Vamana Karma

Vamana is body purifying therapy and help to remove excessive Doshas (Kapha) from body. It maintains appetite, cures disease, increases strength, complection and efficacy of an individual.Thus help for individual to live healthy for longer period. In this Modern Era people are more dependants on machines and gadgets. Physical activity is decreasing considerably. Junk and Fast food is becoming a source of unwanted fat and calories in the body. Also environmental changes are helping in collection of toxins leading to the progression of severe disease of Heart, Lung and Kidenys.

As the Panchakarma therapies are Biopurification methods, helps in removing these excessive Doshas, unwanted fat, toxins and Callories. As all these unwanted things get removed from all the systems (Strotasas) of body; it become fresh and its efficiency gets increased. There is sense of lightness (Laghuta) and person becomes more active in his day to day life.

According to Ayurvedic classical texts the ideal time period for Vamana is Vasant Ritu i.e. month of February and March. As Vamana is remedy for Kapha Dosha and in Vasant Ritu, Kapha is at its maximum level in body. Also environmental heat helps in its easy excretion from the body by melting it. But in diseased condition one can go for Vamana at any time according to the need.

Process of Vamana Karma:

Purvakarma: It include following steps.

1) Pachana: Pachana means to digest the Aam and vitiated Doshas. Charak has said that if Samsodhana medicine is taken in the condition of Ajirna, it will lead to Vibandha and Glani. On the contarary, it will produce Samyaka Sodhana in the absence of Aam in it. The Aam Pachna drug like Shunthi, Trikatu are given for Pachana before Snehana.

2) Snehana: Snehana refers to internal as well as external oleation of body. Internal oleation include intake of Ghrita or Oils in particular doses for about three to seven days depending upon the Dhoshic and Koshtha constitution of an individual. Symptoms like oily loose motions, oily skin and nausea even after smell of Ghrita confirms the proper oleation of body. Due to Snehana all the channels of systems become lubricated. This helps in easy passage of Doshas from periphery to the stomach without any obstruction. Increasing dose schedule of Snehapana is not described in any of the Brihatatrayi. Kalyanakara(6th A.D.) first time, clearly mentioned that Sodhanartha Abhyantara Snehapana is to be given in increasing doses only. Vangasena (9th A.D.) also repeated "VardhAamna dose schedule". This pattern was practically followed for Snehapana. External oliation is done by application of medicated oils over the body. Charak has mentioned that external oliation should be done along with Fomentation (Swedana) for two to three days.

3) Swedana: Swedana Karma is simply the group of procedures used to induce sweating. Charak eloquently tells us that Swedana is “whatever relieves stiffness, heaviness and cold in the body and produces sweat”. This is of two type

· Agni Sweda (Direct fomentation by heat or steam)
· Anagni Sweda (Indirect fomentation)

Chakrapani while elaborating Snehana and Swedana states that Abhayanaga should be done along with Swedana for two or three days i.e on the day when Snehapana is completed, gap day and the day on which Vamana is to be administered. Charaka stated that Swedana liquefies the morbid matter, which is stuck up in the minute channels of the body of the person who has undergone oleation therapy.

Due to fomentation all the vitiated Doshas are melted. Blocks in various channels are removed leading to safe passage of Doshas without any obstruction.

4) Dietetic regimen: It can be catagerised into following three groups

Diet During the Days Of Snehapana:
During Snehapana, patients are advised for having the diet of Drava (liquid), Usna(hot), Anabhisyandi properties in appropriate quantity. The food must not have too unctuous material mixed in it. Also it should not contain the articles having the property to provoke any other dosha. Patient should be advised to consume lukewarm water whenever needed.

Diet for previous night of Vamana
In previous night just before of the Vamana Karma, patient is advised to take the diet that increases Kapha in body. Thus it should have the properties like heavy, liquid and ability to produce secretions (Abhisyandi). The Mansarasa of the animals of Gramya, Anupa &Audakaorigin. The articles made of milk Sesame, Black gram, Curds, Milk, Jaggery, Fishes, Mutton soup etc can be used.

Diet just preceding to Vamana karma
Charak has mentioned that patient should be empty stomach or the drug given before Vamana should not be too unctuous or one may add a little unctuous material in it. One can use Peya mixed with Grita, Yusha, Mansarasa, Yavagu, Manda before giving vamak drug.
Acharya Bhela said that in emesis proses during empty stomach, Vayu gets very much aggravated (samprakupyati), spleen moves away from its place and because of this aggravated Vata it takes away the Life. So before starting Vamana procedure diet has given to patient.

Pradhanakarma: The main procedure of Vamana Karma is included in it.

1) Vamana Room & Position of Patient
After performing all the regularities in Purvakarma, Snehana Swedana is performed on the day of Vaman. After this patient is brought in Vamana Room. Charaka has mentioned to prepare specific Vamana room for Vamana karma. He has advised to observe the patient for Jirnahara (whether digestion of food of previous night has completed or not) and then carry out the process under auspicious Constellation, Day, Karana, and Muhurta. He also says that before Vamana, “Svastivachana” should be performed by Brahmins. Patient is asked to sit on the chair upto his knees (Janutulyasan) .

2) Administration of Vamaka Dravya
Ikshurasa, Yashtimadhu Fanta etc were given for Akantha pana. Then Madanphala mixed with Madhu and Saindhv was administered. Rhymes described in texts was chanted for successful and uneventful complication of the procedure.

3) Observation Of Patient :
After giving the Vamaka Yoga it was advisible to wait for one Muhurta i.e. 48 minutes. When patient starts vomiting keen observation should be done regarding manner of emesis, number of vega, symptoms and sign in patient, symptoms of Heena or Vyapada of Vamana etc.
After completion of Vamana Karma detailed examination of patient and fluid come out after emesis should be done. It is done on four levels.

• Antiki Pariksha:
  It denotes which of Doshas was evacuated lastly by Vamana. Genarally if Vamana starts with Kapha followed by Pitta then Vata Dosha it is considered normal.
  
• Vaigiki Pariksha:
  It count number of bouts of emesis. By classical texts 8, 6 and 4 bouts are seen in Uttama, Madhyama and Heena Shuddhi.
  
• Laingiki Pariksha:
  It include sign felt by patient. Signs of good emesis are Hridaya Shuddhi; Kale Pravrutti; (of natural urges) Parshva, Murdha, Strotas Shuddhi; Indriya Shuddhi; Laghavata and Daurbalya etc. And called as Samyak Suddhi. Symptoms of Ativega include Trishna, Moha, Murccha, Vata Prakopa, Nidra Hani, Bala Hani, Hritpida, Kantha Pida, Bhram, Tam Pravesh etc. A physician should treat it as an emergency and should follow necessary steps required to manage the situation. Symptoms of Heena vega are Vega Aravritti, Vibandha, Hridaya Ashuddhi, Sphota, Kandu, Guru Gatrata, Jwara, Kapha Prasek etc. In these cases appropriate reason for Heenavega should be found out and again Vamana should be given if required.
• Maniki Pariksha:
  It includes measuring of emetic fluid. The amount emitted out can denote the amount of Shuddhi in patient. In Uttama, Madyama and Heena Shuddhi amount of fluid emitted is Two Prastha, One and half Prastha and One Prastha respectively.

Pashcchyata Karma: It can be divided into following three parts.

1) Dhumapana:

Charaka stated that after Samyaka Vamana, patient is advised to wash mouth, hands & feet, then to rest for a Muhurta . Afterwards one is advocated to inhale the smoke from any one of the three types of smoke i.e. Snaihika (unctuous), Vairechanika or Upashamniya (Sedative), which will be suitable for him. Then one is made to wash again. Dalhana provides the reason behind it as smoke will help to separate Kapha which is stuck to strotasas.
2) Sansarjana Krama:
After thoughtful examination of patient and Vamana Karma; status of Suddhi is decided and patient is adviced Sansarjana Krama. For Uttama Shuddhi it is administerd for 3 Annakala, for Madhyama Shiddhi 2 Annakala and for Heena Shuddhi 1 Annakala.Vamana itself produces a lot of strain on the body and hence responsible for low level of Bala and capacity for digestion. With Sansarjana Krama the low Agni is stimulated and is flourished up to normal state. After the Panchakarma procedure digestive power gets hampered, so one is unable to digest normal diet. To increase the digestive power, patient should be gradually shifted to normal diet from Peya (thin rice water), Vilepy (thick rice water), Yoosha (moonga soup) etc. This type of diet regimen after Panchakarma procedure is called as Sansarjana Krama. This type of diet therapy can be advocated for three to seven days depevding upon the Shodhana process. Seven days of Sansarjana Krama is tabulated below.

Table showing Sansarjana Kram :

Pariharya Vishaya after Vamana:

Behavioral Restrictions:
Loud speeches, sitting in one position for long duration, standing in oneposition for long duration, long walks should be avoided. Exposure to excessive cold or heat or dew, exposure directly to flowingwinds, long journey, sleeplessness in the nights, sleepsduring day time, to retain strong urge or provocation of the urges should be avoided.

Dietetic Behaviour:
Viruddhadiets, diet during AjirnaState, Apathyadiet, meals at wrong times, Pramita diets, excessive diet, less diet, heavy diet,Vishamdiet should be avoided. Usually desired rasayana therapy is given after purification of body by Panchakarma treatment.