If the virechana drug stops action after the elimination of the fecal matter and the emetic recipe stops action after the elimination of medicine, the excited doshas do not get properly eliminated leading to symptoms like itching etc. This spectrum is termed as vibhramsha. These should be managed as per their individual disease protocols.
पीतं स्निग्धेन सस्नेहं तद्दोषैर्मार्दवाद्वृतम्| न वाहयति दोषांस्तु स्वस्थानात् स्तम्भयेच्च्युतान्||८८||
[Complication of stambha (stiffness) and its management] Unctuous medicine for virechana when given to a person with an oleated body, because of the mild nature of doshas, they are not let out and cause occlusion in its own site. Because of the obstructed vayu, there will be obstruction and pain in the rectum and there will be frequent expulsion of doshas in little quantity.
वातसङ्गगुदस्तम्भशूलैः क्षरति चाल्पशः| तीक्ष्णं बस्तिं विरेकं वा सोऽर्हो लङ्घितपाचितः||८९||
Here highly potent basti or virechana, need to be given. First he must observe fast or take light food (langhana), then give pachana (digestive medicine ).
[Complications and its management] Individual with un-unctuous body and who is weak, when given an un-unctuous virechana recipe, will result in severe vitiation of vayu and cause serious complications.