Introduction

The most important aspect of Ayurvedic therapy is Panchakarma. It is a therapy that is used to prevent, preserve, promote, cure, and rehabilitate the person for better health.  Panchakarma basically includes 5 therapeutic procedures that includes Vaman, Virechan, Niruha Basti, Anuvasan Basti and Nasya. Each of these procedures are useful for therapeutic purposes and each procedure is used for different diseases as per the need of the Disease and Diseased person. Vaman karma or the therapeutic  emesis is one of the  integral parts of therapeutic procedure of Ayurvedic system of medicine i.e. Panchakarma. According to Acharya Charaka and Vagbhatta, Vamana is included in Langhana Upakrama.[1]  Ayurveda emphasizes the use of various therapies to eradicate vitiated Dosha according to seasonal variations, such as Vamana in Vasant Rutu, Virechana in Sharad Rutu, Basti in Varsha Rutu, and so on, for the preservation and promotion of health and illness prevention.[2]

Each procedure has its own therapeutic value as follows-

1.Vaman- Kaphaj diseases

2. Virechan- Pittaj diseases

3. Niruha basti-

4. nuvasan basti-

5. Nasya- Urdhva-jatrugata rog.

Here as said Vaman is used for treatment of Kapha dominant disorders. These Kapha dominant disorders may are of two types-

1. Pure Kaphaj
2. Kapha in association with other doshas but dominance of Kapha is present.

Importance  Vaman for Kaphaj disorders :

Kapha, dosha that resides in the upper part of the body , main place of residing being the Aamashay and the two main openings of our body being the Mouth and Anus. If compared, for kapha that resides in the upper part of body the mouth is much nearer for extraction of doshas from body. While for being extracted from Anus the doshas will have to pass through whole of Small and Large Intestine. Also being of sticky nature if kapha dosha gets stuck to any of the folds of intestine throughout the journey from aamashay to guda, it will be difficult for it to excrete and that stuck dosha will give rise to new disease in body after Shodhan is done.[3] As the doshas are accumulated in koshtha before panchakarma with the use of Snehana and Swedana. After that Accumulation of doshas the nearest path of excretion is used as a path of excreting the excess and impure doshas from out of our body.[4]

Indication and Contraindications of  Vamana Karma:

1. Indications:

Diseases where Sodhana (Detoxification) required like  Unmada (Psycholigical disorder), Apasmara (Epilepsy),    Prameha (Diabetes), Kustha (Skin disorders),  in the Kapha dominant conditions e.g. Ajirna (Indigestion), Kasa (Cough), Agnimandya (reduced appetite), Pinasa, (cold), Shvasa (Asthma).[5]

1. Contraindications:

Diseases with acute onset eg. Hrudgraha (Heart ailments),  Udavarta, conditions in which body is  maciated eg. Kshataksheena, where Doshas move in upward direction eg. Urdhwaga Raktapitta (upper tract bleeding disorders) and in weak, old aged individuals, and diseases involving vital organs.[6]

Vaman

VAMAN:

Before any Panchakarma, the patient has to do some other things as well that is helpful in preparation of body to successfully complete the karma and excretion of doshas from body so that doshas can be normalized and further it can recover properly. This is called as Poorva karma. After this- Pradhan Karma need to do  i.e. Vaman karma then Pashchat Karma followed by Sansarjan Karma. It can be divided into three steps

1. Purva Karma (preoperative preparation)
2. Pradhana Karma (operative procedure/induction of Vamana)
3. Pashchat Karma (post operative care)

1. Poorva Karma

In Poorva karma- as understood earlier- it is focus is to prepare body for the Pradhan karma ( main karma). The preparation means- the doshas that has moved from koshtha to shakha due to various reasons, these doshs are aggravated and melted afterwards, so that they can be cumulated in koshtha,  for this purpose, Snehana and Swedana is required to pull these dohasj into the kostha.[7]

a. Snehana-

Used for aggravating the amount of doshas that has accumulated in our body. It can be understood using the example of – when too much of sticky dirt is accumulated on a place, we put some water over itand let it stay there for some time so that it can be bit aggravated and this way the clinginess is reduced by some level after which it becomes bit easier to remove. It is exactly how the sneha works inside human body. The sneha dravya and the quantity of this sneha can vary accordingly to the needs of disease and diseased person.[8]

b. Swedana –

Swedana is the  process of poorva karma, the person after snehana through which the doshas are aggravated are now to be brought to koshtha for accumulation so that later they can be excreted out of body using appropriate method of excretion.

Here swedana, works in following ways-

When the dirt we have put water on in order for it to swell up after that when such a sticky and oily dirt is given heat  this dirt slowly starts to melt and move downwards and if we see it then in the very same way , this aggravated dosha melts slowly and accumulates in the common place i.e. koshtha when this stage is reached then swedana action is complete.Whole of the procedure of shehana and swedana should be planned according to the need of patient’s body. After the completeion of snehana and swedana the following stages are reached-

The doshas are melted and accumulated in koshtha region ( gastro-intestinal region) Now, these doshas are ready for excretion through chosen method.[9]

 Pradhan karma-

It refers to main Vaman karma. After, the doshas are accumulated in koshtha are excreted from body through mouth. But, these doshas cannot come out of the body on its own, thus they need  medium through which these doshas can come out of body. On the other hand, a drug that promotes emesis is also needed so that the diluted doshas and the medium does not start getting digested in koshtha but rather is vomited outside from body so that the doshas are excreted outside the body. This is the basic principle behind Vaman. i.e., just fill up the Amashay just like a vessel till top and then with the help of medium and emetic drugs the Amashay is emptied with doshas mixed with medium.[10,11]

The main properties of Vaman Dravya –

Rasa- Tikta, Katu, Kashaya

Guna- Laghu, Ruksha

Vipaka- katu

Most of the Vaman drugs are used based on these qualities.

Panchabhautik constitution of Vamak Dravya-

Important factor to take under consideration is that in Vaman the action occurs in Vaman in opposite direction to gravity. So, the properties that promotes such actions has to be lightweight so that they can support the action properly thus the qualities supporting Vaman action are- ruksha, laghu etc. The min mahabhuta according to the lightweight etc properties are Vayu and Aakash mahabhuta.

C. Pashchat karma ( Sansarjan karma)

In pashchat karma mainly, after the Pradhan karma, some specific precautions and some dietary precautions are needed to be followed so that the body can recover from the weakness it has to experience after Vaman. This period of karma is also called as Sansarjan karma.[12]

The main purpose of Sansarjan karma is as follows-

Due to Vaman, the body has to undergo the regular procedure of excreting/vomiting out of body  due to which body is exhausted and weak following this Sansarjan karma helps in restoring the strength of body slowly and steadily so that no sudden change is brought in body and body can recover and maintain its health. 

The weakness is not observed just in body but also in the digestive power of body, which in Ayurved is called as Agnimandya and the process of giving food in Sansarjan karma is designed in such a manner that body can easily digest and provide energy such food is given first in the order as it will be helpful for body to recover the strength afterwards bit more heavier food is given and so on. So  that slowly and steadily the strength of agni  and thus the digestive power can be re-established slowly and steadily in a stable manner. The whole purpose of this Sansarjan karma is to help recover the body in a slow, steady and stable manner.[13]

Sansarjan karma: It  is designed to be of 12 kala and 7 days. Now ,these kala can differ according to the amount and nature of vaman and also the need of patient. The formulations used in Sansarjankarma are as follows- Manda, Peya, Yavagu, Odan, Mansarasa etc.[14]

Table no 1  The sequence of Sansarjan Karma[15,16]

Discussion

VamanaKarma, the first measure amongst Panchkarma has been considered as the best line of treatment for the Kaphaja disorders. Vaman or emesis under all the protective precautions in Ayurved is used as a procedure that shows tremendous results to even some conditions that are considered as non-treatable by other pathies. the best period for this vaman procedure is said to be Vasant Rutu as in this season, the kapha in body is melted naturally the due to increased heat after cold season. So, this procedure should be done in Vasant rutu for the purpose of maintenance of health as after Vaman the chances of any seasonal also reduced.

Conclusion

Vaman is one of the main Panchakanna procedures that is used for treating kaphaj disorders. For Vaman the body is needed to be prepared for which the poorva Karma - Snehana and swedana is used after which the pradhan karma -vaman is carried out and for the purpose of steady recovery of body the sansarjana karma is carried out. Vaman  is most useful in Kaphaj Vyadhi as body channels (srotas) are purified which help to cure the diseases from its root.