|Year : 2015 | Volume
| Issue : 4 | Page : 219-223
A study on the role of vamanam on serum bilirubin and calcium levels
Vijaya Lakshmi Narra
Department of Basic Principles, Maior S.D. Singh College, Farukabad, Uttar Pradesh, India
|Date of Web Publication||14-Dec-2015|
Vijaya Lakshmi Narra
SV Apartments, Flat No. 304, Kalyannagar, Hyderabad - 500 038, Telangana
Source of Support: None, Conflict of Interest: None
Introduction: Normal pitta maintains normal hepatic metabolism. Serum bilirubin and calcium levels are associated with hepatic function. Vamanam and Sweda Karma increase agni, which in turn affects the liver metabolism. The raised agni after sweda and vamanam increase the metabolic activity of the body. Today's quality of food and dietary habits, lifestyle, and changes in seasons are often the cause of saturation of toxins in the body, which according to Ayurveda are malas and aam, and these are also the cause for vitiation of the doshas. When the body becomes free from this malas, aam (toxic materials), and vitiated doshas, a state of good health can be achieved. Ayurveda has the best therapies in the form of Panchakarma to make the body free from these disease-causing factors.
Aim: Is to study on the role of vamanam on serum bilirubin and calcium levels. To study the bodily changes after Vamana Karma.
Materials and Methods: 40 patients of Tamakaswasa and Sidhma Kushta divided into two group each consisting of 20 patients. The treated group patients were divided into 10 each of Tamakaswasa and Sidhma Kushta managed with Snehapana, Sweda Karma and finally with Vamana Karma. Effects of Snehapana, Sweda and Vamanam on serum bilirubin, calcium were evaluated before treatment, after Sneha, Sweda and at the end of the treatment.
Results: Marginal changes seen in this study. 85% symptoms relieved in both the diseases.
Conclusion: Vamana can improve the functional and metabolic activities of the body. The clinical signs and symptoms were decreased after Vamana Karma.
Keywords: Kapha , medicated emesis, Sidhma Kushta, Tamaka Swasa, vamanam
|How to cite this article:|
Narra VL. A study on the role of vamanam on serum bilirubin and calcium levels. J NTR Univ Health Sci 2015;4:219-23
| Introduction|| |
Tamaka Swasa and Sidhma Kushta are selected because of their chronic nature. Vamanam is selected for purification of vitiated Kapha, which is mainly responsible for the pathology in both the diseases. This topic is selected as vamanam expels abnormal kapha dosha and vidagda pitta. Kapha and rasa have dosha dhatu asraya asryee bhava sambandha. Vamanam and Sweda Karma increase agni, which in turn affects the liver metabolism. Normal pitta maintains normal hepatic metabolism. Serum bilirubin and calcium levels are associated with hepatic function. The liver is the largest and most significant metabolic organ of the body. It is the center of diverse metabolic reactions that occur in the body. The raised agni (enzymes) after sweda and vamanam increase the metabolic activity of the body.
Vamanam (medicated emesis) is the best biopurificatory procedure in Kapha dominant and vitiated conditions such as Tamaka Swasa (asthma) and Sidhma Kushta (psoriasis) as described in Ayurveda. While studying Chikitsa (line of treatment) from the Ayurveda text, it was noticed that Shodhana (purificatory measure) is advised first. Obstruction (sanga) pathology was observed to be due to vitiation of the doshas. Kapha has the maximum ability for obstruction due to its attributes. Today's quality of food and dietary habits, lifestyle, and changes in seasons are often the cause of saturation of toxins in the body, which according to Ayurveda are malas and aam, and these are also the cause for vitiation of the doshas. Unless and until the body becomes free from this malas, aam (toxic materials), and vitiated doshas, a state of good health cannot be achieved. Ayurveda has the best therapies in the form of Panchakarma to make the body free from these disease-causing factors. Excellent results can be achieved even in a lesser time, and after Panchakarma, the patient can be treated well with less consumption of medicines within a short period; so it saves time as well as the expenses of medicines.
Aims and objectives
- To see the effect of Vamana Karma on serum bilirubin, calcium values.
- To throw light on the bodily changes after Vamana Karma in the rasa component of rasa-rakta complex.
| Materials and Methods|| |
Forty patients were selected irrespective of sex and religion randomly from the Outpatient Department (OPD) of Dr. B. R. K. R. Government Ayurved Medical College, Hyderabad, Andhra Pradesh, India and divided into a treated group and a control group, each consisting of 20 patients. The treated group of patients was divided into 10 each of Tamaka Swasa (asthma) and Sidhma Kushta (psoriasis) managed with Snehapana, Sweda Karma,, and finally Vamana Karma (medicated emesis).
Laboratory investigations such as routine biochemical tests were conducted and recorded at the time of admission. All the investigations were repeated at the end of Sweda Karma and also on the 4th day of Vamana Karma in the treated group of patients. In the control group of patients, these were repeated at the end of the treatment. All patients were advised to fast for about 12 h before the collection of blood samples. Blood was collected from the cubital vein.
Parameters of assessment
- Administration of Snehapana (internal oleation): After completing all the examinations and investigations, the treated group of patients were given Snehapana. Indukanta Ghritam,  given in Tamaka Swasa patients as mentioned in Sahasrayogam and Mahtiktaka Ghritam said in Astanga Hridayam, was given to Sidhma Kushta patients at 6 AM. The digestive power and thirst was noted on a daily basis to assess the state of koshta of the patients.
- Sweda karma (sudation): Bhashpa sweda was done that was preceded by abhyanga with Dhanvantari tailam in Tamaka Swasa patients and Dineshakeram in Sidhma Kushta patients.  It was noted that the desired effects of Sweda karma were seen in all patients within 20 min. After completion of purva karma, the investigations were carried out.
- Vamana Karma : A day previous to Vamana Karma, i.e., after 2 days of Sweda Karma the patients were fed with masha and milk for kaphotklesha.  On the day of Vamana Karma during the kaphakala, i.e., in the morning the patients were once again subjected to local massage with Snehakarma and Sweda Karma before giving the vamana drug. Cow's milk of 2-3 L was given to the patients to drink followed by the actual vamana drug in a single dose. It contained 10 g Madanaphala Pippali Churna (Randia dumetorum),, 5 g of vacha (Acorus calamus),10 g of saindhava lavana (rock salt), and madhu (honey).  All these were mixed well by grinding and this paste was mixed with 100 mL of milk and was administered.
In most of the cases, spontaneous vomiting started with in a maximum period of 30 min. A little quantity of saindhava lavana with warm water was given as an adjuvant to the original vamana drug to induce vomiting. After vamana, the patients were given a short course of Samsarjana karma in the form of kanji (peya) for 3 days. During the entire process of treatment, no other medicine was given to any of the patients. 
On the 4 th day of Vamana Karma, the laboratory investigations were once again recorded.
In the control group, the patients were treated with symptomatic treatment only. In Tamaka Swasa patients, Dashamula katu traya kwatham 90 mL ter die sumendum or three times a day (tds), Kanakasava with Vasarishta 30 mL tds were given for 20 days. In Sidhmakushta patients, patavaladi kwatha 90 mL and guggulu tiktaka ghritam 15 g bis die sumendum or two times a day (bds) were given for 20 days.
The laboratory investigations were carried out in order to assess the treatment in this group too. All the patients were advised to report once in a month for follow-up studies. After completing all the examinations and investigations, the treated group of patients were subjected to a course of snehapana. The results obtained were compared each other and analyzed statistically.
| Observation and Results|| |
Biochemical and serological investigations
The results of serological investigations are very incitory and throw light on the bodily changes after Vamana Karma.
There was a marginal change in serum bilirubin that was observed in the treated group while the serum bilirubin in the control group remained unchanged. In the treated group before sneha sweda, the mean was 0.23 mg/100 mL; after sneha sweda, it was 0.26 mg/100 mL and after vamana, it was 0.24 mg/100 mL. In the control group, initially the mean was 0.27 mg/100 mL and after treatment it was 0.27 mg/100 mL [Table 1].
There was a marginal increase in serum calcium in the treated group of patient while a marginal reduction in serum calcium in the control group was observed. In the treated group, the mean before sneha sweda was 9.53 mg/100 mL while after sneha sweda it was 9.98 mg/100 mL and after vamana it was 9.95 mg/100 mL (P 0.10). In the control group, initially the mean was 9.15 mg/100 mL and after treatment it was 9.03 mg/100 mL. (P 0.05) [Table 2].
In Tamaka Swasa patients, 85% of the cases improved well with respect to recurring attacks of paroxysmal dyspnea, wheezing, cough, a sense of constriction in the chest, hyperresonance; 15% of the cases were had a moderate response. In the treated group patients, out of 85% cases one patient showed immediate change in the signs and symptoms after Vamana Karma.
The primary characteristics of Sidhma Kushta are itching, circumscribed eruption, and reddish brown papules. The beneficial effects of vamana therapy are:
- Stoppage of spreading of the lesion but no change in color.
- Change of the color from reddish brown to normal 1 month after Vamana Karma.
All the patients were advised to report once in a month for follow-up. About 80% of the patients cooperated with follow-up studies. The most interesting phenomenon noted in this period was that the patients who underwent vamana therapy from the group of Sidhma Kushta got a very good response.
In the case of Tamaka Swasa, the relapse was very rare. Only three patients complained about relapse. In these cases also, the intensity was very much reduced than previously.
| Discussion|| |
Systemic samsodhana of the body has been conceived as the prime prerequisite for all kinds of preventive and curative procedures. Vamana is one of the most effective treatments for a number of pathological conditions, especially Kapha-predominant diseases.
Mode of action of Vamana Karma
The mechanism of action is complex in nature. The Kapha located in the stomach supports all other Kaphas of the body by its Ambukarma (welfare of the body through its watery component). The different Kaphas in the body represent different fluids located and associated with different organs of the body by support and nourishment. These may also be understood as various extracellular fluid components of the body but the transport of essential nutrients including water into this different fluid compartment for the specific purpose of support and nutrition of the respective organs associated with this Kaphas takes place through the rasa-rakta complex, especially the rasa component. Similarly, the Ambukarma of Kapha is associated with the rasa component of the rasa-rakta complex as explained by Sushruta who said that the Kledaka Kapha, which is located in the amasaya when eliminated from that organ by the upper route through the process of Vamana Kriya, it being a supporter of all the other Kaphas of the body leads to the correction of the vitiation of the Kaphas in the body.  Here, the elimination of Kapha is understood by its Ap Dhatu through the mouth that will prevent its passage through small intestines. Therefore, Vamana Kriya prevents the reabsorption of this factor through the kshundranthras and thereby ensures a definite elimination of the body.
By equating the Kapha with mucopolysaccharides while studying the effects of Vamana Karma, K.N. Udupa and R.H. Singh have already established that there is an increased elimination of the Kapha from the stomach.  Since pitta is also located in the amasaya during the process of Vamana Kriya, pitta also gets eliminated from the amasaya (stomach) through the mouth. While describing the physical qualities of pitta, Sushruta stated that the rasa of pitta is katu and in the vidagda state it is amla.  According to Dalhana, the taste is katu in the prakrita state and amla in the immature state. Therefore, there is a taste of pitta present in amasaya in case the digestion of the food is not complete and the products of such digestion are only ama (immature) due to the amlavastha that is to be considered as amla rasa only. It is an undisputed fact that the amlarasa of pitta located in the amasaya is due to the HCl component of the gastric juice. Therefore, in vamanam, the amlarasa pitta, along with HCl is eliminated from the stomach by the upper route. Therefore, it is clear that there is a loss of not only water but also the chloride (Cl) radicle. Along with this chloride radicle, a certain amount of sodium (Na+) is eliminated.
It was observed that all the serological results were increased after sneha sweda karmas.
The sneha sweda will bring the vitiated doshas from the various parts of the body (the dhatu) through the transport vehicle of rasa-rakta complex to koshta; vamanam eliminates the causative factors of the somatic diseases and maintains homoeostasis.
The doshas, which might have lodged in koshta, dhatu, or srotas made klinnatva by the administration of sneha. The klinna malas are liquefied by the use of sweda karma in the presence of agni. This agni (enzymes) increases the metabolic activity of the body. Sneha, sweda showed improvement. 
Mode of action on serum bilirubin
It is observed that the serum bilirubin was increased slightly. As this value is related to Liver functions, Liver is the largest and most significant metabolic organ of the body. It is the center of diverse metabolic reactions that occur in the body. So after vamanam, the metabolic processes of the body may be enhanced. 
Mode of action on serum calcium
Sneha sweda and vamanam increase agni (enzymes), maintain normal hepatic metabolism, and facilitate normal calcium absorption from the diet. By producing normal asthi, majja dhatus helps to keep the calcium levels normal in the body. 
The clinical improvements were agreed with the laboratory investigations. The patients were reported good relief during the follow up studies. Most of the signs and symptoms were disappeared with in a short time after Vamana Karma. No inspiring results were obtained from the control group patients.
| Conclusion|| |
It was proved that 5-7 days were taken to produce optimum Snehapana effects. It was noticed that sneha sweda karmas were highly essential prior to vamana. Vamana can improve the functional and metabolic activities of the body. The clinical signs and symptoms of Sidhmakushta patients were decreased after Vamana Karma. In Tamaka Swasa, vamanam eliminates vitiated Kaphas and subsides the congestion of the chest; it will minimize the relapses and also the intensity of Tamaka Swasa.
All the serological results were within normal limits in both the treated group and control group of patients. The therapy not only produces symptomatic relief but also controls the disease process. It maintains the health of the individual and helps in the promotion, preservation, and longevity of life. The present trial is only a preliminary study on this subject even though some changes have been found in the blood chemistry; it is suggested that further studies be conducted on eligible ailments of Vamanam where abnormal blood chemistry can be noticed due to the pathological condition of the respective diseases.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]