Virechanam (including purgation) is a sodhana/purificaton treatment. Medicine should be taken on an empty stomach. This is usually done after proper snehapanam and 3 days of fomentation. Medicine shall be in any form, either liquid or powder or oil or jam or decoction. After taking the medicine the patient should drink hot water frequently till bowel movements start. Except hot water no other food shall be taken. The patient has to rest lying on the left hand side. Bowel movements starts with evacuation of solid stools first. After a few times it changes to semi-liquid. If the bowel movements are not satisfactory more and more hot water should be given to induce urge