RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BANGALORE.
SYNOPSIS BY

Dr. SUPRIYA BHAT

GUIDE

DR.R. SHYLAJA KUMARI MD(AYU) ,

PROFESSOR
DEPT OF PG STUDIES IN PANCHAKARMA
G.A.M.C BANGALORE-09
CO GUIDE

DR. ANANTA S. DESAI

MD(AYU),

LECTURER
G.A.M.C BANGALORE-09
FOR THE DEGREE OF AYURVEDA VACHASPATHI
M.D. (AYURVEDA) IN PANCHAKARMA
2012
TITLE OF THE TOPIC
EVALUATION OF THE EFFICACY OF VAMANA KARMA AND

VIRECHANA KARMA IN STHOULYA - A COMPARATIVE

STUDY.

NAME OF THE INSTITUTE

GOVERNMENT AYURVEDIC MEDICAL COLLEGE,
1

DHANWANTARI ROAD, BANGALORE 09, KARNATAKA.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE.
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1.

NAME OF THE

Dr. SUPRIYA BHAT.

CANDIDATE AND

PG SCHOLAR,
DEPT OF PG STUDIES IN PANCHAKARMA,
GOVT AYURVEDIC MEDICAL COLLEGE ,
DHANVANTARI ROAD,
BENGALURU-09

ADDRESS

PERMANENT
ADDRESS

2.

D/O SHRI GANAPATI .V. BHAT,

SHRI SIDDHI VINAYAKA SADAN,
NIRMAL NAGAR,DANDELI -581325 (N.K)
KARNATAKA.

NAME OF THE

GOVT. AYURVEDIC MEDICAL COLLEGE,

INSTITUTION

DHANWANTARI ROAD,
BENGALURU-09

3.

COURSE OF STUDY

AYURVEDA VACHASPATI .

AND SUBJECT

MD(AYU).
PANCHAKARMA.

4.

DATE OF ADMISSION

29/10/2011.

TO THE COURSE
5.

TITLE OF THE TOPIC

EVALUATION OF THE EFFICACY OF

VAMANA KARMA AND VIRECHANA
KARMA IN STHOULYA
A COMPARATIVE STUDY.
2

From,
Dr. SUPRIYA BHAT.
P.G. Scholar,
Dept. of Post Graduate Studies in Panchakarma,
Government Ayurvedic Medical College,
Bengaluru -560009.
To,
THE REGISTRAR,
Rajiv Gandhi University of Health Sciences,
Bengaluru, Karnataka.
Through,
THE PRINCIPAL AND HOD OF PG STUDIES IN PANCHAKARMA,
Government Ayurvedic Medical College,
Bengaluru -560009.
Respected sir,
Sub: Submission of proforma for Registration
of Subject for dissertation.
I request you to kindly register the below mentioned subject against my name for the
submission of dissertation to the Rajiv Gandhi University of Health Sciences, Bengaluru for the
partial fulfillment of M.D. (Ayu) in Panchakarma.

TITLE OF DISSERTATION:

EVALUATION OF THE EFFICACY OF VAMANA KARMA AND

VIRECHANA KARMA IN STHOULYA - A COMPARATIVE STUDY.

Here with I am enclosing proforma for registration of subject for dissertation.

Thanking you,
Place: Bengaluru
Date:

Yours sincerely,
( Dr .SUPRIYA BHAT)
3

6. BRIEF RESUME OF THE INTENDED WORK:

6.1 NEED FOR THE STUDY :

Shodhana therapy is indicated in santarpanajanya vyadhis.Sthoulya belonging to the
category of santarpanotha vikara is best treated by vamana and virechana karma.Vamana karma
is the prime therapy for kaphaja vikaras and Virechana corrects agni and causes stability of
dhatus.1a
Sthoulya is medopradoshaja and kapha pradhana vyadhi.In modern medical science it
can be compared with Obesity,which is defined as excess deposition of body fat that poses a
health risk13.As a general rule,10% above the standard weight for that height and age can be
considered as over weight and 20% above the standard weight as pathological obesity.12
. Sthoulya is the curse of modern age of machine and materialism which occurs due to
lack of physical activities, increased intake of food and change of dietic habits leading to
impairment of metabolism in an individual and making him prone to series of disorders called as
lifestyle disorders.
Globally more than one billion adults are over weight and atleast 300 million of them
are clinically obese. W.H.O further projects that by 2015,approximately 2.3 billion adults will
be over weight and more than 700 million will be obese 11. According to the surveys, obesity has
reached epidemic proportions in India in the 21st century, affecting about 12 million of the
countrys urban population.India ranks among the top 10 obese nations. As compared to normal
individuals,obese persons are 17 times more prone for back ache and knee pain,8 times more
prone to get fatty liver,5 times for diabetes,4 times for hypertension and 2 times more prone to
get breast cancer, CA of uterus and infertility. Obesity is ranked one among the top 10 health
risks. These statistical datas on the prevalence of obesity clearly shows that there is an urgent
need of a wake up call for global community to curb the health risks, mortality rates and
economic costs associated with these diseases.10
Many theory and medicaments have been put towards us for the management of the
disease,but till now no perfect remedy has been found in any of the contemporary sciences.
Hence there is an immediate need to explore an effective line of management for this disorder.
So here an attempt has been made to evaluate the efficacy of vamana karma and virechana
karma in sthoulya which is essentially managed by shodhana.
4

But a sthula purusha is sukumara and tikshna oushadha asaha 2c.Therefore to achieve
shodhana here, Ikshvaku for vamana2a and aragvadadyavaleha for virechana2b which are of
milder potencies have been selected.

6.2 REVIEW OF LITERATURE:

Acharya charaka has mentioned the use of Vamana and Virechana karma as treatment
procedures in santarpana janya vikaras.2d
zxiqssZl i uUM Uqh | (./)

Indications of ikshvaku2e for vamana and aragvadha2f for virechana has been explained
in charaka samhita kalpa sthana.

Acc to text Basavarajeeyam, vamana and virechana have been mentioned as the line of
treatment for medoroga4c.Even the nidana4a and lakshanas4b have been explained.
cli q eaUh---------|
-------uUM mcNSlq cmrmimhq c ||
Lil xuh lwuil qSaS xiuUqmli ||

4c

( /-)

Nidana2g,samprapti2h, lakshana2i and chikitsa sutra2j of sthoulya has been mentioned in

charaka samhita.
The samanya lakshanas of sthula purusha are:
:

../

Sushruta has mentioned the nidana, lakshana,upadravas and chikitsa sutra of sthoulya.1b

Chakradatta has explained the chikitsa for sthoulya in 36th chapter verse 1-2.5

References of medo roga(sthoulya being one of the medo pradoshaja vikara) are also
available in Gadanigraha3,madhava nidana6,Sharangadhara samhita7, Bhavaprakasha,8
and Yoga ratnakara9.
5

PREVIOUS DISSERTATION WORK DONE:.

Dr.Vibhas Chhipa-A role of bhadradi asthapana basti in the management of sthoulya w.s.r
to obesity.Dept. of panchakarma.2010,GAU,Ahmedabad.

Dr.Jyothi-Clinical study on the effect of vamana and udvartana karma in the management
of sthoulya.Dept of Panchakarma,2008, N K Jabshetty Ayurvedic Medical College & PG
Centre, Bidar,RGUHS,Bangalore.

Dr.Magdum Rahul Ravindra-A clinical study to evaluate the efficacy of virechana karma in
sthoulya

w.s.r to overweight.

Dept of Panchakarma,2008,

,SDM

College

of

Ayurveda,Udupi, RGUHS.Bangalore.

Dr.Prajwal Narayan -A clinical study to evaluate the efficacy of vamana karma in

medoroga

w.s.r to obesity. Dept of Panchakarma,2007,SDM College of

Ayurveda,Udupi,RGUHS.Bangalore.

6.3 OBJECTIVES OF THE STUDY:

1. To evaluate the efficacy of Vamana karma and virechana karma in sthoulya.
2. To evaluate the efficacy of Vamana karma followed by Virechana karma in sthoulya.
3. To compare the efficacy of Vamana and Virechana karma in sthoulya.

7. METHODOLOGY:
7.1 Source of Data:
For the present study patients are randomly selected from the OPD and IPD of Shri
Jayachamrajendra Institute of Indian Medicine Hospital,(Teaching hospital of GAMC),
Bengaluru-09

7.2 Method of collection of data :

30 patients who fulfill the inclusive criteria will be selected randomly irrespective of sex,
religion, occupation and economic status.
6

A) Diagnostic criteria:
Diagnosis will be based on

Clinical features of sthoulya as mentioned in the classics like Chala spik udara stana and
ayathopachaya utsaha.

B) Inclusion criteria :

Aged between 18-60 yrs.

Having clinical features of sthoulya.

BMI greater than 25 and less than 40 (kg/m2)

Fit for vamana and virechana karma.

C) Exclusion criteria:

Associated with evidence of cardiovascular,hepatic and renal disorders.

Patient with long term steroid treatment.

Associated with any rectal pathology like haemarrhoids, fissure etc

D) Plan for the treatment:

A minimum of 30 patients randomly divided into 3 groups A, B and C with 1O patients in
each group

STUDY DESIGN
GROUP A = VAMANA KARMA IN 10 PATIENTS.
Poorva karma

1) Deepana Pachana with 3 days. If ama pachana not

Trikatu churna (1-2gms b.d) achieved

then

continued
7

with sukhoshna jala.

2) Snehapana in

until niramavastha.
arohana until na ati snigdha lakshana

krama with murchita tila

taila

3) Abhyanga with murchita

Tila

taila,

followed

For 1 day.

by

mrudu svedana.
Pradhana karma

Vamana

with

ikshvaku For 1 day

beeja kalka yoga2a.

(Dose acc. to bala, agni &
koshta of patient )
Paschat karma

1)Kavala with sukhoshna

jala and Dhoomapana with
dhoomavarti

prepared

of

haridra.
2)Samsarjana karma

Peyadi

according

to

shuddhi(pravara,madhyama
and avara)
Duration of treatment in group A is approximately 10 days. May vary slightly according to
agni, koshta and shuddhi of the patients.

GROUP B =VIRECHANA KARMA IN 1O PATIENTS

1)Deepana pachana with

trikatu churna (1-2gms bd)
with sukhoshna jala .
Poorvakarma
2)Snehapana

in

achieved then continued until

niramavastha .

arohana

krama with murchita tila taila

3) Abhyanga with murchita

Tila taila, followed by mrudu

swedana.

Pradhana karma

3 days. If ama pachana not

Virechana with
aragvadadyavaleha2b

Until na ati snigdha lakshana

For 3 days

1 day

(according to bala,agni and

kosta of the patient)

Paschat karma

Samsarjana krama

Peyadi according to
shuddhi(pravara,madhyama
and avara)

Duration of treatment in group B is approximately 12 days.May vary slightly according to agni ,

kosta and shuddhi of the patients.

GROUP C :VAMANA KARMA FOLLOWED BY VIRECHANA IN 10 PATIENTS

Poorva karma( for vamana)

1) Deepana Pachana with 3 days. If ama pachana not

9

Trikatu churna (1-2gms b.d) achieved then continued until

with sukhoshna jala.
2) Snehapana in

niramavastha.
arohana until achieving na ati snigdha

krama with murchita tila taila

lakshana

3) Abhyanga with murchita

Tila taila, followed by mrudu
swedana.

Pradhana karma

For 1 day.

Vamana with ikshvaku beeja 1 day

kalka yoga2a.
(Dose acc. to bala, agni &
koshta of patient )

Paschat karma

1)Kavala with sukhoshna jala

and

Dhoomapana

dhoomavarti

prepared

with
of

haridra.
Peyadi

2)Samsarjana karma

according

to

shuddhi(pravara,madhyama
and avara)
Snehapana in arohana krama Na ati snigdha lakshana
Poorvakarma(for virechana)

with murchita tila taila

3) Abhyanga with murchita
Tila taila, followed by mrudu
For 3 days

swedana.

Pradhana karma

Virechana

with

1 day

aragvadadyavaleha2b
10

(according to bala,agni and

kosta of the patient)

Paschat karma

Samsarjana krama

Peyadi

according

to

shuddhi(pravara,madhyama
and avara)

STUDY DURATION : Approximately 20 days.May vary slightly according to agni, koshta

and shuddhi of the patient.

Follow up: Patients of all the three groups will be followed up after the course of treatment
and by the end of one month (30 days).
E. ASSESSMENT CRITERIA
Assessment will be done on the basis of clinical observation (subjective and objective)
before treatment, after treatment and after follow up.

Subjective parameters:
Classical features of sthoulya like

Chala spik udara and stana

Ayatopachaya utsaha.

Objective parameters :

Body mass index (kg\m2)

Anthropometric features-measurement of abdominal girth,circumference of

waist,mid thigh and mid arm.

Lipid profile

Skin fold thickness(measuring skin fold thickness by using slide calipers).

11

Test of significance to be used:

Subjective and objective parameters will be statistically analysed before and after treatment
by proper methods and appropriate conclusions will be drawn.(Paired T test and ANOVA test)

7.3 INVESTIGATIONS:
Blood investigation which include Hb%, TC, DC, ESR,RBS.
Urine-Sugar,albumin and microscopic,
Lipid profile
Any other investigations if necessary.

7.4 Whether the Ethical Clearance has been obtained from the Institution :
Yes

8. BIBLIOGRAPHY:
1. Sushruta. Sushruta samhita, with Nibandha sangraha commentary of Dalhanacharya &
Nyayachandrika of Sri Gayadasacharya on Nidanasthana edited by Vaidya Yadavji
Trikamji Acharya & the rest by Narayan Ram Acharya Kavyatirtha, Varanasi:
Chowkambha Orientalia; reprint 2010. Pp824.
a) Chi.33/27 pn 519
b) Su 15/32 pn 73
2. Agnivesha, Charaka samhita, revised by Charaka Dridabala, with Ayurveda Dipika

commentary of Chakrapanidatta edited by Vaidya Yadavji Trikamji Acharya, Varanasi:

Chowkambha Orientalia; reprint 2011.Pp 738
12

a) Ka 3/14 pn 658

g)Su 23/3-6,pn 122

b) Ka 8/5,pn 666

h)Ka 8/12, pn 666

c) Su 23/3-6,pn 122

i)Si 2/9, pn 687

d) Su 21/5-8,pn 116

j)Su 23/8, pn 122

e) Su 21/9,pn 117

k)Ka 3/4 , pn 657

f) Su 23/8,pn 122
3.Shodala. Gadanigraha,vyakhyakara Shri Indra dev Tripathi,editor Shri Gangasahay
Pandey,3rd Edition:1999,pn 680
4.Basavarajeeyam .edited by Dr Ala Narayan, Vaidya V.Rangacharya, Bharateeya
Ayurvignyan Itihasa Samsthan;1st edition, reprint 2007, Pp952 .pn 603.
a)18/4
b)18/5-6

c)18/28-30

5. Chakrapanidatta. Chakradatta,Sanskrit text with English translation,edited and translated by

Priya Vrat Sharma,Third edition.Varanasi:Chowkambha Publishers;2002.Pp 731,pn 308.
6. Madhavakara. Madhava Nidana, with madhukosha Sanskrit commentary by Vijayarakshita
and Srikanthadatta,with Vidyotini hindi commentary and notes by Sudarshan
Shastri,volume 2,reprint edition 2004,Pp 508,pn 28.
7. Acharya Sharangadhara.Sharangadhara Samhita , Jiwanaprada Hindi commentary by
Dr.Shailaja Srivatsa;reprint edition 2011;Choukambha Orientalia;Pp 578,pn 87.
8.Bhavamishra. Bhavaprakasha, edited by Prof K.R. Shrikantha Murthy, 3rd edition. Varanasi:
Choukambha Orientalia; Volume 2,2005. Pp 884 pn 502
9. Yogaratnakara, Vidyotini hindi commentary by Vaidya Shri Laxmipati Shastry, edited by
Bhishagratna Shri Brahma Shankar Shastry, Varanasi; Chowkambha Sanskrit Samsthan ;
2005.pp 504,pn 98
10. www.wpro.who.int/health topics/obesity access date 28.3.2012
11. http://who.int/mediacentre/fact
12. S.N.Khosla,Essentials of Medicine,published by Satish Kumar Jain,Publishers and
13

Distributers for CBS,New Delhi;1ST Edition 2008,Pp 966,pn 544.

13. A P I TEXT OF MEDICINE,published by The Associations Of
Physicians Of India,Chief editor- Siddharth N Shah,8th edition 2008,Pp 1624,pn 985
Disorders of Adipose Tissue Obesity by Shashank R. Joshi .

Signature of Candidate:

10

Remark of the Guide:

11

Name and Designation of Guide(In

block letters):

11.

Dr.R. SHYLAJA KUMARI M.D(Ayu),

Professor,
Dept Of P.G.Studies In Panchakarma,
Govt Ayurvedic Medical College,
Bangalore-560009.

Signature:

14

11.
2

Name and Designation of Coguide(In

block letters):

11.

Signature:

Dr.ANANTA S. DESAI
M.D(Ayu), Lecturer,
Govt Ayurvedic Medical College,
Bangalore-560009

3
11.

Head Of The Department:

Dr.SHALINI. C. ELI

M.D.

(Ayu),DNY Prof.& H.O.D. Dept Of

P.G.Studies In Panchakarma, Govt
Ayurvedic Medical College,
Bangalore-560009

11.

Signature:

5
12.

Remark of the chairman and

Principal:

12.

Signature:

15