International Journal of Ayurveda Vyapat

ISSN: 2456-6640 International Journal of Ayurveda (A Monthly Scientific Journal of Kiban Research Publications) www.kibanresearchpublications.com

REVIEW ARTICLE

Vyapat: The Complications of Vamana & Virechana Karma and its Management

Roshni Dhurve*

Department of Panchakarma, Pt. Shivnath Shastri Govt. Ayurveda College, Burhanpur (M.P), India.

*Corresponding Author Email: [email protected]

Abstract: Panchakarma is the most important and useful part of the Ayurveda. It is a set of 5 procedures namely Vamana, Virechana, Nasya, Asthapana Basti, Anuvasana Basti. The aim of Panchakarma is to maintain the health and elimination of the vitiated doshas from the body. Panchakarma is performed in various diseases and specifically in ritu. False assessment of Panchakarma procedure may lead to Vyapat. Inaccurate assessment of rogibala, ritu, kala, agni, kostha, dravya matra may cause the complication during or after the Panchakarma procedure. Vyapat are caused either due to Atiyoga or Ayoga of the Panchakarma.

Keywords: Vyapat, Vamana, Virechana, Atiyoga, Ayoga. Article Received: 15 Dec. 2020 Revised: 16 Jan. 2021 Accepted: 24 Jan. 2021

Introduction Panchakarma is a set of 5 procedures The complications are occured If the dosage comprises Vamana, Virechana, Asthapana of medicine is low or high, unprocessed Basti, Anuvasana Basti & Sirovirechana. medicines, inaccurate timing of Acharya Sushruta has mentioned administrating drug and the medicine is too Panchakarma namely Vamana, Virechana, old [3]. The patient may suffer from critical Basti, Nasya & Raktamokshana. The condition if meticulous care is not taken elimination of vitiated Vata, Pitta & Kapha during the administration of Vamana & Doshas in Varsha, Sharad & Vasant ritu Virechana karma. respectively. Basti karma is performed in Varsha ritu due to vitiated Vata Dosha, The Following Reasons Poor Response Virechana karma in Sharad ritu due to to the Vamana Karma is Improper vitiated Pitta Dosha and Vamana karma in Snehana and Swedana prior to Vasant ritu due to vitiated Kapha Dosha [1]. administration of Vamana.  Administration of small dose of Vamana Unexpected situations arise during or after aushadh in a physically strong person. Vamana & Virechana karma may lead to difficult situation. Unprocessed medicines,  Intake of Vamana aushadh that are old or inaccurate dose of ausadh dravya, hina satva of poor quality. rogi, improper Snehana-Swedana may  Subjecting Vamana karma in a client produce the vyapat during or after Vamana having Koshtha of krura type. & Virechana karma. The administration of drug for Samshodhan karma eliminate the  Administration of Vamana karma in the vitiated Doshas after the Samyak Snehana & presence of ama. Swedana but without Snehana Swedana, it  Consuming the emetic drugs when the agni aggravate the vitiated Doshas and cause is unusually strong [4]. various symptoms in the body namely Vibhransh, Shotha, Hikka, Tamo darshana, All the precautionary measures must be Pindikaudvestana, Kandu, Sadh, Vivarnta taken to avoid complications. Meticulous care [2]. is important for saving patient’s life. So, the

©2016-2021, IJA. All Rights Reserved 1 Roshni Dhurve | International Journal of Ayurveda | Feb. 2021 | Vol. 06 | Issue 02|01-05 emergency drugs must be collected before In vata aadhikya condition, Ghritha pana conducting any procedure of Panchakarma. should be administered which is prepared The emergency drugs may be needed at the from dhataki pushpa, shudha kasish mixed time of Vyapat. Without any emergency with kshara or lavana and dadima swaras. management, not supposed to administer any Ushna jala pana: Devadaru and tila drug for the procedure. Proper Snehana and Swedana must be done for the clearance of Ksheera paka: Ashwatha, Udumbara, Dosha from the body before Vamana and Plaksha, Kadamba twak kalka Virechana karma. To assess the sign and Piccha basti: Kashaya and madhura ras symptoms, observe the patient during pradhan dravya prepared Kalka. Shodhana karma. Acharya Charak has explained 10 Vyapat of Vamana & Virechana Anuvasana basti: Madhuyasthi prepared karma with detailed description and their kalka or kwatha. management [5]. Parisrava Vyapat Adhmana Vyapat Nidana & Samprapti Nidana & Samprapti Low potency in low dose aushadh is administered in bahudosha condition fails to Adhmana vyapat is due to the administration eliminate the doshas which leads to of alpa matra aushadh in the condition of Parisrava. Alpa aushadh cause dosha kaphaadi dosha, ruksha, mandaagni and utkleshana leading to the elimination of alpa udavarta. Alpa matra aushadh aggravate the dosha from sharir. Kaphaadi Doshas leads to avarodha in the srotas and cause adhmana at nabhi Pradesh Lakshana [6]. Kandu, Shopha, Kushtha, Gauravata, Lakshana Agnimandya, Utklesha, Staimitya, Aruchi, Pandu. Shoola in Pristha, Parshwa, Shiro, Shwas and obstruction in the passage of mala,mutra Chikitsa and apan vayu. Snehana-swedana is followed by Vamana or Chikitsa tikshna Virechana. After samyak shodhana, administered choorna, asava, aristha Ahyanga, Swedana, Varti, Niruha Basti, samsakarit dravya [8]. Anuvasana Basti and all the Udavarta har chikitsa is to be useful. Hridgrah Vyapat Parikartika Vyapat Nidana & Samprapti Nidana & Samprapti If the patient suppress the vega during Vamana and Virechana karma. It aggravates Parikartika vyapat is due to the Vata Dosha leads to Hridgrah. administration of tikshna aushadh in the guru koshtha, sama dosha or kshama, mridu Lakshana koshtha, shranta and bala hina. Tikshna aushadh cause quickly eliminate the doshas Hikka, Kasa, Parsva arti, Atyaadhik from Guda [7]. Lalasrava, Akshi vibhram, Jivha khadti, Nisangya, Dantan kitkitayan. Lakshana Chikitsa Raktashrava and Tivra shoola in Guda. Pittaja murcha : Vamana should be Chikitsa administered by vamaka aushadh prepared with madhura dravya. Kaphaja murcha : In sama condition: Langhan, pachana, Vamana should be administered by vamaka ruksha, ushna, laghu ahara. aushadh prepared with katu dravya. In kshama condition: Brihaniya chikitsa and Pachana dravya should be used for the rest of madhura ras. the doshas after Vamana karma. If Vamana Kshara yukta, amla and laghu ahara should aadhikya, Hridpeeda occur due to vitiated be advised if Parikartika persist even after Vata, Pitta & Kapha Dosha. If Vata dosha ama pachana. vitiate, Vata har chikitsa should be adopted

©2016-2021, IJA. All Rights Reserved 2 Roshni Dhurve | International Journal of Ayurveda | Feb. 2021 | Vol. 06 | Issue 02|01-05 i.e. Sneha yukta amla, lavana. If Pitta dosha administered for Virechana karma, only vitiate, it should be managed with madhura mala is eliminated. Kapha and Pitta Doshas & kashaya dravya. If Kapha dosha vitiate, it are obstructed after eliminating mala. should be managed with ruksha, katu and Similarly, vamana aushadh is administered tikta dravya [9]. for Vamana karma, only vamana aushadh is eliminated whether kapha and pitta doshas Gatragrah Vyapat fail to eliminate. So, These Vamana and Nidana & Samprapti Virechana aushadh aggravate the kaphaadhi doshas to cause Kandu [13]. Vata Dosha vitiate if patient suppress the vega during Vamana and Virechana karma Chikitsa or atishodhana. This aggravated Vata dosha In Gudabhramsh, Prakshalana with kashaya cause Gatragrah. dravya followed by Sthambhana. Lakshana In Sangyanasha, recitation of sama gandharv Sthambha, Vepathu, Nistoda, Sada, shabd. Udvesthan, Manthan vata shoola. Sthambha Vyapat Chikitsa Nidana & Samprapti Vatahar Snehana, Swedana etc [10]. If samshodhana aushadh is given to the Jeevadana Vyapat snigdha rogi. It causes Dosha avarana due to mridu guna of aushadh and is not eliminated Nidana & Samprapti from the body rather it retains in its own site Eliminate blood from the body if tikshna [14]. aushadh is administered in mridu koshtha or alpa dosha avastha. Lakshana Vata sangha, Guda sthambha, Shoola and Chikitsa Alpa alpa dosha ksharan. If the symptoms are appeared i.e. trishna, murcha & mada. Until the patient alive, Chikitsa treatment should be continuing for saving his Langhana and pachana followed by tikshna life. Fresh blood of deer, cow, buffalo, goat Basti or tikshna virechana should be given should be taken for protecting the life. for the elimination of doshas. Animal blood mixes with human blood and brings about homeostasis [11,12]. Rakta Updrava Vyapat Basti should be administered with fresh Nidana and Samprapti blood mix with kusha if patient is unable to drink fresh blood. If ruksha virechana aushadh is given to the ruksha sharira, alpa bala and asingdha. It Sheetal Piccha Basti vitiates Vata dosha leading to Updrava [15].

Kalka is prepared with nishoth, kashmarya, Lakshana badri, durva, usheer and mixed with gritha manda & anjana. Murcha, Sthambha and Shoola.

Anuvasana basti: Gritha manda Chikitsa Snehana, Swedana followed by vata hara Vibhramsha Vyapat chikitsa. Vibhramsha has 3 different understanding factors: Klama Vyapat Nidana and Samprapti Virechana atiyoga: Gudabhramsh & Sangyanasha Mridu aushadh is given to the snigdha and mridu koshtha rogi. It vitiate kapha and Aushadh ayoga: Kandwadi vibhramsh pitta doshas causing obstruction of vata dosha [16]. It is due to the remnant of doshas in the body. When virechana aushadh is

Lakshana Bhramananda Tripathi, C.Si.6/38-39, Chowkhambha Surbharati Prakashan, Tandra, Gaurava, Klama, Daurbalya and Varanasi. Angasada. 3. Agnivesha, Charak Samhita (2011) revised Chikitsa by Charaka and Dhabala, Charaka  Sadhyo Vamana Chandrika hindi commentary by  Langhana pachana Bhramananda Tripathi, C. Si. 6/28, Chowkhambha Surbharati Prakashan,  Tikshna Virechana by snigdha dravya. Varanasi.

Discussion 4. Dr. G Shrinivasa Acharya (2013) The complications parikartika, jivadana and Panchakarma illustrated, 334, vibhramsha are because of the over effect of Chaukhamba Sanskrit pratishthan Delhi. Vamana. Adhmana, parisrava, hridgraha, angagraha and klama are the result of poor 5. Agnivesha, Charak Samhita (2011) revised effect of the Vamana karma [17]. Excessive by Charaka and Dhabala, Charaka vomiting can cause dehydration, electrolyte Chandrika hindi commentary by imbalance or oesophageal tear lead to severe Bhramananda Tripathi, C. Si. 6/30, complications. If the patient is unconscious, Chowkhambha Surbharati Prakashan, the acid in the vomitus can severely irritate Varanasi. the lungs causing aspiration pneumonia [18]. 6. Agnivesha, Charak Samhita (2011) revised Dosage of vamana dravya should be decided by Charaka and Dhabala, Charaka according to rogibala, ritu, kala, agni, kostha. Chandrika hindi commentary by If the dose administration is not correct Bhramananda Tripathi, C.Si. 6/58-60, results in either inadequate effect or Chowkhambha Surbharati Prakashan, excessive effect. Hence, Assessment of Varanasi 2011. aushadh matra and rogi bala is mandatory 7. Agnivesha, Charak Samhita (2011) revised before proceeding the Vamana & Virechana by Charaka and Dhabala, Charaka karma. Atyaadhik aushadh matra, old & poor Chandrika hindi commentary by quality of the aushadh dravya and Bhramananda Tripathi, C. Si. 6/61-63, inadequate Snehana & Swedana produce Chowkhambha Surbharati Prakashan, Vyapat lakshana which can create some Varanasi. critical conditions. Therefore, examine the patient, good quality of the aushadh dravya, 8. Agnivesha, Charak Samhita (2011) revised correct aushadh matra and proper Snehana, by Charaka and Dhabala, Charaka Swedana should be considered prior to the Chandrika hindi commentary by administration of the Vamana and Bhramananda Tripathi, C. Si. 6/68-70, Virechana. Chowkhambha Surbharati Prakashan, Varanasi. Conclusion Proper monitoring of the patients during & 9. Agnivesha, Charak Samhita (2011)revised after the Vamana and Virechana karma. by Charaka and Dhabala, Charaka Adequate assessment of the rogi bala, Chandrika hindi commentary by koshtha, agni, kala, aushadh matra and Bhramananda Tripathi, C. Si. 6/71-75, quality of the drugs to avoid complications. Chowkhambha Surbharati Prakashan, Varanasi. References 10. Agnivesha, Charak Samhita (2011) revised 1. Kaviraj Ambikaduttashastri (2010) by Charaka and Dhabala, Charaka Sushruta samhita Ayurveda tattva Chandrika hindi commentary by sandipika hindi commentary, Bhramananda Tripathi, C. Si. 6/76-77, S.Su.6/38,Chowkhambh Sanskrit Chowkhambha Surbharati Prakashan, sansthan, Varanasi, edition. Varanasi.

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Bhramananda Tripathi, C. Si. 6/78-84, 15. Agnivesha, Charak Samhita (2011) revised Chowkhambha Surbharati Prakashan, by Charaka and dhabala, Charaka Varanasi. Chandrika hindi commentary by Bhramananda Tripathi, C. Si. 6/90-91, 12. Shilpa S, Biradar (2020) Vyapat-a Chowkhambha Surbharati Prakashan, complication, IAMJ 8-1. Varanasi.

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