Concept Analysis on Vamana Karma with Madanagu...
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AAMJ / Vol. 2 / Issue 6 / November – December 2016
A A M J Anveshana Ayurveda Medical Journal
www.aamj.in ISSN: 2395-4159
Review Article
Concept Analysis on Vamana Karma with Madanaguḍūchi Ghana
in the management of Ūrdhvaga Amlapitta
Priya Nashine 1 Nakade Mamta 2 Varghese Jibi 3 Auti Swapnil 4
Chaudhari Vaishali 5 Pranesh Gaikwad 6
A b s t r a c t
In today’s modern era of science and technology the concept of early to bed and early to rise has
taken a back seat ,people are lacking in their intelligence on what to eat ?when to eat ?why to eat?,
they are working with stress and strain. All these hamper the digestion and causing acidity, gastritis,
dyspepsia and anorexia etc. which can be grossly co-related with Ūrdhvaga Amlapitta in Ayurveda.
Amlapitta disease is having the symptoms like Avipāka (indigestion), Klama (psychological tired without
doing any work), Utkleśa (nausea), Tikta-Amlodgara (acid eructation), Guruta (body heaviness), Hrud-
Kantha dāha (heart burn), Aruchi (anorexia). Modern Science is having only symptomatic treatment for
the disease, but with the help of Śodhana Karma complete cure is possible as it cures the disease from
its root cause. Vamana and Virechana have been described as Śodhana Chikitsa for Amlapitta. Since
Ūrdhvaga Amlapitta is Āśaya Duśti Pradhāna Vyādhi and gati of Doṣas is in upward direction,
Vamana with Madanguḍūchi Ghana may prove to be the complete cure. Madanguḍūchi Ghana due to
its Tikta, Madhura, Kaśāya rasa may prove to be the Vyādhipratyanik Vāmaka yoga. Madanguḍūchi
Ghana may prove to be a unique formulation because of its palatability, small dose size and long shelf
life. After critical analysis of the available literature and reviewed previous scientific researches it can
be inferred that Madanguḍūchi Ghana as a Vāmaka Yoga in the Management of Ūrdhvaga Amlapitta
is effective through Āmāśaya Śuddhi, Agni Dīpti and Śamana of the left over Doṣas.
Keywords: Ūrdhvaga Amlapitta, Vamana, Madanguḍūchi Ghana.
1PG Scholar, 2 Professor and Head, Dept. of Panchakarma, 3Associate Professor, Dept. of Kay-
achikitsa, 4Lecturer, 5Associate Professor, 6Assistant Professor, Dept. of Panchakarma,
Dr.D.Y.Patil College Of Ayurveda & Research Centre, Pimpri, Pune, Maharashtra, India.
CORRESPONDING AUTHOR
Dr. VARGHESE JIBI THANKACHAN
Associate Professor,
Department of Kayachikitsa,
D.Y. Patil College of Ayurveda & Research Centre, Pimpri,
Pune, Maharashtra, (India).
Email: [email protected]
Priya et.al, : Concept Analysis on Vamana Karma with Madanaguḍūchi Ghana in the management of Ūrdhvaga Amlapitta
AAMJ / Vol. 2 / Issue 6 / November – December 2016 1069
INTRODUCTION
he word “Amlapitta” is comprised of 2 words –
‘Amla’ and ‘Pitta’. Amlapitta is a pathological
condition in which there is vitiation and exaggera-
tion of Pitta Doṣa in the body. Here, the original Katu
rasa of Pitta is changed into Amla rasa. Amlapitta is
grossly correlated with acid peptic disorder.
The incidence of gastritis in India is approximately 3 in
869 that is about 12,25,614 people suffering from gas-
tritis out of the total 1,06,50,70,607 population. The
sero-prevalance studies from Delhi, Hyderabad and
Mumbai have shown that by 10 yrs of age more than
50% and by 20yrs more than 80%of population is af-
fected with gastritis.[i]
In Amlapitta both Śamana and Śodhana Chikitsa has
been described. Vamana and Virechana have been
described as Śodhana Chikitsa for Amlapitta.[ii]
Since Amlapitta is Āśaya Duśti Pradhāna Vyādhi,
Vamana may prove to be the complete cure of it. In
most of the Samhitas like Kashyapa Samhita[iii], Bhava
Prakash[iv], Chakradatta[v], Vangasen[vi], Gada Ni-
graha[vii] Vamana has been considered as the classical
treatment of Ūrdhvaga Amlapitta.
But the Vāmaka yoga mentioned in these texts com-
prises of all the tikta rasātmak drugs in kvātha form,
which are Vyādhi Pratyanik but are not palatable to
patient, as a result patient often refused or quit the in-
take of Kvātha during the procedure only. It becomes
difficult for Vaidya to convince the patient to complete
the procedure.
To avoid this situation and to make Vamana an easy
and friendly procedure for both patient and Vaidya
keeping the concept of using Tikta drugs intact, Ghana
of Madanguḍūchi can prove beneficial.
Madanguḍūchi leha yoga has been described by
Acharya Charak in Kalpasthan[viii]. Ghana of
Madanguḍūchi as Vāmaka yoga increases the shelf life
of a drug. The drug being tikta Rasa Pradhāna may
prove to be Vyādhi Pratyanik, and directly act on Vik-
ruta Pitta and may increase the efficacy of Vamana.
Madanguḍūchi Ghana formulation has following bene-
fits:
Presence of Madan helps as Vāmaka.
Presence of Guḍūchi acts as Vyādhi pratyanik drug.
Being in a Ghana form it may be palatable when
given with Madhu and Saindhava
Small in dose.
It may be easy to administer.
Being in a Ghana form ,its shelf life may increase
up to 6 months
It may prove to be Vaidya friendly drug as less en-
ergy might be required to convince the patient to
take medicine.
CONCEPT OF AMLAPITTA
Amlapitta as an individual disease has not been de-
scribed in Bruhatrayee, but there are number of places
where Acharya Charak has mentioned about Amlapitta
symptoms. It was the Acharya Kashyap who for the
very first time mentioned about Amlapitta in detail.[ix]
Acharya Madav Nidan has described about Amlapitta
and its classification according to Doṣa gati as
Ūrdhvaga Amlapitta and Adhoga Amlapitta.[x]
Nidāna of Amlapitta
Āhāraj hetu:[xi]
1. Viruddha bhojan (incompatible food like intake of
milk and fish together)-Tridoṣa duśti - Amlapitta
2. Duśtāmla Bhojan(stale food attained sour taste)-
Pittaduśti - Amlapitta
3. Vidāhi Bhojan(Spicy food)-Pittaduśti - Amlapitta
4. Vidagdh bhojan(Fermented food)-Pittaduśti - Am-
lapita
Vihāraj hetu:[xii]
1. Divāsvāpa (sleeping during day)- Tridoṣa Duśti –
Amlapitta
2. Atiuśna jala snana (lengthy bath)-Pitta Duśti- Am-
lapitta
3. Uśna Avagāhana ( tub bath)-Pitta Duśti-Amlapitta
Mānasika Hetu:[xiii]
Kāma, Krodha, Moha, Lobha, Irśya, Bhaya, Śoka –
Vāta-pittaduśti - Amlapitta
Pūrvarūpa of Amlapitta:
Pūrvarūpa of Amlapitta is not mentioned in any of the
Classical text. Since Almapitta can be co-related with
Pittaja Grahaṇī therefore Pūrvarūpa mentioned by
Acharaya Charak for Grahaṇī Vyādhi like Truśṇa,
Ālasya, Balkśaya, Vidagdha Anna, Gaurava [xiv] which
may be considered as Pūrvarūpa of Amlapitta.
Rūpa of Amlapitta:
Avipāka (indigestion), Klama (psychological tired with-
out doing any work), Utkleśa (nausea), Tikta-Amlodgara
(acid eructation), Guruta (body heaviness), Hrud-Kantha
dāha (heart burn), Aruchi (anorexia)[xv]
Rūpa Of Ūrdhvaga Amlapitta:[xvi
Vānta harita (green colour vomitus),Vānta pitta (yellow
colour vomitus),Vānta nīla (blue colour vomitus),Vānta
Krishna (black colour vomitus),Vānta sarakta –(reddish
T
Priya et.al, : Concept Analysis on Vamana Karma with Madanaguḍūchi Ghana in the management of Ūrdhvaga Amlapitta
AAMJ / Vol. 2 / Issue 6 / November – December 2016 1070
colour vomitus), Vānta raktābha (bright red colour vomi-
tus),Vānta atīvāmla (vomitus excess sour in taste),Vānta
māmsdokābham (vomitus resembling mutton washes),
Vānta atipichilla (sticky vomitus), Vānta Atiachha (thin
vomitus), Vānta Sleshma anujata, Abhuktevami (vomit-
ing occurs on empty stomch), Abhukte va tiktavami (bit-
ter taste vomiting occurs on empty stomach) Abhukte
tikta udgara (bitter taste belching occurs on empty
stomach), Abhukteamlavami (sour taste vomiting occurs
on empty stomach), Bhukte vidhagdhatiktavami (bitter
taste vomiting occurs during digestion of food), Bhukte
vidhagdha Amlavami (sour taste vomiting occurs during
digestion of food), Bhukte vidagdha Tiktodgara (bitter
taste belching occurs during digestion of food), Cha-
ranadāha (burning sensation in foot region), Hritdāha
(buring sensation in chest region), Karadāha (burning
sensation in palm region), Kukśidāha (burning sensation
in flank region), Kandu (itching) Kanthadāha (buring
sensation in throat region), Mandal (circular rashes),
Mahati aruchi (anorexia), Pidika (papule), Śiroruja
(headache),Uśṇata( Burning sensation in the body).
Samprāpti of Amlapitta:[xvii]
Drug Review:
Madanguḍūchi Ghana: It consists of Madanphala and Guḍūchi in the ratio of 1:5.
Drug name Rasa Vīrya Vipāka Guṇa Doṣaghnata
Madanphala Madhura,
Tikta, Katu Uśṇa Katu Laghu, Rūkśa Kaphavātaghna
Guḍūchi Katu,Tikta,
Kāśaya Uśṇa Madhura Laghu Tridoṣaghna
Madanphala[xviii]: is the best Vāmaka drug mentioned
by Charak Acharya. It acts by its Vāmaka Prabhāv.
Guḍūchi[xix]: being tikta rasātmak act as a Vyādhi
pratyanik drug. It decreases the Abhiśyand in Pit-
tamārga and helps in proper strāva of Pitta.
Administration: Orally (chewable tablet) with Madhu
and Saindhava.
Dose: 6 – 8 gm.
VAMANA WITH MADANAGUḌŪCHIGHANA:
Vamana is the first procedure narrated under
Panchakarma therapy by the Ancient Ayurve-
daacharya.
Vamana Karma is the principle treatment told for
Kaphaja disease.[xx]
The process in which Apakva Pitta and Kapha are
forcibly expelled through the oral route is called as
Vamana.[xxi] Apakva Pitta literally means undigested or
unripe .When Pitta is undigested changed into Vidag-
dha Avasta, which is one of the type of Ajīrṇa. To pac-
ify this stage, there are 3 methods of treatment
i.e.Langhan, Pāchana and Doṣāvasechan [xxii].Langhan
is not capable of pacifying the Vidagdha Pitta. If
Pāchana Dravya is used for Āma Pāchana, they will be
transformed into Āma.[xxiii] From this evidence it is clear
that Vamana Karma is proper way to remove Apakva
Pitta, the condition which is seen in Ūrdhvaga Am-
lapitta.
Madanphala (Randia dumetorum Lam). is a usual drug
of choice for Ayurvedaic physicians since past due to its
therapeutic properties like emetic, antipyretic, anti-
Drug name Botanical name Family Used part Quantity
Madanphala Randia dumetorum.Poir. Rubiaceae Fruit 10gms
Guḍūchi Tinospora cordifolia, Willd. Meni-Spermaceae Stem 50gms
Priya et.al, : Concept Analysis on Vamana Karma with Madanaguḍūchi Ghana in the management of Ūrdhvaga Amlapitta
AAMJ / Vol. 2 / Issue 6 / November – December 2016 1071
inflammatory, antiallergic, antihelmenthic, immuno-
modulatory, analgesic, wound healing etc. All the quali-
ties of mMadanaphala are almost same in Ayurveda
and nighantu classics but according to Charaka it is of
Arūkśa (less rough), Vijjal (picchila), āśukāri (Fast act-
ing) properties.[xxiv] Due to these properties Madana-
phala has been used as excellent drug as Vāmaka in
Ūrdhvaga Amlapitta.
Guḍūchi for time immemorable is being used in one or
the other way in different forms in different variety of
disease condition. An anti-spasmodic, anti-
inflammatory, anti-stress, anti-microbial property of
guḍūchi has been proved[xxv]. These properties of
Guḍūchi may prove to be beneficial in Ūrdhvaga Am-
lapitta.
Ghana is one of the Auśadha Kalpana. According to
Sharangdar, Kvāthādi are boiled down to a thick con-
sistency is called as Avaleha.[xxvi] More concentrated
form of Avaleha which can be moulded into Guti form
is called as Ghana. Madan Guḍūchi Ghana formula-
tion is based on this concept only.
MECHANISM OF VAMANAA WITH
MADANAGUḌŪCHI GHANA
For the procedure of Vamana following plays most im-
portant role as,
Properties - Uśṇa, Tīkśṇa, Sūkśma, Vyavāyi, Vikāsi
Sites- Hridaya, āmāśaya
Stimulant -Udāna Vāyu
Constitution - Agni + Vāyu
Prabhāva - ūrdhva bhāghara
It seems that Śodhana drugs because of their Vyavāyi
guṇa escapes the normal digestion by Jātharāgni,
reach in the whole body and starts acting immediately.
Sūkśma guṇa helps to reach them up to the minute
channels. Doṣas are digested and liquefied by Uśṇa
guṇa and then are detached from the srotasas because
of Tikśṇa and Vyavāyi guna. It is the Sara guna which
help the detached Doṣas to reach the Koṣtha, from there
they are to be expelled out. Lastly it is the Prabhāva
which according to drug throws the Doṣas out.[xxvii]
In Ūrdhvaga Amlapitta Utkleśa (Bahudoṣa avastha )[xxviii]
of doṣas is present and in Bahudoṣa condition Śodhana
Chikitsa is indicated[xxix] therefore Vamana may prove to
be a fruitful procedure.
In Ūrdhvaga Amlapitta, Gati of Doṣa’s is in upward
direction and Acharya Vagbhat has told to remove the
doṣas from the nearest route.30
In Ūrdhvaga Amlapitta, Amāśaya Duśti mainly occurs
and Vamana helps in the Śuddhi of Amāśaya.
Significance of use of Guḍūchi with Madanaphala:
Madanaphala by its pharmacological properties is hav-
ing irritant properties. But Amlapitta is a condition
where there is increased acidic secretion from Parietal
cells which may get stimulated due to Madanaphala
increasing the acidity transiently during Vamanaa pro-
cedure. Guḍūchi being anti-inflammatory and antacid in
properties is potent to modify the pH of the stomach
and protect gastric mucosa. This may solve the purpose
of Doṣaśodhana without any harmful effect on the GIT.
Vamana helps in the removal of the morbid doṣas
which are present in the Āmāśaya and help in Sam-
prāpti Vighatana by following way:
1. In Vamana Āmāśaya Śuddhi occurs which helps in
removing the Amlata in the Āmāśaya which has oc-
curred due to Vidaghata and Śuktibhāva of ingested
food.
2. After Vamana Agni attains its normal state therefore
proper digestion of the ingested food occurs.
3. Madanaguḍūchi Ghana may proves to be a
Vyādhipratyanik Vāmaka drug as it may helps in the
Śodha of doṣas before its digestion by Jatharāgni by
Prabhāva and after its digestion it may help in Śamana
of the remaining doṣas by its Tikta ,Madhura and Ka-
śāya Rasa.
CONCLUSION
On the virtue of the incredible benefits and astonishing
properties of the Madanguḍūchi Ghana it can be con-
cluded that Vamana with Madanguḍūchi Ghana may
prove to be the effective treatment modality in the man-
agement of Ūrdhvaga Amlapitta.
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AAMJ / Vol. 2 / Issue 6 / November – December 2016 1072
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Source of Support: Nil.
Conflict of Interest: None declared
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How to cite this article: Priya et.al, : Concept Analysis on
Vamana Karma with Madanaguḍūchi Ghana in the man-
agement of Ūrdhvaga Amlapitta. AAMJ 2016; 6:1068 –
1073