Changes

In ''vamana'', ''kapha utklesha''(excited) is expected which is evident by excess salivation, nausea etc. These factors plays an important role in  induction of vomiting. The vagal and enteric nervous system inputs transmit information regarding the state of the gastrointestinal system. Irritation of the GI mucosa by any drug or distension activates the 5-HT3 receptors of these inputs. Thus if ''kapha'' is not aggravated then the key mechanism of distension of stomach, excess salivary secretions and nausea fails to initiate vomiting thus drug passes to the intestine and causes purgation. On contrary if ''kapha'' is highly aggravated then drug for purgation may lead to vomiting due to above said mechanism. This is the probable reason for specific diet before cleansing processes.

In ''vamana'', ''kapha utklesha''(excited) is expected which is evident by excess salivation, nausea etc. These factors plays an important role in  induction of vomiting. The vagal and enteric nervous system inputs transmit information regarding the state of the gastrointestinal system. Irritation of the GI mucosa by any drug or distension activates the 5-HT3 receptors of these inputs. Thus if ''kapha'' is not aggravated then the key mechanism of distension of stomach, excess salivary secretions and nausea fails to initiate vomiting thus drug passes to the intestine and causes purgation. On contrary if ''kapha'' is highly aggravated then drug for purgation may lead to vomiting due to above said mechanism. This is the probable reason for specific diet before cleansing processes.

==== Post therapeutic measures (samsarjana krama) (verse 11-12) ====

==== Post therapeutic measures (''samsarjana krama'') (verse 11-12) ====

Duration of post therapeutic measures varies with type/quality of cleansing. This is directly related to the extent of changes brought by cleansing the digestive system and duration required to regain its normal functioning. Mucosal layer in the digestive tract plays important functions like barrier to protect from acids,  maintaining optimal immune function, proper digestion & assimilation of food & nutrients etc. also the bacterial flora residing in intestine is also responsible for some functions like fermentation of undigested carbohydrates and the subsequent absorption of short-chain fatty acids, plays a role in synthesizing vitamin B and vitamin K as well as metabolising bile acids, sterols and xenobiotics. Vomiting and purgation leads to cleansing of entire tract that causes removal of unhealthy bacterial flora and also inflammation and damage to the mucosal barrier. Thus till regeneration of new flora and proper mucosal barrier, the diet needs to be light and gradually increasing in thickness. Fats and some spices are given at later phases as they require proper mucosal functioning for absorption. Moreover this regimen facilitates the gradual induction of carbohydrate, vegetable protein, fat and meat protein as digestion improves gradually.

Duration of post therapeutic measures varies with type/quality of cleansing. This is directly related to the extent of changes brought by cleansing the digestive system and duration required to regain its normal functioning. Mucosal layer in the digestive tract plays important functions like barrier to protect from acids,  maintaining optimal immune function, proper digestion and assimilation of food and nutrients etc. Also the bacterial flora residing in intestine is also responsible for some functions like fermentation of undigested carbohydrates and the subsequent absorption of short-chain fatty acids, plays a role in synthesizing vitamin B and vitamin K as well as metabolising bile acids, sterols and xenobiotics. Vomiting and purgation leads to cleansing of entire tract that causes removal of unhealthy bacterial flora and also inflammation and damage to the mucosal barrier. Thus till regeneration of new flora and proper mucosal barrier, the diet needs to be light and gradually increasing in thickness. Fats and some spices are given at later phases as they require proper mucosal functioning for absorption. Moreover this regimen facilitates the gradual induction of carbohydrate, vegetable protein, fat and meat protein as digestion improves gradually.

==== Characteristics of Three types of emesis and purgation (verse 13-15) ====

==== Characteristics of Three types of emesis and purgation (verse 13-15) ====