UG Module 4 - Lesson 8

VAMANA KARMA

EXPLANATORY NOTES

COMPLICATION OF VAMANA AND ITS MANAGEMENT

Vamana Ayoga and Atiyoga Vyāpat explained by Ācārya Caraka

According to Ācārya Caraka, Vyāpats may be caused due to Vamana Ayoga and Atiyoga.

Vyāpat

Nidāna

Lakṣaṇas

Treatment

Ayoga

Expulsion of Doṣa in small amount or in reverse route or Doṣas are not at all expelled

Vibhraṃśa, Śvayathu,

Hikkā, Tama Darśana,

Piṇḍikodveṣṭana,

Kaṇḍu,

Ūrusāda, Vivarṇa

Abhyaṅga with Taila and Lavaṇa, then Sankara and Prastara Sveda.

Nirūha Basti with Gomūtra. Anuvāsana with Taila processed with Madana, Māgadhi, Dāru.

Again Tīkṣṇa Śodhana should be given after proper Snehana with Vātahara Dravya.

Atiyoga

Excessive expulsion of aggravated Doṣas due to Ati Tīkṣṇa Dravyas, administered when hunger and who has Mṛdu Koṣṭha.

Bala Svara Kṣaya, Dāha, Kaṇṭha Śoṣa, Bhrama

Vamana with Madhura Dravya for expulsion of remaining Dravya.

Mṛdu Virecana in Atiyoga of Vamana and Vamana in Atiyoga of Virecana.

Raktapitta, Dāha, Jvara, Atisāra line of management is opted.

Picchābasti and Anuvasāna Basti with Kṣīrasarpi.

आध्मानं परिकर्तिश्च स्रावो हृद्गात्रयोर्ग्रहः|
जीवादानं सविभ्रंशः स्तम्भः सोपद्रवः क्लमः||
अयोगादतियोगाच्च दशैता व्यापदो मताः|
प्रेष्यभैषज्यवैद्यानां वैगुण्यादातुरस्य || (Cha. Si. 6/29-30)

The ten cardinal complications arising out of improper administration of emesis and purgation are Aādhmāna (distension of abdomen), Parikartikā (fissure in ano), Srāva (excess discharge), Hṛt-graha (congestion in cardiac region), Gātra-graha (body stiffness), Jīvādāna (bleeding), Vibhraṃśa (prolapse of rectum), Stambha (body stiffness), Upadrava (complications), Klama (fatigue without excertion).

The above complications arise out of either under activity or excessive activity of the drug because of the following:

  • Preṣya – Vaiguṇya (incompetency of the attendant)
  • Bhaiṣajya – Vaiguṇya (incompetency of drug)
  • Vaidya – Vaiguṇya (incompetency of physician)
  • Ātura – Vaiguṇya (incompetency of the patient)

वैद्यातुरनिमित्तं वमनं विरेचनं  पञ्चदशधा व्यापद्यते |तत्र वमनस्याधो गतिरूर्ध्वं विरेचनस्येति पृथक्सामान्यमुभयोः– सावशेषौषधत्वंजीर्णौषधत्वंहीनदोषापहृतत्वंवातशूलम्अयोगो,अतियोगोजीवादानम्आध्मानंपरिकर्तिकापरिस्रावःप्रवाहिकाहृदयोपसरणंविबन्धअङ्गप्रग्रह इति || (Su. Chi. 34/3)

Fifteen  different  kinds  of Vyāpats  may  result  from  an  injudicious  use  of  emetics and  purgatives  owing  to  the  ignorance  of  the  physician or  of  the  patient.  Of  these  fifteen,  the  upward  coursing in  cases of  purgatives  and  the  downward  coursing  in  cases of  emetics  are  peculiar  to  each  of  them  respectively. The  fourteen  other  remaining Vyāpats are common  to  both.  They  are  Sāvaseṣa Auṣadhatva (continuance  of  the  drug  in  the  stomach),  Jīrṇa Auṣadhatva  (complete  digestion  of  the  medicine),  Hīna Doṣa Apahṛtatva  (insufficient  elimination  of  the  Doṣas from  the  system)  Adhika Doṣa Apahṛtatva  (excessive elimination  of  the  Doṣas  from  the  system),  Vāta Sūla (pain due to Vāta), Ayoga  (insufficient  dosage),  Atiyoga (over  dosage),  Jivādāna  (vomiting blood),  Ādhmāna (distention of abdomen),  Parikartikā  (cutting  pain  in  the  anus.), Parisrāva  (oozing  out  of  stools),  Pravāhika(  (diarrhoea), Hṛdayopasarana  (rising  of  the  Doṣas  towards  the heart)  and  Vibandha  (constipation)

Vamana Vyāpat

Ayoga Vamana Vyāpat

Vyāpat Nidāna

Vyāpat

Vyāpat Lakṣaṇas

Chikitsā

Due to the administration of Alpa Mātrā Auṣadha in Bahu Doṣaja condition and in Rūkṣa, Hina Agni, Udāvarta condition, Doṣas cannot be eliminated properly and it obstructs the Srotas.

Ādhmāna

(Abdominal distension)

Distension of abdomen, pain in chest region, Śiras, obstruction of stool, urine, and breath

Abhyaṅga, Svedana, Phalavarti,  Nirūha and Anuvāsana Basti

Alpa Auṣadhī administered to a person with aggravated Doṣas, only small amount of Doṣas is eliminated.

Kapha Praseka 

Excessive discharge of phlegm

Vamana, administration of Cūrṇa, Āsava, Ariṣṭa

If a person undergoes Vega Dhārana, during Vamana, the Doṣas aggravates and reaches Hṛdaya and produce Hṛītgraha.

Hṛītgraha (Cardiac Spasm)

Hiccough

Cough

Unconsciousness

Pain over flanks

Vamana

In Pittajanya Mūrchā: Madura Dravya Prayoga.

In Kaphajanya Mūrchā: Kaṭu Dravya Prayoga.

If Vāta aggravated: Snigdha, Amla, Lavaṇa Dravya Prayoga.

If Pitta and Kapha aggravated: Rūkṣa, Tikta, Kaṭu Dravya Prayoga.

If a person suppresses the Vega after intake of Auṣadhī, Vāyu gets obstructed by Kapha, or there will be Atiśodhana, then Vāyu gets vitiated and causes Graha in the limbs

Gātragraha

(Spasam of limbs)

Spasm of limbs, twisting and pricking type of pain

Sneha, Svedana, Vātahara Karma.

It occurs when Śodhana Dravyas stops its action before proper expulsion of Doṣas.

Kaṇḍvādi Lakṣaṇa

Itching

Sneha, Svedana, Vātahara Karma.

If Snigdha Dravyas are used for Śodhana to a properly Snigdha Puruṣa, then the Dravyas due to their Mṛdu Guṇa becomes difficult for expelling Doṣas. These Doṣas displaced from their own sites gets obstructed

Stambha

Vāta Saṅga, Guda Stambha,  Sūla

Langhana, Pācana,  Tīkṣṇa Basti, Virecana.

If Rūkṣa Auṣadha given to a Rūkṣa and Durbala person, Vāta gets aggravated immediately and causes complications.

Upadrava

(serious affliction)

Sthambha, Śūla , Gatragraha, Mūrchā

Snehana, Svedana, Vātahara Kriya.

Mṛdu Dravya when administered to a Snigdha person, it aggravates Kapha and Pitta. As a result, Vāta gets aggravated.

Klama

(exhaustion)

Tantra

Gavrava

Weakness and pain in the body

Langhana, Pācana, Tikta Dravya Prayoga.

 

Atiyoga Vamana Vyāpat

Tīkṣṇa Auṣadhī administered to a Snigdha  Puruṣa having Guru Koṣṭha associated with Āma or in Durbala having Mṛdu Koṣṭha

Kaṇṭha

Kṣaṇana

Throat irritation

Vātahara Karma.

In Mṛdu Koṣṭha person, if  Tīkṣṇa Dravyas are administered or when administered in Alpa Doṣa, pure blood gets eliminated.

Jīvādāna

Blood Discharge in vomitus

Pittanaśaka  Chikitsā, Raktapāna, Raktabasti. Basti with – Kṣīra processed with Śyāma, Kāśmarya, Badari, Durvā, Uśīra, Ghṛta Maṇḍa, and Anjana. Picchābasti. Anuvāsana with  Ghṛta  Maṇḍa.

It occurs when Śodhana Dravyas stops its action before proper expulsion of Doṣas.

Sañjā

Bramśa

Unconsciousness

Priyaśabdha Vacana, Sānthvana, Samaveda Paṭhana.

IMPORTANT SLOKA

आध्मानं परिकर्तिश्च स्रावो हृद्गात्रयोर्ग्रहः|
जीवादानं सविभ्रंशः स्तम्भः सोपद्रवः क्लमः||
अयोगादतियोगाच्च दशैता व्यापदो मताः|

प्रेष्यभैषज्यवैद्यानां वैगुण्यादातुरस्य च||            (Ch.Si.6/29-30)

The ten cardinal complications arising out of improper administration of emesis and purgation are Aādhmāna (distension of abdomen), Parikartikā (fissure in ano), Srāva (excess discharge), Hṛt-graha (congestion in cardiac region), Gātra-graha (body stiffness), Jīvādāna (bleeding), Vibhraṃśa (prolapse of rectum), Stambha (body stiffness), Upadrava (complications), Klama (fatigue without excertion).