A conceptual study of Virechan Karma

Ayurveda, a science of longevity, is getting its glory back and panchkarma is playing a very important role in it. Panchkarma as described in classical texts consists of five shodhana karmas which removes the vitiated doshas and malas from the body through different routes. Virechan is one of those shodhana karma which pacifies the vitiated doshas from adhomarg i.e. guda. Easy intake of oral medicines and removal from physiological pathwaymakes it easily acceptable. This article tries to summarize the different classifications of virechan drugs, the process and utility of Virechan in different diseases.


Introduction
Ayurveda, a science of harmony and longevity of the coordination of body, mind and soul. And to maintain this absolute health, a disease-free body is the prime requirement. Nowadays panchkarma is getting popular and becoming a prominent tool in breaking the pathogenesis of disease and bringing the health to the patients at a faster pace. Some ignorant people still look it as merely detoxifying process but others could understand the wide dosha and mala pacifying property of the procedures. Panchkarma comprises five procedures of shodhana which are known to remove disease from its roots and prevents its reoccurrence.
Virechan is a type of shodhana procedure which comes under panchkarma and is a method of inducing therapeutical purgation. Four different types of virechan karma are being mentioned by Sharangdhar and the procedure of virechan karma is significantly described in brihtarriya emphasizing its importance and ability in pacifying vitiated doshas and malas.

Virechana
पिते तु पिरे क ं श्ले ष्मसं सृ ष्टे िा तत्स्थानगते िा श्ले ष्मणीपत॥ [1] Virechana is most important measure of Shodhana therapy. It is a specific modality for the elimination of pitta dosha but it is also effective upon Kapha and Vata. It is less stressful procedure than Vamana and has less possibility of complications. Among the Panchakarma therapy by Virechana the Pitta dosha clear not only from the Amashaya but from all over the body i.e. from cellular level. Apart from Pitta it is also useful in the elimination of Kapha Dosha. It is easy to perform and having least complication, hence it is widely used by the Ayurvedic Physicians

Definition [3]
"Tatra dosh harnam adhobhagam,Virechan sangyakam" The elimination of Dosha from the 'Adhobhagena' is symbolized as Virechana. The word 'Adhobhagena' is used for Guda as commented by Chakrapani. It is one of the Shodhana Karma as mentioned in the Ayurvedic classics. According to 'Gangadhara' Virechana means "Maladeh Nirharanam" i.e. expelling out of Malas. Sometimes action of expelling the Doshas through both routes -Urdhva and Adho are known by the common term Virechana.

On the bases of the mechanism of action of drug [4]
Anulomana The drug which digests the ama Dosha of malas & breaks their consolidation and after removing vibandha, expels them out through adhobaga is known as Anulomana, like Haritaki. According to Dalhana, Anulomana causes expulsion of Vata and Kapha [5].

Sramsana
The drug which does not digest the Aam Dosha of malas but drag the malas which are fixed in koshta to adhobhaga and excrete them out is known as Sramsana like Aragvadha. In Jvara Chikitsa, it has been mentioned that Sramsana eliminates the Pitta and Kapha situated in Pakvasaya [6].

Bhedana
The drug which breaks abaddha, baddha & pindita malas and expels them out through Adhobhaga is known as Bhedana like Katuki. Katuki is considered as cholagogue i, e. Pitta Virechana.

Rechana
The drug which expels pakva or apakva malas after diluting them through adhobhaga is known as Rechana like Trivrita. The 'Rechana" and "Virechana" words seem to be similar but the Virechana represents the complete therapy while the Rechana is the action of some types of drugs used in Virechana [7] The Virechana drugs are divided into two types depending upon its physical Characteristics

Snigdha Virechana
The Virechana given by using snigdha dravyas is known as snigdha Virechana. It is contraindicated in those patients who have been given much of aabhyantar snehana. Drugs used are -Eranda, Tilvaka, Aragvadha, saptala. In Pakwaashyagata vata [8], this type of Virechana is indicated.

Rooksha Virechana
The Virechana given by using rooksha dravyas, is known as rooksha Virechana. It is indicated in those patients who have snigdha sharira & having doshotklesha avastha after snehapana. eg.-Haritaki, Danti, Katuki. [9] Mridu The drugs which are Manda in Veerya or when combined with opposite Virya, or given in low Dosage, given to the Ruksa patient and causes less purgation is known as Mridu Virechana If patient is of alpa bala, diseases having dominance of Vata, mridu or unknown koshta disease is of alpa Dosha then Mridu Virechanais adviced.

Tikshna
In krura koshta, balvana rogi and disease with bahu Doshas, tikshna Virechana is indicated. The drugs which causes numerous (Mahavega) motions and eliminates the Doshas in large quantity by quick (Kshipra) and gentle (Sukha) purgation without causing either much Glani (depression) and pain in heart area or anus or harmful to internal organs, is known as Tiksna Virechana

Procedure of virechana karma
On the basis of the opinion of Dalhana about 'Trividha Karma', the procedure of Virechana Karma may be classified into three stages:

Purvakarma (Pre-operative procedure)
In Virechana karma, following procedures may be taken as Purvakarma which are illustrated below.

Sambhara Sangraha
The drugs and other apparatus which are considered to be useful in the different stages of Virechana karma as well as to tackle the complications (if develope at any stage) should be arranged prior to the administration of Pradhanakarma.  Table 4 as follows: The patient which is weak, having Alpa Dosha, devoid of strength, whose Shodhana has been done and whose Koshtha is unknown then in such patients Mridu Aushadhi in Alpa Matra is advisable. If the Koshtha of patient is unknown then also Mridu Ausadhi should be administered. Accordingly, the appropriate time for administering Virechana drug may be regarded as between 8 a.m. to 10 a.m. It should preferably be administered empty stomach.

Dose of Aushadhi (Virechana): It can be tabulated in summarized in
Atura Paricharya: As soon as the drug administered,patient is adviced to sprinkle the hot water over the face, gargle by hot water and have a fragrance of flowers. Patient must take complete rest. Patient should be given hot water repeatedly in little quantities. Cold water should be given to the patient with preparation containing Jaypala.

Hritadosha Lakshana
In the Samyaka Virechana, the evacuation of Mala, Pitta and Kapha occurs from the bowels. Hence Kaphanta should be considered. Karshya and Laghuta are the other symptoms to be observed in the patients (Ch. Si. 1).

 Vaigiki standard
After the administration of the medicine while counting the Vegas, the first 2 -3 Vegas mixed with Mala should not be counted (Ch. Ka. 14).In Vaigiki standard the number of Vega according to different type of suddhi are as follows.   Antiki standard When Shodhana i.e.; Virechana is given there should be limit where one has to the process and for this Antiki standard mentioned by Acharyas is best limit (end point). In case of Virechana, Kaphanta condition should be reached.
Acharya Charaka says that after elimination of Kapha up to 'Anilagamana' means there is total expulsion of Vata, Pitta and Kapha Dosha and nothing is remained there in Koshtha to be expelled out.

Paschat Karma
The time period from the completion of Vegas, till the patient reached his normal diet is crucial and the specific management that has to be taken at this juncture is known as Paschat Karma.

Sukshma
Sukshma guna due to its Anupravanabhava, i.e. "Anutvat Pravanabhavach…… (Ch. Ka. 1/5 -Chakrapani) its helps to dilate the channel and to pass the drug into micro-channel. This property helps to remove the morbid matter from micro-channels and brings them to Kostha for expulsion.

Vyavayi
Due to this, drugs spreads quickly throughout the body & starts their action before its digestion. Due to Vyavayi Guna, Virechaka drugs spreads all over the body without changing their form.

Vikasi
Due to this property drugs loosens the dhatu bandhana (Sh.Sam.Pu.Kh.4). It creats the dhatu shaithilyata (Dalhana). Hence drugs initiate their action without being digested. From all these properties doshas are driven to kostha. The drugs which are having Jala and Prithvi Mahabhutas dominancy have a natural tendency to go downwards and thus they can assist in induction of Virechana. If drugs are having all above said properties but if it is not having Virechaka Prabhava then it will not induce the Virechana. Hence we can say, drugs act by its active principle can be said as Virya or Prabhava not by property, but properties assist in carrying the function of drug.

Conclusion
Virechan karma is considered best for increased and morbid Pitta and Kapha dosha and is also responsible for Vata anulomata thus acts on tridosha. Judicious use of drugs for Virechan process, a shodhana karma, can bring markable results, when given after proper assessment of disease and patient. Virechan is the easily accepted procedure as it is safe, have less complications and an almost painless procedure. Virechan removes the doshas from adhomarga that is the physiological route of eradication of mala by an individual thus comfortable. All these factors marks its easy acceptability and its tridosha pacifying quality, the best suitable process in several diseases.