VIRECHANA KARMA: A CLASSICAL PURIFICATION THERAPY AND ITS CLINICAL APPLICATIONS – A REVIEW

Abstract

Background: Virechana Karma, the therapeutic purgation, is one of the five principal Shodhana therapies (Panchakarma) in Ayurveda. Primarily indicated for the expulsion of vitiated Pitta dosha, it plays a crucial role in managing a wide spectrum of disorders involving Pitta, Rakta, and metabolic dysfunction. With increasing global interest in detoxification therapies, Virechana Karma has garnered attention for its potential applications in gastrointestinal, dermatological, metabolic, and hepatic disorders. However, a systematic evaluation of its safety, efficacy, and therapeutic outcomes is essential for its broader acceptance and integration into contemporary healthcare. Aim: To review the classical concepts, safety, efficacy, and clinical applications of Virechana Karma. Objectives: To study classical indications and principles of Virechana Karma. To assess its clinical efficacy in Pitta and Rakta disorders. To review safety and reported adverse effects. To evaluate outcomes from clinical studies. To suggest future research directions. Materials and Methods: A comprehensive literature search was conducted through classical Āyurvedic texts, recent textbooks, and electronic databases including PubMed, Scopus, AYUSH Research Portal, and Google Scholar. Clinical trials, case studies, observational studies, and pharmacological research related to Virechana Karma were included. The findings were synthesized to evaluate the clinical efficacy, safety profile, and reported outcomes. Results: The review indicates that Virechana Karma has demonstrated significant therapeutic benefits in managing conditions such as Amlapitta (acid peptic disorders), Kamala (jaundice), Prameha (type 2 diabetes mellitus), skin disorders (Kustha, psoriasis, eczema), and obesity (Sthaulya). Clinical studies report improvements in biochemical parameters, symptom relief, and enhanced quality of life. When performed according to classical guidelines (Poorva Karma, Pradhana Karma, and Pashchat Karma), Virechana Karma exhibits a favorable safety profile with mild, self-limiting adverse effects in rare cases. Conclusion: Virechana Karma stands as a clinically effective and safe therapeutic modality for a variety of Pitta and Rakta predominant disorders. Further high-quality, large-scale randomized controlled trials are recommended to substantiate the findings and to standardize protocols for integrative medical practice.