Vamana Karma- Medicines, Indications, Procedure & More
Vamana Karma is a process by which the elimination of vitiated dosha (kapha and pitta) from the stomach and whole body through the mouth. The endotoxins (vitiated kapha and pitta) which are present in the stomach, in cells and tissues of the entire body are eliminated by the vamana therapy. When kapha dosha is raised in a small quantity it leads to diseases like cough, cold, heaviness, indigestion etc. then the oral medications are very effective in suppressing kapha dosha. By removal of excess kapha dosha illness gets treated completely. So today we will read about vamana therapy in detail in this article.
तत्र दोषहरणमूर्ध्व वमनसंज्ञकम। (C.kalpa.1/4)
According to the above shloka:- The excess dosha expelled out by the mouth is known as vamana karma.
Vamana is indicated in all types of kapha predominant diseases. They are:-
- Kasa (cough)
- Swasa (asthma)
- Amlapitta (hyperacidity)
- Apasmara (epilepsy)
- Unmada (insanity)
- Putinasa (sinusitis)
- Granthi (cyst)
- Arbuda (tumor)
- Kustha (skin diseases)
- Sleepada (elephantiasis)
- Agnimandya (indigestion)
- Visha (poisoning)
- Garavisha (toxicosis)
- Medaroga (obesity)
- E.N.T diseases
- Children, old age persons
- Hridroga (heart diseases)
- Garbhini stree (pregnant woman)
- Gulma (lump)
- Urdhwanga raktapitta (hemoptysis and epistaxis)
- Pleeha vridhi (splenomegaly)
- Udara roga (ascitis)
- Random blood sugar
- Lipid profile
- Blood urea
- CT and BT
- Hb%, ESR, TLC, DLC
- Urine examination
- Stool examination
- LFT test
- Chest X-ray
Collection Of Material
The physician, who wants to administer emetic or purgative to a king, a kingly or a wealthy person, has to arrange the necessary equipments before-hand, in order to provide pleasure in case of the drug being favorable and counter-action in that of complications arisen keeping in view the nature of complications. Because it is not possible to arrange for the proper drugs easily and immediately, in spite of the arrangement of sale and import, in case an emergency occurs, when there is no time.
- Madanaphala (randia dumatorum)
- Madhuka (glycyrrhiza glabra)
- Nimba (azadirachta indica)
- Jeemutak/devadali (luffa echinata)
- Kosataki/kritvedhana (luffa acutangula)
- Pippali (piper longum)
- Kutaja (holarrhena antidysenterica)
- Ekshawaku (legenaria vulgaris ser)
- Ela (elettaria cardamomum)
- Dhamargava (luffa aegyptiaca)
These herbs should be used by the physician for emesis in arrival of kapha and pitta in disorders of amashaya (stomach) without producing any harmful effect on the body.
Materials And Medicines
- Ghrita (ghee)-500 ml
- Saindhav lavana (rock salt)-100 gm
- Madan phala (randia dumatorum) pippali churna (piper longum)-10 to 20 gm
- Vacha churna (acorus calamus)- 10 gm
- Yastimadhu churna (glycyrrhiza glabra)- 100 gm
- Milk or sugarcane juice- 1 litre
- Lukewarm water
- Bashpa swedana yantra (Box type streamer)
- Two measuring glasses
- Two plastic glasses
- Chair for sitting (vamana chair)
Before Vamana Therapy (Poorva Karma)
Digestive medicine (pachana dravya) should be given before the vamana karma such as Hingwastaka churna, Trikatu churna and Chitrakadi vati etc. for at least three days. Ghee should be given to the patient for 3 to 7 days. The amount of ghee should be increased gradually every day. This is the process known as oleation therapy (sneha karma).
After samyak snigdha lakshanas are found in the patient next day he should be asked to take kaphotkleshak (diet that increases kapha more) ahara that is diet such as khichdi, shrikhand, fish, sweet curd, black gram, ravadi etc. in the afternoon and evening without disturbing the digestion. The same day the patient should be given massage with oil and bashpa swedana (box like steamer) in the morning and evening.
Pradhana Karma (Operative Procedure)
- Milk/Sugarcane juice- 1 litre
- Yastimadhu decoction- 1 litre (4 litres water+50 gm of yashtimadhu churna- ¼ decoction)
- Madanaphala pippali decoction- 50 ml (10-15 m of madanaphala pippali and 50 ml of yastimadhu kwath)
- Salt water- 1 litre
- Lukewarm water- 2 to 3 litres
500 ml to1litre milk and 250 ml to 500 ml yastimadhu kwath should be administered according to the patient's physical and psychological condition. Then the patient should be administered 40 ml to 50 ml of madan phala decoction after performing Dhanvantari pooja. After the patient has taken the drug, he should be observed for a while. When there is the appearance of sweat, it indicates that the dosha has been liquified. Likewise, horripilation will indicate the movement of dosha from its upward tendency. Now the patient is seated on a cot which is of knee-height, comfortable, well-equipped with carpet, bed sheet and pillow along with accessory support. Spittoons should also be kept there. In supporting his head and sides, pressing the navel and back, his very close and gentle favorites, whose presence is non-embarrassing. Now the physician should instruct the patient-keeping your lips, palate and throat open, exert moderately to produce un-risen urges (of vomiting), while bending the neck and upper part of the body slightly, you may help elimination of the vomit if it is not complete, after the urge or for this you may touch your throat with two fingers having nails cut or the stalks of water lily and saugandhika (a variety of lotus). He should do so accordingly. Then the physician should observe carefully the bouts of vomit collected in the spittoon. By observing, the one expert in this knows the characteristics of proper, inadequate or excessive administration. After observing the characters of bouts he may decide about the necessary action on the basis of symptoms. Hence one should observe the bouts carefully and observe the following samyak vamana lakshanas (adequate symptoms).
- Lightness of the body
- Cheer fullness (indriya prasannata)
- Vegas stops automatically
- Lightness in chest and other regions
- Feeling happy
- Pravara suddha - 8 vegas
- Madhya suddha - 6 vegas
- Avara suddha - 4 vegas
- The input (vamanopaga and vamana dravyas) and output of the vomitus should be measured or weighed.
- Pravara-2 prasth
- Madhya-1.5 prasth
- Avara-1 prasth
- “Pittantamistham vamanam” pitta should come out at last.
There are the signs and symptoms of inadequate, proper and excessive administration of drugs such as- absence of bout or occasional bout, vomiting of the entire drug only and bouts with obstruction- these are the symptoms of inadequate administration of drug.
If the drug is administered properly, there will be timely vomiting with not much uneasiness, elimination of doshas in order and automatic stoppage of vomiting. This has been divided into three groups-intense, soft and medium according to the quantity of doshas (eliminated). If the drug is administered in an excessive dose there will be the appearance of foam, blood or brightness in the vomit-these are the symptoms of over-administration.
Due to excessive and inadequate administration the complications caused are-tympanitis, cutting pain, secretion, palpitation, body-ache, discharges of pure blood, displacement of viscera, stiffness and exhaustion.
On proper administration of drugs when the patient has vomited well, he should wash hands, feet and face well and after having been assured for a while, he should use one of the three types (unctuous, evacuative and pacifying) of smoking according to his strength. Then he should take ablution.
Paschat Karma (Post-Operative Procedure)
After samyak vamana (adequate amount of vomiting) the patient should be advised to take complete rest physically and mentally and should be allowed to take a normal diet. Digestive power becomes very weak after vamana treatment.
1st Day:- Whenever a patient gets a good appetite they should be given yusha (moong dal water) in the afternoon and at night.
2nd Day- If a patient gets a good appetite should be kept on moong dal khichdi otherwise should be given only moong dal water in the afternoon and khichdi at night.
3rd Day- If a patient has a good appetite should be given moong dal khichdi with ghrita. Till the patient gets a good appetite should follow the above procedure and then advise on a normal diet.
Panchakarma Vyapat (Complications) And Their Management
Panchakarma therapy is getting more and more popular in the public hence many ayurvedic and modern physicians are coming forward to adopt and implement this therapy not only in India but also in western countries. While performing the panchakarma treatments, some physicians are trying to adopt short cut methods such as one day Sadhya snehapana for vaman poorvakarma. It is not advisable to change the classical procedures without a series of clinical trials and scientific studies. One should stick up to the texts otherwise we may damage the image of the existing science which has been established after a series of observations by our Acharyas. If we are not following the proper procedures mentioned in the texts the panchakarma therapy may create many complications and side effects. Hence one should be careful while practicing this therapy. Panchakarma vyapats (complications) may arise due to four reasons as mentioned by Acharya Charaka.
Physician:- Not taking proper decisions regarding the selection of patient, preparation of the patient, selection of the drug and dose.
Drug:- The drug with less potency, old Atirukasha (dry) may produce vyapat.
Pricharak (attendant):- Not performing proper duties while preparing the drug and preparation of the patients.
Rogi (patient):- Non co-operation with physicians may lead to complications (vyapat).
Vaman Vyapat (Complication Of Vomiting) And Management
Vamana vyapat can be divided into two varieties:-
- Ayoga (inadequate)
- Atiyoga (excessive)
Due to excessive (atiyoga) and inadequate (ayoga) administration the complications caused are-tympanitis, cutting pain, secretion, palpitation, bodyache, discharge of pure blood, displacement of viscera, stiffness and exhaustion. In ayoga the vyapats may be produced due to alpa pravrutti vegas (less), apravrutti vegas (absence) and asamyak pravrutti vegas (improper) where as in atiyoga the vyapat may produce due to atipravrutti (excess).
Causes Of Vamana Ayoga And Atiyoga
- Improper snehana that is internal oleation as well as external application of snehana.
- Improper swedana (sudation therapy)
- Selection of improper drug and dose, old and less potency drug.
- Krura (hard/vaat) or mridu (soft/pitta) kostha
- Teekshna or mandagni
- Strong body or weak body.
- Predominance of Ama.
Vamana Ayoga And Management
If we administer the vamana drugs for the patient who is having more appetite, tikshna agni (sharp digestive fire), mridu kostha (influence by pitta dosha), swalpa utklishta kapha (increased kapha), then instead of vamana he may get virechana due to ayoga. In above conditions the doshas are not evacuated properly hence patients may get alpavega (less) or avegaa (absence).
In vamana ayoga we may see two types of symptoms one is jeerna (digestion) aushadhi and second one is ajeerna (indigestion) aushadhi symptoms.
If we observe the symptoms like, vata anulomana (give direction to the movement of vata), good appetite, thirst, indriya prasannata (cheer fullness) and feeling happy then we can say that vamana aushadhi which is administered to the patient has been completely digested.
Then the patient should be kept once again on snehana (oleation therapy), swedana (sudation therapy) and vamana drugs according to the kostha. In some patients Niruha Basti with Gomutra (cow urine) and Madanaphala sidda tail anuvasana basti can be administered.
If the patient gets a burning sensation, headache, weakness, bodyache, restlessness etc. it indicates that the vamana drug is still present in amashaya (stomach) itself.
The following treatments should be kept in above conditions.
- Yastimadhu kwath and Lavana jala should be given according to the condition of the patient.
- Mechanical stimulation:- Madanaphala churna mixed with honey should be kept on tongue and ask the patient to do utklesha with his fingers.
- After getting a few vegas the patient may be kept on pachana (digestive) drugs like shankha vati, trikatu churna, sutshekhar etc.
Vamana Atiyoga And Management
The following conditions may lead to vamana atiyoga:-
- Mridu kostha (influence by pitta dosha)
- Excessive dosage of teekshna vamana drug.
- The patient should be kept on massage with ghee, avagaha swedan (sudation therapy) with cold water and sugar and honey will be given orally.
- Sthambhana treatment should be given.
- After vegas are stopped the patient should be given Laja manth and chandan and usheer siddha jala.
- In dehydration the patient may be kept on I.V. fluids.
Pharmacokinetics Of Vamana Dravyas
Vamana dravyas have the characters of vyavahi (diffuse) and vikasi (spreading nature) by virtue of veerya (potency) they get quickly circulated into large and small capillaries of the body. It pervades all over the body. By virtue of its ushna (hot) and tikshna (sharp) properties, the accumulated doshas get liquified and break up into small pieces at cellular level. Doshas started melting in the body due to ushna guna, we can observe the perspiration (sweda pradurbhava) on a patient's forehead or sometimes the whole body. Because of its vikashi guna, it detaches the malas from dhatus. At this stage we can observe horripilation (lomaharsha) in the patient. Owing to the presence of sukshma (tiny) guna and anupravana properties in the malas or doshas float because already the body has got smayak snigdha (internal oleation) and passes through smallest capillaries and ultimately reaches to stomach. Detached malas won’t obstruct even in the smallest capillaries. When a patient feels adhamana (flatulence) it indicates that doshas are shifted to the stomach. Vamana dravyas are predominant of Agni and vayu mahabhutas. When a patient feels nausea (hrillas) it indicates the doshas are urdhwagami (upward direction) and he may get vamana vega at any time.
In this article we read about vamana karma in which the elimination of imbalanced doshas (kapha and pitta) from the stomach and whole body through the mouth. It is indicated in various diseases like cough, asthma, sinusitis, skin diseases, poisoning, insanity etc. This procedure is done by various herbs like Madan phala (randia dumatorum), Madhuka (glycyrrhiza glabra), Nimba (azadirachta indica), Jeemutak (luffa echinata), etc.