1. Dr. Suraj Kumbar
PG Scholar
Department of Panchakarma
S.D.M.College of Ayurveda & Hospital, Hassan
VIRECHANA KARMUKATA
2. INTRODUCTION
• Acharya Charaka’s described a very unique and
conceptual mechanism of Vamana and Virechana Karma.
• The mechanism of Vamana as well as Virechana is
almost the same because they have more or less the same
properties.
• The difference between both mechanisms is in the
Pancha-Mahābhaūtik composition of Kalpas(medicine)
thereby eliminating route.
3. PROPERTIES OF VIRECHANA DRAVYAS
Guna: Virechana Dravyas have all the properties of Vamana
Dravya i.e. Ushna, Tikshana, Sukshma, Vyavayi and Vikasi.
Panchabhautika Sanghathana : Prithvi and Jala Mahabhuta.
Virya :Virechana drugs possess an inherent Virya.
Prabhava: Inherent Prabhava on virtue of which, they can induce
Virechana.
The main action of Virechana Dravyas is on Adhobhaga of the
individual.
The vitiated Pitta Dosha present in entire body is alleviated and
expelled out through he mechanism of Virechana and the disease
process is arrested.
4. The Virechana Dravya spreads throughout the body of cellular
level due to its pharmacological properties.
Vyavayi property of Virechana Dravya is responsible for
quick absorption, while Vikasi Guna causes softening and
loosening of the bond by Dhatu Saithilya Karma.
Due to Ushna Guna, the Dosha Sanghata (compeactness) is
liquefied (Vishyandana).
Tikshna properties of Virechana drugs produce Chedana of
the Doshas, which are already softened due to snehana
karma or able to disintegrate the Sanghata of the Doshas.
According to Dalhana this action is due to quick excretion
(Dosha Sravana- Karatvam )Thus, liquefied Doshas are
dragged towards the Koshtha.
5. Due to Sukshma property by reaching in micro channels, disintegrates
endogenic toxins, which are then excreted through micro channels.
Due to dominance of Prithivi and Jala Mahabhutas in the
Virechana drugs and their potent Adhobhaga Hara Prabhava, the
vitiated Doshas are made to pass through anal route and are expelled
out of the body.
The Vamaka and Virechaka Dravya induce emesis and purgation
respectively due to their specific Prabhava.
For example, Danti and Chitraka both have same rasa and Virya,
but Danti on administration internally produces Virechana Karma,
but Chiktraka does not produce Virechana. This is called selective
action of the drug i.e. Prabhava. When there is similarity in two
drugs in relation to their Rasa,Vipaka and Virya, their
pharmacological actions may be different due to Prabhava of these
drugs.
6. PHARMACODYNAMIC OF VIRECHANOPAGA DRAVYAS
The overall Pharmacodynamic of Virechanopaga Dashamanai dravyas is
based on Guna concept.
Most of the drugs are having property of Madhura Rasa and Snigdha Guna.
These are based on Prithvi and Jala Mahabhauta in composition.
Acharya Charaka has mentioned only the role of Gunas in the
pharmacodynamic of Virechana Karma. In fact Guna is the thing which
represents a drug. So, the selection of a drug should be on the basis of Gunas
for Virechana karma.
Acharya Charaka has mentioned predominance of Prithavi and Jala
mahabhuta drugs for Virechana Karma. Rasas of Virechano-paga Dravyas
are chiefly Madhura, Kashaya and Amla Rasa which are composition of the
same Mahabhutas.
Most of drugs are Madhura Vipaka having similar Bhautik constitution.
Other drugs are supportive to the therapy or to avoid complications during
Virechana Karma.
7. As an example;
Draksha which is mentioned in Virechano-paga Dashamani used with
Virechna drugs for increasing the palatability and giving soothing effect.
Draksha is said to be Srista-virna Mutra(increases amount of excreta), and
due to Snigdha, Sheeta, Madhura Guna, it may be used in complications of
Virechana like thirst, burning sensation, fever, bleeding disorders. So with
the addition of Draksha, in Virechana Karma the procedure becomes
comfortable and smooth.
In common practice decoction of Triphala is used as Anupana of Virechana
Yoga like Trivruta , Danti Yogas etc. for induction of better Vega in
Virechana Karma. As per the Ayurvedic pharmacology it is a good Pitta-
kapha-hrit , Sara, safe in nature so helps in Virechana Karma for eliminating
the Dosha through anal route. That’s why Triphala does not only increase the
potency of Virechana Dravyas but also soothing effect of the irritation and
decreases the complications of Virechana karma.
10. VIRECHANA DRUGS ACCORDING TO THEIR
MODE OF ACTION
Acharya Sharangadhara has classified the drugs from their mode
of action. A group of drugs known as ‘Virechanopaga’
mentioned by Acharya Charaka, which may also beaded to this
classification.
Anulomana: The drugs, which move the Malas downwords
after digestion and breaking their bandha, are known as
Anulomana. e.g. Haritaki
Sransana: The literary meaning of Sransana is to slip or to
fall down. The drugs, which bring the semi-digested and
sticky Malas without causing their digestion is known as
Sransana. e.g. Aragvadha.
11. Bhedana: The Drugs which disintegrate the Abaddha (unformed)
or Baddha (formed) or Pindita (dried focal mass) forms of Malas
by facilitating penetration into it and then evacuating through the
lower gut is known as Bhedana e.g. Katuki. Acharya
Charaka has described a group of drug named as Bhedaniya.
This includes Suvaha (Trivrit), Arka, Urubuka (Eranda),
Agnimukhi (Kalihari), Chitra (Danti), Chitraka, Chirabilva,
Sanhini, Shakuladani (Katuki) and Svarnakshiri.
Rechana: The drugs which eliminates Pakvam (digested) and
Apakvam (undigested) Malas or Doshas by making them
watery through the lower gut is known as Rechana. e.g. Trivrut.
Virechanopaga: The Virechanopaga Gana described in Charaka
Samhita has been considered as helping in inducing Virechana.
These are Draksha, Kasmarya, Parusaka, Abhaya, Amalaki,
Bibhitaki, Badara, Karkandu and Pilu.
12. THE TRANSIT OF PHARMACEUTICALS IN THE
GASTROINTESTINAL TRACT
The transit time in the stomach is highly variable
and depends on the dosage form and the fed or
fasted state of the stomach.
Once a drug is placed in the mouth it is moved
down the oesophagus by the swallowing reflex.
The transit time of the dosage form in the
oesophagus is rapid usually 10-14 seconds.
13. The transit time is long and variable and
depends on the following; type of dosage
form, diet, eating pattern and disease state.
The transit time is relatively constant, at around 3
hours. This contrasts with the stomach as it does not
discriminate between different dosage forms or
between fed or fasted state. It is the main site for
absorption for most drugs. Hence, an important
parameter for drug targeting.
16. Mass peristaltic movements push fecal material from the sigmoid
colon into the rectum.
The resulting distension of the rectal wall stimulates stretch
receptors, which initiates a defecation reflex that empties the rectum.
The defecation reflex occurs as follows: In response to distension of
the rectal wall, the receptors send sensory nerve impulses to the sacral
spinal cord. Motor impulses from the cord travel along
parasympathetic nerves back to the descending colon, sigmoid colon,
rectum and anus.
The resulting contraction of the longitudinal rectal muscles shortens
the rectum, thereby increasing the pressure within it.
This pressure, along with voluntary contractions of the
diaphragm and abdominal muscles, plus parasympathetic
stimulation, opens the internal anal sphincter and defecation occurs
and the feces are expelled through the anus.
Physiology of Virechana (The defecation reflex)
18. MECHANISM OF PURGATION
All purgatives increase the water content of faeces by:
Ahydrophilic or osmotic action, retaining water and electrolytes
in the intestinal lumen – increase volume of colonic content and
make it easily propelled.
Acting on intestinal mucosa, decrease net absorption of water and
electrolyte; intestinal transit is enhanced indirectly by the fluid
bulk.
Increase propulsive activity as primary action, allowing less time
for absorption of salt and water as a secondary effect.
19. For some of the drugs, controversy continues as to whether they
increase water content of stools as the primary action or it is a
consequence of increased motility. However, certain purgatives
do increase motility through an action on the mesenteric
plexuses. Laxatives modify the fluid dynamics of the mucosal
cell and may cause fluid accumulation in gut lumen by one or
more of following mechanism :
Inhibiting Na+ K+ ATPase of cells – Impairing electrolyte and
water absorption.
Stimulating adenylyl cylase in crypt cell – Increasing water
and electrolyte secretion.
Enhancing PG synthesis in mucosa which increase secretion.
Structural injury to the absorbing intestinal mucosal cells.
21. AMLAPITTA
Amashaya is the specific seat of Pitta and Kapha. Though Virechana
is a specific therapy for Pitta Dosha, it may also be used for
eliminating Kapha Dosha.
The Aashaya involved in this disease are Aamashaya and upper end of
Pakvashaya. The Dosha involved is mainly Pitta, which includes the
Pachaka Pitta of Amashaya and Achcha Pitta of Pittashaya and the
Dushya are Rasa and Rakta.
Virechana may be able to expel the excessive Dravata of Pitta and
Pitta present in rest of Avayavas. Rasa Dushti can be corrected by this
process.
After the process of Virechana, the Agni, digestive power is increased
so it is beneficial for further digestion.
There is reduction in severity of symptoms like Daha, Shula,
Amlodgara, Chhardi, Avipaka which helps in further Shamana
therapy.
22. AMAVATA
After Langhana, Swedana and Tikta, Katu, Deepana Dravyas, Doshas
attain Niramavastha and may require elimination from the body by
Shodhana.
Production of Ama is the result of Avarana of Pitta Sthana by
Kledaka Kapha, thus hampering the digestive activity of the Pachaka
Pitta.
Virechana removes the Avarana produced by Kledaka Kapha and
most suited therapy for the Sthanika Dosha Pitta. It helps to normalize
the Pratiloma Gati of Vata, which produces symptoms like Anaha,
Vibandha, Antrakujana, Kukshishula etc.
It has direct effect on Agnisthana and hampered Mandagni is one of
the initiating factors in Amavata. It pacifies the vitiated Kapha and
Vata Dosha and has the quality of Srotovishodhana.
23. HRIDAYA ROGA
Hridaya is the specific seat of Sadhak Pitta and Avalambak
Kapha.
Virechana drugs gets absorbed and due to Virya, it reaches to
the Hridaya than the Dhamanis and thereafter reaches to Sthula
and Anu Srotas i.e. macro and micro channels of the body
24. MADHUMEHA
The main Dushya involved in the pathogenesis are Rasa, Meda, Mamsa
and Kleda. They are closely related with each other because of their same
qualities and etiological factors. The treatment principles are also more or
less same.
Vamana Karma and Virechana are very useful in Rasa and Meda Dushti.
Madhumeha, the Kapha and Pitta are vitiated excessively and they
remain lying in the lower part of the body.
The Virechana has the quality to eliminate both Pitta and Kapha, also it
is the best Shodhana therapy for the elimination of Dosha lying in the
lower parts of the body.
By the elimination of Kapha and Pitta removes the obstructions
(Avarana) caused by them to the path of Vata. Same time the elimination
of Kapha also alleviates the vitiated Kapha Vargiya Dushyas.
In this way, the Virechana therapy reduced the vitiation of Tridosha and
the Dushyas
25. PAKSHAGHATA
In Pakshaghata the main Dosha involved is Vata. The natural abode of
Vata is Pakvashaya.In Pakvashaya Gata Vata, Virechan is indicated.
In Pakshaghata Sira Snayu Vishosha has been described as a
symptom. Sira and Kandara are the Upadhatus of Rakta.
Hence in this disease Rakta Dhatu involvement is also seen. Pitta
being Mala of Rakta, its involvement may also occur. In Raktaja and
Pittaja Vikara, Virechan is the treatment of choice. Kaphandubandhit
and Pittanubandhit Pakshaghata have been described in text.
This can be compared with Kaphavritta and Pittavritta Vata
respectively. In treatment of both these conditions Virechan is
beneficial.
26. STHAULYA
Virechana is not only effective to eliminate Pitta Dosha but also effective
for Kapha, Meda and Vata.
It helps to remove Vayu Avarana thus helps in correcting Agni-vaigunya
which corrects Meda Dhatu Agni and the proper amount of Meda Dhatu
is formed.
It helps in flushing excessive Ambu Dhatu which is a content of Meda
Dhatu. It proves to be much beneficial in alleviating Pitta prominent
symptoms of Sthaulya like – excessive hunger (Ati-kshudha), excessive
thirst (Atipipasa), excessive sweating (Swedadhikya) and foetid odour
(Daurgandhya). Moreover, it corrects the Medodhatvagni.
Therefore, the formation of Uttardhatu is increased, while the formation
of Medodhatu is decreased. Thus, symptoms of Sthaulya are subsided.
27. TAMAK SHWASA
Virechana is very useful in Tamaka Shvasa, particularly when it is
combined with Vatahara and Kaphahara drugs.
In Tamaka Shvasa Kapha obstructs the passage of Vata and the
obstructed Vata traverses in reverse direction.
In such conditions the drug and food which are Ushna and
Vatanulomana in nature having Kapha and Vata alleviating property
are helpful in relieving the Shwasa.
Virechana drugs have the quality of Kaphaghna and Vatanulomana
proves beneficial in the condition of Shwasa and also corrects the
direction of Vata to set it on normal course.
28. VICHARCHIKA
Vicharchika being Kapha dominant even has features of Tridoshas
which can be appreciated by presence of Kandu, Strava, Pidika and
Shyavata. The Dushyas are Twak, Rakta, Mamsa and Lasika.
Virechana has actions on all types of Pitta and even eliminates Kapha
to some extent which helps in reduction of Shyavata and Kandu.
A large amount of fluid in the body is eliminated in the process of
Virechana along with Pitta, reduces the Strava present in Vicharchika.
The Bhrajaka Pitta will also be corrected & hence Pidika subsides.
Daha, Paka which are due to predominance of Pitta and Rakta even
gets subsided.
Vedana or Ruja even found as associated symptom is reduced since
Vata is controlled and regulated. Parushya which is due to Swedavaha
Sroto Dusthi is corrected, since Pitta and Sweda has got
Ashrayashrayi Bhava.
29. CONCLUSION
Virechana Karma is safe and effective treatment modality for Pitta
disorders and can be effectively used among all classes of patients.
It pacifies Tridosha specially Pitta Dosha and thus effective in
multiple conditions.
By knowing probable mode of action and pharmacodynamics of
virechana dravya one should treat a diseases properly
Hinweis der Redaktion
The Vamana & Virechana Dravyas have the properties like Ushna, Tikshna, Sukshma, Vyavayi & Vikasi.
Due to its Vyavayi Guna they get quickly circulated in to large and small capillaries of the body.
Because of its Vikasi Guna, it detaches the Malas from Dhatus.
By virtue of its Ushna and Teekshna qualities the accumulated Doshas gets liquified and disintegrated in to small particles at cellular level.
Owing to the presence of Sukshma Guna and Anupravana nature, the Malas or Doshas float because already body has got Samyak Snigdhata and through smallest capillaries towards Koshtha ultimately reaches to Aamashaya.
Detached Malas would not be obstructed even in the smallest capillaries (Asajjannamiti- Na Kwachidapi Sangha Gacchati ).
Virechana Dravyas are predominant of Prithvi and Jala Mahabhuta dominent expel the vitiated Doshas in Downwards direction through anal route.