A REVIEW ON PHARMACODYNAMICS OF VAMANA KARMA AND VAMANOPAGA DASEMANI

Abstract

According to Acarya Caraka, Virecana procedure, which is having the property of eliminating dosas from the body, is of two types. [...]guna is the thing which represents a drug. Synchronous contraction of diaphragm, inter costal muscles and abdominal muscles raising the abdominal pressure, combined with relaxation of the lower esophageal sphincter, results in forcible ejection of gastric content.

Headnote

ABSTRACT

Sodhana therapy is considered as the best management technique for a disease. Vamana karma is the first Pancakarma procedure and the best treatment for kapha dosha. Quick response of a drug on the body and the bodys' response to the drug results Vamana karma. This procedure is quite difficult in some cases. Pharmacokinetics and Pharmacodynamics of Vamanopaga drugs is not clear yet. Pancakarma procedures are becoming popular among people as these cure diseases from the root cause. So it is necessary to establish mode of action of Vamana and Vamanopaga dravya for the betterment. This article is an effort to make a concept regarding mechanism of Vamana karma and Pharmacodynamics of Vamanopaga dasemani of Caraka Samhita.

KEYWORDS: Vamana karma, Mechanism, Vamanopaga Dasemani, Pharmacodynamics

INTRODUCTION

Vamana and Karma both words together make a procedure, Vamana karma (therapeutic emesis). This special procedure is preceded by Snehana (oleation) and Swedana (sudation) karmas. All together these procedures make a unique therapy for Kapha dosa. There are two types of conditions of dosas in the body. One is physiological, which maintain and helps in the functions of the body and the other is malabhuta (morbid), causing various diseases. Agnimandya of Rasa and Raktadhatu produces morbid kapha and pitta respectively. The forcible expulsion of malarupi kapha (morbid kapha) or excess pitta through the upper route is called Vamana. After preoperative procedures (snehana and swedana procedures) the process is followed by induction of Vamana by Vamana kalpas (medicine for Vamana), which are described in Chardaniya gana and Kalpa sthana (Agnivesa, Caraka Samhita, 2001). The patient is advised to Samsarjana krama (specific dietary regimen) to reach up to normal diet and to complete the therapy. The whole procedure including Snehana, Swedana and Samsarjana krama is called Vamana karma.

According to Acarya Caraka, Virecana procedure, which is having the property of eliminating dosas from the body, is of two types. The removal of malarupi dosas through oral route is called Vamana and through anal route is called Virecana (therapeutic purgation) (Agnivesa, Caraka Samhita, 2001). A lot of literature about indications and contraindications of Vamana karma are available in our classics. Selection of patient and Vamana kalpa (medicine) are the important factors for the procedure. Acarya Caraka has mentioned six important drugs for Vamana and lots of combinations of them, in kalpa sthana for different diseases (Agnivesa, Caraka Samhita, 2001). In the context of Mahakasaya, Acarya mentioned Vamanopaga dasemani (table no.1), ten drugs which are helpful in Vamana karma (Agnivesa, Caraka Samhita, 2003). Later Acarya Vagbhata mentioned Chardaniya gana having 21 drugs, Vamana and Vamanopaga (drugs help during therapeutic emesis) together (Acarya Vagbhata, Astanga Hrudaya, 2003). Vagbhata has not mentioned about upaga dravyas separately for vamana karma. Practically the drugs which are mentioned in kalpa sthana are the main constitution of Vamana kalpas and drugs of Vamanopaga dasemani are having supportive action on therapy.

Definition and nirukti

"Tatradosasharanam Urdhabhagam vaman samjñakam" (Agnivesa, Caraka Samhita, 2001). 'Vama dhatu' adding by 'ach' pratyaya derived as word vamana. (Siddhanta Kaumudi)

It means the purification of body or elimination of malarupi dosas through oral route. Vamanopaga means helpful in Vamana and dasemani means a group of ten drugs, which have similar pharmacological action, together or individual in case of Vamana karma.

Mechanism of Vamana Karma

Acarya Caraka mentioned a deep conceptual mechanism of Vamana and Virecana karma. The difference between both mechanisms is in the mahabhautik composition of kalpa (medicine) thereby eliminating route. The mechanism described in the first chapter of kalpa sthana said that, the drugs which are having Usna, Tiksna, Suksma, Vyavayi, Vikasi guna (hot, sharp, micro and fast acting properties), by their own Virya (potency) enters in to the heart. With the help of dhamani (arteries) it enters in to both types of Srotas, Suksma and Sthula (subtle and gross channels). After entering in to the all channels of the body due to Agneya guna, it causes instant digestion and initiates the movement after softening. Here Tiksna guna separates the ready to go sticky dosas in the channels. After the detachment of dosa and mala from subtle and gross channels, these malarupi dosas are ready to come in to mahasrotas. A proper snehana and swedana procedure is helpful in this phenomenon. Acarya has given a simile for this process. Due to oleation therapy, dosas will be not remaining in the Srotas. It is just like a well oleated container never retains a drop of water inside it. Gunas (properties) of vamana drugs assist specific stages of vamana karma. Suksma property of medicine allows penetration into minute channels. Downward movement of dosas from suksma to mahasrotas (gross channels) helps to come into Amasaya (Stomach). The pressure gradient developed by Anu-Pravanabava (difference between subtle and gross channels) of medicine between Suksma and mahasrotas helps to maintain a flow from channels. Due to the specialty of Vamana drugs (Agni and Vayu mahabhuta dominant) (Maharsi Susruta, Susruta Samhita, 2005) these accumulated dosas and malas in the stomach move in the upward direction and gets expelled out, result Vamana karma (Agnivesa, Caraka Samhita, 2001). On the other hand this procedure facilitating the function of Udana vayu (one of the type of Vata dosa).

Vayu dosa is responsible for the movement of muscles involved in Vamana. Agni mahabhuta or Pitta dosa can be correlated with hormone or chemical trans-mediators of muscles and cells. Initiation of muscular contraction by Agni mahabhuta and Usnaguna, followed by Vayu mahabhuta makes a forcible contraction of diaphragmatic and inter-costal muscles. Vyavayi and Vikasiguna make Vamana in faster pace. Due to the action of these gunas, drugs used in Vamana kalpa do not undergo digestion.

All the drugs which possess emetic effect cannot be used for Vamana karma. The specialty of Vamana drugs is Anu- Pravanabava, which is discussed above. Due to this, drugs are not deposited in the cells therefore not causing any complication. The Vamana drug goes to minute channels and returns quickly after exerting their effect at the site of action. This is the main difference between poisonous drug and Vamana drugs, though they have some similar property.

Observations during Vamana Karma

1. Perspiration - Liquidity of dosas in Srotas.

2. Romaharsa (horripilation) - Calatva (mobilization) of dosas.

3. Fullness of kostha (GIT) - Dosas have reached in to stomach.

4. Hrallas (nausea) - Dosas ready to get expelled out.

Pharmacodynamic of drugs (Table no. 1)

The overall Pharmacodynamic of Vamanopaga dasemani drugs is based on guna concept. Most of the drugs (90%) are having property of Laghu and Ruksa guna. These are based on Vayu, Agni and Akasa mahabhautik (one of the five elements of the universe) composition. Acarya Caraka has mentioned only the role of gunas in the Pharmacodynamic of Vamana karma (Bhadanta Nagarjuna, Rasavaisesika, 2010). In fact guna is the thing which represents a drug. So, the selection of a drug should be on the basis of gunas for Vamana karma. (Table no. 2)

Acarya has mentioned predominance of Vayu and Agni mahabhuta drugs for Vamana karma. Rasas (taste) of vamana dravyas are chiefly katu and kasaya rasa which are composition of the same mahabhutas. Most of drugs are katu Vipaka having similar bhautic constitution. Other drugs are supportive to the therapy or to avoid complications during Vamana karma. As an example; honey which is mentioned in Vamanopaga dasemani is added to Vamana kalpa (prepared medicine) for increasing the palatability and giving soothing effect. Ayurveda says it is a good kapha chedaka (expectorant), helps in better expulsion of malarupi kapha by vamana karma. Likewise Saindhava (salt) should be added to Vamana kalpa for Vilayana (Agnivesa, Caraka Samhita, 2001) (liquefying) of sticky Kaphadosa in channels. Effect of both the drugs is to help in a comfortable and irritation less procedure.

In common practice hot infusion of Yasthimadhu (Glycyrrhiza glabra Linn.) is used in higher dose for induction of better vega in vamana karma. Yasthimadhu is sweet, demulcent, cool and softin nature, in high dose acts as emetic but simultaneously soothes the throat. As per the Ayurvedic pharmacology it is a good kapha nihsaraka (expectorant) so helps in vamana karma for eliminating the dosa through oral route.

Comparison of Vamana and Vamanopaga Drugs

There is a modest difference between these drugs in their pharmacological actions because of their different bhautik composition and time of administration. (Table no. 3)

Mechanism of Vomiting

In the mechanism of Vomiting, different receptors are activated depending on the cause of vomiting or cause of nausea. For example

1. Dopamine receptors in the chemotactic trigger zone (CTZ) in the fourth ventricle are stimulated by metabolic or drug causes of nausea.

2. On the second way, gastric irritation stimulates histamine receptor in the vomiting centre via vagus nerve.

Vomiting is a highly integrated and complex reflex involving both autonomic and somatic neural pathway. Synchronous contraction of diaphragm, inter costal muscles and abdominal muscles raising the abdominal pressure, combined with relaxation of the lower esophageal sphincter, results in forcible ejection of gastric content. Stretch reflex and psychic stimuli are also the factors which initiate the sense of vomiting. (Davidson, Principles & Practice of Medicine, 2006)

CONCLUSION

Vamana drugs act on the basis of Usna, Tiksna, Suksma, Vyavayi, Vikasi gunas and bhautik composition. Drugs of Vamanopaga dasemani support the whole procedure. Their action differs from drug to drug. From the modern point of view the drugs act via any of the pathways mentioned above. Thinking of individual guna and the overall effect of kalpa should be evaluated prior to the therapy. Vamanopaga daSemani and Chardaniya gana of Susruta and Vagabhata are the guidelines for making a suitable Vamana kalpa.

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To Cite this article:

Ujjaliya Nitin, Remadevi R (2012), A REVIEW ON PHARMACODYNAMICS OF VAMANA KARMA AND VAMANOPAGA DASEMANI, Global J Res. Med. Plants & Indigen. Med., Volume 1(11), 644-649

References

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Agnivesa 'Caraka Samhita', revised by Caraka and Drudhabala with 'Ayurveda Dipika' commentary, by Cakrapanidatta, edited by Pt. Kashinath Sastri and Dr. Gorakhnath Chaturvedi (reprint 2003), Chaukhamba Vishvabharti, Varanasi -221001 (India), Sutra Sthana 4/8/13.

Astanga Hrudaya of Acarya Vagbhata edited by Prof. K.R. Srikantha Murthy (2003), Chaukhamba Krishnadas Academy, Varanasi, Sutra Sthana 15 / 1.

Bhadanta Nagarjuna's Rasavaisesika , edited by Vaidyabhushanam K. Raghvan Thirumulpad (2010,), Department of publication, Arya Vaidya Sala Kottakkal, 1st Edition Chapter 3 / 118- 124 & 3/45-51.

Davidson Principles & Practice of Medicine, Sir Stanley Davidson, 20th Edition, Churchill Livingstone Elsevier Health Science, Philadelphia, (2006).

Susruta Samhita of Maharsi Susruta, edited by Ayurveda Tattva Sandipika by Kaviraj Ambikadatta Shastri (2005,), Chaukhamba Samskrit Samsthan, Varanasi -221001 (India), Sutra Sthana 37/7.

Source of Support: Nil Conflict of Interest: None Declared