or impaired
water metabolism that prevents the normal
motility and stool evacuation is eliminated by
Bhedana Virechana
– The Bhedana works locally much and breaks
bigger molecules in system

01
Rechana
• The Mala either digested or not but
accumulated in the intestines is propelled out
by liquefying is Rechana
– Here we observe water transportation from
interstitial compartment to Gut along with Bio‐
waste
– Rechana may remove only water soluble bio waste

01
Standardization of Virechana Drug
• At present we get many combination and
permutation of Virechana drugs in the market
• The Virechana drug mainly acts over –
– Digestion (Achapitta, Pachaka pitta, Mlaarupapitta)
– Blood pH (all acids)
– Water Metabolism
• The drug standardization needs to observe
these issues while grading the Virechana effect

01
Standardization of Virechana Dose
• The dose is to be determined by Age and GUT
activity of individual based on Mrudu to
kathina which is body fluid dependent
• The drug acting time also plays an important
role with quantity of Virechana drug
• All Churna or Lehya require 15 gms
• The Yoga told in specific Diseases by Acharya
do require emphasis as a combination in
which the dose is readily described

01
Selection of Virechana
• Virechana is commonly used Panchakarma but less
focused in literature and mostly narrated as like
Vamana Karma
• Virechana selection is best to adopt in –
– Anulomana – Digestive disorders or Amashaya Samutha
Vyadhi; Amlapitta
– Sransana – is used the Koshta involvement such as Liver
etc. ; Udara
– Bhedana – is used in water metabolism impairement and
added heavy molecular bio waste in blood ‐Kamala
– Rechana – is used very commonly to clear the stools from
intestines where water metabolism is impaired ‐
Malavashtambha

01
Sansarjana Krama
Megha R. Survase , A CRITICAL ANALYSIS OF SAMSARJANA KRAMA, wjpmr, 2018,4(3), 176‐183

01
Sansarjana Krama
(P‐Peya; V –Vilepi; AY‐ Akruta Yusha; KY‐Kruta Yusha, AM‐Akruta Mamsarasa; KM‐Kruta Mamsarasa, PB‐Prakrutibhojana;
E‐ evening; M – morning; PC‐ Padartha Chandrika Tika, IT – Indu Tika, SST – Sarvanga sunder Tika, CT – Chakrapani Tika)

01
Sansarjana Krama

01
Conclusion
• Virechana a major eliminative & Putative
Panchakarma procedure is day to day used
modality in Ayurveda Treatment Schedules
• It starts as Koshta Shuddhi before to initiate
treatment
• Used as Nitya Shodhana in long standing diseases
and Geriatric population
• Practiced in 4 stage Karma Based Sharangadhara
Anulomana etc. model for all Pitta diseases
involving Annavaha, Purishavaha, Udakavaha,
Rasavaha, Raktavaha, Medovaha srotas in specific

01
Thank
You

Virechana 02 varanasi

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