Changes

== Etymology ==

== Etymology ==

The word “vamana” in Sanskrit is made from root word “vam” which means to eject. Suffix “lyut” is added. <blockquote>वमन न० वम ल्युट् ।१ मर्दने २ छर्दने मेदि०) (Vachaspatyam)<ref>Vachaspatyam Pg 4847</ref></blockquote>Vama and lyut pratyaya together makes word vamana.

 

The word “vamana” in Sanskrit is made from root word “vam” which means to eject. Suffix “lyut” is added.

 

Vama and lyut pratyaya together makes word vamana.

Meaning, to vomit, to expel, to move or movement.

Meaning, to vomit, to expel, to move or movement.

== Indications for Vamana Karma ==

== Indications for Vamana Karma ==

Indications for any panchakarma are mainly based on the dominance of dosha in a particular disorder and the site at which dosha provokes.  Thus, to mention few, indications for vamana karma are,

Indications for any panchakarma are mainly based on the dominance of dosha in a particular disorder and the site at which dosha provokes.  Thus, to mention few, indications for vamana karma are,

(To/beEdited)Acute fever, diarrhoea, bleeding disorders, tuberculosis, different types of skin disorders, diabetes, tumours, cough, asthma, obesity, heart diseases, epilepsy, piles, anaemia etc. (asht. sutr.27) (char. sidd.2.10) (sush.chik. 33.18)  

* Nava jwara(Acute fever),

* Atisaara (diarrhoea),  

* adhoga rakta pitta (bleeding disorders),  

* rajayakshma (tuberculosis),

* kushta (different types of skin disorders),  

* prameha (diabetes),  

* arbuda (tumours),

* kasa (cough),  

* shwasa (asthma),  

* medoroga (obesity etc),  

* hridroga (heart diseases),  

* apasmara (epilepsy),  

* arshas (piles),  

* pandu (anaemia) etc. (asht. sutr.27) (char. sidd.2.10) (sush.chik. 33.18)    

== Contraindications for Vamana Karma ==

== Contraindications for Vamana Karma ==

Vamana is mainly not considered in Vata dosha predominant diseases, where body is highly emaciated, in very weak and very old individuals. Thus, to mention few,

Vamana is mainly not considered in Vata dosha predominant diseases, where body is highly emaciated, in very weak and very old individuals. Thus, to mention few,

In infant, very old, weak, tired, hungry, excessive thirst, exhausted from lifting weights, pregnancy, suffering from anxiety, worm infestations, bleeding disorders having pathology in upper half of body etc.

* Ati baala (In infant),  

* ati vriddha (very old),  

* durbala (weak),  

* shranta (tired),  

* kshudita (hungry),  

* pipasita (excessive thirst),  

* bhaaarahata (exhausted from lifting weights),  

* garbhini (pregnancy),

* chinta prasakta (suffering from anxiety),  

* krimi (worm infestations),  

* urdhvaga raktapitta (bleeding disorders having pathology in upper half of body) etc.

== Vamana Procedure ==

== Vamana Procedure ==

# '''Dhumapanam:''' Dhumapana (धूमपानम्) or inhalation of medicated smoke wherein the dravya or herbs to be smoked are decided based on the health of the patient. Dhumapana is essential procedure to eliminate the remnant kapha dosha which is adhered to bodily channels locally even after vamana.<ref>Sushruta Samhita (Chikitsasthanam Adhyaya 33 Sutram 11)</ref>  

# '''Dhumapanam:''' Dhumapana (धूमपानम्) or inhalation of medicated smoke wherein the dravya or herbs to be smoked are decided based on the health of the patient. Dhumapana is essential procedure to eliminate the remnant kapha dosha which is adhered to bodily channels locally even after vamana.<ref>Sushruta Samhita (Chikitsasthanam Adhyaya 33 Sutram 11)</ref>  

# There are certain behavioral instructions stated to avoid further complications.  Patient should avoid sitting or standing in one position for too long, long walks must be avoided, speaking loudly, anger, grief, exposure to excessive cold, sunlight, winds etc.  sexual indulgence, sleeping during daytime, staying awake late at night are few restrictions to be avoided after vamana karma.

# There are certain behavioral instructions stated to avoid further complications.  Patient should avoid sitting or standing in one position for too long, long walks must be avoided, speaking loudly, anger, grief, exposure to excessive cold, sunlight, winds etc.  sexual indulgence, sleeping during daytime, staying awake late at night are few restrictions to be avoided after vamana karma.

# '''Samsarjana krama''':  (संसर्जन क्रमम्) It refers to the specific diet plan after vamana karma (rehabilitation diet) which is given from aat least 3 to 7 days depending on the grade of shuddhi (purification) happened by vamana. It is to be started from the same day (evening) of the procedure or on the next day morning if there is any vitiation of doshas observed and remaining doshas are yet to be eradicated.

# '''Samsarjana krama''':  (संसर्जन क्रमम्) It refers to the specific diet plan after vamana karma (rehabilitation diet) which is given for at least 3 to 7 days depending on the grade of shuddhi (purification) happened by vamana. It is to be started from the same day (evening) of the procedure or on the next day morning if there is any vitiation of doshas observed and remaining doshas are yet to be eradicated.

# On the first day or as a first meal, “manda” (मण्डम्) is ideally made with red variety of rice which is a gruel like food preparation which is given for three consecutive meals. This kind of preparation is liquid in nature and helps the weak digestive state which is present after the vamana karma.

# On the first day or as a first meal, “manda” (मण्डम्) is given. It is ideally made with red variety of rice which is a gruel like food preparation which is given for three consecutive meals. This kind of preparation is liquid in nature and helps the weak digestive state which is present after the vamana karma.

# For the next 1 or 2  consecutive meals “vilepi” (विलेपी) which is again a kind of gruel, made with red type of rice is given. This is semisolid in consistency.

# For the next 1 or 2  consecutive meals “vilepi” (विलेपी) which is again a kind of gruel, made with red type of rice is given. This is semisolid in consistency.

# After this,” odana” (ओदनम्) which is a well cooked rice made with red rice along with mudga yusha (मुद्ग यूषम्  soup from green gram) is given for next one or three meals. Warm water is consumed during samsarjana krama.

# After this,” odanam” (ओदनम्) which is a well cooked rice made with red rice along with mudga yusha (मुद्ग यूषम्  soup from green gram) is given for next one or three meals.  

# Warm water is consumed during samsarjana krama.

# For the next one or three meals meat soup is given or for vegetarians simple regular diet is started. Later, the patient is expected to have a normal diet.

# For the next one or three meals meat soup is given or for vegetarians simple regular diet is started. Later, the patient is expected to have a normal diet.

In this way gradual shift in diet from rice water to normal diet helps one to regain his digestive strength which is significantly hampered in the process of vamana. Thus if one follows all the diet and other guidelines carefully can recover from illness and also prevent adverse effects of the therapy.  

In this way gradual shift in diet from rice water to normal diet helps one to regain his digestive strength which is significantly hampered in the process of vamana. Thus if one follows all the diet and other guidelines carefully can recover from illness and also prevent adverse effects of the therapy.  

== Mode of action of vamana karma ==

== Mode of action of vamana karma ==

Vamana karma is not just a gastric lavage, or a pathological vomiting, it is a complete systemic cleansing of morbid Kapha dosha having widespread advantages. When vamana drug is given orally, the active principle present in the drug reaches the cell where it forces the cell to release the toxins back in the stomach. (NeedsCitation) From there on the vomiting occurs. This process occurs due to the irritant action of the drugs, which leads to mild inflammation at the site of action. This in turn leads to increased permeability in the capillaries which will allow the absorption as well as excretion of the substances. The vamana drug are given in full stomach when the pyloric end of stomach is closed allowing all the activities of the vamana dravya to remain in stomach itself. At the end of process bile is seen in vomitus due to flux of antiperistalsis set during the process, which means that the pyloric valve is open, and the procedure is completed or the morbid kapha dosha has been completely expelled out.

Vamana karma is not just a gastric lavage, or a pathological vomiting, it is a complete systemic cleansing of morbid Kapha dosha having widespread advantages. When vamana drug is given orally, the active principle present in the drug reaches the cell where it forces the cell to release the toxins back in the stomach. From there on the vomiting occurs. This process occurs due to the irritant action of the drugs, which leads to mild inflammation at the site of action. This in turn leads to increased permeability in the capillaries which will allow the absorption as well as excretion of the substances. The vamana drug are given in full stomach when the pyloric end of stomach is closed allowing all the activities of the vamana dravya to remain in stomach itself. At the end of process bile is seen in vomitus due to flux of antiperistalsis set during the process, which means that the pyloric valve is open, and the procedure is completed or the morbid kapha dosha has been completely expelled out.<ref>Principles and practice of panchakarma, Dr. Vasant C. Patil , Chaukhamba publications 5^th edition chap 11^th pg 340-345</ref>

In a nut shell, vomiting in modern view is a cascade of events which leads to expulsion of upper gastrointestinal contents.

In a nutshell, vomiting in modern view is a cascade of events which leads to expulsion of upper gastrointestinal contents.

== Therapeutic considerations ==

== Therapeutic considerations ==

Vamana is advised even prophylactically in Vasant [[Rutucharya (ऋतुचर्या)|rutucharya]] where kapha dosha is seen in prakopa awastha (exaggerated). Mainly in chaitra month of hindu calendar which is mid-March to mid-April.   (char. Sutr.10.46)

Vamana is advised even prophylactically in Vasant [[Rutucharya (ऋतुचर्या)|rutucharya]] where kapha dosha is seen in prakopa awastha (exaggerated). Mainly in Chaitra month of hindu calendar which is mid-March to mid-April.<ref>Charaka Samhita (Sutrasthanam Adhyaya 10 Sutra 46)</ref> 

 

Few pathological and biochemical examinations, ECG etc before vamana karma as a routine is done.

Assessment of the patient before Vamana includes Dashavidha (10 fold examination parameters) and astha vidha pareeksha (8 fold examination parameters)  alongside other clinical examinations like respiratory system examination, Gastrointestinal Tract examination, Cardiovascular examination etc. Blood Pressure, temperature, pulse and other vitals are also checked before, during and after vaamana karma. In certain traditions of vaidys or at institute level, routine blood check up, ECG etc are also done before the patient is posted for vamana.  

Vamana is contraindicated in vata dosha related diseases but there can be certain exceptions also, in such cases mild vamana is indicated.

Vamana is contraindicated in vata dosha related diseases but there can be certain exceptions also, in such cases mild vamana is indicated.

== References ==

== References ==