Chikitsaa Prakaara: Vamana (Emesis)

Prakaara Paribhaashaa:

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The process of inducing forceful and complete elimination of Apakva Pitta and Kapha by emetic medication.

Description:Kaala/Vaya/Ahoraatra/Ritu/Bhukta

Emesis should be induced in spring season by Teekshn`a (intense) drugs for a healthy person as a preventive measure. A H. Su. 3/18
Theactualemesis should be induced in the forenoon in a moderate season.

Poorvakarma (Prerequisites):

Instrument Checklist:

Patient Preparation:

Fomentation and oleation should be administered.
The patient should be advised to take head bath.
Dose of the emeticdrug should be decided according to the Vyaadhibala, Kosht`ha, Des`ha, Vaya and Kaala. According to Charaka Madanaphala Pippali should be given in amount of Antarnakha Musht`i Pramaan`a (fist full). According to Sus`hruta the dose of the decoction should be 10-20 Tolaa, that of Choorn`a or Kalka should be 1 Tolaa.
Abhyantara Snehapaana (internal oleation), Abhyanga (external oleation) and fomentationshould be administered for 3 days. Internal oleation should always be Salavan`a (added with rock salt).Then only external oleation and fomentation should be applied for next 3 days (The day of completion of internal oleation, Vis`hraama Dina and the morning of Vamana day.)
Patient counselling and efforts should be done to maintain good mental health.
Patient should be asked to consume Kapha precipitating diet (like fish, black gram, sesame) on the previous night of emesis. He should be asked to consume Peyaa, Yavaagu, Ghee or only milk on the morning of emesis.

Pradhaanakarma

The patient should sit on a chair of height equal to knee (Vamana Peet`ha). The chair should have a comfortable back so that the patient can rest in between two bouts.
The patient should be covered with a clean white cloth up to his neck. The patient should be asked to consume the prescribed Vaamaka medicine. There are three methods of consuming this.

Consuming food items like milk, curd, meat soup etc medicated with pro-emeticdrugs.
First consuming above mentioned food items and then consuming pro-emetic drugs.
Consuming decoction of Yasht`eemadhu etc added with pro-emetic drugs.

After consumption of medicine the physician should foment patient’s face, chest, and back with warm hands (made by heating).
Then one should wait for one Muhoorta (48 min) for the first bout.
When the perspiration occurs over forehead it is the sign of moving, liquefied and upcoming Dosha.
When Romaharsha appears it is the sign of movement of Dosha towards the alimentary canal.
When there is increase of salivary secretions inside mouth it is the sign of movement of Dosha towards mouth. The patient should be asked to vomit inside the container kept in front of the patient. If emesis doesn’t occur then the patient should be asked to induce emesis by inserting his finger or any blunt tube like structure inside throat. If this doesn’t induce emesis then again Madanaphala Yoga should be administeredwith honey.
The assistant should stand behind the patient and should massage the patient from below upwards on back. He should hold his hands over patient’s temporal region tightly.
The physician should monitor following things during the procedure –

Pulse
Blood pressure
Heart rate
Respiration rate and quality
The bouts should be examined according to quantity, sounds, properties and taste – Very small quantity of emetic material and expulsion with loud noise is a sign of aggravation of Vaata Dosha. Slimy and fibrous emetic material is a sign of aggravation of Kapha Dosha. The colour of the emetic drug should be kept in mind while accessing the Doshaprakopa according to colour of the emetic material. Appearance of red coloured material in emetic material is a sign of bleeding and emesis should be stopped immediately. Knowing the taste inside the patient’s mouth also helps to understand the Doshaprakopa. Patient’s abdomen should be palpated frequently during the procedure.

Laingiki Parikshaa à Expulsion of Praseka à emetic drug à Kapha and then Pitta in a sequential manner.

Pas`hchaatkarma

The patient should be cleaned after adequate emesis and then advised to rest for 48 minutes.
Dhoomapaana (medicated smoking) – This helps to decrease the sliminess inside throat and oral cavity. Due to this the throat, nose and channels situated in upper part of the body get cleaned.
The patient should be advised to avoid following things immediately after emesis

Diet should be administered according to the Sansarjana Krama from the evening of emesis.
In the absence of adequate emesis Santarpan`a should be administered instead of Sansarjana Krama.
If Virechana is to be administered after Vamana then Snehapaana should be started from the 9^th day after emesis.

Other Information:

This procedure is indicated in Utsanna Maamsayukta S`hotha and Dusht`a S`hyaama Varn`yukta Rakta containing Vran`a.
After S`hastrakarma or Agni and Kshaarakarma over Vartmaars`ha, S`hushkaars`ha (Netra Roga) and Arbuda Netra Roga Vamana should be induced to eliminate the S`hesha Dosha.
Indications and various formulations used can be got through Anveshak search facility.

Last updated on April 30th, 2021 at 08:29 am