WELCOM

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VAMANA IN ANNAVAHA SROTO VIKARA

PRESENTER : DR. SAYANTAN BERA3rd YEAR P.G. SCHOLARDEPARTMENT OF PANCHAKARMAD.G.M.A.M.C. GADAG

CONTENTS• Introduction•Vamana • Indication of Vamana•Sadyo Vamana•Difference between Sadyo Vamana & Classical Vamana•Samyak yoga, Ati yoga & Ayoga lakshana of Vamana•Srotos & Paryay•Types of Srotos

•Sroto dushti•Annavaha Sroto Mula •Annavaha Sroto dushti hetu & lakshana•Application of Vamana in Annavaha sroto vikara•Mode of action of Vamana•Discussion •Conclusion

INTRODUCTIONAyurveda is the only system of medicine which proposes the need of undertaking the purification of biological system from gross channels up to the molecular levels aiming to clean the entire organism to render it suitable for self recovery and therapeutic responsiveness. It is described classically in terms of samshodhana.

Cont…Vamana is usually the first major procedure in Panchakarma and is the best treatment for Kapha Dosha vikaras and kapha dosha associated with Pitta. It is very much useful in many diseases especially of Kapha origin. Numerous references regarding the Vamana Karma are available in the Ayurveda classics.

Cont…Srotas have foremost role in maintenance of the body.

Any imbalance in the doshas or injury to internal structures shows its external signs themselves in the form of various symptoms.

Cont…Vitiated doshas in the body causes the vaisamyata of the dhatus and circulates in the srota causes the disease.

Without involvement of the Srotas (sroto dushti) there will not be any vriddhi or kshaya of body substances.

VAMANA

VAMANA•वमन – तत्र दोषहराणं ऊर्ध�भागं वमन संज्ञकम् ।

(च.क. – १/४)

By which procedure vitiated doshas are expelled out from the upper part of the body through oral route, is known as vamana.

अपक्वपिपत्तशे्लष्माणौ वलात् ऊर्ध्वंव( नयेत्तु यत् ।वमनं तद्धि, पिवज्ञेयं…………………….॥ (शा.प.ू ४/८)

By which procedure apakwa pitta & sleshma are expelled out from the upper part of the body, is known as vamana.

पिवशेषतस्तु पीनसकुष्ठनवज्वरराजयक्ष्मकासश्वास-गलग्रहगलगण्डश्लीपदमेहमन्दाग्नि>नपिवरु,ाजीणा�न्नपिवसुचिचकालसकपिवषगरपीतदष्टदिद>र्धपिव,र्धःशोणिणतपिपत्तप्रसेकहृल्लासारोचकापिवपाकऽपच्यपस्मारोन्मादापितसारशोफपण्डुरोगमुखपाक दुष्टस्तन्यादयः श्लेष्माव्यार्धयो पिवशेषेण... (च.चिस. २/१०)

INDICATION

सद्य प्रत्ययः – तत् क्षणे, तत् काले (शब्दकल्पद्रुम)

Here sadhya means – immediately, Recently, Quickly attaining.

SADYO VAMANA

Sadyovamana means to attain an immediate or quick elimination of vitiated doshas through oral route.

It is a process, where vamana is carried out immediately without following any purvakarmas like Pachana, Snehana and Swedana.

DEFFERENCE BETWEEN VAMANA & SADYO

VAMANASADYO VAMANA CLASSICAL VAMANA

Vamana which is conducted

immediately in a single day.

Vamana conducted by arohan krama sneha pana upto samyak snigdha lakshana.

Not require vishrama kala.

Require vishrama kala.

Purva karmas like ama pachana, snehana, swedana are not mandatory to carry out sadyo vamana.

Purva karmas like ama pachana, snehana, swedana are mandatory to carry out classical vamana.

SAMYAK YOGA LAKSHANA

क्रमात्कफः पिपत्तमथापिनलश्च यस्यैपित सम्यक् वमिमत स इष्टः।

हृत्पाश्व� मूर्ध]द्धिन्^य माग� शु,ौ तथा लघुत्वेपिप च वक्षमाणे ॥

(च.चिस. – १/१४)

योगामिर्धक्येन तु फेपिनलरक्त चंदि^कोपगमनं इत्यपितयोग लक्षणापिन भवनं्तिन्त । (च. सू. १५/१३)

तृण्मोहमूर्च्छाा�पिनलकोप पिन^ावलादिदहापिनः वमनेऽपित च स्यात् । (च.चिस. १/१६)

ATIYOGA LAKSHNA

AYOGA LAKSHANAकेवलस्य वाप्यौषर्धस्य, पिवभं्रशः पिवबंर्धः वेगानां अयोग लक्षणापिन भवन्तिन्त । (च. सू. – १५/१३)

दुश्छर्दिदmते स्फोटकोठकण्डुहृत्खापिवशुद्धि,ः गुरुगात्रता च । (च.चिस. १/१७)

SROTAS

SROTASस्रवणात् स्रोतांचिस ।

Charaka has defined it as “Sravanat Srotamsi” meaning the structure through which sravanam takes place.

Sravana – स्रवणाद ्इपित रसादेरेव पोष्यस्य स्रवणात् ।

(चक्रपाणिण)

The term Srotas means a channel.It is derived from the root “su sravane” meaning, to exude; to ooze; to filter; to permeate.

स्रोताचंिस खलु परिरणाम् मापद्दमानानाम् र्धातुनामणिभवापिहपिन भवन्त्ययनाथ]न । (च.पिव. ५/३)

Srotas are the places where they will be carrying the substances (Asthayi Dhatu) which are ready for transformation to the Dhatu form.

PARYAY I.Srotamsi II.Siras III.Dhamanis

IV.Rasayanis V.Rasavahinis VI.Nadis VII.Panthanas

VIII.Margas IX.Sharira Chidras X. Samvruta samvrutani XI.Sthanas XII.Ashayas XIII.Niketas

(Cha.vi.5/9)

TYPES Charaka – 13i.Pranvaha srotasii.Udakavaha srotasiii.Annavaha srotasiv.Rasavah srotasv.Raktavaha srotasvi.Mamsavaha strotasvii.Medovaha srotasviii.Asthivaha srotasix.Majjavah srotasx.Sukravah srotasxi.Mutravha srotasxii.Swedavaha srotasxiii.Purishavaha srotas

Susruta – 11 pairsxiv.Pranvaha srotasxv.Annavaha srotasxvi.Udakavaha srotasxvii.Rasavah srotasxviii.Raktavaha srotasxix.Mamsavaha srotasxx.Medovaha srotasxxi.Mutravaha srotasxxii.Purishavaha srotasxxiii.Sukravaha srotasxxiv.Artavavaha srotas

SROTO DUSHTIAÌiÉmÉëuÉëÑ̨É:xÉÇaÉÉåuÉÉÇï ÍxÉUÉhÉÉqÉç

aÉëljÉrÉÉå AÌmÉ uÉÉÌuÉqÉÉaÉïaÉqÉlÉÇ cÉÉÌmÉ xÉëÉåiÉxÉÉqÉç

SÒÎxOû sɤÉhÉ|| (cÉ.ÌuÉ.5/24)

There are four types of sroto dusti vikara1. Atipravritti2. Sanga3. Sira granthi4. Vimarga gamana

SROTO DUSHTI HETUआहारश्च पिवहारश्च यः स्यात् दोष गुणैः समः Iर्धातणुिभर्विवmगणैुश्चापिप स्रोतसाम् स प्रदूषकः II (च.पिव.5/23)

Aahara and vihara that promote the Improper utilisation of foods, drinks and action that promote the morbidity of (aggravated) Doshas and go contrary to the well being of the Dhatus and vitiate the srotas.

ANNAVAHA

SROTAS

SROTO MULA The Moola sthanas can be considered as governing sites of that particular srotas for proper maintenance of the dhatus.

The sroto mula of Annavaha sroto are –अन्नवहानां स्रोतोसामाशयो मूलं वामं च पाश्व( (च.पिव. ५/८)अन्नवहे दे्व, तयोमू�लामाशय अन्नवापिहन्यश्च र्धमन्यः (सु.शा. ९/१२)

PARYAY• This srotas is related to the carrying,digestion,& absorbtion of food i.e. it is one of the most important srotases in the body.• This is a part of kostha,which has the following synonyms:

- Mahasrotas- Sariramadhya- Mahanimna- Abyantararogamarga- Amapakwashaya

--- (ch.su. 11/48)

ANNAVAHA SROTODUSTI HETUअपितमात्रस्य चाकाले चापिहतस्य च भोजनात् ।अन्नवापिहनी दुष्यन्तिन्त वैगुण्यात् पावकस्य च॥

( च.पिव. ५/१२)

ANNAVAHA SROTODUSTI LAKSHANA

अनन्नाणिभलषणमरोचकापिवपाकौ छर्दिदm च दृष्टवाऽन्नवहान्यस्य स्रोतांचिस प्रदुष्टानीपित पिवद्यात् ।

(च.पिव. ५/८)

तत्र पिव,स्यार्ध्वंमानं शूलोऽन्नदे्वषश्छर्दिद्दmः……..(सु.शा. ९/१२)

APPLICATION OF VAMANA IN

ANNVAHA SROTO VIKARA

ANNAVAHA SROTO VIKARAArochaka AjeernaAlasaka Visuchika

ChardiAmlapitta GrahaniShoola

AROCHAKA

प्रणिक्षप्तं तु मुखे चान्नं जन्तोन� स्वदते मुहुः । अरोचक स पिवज्ञेयः ......... (वृ, भोज)In a clinical condition where loss of appetite is present due to tastelessness in mouth.

Nidana sevana

Dosha vititiation

Affects Annavaha srota & Hridaya

Aversion of food

Arochaka (SU,UTT – 57/3)

SAMPRAPTI

वस्तिस्त समीरणे, पिपते्त पिवरेकं, वमनं कफे.........

(च.चिच. २६/२२०) (यो.र. – अरोचक चिचपिकत्सा/२) (व.स. – अरोचक चिचपिकत्सा/८)

•वाते वचाम्बुवमनं कृतवान्.... (सु.उ. ५७/६)

•पिपते्त गुडाम्बुमर्धुरैव�मनं...... (सु.उ. ५७/७)

•पिनम्बाम्बुवामिमतवतः कफजे ...... (सु.उ. ५७/८)

•कफाद्वमेमिन्नम्बजलै....... (अ.हृ. चिच. – ५/५२)

AJEERNA कालेऽपिप सात्म्यं लघु चापिप भुक्तमन्नं न पाकं भजते नरस्य ।

In a clinical condition when food (even lessquantity) is not digested properly.

Nidana sevana

Kapha pradhana tri dosha vititiation

Impairs agni function

Agnimandya

Leads to ahara avipaka

Ajeerna (च.चिच. १५/४४)

SAMPRAPTI

•ÌuÉSakÉå uÉqÉlÉçÇ ÌWûiÉqÉç|{xÉÑ.xÉÔ.46}

•ÌuÉSakÉå uÉqÉlÉÇ rÉ²É rÉjÉÉuÉxjÉÇ ÌWûiÉqÉç | [A.WØûxÉÑ 8]

•वचालवणतोयेन वान्तिन्तरामे प्रशस्यते । (चक्रदत्त अग्नि>नमान्द्य चिचपिकत्सा - ७६)

वमनाथ� पिवद्येयः स्यान्मर्धुसैन्धव मूर्छिछmतः ।न तु अजीण] पिहत तु अत लवणोष्णाम्बु केवलम् ॥तपिद्व सव� समुत्क्लित्क्लश्चमुखेनाशु पिवपिनह�रेत् ।

Person suffering from Ajeerna should not be given normal vamana dravyas to induced vamana. Lukewarm salt water is advised in this situation.

ALASAKA प्रयापित नोर्ध्वंव( नार्धस्तादाहारो न पिवपच्चते ।आमाशयेऽलसीभुतस्तेन सोऽलसकः स्मृतः ॥ (मर्धुकोष)

The ingested food remains stand still in the amashaya without getting digested for long time nor moves upward or downward.

Ati matra ahar

Mandagni

Vatadi dosha prakopa

Leads to ahara avipaka & Obstructs srotas

Failure to eliminate apakwa anna & dosha

Alasaka (AH,SU – 8/4)

SAMPRAPTI

•AÌiÉqÉÉ§É SÒ¹ÉxÉÑ SÉåwÉÈ mÉëSÒ¹ ............| (AS.SU.11/13)

In Alasaka utklishta dosha is present. Hence there is no need to produce the utkleshana of doshas further. So sadyovamana can be performed.• In amavisha condition emergency treatment should be given (its mentioned as “ashukarayita virudhopakrama cha”).

• In samadosha conditions, made to vomit with luke warm water with salt, followed by swedana. (Cha.vi.2/13)

•वमनन्त्वलसे पूव( लवणोष्णवारिरणा.......... (चक्रदत्त अग्नि>नमान्द्य चिचपिकत्सा - ९३)

VISUCHIKA सूचीणिभरिरव गात्राणिण तुदन् सन्तिन्तष्ठतेऽपिनलः ।यस्याजीण]न सा वैदै्दरुच्चते तु पिवसुचिचका ॥ (स.ुउ. ५६/४)

In a clinical condition where in aggravated Vata, because of severe Ajeerna produces pricking pain (toda) in the body is called Visuchika.

Nidana sevana

Mandagni

Vatadi dosha prakopa

Leads to ahara avipaka

apakwa anna & dosha moves rapidly upward or downward

Visuchika

SAMPRAPTI

•uÉqÉlÉÇ MüÉUrÉåiÉç ͤÉmÉëqÉÑwhÉålÉ sÉuÉhÉÉqoÉÑlÉÉ |

(Vang.Ajeerna/160)Vamana should be done with Luke warm salt water.

•.............वमनं च तीक्ष्णम् । (सु.उ. ५६/१२)

•पिवसूचिचकायां वमिमतं......... (चक्रदत्त अग्नि>नमान्द्य चिचपिकत्सा - ८५)

CHARDI उर्ध्वंवा�पितदोषप्रवृत्त रूपा छर्दिदmरुच्चते । (च.चिच. – २०/१, चक्रपाणिण)

In a clinical condition where the contents are expelled through mouth with anexpulsive force is known as Chardi.

Nidana sevana

Vyana vayu vitiation

Kanthastha udana vata vitiation Due to viruddha ahar sevana

Urdhwa gamana of vitiated dosha With food

Chardi (su.utt – 49/7)

SAMPRAPTI

वमिमषु वहुदोषासु छद�नं पिहतमुच्हते । (सु.उ. ४९/१६)

वहुदोषास्तिस्वपित प्रबलकफासु , अन्यथा सामिन्नपापितक्यामेव वमनं प्रापु्नयात् ,... (डल्हण्)

•Pittaja chardi – कफाशयस्थन्त्वपितमात्रव,ंृ पिपत्तं जयेत् स्वादुणिभरूर्ध्वंव�मेव ॥

(चक्रदत्त, छर्दिदm चिचपिकत्सा – ४)

•Kaphaja chardi – कफात्मित्मकायां वमनं प्रशस्तं सपिपप्पली सष�पपिनम्बतोयै: ।पिपण्डीतकैः सैन्धवसंप्रयुकै्त छद्दा( कफामाशय शोर्धनाथ�म् ॥

(चक्रदत्त, छर्दिदm चिचपिकत्सा – ४)

AMLAPITTA

अम्लं पिवद>र्धं च तत् पिपत्तं अम्लपिपत्तम् । (मर्धुकोष)

In a clinical condition where vidagdha pitta becomes amlibhava is known as Amlapitta.

Nidana sevana

Pitta vidagdha

Undergoes amlabhava process

Amlapitta

SAMPRAPTI

दोषोत्क्लेशो न सहसा ^वं औषर्धमाचरेत् ।वमनीयात् दृतौ तपिद्व न सम्यक् परिरपच्यते ॥(का.ग्निख. – अम्ल/२२)

Acharya Kasyapa has clearly mentioned that no liquid medicine should be administered suddenly, other than the Vamanoshadha.

अम्लपिपते्त तु वमनं पटोलारिरष्टवारिरणा । कारयेन्मदनक्षौ^चिसनु्धयुकं्त ततो णिभषक् ॥

(यो.र. अम्लपिपत्त चिचपिकत्सा – १)

प्रागम्लपिपत्तरोगात( कुलकारिरष्टवारिरणिभः । सराठक्षौ^चिसनु्धत्थैव�मनं कारयेद ्णिभषक् ।

(चक्रदत्त, अम्लपिपत्त चिचपिकत्सा – १)

उर्ध्वंव�गं वमनै........ (चक्रदत्त, अम्लपिपत्त चिचपिकत्सा – ४)

GRAHANI ग्रहण्यां सम्भवो रोगो ग्रहणीरोग, स्वनाम ख्यातेरोगभेदे ।

The disorder that occur in grahani

is known as grahani roga.

Nidana sevana

Mandagni

Improper digestion

Ama dosha goes to grahani & leads to grahani dusti

apakwa anna & dosha moves rapidly downward

Drava mala pravritti Grahani

SAMPRAPTI

स्नेहनं स्वेदनं शुद्धि,ल�ङ्घनं दीपनं च यत् । (च. चिच.

१५/१९६)

Snehana, swedana, shuddhi(Vamana, virechana, basti), langhana, deepaniya oushadha.

•……………….. पिवशु,स्य यथाक्रमम् | (सु. उ.४०/१७८)

Sl. No दोषजग्रहणी शोधनकर्म�

१. वात बस्ति�त

२. पि�त्त रृ्मदुपिवरेचन

३. कफ वर्मन

४. सन्नि �ातज �ञ्चकर्म�

•Pittaja grahani:पिपत्तं ज्ञात्वा पिवरेकेण पिनह�रेद्वमने वा । (च.चिच. १५/१२२)

•Kaphaja grahani:ग्रहण्यां श्लेष्मदुष्टायां वमिमतस्य यथापिवमिर्ध । (च.चिच. १५/१४१)

•Tridoshaja Grahani Chikitsa:

पित्रदोषे पिवमिर्धपिवद ्वैद्य: पञ्च कमा�पिन कारयेत् । (च. चिच. १५/१९४)

चक्र�ाणिण:Nasya does not help to treat grahani, but the other karmas are used to treat grahani.

•Ama grahani:

आमलिलmगान्तिन्वतं दृष्टवा सुखोष्णोनाम्बु उर्धरेत् ।फलानां वा कषायेण पिपप्पलीसष�पैस्तथा ॥ (च.चिच. १५/७४)

PARINAMA SHOOLA & ANNADRAVA SHOOLA pÉÑ£åü eÉÏrÉïÌiÉ rÉiÉç zÉÔsÉÇ iÉSæuÉ mÉËUhÉÉqÉeÉÇ |( qÉkÉÑ MüÉåzÉ )The pain which occurs at the end of digestion of food is known as parinama shoola.

जीण] जीय�त्यजीण] च यरु्च्छालमुपजायते । (यो.र.)The pain which occurs during digestion of food is known as annadrava shoola.

Nidana sevana

Agnidushti

Grahani & amashaya shotha

Shoola

SAMPRAPTI

लङ्घनं प्रथमं कुया�द्वमनं ....... (यो.र.)

कफजं वमनादै्दश्च पचिक्तशुलमुपाचरेत् । (यो.र.)

पिपत्तन्तं वमनं कृत्वा....... (भै.र. ३०/२६८)

VAMANA DRAVYAS

DISEASE DRUGSVataja arochaka Vachambu Pittaja arochaka Gudambu & madhura

dravyaKaphaja arochaka Nimbambu Ajeerna Vacha & lavanambuAlasaka Ushna lavanambu

DISEASE DRUGSVisuchika Ushna lavanambuPittaja chardi Madhura dravyaKaphaja chardi Pippali, sarshapa, nimba

kashaya, madana phala, saindhava lavana

Amlapitta Patola nimba kashaya, madana phlala, madhu, saindhava lavana

Ama grahani Sukhoshna ambu, madana, pippali

MODE OF ACTION

Vamaka drugs possessing the properties like Usna, Tiksna, Suksma, Vyavayi,

Vikasi

and with their ‘Swavirya’

Move to ‘Hridaya’

From there, through various ‘Dhamanis’ lead to micro and macro channels in the body

Act over the vitiated complexes in the body

(i) With 'Agneya Property' - liquify the complexes

(ii) With 'Tiksna property' - Break them down into several particles

Liquefied matter then glides through various unctuous or smooth channels

towards Kostha

Enter 'Amasaya' and then stimulated by 'Udana Vayu“

Having the dominance of 'Agni' and 'Vayu' elements in the constitution

along with self diposition

Move in upward direction towards oral cavity(due to urdhaga prabhava)

Expelled to outside through it

VAMANA

PROBABLE MODERN CONCEPT

Upper GIT Electrical Stimuli for Psychic Stimuli

when full of contents administration of drugs direct

stimulation

Over distended & CTZ stimulation Stimulates Over excitable hypothalamus

Stimulates Vomiting center

Automatic motor reaction

Motor impulses are transmitted from vomiting centre through

5th,7th,9th,10th,12th Cranial nervesSpinal nerves

Upper GIT Diaphragm & abdominal muscles

Initiates VOMITING

DISCUSSION Is Vamana the complete treatment for Annavaha sroto vikara?

CONCLUSION •Vamana is majorly associated with kaphaja vikara and kapha associated with pitta.• In the management of Annavaha sroto vikara, Vamana plays the major role.• In some of the Annavaha sroto vikara, Vamana act as avasthika chikitsa.•Among the shodhana Vamana is the vital procedure applied in sama avastha.