Virechana Karma is the specific treatment for the regulation of Pitta and Kapha Samsargaja Pitta. Other than this as per Charaka, Asrigdara is a Rakta-Prdoshaja Vikara. in the treatment Rakta-Prodoshaja Vikara a Virechana is superior among all. Kashyapa had described that Virechana therapy, mitigates vitiated Pitta and Rakta Doshas and maintains the healthy state of Aamashaya, Pakwashaya, and Garbhashaya. It is a bio cleansing method meant to clean the obstruction of Srotas. Virechana normalises Pitta Dosha condition.
Etymology: The word Virechana components
विरेचन: वि उपसर्ग + रिच (धातु) + (ल्युट प्रत्यय) मलादे: निसरण ||
i.e., By applying „Lyuta‟ Pratyaya to „Rechana-rich‟ Dhatu word “Rechana” is formed that means „Mala Bhedana‟ (expelling out the Malas).
विरेचन:वि +रिच + णिच- ल्युट | विशेषेण रेचयतिती ||
The word ‘Rechana’ commonly stands for evacuation
तत्र दोषहरणमूर्ध्वभागं वमनसञ्ज्ञकम्, अधोभागं विरेचनसञ्ज्ञकम्;
उभयं वा शरीरमलविरेचनाद्विचनसञ्ज्ञां लभते||
Elimination of Dosha through the Adhobhaga (Guda) considered as Virechana Karma.
Benefits of Virechana:
विरेचनं पित्तहराणां || (Cha. Su.25/40)
विरेचनं तु सर्वोपक्रमेभ्यः पित्ते प्रधानतमं मन्यन्ते भिषजः|| (Cha. Su.20/16)
Virechana is among the main procedures out of all Panchkarma, especially for the elimination of Pitta dosha. In Ashtanga Samgraha, commentator Indu said that Virechana indicated for Shleshma Sanshrusta Pitta dosha and Pittasthanagata Prakupita Shleshma or Shleshmasthanagata Prakupita Pitta, too.
संशोधनमिह वमनं न विरेकः” इत्यपरे, कुतः? विरेचनेन हि पित्तक्षयादार्तवस्य क्षय एव स्यादिति, वमनेन तु सौम्यधातौ निर्हृते आग्नेयधातौ वृद्धे आर्तवमाप्याय्यते| (Su. Su 15/12) Dalhana
Shamshodhan stands for the elimination of toxins from tissues. The prime Shodhana protocol indicated in this condition is „Vamana‟; if the predominant Dosha is Kapha, and „Basti‟; if the same is Vata for its Anulomana. Though „Virechana‟ is effective for Kapha Dushti to a certain extent and Vatanulomana. Virechana has a direct effect on Agnisthana and it pacifies the vitiated Kapha and Vata Dosha and has the quality of Srotovishodhana and helps to normalize the Pratiloma Gati of Vata, which produces symptoms like Vibandha, Kukshikathinya, Kukshi Shoola, etc. It has got much wide scope to be effective in many diseases with a varied involvement of Dosha and Dushyant.
The scope of Virechana is as follows.
Dosha: Pitta, Pitta Sthanagata Alpa Kapha, Kapha Sthanagata Bahu Pitta, Pittavrita Vata, Sannipata (Bhela).
Dushya: Rasa, Rakta, Mamsa, Asthi, Majja, Shukra Dushtiiii
Srotas: Rasavaha, Raktavaha, Mamsavaha, Asthivaha, Majjavaha, Artava Vaha Srotas.
In the treatment of Apana AavritVata, Acharya Charaka mentioned Vatanulomana and Pakvashaya–Vishodhana. Therefore, Virechana is the best line of treatment for Pittavrita Apana i.e., Asrigdara.
Line of treatment of Asrigdara (Abnormal Uterine bleeding)–
अपानेनावृते सर्वं दीपनं ग्राहि भेषजम्|
वातानुलोमनं यच्च पक्वाशयविशोधनम् || (Ch. Chi 28/43)
मपानं चानुलोमयेत् || (Ch. Chi 28/43)
Shodhana therapy is the most important measure for Bahudoshaja Vyadhi. If Doshas are depleted with Shamana therapy, there is a chance to provoke that Doshas again, but if they are removed by Shodhana therapy, there is no chance to provoke again. (Apunarbhava) (Ch. Su. 16/20).
Virechana is the most important appraise for Pitta. It is a specific modality for the elimination of Pitta Dosha but it is also effective upon Vata & Kapha Dosha as well as Rakta.
- Deepana-Pachana: Sunthi, Guduchi, Haritaki (1:2:2=5gm BD) before food with luck warm water.
- Snehapana: Go-Ghrita 30ml/day increasing dose for 5 to 7 days with luck warm water (As per Koshtha & Agni)
- Abhyanga: With BalaTaila for 3 days
- Swedana: Bashpa Sweda for 20 minute per day for 3 days.
Importance of Deepana -Pachana:
The purpose of Shodhana is to eliminate out morbid Doshas from the body. These Doshas remain adherent with Dhatus in their Sama condition. To detach them from tissues, they should be free of Ama’s condition. So, Before Snehapana, mild medicines which stimulate the digestive fire and cause lightness of Koshtha are used. Deepana isolates Doshas from tissues, which can then be moved to Koshtha for their expulsion.
विरेचनमपि स्निग्धस्विन्नाय|| (Su.Chi.33/19)
Snehapana plays a vital role in any type of Shodhana Karma. Snehana has properties like Vishyandana, Kledana, etc., which help in dissolving the vitiated Dosha.
The time limit for Snehapana as per Koshtha:
Koshtha is the deciding factor for the time limit of Snehapana in a patient. To get a proper idea of the Koshtha of a person, firstly, Hrasiyasi Matra (Small test dose) of Sneha is administered. After ascertaining the Koshtha in this way, further doses of Sneha are prescribed accordingly. Generally, it takes three, five, and seven days respectively for the oleation of persons having Mridu, Madhyama, and Krura Koshtha. After this duration, Sneha becomes accustomed to the body and does not excite Doshas anymore.
Regimen in Snehapana:
- Warm water used for all purposes
- Celibacy – observed
- Day sleep and awakening at night -avoided.
- Natural urges should not be with holed.
- Exercise, Anger, exposure to wind – avoided.
- Anabhishyandi, liquid, hot diet mixed with slight unctuous substances – taken.
Observations during Snehapana:
During the period of Snehapana, the Patient observed for the appearance of Samyak Snigdha Lakshana like Vatanulomana, Diptagni, Snigdha, and Asamhat Varcha, Snigdhangata, etc.
Abhyanga – Swedana:
After Samyak Snigdha Lakshana , Sarvanga Abhyanga Swedana (whole-body massage and fomentation) – for 3 days during Vishrama Kala (Intermediate days between completion of Snehapana and Virechana).
Need of Snehana and Swedana:
Emphasizing the role of Snehana and Swedana as preparative procedures, Charaka quoted that as in a vessel smeared with oil, water slips down without efforts; similarly, Kapha and other Doshas slip out easily in the body that has undergone Snehana therapy. as the fire makes the water in moist wood trickle out from every pore, similarly Swedana (Sudation) causes the adhered toxic matter to melt and flow out in a person who has been previously oleate.
Action of Abhyanga and Swedana
Snehana moistens and liquefies the Doshas and Swedana disintegrates them responsible for Vilayana of Doshas. According to Vagbhata, by the action of Snehana and Swedana, the morbid Doshas are liquefied and dissolved in Sneha and brought to Koshtha.
Charaka quoted that by Vriddhi (increase), Vishyandana (dissolving), Paka (digesting) Strotomukhavishodhana (Clearing the orifice of channels), and Vata Nigraha (regulating the movement of Vata); the morbid Doshas brought back from Shakha to Koshtha. Here, Snehana and Swedana act on every aspect of the above processes.