Presented by Dr. Srinidhi S. PG Scholar, Department of Panchakarma, SDMCAH Hassan.

2. CONTENTS
 INTRODUCTION
 ANATOMY
 PHYSIOLOGY
 MODE OF ACTION
 VYAPAT AND ITS MANAGEMENT
 DISCUSSION AND SCIENTIFIC INTERPRETATION
 CONCLUSION

3. INTRODUCTION
तत्र दोषहरणम ् उर्ध्वभागम ् ्मनसंज्ञकम् ………..(च.क.१/४)
 Vamana is a process in which vitiated doshas are expelled through the upper route (mouth).
 Chakrapani  urdhvabhaga = urdhvamukha
अपक्् पपत्तश्लेष्माणम् बलात् उर्ध्वनयेत्तु यत् |
्मनं तध्र्धद प्ज्ञेयं मदनस्यफलं यथा ||८४|| -(शा.प्र.१)
 Apakva pitta  vidagdha avastha (ajeerna)  doshavasechana  vamana

4. ANATOMY

5. ORAL CAVITY
 Used for ingestion of food and fluids
 Posteriorly  oropharynx
 Upper part  opens to the posterior part of the nasal cavity
 Lower part  inlet of the larynx
 Roof  hard and soft palate
 Vestibule and oral cavity proper

6. CHEEKS(BUCCAE):-
 Fleshy flaps,forming a large part of each side of the
face.
 Each cheek is composed of:
1)skin
2)superficial fascia
3)submucosa,with mucous buccal glands
4)mucous membrane

7. HARD PALATE :-
 It is partition between the nasal and oral cavities
 Its anterior 2/3rd are formed by the palatine process of maxillae
 Its posterior 1/3rd by the horizontal plates of the palatine bones
SOFT PALATE :-
 Is a fold of mucous membrane containing
1)fibrous basis of platepalatine aponeurosis
near median plane splits to enclose musculus uvulae
2)numerous mucous glands and some taste buds are present

8. OESOPHAGUS
 It is a muscular food passage lying between the trachea and the
vertebral column.
 Normally, its anterior and posterior walls are in contact.
 Expands during the passage of food by pressing into the
posterior muscular part of the trachea.
 Is downward continuation of pharynx

9.  Beginning :- Begins at lower end of cricoid cartilage opposite the lower border of the
body of C6
 Course :- passes downwards behind the trachea traverses the superior mediastina of the
thorax
 Ending :- ends by opening into the cardiac end of the stomach in the abdmen.
 Lengh :- 25 cm long
 Parts :- 1)cervical 2)thoracic 3)abdominal
 Histology :- 1) Mucous membranestratified squamous epithelium
2)Muscularis mucosae longitudinal muscle fibres
3)Submucosa contains mucus secreting oesophageal glands
4)Muscularis externa
i]upper 1/3rd striated muscle
ii]middle 1/3rd mixed type
iii]lower 1/3rd  smooth muscle

10. STOMACH
 Expansible muscular sac—acts as reservoir for food and fluid
 Three smooth muscle layers
 In pyloric end,there are mucus secreting pyloric glands in the basal 1/3rd
 Constant mixing and churning of food
 Initial digestion of proteins
 By pepsin
Formed by combination of pepsinogen and HCl
 Production of intrinsic factor
 Essential for absorption of vitamin B12 in the ileum
 Formation of chyme
 Absorption of small and lipid-soluble molecules

11. PHYSIOLOGY
 NAUSEA:-
an unpleasant sensation that immediately precedes vomiting.
 Accompanying symptoms-
 Cold sweat, pallor, salivation.
 Noticeable disinterest in the surroundings,
 Loss of gastric tone.
 Reflux of intestinal contents into the stomach

12. RETCHING
 comprises labored spasmodic respiratory movements against a
closed glottis with contractions of the abdominal muscles,
chest wall and diaphragm without any expulsion of gastric
contents.
 can occur without vomiting but normally it generates the
pressure gradient that leads to vomiting.

13. VOMITTING:-
Expulsion of gastroduodenal content from GIT to the external environment via
mouth.
caused by:
 the powerful sustained contraction of the abdominal and chest wall
musculature,
accompanied by
 The descent of the diaphragm and the opening of the gastric cardia.
It results in the
 rapid and forceful evacuation of stomach contents up to and out of the
mouth
Reflex activity that is not under voluntary control.

14. NAUSEA
RETCHING
VOMITTING

15. MECHANO AND CHEMO RECEPTORS
located in
 stomach, jejunum and ileum
involved with
 detection of emetic stimuli in the gastrointestinal tract.
Mechanoreceptors are
tension receptors that initiate emesis
in response to
distension and contraction
e.g. from bowel obstruction.
Chemo receptors respond to
a variety of toxins in the intestinal lumina

16. VOMITING CENTRE
 controls the act of vomiting.
 not a discrete anatomical site, but represents inter-related neuronal
networks.
 inputs include: vagal sensory pathways from the gastro-intestinal tract and
neuronal pathways from the labyrinths, higher centres of the cortex,
intracranial pressure receptors and the chemoreceptor trigger zone.
 When activated induces: vomiting via stimulation of the salivary and
respiratory centres and the pharyngeal, gastrointestinal and abdominal
muscles.
 final common pathway for efferent responses that produce emesis

17. CHEMORECEPTOR TRIGGER ZONE
 present in the area prostrema of the 4th ventricle of the brain
 acts as the entry point for emetic stimuli
 CTZ is outside the blood-brain barrier
 therefore responds to stimuli from either the cerebral spinal fluid (CSF) or the
blood.
 Impulses from CTZ pass to area of brainstem called vomiting centre that
control and integrate the visceral and somatic functions involved in vomiting.

20. EMETICS
Emetics are two types 1.Reflex emetics(gastric emetics)
2.Central emetics.
 Gastric emetics stimulates the gastric musoca, from there it stimulates vagus
/sympathetic n. stimulation, from there it stimulates vomiting center in the brain.Ex.
Znso4, Alum, Bicorbonate, mustard.
 Central emetics stimulates Medulla of the brain (near resp. center), from there it
stimulates vomiting center in the brain, contraction of amashaya, annanalika,
abd.muscles, peristalsis, vomiting Ex:Ipecac, Apomorphine, digitalis

21. EFFECTS

23. VAMANA DRAVYA KARMUKATA
-cha.kal.1/5

24. 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 guna' - liquify the complexes
(ii)With 'Tiksna guna' - Break them down into several particles

25. 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

26. VAMANA VYAPAT
Vyapath are divided into two types 1.Atiyoga vyapat(red marked vyapats)
2.Ayoga vyapat
Sushrutha mentioned 15 vamana/virechana vyapats
-cha.sid.6/29,30

27. AYOGA-DIFFERENT CONDITIONS -TREATMENT
Condition Lakshanas chikitsa
Vigraditha dosha(Accumulated
dosha)
Trisha, murcha, hrillasa, aruchi,
arati, udgara asuddi, parshavashula,
parvabheda.
Give luke warm water then Vamana
If sneha & sweda not done Gourava, utklesha, hridaya asuddi,
vibramsha, shotha, hikka,
tamodarshana, pindikodveshta,
kandu,
Teekshna vamana
Oushada jirna due to increased agni Gourava, hridaya asuddi 1.Give adhik/ teekshna oushada.
2.taila+saindava lavana abyanga
3.prastara/sankara sweda.
4.gomutra N.V/A.V/Tikshna shoda
Increased dosha due to increased
aama
glani, vibandha Amadosha hara treat.
Pachana drugs.

28. conditions lakshanas chikitsa
Mridu koshti Ati pravriti, vata prakopa,
balakshaya
Abhyanga,sheeta jala
avagaha,avalehya.
Mridi koshti, Teekshna drug Bala hara, daha,
kantashosha, brama,trisha
Madhura upachara, remove
remaining
medicine(virechna), shita
jala parisechana, avagaha,
stambha chikitsa.
Jihva bahya pravishta Tila,draksha kalka lepam
and put inside.
Jihva anta pravishta Kavala graha
Udgara,mucha Dhanyka churna
ATIYOGA-DIFFERENT CONDITIONS & TREATMENT

29. ATIYOGA-DIFFERENT CONDITIONS -TREATMENT
conditions Line of treatment
To stop vomitings Sutasekara ras 2 rati,
Shankha basma 2 rati,
Hemagarba P.R ½ rati,
Mayura pincha b.1 rati give it every 10-15
min,after 3-4 times it will subsides.
Abdominal pain Shankha vati

30. DISCUSSION AND SCIENTIFIC INTERPRETATION
 Hridaya have two meanings viz., Heart and Brain.
 Here hridaya may be heart or brain because both are able to carry dravya
all over the body in a short duration by using their circulatory or nervous
system, respectively.
 Ooushdhi have above mentioned gunas move towards Hridaya because of
its swavirya. Here Swavirya may be vascular path (veins) or sensory stimuli
by nerve (chemo- receptor and baro- receptors) which are connected to
heart and brain, respectively.

31.  Now it goes to all sthoola(macro) and sukshma( micro) strotas through
various dhamanis. Here dhamanis may be vascular path (arteries) or motor
impulses by nerve. At this place (srotas) liquification of doshas takes place
by virtue of Aagneya guna and break down into several particles by
Tikshna guna.
 Due to anupravanbhava these doshas enter into Aamashaya (stomach).
These doshas are stimulated by Udana vayu .
 Vamana aousadhi has urdhabhaga prabhava due to its agni and vayu
mahabhut pradhaanya. Combined effect of both of the above facts is that
doshas move towards oral cavity and are finally removed through mouth.

32.  Here urdhvabhaga prabhava can be related to ability of certain
drugs that direct induce chemoreceptor trigger zone (CTZ).
 If vegas (urges) do not occur, patient should be guided to use
Eranda nala (small stick of errand plant) or fingers to induce
vegas . It can be correlated with mechanical stimulation of
pharynx. It is one of the causes of vomiting which eventually it
leads to vomiting reflex.

33. CONCLUSION
 Vamana vidhi (procedure) and vaman karmukta (mechanism of action)
described by Acharya Charak has scientific base in Ayurveda and Modern
medical sciences also.
 Vaman is a safe treatment if we follow guidelines stated and precautions
mentioned by Acharyas .
 It is an IPD basis procedure and the subjects should be advised strictly not
to practice at home.
 Ideal if conducted by physician specialised in panchakarma .