Chardi Roga – Vomiting: Ayurveda Explanation, Types, Symptoms

Article by Dr Raghuram Y.S. MD(Ayu)
Vomiting is called as Chardi Roga in Ayurveda. Chardi is an act of expulsion of gastric contents.

Chardi as vega

Chardi as vega – Chardi is also mentioned as ‘adhaaraneeya vega’, a natural urge expressed by the body. This means to tell that we should not control or suppress vomiting because it is a process in which the body is trying to throw out the unnecessary contents, contaminants and toxins out of the body, which would otherwise prove to be harmful when left alone in the body. Stomach identifies the incompatible foods and rejects them in the form of expulsion through vomiting. Chardi as roga or disease – Chardi is a disease when the pathology is head by the vitiated doshas. Even here too, if the patient is strong enough, the vomiting process should be allowed until the unwanted things have been ejected out of the system. When comes to treating vomiting, the pathology should be addressed and treated only after the unnecessary things have been thrown out of the body.

Classification

Classification of Chardi –
Chardi is classified as:
Primary Chardi – Here the vomiting is caused by the vitiation of doshas and the disease will have its own pathological process. The treatment is oriented towards controlling the morbid doshas and breaking the samprapti (pathological process) of the disease. Thus, the Primary Chardi will have its own set of Nidanas or aetiological factors (causative factors), own samprapti (pathogenesis), own set of Purvarupa (premonitory symptoms), Rupa or Lakshanas (Signs and symptoms), upadravas (complications) and chikitsa (treatment protocol).

This type of Chardi again is of 5 sub-types, they are –

• Vataja Chardi – Vomiting caused by vitiated Vata
• Pittaja Chardi – Vomiting caused by vitiated Pitta
• Kaphaja Chardi – Vomiting caused by vitiated Kapha
• Sannipataja Chardi – Vomiting caused by vitiation of all 3 doshas
• Drustartha Samyogaja (Agantuja) Chardi – Vomiting caused due to consumption or sight or exposure to incompatible foods and things

Read related: Vomiting: Causes, Complications, Pathophysiology, Treatment

Secondary Chardi – This type of Chardi is not manifested by itself. It is a part of yet another disease and is thus secondary to another primary disease. Thus secondary Chardi doesn’t have an independent existence. This chardi is dependent on the causative factors, pathogenesis and manifestation of another disease. This type of chardi occurs in the form of a premonitory symptom, symptom, complication or sign of bad prognosis of yet another disease. The treatment of this chardi is also not symptomatic. If the main disease which is causing vomiting is addressed, the vomiting comes down. Special and separate treatment for this type of Chardi is not needed unless it is a predominant symptom of the primary disease and needs special attention.
Read related: Charaka Chardi Chikitsa – 20th Chapter | Vomiting Treatment

Causative factors

Primary Chardi
Causative factors (Nidana) of Chardi in general –
Ati dravaiH ati snigdhaihi ahrudhyaihi lavanaihi ati
Akaale cha ati maatraihi cha tathaa asaatmyaihi cha bhojane
Shramaad bhayaat tathaa udvegaat ajeernaat krimi doshataha
Naaryaa cha aapanna sattvaayaaha tathaa ati dhrutam ashnataha
Beebhatsaihi hetubhihi cha anyaihi…(Ref – Sushruta Uttara 49)

Below mentioned are the causative factors of CHardi vis-à-vis vomiting –

• Ati drava – excessive consumption of liquid foods or liquids
• Ati snigdhihi – excessive consumption of unctuous or oily foods, fried foods
• Ahrudhyaihi – excessive consumption of incompatible or unsuitable (unwholesome) foods
• Ati lavana – excessive use of salt or salty foods
• Akala bhojana – untimely intake of food
• Ati matra bhojana – eating in excess
• Asaatmya bhojana – incompatible foods
• Shramaat – exhaustion
• Bhayaat – fear, panic
• Udwega – high end emotions
• Ajeernaat – indigestion
• Krimi dosha – infection
• Naaryaha aapanna satva – pregnancy
• Ati drutam ashnataha – eating food in hurry
• Beebhatsa hetu – anything which creates an awkward feel

Pathogenesis

Pathogenesis (Samprapti of Chardi) of vomiting –
On getting provoked by the above said causative factors, the doshas get immediately vitiated. They quickly move upwards and fill up the mouth. In the process they cause serious discomfort, bends and twist the body parts. The condition in which there is quick movement of doshas towards the mouth is called Chardi.

Poorvarupa

Premonitory Symptoms of Chardi –

• Hrudaya utklesha – feeling of discomfort in the region of the heart, nausea (repeated)
• Kapha praseka / Hrillasa – filling of mouth with watery secretions, water brash, excessive salivation
• Ashana dwesha – aversion or lack of interest in food
• Udgara rodha – obstruction to belchings
• Tanu, lavana srava – thin salty secretions in the mouth

Vataja chardi

Vataja Chardi (vomiting caused by vitiated Vata)

Causes:

• Vyaayaama – excessive exercise
• Teekshna aushadha – strong medicines
• Shoka – grief
• Jeerna roga – chronic diseases
• Bhaya – fear
• Upavasa – excessive fasting

Read related: 21 Lifestyle And Prevention Tips To Stop Vomiting And Nausea
Pathogenesis:
Due to the above said factors, the person becomes debilitated and emaciated. In the process, the vata gets severely aggravated in the maha srotas (passages of food; gut) and in turn provokes the other doshas and contaminants in the gut. The vitiated vata pushes these doshas in an upward direction. While throwing the doshas in an upward direction, vayu causes provocation and disturbance in the stomach. The whole set of process causes vomiting producing sever pain in the region of heart.

Symptoms –

• Hridaya peeda – pain in the heart or cardiac region
• Parshwa peeda – pain in the flanks or sides of the chest
• Mukha shosha – dryness of the mouth
• Murdha arti (shira shula) – head ache
• Nabhi arti – pain in the navel region
• Kasa – cough
• Swara bheda – hoarseness of voice
• Toda – pricking pain (in the belly, tummy pain)
• Udgara shabda prabalam – severe sounds while vomiting (vomiting with sounds of expulsion of contents)
• Nature of vomitus – saphena (frothy), vichinna (content of vomiting is in the form of broken pieces), krushnam (blackish colour), tanukam (thin or less concentrated liquid in the content) and kashayam (gives an astringent taste in the mouth)
• Kruchra – vomiting occurs with much difficulty and distress
• Alpam – less quantity of vomitus
• Mahati vegam – comes in quick and forceful bouts

Pittaja chardi

Pittaja Chardi (vomiting caused by vitiated pitta)
Causes:

• Ajeerna bhojana – indigestion
• Katu – excessive consumption of pungent foods
• Amla – excessive consumption of sour foods
• Vidahi – excessive consumption of corrosive foods
• Ushna – excessive consumption of hot foods

Pathogenesis:
The pitta vitiated due to the above said factors accumulates in the amashaya (stomach and upper intestines). When the quantity of accumulation becomes excessive, the pitta gains enormous power and tends to move upwards. Due to the intense provocation, pitta enters the rasayanis (channels of nutrition, oesophagus here), moves upwards in a projectile and causes vomiting causing severe pain and discomfort in the heart.

Symptoms:

• Murcha – fainting, loss of consciousness
• Pipasa – excessive thirst
• Mukha shosha – dryness of mouth
• Murdha santapa – feeling of excessive heat in the head
• Talu santapa – feeling of excessive heat in the palate
• Akshi santapa – feeling of excessive heat in the eyes
• Tama – feeling of darkness in front of the eyes
• Bhrama – giddiness
• Nature of vomitus – peeta (yellow), ushna (hot), haritam (green), tiktam (bitter in taste), dhumram (feeling of smoke or flames being eliminated from mouth) and daha yukta (burning sensation)

Kaphaja chardi

Kaphaja Chardi (vomiting caused by vitiated of Kapha)
Causes:

• Snigdha – excessive consumption of unctuous, oily and fried foods
• Guru – excessive consumption of heavy ‘to digest’ foods
• Ama – excessive consumption of unprocessed and immature / improperly prepared (cooked) food components
• Vidahi – excessive consumption of corrosive foods
• Swapna – excessive sleeping, sedentary life, rest prone etc

Read related: 25 Easy, Effective Home Remedies for Vomiting And Nausea
Pathogenesis:
The kapha gets severely aggravated due to the above said causes and causes vomiting by filling up in the ura (chest), shira (head), rasaayani (channels of nutrition) and marma (heart). While causing vomiting, the vitiated kapha produces serious discomfort in the mentioned regions.

Symptoms:

• Tandra – sleepiness, stupor
• Asya madhurya – sweetness in the mouth
• Kapha praseka – excessive filling of phlegm or watery secretions in the mouth
• Santosha – the person feels as if he has just consumed food i.e. feeling of saturation
• Nidra – sleep
• Aruchi – anorexia, tastelessness, aversion towards food
• Gourava – feeling of heaviness of the body
• Nature of vomitus – snigdha (oily, fatty), Ghana (thick, concentrated), swadu (sweet taste)
• Shuddha kapha – contains clear phlegm
• Loma harsha – horripulation
• Alpa rujam – vomiting occurs with minimum pain or discomfort

Sannipataja chardi

Sannipataja Chardi (vomiting caused by vitiation of all the 3 doshas)
Causes:
Samashnatam sarvarasaan – intake of all the rasas (foods having all the tastes – sweet, sour, salt, pungent, bitter and astringent) in an unbalanced way, not taking into consideration about good and bad food (suitable and unsuitable foods)

Prasakta ama – formation of ama in severe quantities in the body (ama is the immature essence formed after the digestion of the food and is in circulation, considered as unwanted toxin and intermediate product of metabolism, tends to clog the channels and cells in the body by the virtue of its sticky nature, leading to serious damage and disorders)

Rutu viparyaya – seasonal incompatibility, seasonal drift (one season encroaching the other and occurring in wrong time, example, severe rain in summer, severe heat in winter etc)

Pathogenesis:
Due to the above said causes, all the 3 doshas i.e. vata, pitta and kapha gets aggravated together and cause vomiting. This is called sannipataja or tridoshaja chardi.

Symptoms:

• Shula – colic, pain abdomen
• Avipaka – indigestion
• Aruchi – tastelessness, anorexia, aversion towards food
• Daha – burning sensation
• Trishna – thirst
• Shwasa – shortness of breath, dyspnoea
• Pramoha – delirium, loss of consciousness
• Prabala – severe vomiting with severe bouts
• Prasaktam – repeated or frequent vomiting
• Nature of vomitus – lavana (salty), amla (sour taste), neela (blue in colour), saandra (dense, concentrated), ushna (hot), raktam (mixed with blood)

Read related: Chardi Roga Chikitsa: Ayurvedic Treatment For Vomiting, Limitations
Asadhya Sannipataja Chardi (sannipataja chardi with bad prognosis):
Sannipataja chardi is said to be having a bad prognosis (not possible to treat) when associated with below said complaints or symptoms –

• Vin mutrayoho tat – the materials or contents of vomiting will have the appearance, colour and smell of stools (faeces) and urine
• Prasakta trishna – repeated thirst
• Prasakta shwasa – repeated bouts of breathlessness or dyspnoea
• Prasakta hikka – repeated bouts of hiccoughs
• Ativega – severe bouts of projectile vomiting, comes in quick successions
• Dushta chardi – vomitus contains severe contaminated material

The person who has the above said symptoms of sannipataja chardi is said to die in a short period of time.

Dwishta artha samyogaja chardi

Dwishta artha samyogaja Chardi (Vomiting caused due to consumption, sight or exposure to incompatible, disturbing, repulsive or awkward foods and things)
Causes –
Smells, food or things which are:

• Dwishta – repulsive to the mind
• Prateepa – against the need of mind
• Ashuchi – untidy, clumsy, unwholesome, unclean
• Puti – putrid, decayed,
• Amedhya – disturbs the mind
• Beebhatsa – horrifying, scary

Pathogenesis –
Due to the above said factors, the mind becomes disturbed and causes vomiting

Asadhya lakshana

Symptoms of bad prognosis (asadhya lakshana) in Chardi –
Chardi is said to be difficult to cure (has bad prognosis) when the below said conditions prevail:

• Ksheena – person is emaciated or has tissue depletion
• Ati pravrudda vamana – severe vomiting occurring repeatedly
• Sa upadrava – vomiting associated with complications
• Shonita yukta – blood mixed vomitus
• Pooya yukta – pus mixed vomitus
• Sa chandrika – vomitus having shiny materials

Chardi as symptom

Secondary Chardi (Differential diagnosis of Chardi)
Chardi is a part of some other disease. Below mentioned are different diseases in which Chardi appears as a symptom or premonitory symptom or complication.

As purvarupa (premonitory symptom) in –
Urustambha – stiffness of thigh
Raktapitta – bleeding / haemorrhagic disorders
Rajayakshma – Tuberculosis, tissue depleting diseases, consumption

As Lakshana (symptom) in –

• Antarayama – type of tetanus
• Atisara – in kaphaja, pittaja and vataja types of atisara (diarrhoea)
• Amlapitta – gastritis, GERD (gastro intestinal reflux disease)
• Pureeshaja Aanaha – Flatulence or distension of abdomen caused due to improper or inadequate defecation
• Kaphaja arshas – piles caused due to morbid kapha
• Udavarta – upward movement of vitiated vata due to forcible suppression of puresha vega (urge to defecate), vata (urge to fart), mutra (urge to urinate)
• Kaphaja unmade – insanity caused by vitiated kapha
• Urustambha – stiffness of thigh
• Pittaja kasa – cough caused by vitiated pitta
• Kaphaja krimi – worm infestations caused by vitiated kapha
• Koshta shula (bala roga) – abdominal colic (paediatric disease)
• Kaphaja grahani – sprue or small bowel disease caused by vitiation of kapha
• Jwara – fever, pittaja jwara (caused by vitiated pitta), kaphaja jwara (caused by vitiated kapha), vata-pittaja (caused by vitiated vata and pitta), rasagata (seated in plasma or lymph), raktagata (seated in blood), medogata (seated in fat), asthigata (seated in bones), majjagata (seated in bone marrow) and aushadha gandhaja (due to smell of medicines)
• Talukantaka – disease of palate (paediatric)
• Kapha dushta stanya pana – due to consumption of breast milk contaminated by kapha (paediatric)
• Kaphaja parinamashula – duodenal (peptic) ulcer caused by vitiated kapha
• Sannipataja pandu – anaemia or liver disorders caused by vitiation of all the 3 doshas
• Panavibhrama – disease caused due to excessive consumption of alcohol
• Panajeerna – disease caused due to indigestion of consumed alcohol
• Parigarbhika – paediatric disease
• Pittavrita prana – pitta obstructing functions of prana vayu
• Bala graham – infective diseases or neurological, nutritional, abdominal or idiopathic disease occurring in infants and children
• Andhaputana, naigamesha, sheetaputana, skandapasmara – paediatric diseases
• Bhinnakoshta – tear or injury in visceral organs
• Kaphaja madatyaya – alcoholic intoxication caused by excessive vitiation of kapha
• Visha – poisoning – by the poison of dooshi visha (mixed poisons), pushpa (poisonous flowers), manduka (frog), mushika (rat), vishapana (intake of poisons), sthavara (plant poisons or chemical poisons), ksheeri visha (poisons of latex yielding poisons) etc
• Visarpa – herpes or erysipelas (agni, kaphaja, granthi and pittaja types)
• Vishuchika – cholera
• Vishpota – eruptive disorder, boils, blisters (kaphaja, kapha-pittaja and sannipataja types)
• Sheetapitta – urticaria, allergic disorders
• Amaja shula – colic caused by excessive ama (metabolic endo-toxins)
• Kaphaja shotha – inflammation or oedema caused by vitiated kapha

As Upadrava (complication) in –

• Ajeerna – indigestion
• Atisara – diarrhoea
• Arshas – piles
• Ashmari – urinary stones (calculi)
• Amavata – rheumatoid arthritis
• Kaphaja prameha – urinary disorders or diabetes caused by vitiated kapha
• Madatyaya – alcoholic intoxication
• Raktapitta – bleeding disorders
• Visarpa – herpes
• Vrana – ulcers, wounds

As Asadhya Lakshana (sign of bad prognosis) in –

• Atisaara – diarrhoea
• Apache – lymphadenitis
• Arshas – piles
• Alasaka – lazy stomach
• Akhu visha – rat poison
• Udavarta – upward movement of vitiated vayu
• Kamala – jaundice
• Kumbhakamala – complicated stage of jaundice
• Gandamala – cervical lymphadenopathy
• Gulma – abdominal tumours
• Grahani – sprue, irritable bowel disease, inflammatory bowel disease, small bowel disease
• Trishna – thirst
• Pandu – liver disorders, anaemia
• Madatyaya – alcoholic intoxication
• Raktapitta – haemorrhagic disorders
• Antar vidradhi – internal abscess
• Vishuchika – cholera
• Kshata ksheena – emaciation due to chest injury (bleeding within the chest organs)

Chardita dravya lakshana

Chardita dravya lakshana (signs and symptoms on observing the nature of vomitus)
Appearance:

• Alpa drava (less in quantity) – in Vataja chardi
• Arakta (reddish colour or blood mixed) – in urdhwagata raktapitta (haemorrhagic disorders, bleeding in upward direction or through mouth), tridoshaja chardi (vomiting caused by vitiation of all 3 doshas), rakta purna koshta (blood filled viscera), kamala (sign of bad prognosis in jaundice), raktapitta (sign of bad prognosis of bleeding disorders), ura kshata (chest injury) and akhu visha (rat poisoning)
• Krishna varna (blackish blue colour) – vataja chardi (vomiting caused by vitiated vata)
• Chandrika yukta (with shining particles) – chardi asadhya lakshana (sign of bad prognosis of vomiting)
• Dhumra varna (smoky or dusky appearance) – pittaja chardi (vomiting caused by vitiated pitta)
• Nila varna (blue colour) – in urdhwaga amlapitta (gastritis having upper course) and tridoshaja chardi (vomiting caused by vitiation of all 3 doshas)
• Peeta varna (yellow colour) – in urdhwaga amlapitta (gastritis having upper course), pittaja kasa (cough caused by vitiated pitta) and pittaja chardi (vomiting caused by vitiated pitta)
• Phena yukta (frothy appearance) – in Vataja chardi (vomiting caused by vitiated vata), balagraha samanya lakshana (common symptom of paediatric idiopathic diseases), skandapasmara (epilepsy caused by infection in children and infants) and vataja apasmara (epilepsy or memory related disorders caused by vitiated vata)
• Mamsa udakabha (meat washed water) – in urdhwaga amlapitta (gastritis having upper course)
• Vichchinna (split into pieces) – vataja chardi (vomiting caused by vitiated vata)
• Vit varna (faecal appearance) – chardi asadhya lakshana (sign of bad prognosis in vomiting)
• Snigdha (unctuous, fatty) – kaphaja chardi (in vomiting caused by vitiated kapha)
• Harita (green) – in urdhwaga amlapitta (gastritis having upper course) and pittaja chardi (vomiting caused by vitiated pitta)
• Ghana (dense, concentrated, having more solid) – kaphaja chardi (vomiting caused by vitiated kapha)
• Tanu (light, thin, diluted) – vataja chardi (vomiting caused by vitiated vata)
• Vishuddha (clean, clear) – kaphaja chardi (vomiting caused by vitiated kapha)
• Shakrut chardi (faecal vomitus) – in pureeshaja anaha (flatulence caused by obstruction of stools) and udavarta asadhya lakshana (bad prognosis of vata moving upwards)
• Sandra (viscous) – kaphaja chardi (vomiting caused by vitiated kapha)
• Shonita puya yukta (mixed with blood and pus) – chardi asadhya lakshana (bad prognosis of vomiting)

Feel:
Ati pichchila (too sticky) – urdhwaga amlapitta (gastritis having upward course)
Ushna (hot) – in pittaja and tridoshaja (vomiting caused by vitiated pitta and vitiation of all 3 doshas)

Taste:

• Amla rasa (sour taste) – in urdhwaga amlapitta (gastritis with upper course) and tridoshaja chardi (vomiting caused by vitiation of all 3 doshas)
• Katu rasa (pungent taste) – pittaja kasa (cough caused by vitiated pitta)
• Kashaya rasa (astringent taste) – vataja chardi (vomiting caused by vitiated vata)
• Tikta rasa (bitter taste) – vataja chardi (vomiting caused by vitiated vata)
• Madhura rasa (sweet taste) – kaphaja chardi (vomiting caused by vitiated kapha)
• Lavana rasa (salty taste) – tridoshaja chardi (vomiting caused by vitiation of all 3 doshas)

Smell:
Mutra gandha (smell of urine) – chardi asadhya lakshana (bad prognosis of vomiting)
Vit gandha (faecal smelling) – chardi asadhya lakshana (bad prognosis of vomiting)

Effective decoctions for vomiting from Sahasrayogam

Ref – Sahasrayogam, Kashaya Prakaranam, 31

a. Bilwadi Kashayam

b. Lajadi Kashayam

c. Jambvadi Kashayam

2. Drakshadi Kashayam (Vata-Pitta Jwarahara Kashayam)

Ref – Sahasrayogam, Kashaya Prakaranam, 6

3. Amrutashtaka Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 9

4. Panal Veradi Kashayam

Ref – Sahasrayogam, Parishishta Prakarana, 27

5. Mudgadi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 35

6. Parpataka Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 35

7. Bilwadi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 37

8. Trayantyadi Kashayam

9. Chardhihara kashaya
10. Tugadi choornam
11. Talisapatradi choornam
12.Magdhajadi choornam
13.Karpasasthyadi choornam
14. Eladi choornam
15. Avipathi choornam
16. Karpooradi choornam
17.Bala Soolari choornam
18.Dasamoolarishtam
19. Bilwadi lehyam
20 Dhanwantari gutika

Ref – Sahasrayogam, Parishishta Prakaranam, 111

Pathya-apathya in Chardi according to Yogaratnakara

Peanut, barley, wheat, green gram, rice grown in sixty days, soup of meat of rabbit, partridge, quail and meat of animals of arid, desert-like land, murabba, tender bamboo shoots, jujube fruit, grapes etc.

Click to consult Dr Raghuram Y.S. MD(Ayu) – email / skype