Virechana is the Panch Karma therapy to expel pita. It also expels some kapha. It is a very reducing treatment and the patient must be very strong in both body and spirit. Pre-treatments, called Purva Karma, are given to strengthen the mind and body including massage and shirodhara. Panch Karma should only be carried out under the strict supervision of an Ayurvedic Physician.
Next ghee is taken daily on an empty stomach to saturate all seven tissues and a series of massage and steam treatments are given. On the day before final purgation the patient must eat a pita enhancing diet including spicy and fried food. This process is designed to draw out deep seated ama from all tisues into the digestive system ready for elimination, and takes about a week. Without this preparation, purgation only removes 48 hours worth of toxins from the body.
Early the next morning on an empty stomach the patient is given purgatives chosen especially for their constitution and in accordance with the seasons. This usually includes oil, pills and a decoction.
The body responds as it needs to respond so it is impossible to explain what to expect. Commonly however the purgatives cause an unpleasant metallic taste in the mouth. The patient will begin to feel very hot, though it is crucial not to take cool drinks or a shower. Nausea is a common complication, and sometimes leads to vomiting. Keep a spray bottle handy with two drops each of lemon and jasmine essential oil in one cup of water to spray on the patients face only. Drinking luke-warm water with lemon, jaggary and rock salt may relieve nausea. Sandalwood and lavender bring some comfort.
It is also very common to feel very emotional. Fear, anxiety and grief may be brought up by the treatment. Watch these emotions with detachment, allow them to flow over you and be released. These emotions may continue for a number of days as your body releases excess dosha's. Put you complete faith in Ayurveda as nature takes it's course. This is, in my experience, the most difficult aspect of healing, but the most vital and rewarding too.