Virechana is the purgative treatment that cleanses the small intestine and associated Pitta dominant organs for, example liver, gall bladder and pancreas. It works in the downward direction to eliminate Pitta related toxins and excess Pitta in the form of acidic and inflammatory secretions. It is performed in chronic skin diseases, chronic constipation, obesity, Chronic acidity, various metabolic diseases like Diabetes, thyroid abnormalities, PCOS etc. It is advised only after the naadi parikshan & detail history of the patient. It must be performed under the supervision of experienced vaidya.