INTERNATIONAL AYURVEDIC MEDICAL JOURNAL International Ayurvedic Medical Journal, (ISSN: 2320 5091) (November, 2017) 5(11) AN OBSERVATIONAL STUDY ON REVALIDATION OF MANIKICRITERIA OF VAMANA KARMA BendeYogita1, ChandaliyaSachin2, Girde Sameer3, Chafle Shilpa4 1Associate professor, 2Professor, 3Assistant professor, 4Assistantprofessor, Department of Panchakarma, Shri Ayurved Mahavidyalaya, Nagpur, Maharashtra, India Email: [email protected] ABSTRACT In today’s world, Ayurveda’s Samshodhana karma (internal cleansing practices) are getting momentum. So, it has become very important for the physician to be careful in deciding the status of these internal purification. After samshodhana procedure, analysis of the procedure helps in deciding the quantum of purification. Measurement of the quantity of doshas (humors) expelled and the quantity of vega (bouts) help in deciding plan of diet and further line of treatment of the disease1. So, the correct measurement of the quantity of the expelled doshas becomes mandatory. In the present study, an attempt was made to analyze the maniki criteria, its utility and clinical importance for deciding the success of treatment. Keywords – Vamana, Maniki Criteria, MSI INTRODUCTION While performing the Panchakarma procedures, Manaki and Laingiki criteria3. It seems that the status of procedures, assessment of the de- there remained a lot of controversies amongst gree of completion of these procedures is im- the commentators for awarding one as “the best portant. So an attempt should be made to review criteria” in these special four. Number of bouts and analyze the literature related to the charac- is counted as vegas and the assessment is termed teristic of samyak shodhana karma (process of as Vaigiki shudhi. Similarly, the quantity of purification) in the light of scientific view as to doshas expelled is calculated and the calcula- get the true interpretation of procedures. tions are expressed in terms of Maniki shudhi. To Assess the samyaka lakshana of Vamana The criteria assisting to count the magnitude of (sign and symptoms of proper vamana), humours (removed in the vomitus) are named as Charaka suggested some parameters like colour, “Maniki criteria”. Chakrapani considers quanti- taste, odour and consistency of doshas which are ties of one, one and half, two prastha of vomitus gets expelled through the process.2 Chakrapani as hina (minimum purification), madhyama categorized them by naming Antiki, Vaigiki, (medium purification), pravarasuddhi (maxi- Bendeyogita Et Al: An Observational Study On Revalidation Of Manikicriteria Of Vamana Karma mum purification)respectively and put them un- the proper inclusion and exclusion criteria for der the term”ManikiPariksha”5 During vamana, Vamana. Proper consent of every patient was if two prastha vomitus is expelled through eight taken. vega4, it is be said as pravara shuddhi (Best pu- rification), if one and half prastha of vomitus is Inclusion criteria: expelled in six vegas, it is said as Madhyama All the Vamana arha (fit for vamana) pa- Shudhi (medium purification) and if one prastha tients explained in samhitas7. doshas are expelled in four vegas, it is called as Patients with kapha and kapha pitta consti- Avaara shudhi (least purification). tutions. Vamana karma is indicated in Patients suffering from kapha diseases. bahudoshaawastha (maximum accumulation of Diseases associated with pitta disorders. humors) in which kapha and pitta are increased Bronchial asthma, allergic bronchitis, sinusi- 6 by all means . So, the maniki pariksha high- tis, COPD, productive cough, migraine, hy- lights the quantitative analysis of the vomitus peracidity, anorexia, obesity, overweight, i.e. the quantity of kapha or pitta that is to be dysllipedemia, diebetis mellitus, skin diseas- expelled out. es like acne vulgaris, psoriasis, eczema, While deciding the prastha, looking at the dermatitis, lichen planus, vitiligo, urticaria, pancabhautika (penta elemental) constitution of falling and greying of hairs, inflammatory kapha which is of drava mahabhuta (water el- conditions etc. ement) dominance, maniki criteria can be stud- ied by considering volume. Exclusion criteria: All the Vamana anarha (clinically unfit) pa- Aim: To assess the Maniki criteria of Vamana tients explained in samhitas process. The patients with serious heart, brain and kidney disorders. Objectives: The patients with IDDM 1. To measure the exact output of vomitus ex- Chronic debilitating disease pelled through Vamana process. Malignant hypertension 2. To measure the difference between the input Pregnant ladies and output of vomitus in Vamana process. 3. To find the nature of shudhhi with various Patients not willing for IPD probabilities of measurements of residue af- ter Vamana. For measuring purpose a special measuring jar 4. To revalidate the measurements of vomitus was used. Gloves, vessels for Vamana process expressed in texts or samhitas. were used as per requirement. Materials and methods: Assessment of Maniki criteria: Twenty eight (28) subjects were selected from There are two ‘practical’ possibilities while the OPD and IPD of Pakwasa Samanvaya counting the expelled material. As per the prac- Rugnalaya, Nagpur. They were analyzed with tical observations, the quantity of vomitus com- IAMJ: NOVEMBER, 2017 4108 Bendeyogita Et Al: An Observational Study On Revalidation Of Manikicriteria Of Vamana Karma ing out after vamana can either be higher than quantity of output and total quantity of input. that given to the patient earlier during the pro- According to chakrapani8, 1 Prastha=13. 5 cess or will be lower than that consumed by the pala= 54tola =540ml approximately during each patient. To understand the maniki shuddhi, both type of purification, the matter in respective the calculations were analyzed in a practical proportions should be expelled out. way. Trividha Shuddhi (pravara – madhyama – hina Shuddhi) parameters provided by texts Hinashuddhi 540ml were used when the same was higher Madhyamashuddhi 810ml and’Maniki shudhi Index’(MSI) was used when Pravarashuddhi 1080ml the output was found lesser than input as fol- lows. Three grades of purification viz. Pravara, Madhyama and Hina point the values as 1080ml, 810ml and 540ml respectively. To de- A. Trividha Shuddhi wise Maniki assessment cide the nature of purification according to the – Based on the elimination of dosha in the quanti- various values obtained by measuring the vitiat- ed matter, the range of these three different fig- ties of one, one & half and two prastha (prastha ures was decided. If these are considered as sta- 540ml) of vomitus, there are three types of shuddhi viz. Hina ,Madhyam and Pravara tistical mean values of the respective figures, the shuddhi, respectively. This quantity is derived range can be achieved to decide the three types of purification accordingly as follows - by finding the difference between the total Type of purification Quantity mentioned in ml Range of purification in ml Pravara 1080ml 945-1215 Madhyam 810ml 675-945 Avara 540ml Up to 675 ml Only in case of Avara Shuddhi, it was decided M.S.I. = V. Is. X 100 that any quantity up to 675 ml should be consid- V. Ip. ered as Avara Shuddhi. There are no other crite- where = V.Is. = Volume Inside ria left below the statistical range of Avara V.Ip. = Volume Input Shuddhi to be used. Ayoga term cannot be used M.S.I. = ManikiSuddhi Index. for the quantity below the statistical lower range of avara shuddhi (i.e.405 ml) as all these three M.S.I. provides the clue about the percent- types of shuddhi are applied after samyaka age of the volume remained inside in com- vamana only. parison to the quantity that was ingested. The M.S.I. should be lowering as much as B. Maniki Shuddhi Index (MSI) wise Maniki possible which will indicate that maximum Assessment –'Maniki Shuddhi Index' was quantity has been expelled out. More M.S.I. designed as given below - will indicate that still more quantity is re- Maniki Shuddhi Index9: maining inside. So, more M.S.I. will mark IAMJ: NOVEMBER, 2017 4109 Bendeyogita Et Al: An Observational Study On Revalidation Of Manikicriteria Of Vamana Karma the Avara type of purification, while lesser swedana (fomentation) were done on the gap M.S.I. will point to the achievement of day11. On the next day, Vamana was adminis- greater level of purification. tered. The process was carried out as per the Thus, standard protocol12. After akanthapana, vamaka yoga was given for the initiation of the process. M.S.I. 1 Once the process of vomiting started, Nature of ManikiSuddhi vamanopaga medicine like Yashtimadhu kwatha was given for the continuation till the arousal of This can be stated as, M.S.I. is inversely Pittanta signs and symptoms13. The bouts were proportion to the type of Maniki purifica- counted and the quantity was noted14. After fin- tion, when quantity expelled outside is less ishing the procedure, the residue or vomitus was than quantity ingested by an individual .It counted with the special precautions to calculate simply means that if M.S.I. is greater, then the exact amount of expelled doshas. Records of nature of Shuddhi will be lower (pointing Input - Output and other observations were towards Avara Shuddhi). Hence physician maintained. should always be more attentive to lower the M.S.I. Clinical observations - When the output is lower than the input, the Procedure - MSI was measured and the observations are put After three days of pachana, snehapana (con- in the table no 1 and when the output was more sumption