Ayurved classically considers two asayas in connection with GIT- amasaya and pakvasaya.Amasaya attracts everything to its in doors,into its lumen - food and it's secretions, thereafter absorbs the nutrients .It is the classics through it helps to explain doshas,agni. Its secretions are both acidic a(a stomach) and alkaline ( duodenum).Pakvasaya on the contrary is not not concerned with digestion and is involved in excrtion - expulsion. So,while amasaya is concerned with absorption ( saman vayu), Pakvasaya is concerned with expulsion ( apan vayu).
The natural process of emesis is not a routine a activity. They occur because of the need of body to remove toxins or micro- orginsms or because of GIT irritation.Emetics or purgatives used therapeuticly are hence to be toxic or GIT irritants ,but a lesser amount than which can effect toxicity or untoward effects in the body.Neverthless the body tries to remove them and while doing this, vomitting or purgation occurs.Vomitting is aided by reflex activity at the CTZ level and purgation by the hypermotility of the hindegut. The concept of emesis as a procedures in Ayurvedic classics is totally different from its use in eastern medicine,Ayurveda lay emphasis on the removal of metabolic wastes, afternoon their being brought to koshtha( GI T) with the help of unction and sudation. Hence emesis and purgation done as an among the 5 procedures,in person subject to both unction and sudation and the GIT being made highly' utklishta' ( secretary) of these metabolic wastes.
The physiology of
Vomitting -The enteric system with long and short vaso vagal reflexes activities secretion of Ach, histamine,HCL and cortisol.These ultimately results in ' eustress' with low grade inflammation and consequential activation of the defence mechanism of the body.
Emesis and nausea are protective reflexes which helps to get rid of toxic substance and prevent ther from their absorption.Vomitting is a complex process involving three phases- pre-ijection,retching and ejection.All these being accompanied by automatic phenomenon such as salivation, shivering and vasomotor changes. The whole process is coordinated by central emesis and center in the lateral reticular formation of the mid brainstem adjacent to the CTZ in the Arra Postrema at the bottom of the 4 th ventricle and Nucleus Tractus Solitarius of the vagus nerve. The emesis center of the medulla recives information from two sources-The CTZ constantly monitor and relay information of toxic substances in blood or CSF,and from the gut by the NTS of vagus nerve or splanic afferents,to trigger nausea or vomitting. Additional inputs to the emetic centers have been recognised from the cerebral cortex and from the vestibular apparatus
The center hence send out efferent signals to the respiratory, salivary and vosomotor centers and to striated and smooth muscle involved in the vomitting. Also a type of neurotransmitter like substance-P ,are involved in this process besides serotonin( 5 ht3), dopamine, histamine,cholinargic resceptors.
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