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{{#seo:

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|title=Madanakalpa Adhyaya

|title=Madanakalpa Adhyaya

|type=article

|type=article

}}

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'''<big>[[Kalpa Sthana]] Chapter 1. Pharmaceutical preparations of Madanaphala</big>'''

'''<big>[[Kalpa Sthana]] Chapter 1. Pharmaceutical preparations of Madanaphala</big>'''

{{Infobox

{{Infobox

|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Siddhi Sthana]]

|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Siddhi Sthana]]

|label6 = Translator and commentator

|label6 = Translator and commentator

|data6 = Joshi V.K.,Ghildiyal S.,Chavan S.

|data6 = Joshi V.K., Ghildiyal S., Chavan S.

|label7 = Reviewer  

|label7 = Reviewer  

|data7  = Chavan S., Nishteswar K.

|data7  = Chavan S., Nishteswar K.

|label8 = Editors

|label8 = Editors

|data8  = Nishteswar K., Sawant B., Deole Y.S., Basisht G.

|data8  = Nishteswar K., Sawant B., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]

|label9 = Year of publication  

|label9 = Year of publication  

|data9 =  2020

|data9 =  2020

}}

}}

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

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

 

<p style="text-align:justify;">The present 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.

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

 

 

== Introduction ==

== Introduction ==

== Tattva Vimarsha (Fundamental Principles)==

== Tattva Vimarsha (Fundamental Principles)==

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*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).

*The therapeutic emetic drugs shall possess qualities like ''ushna'' (hot), ''tikṣhṇa'' (sharply acting), ''sukshma'' (deeply  

*The therapeutic emetic drugs shall possess qualities like ''ushna'' (hot), ''tikṣhṇa'' (sharply acting), ''sukshma'' (deeply  

penetrating), ''vyavayi''(quality of spreading all over body before digested/quickly acting) and ''vikashi'' (quality of spreading all  

penetrating), ''vyavayi''(quality of spreading all over body before digested/quickly acting) and ''vikashi'' (quality of spreading all over body before digested/quickly acting and displaces tissues from physiological sites).

over body before digested/quickly acting and displaces tissues from physiological sites).

*In the process of therapeutic emesis, it is necessary for drug to reach the heart, circulate through vessels and effect the mass of  

*In the process of therapeutic emesis, it is necessary for drug to reach the heart, circulate through vessels and effect the mass of  

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 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]] ([[Mahabhuta]]) and the specific potency (for emesis).  

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

*Therapeutic emesis occurs when the natural composition of the drug predominates in [[Jala]] and [[Prithvi mahabhuta]] and there is specific potency (for purgation).  

(for emesis).  

*Three types of habitat are ''Jangala''(arid), ''Anupa''(marshy) and ''Sadharana'' (medium). People with [[Vata]] and [[Pitta]] dominance are seen in 'Jangala'' habitat. People with ''Vata'' and ''Kapha'' dominance are seen in ''Anupa'' habitat.

*Therapeutic emesis occurs when the natural composition of the drug predominates in ''Jala'' and ''Prithvi mahabhuta'' and there is  

*The drugs are required to be collected keeping in view the appropriate habitat (''desha-sampat''), appropriate season (''kala sampat'') and their effective attributes ([[guna]] smapat). The [[Vamana]] dravya (drug) possesses strong potency endowed due to  

specific potency (for purgation).  

''desha''(habitat),  ''kala''(time) [[guna]] (properties) and ''bhajana'' (container).

*Three types of habitat are ''Jangala''(arid), ''Anupa''(marshy) and ''Sadharana'' (medium). People with ''Vata'' and ''Pitta''

*The proportion of active principle in useful parts of medicinal plant varies according to season. Hence, time of collection is important while collecting the medicinal plant, in order to achieve its highest potency, safety and efficacy.

dominance are seen in 'Jangala'' habitat. People with ''Vata'' and ''Kapha'' dominance are seen in ''Anupa'' habitat.

*The drugs are required to be collected keeping in view the appropriate habitat (''desha-sampat''), appropriate season (''kala sampat'')  

and their effective attributes (''guna smapat''). The ''Vamana dravya'' (drug) possesses strong potency endowed due to  

''desha''(habitat),  ''kala''(time) ''guna'' (properties) and ''bhajana'' (container).

*The proportion of active principle in useful parts of medicinal plant varies according to season. Hence, time of collection is  

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 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).

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

</div>

</div>

== Vidhi Vimarsha (Applied Inferences) ==

== Vidhi Vimarsha (Applied Inferences) ==

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

=== Mode of action of therapeutic emesis (vamana) ===

=== Mode of action of therapeutic emesis (vamana) ===

*''Ushna-Tikshna-Sukshma-Vyavayi'' and ''vikasi'' are the common properties of the ''Vamanakarma dravya''. According to Sushruta, the ''ushna'' property has ''pachana karma'' <ref>Sushruta. Sutra Sthana, Cha.46 annapanavidhi Adhyaya verse 515. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>.Chakrapani (the commentator on [[Charaka Samhita]]) states that ''ushna'' means ''ushna veeryam''. This has been cleared in AshtÁnga Sangraha by Vagabhata and the function are like ''dahana'' and ''pachana'' and having ability to decrease ''vata'' and ''kapha dosha'' <ref>Indu, Vagbhata,Ashtanga Sanngraha, Sutra Sthana 17 Dravyadiivijnaniya, Verse 15.In:Dr Shivaprasad Sharma editor,Astanga Sangraha, ? ed.,Varanasi, Chowkhamba Sanskrit Sansthan, 2006 Pp965. </ref>. Sushruta defines that ''tikshna'' as the property produces ''daha, paka'' and ''srava''<ref>Dalhana, Sushruta,Sutra sthana Cha 46, Annapana Vidhi Adhyaya , Verse 518  In:Vaidya Jadavji Trikamji Acharya,editors, Varanasi: Chaukhambha Orientalia,1992.</ref>. According to Charaka, ''Tikshna guna'' is ''vichchindana'' <ref>Chakrapanani,Charaka, Kalpa sthana 1 Madanakalpa Adhyaya, Verse 5, In: Vaidya Jadavji Trikamji Acharya, published by Chaukhambha Sanskrit Sansthan, Varanasi, 1984.</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 <ref>Dalhana, Sushruta,Chikitsa sthana Cha 33, Vamanavirechana sadhyopadrava Chikitsitam Adhyaya , Verse 33 In:Vaidya Jadavji Trikamji Acharya,editors, Varanasi: Chaukhambha Orientalia,1992.</ref>. 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'' <ref>Dalhana, Sushruta,Sutra sthana Cha 46, Annapana Vidhi Adhyaya , Verse 5523  In:Vaidya Jadavji Trikamji Acharya,editors, Varanasi: Chaukhambha Orientalia,1992.</ref>.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'' <ref>Sushruta. Sutra Sthana, Cha.46 annapanavidhi Adhyaya verse 515. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>.Chakrapani (the commentator on [[Charaka Samhita]]) states that ''ushna'' means ''ushna veeryam''. This has been cleared in AshtÁnga Sangraha by Vagabhata and the function are like ''dahana'' and [[pachana]] and having ability to decrease [[vata]] and [[kapha]] [[dosha]] <ref>Indu, Vagbhata,Ashtanga Sanngraha, Sutra Sthana 17 Dravyadiivijnaniya, Verse 15.In:Dr Shivaprasad Sharma editor,Astanga Sangraha, ? ed.,Varanasi, Chowkhamba Sanskrit Sansthan, 2006 Pp965. </ref>. Sushruta defines that ''tikshna'' as the property produces ''daha, paka'' and ''srava''<ref>Dalhana, Sushruta,Sutra sthana Cha 46, Annapana Vidhi Adhyaya , Verse 518  In:Vaidya Jadavji Trikamji Acharya,editors, Varanasi: Chaukhambha Orientalia,1992.</ref>. According to Charaka, ''Tikshna guna'' is ''vichchindana'' <ref>Chakrapanani,Charaka, Kalpa sthana 1 Madanakalpa Adhyaya, Verse 5, In: Vaidya Jadavji Trikamji Acharya, published by Chaukhambha Sanskrit Sansthan, Varanasi, 1984.</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 <ref>Dalhana, Sushruta,Chikitsa sthana Cha 33, Vamanavirechana sadhyopadrava Chikitsitam Adhyaya , Verse 33 In:Vaidya Jadavji Trikamji Acharya,editors, Varanasi: Chaukhambha Orientalia,1992.</ref>. 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'' <ref>Dalhana, Sushruta,Sutra sthana Cha 46, Annapana Vidhi Adhyaya , Verse 5523  In:Vaidya Jadavji Trikamji Acharya,editors, Varanasi: Chaukhambha Orientalia,1992.</ref>.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 ''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.<ref>Dalhana, Sushruta,Chikitsa sthana Cha 33 Vamanavirechana sadhyopadrava Chikitsitam Adhyaya, Verse 19  In:Vaidya Jadavji Trikamji Acharya,editors, Varanasi: Chaukhambha Orientalia,1992.</ref>.

*[[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.<ref>Dalhana, Sushruta,Chikitsa sthana Cha 33 Vamanavirechana sadhyopadrava Chikitsitam Adhyaya, Verse 19  In:Vaidya Jadavji Trikamji Acharya,editors, Varanasi: Chaukhambha Orientalia,1992.</ref>.

*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 [[vamana]]karma before aforesaid therapies for excellent results. Thus, it is obvious that [[Panchakarma]] has dual benefits i.e., health preventive and disease curative.   

    

    

*''Virechana, vireka, chhardi, chardana, vami, ullekhana, lekhana, shodhana'' and ''sansodhana'' are the various synonyms of ''vamana'' as found in Ayurvedic classics.

*[[Virechana]], vireka, chhardi, chardana, vami, ullekhana, lekhana, shodhana'' and ''sansodhana'' are the various synonyms of [[vamana]] as found in Ayurvedic classics.

*''Vamanakarma'', causes cleanliness of the stomach, which enhances ''kayagni'' (body fire), diseases get pacified, normalcy is maintained, sense organ, intellect, and complexion are improved, strength, nourishment, progeny and potency are produced, the old age does not his hold easily and the person lives long from disorders. Therefore, one should use the evacuation therapy [Cha.Sa.[[Sutra Sthana]] 16/17-19].

*[[Vamana]]karma, causes cleanliness of the stomach, which enhances ''kayagni'' (body fire), diseases get pacified, normalcy is maintained, sense organ, intellect, and complexion are improved, strength, nourishment, progeny and potency are produced, the old age does not his hold easily and the person lives long from disorders. Therefore, one should use the evacuation therapy [Cha.Sa.[[Sutra Sthana]] 16/17-19].

*Evacuated ''doshas'' never reoccur, if they are subdued with evacuation therapy. ''Vamana karma'' is considered the best line of therapeutic procedure for all the diseases having ''kaphaja'' origin [Cha. Sa. [[Sutra Sthana]] 33/19]Sharangadhara.<ref>Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.pp--.</ref>.

*Evacuated [[dosha]] never reoccur, if they are subdued with evacuation therapy. [[Vamana]] karma'' is considered the best line of therapeutic procedure for all the diseases having [[kapha]]ja origin [Cha. Sa. [[Sutra Sthana]] 33/19]Sharangadhara.<ref>Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.pp--.</ref>.

*''Sharngadhara'' in ''Sharngadhara Samhita'' stated that ''apakva pitta'' and ''kapha'' are forcefully expelled out through the upward route. Thus ''vamana'' is the best for vitiated ''kapha'' and ''apakva pitta'' <ref>Addhamala,Sharangadhara,Sharangadhara Samhita, Purva khanda Chapter 8, Verse 7,ed. 3,Varanasi : Chaukhambha Orientalia,1983.</ref>.

*''Sharngadhara'' in ''Sharngadhara Samhita'' stated that apakva [[pitta]] and [[kapha]] are forcefully expelled out through the upward route. Thus [[vamana]] is the best for vitiated [[kapha]] and apakva [[pitta]] <ref>Addhamala,Sharangadhara,Sharangadhara Samhita, Purva khanda Chapter 8, Verse 7,ed. 3,Varanasi : Chaukhambha Orientalia,1983.</ref>.

=== Phytochemistry of madanaphala===

=== Phytochemistry of madanaphala===

=== Recent researches on action of herbs ===

=== Recent researches on action of herbs ===

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*''Vamana'' is believed to be controlled by two distinct brain centers - the vomiting center(tractus soitorius and the Chemoreceptor Trigger Zone both located in the Medulla Oblongata. The CTZ is close to the area postrema on the floor of the fourth ventricle and is outside of the blood brain barrier and communicates with the vomiting centre to initiate ''vamana''. The CTZ being outside the blood-brain barrier, and can therefore be stimulated by blood-borne drugs that can stimulate vomiting, or inhibit it.

*[[Vamana]] is believed to be controlled by two distinct brain centers - the vomiting center(tractus soitorius and the Chemoreceptor Trigger Zone both located in the Medulla Oblongata. The CTZ is close to the area postrema on the floor of the fourth ventricle and is outside of the blood brain barrier and communicates with the vomiting centre to initiate [[vamana]]. The CTZ being outside the blood-brain barrier, and can therefore be stimulated by blood-borne drugs that can stimulate vomiting, or inhibit it.

*''Vamana'' stimuli act at several anatomic sites.

*[[Vamana]] stimuli act at several anatomic sites.

*''Vamana'' provoked by noxious smells originates in the cerebral cortex (through chemoreceptors in nasal mucosa - ''Ghreya Vamana'').

*[[Vamana]] provoked by noxious smells originates in the cerebral cortex (through chemoreceptors in nasal mucosa - Ghreya [[Vamana]]).

*Cranial nerves mediate ''vamana'' after gag reflex activation (''Anguli, Kamala nala pravesha'').

*Cranial nerves mediate [[vamana]] after gag reflex activation (''Anguli, Kamala nala pravesha'').

*Gastric reflex : ( Āmāśaya utkleśya bhāva)

*Gastric reflex : ( Āmāśaya utkleśya bhāva)

**Strech reflex - Ākaṇṭhapāna

**Strech reflex - Ākaṇṭhapāna

Followed by antiperistalsis movements - Electrical stimuli : (prabhava) by stimulating CTZ centers in brain

Followed by antiperistalsis movements - Electrical stimuli : (prabhava) by stimulating CTZ centers in brain

=== Research work on comparative study of Vamana by two different methods ===

=== Research work on comparative study of [[Vamana]] by two different methods ===

A comparative clinical study on standardization of Vamana Vidhi by classical and traditional methods was carried out<ref>Ranjip Kumar Dass, Nilesh N. Bhatt, Anup B. Thakar,  Vagish Dutt Shukla. Ayu. 2012 Oct-Dec; 33(4): 517–522. doi:  10.4103/0974-8520.110531 </ref>.  Total 50 patients and healthy volunteers were selected irrespective of gender, religion, occupation, etc., from O.P.D. and I.P.D. of Panchakarma Department of Institute for Post Graduate Teaching and Research in [[Ayurveda]], Jamnagar. The patients as well as healthy volunteers were randomly divided into following two groups: One group had performed Vamana by the classical methods according to Charaka and Sushruta Samhita.  Madanphala Pippali was taken in Antarnakha Mushti (making fist) Pramana by the patient's own hand. It was then added in Yashtimadhu Kwatha and kept for one night (previous night of Vamana Karma). In the morning time, it was stirred properly and filtered. Then it was given to the patient in lukewarm state mixing with honey and Saindhav Lavana (rock salt) upto Pittanta Vamana (till bile comes). Before that in early morning, Ghritayukta Yavagu was given to the patient after Abhyanga (massage) and Swedana (fomentation).

A comparative clinical study on standardization of Vamana Vidhi by classical and traditional methods was carried out<ref>Ranjip Kumar Dass, Nilesh N. Bhatt, Anup B. Thakar,  Vagish Dutt Shukla. Ayu. 2012 Oct-Dec; 33(4): 517–522. doi:  10.4103/0974-8520.110531 </ref>.  Total 50 patients and healthy volunteers were selected irrespective of gender, religion, occupation, etc., from O.P.D. and I.P.D. of Panchakarma Department of Institute for Post Graduate Teaching and Research in [[Ayurveda]], Jamnagar. The patients as well as healthy volunteers were randomly divided into following two groups: One group had performed Vamana by the classical methods according to Charaka and Sushruta Samhita.  Madanphala Pippali was taken in Antarnakha Mushti (making fist) Pramana by the patient's own hand. It was then added in Yashtimadhu Kwatha and kept for one night (previous night of Vamana Karma). In the morning time, it was stirred properly and filtered. Then it was given to the patient in lukewarm state mixing with honey and Saindhav Lavana (rock salt) upto Pittanta Vamana (till bile comes). Before that in early morning, Ghritayukta Yavagu was given to the patient after Abhyanga (massage) and Swedana (fomentation).

   

   

In the other group B (traditional group), twenty two individuals had performed Vamana by traditional methods .  In the morning time at first after massage and sudation, milk or Ikshu Rasa was given to the patient upto Aakanthapana (fullness upto throat). Then Madanphala Pippali Churna, Vacha and Saindhav Lavana were taken in a ratio of 4:2:1 part, respectively and a paste was made with honey. It was then given to the patient directly or indirectly by mixing with any liquid media like milk or Ikshu Rasa or Yashtimadhu Phanta. Afterwards, Yashtimadhu Phanta made freshly in the morning was given upto Pittanta Vamana.  

In the other group B (traditional group), twenty two individuals had performed Vamana by traditional methods .  In the morning time at first after massage and sudation, milk or Ikshu Rasa was given to the patient upto Aakanthapana (fullness upto throat). Then Madanphala Pippali Churna, Vacha and Saindhav Lavana were taken in a ratio of 4:2:1 part, respectively and a paste was made with honey. It was then given to the patient directly or indirectly by mixing with any liquid media like milk or Ikshu Rasa or Yashtimadhu Phanta. Afterwards, Yashtimadhu Phanta made freshly in the morning was given upto [[Pitta]]nta [[Vamana]].  

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., [[Kapha]]ja 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 emesis performed during Spring season:]]===

===[[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>

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== References ==

== References ==