The therapeutic purgation in Panchakarma is called Virechana which is one of the purification methods used alongside the Ayurvedic treatments. It is used as a preventive measure which maintain the wellbeing and also as a treatment procedure. It is considered ideal to eliminate the aggravated Pitta dosha and the Pitta predominant disorders occurred in the body. In other words it purifies the blood toxins in the body which are accumulated in the liver and gallbladder and also cleanses the gastro intestinal tract by facilitating the defecation.

This procedure is followed by Purva karma (preparatory procedures).Pradana karma (Major purification therapy) and Paschath karma( post-operative procedures).

The patient is examined and the strengths of the patient and the disease along with the nature of the patient’s Koshta (digestion- Mrudu koshta, Madya koshta, Krura koshta) are examined as well. Then the treatment protocol is planned accordingly. Snehapana (internal oleation) is applied with ghee for 3-7 days depending on the above examined factors. Then Abyanga(external oleation) and Sweda (sudation) are performed for 3 days. On the day of purgation Virechana yoga (medicinal preparation to facilitate the purgation) is given to the patient empty stomach. The materials and doses are decided by the doctor after examining the patient and the disorder. Usually the purgation starts after 3 hours. Meanwhile the pulse, blood pressure etc are examined and warm water or decoction prepared with Velmi (Liquo rice) is given as Saha pana(supporting liquids) for purgation.  The assessment criteria to be observed during the purgation namely Jaghanya(mild)- 10 vegas, Madhyama( moderate)-20 vegas and Pravara( Excellent)-30 vegas. When the Samyak virecha (proper purgation) completed, patient is advised to take rest and the post-operative procedures are to be continued.

Post-operative procedures include washing the patient’s hands and feet with warm water, consuming warm herbal preparations like Peya and application of Sansarjana karma.Sansarjana karma are the diet plan prepared by a doctor for the patient to gradually adapt into normal diet by strengthening the digestive fire.

Most commonly used purgative herbs are Baliospermum axillare, Operculina turpethum,euphorbia nerifolia, Cassia fistula, Croton tinglium, Acorus calamus, Mallotus phillippinensis, Vitis vinifera. Variety of herbs are used in different preparation to be used in this Virechana process.

Depending on the doctors experience, they use this procedure in variety of disorders while the classics mentions the common indications such as gastrointestinal disorders such as Krimi(worm infections), Muthragatha( obstructive urinary diseases),constipation, Kamala(jaundice), dermatological disorders such as allergies, eczema, dermatitis conditions, Pakshagatha (hemiplegia), Madhumeha (Diabetes), Arbuda(tumors),Tamak swasa( Bronchial Asthma), Galaganda(goiter), Bhagandara(fistula-in-ano), Arshas(piles),Pleeha dosha(Splenic disorders), Shirashula(Headaches) and liver disorders, Netra and Nasa daha(burning sensation in eyes and nose), Gynecological disorders, Asthma, Epilepsy, Anorexia, Anemia etc.

Contraindications are also listed in classics as Krisha(emaciated patients), Bala(children), Garbhani(pregnant)Hridroga(heart problems) etc.

The effectiveness of this bio purification treatment has been proved through many scientific researches and used to enhance the holistic wellbeing as a preventive and also as a therapeutic procedure.