Global J Res. Med. Plants & Indigen. Med. Volume 1, Issue 11 November

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1 ISSN International, Peer reviewed, Open access, Monthly Online Journal A REVIEW ON PHARMACODYNAMICS OF VAMANA KARMA AND VAMANOPAGA DASEMĀNI Ujjaliya Nitin 1 *, Remadevi R 2 `1 Lecturer, Dept of Dravyaguna, Shri Dabur Dhanvantari Ayurveda College, Chandigarh, India 2 Prof. & HOD. Dept of Dravyaguna, V.P.S.V. Ayurveda College, Kottakkal, Kerala, India *Corresponding Author: drnujjaliya@gmail.com; Mobile: Received: 06/10/2012; Revised: 31/10/2012; Accepted: 04/11/2012 Review article 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 dasemāni of Caraka Samhitā. KEYWORDS: Vamana karma, Mechanism, Vamanopaga Dasemāni, Pharmacodynamics To Cite this article: Ujjaliya Nitin, Remadevi R (2012), A REVIEW ON PHARMACODYNAMICS OF VAMANA KARMA AND VAMANOPAGA DASEMĀNI, Global J Res. Med. Plants & Indigen. Med., Volume 1(11),

2 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 malabhūta (morbid), causing various diseases. Agnimāndya of Rasa and Raktadhātu produces morbid kapha and pitta respectively. The forcible expulsion of malarūpī 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 Chardanīya gana and Kalpa sthāna (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 Ācarya Caraka, Virecana procedure, which is having the property of eliminating dosās from the body, is of two types. The removal of malarūpī dosās 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. Ācarya Caraka has mentioned six important drugs for Vamana and lots of combinations of them, in kalpa sthāna for different diseases (Agnivesa, Caraka Samhita, 2001). In the context of Mahākasāya, Ācarya mentioned Vamanopaga dasemāni (table no.1), ten drugs which are helpful in Vamana karma (Agnivesa, Caraka Samhita, 2003). Later Ācarya Vāgbhata mentioned Chardanīya gana having 21 drugs, Vamana and Vamanopaga (drugs help during therapeutic emesis) together (Ācarya Vāgbhata, Astānga Hrudaya, 2003). Vāgbhata has not mentioned about upaga dravyas separately for vamana karma. Practically the drugs which are mentioned in kalpa sthāna are the main constitution of Vamana kalpas and drugs of Vamanopaga dasemāni are having supportive action on therapy. Definition and nirukti Tatradosasharanam Urdhabhāgam vaman samjñakam (Agnivesa, Caraka Samhita, 2001). Vama dhatu adding by ach pratyaya derived as word vamana. (Siddhānta Kaumudī) It means the purification of body or elimination of malarūpī dosas through oral route. Vamanopaga means helpful in Vamana and dasemāni means a group of ten drugs, which have similar pharmacological action, together or individual in case of Vamana karma. Mechanism of Vamana Karma Ācarya Caraka mentioned a deep conceptual mechanism of Vamana and Virecana karma. The difference between both mechanisms is in the mahābhaūtik composition of kalpa (medicine) thereby eliminating route. The mechanism described in the first chapter of kalpa sthāna said that, the drugs which are having Usna, Tiksna, Suksma, Vyavāyī, Vikāsī guna (hot, sharp, micro and fast acting properties), by their own Vīrya (potency) enters in to the heart. With the help of dhamanī (arteries) it enters in to both types of Srotas, Suksma and Sthūla (subtle and gross channels). After entering in to the all channels of the body due to Āgneya guna, it causes instant digestion and initiates the movement after softening. Here Tiksna guna separates the ready to go sticky dosās in the channels. After the detachment of dosa and mala from subtle and gross channels, these malarūpī dosās are ready to come in to mahāsrotas. A proper snehana and swedana procedure is helpful in this phenomenon. Ācarya has given a simile for this process. Due to oleation therapy, dosās will be not remaining in the Srotas. It is just like a well

3 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 dosās from suksma to mahāsrotas (gross channels) helps to come into Āmāsaya (Stomach). The pressure gradient developed by Anu-Pravanabāva (difference between subtle and gross channels) of medicine between Suksma and mahāsrotas helps to maintain a flow from channels. Due to the specialty of Vamana drugs (Agni and Vāyu mahābhūta 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 Udāna vāyu (one of the type of Vata dosa). Vāyu dosa is responsible for the movement of muscles involved in Vamana. Agni mahābhūta or Pitta dosa can be correlated with hormone or chemical trans-mediators of muscles and cells. Initiation of muscular contraction by Agni mahābhūta and Usnaguna, followed by Vāyu mahābhūta makes a forcible contraction of diaphragmatic and inter-costal muscles. Vyavāyī and Vikāsiguna 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- Pravanabāva, 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. Hrallās (nausea) Dosas ready to get expelled out. Pharmacodynamic of drugs (Table no. 1) The overall Pharmacodynamic of Vamanopaga dasemāni drugs is based on guna concept. Most of the drugs (90%) are having property of Laghu and Ruksa guna. These are based on Vāyu, Agni and Ākasa mahābhaūtik (one of the five elements of the universe) composition. Ācarya Caraka has mentioned only the role of gunas in the Pharmacodynamic of Vamana karma (Bhadanta Nāgārjunā, 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) Ācarya has mentioned predominance of Vāyu and Agni mahābhūta drugs for Vamana karma. Rasas (taste) of vamana dravyas are chiefly katu and kasāya rasa which are composition of the same mahābhūtas. Most of drugs are katu Vipāka having similar bhaūtic constitution. Other drugs are supportive to the therapy or to avoid complications during Vamana karma. As an example; honey which is mentioned in Vamanopaga dasemāni is added to Vamana kalpa (prepared medicine) for increasing the palatability and giving soothing effect. Āyurveda says it is a good kapha chedaka (expectorant), helps in better expulsion of malarūpī kapha by vamana karma. Likewise Saindhava (salt) should be added to Vamana kalpa for Vilāyana (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.

4 Table no. 1. Vamanopaga DaSemāni No. Drugs Latin name 01 Madhu Honey 02 Madhuka Glycyrrhiza glabra. Linn. 03 Kovidār Bauhinia purpurea. Linn. 04 Karbudār Bohania variegata. Linn. 05 Nīp Anthocephalus cadamba. Miq. 06 Vidul Baringtonia acutangula. ( Linn) Gaemt. 07 Bimbī Coccinia indica. W & A. 08 Sanapuspī Crotalaria verrucosa. Linn. 09 Sadāpuspī Calotropis procera. (Ait.) R. Br. 10 Pratyakapuspī Achyranthes aspera. Linn. Table no. 2. Pharmacodynamic of drugs Rasa Percentage Katu 40 Kasāya 30 Tikta 20 Madhura 10 Guna Percentage Laghu, Ruksa 90 Guru, Snigdha 10 Table no. 3. Vamana and Vamanopaga Dravyas VAMANA DRAVYAS The main constitution of vamana kalpa (medicine) Single dose is adequate as per given in classics Vamana dravyas act in a faster pace with a minimum dose A therapeutic vamana kalpa should contain these drugs Vamana drugs act on the basis of Prabhāva Used according to disease Reach in all Srotas of the body VAMANOPAGA DRAVYAS Supportive to the kalpa during therapeutic vamana Dosage can be changed according to Vegas during vamana Act under the influence of vamana drugs These can induce vomiting but cannot perform therapeutic vamana Act on the basis of Pancabhautik composition More than a disease depend on present condition of procedure Mainly act on mahāsrotas

5 In common practice hot infusion of Yasthīmadhu (Glycyrrhiza glabra Linn.) is used in higher dose for induction of better vega in vamana karma. Yasthīmadhu is sweet, demulcent, cool and soft in nature, in high dose acts as emetic but simultaneously soothes the throat. As per the Āyurvedic pharmacology it is a good kapha nihsāraka (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 bhaūtik 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, Vyavāyī, Vikāsī gunas and bhaūtik composition. Drugs of Vamanopaga dasemāni 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 dasemāni and Chardanīya gana of Susruta and Vāgabhata are the guidelines for making a suitable Vamana kalpa. REFERENCE Agnivesa Caraka Samhita, revised by Caraka and Drudhabala with Ayurveda Dīpikā commentary, by Cakrapānīdatta, edited by Pt. Kashinath Sastri and Dr. Gorakhnath Chaturvedi (reprint 2001), Chaukhamba Vishvabharti, Varanasi (India), Kalpa Sthāna 1/4. Agnivesa Caraka Samhita, revised by Caraka and Drudhabala with Ayurveda Dīpikā commentary, by Cakrapānīdatta, edited by Pt. Kashinath Sastri and Dr. Gorakhnath Chaturvedi (reprint 2003), Chaukhamba Vishvabharti, Varanasi (India), Sutra Sthāna 4/8/13.

6 Astānga Hrudaya of Ācarya Vāgbhata edited by Prof. K.R. Srikantha Murthy (2003), Chaukhamba Krishnadas Academy, Varanasi, Sutra Sthāna 15 / 1. Bhadanta Nāgārjunā s Rasavaisesika, edited by Vaidyabhushanam K. Raghvan Thirumulpad (2010,), Department of publication, Arya Vaidya Sala Kottakkal, 1 st Edition Chapter 3 / & 3/ Davidson Principles & Practice of Medicine, Sir Stanley Davidson, 20 th Edition, Churchill Livingstone Elsevier Health Science, Philadelphia, (2006). Susruta Samhita of Maharsi Susruta, edited by Āyurveda Tattva Sandīpikā by Kaviraj Ambikadatta Shastri (2005,), Chaukhamba Samskrit Samsthan, Varanasi (India), Sutra Sthāna 37/7. Source of Support: Nil Conflict of Interest: None Declared