Standardization of Vamana karma

Standardization of Vamana karma 


The verb “to standardize” means average out, equalize, homogenize, systematize,make uniform, regulate, normalize, regiment or bring into line.

The available References are dated from B.C  where the technology has not developed but in the  Present era, science is developing drastically where objectivity is mandatory.
In classics for each procedure there are different explanation where understanding the context is  found to be difficult.

If Physicians are having Alpa Buddhi like in the present day, then the basic understandings of the concept is found to be difficult for its application.


To remove  misconception  regarding Panchakarma therapy  in Allied sciences.
Awareness in Public.
Uniformity in adaption of treatments like Modifications in Procedures, Use of New Instrument…...



References in classics 

¨Charaka 1st time described Vagiki, Maniki, Antiki &  Langiki  Lakshana as criteria for Assessment
¨1 Mhuhurta Nirikshana Kala for Vamana
¨Sarangadhara mentioned different Pramana for administration of  Vamana Dravya.
¨Dose of Niruha Basti according to Age
¨Dose of Nasaya
¨Arohana Snehapana krama( Vangasena)

General Guidelines

 ¨All the Panchakarma Procedures should be performed by the same Therapist/ Physician till the completion of Clinical trial.
¨The Medicine which is used in the trial for the Participants shouldn’t be changed.
¨The Participants belonging to the same region should be considered for the clinical Trial.
¨The shodhana therapy should be conducted in the respective season  Eg- vamana in Vasanth Rutu
Steps of Standard Operative procedures….(sop)

Pre-operative Procedure

¨Material required with Quantity and specifications
¨Therapist requirement
¨Drugs required for therapy- Number, Quantity
¨Formulation/Medicine preparation method
¨Selection of medicine based on Prakriti, Dosha and Dushya.
¨Use of the genuine drugs
¨In case of non availability of genuine drugs, the best possible alternatives should be used.

Operative procedure

¨Procedure step by step
¨Suitable time
¨Frequency of Therapy
¨Duration of Procedure
¨Course  of Therapy

Post operative procedure

¨Rest duration
¨Bath - Medicated or non medicated
¨Meals - Quantity, Quality, Frequency
¨Dietetic at Behavioral restrictions
¨Oral medicines  (Dose, Time,Anupana)

Vamana Karma

¨Vamana – 1st Shodhana karma
¨Vamana – Reference found in Vedic period
¨Vamana – Tatra Dosha Hara Urdhwabhagam
¨Vamana – Kaphaja Disorders…
¨Vamana – Acute to Chronic disorders.
¨Vamana – Dravyas

Poorva karma

¨Sambhara Sangraha
¨Atura Pariksha
¨Matra Nirnaya
¨Atura Siddhata includes-
    - Vamana Poorva Bhojana Vyavastha
    - Snehana and Svedana
    - Manasa Upacara

Pradhana karma

¨Administration  of Vamana Yoga
¨Observation of the Patient
¨Vega Nirikshana and Nirnaya
¨Observation of Yoga, Ayoga and Atiyoga
¨Vamana Vyapad and Chikitsa

Paschatkarma

¨Dhumapana
¨Pariharya Vishaya
¨Samsarjana Krama

Standardization of vamana

Materials required:-

¨Large Basin      - 1
¨Medium sized vessel     - 2
¨Steel glass (capacity-250ml) - 2
¨Table spoon                       - 2
¨Khalwa Yanthra                 - 1
¨Stool                                 -1
¨Chair with arm rest     - 1
¨Cotton cloth                 - 2
¨Hot water bath vessel    - 1
¨Stove    - 1

Pre-operative procedure

1. Preparation of the Patient:-

¨The Patient should be made Samyak Snigdha by proper Snehapana.
¨On attaining Samyak Snigdha Lakshanas, Abhyanga and Ushma Sveda are done on next day.
¨ Kaphothkleshakara Aharas are given in the afternoon.
¨On the day of Vamana  Abhyanga and Ushma Sveda

2. Preparation of medicine:-

Vamana Dravya
¨Madanaphala Choorna               -  3 to 5 grams
¨Vacha                                         -  5 grams
¨Yashtimadhu Choornam            -  7.5 grams
¨Honey                                        -  QS
¨Saindhava                                  - 15 grams
¨Milk                                           -  4 to 6 liters
¨Hot water                                    - QS
¨Karpooradi or Haridradi Varthi  -  1
¨Oil                                               -  QS

Operative procedure

¨The patient should be anointed with proper oil followed by proper Svedana.
¨All these process should be completed around 7am.
¨He should then be seated on a chair facing a basin kept on a stool.
¨At first the patient should be given around 6 glasses of milk to facilitate easy bouts of vomiting as well as to prevent the complication of forceful vomiting.
¨After that the medicine for Vamana should be administered.
¨Advice the patient to sit comfortably and concentrate on the forth coming signs of vomiting.
¨The maximum time interval for the first bout to occur should not exceed more than 48 minutes after the medicine is given
¨The physician should observe for the following signs
¤Sweating
¤Horripilations
¤Distention
¤Salivation
¤Oppression in chest etc
¨Vomiting usually occurs following the appearance of this/these signs.
¨The patient is asked to bend forward and vomit into the basin kept in front.
¨Simultaneously the two flanks and fore head of the patient should be held by another person
¨His umbilical region and back should be massaged in upward direction.
¨The appropriate Drava Dravyas are administered in between if necessary.
¨If the bouts are not coming up easily, then the patient is asked to bring the bouts manually by tickling his throat either with his fingers or a soft tube without injuring the throat.
¨Vamana is continued till the Samyak Lakshanas are seen viz. Pittanta (most preferable)/ sufficient Kapha Chardhana/Shareera Laghuta-Kosta Laghavata/Dourbalya.
¨The patient should be asked to wash his face with Luke warm water followed by Dhoomapana with Karpooradi or Haridradi Varti.


Vamana yoga

¨Classical method- On Previous day  Antarnakamusti Pramana of Madhana Phala Pippali is taken & mixed with  Yastimadhu Kashaya . On the day of Vamana, Kashaya is filtered & mixed with Madhu & Saindhava

¨Traditional method- Madhanaphala Pippali Churna , Vacha Churna & Saindhava mixed with Madhu.

¨Standardized method- Yastimadhu Kashaya prepared in the ratio 1:8

Vega Pratikshakala

¨Classical Method :-  1 Muhurtha
¨Standardization :- 20-25 mins


Vega Nirikshana

¨Classical  Method - , Vaigiki, Maniki, Antiki & Laingiki
¨Standardization – Colour, Consistency, Odour
                                 Sound

Vaigika lakshana

¨Quantity - At least the quantity of Vega should be more than that administered at a time; was taken as Quantity Parameter.
¨Duration – Average time 5-6 sec
¨Force

Conclusion

¨Standardization is not a new topic in Ayurveda , though the reference are dated from B.C  but Acharyas have concluded only after various clinical studies.

¨Standardization is required for the physicians for performing Effective and Safe Panchakarma