Impact of Vamana dhauti in Amalapitta: A Critical Review

Changing in environment and lifestyle has leds to different diseases one among them is amlapitta, amlapitta related to annavaha srothas and various research shows that the eattind of viruddha ahara (incommpatable food) will cause agnimandya and there by ajjeerna which is root cause for all the diseases. According to the Center for Disease Control and Prevention (CDC), more than 72 million adults are suffering from GERD and no state has a GERD rate less than 15% the national goal. It also leads many complication like ulcer, gastritis, anemia, IBS, and malabsorption etc In spite of many available drugs in market there is no significance reduction in the prevalence and incidence of this illness which remarkably emphasis on the need of novel approaches in combating those illnesses.


INTRODUCTION
Changing in environment and lifestyle has leds to different diseases one among them is amlapitta, amlapitta related to annavaha srothas and various research shows that the eattind of viruddha ahara (incommpatable food) will cause agnimandya and there by ajjeerna which is root cause for all the diseases. According to the Center for Disease Control and Prevention (CDC), more than 72 million adults are suffering from GERD and no state has a GERD rate less than 15% -the national goal. It also leads many complication like ulcer, gastritis, anemia, IBS, and malabsorption etc In spite of many available drugs in market there is no significance reduction in the prevalence and incidence of this illness which remarkably emphasis on the need of novel approaches in combating those illnesses.

Etymology of Word Amlapitta
The word Amlapitta made up of two words, "Amla" + "Pitta"

POORVAROOPA OF AMLAPITTA
The poorvarupa of Amlapitta are not explained in the classics. Still however the Alpamatra of Roopa may be considered here as the poorvarupa of Amlapitta Table 2, Roopa of Amlapitta in Table 3.

VAMANA DHAUTI REVIEW
Shatkarma are 6 major procedures explained by yoga shastra for cleaning of the body these are the pre requisite for doing pranayama. Vamana dhauti one among them to remove toxins and promote proper digestion. This procedure is practiced early in the morning in empty stomavh for cleaning GI track it is done by drinking lucke warm saline (Akanta pana).
Systemic and local examination of the patient.

Method of preparation of Vamana Dravya
Take 3-4 Liters of water and boil it well, add salt to the water in a proportion of one teaspoonful per liter of water. Stir well and keep in separate jar for drinking. We recommend that the water be lukewarm as of body temperature. 18,19 b. Pradhana Karma After examination, the patient is made to sit on the chair in a comfortable posture. Asked the patient to drink the Vamana dhauti Dravya i.e. the warm salted water. Until he feels the stomach and throat is full.

POSTURE
Sit in the chair comfortably with back bend forward so that vomiting becomes easier.

PROCESS OF VAMAN DHAUTI
Subject is made to drink water continuously, uninterruptedly until the stomach is full and can no more take a single drop of water further then given one more glass. This may be a little difficult but it is essential to fill the stomach as fully as possible. Under these circumstances the urge to throw out the water from the stomach hardly needs to be stimulated, it may even occur spontaneously. 6 medium sized glasses (300ML) of water are about the average number required to fill the stomach. Then from a standing position bend forwards to any container dedicated to collect vomitus. Make sure the trunk is as horizontal as possible. Then open your mouth as wide as possible. This should induce the water to suddenly and effortless. Gush out from the stomach. Continue in this way until there is no more water in the stomach. This is indicated when tickling the back of the throat does not bring up any more water. Now it completes the vamanadhauti procedure.

c. Paschat Karma
Patient is adviced to face wash, Kavala, and Gandusha with lukewarm water and Rapid exhalation to remove the water remaining in the GI tract, then rest in Shavasana.

CONTRAINDICATION
Most people can do this practice but it is contraindicated in hernia, Hypertension, CVD Cardiovascular diseases, Headache (migraine, Tension headache, cluster headache etc.) Epilepsy, recent surgeries, pregnancy and menstruation. 21

PROBABLE MODE OF ACTION OF VAMANDHAUTI KARMA
Amlapitta is maily due to pitta dosha, acharya madhava has narreted all the teatment modalities aiming towrds maintaining equilibirium   Upashaya Anupashaya Upashaya and anupashaya according to Kashyapa Table 5.

a. Purva Karma
Time of the procedure: early in the morning in empty stomach. 16 Vamandhauti mainly acts on Amashaya and Annavaha Srotasa. It neutralizes the acid balance in stomach thus helpful in counteracting Tivra Jatharagni., Salt water-helps in osmosis removes toxins from cells. And also help in liquification of Achadita and Avalipta Dhatugata Ama. Suddhikriya resulting in metabolism. In this way Vamana dhauti is the best possible helps to maintain the homeostasis of the stomach through its cleansing effect.    AMLAPITTA TABLE 8