Purgation

Meaning of Purgation:

Purgation means expulsion of malas or dosas through the anal route via lose motions. The objective is to clear the intestines. 

Purgation removes toxins accumulated in the middle part of the alimentary tract.¹

Link with Seasons:

It can be done throughout the year, but the best time to do it for most people is in autumn.

Link with Doshas:

It is considered the best procedure for elimination of Pitta.

Uses:

• Provide strength to the sensory and motor organs.
• Refreshes the brain
• Increases the digestive fire
• Stabilizes the tissues
• Increases body strength
• Especially useful in elimination of issues caused by ama (undigested and semi-digested food)
• Issues related to hemorrhoids, worms and flatulence
• In skin diseases such as dermatitis
• Helpful in treating various Pitta related disorders, including inflammations, infections, migraine, parasites, fungal or bacterial or viral infections 

Pre-Purgation Measures¹:

• Before purgation, oleation and fomentation therapy is done.
• Light food is taken on the previous night since purgation is done on empty stomach.

Medicinal Purgative substances as used in most Panchkarma centres¹:

• Gandharva Hastadi Avanakenna (25-50 ml) for Vata body type
• Nimbamritadi Avanakenna (25-50 ml) for Vata-Pitta body type
• Avipathi Churna (15-30 gm) for Pitta body type
• Castor oil is the most easily available option
• The dosage of the substance will depend on the state of alimentary tract (determined on the basis of bowel movements of the last few days).

Method¹:

• Squeeze lime juice on your tongue and inhale the fragrance of the lime.
• Now close your nose and quickly drink the medicine. If it feels too thick, mix the medicine in half a glass of warm water and then drink it.
• If taking the powdered medicine, it can be taken after mixing with the warm water or by mixing it with the honey.
• Drink warm water after drinking the medicine.
• Soon the diarrhoea will begin.
• After every visit to the washroom, drink some hot water. It replenishes the lost water in between.
• Eventually a stage will come when even after drinking the hot water, there will be no cramps in the intestine. This implies that the impact of the medicine is over.

Post-purgation Measures:

The measures that need to be taken after purgation include:

• Take a warm shower after the completion of the process.¹
• Diet to be taken when hungry: food which is light, warm and lubricating - broken grain (like rice) cooked with water and salt.¹

The measures to be followed for a few days after purgation are:

• Avoid cold drinks and cool substances.¹
• Do not eat anything which is heavy, oily, fried.¹
• Do not eat raw foods.¹

Choosing the right laxatives for purgation:

The laxatives are chosen on the basis of doshas indicated by the bowels.

• Soft bowel - Pitta dominant - Use mild laxatives in low doses. Examples of mild laxatives used: Milk, water, oil and grapes.
• Moderate bowel - Kapha dominant - Use moderate strength laxatives with moderate intensity. Examples of moderate laxatives: Indian jalap (Nisoth), Indian laburnum (Amaltas)
• Hard bowel - Vata dominant - Use strong laxatives such as common milk hedge and purging nut (jatropha curcas)

Should not be done in the following cases:

• Childhood, old age, debility
• Inflammation in lower part of alimentary tract¹
• Any bleeding in downward direction (including menstruation)¹
• Emaciation
• Soft-natured person
• Pregnancy, post-delivery
• Stout person
• Intoxification
• First stage of fever
• Diarrhoea
• People with low digestive fire
• Wounds caused by weapons
• Dry body constitution
• One suffering from dehydration¹
• Immediately after emesis
• Ulcerative colitis
• Uterine prolapse¹
• Prolapsed rectum 
• One who has low Agni¹

How to measure the success of purgation¹:

• There is a decrease in all three Vata Pitta and Kapha.
• There is lightness experienced in the whole body.
• The channels get purified.
• There is an increase in hunger.

Other visible benefits of purgation¹:

• Body gets cooler and calmer.
• Skin gets clearer.
• There is a decrease in signs of ageing.

Complications visible when the process of purgation is overdone¹:

• There will be too much of diarrhoea.
• Body will feel dehydrated.
• There is bleeding through anus.
• Pitta increases resulting in inflammation and feeling of burning sensation.
• The dryness of the body increases. Other symptoms of Vata increase are visible such as rectal prolapse etc.
• Tremors and fainting 

Complications visible when the process of purgation is left incomplete¹:

• There is still a feeling of heaviness.
• Toxins left loose in the body can result in skin rashes, fever etc.
• Congestion is felt in abdomen and the chest. Secretions from nose and mouth can be seen.

What to do if things are better but full benefits are not experienced¹:

• The procedure can be repeated after 7 days.

Should Purgation be done by fully healthy person?¹:

• Yes 
• In fact, a monthly mild purgation is the form of detoxification recommended for all, right from teenagers to people in old age.
• Mild purgation can also be done in case someone is suffering from constipation.

Emergency cases when Purgation might be induced¹:

In these cases, purgation can be down without the preparatory procedures.

• In case of intake of poison - purgation should be done after doing emesis
• Suffering from constipation
• Bleeding happening in the upward direction (for example in mouth, gums, nose, eyes etc.)
• In case of one having hiccups, burps, cough, nausea or vomiting
• Those suffering from epilepsy, fits or high fever
• In case of intestinal parasites or worms
• Those with high BP
• In case of Pitta headaches
• Those with too much anger or frustration

References:

Primary Source: Acharya Balkrishna: A Practical Approach to The Science of Ayurveda - A Comprehensive Guide for Healthy Living - Chapter - Treatment Methods 

1. School of Ayurveda and Panchkarma - Lectures and Notes