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|title=Virechana

|title=Virechana

|titlemode=append

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|keywords=Virechana,Virechana in ayurveda,Virechana meaning,Virechana Definition,Charak samhita,carakasamhitaonline, Indian System of Medicine

|keywords=Virechana, Virechana in ayurveda, Virechana meaning, purging therapy, Charak samhita, carakasamhitaonline, Indian System of Medicine, therapeutic purgation, purgation therapy in ayurveda, detoxification therapy, bio purification, panchakarma, treatment of excess heat, skin diseases, constipation, bowel cleansing therapy   

|description=Therapeutic purgation is one of the five Panchakarma procedures mainly indicated in disorders due to excess vitiation of Pitta dosha and rakta

|description=Therapeutic purgation is one of the five Panchakarma procedures mainly indicated in disorders due to excess vitiation of Pitta dosha and rakta

|image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg

|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg

|image_alt=carak samhita

|image_alt=carak samhita

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|type=article

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{{Infobox

{{Infobox

|label6 = Date of first publication:

|label6 = Date of first publication:

|data6 = December 01, 2020

|data6 = December 01, 2020

|label7 = DOI

|label7 = DOI

|data7 = Under process

|data7 = [https://doi.org/10.47468/CSNE.2020.e01.s09.033 10.47468/CSNE.2020.e01.s09.033]

 

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==Etymology and derivation==

==Etymology and derivation==

 

The word virechana is derived by adding ‘vi’ prefix and ‘lyut’ suffix to the Sanskrit root ‘rich’ [vacaspatyam]. It means evacuation of waste materials (mala nissaranam).<ref name=VCP>Patil V C. Chap.12 Virechanakarma (Purgation therapy), In: Principles and practice of Pancakarma. Reprint ed. New Delhi: Chaukamba publications;2016</ref>

The word virechana is derived by adding ‘vi’ prefix and ‘lyut’ suffix to the Sanskrit root ‘rich’ [vacaspatyam]. It means evacuation of waste materials (mala nissaranam).<ref name=VCP>Patil V C. Chap.12 Virechanakarma (Purgation therapy), In: Principles and practice of Pancakarma. Reprint ed. New Delhi: Chaukamba publications;2016</ref>

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  *Dosage as per Sharangadhara if the medicine used is in the form of paste or tablet or powder form.[Sha.Sa.Uttara Khanda 4]<ref name=Shargadara>Sharangadhara. Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.</ref>

[Dalhana on Su.Sa.Chikitsa Sthana 33/20] *Dosage as per Sharangadhara if the medicine used is in the form of paste or tablet or powder form.[Sha.Sa.Uttara Khanda 4]<ref name=Shargadara>Sharangadhara. Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.</ref>

===Therapeutic purgation (pradhanakarma)===

===Therapeutic purgation (pradhanakarma)===

Therapeutic purgation is always performed late morning during the time of the natural decrease of [[kapha]] [[dosha]] and increase of [[pitta dosha]]. [A.Hr.Sutra Sthana.18/33] <ref name=Hridaya>Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> Practically the purgative medicines are administered between 9 AM to 11 AM <ref name=VCP/> on empty stomach. The person is advised to pass stool whenever the urge is felt and to take rest in between the urges. He should not indulge in other activities and should concentrate in the procedure itself. [Su.Sa. Chikitsa Sthana 33/21]<ref name=Susruta>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005</ref> Drinking a little amount of warm water and mild sudation with warm palms over abdomen region to trigger the urge is advised.[A.Hr.Sutra Sthana.18/36]<ref name=Hridaya/> The person should never withhold the urge for defecation and should not strain while passing the stool [Su.Sa. ChikitsaSthana 33/22]<ref name=Susruta/> as these may aggravate the [[vata dosha]]. After intake of purgative medicine, the person should only use warm water for drinking and cleaning purpose. Cold water may obstruct the movement of [[dosha]] and thereby prevents evacuation due to its styptic action.

Therapeutic purgation is always performed late morning during the time of the natural decrease of [[kapha]] [[dosha]] and increase of [[pitta dosha]]. [A.Hr.Sutra Sthana.18/33] <ref name=Hridaya>Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> Practically the purgative medicines are administered between 9 AM to 11 AM <ref name=VCP/> on empty stomach. The person is advised to pass stool whenever the urge is felt and to take rest in between the urges. He should not indulge in other activities and should concentrate in the procedure itself. [Su.Sa. Chikitsa Sthana 33/21]<ref name=Susruta>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005</ref> Drinking a little amount of warm water and mild sudation with warm palms over abdomen region to trigger the urge is advised.[A.Hr.Sutra Sthana.18/36]<ref name=Hridaya/> The person should never withhold the urge for defecation and should not strain while passing the stool [Su.Sa. Chikitsa Sthana 33/22]<ref name=Susruta/> as these may aggravate the [[vata dosha]]. After intake of purgative medicine, the person should only use warm water for drinking and cleaning purpose. Cold water may obstruct the movement of [[dosha]] and thereby prevents evacuation due to its styptic action.

   

   

Purgative medicine shows effect only after its digestion. [Su.Sa.Chikitsa Sthana 33/34]<ref name=Susruta/> Depending upon the time required for digestion of medicine, the first urge to defecate varied from one hour to three hours after administration of medicine.<ref name=GuptaSK>Gupta SK, Thakar AB, Dudhamal TS, Nema A. Management of Amavata (rheumatoid arthritis) with diet and Virechanakarma. Ayu 2015;36:413-5.</ref>

Purgative medicine shows effect only after its digestion. [Su.Sa.Chikitsa Sthana 33/34]<ref name=Susruta/> Depending upon the time required for digestion of medicine, the first urge to defecate varied from one hour to three hours after administration of medicine.<ref name=GuptaSK>Gupta SK, Thakar AB, Dudhamal TS, Nema A. Management of Amavata (rheumatoid arthritis) with diet and Virechanakarma. Ayu 2015;36:413-5.</ref>

In a case report on rheumatoid arthritis, virechana showed significant reduction in RA factor to 50 IU/ml  from earlier level of 94 IU/ml. Virechana followed by avoidance of allergens reduced the CRP level from 22.7mg/l to 1.8 mh/l. After 3 months of follow up the IgE levels reduced from 680kU/l to 53.7 kU/l. The 40% relief in pain and stiffness of joints were reported soon after the virechana.<ref name=GuptaSK/>

In a case report on rheumatoid arthritis, virechana showed significant reduction in RA factor to 50 IU/ml  from earlier level of 94 IU/ml. Virechana followed by avoidance of allergens reduced the CRP level from 22.7mg/l to 1.8 mh/l. After 3 months of follow up the IgE levels reduced from 680kU/l to 53.7 kU/l. The 40% relief in pain and stiffness of joints were reported soon after the virechana.<ref name=GuptaSK/>

A study conducted on 20 non-insulin dependent diabetes patients showed a better reduction in fasting blood sugar (FBS) and post prandial blood sugar (PPBS) levels through virechana, when compared with therapeutic emesis (vamana). The 51.5% reduction is observed in FBS levels after virechana, at the same time PPBS values shows 81.6% reduction. It is assumed that virechana acts on liver and pancreas as they are the sites of [[pitta dosha]]. It may reduce the hepatic glucose production or may increase the insulin secretion.<ref>Jindal N, Joshi NP. Comparative study of Vamana and Virechanakarma in controlling blood sugar levels in diabetes mellitus. Ayu. 2013 Jul;34(3):263-9. doi: 10.4103/0974-8520.123115. PMID: 24501520; PMCID: PMC3902591.</ref>  

A study conducted on 20 non-insulin dependent diabetes patients showed a better reduction in fasting blood sugar (FBS) and post prandial blood sugar (PPBS) levels through virechana, when compared with therapeutic emesis (vamana). The 51.5% reduction is observed in FBS levels after virechana, at the same time PPBS values shows 81.6% reduction. It is assumed that virechana acts on liver and pancreas as they are the sites of [[pitta dosha]]. It may reduce the hepatic glucose production or may increase the insulin secretion.<ref>Jindal N, Joshi NP. Comparative study of Vamana and Virechana karma in controlling blood sugar levels in diabetes mellitus. Ayu. 2013 Jul;34(3):263-9. doi: 10.4103/0974-8520.123115. PMID: 24501520; PMCID: PMC3902591.</ref>  

In another study conducted on 30 dyslipidemic persons, a significant reduction is reported in serum cholesterol, triglyceride and VLDL levels after virechana. LDL also shows reduction. Serum HDL increased significantly. Evacuation of [[pitta]] is the prime phenomenon achieved through virechana. Large amount of bile is excreted through virechana which results in reduction of cholesterol levels.<ref>Pooja BA, Bhatted SK. A standard controlled clinical study on Virechana Karma and Lekhana Basti in the management of dyslipidemia (Medoroga). AYU 2016;37:32-7.</ref>

In another study conducted on 30 dyslipidemia persons, a significant reduction is reported in serum cholesterol, triglyceride and VLDL levels after virechana. LDL also shows reduction. Serum HDL increased significantly. Evacuation of [[pitta]] is the prime phenomenon achieved through virechana. Large amount of bile is excreted through virechana which results in reduction of cholesterol levels.<ref>Pooja BA, Bhatted SK. A standard controlled clinical study on Virechana Karma and Lekhana Basti in the management of dyslipidemia (Medoroga). AYU 2016;37:32-7.</ref>  

In a study conducted on 30 patients,virechana is reported to be more effective in reducing the signs and symptoms of psoriasis than therapeutic emesis ([[vamana]]). <ref>A. N. Parida, N.N Bhatt et al. A comparative study of vamana and virechana karma in ekakushta w.s.r to psoriasis. Ayu. 2009 Jul-Sep; VOL. 30, NO. 3: 255 - 259</ref>

In a study conducted on 30 patients, virechana is reported to be more effective in reducing the signs and symptoms of psoriasis than therapeutic emesis ([[vamana]]). <ref>A. N. Parida, N.N Bhatt et al. A comparative study of vamana and virechana karma in ekakushta w.s.r to psoriasis. Ayu. 2009 Jul-Sep; VOL. 30, NO. 3: 255 - 259</ref>

==List of theses done==

==List of theses done==

#Shiho Oikawa (2018): Virechana karma along with vaitaranabasti followed by mahabhallataka avaleha in the management of amavata wsr to rheumatoid arthritis-A comparative randomized controlled study . Department of Panchakarma, IPGT&RA  Jamnagar

#Shiho Oikawa (2018): Virechana karma along with vaitaranabasti followed by mahabhallataka avaleha in the management of amavata wsr to rheumatoid arthritis-A comparative randomized controlled study . Department of Panchakarma, IPGT&RA  Jamnagar

==More information==

==Related chapters==

[[Upakalpaniya Adhyaya]], [[Chikitsaprabhritiya Adhyaya]], [[Kalpana Siddhi]], [[Shyamatrivrita Kalpa Adhyaya]], [[Chaturangula Kalpa Adhyaya]], [[Tilvaka Kalpa Adhyaya]], [[Sudha Kalpa Adhyaya]], [[Saptalashankhini Kalpa Adhyaya]], [[Dantidravanti Kalpa Adhyaya]]

[[Upakalpaniya Adhyaya]], [[Chikitsaprabhritiya Adhyaya]], [[Kalpana Siddhi]], [[Shyamatrivrita Kalpa Adhyaya]], [[Chaturangula Kalpa Adhyaya]], [[Tilvaka Kalpa Adhyaya]], [[Sudha Kalpa Adhyaya]], [[Saptalashankhini Kalpa Adhyaya]], [[Dantidravanti Kalpa Adhyaya]]

==List of References==

==List of References==

The list of references for Virechana in Charak Samhita can be seen[[Media:List_of_references_of_word_virechana_in_charaka-converted.pdf|here]]

The list of references for Virechana in Charak Samhita can be seen [[Media:List_of_references_of_word_virechana_in_charaka-converted.pdf|here]]

 

==Reference==

==Reference==

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