Changes

Similarly, though one cannot measure the exact quantity of dosha, still on basis of symptoms, koshtha, agni etc. one need to decide the dose of drug to be given for cleansing. If dose calculation or the treatment is administered is wrong, then even if the drug is proper then also results may be adverse.

Similarly, though one cannot measure the exact quantity of dosha, still on basis of symptoms, koshtha, agni etc. one need to decide the dose of drug to be given for cleansing. If dose calculation or the treatment is administered is wrong, then even if the drug is proper then also results may be adverse.

==== Procedures followed practically for vamana & virechana are as follows ====

==== Procedures followed practically for ''vamana'' and ''virechana'' are as follows ====

• After proper deepana and pachana, 30-40 ml of the fat is given empty stomach in the morning around 6.00 to 7.00 a. m. This dose is considered as test dose.

*After proper ''deepana'' and ''pachana'', 30-40 ml of the fat is given empty stomach in the morning around 6.00 to 7.00 a. m. This dose is considered as test dose.

• Depending upon time taken for complete digestion of this dose, the dose required as per disease severity is calculated. Generally the dose which can be digested in 12 hours is considered as moderate.

*Depending upon time taken for complete digestion of this dose, the dose required as per disease severity is calculated. Generally the dose which can be digested in 12 hours is considered as moderate.

• The quantity of fat to be administered is increased gradually till required dose is administered. Hence the dose for oleation decided on the basis of test dose is the actual quantity of fat to be administered on last day of oleation.

*The quantity of fat to be administered is increased gradually till required dose is administered. Hence the dose for oleation decided on the basis of test dose is the actual quantity of fat to be administered on last day of oleation.

• Maximum duration for oleation is seven days which is for krura koshtha and least duration is three days which is for mridu koshtha.

*Maximum duration for oleation is seven days which is for ''krura koshtha'' and least duration is three days which is for ''mridu koshtha''.

• Proper oleation is decided on basis of symptoms like fats in feces, oiliness in skin etc.  

*Proper oleation is decided on basis of symptoms like fats in feces, oiliness in skin etc.  

• Fomentation with whole body massage is practised in certain areas twice in one day for Vamana and twice for three days in case of virechana after completion of oleation.

*Fomentation with whole body massage is practised in certain areas twice in one day for ''vamana'' and twice for three days in case of ''virechana'' after completion of oleation.

• During this period of fomentation the diet as specified above in verse 8-9 is given for better results

*During this period of fomentation the diet as specified above in verse 8-9 is given for better results

• On the day of vamana, in the morning again whole body massage with fomentation is given. Milk or any other material like sugarcane juice that helps initiating emesis is given to fill the stomach especially if the patient is weak. The quantity administered ranges from 500 ml to 1200ml depending upon patient’s gastric capacity. After that vamana drug is administered at around 7.00 a.m. (commonly used formulation- madanaphala pippali powder 5-7 gm+ vacha powder 2-3 gm+ rock salt powder 1-2 gm+ honey Q.S.) and wait and watch strategy is used for 45 minutes till emesis starts. Then yashtimadhu fanta (prepared by adding coarse yashtimadhu powder in hot water) is given continuously to induce and to facilitate the emesis till pitta is observed in bouts of vomitus. At the end of the procedure luke warm salt water is given to cleans the stomach. Medicated smoke inhalation is preferred in order to clear the kapha in upper upper respiratory tract.

*On the day of vamana, in the morning again whole body massage with fomentation is given. Milk or any other material like sugarcane juice that helps initiating emesis is given to fill the stomach especially if the patient is weak. The quantity administered ranges from 500 ml to 1200ml depending upon patient’s gastric capacity. After that vamana drug is administered at around 7.00 a.m. (commonly used formulation- madanaphala pippali powder 5-7 gm+ vacha powder 2-3 gm+ rock salt powder 1-2 gm+ honey Q.S.) and wait and watch strategy is used for 45 minutes till emesis starts. Then yashtimadhu fanta (prepared by adding coarse yashtimadhu powder in hot water) is given continuously to induce and to facilitate the emesis till pitta is observed in bouts of vomitus. At the end of the procedure luke warm salt water is given to cleans the stomach. Medicated smoke inhalation is preferred in order to clear the kapha in upper upper respiratory tract.

On day of purgation, in the morning again whole body massage with fomentation is given. Then virechana drug as per the koshtha and disease is administered at around 10.00-10.30 a.m. in the morning. This time specification is not always suitable, varies according to season, desha (place), appetite of patient etc. better to detail the concept of ‘shleshmakale gate”  

On day of purgation, in the morning again whole body massage with fomentation is given. Then virechana drug as per the koshtha and disease is administered at around 10.00-10.30 a.m. in the morning. This time specification is not always suitable, varies according to season, desha (place), appetite of patient etc. better to detail the concept of ‘shleshmakale gate”  

• Purgation is continued till mucus is visible in the faeces. If proper purgation is not occurring with given dose then strong purgative like icchabhedi rasa or abhayadi modaka may be given to boost up the process.

• Purgation is continued till mucus is visible in the faeces. If proper purgation is not occurring with given dose then strong purgative like icchabhedi rasa or abhayadi modaka may be given to boost up the process.