Changes

<big>'''Abstract''' </big>

<big>'''Abstract''' </big>

<div style="text-align:justify;">The chapter [[Madanakalpa Adhyaya]] deals with the basic and important concepts about the drugs used for [[vamana]] (therapeutic emesis) and [[virechana]] (therapeutic purgation). Among the emetic drugs, ''Madanaphala'' is the best because it does not produces any adverse effects, therefore the section of [[Kalpa Sthana]] is started from ''Madanaphala'' formulations. Hereafter,a brief definition of [[vamana]] and [[virechana]] therapies, and the mode of action of these drugs has been described. The factors responsible for promoting therapeutic efficacy of these drugs have also been mentioned. Further, three kinds of habitats and the characteristic features of these habitats, suitable time and method for drug collection are given. Subsequent to collecting the drugs (or herbs), storage and formulations of ''Madanaphala'' and specific procedure for administering emetic drugs have been given. Several dosage forms of ''Madanaphala'' viz. – pills, powders, linctus, ''utkarika'', ''vati'', ''modaka'', ''sashkuli'' and in the forms of ''badara'' and ''sashava'' have been discussed. At the end of the chapter, important synonyms of ''Madanaphala'' viz. ''madana'', ''karahata'', ''ratha'', ''pinditaka'', ''phala'' and ''ivasana'' is given.

<div style="text-align:justify;">The chapter [[Madanakalpa Adhyaya]] deals with the basic and important concepts about the drugs used for [[vamana]] (therapeutic emesis) and [[virechana]] (therapeutic purgation). Among the emetic drugs, ''Madanaphala'' is the best because it does not produces any adverse effects, therefore the section of [[Kalpa Sthana]] is started from ''Madanaphala'' formulations. Hereafter,a brief definition of [[vamana]] and [[virechana]] therapies, and the mode of action of these drugs has been described. The factors responsible for promoting therapeutic efficacy of these drugs have also been mentioned. Further, three kinds of habitats and the characteristic features of these habitats, suitable time and method for drug collection are given. Subsequent to collecting the drugs (or herbs), storage and formulations of ''Madanaphala'' and specific procedure for administering emetic drugs have been given. Several dosage forms of ''Madanaphala'' viz. – pills, powders, linctus, ''utkarika'', ''vati'', ''modaka'', ''shashkuli'' and in the forms of ''badara'' and ''sashava'' have been discussed. At the end of the chapter, important synonyms of ''Madanaphala'' viz. ''madana'', ''karahata'', ''ratha'', ''pinditaka'', ''phala'' and ''ivasana'' are given.

'''Keywords''': ''Madanaphala'', [[vamana]], [[virechana]]

'''Keywords''': ''Madanaphala'', [[vamana]], [[virechana]]

Among emetic drugs, ''Madanaphala'' is considered to be the best because it does not cause any adverse effect. That explains why a chapter on ''Madanaphala'' precedes all other chapters in this section.

Among emetic drugs, ''Madanaphala'' is considered to be the best because it does not cause any adverse effect. That explains why a chapter on ''Madanaphala'' precedes all other chapters in this section.

''Kalpa'' means "that which is processed". In this context, pharmaceutical preparations are called ''Kalpa''. This ''Sthana'' is called [[Kalpa Sthana]] since formulations of emetics and purgatives have been described here. The preparations which expel the ''dosha'' upwards through mouth are called ''Urdhavabhagahara'' (emetics) and those which expel downwards through rectum are ''Adhobhagahara'' (purgatives). For this action, the ''vamana'' drugs having ''vayu'' and ''agni'' predominance and ''virechana'' drugs are ''prithvi'' and ''jala'' predominant. But the ''vamana'' and ''virechana'' action is mainly due to ''prabhava'' (effect). It is clearly mentioned that these drugs became efficacious by the effect of ''desha'' (appropriate habitat), ''kala'' (season and time), ''guna'' (enriched with excellent attributes) and ''bhaajana'' (storing in appropriate containers).

''Kalpa'' means "that which is processed". In this context, pharmaceutical preparations are called ''Kalpa''. This ''Sthana'' is called [[Kalpa Sthana]] since formulations of emetics and purgatives have been described here. The preparations which expel the ''dosha'' upwards through mouth are called ''Urdhavabhagahara'' (emetics) and those which expel downwards through rectum are ''Adhobhagahara'' (purgatives). In this section, it is explained that drugs possessing [[vayu]] and [[agni]] [[mahabhuta]] predominance initiate [[vamana]] action, while drugs with [[prithvi]] and [[jala]] predominance produce [[virechana]] action. However these actions have been attributed to principle of specific action(prabhava). It is clearly mentioned that these drugs became efficacious by the effect of ''desha'' (appropriate habitat), ''kala'' (season and time), ''guna'' (enriched with excellent attributes) and ''bhaajana'' (storing in appropriate containers).

In this reference three basic kind of ''desha'' (habitat) i.e. ''jangala'', ''anupa'' and ''sadharana'' have been ascribed on the basis of specific flora and fauna. Laws for collection of different parts of a plant ,i.e., roots in summers or late winter when the leaves of the trees have ripened and withered away; barks, rhizome and latex in autumn; heartwood in ''Hemanta'' (early winter); and flowers and fruits during appropriate seasons have been laid out.

In this reference three basic kind of ''desha'' (habitat) i.e. ''jangala'', ''anupa'' and ''sadharana'' have been ascribed on the basis of specific flora and fauna. Laws for collection of different parts of a plant ,i.e., roots in summers or late winter when the leaves of the trees have ripened and withered away; barks, rhizome and latex in autumn; heartwood in ''Hemanta'' (early winter); and flowers and fruits during appropriate seasons have been laid out.

Since these are variations with regard to place (''desha'') and time (''kala''), preparations and processing of drugs and it is not possible to prescribe one drug which might be universally applicable. Moreover the drugs may not be available everywhere. Hence a number of formulations of ''Madanaphala'' are described. The physician may select one out of them which is suitable for the person.

Since these are variations with regard to place (''desha'') and time (''kala''), preparations and processing of drugs and it is not possible to prescribe one drug which might be universally applicable. Moreover all the drugs may not be available everywhere. Hence a number of formulations of ''Madanaphala'' are described. The physician may select one out of them which is suitable for the person.

Further the number six hundred for ''vamana'' and ''virechana'' preparations is not restrictive, it is only for guidance to brilliant scholars to formulate more while it would serve as standard for average physician.

Further the number six hundred for ''vamana'' and ''virechana'' preparations is not restrictive, it is only for guidance to brilliant scholars to formulate more while it would serve as standard for average physician.

<div style="text-align:justify;">The patient, the subject of emesis, having been administered with unction and sudation for two or three days, should be fed meat soups of domestic, marshy and aquatic animals, milk, curd, black gram, sesamum, vegetable etc. in the night prior to emesis, in order to excite ''kapha''. Next day when the previous food is digested, in the forenoon, after performing offering, oblations, auspicious and expiatory rites, he should take a dose of ghee along with gruel (on an empty stomach) that may not be very smooth or greasy. The physician should take one closed fist sized dosage of seeds of ''Madanaphala'', pound them and impregnate them with a decoction of ''Yastimadhu'' or one of these-''Kovidara, Karbudara, Nipa, Vidula, Bimbi, Sanapuspi'' and ''Prayakpuspi''-for the whole (previous) night. In the morning, this mix should be pressed and filtered, added with honey and rock salt and heated slightly. The cup filled with the drug should be enchanted with the following hymn:-

<div style="text-align:justify;">The patient, the subject of emesis, having been administered with unction and sudation for two or three days, should be fed with meat soups of domestic, marshy and aquatic animals, milk, curd, black gram, sesamum, vegetable etc. in the night prior to emesis, in order to excite ''kapha''. Next day when the previous food is digested, in the forenoon, after performing offering, oblations, auspicious and expiatory rites, he should take a dose of ghee along with gruel (on an empty stomach) that may not be very smooth or greasy. The physician should take one closed fist sized dosage of seeds of ''Madanaphala'', pound them and impregnate them with a decoction of ''Yastimadhu'' or one of these-''Kovidara, Karbudara, Nipa, Vidula, Bimbi, Sanapuspi'' and ''Prayakpuspi''-for the whole (previous) night. In the morning, this mix should be pressed and filtered, added with honey and rock salt and heated slightly. The cup filled with the drug should be enchanted with the following hymn:-

“Brahma, Daksa, Asvina, Rudra, Indra, Earth, Moon, Sun, Air, Fire, Sages, medicinal plants and multitude of creatures may protect you.This drug may prove for you as ''Rasayana'' for the sages, nectar for the gods and ambrosia for the best among serpents.”

“Brahma, Daksa, Asvina, Rudra, Indra, Earth, Moon, Sun, Air, Fire, Sages, medicinal plants and multitude of creatures may protect you.This drug may prove for you as ''Rasayana'' for the sages, nectar for the gods and ambrosia for the best among serpents.”

Nine formulations in decoctions, eight in ''Matra'' (like ''Haritaki'' fruit etc.) five in milk and ghee, two in ''Phanita'' and ''Churna'', one in inhalation, six in caplets, twenty each in ''Leha, Modaka'' and ''Utkarika'', sixteen each in ''Saskuli'' and ''Pupa'' and ten others in ''Sadava'' etc. Thus total 133 formulations are described by the great sage in the chapter on pharmaceuticals of ''Madanaphala''. [28 – 30]

Nine formulations in decoctions, eight in ''Matra'' (like ''Haritaki'' fruit etc.) five in milk and ghee, two in ''Phanita'' and ''Churna'', one in inhalation, six in caplets, twenty each in ''Leha, Modaka'' and ''Utkarika'', sixteen each in ''Saskuli'' and ''Pupa'' and ten others in ''Sadava'' etc. Thus total 133 formulations are described by the great sage in the chapter on pharmaceuticals of ''Madanaphala''. [28 – 30]

=== ''Tattva Vimarsha'' / Fundamental Principles===

=== ''Tattva Vimarsha'' (Fundamental Principles)===

*The impurities in upper part of body can be removed through mouth by ''Vamana'' (therapeutic emesis).

*The impurities in upper part of body can be removed through mouth by ''Vamana'' (therapeutic emesis).

*The impurities in lower part of body can be removed through rectum by ''Virechana'' (therapeutic purgation).

*The impurities in lower part of body can be removed through rectum by ''Virechana'' (therapeutic purgation).

impurity in the entire body, liquefy it out through large and small ducts due to agni (factors responsible for digestion and  

impurity in the entire body, liquefy it out through large and small ducts due to agni (factors responsible for digestion and  

metabolism) nature and disjoin it due to sharpness.  

metabolism) nature and disjoin it due to sharpness.  

*The impurities, thus dislocated from the micro-circulation by drugs, consequently the float (in circulation) and get propelled upside  

*The impurities, thus dislocated from the micro-circulation by drugs, consequently float (in circulation) and get propelled upside  

by force of ''Udana'' (''Vayu'') towards mouth.  

by force of ''Udana'' (''Vayu'') towards mouth.  

*Therapeutic emesis occurs by the natural composition of the drug with ''Agni'' and ''Vayu'' (''Mahabhutas'') and the specific potency  

*Therapeutic emesis occurs by the natural composition of the drug with ''Agni'' and ''Vayu'' (''Mahabhutas'') and the specific potency  

important while collecting the medicinal plant, in order to achieve its highest potency, safety and efficacy.

important while collecting the medicinal plant, in order to achieve its highest potency, safety and efficacy.

*The timely grown, naturally matured, unaffected by environment and organisms are the best drug for collection.  

*The timely grown, naturally matured, unaffected by environment and organisms are the best drug for collection.  

*Effect of drugs vary, depending upon their habitat, collection, storage and on patients, ''deha'' (physique), ''Doshas'', ''prakriti''  

*Effect of drugs vary depending upon habitat, collection, storage of herbs. The biological effect depends upon patients' ''deha'' (physique), ''Doshas'', ''prakriti'' (constitution), ''Vaya'' (age), ''Bala'' (strength), ''Agni'' (power of digestion and metabolism), ''Bhakti'' (liking of particular type of recipe), 'Satmya'' (wholesomeness).

(constitution), ''Vaya'' (age), ''Bala'' (strength), ''Agni'' (power of digestion and metabolism), ''Bhakti'' (liking of particular  

type of recipe), 'Satmya'' (wholesomeness).

=== ''Vidhi Vimarsha'' / Applied Inferences===

=== ''Vidhi Vimarsha'' (Applied Inferences) ===

<div style="text-align:justify;">

<div style="text-align:justify;">

*''Ushna-Tikshna-Sukshma-Vyavayi'' and ''vikasi'' are the common properties of the ''Vamanakarma dravya''. According to Sushruta, the ''ushna'' property has ''pachana karma'' (S.Su.46/515).Chakrapani (the commentator on [[Charaka Samhita]]) states that ''ushna'' means ''ushna veeryam''. This has been cleared in AshtÁnga Sangraha by Vagabhat and the function are like ''dahana'' and ''pachana'' and having ability to decrease ''vata'' and ''kapha dosha'' <ref>Ashtang Sangraha of Vriddha Vagbhata with Shalilekha Sanskrit commentary by Indu, Chaukhambha Sanskrit Series Office, Varanasi. Sutra sthana 17/15 </ref>. Sushruta defines that ''tikshna'' as the property produces ''daha, paka'' and ''srava''<ref> Sushruta Samhita of Susruta, with the Nibandhasangraha Commentary of Sri Dlhanacharya, Edited by Vaidya Jadavji Trikamji Acharya, Published by Chaukhambha Orientalia, Varanasi, 1992 Sutra sthana 46/518</ref>. According to Charaka, ''Tikshna guna'' is ''vichchindana'' <ref> Charaka Samhita by Agnivesha revised by Charaka and Dridhabala with the [[Ayurveda]]-Dipika Commentary of Chakrapanidatta, Edited by Vaidya Jadavji Trikamji Acharya, published by Chaukhambha Sanskrit Sansthan, Varanasi, 1984. Kalpa sthana 1/5</ref>. Chakrapani clarified the word as ''vichchindayati'', means breaking down the complex morbid matter into simple molecules. The ''Sukshma guna'' reaches to minute ''srotasa'' and remove the morbid matter to bring it to reach the ''amashaya'' according to Dalhana (S.Ci.33/33). The ''Vyavayi'' drugs, when administered initiate the action immediately and thereafter bio-transformation takes place. Sushruta has clarified that ''Vikasi'' drugs causes laxity in ''dhatubandhana'' (S.Su. 46/523).Due to above mentioned properties ''Vamana'' drugs are beneficial for therapeutic emesis.  

*''Ushna-Tikshna-Sukshma-Vyavayi'' and ''vikasi'' are the common properties of the ''Vamanakarma dravya''. According to Sushruta, the ''ushna'' property has ''pachana karma'' (S.Su.46/515).Chakrapani (the commentator on [[Charaka Samhita]]) states that ''ushna'' means ''ushna veeryam''. This has been cleared in AshtÁnga Sangraha by Vagabhat and the function are like ''dahana'' and ''pachana'' and having ability to decrease ''vata'' and ''kapha dosha'' <ref>Ashtang Sangraha of Vriddha Vagbhata with Shalilekha Sanskrit commentary by Indu, Chaukhambha Sanskrit Series Office, Varanasi. Sutra sthana 17/15 </ref>. Sushruta defines that ''tikshna'' as the property produces ''daha, paka'' and ''srava''<ref> Sushruta Samhita of Susruta, with the Nibandhasangraha Commentary of Sri Dlhanacharya, Edited by Vaidya Jadavji Trikamji Acharya, Published by Chaukhambha Orientalia, Varanasi, 1992 Sutra sthana 46/518</ref>. According to Charaka, ''Tikshna guna'' is ''vichchindana'' <ref> Charaka Samhita by Agnivesha revised by Charaka and Dridhabala with the [[Ayurveda]]-Dipika Commentary of Chakrapanidatta, Edited by Vaidya Jadavji Trikamji Acharya, published by Chaukhambha Sanskrit Sansthan, Varanasi, 1984. Kalpa sthana 1/5</ref>. Chakrapani clarified the word as ''vichchindayati'', means breaking down the complex morbid matter into simple molecules. The ''Sukshma guna'' reaches to minute ''srotasa'' and remove the morbid matter to bring it to reach the ''amashaya'' according to Dalhana (S.Ci.33/33). The ''Vyavayi'' drugs, when administered initiate the action immediately and thereafter bio-transformation takes place. Sushruta has clarified that ''Vikasi'' drugs causes laxity in ''dhatubandhana'' (S.Su. 46/523).Due to above mentioned properties ''Vamana'' drugs are beneficial for therapeutic emesis.  

*''Vamana'' (emesis) is one of the five physio-therapeutic procedures to eliminate impurities through gastro-oral route emerged due to aggravated ''kapha'' in human body. It is to be noted for vitiation of each ''dosha'' viz. ''kapha, pitta'' and ''vata,'' three therapeutic procedures ''vamana, virechana'' and ''basti'' are recommended respectively.

*''Vamana'' (emesis) is one of the five physio-therapeutic procedures to eliminate impurities through gastro-oral route emerged due to aggravated ''kapha'' in human body. It is to be noted for vitiation of each ''dosha'' viz. ''kapha, pitta'' and ''vata,'' three therapeutic procedures ''vamana, virechana'' and ''basti'' are recommended respectively.

*''Vamana'' is the foremost therapeutic procedure among [[Panchakarma]] (five therapeutic procedures). If ''virechanakarma'' is performed first than the ''vamana'', there are all possibilities of vitiation of the ''kapha''. This vitiated ''kapha'' having ''guru-snigdha guna'' with impurities descends down to ''grahani'' (the seat of ''agni'') and with the result of that ''pravahika'' is developed(S.Ci.33/19).

*''Vamana'' is the foremost therapeutic procedure among [[Panchakarma]] (five therapeutic procedures). If ''virechana karma'' is performed prior to ''vamana'', there are all possibilities of vitiation of the ''kapha''. This vitiated ''kapha'' having ''guru-snigdha guna'' with impurities descends down to ''grahani'' (the seat of ''agni'') and with the result of that ''pravahika'' is developed(S.Ci.33/19).

*Its importance has been realized in ''rasayana'' and ''vajikarana'' therapy; therefore, it is mandatory to do ''vamanakarma'' before aforesaid therapies for excellent results. Thus, it is obvious that [[Panchakarma]] has dual benefits i.e., health preventive and disease curative.   

*Its importance has been realized in ''rasayana'' and ''vajikarana'' therapy; therefore, it is mandatory to do ''vamanakarma'' before aforesaid therapies for excellent results. Thus, it is obvious that [[Panchakarma]] has dual benefits i.e., health preventive and disease curative.   

From the above study it was observed that average no. of Vega and Upavega (i.e., 7.41 and 12.41) were found in by the classical method as compared to traditional methods (i.e., 6.91 and 8.77). Because Vega had come out easily from deeper part of the stomach with viscous matter in group A than the group B as the particles of Madanphal Pippali were present in Yashtimadhu Kashaya (decoction) till end, for which individual had felt more exertions earlier but got more relief later on. The average quantity of every Vega in traditional method was measured more as compared to classical method, as more Kshudra or Madhyama and Khandit Vega had come in this method may be due to less intake of Vamana Kashaya (probably due to more thickened solution). Maximum percentage (i.e., 68.2%) of Pravara Shuddhi was observed in group A as compared to group B (i.e., 59.1), whereas more percentage of Madhyama and Avara Shuddhi were seen in group B most probably due to earlier expulsion of Vamana Yoga with vomitus. As MSI of group B (i.e., 2.86) was lesser than group A (i.e., 4.91) more drug output (more Dosha Shuddhi) were there in group B as compared to group A. Furthermore, more mucous (i.e., Kapha like viscous matter) were expelled in group A than group B, whereas Pitta Darshan was seen easily with a lesser time in group B as compared to group A. The average time taken to complete the Vamana (vomiting) by the classical method (58.36 min) was lesser than the time taken for traditional method (64.91 min), may be due to quick expulsion of vitiated matter, as Madanaphala Pippali was properly diluted in the Vamana Kashaya or may be due to quick appearance of Antiki Lakshanas, which leads the procedure to an end point. Clinically more percentage of individuals had marked improvement in group A, whereas more percentage of individuals got moderate improvement in group B, most probably because of more Shuddhi obtained by the classical method than the traditional. As we know that Vamana Karma is a stressful work, which is done in early morning (i.e., Kaphaja Kala). Likewise, according to modern science the plasma cortisol level also rises in early hours of morning and in any stressful stimuli. So Plasma Cortisol level was tested just before and after Vamana Karma, where a rise in Cortisol level was observed in classical methods. By physical analysis of vomited material, acidic pH was found in earlier stage and alkaline pH was seen in last stage (i.e., when Accha Pitta comes). More value of Specific gravity was found in vomitus of classical method as compared to the vomitus of traditional method. By biochemical quantitative analysis of vomitus (i.e., Hexosamine Test); mucopolysaccharide content of vomitus was found more in group A (669.64 μg/ml) in comparison to group B (480.68 μg/ml), as more viscous matter was expelled during Vamana. From the present clinical study, it can be concluded that the method mentioned in the classics are very much beneficial from every point of view in comparison to the method which has been used traditionally as it is very easy, safe, less time-consuming, and clinically as well as statistically the most effective method.Madanphala Pippali, which was taken in Antarnakha Musti Pramana (By patient's own hand) in case of the classical method measured about average 13.51 g, which should be mixed in 4 l of Yastimadhu decoction for proper dilution. So this proportion can be taken as a standard ratio for Vamana Karma. In concern to Vaigiki Shuddhi, it indicates that more no. of Vega and Upavega come by the classical method as compared to the traditional methods. Measurements of drug inputs and drug outputs (i.e., vomitus) are necessary as Maniki Shuddhi may guide towards proper judgment regarding purification and provide some clues regarding the results obtained. By physical analysis of vomited material, “pH” of the vomitus can be used as an indicator to guide oneself towards “end point” (as Antiki Shuddhi). As acidic pH was found in earlier stage and alkaline pH was seen in last stage (i.e., when Accha Pitta comes), it may help to cease the Vamana at particular point. According to Laingiki Shuddhi, more Pravara Shuddhi is achieved in Vamana by the classical methods in comparison to traditional methods. However, all the Shuddhi have equal role in assessing the proportion of purification and predicting any type of result from it. Regarding the duration of Vamana, it can be said that the time taken to complete the Vamana by the classical method is lesser than the time taken for traditional method. Significant more reduction in FBS and lipid profile test (S. Cholesterol, HDL and S. Triglyceride level) by the classical method (despite of the consumption of a huge amount of Ghee during Snehapana) indicates that classical Vamana improves the internal homeostasis more easily in comparison to traditional method. By comparing the improvements in the symptoms obtained after Vamana with the purification done earlier, it can be said that more expulsion of vitiated matter might be there in the classical method in comparison to traditional methods.

From the above study it was observed that average no. of Vega and Upavega (i.e., 7.41 and 12.41) were found in by the classical method as compared to traditional methods (i.e., 6.91 and 8.77). Because Vega had come out easily from deeper part of the stomach with viscous matter in group A than the group B as the particles of Madanphal Pippali were present in Yashtimadhu Kashaya (decoction) till end, for which individual had felt more exertions earlier but got more relief later on. The average quantity of every Vega in traditional method was measured more as compared to classical method, as more Kshudra or Madhyama and Khandit Vega had come in this method may be due to less intake of Vamana Kashaya (probably due to more thickened solution). Maximum percentage (i.e., 68.2%) of Pravara Shuddhi was observed in group A as compared to group B (i.e., 59.1), whereas more percentage of Madhyama and Avara Shuddhi were seen in group B most probably due to earlier expulsion of Vamana Yoga with vomitus. As MSI of group B (i.e., 2.86) was lesser than group A (i.e., 4.91) more drug output (more Dosha Shuddhi) were there in group B as compared to group A. Furthermore, more mucous (i.e., Kapha like viscous matter) were expelled in group A than group B, whereas Pitta Darshan was seen easily with a lesser time in group B as compared to group A. The average time taken to complete the Vamana (vomiting) by the classical method (58.36 min) was lesser than the time taken for traditional method (64.91 min), may be due to quick expulsion of vitiated matter, as Madanaphala Pippali was properly diluted in the Vamana Kashaya or may be due to quick appearance of Antiki Lakshanas, which leads the procedure to an end point. Clinically more percentage of individuals had marked improvement in group A, whereas more percentage of individuals got moderate improvement in group B, most probably because of more Shuddhi obtained by the classical method than the traditional. As we know that Vamana Karma is a stressful work, which is done in early morning (i.e., Kaphaja Kala). Likewise, according to modern science the plasma cortisol level also rises in early hours of morning and in any stressful stimuli. So Plasma Cortisol level was tested just before and after Vamana Karma, where a rise in Cortisol level was observed in classical methods. By physical analysis of vomited material, acidic pH was found in earlier stage and alkaline pH was seen in last stage (i.e., when Accha Pitta comes). More value of Specific gravity was found in vomitus of classical method as compared to the vomitus of traditional method. By biochemical quantitative analysis of vomitus (i.e., Hexosamine Test); mucopolysaccharide content of vomitus was found more in group A (669.64 μg/ml) in comparison to group B (480.68 μg/ml), as more viscous matter was expelled during Vamana. From the present clinical study, it can be concluded that the method mentioned in the classics are very much beneficial from every point of view in comparison to the method which has been used traditionally as it is very easy, safe, less time-consuming, and clinically as well as statistically the most effective method.Madanphala Pippali, which was taken in Antarnakha Musti Pramana (By patient's own hand) in case of the classical method measured about average 13.51 g, which should be mixed in 4 l of Yastimadhu decoction for proper dilution. So this proportion can be taken as a standard ratio for Vamana Karma. In concern to Vaigiki Shuddhi, it indicates that more no. of Vega and Upavega come by the classical method as compared to the traditional methods. Measurements of drug inputs and drug outputs (i.e., vomitus) are necessary as Maniki Shuddhi may guide towards proper judgment regarding purification and provide some clues regarding the results obtained. By physical analysis of vomited material, “pH” of the vomitus can be used as an indicator to guide oneself towards “end point” (as Antiki Shuddhi). As acidic pH was found in earlier stage and alkaline pH was seen in last stage (i.e., when Accha Pitta comes), it may help to cease the Vamana at particular point. According to Laingiki Shuddhi, more Pravara Shuddhi is achieved in Vamana by the classical methods in comparison to traditional methods. However, all the Shuddhi have equal role in assessing the proportion of purification and predicting any type of result from it. Regarding the duration of Vamana, it can be said that the time taken to complete the Vamana by the classical method is lesser than the time taken for traditional method. Significant more reduction in FBS and lipid profile test (S. Cholesterol, HDL and S. Triglyceride level) by the classical method (despite of the consumption of a huge amount of Ghee during Snehapana) indicates that classical Vamana improves the internal homeostasis more easily in comparison to traditional method. By comparing the improvements in the symptoms obtained after Vamana with the purification done earlier, it can be said that more expulsion of vitiated matter might be there in the classical method in comparison to traditional methods.

'''[[Madanakalpa Adhyaya#Administration of Madanaphala|Research on vasantika vamana:]]'''

'''[[Madanakalpa Adhyaya#Administration of Madanaphala|Research on emesis performed during Spring season:]]'''

Another study on vasantika vamana concluded that average quantity of Madanaphala, Ksheera, Yastimadhu Phanta and Lavanodaka can be 5.81 g, 1130.29 ml, 3202.9 and 2489.13 ml respectively. The study also depicted that laingiki and antiki criteria seem to be the better criteria for the assessment of Vamana.<ref>Bhatted S, Shukla V D, Thakar A, Bhatt N N. A study on Vasantika Vamana (therapeutic emesis in spring season) - A preventive measure for diseases of Kapha origin. AYU [serial online] 2011 [cited 2019 Feb 20];32:181-6. Available from: http://www.ayujournal.org/text.asp?2011/32/2/181/92562</ref>

Another study on vasantika vamana concluded that average quantity of Madanaphala, Ksheera, Yastimadhu Phanta and Lavanodaka can be 5.81 g, 1130.29 ml, 3202.9 and 2489.13 ml respectively. The study also depicted that laingiki and antiki criteria seem to be the better criteria for the assessment of Vamana.<ref>Bhatted S, Shukla V D, Thakar A, Bhatt N N. A study on Vasantika Vamana (therapeutic emesis in spring season) - A preventive measure for diseases of Kapha origin. AYU [serial online] 2011 [cited 2019 Feb 20];32:181-6. Available from: http://www.ayujournal.org/text.asp?2011/32/2/181/92562</ref>