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===Therapeutic purgation (pradhanakarma)===

===Therapeutic purgation (pradhanakarma)===

Therapeutic purgation is always performed late morning during the time of the natural decrease of [[kapha]] [[dosha]] and increase of [[pitta dosha]]. [A.Hr.Sutra Sthana.18/33] <ref name=Hridaya>Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> Practically the purgative medicines are administered between 9 AM to 11 AM <ref name=VCP/> on empty stomach. The person is advised to pass stool whenever the urge is felt and to take rest in between the urges. He should not indulge in other activities and should concentrate in the procedure itself. [Su.Sa. Chikitsa Sthana 33/21]<ref name=Susruta>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005</ref> Drinking a little amount of warm water and mild sudation with warm palms over abdomen region to trigger the urge is advised.[A.Hr.Sutra Sthana.18/36]<ref name=Hridaya/> The person should never withhold the urge for defecation and should not strain while passing the stool [Su.Sa. ChikitsaSthana 33/22]<ref name=Susruta/> as these may aggravate the [[vata dosha]]. After intake of purgative medicine, the person should only use warm water for drinking and cleaning purpose. Cold water may obstruct the movement of [[dosha]] and thereby prevents evacuation due to its styptic action.

Therapeutic purgation is always performed late morning during the time of the natural decrease of [[kapha]] [[dosha]] and increase of [[pitta dosha]]. [A.Hr.Sutra Sthana.18/33] <ref name=Hridaya>Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> Practically the purgative medicines are administered between 9 AM to 11 AM <ref name=VCP/> on empty stomach. The person is advised to pass stool whenever the urge is felt and to take rest in between the urges. He should not indulge in other activities and should concentrate in the procedure itself. [Su.Sa. Chikitsa Sthana 33/21]<ref name=Susruta>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005</ref> Drinking a little amount of warm water and mild sudation with warm palms over abdomen region to trigger the urge is advised.[A.Hr.Sutra Sthana.18/36]<ref name=Hridaya/> The person should never withhold the urge for defecation and should not strain while passing the stool [Su.Sa. Chikitsa Sthana 33/22]<ref name=Susruta/> as these may aggravate the [[vata dosha]]. After intake of purgative medicine, the person should only use warm water for drinking and cleaning purpose. Cold water may obstruct the movement of [[dosha]] and thereby prevents evacuation due to its styptic action.

   

   

Purgative medicine shows effect only after its digestion. [Su.Sa.Chikitsa Sthana 33/34]<ref name=Susruta/> Depending upon the time required for digestion of medicine, the first urge to defecate varied from one hour to three hours after administration of medicine.<ref name=GuptaSK>Gupta SK, Thakar AB, Dudhamal TS, Nema A. Management of Amavata (rheumatoid arthritis) with diet and Virechanakarma. Ayu 2015;36:413-5.</ref>

Purgative medicine shows effect only after its digestion. [Su.Sa.Chikitsa Sthana 33/34]<ref name=Susruta/> Depending upon the time required for digestion of medicine, the first urge to defecate varied from one hour to three hours after administration of medicine.<ref name=GuptaSK>Gupta SK, Thakar AB, Dudhamal TS, Nema A. Management of Amavata (rheumatoid arthritis) with diet and Virechanakarma. Ayu 2015;36:413-5.</ref>