REVIEW OF VIRECHANA KARMA IN CLASSICAL TEXTS OF AYURVEDA

The Ayurvedic management of diseases consists of Shodhana and Shamana treatments. Shodhana Chikitsa is performed mainly by employing Panchakarma, it includes, Vamana, Virechana, Asthapana Basti, Anuvasana Basti and Nasyakarma. Virechana is considered as the best treatment for morbid and increased Pitta Dosha. This paper serves as a collection of references pertaining to Virechana Karma during ancient period of Ayurveda Samhitas, along with some information on the method of Virechana Karma explained in ancient textbooks of Ayurveda Samhitas.


Virechana Drugs According to Their Mode of Action [13]
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, as a fifth group.

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.
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.The patient who have not taken Virechana Drugs in past and whose Kostha is unknown in such patients Sushruta recommended the use of Mrudu Virechana drugs in the beginning and after knowing the Kostha required drug may be prescribed.[15] Sharangadhara recommended that the Mrudu Virechana drugs i.e.Draksha, milk, warm water, castor oil etc. should be used in Mrudu Koshthi patient.[16] Drugs effective in Mrudu Koshta are Guda, Sugar cane juice, Mastu, Ulloditadadhi, Payas, Kshira, Sarpi, Kashmari, Triphala, Pilu and Tarunamadya.[17] Madhya Virechana: The drugs which are moderate in qualities are known as Madhya Virechana drugs.These drugs are specifically indicated in the patients having Madhya Roga (disease with moderate symptoms).The administration of these drugs in Balavana patient is useless, because they are unable to eliminate Dosha completely.[18] Sharangadhara recommended the use of Trivrut, Katuki and Aragvadha for Madhya Kostha.[19] Tikshna Virechana: The drugs which cause Mahavega (numerous motions) and eliminates the Doshas in large quantity by Kshipra (quick) and gentle purgation causing neither much Glani (depression) nor pain in heart area or anus nor harmful to internal organs, is known as Tikshna Virechana.
Acharya Charaka recommended the use of these drugs in the Balvana Rogi, presenting all the symptoms of the disease i.e.Tikshana Vyadhi.[20] Snuhi Kshira is the best Tikshana Virechana drug among those drugs.[21] Virechana From Ruksha And Snigdha Point of View The drugs which are used in the form of oil or the preparation containing Sneha is known as Sneha Virechana e.g.Castor oil.Vagbhatta recommended the use of Sneha Virechana in all patients except Snigdha patient.[22] The use of Sneha Virechana in the patients who have taken higher dosage of Sneha is contraindicated because due to this the movable Doshas may again adhere in the Srotas.[23] The preparations, which do not contain Sneha, can be used as Ruksha Virechana.
It has been recommended on the Snigdha patients who have comparatively taken more Sneha.[ It is better to add Madhu before using these preparations.

Procedure of Virechana Karma
This includes administration of Virechana Yogas, observation especially for Aushadha Jirnata, observation of Shuddhi Lakshanas and management of Vyapada if occurs.

Administration of Virechana Yoga
The Virechana Yoga is given to the patient • After Samyaka Snehana and Svedana.
• While the patient is cheerful, slept well and has fully digested his previous meal.
• After assessing the psychological condition of the patient (Manasamabhisamikshya).

Hrita Dosha Lakshana
The Virechana is considered as Kaphanta and Hritadosha when come out with Pitta and Kapha one by one in sequence.Gatradaurbalya and Laghuta are the associated symptoms.[32] Shuddhi Lakshana Four types of Shuddhi viz.Laingiki, Antiki, Vaigiki and Maniki should be observed according to Chakrapani, but the importance should be given to Laingiki Shuddhi.

Discussion
Samhitas are oldest source of knowledge written before 3000 BC and which provide thorough knowledge of Ayurveda in Sanskrita.Samhitas guided us very well towards different subjects but Shodhana and Shamana therapies were primarily focused to treat various types of diseases.It became clear from screening of Samhitas that Shodhana therapies were widely elaborated but the references found in scattered manner.Out of five, Virechana is less stressful procedure.It has less possibility of complications and could be done easily.So, it is widely used as Shodhana therapy in routine.It is more acceptable to all classes of patients.In addition to the acceptability and popularity, the Virechana is considered as the best treatment for morbid and increased Pitta Dosha.So, it is the need of time to collect all references of Virechana at one place and to get its thorough knowledge at a glance.

Conclusion
Reviewing Samhitas revealed that use of Shodhana therapies especially Virechana is found to be used since long time.It is generally thought that Ayurveda classics i.e., Samhitas such as Charaka, Sushruta and Vagbhata have their major role in contribution of body detoxification procedures i.e., Shodhana therapies.From having looked at references mentioned in above article, it is clear that Samhitas dealt significantly in development of Shodhana therapies.Unfortunately, due to scattered form of references of Virechana, it has become difficult to establish proper method of body detoxification procedures.Therefore, it has become necessity to study Samhitas from various point of view of Ayurveda.This research paper was an attempt to study from Virechana perspective.Scholars would be delighted to know how immense research one can carry out in these Samhitas and bring new knowledge in front of the world.