What Is Vamana Treatment in Ayurveda and How Does It Work?

Vamana is defined as the process of elimination of dosha or waste products/ toxins through the Urdhwamukha or Urdhwamarga (upper route) and that is mouth. This is one of the Panchakarma treatments(five purificatory procedures). This is the emesis therapy. Vamana is ideal for Kapha dosha, or when -Pitta dosha is accumulated in the sites of Kapha dosha in the body. The administration of Vamana treatment is done after the assessment of factors like Agni (digestion strength), Prakruti (constitution), Roga bala (strength or intensity of disease), and Rogi bala (strength of the patient).

Indications and Contra-indications of Vamana Treatment

Indications

• In Kaphaja disorders, where Kapha dosha vitiation is in the high intensity.
• Kaphaja disorders associated with Pitta dosha
• Kapha Prakriti
• Kapha-pitta Prakriti
• Kushtha predominant of Kapha dosha (skin disorders due to Kapha dosha)
• Prameha (diabetes mellitus)
• Shwaasa (dyspnea)
• Kasa (cough)
• Agnimandya (loss of appetite)
• Ajirna (indigestion)
• Pinasa (rhinitis)
• Shlipada (filariasis)
• Adhogaraktapitta (a bleeding disorder in the lower gastrointestinal tract)
• Unmada (schizophrenia)
• Visuchika (diarrhea)
• Visarpa (erysipelas)

Contra-indications

• Hridroga (cardiac diseases)
• Udavarta (obstruction to flatus, urine, and stools due to upward movement of Vata dosha)
• Kshataksheena (emaciated)
• Urdhwagaraktapitta (a bleeding disorder in the upper gastrointestinal tract)
• Weak
• Old aged people
• Children
• Pregnancy
• Who are highly intolerant
• Who indulges in excess weight-lifting
• Who have not undergone Snehana (oleation) and Swedana (fomentation)

Drugs used in Vamana Treatment

Vacha (Acorus calamus), Madanaphala (Randia dumetorum), Saindhava lavana (rock salt), and Madhu (honey) are the drugs that are administered to induce Vamana (emesis)

Drugs that help to induce emesis

Vamanopaga are the drugs that help the Vamaka drugs to induce Vamana (emesis). Some of the drugs to mention here are Madhuka (Glycyrrhiza glabra), Karbudara (white variety of Bauhinia variegata), Pratyakpushpi, Kovidara, Vidula, Bimbi, Shanapushpi, Sadapushpi, etc. These are the drugs that do not induce Vamana directly but rather help the Vamaka drugs to induce emesis.

Time of administration of Vamana

Vasanta rutu or the spring season is the ideal period to administer Vamana treatment (emesis therapy). During the spring season, Kapha dosha is aggravated, and thus, as indicated Vamana eliminates the vitiated Kapha dosha and the associated diseases.

Vamana treatment can also be administered to healthy individuals during Vasanta rutu. It keeps the person healthy by cleansing and activating all the upper body systems and the channels in a normal state.

Apart from this, Vamana treatment can be given based on the condition of the patient and the intensity of the dosha which is to be decided by the physician.

Vamana Treatment

The administration of Vamana Treatment is divided into three stages: Purva karma, Pradhana karma, and Paschat karma.

Purva karma: The pre-requisites and the pre-arrangements before carrying out Vamana treatment.

• The screening of the patients is done based on indications and contra-indications for Vamana treatment.
• The Agni (digestion strength), Prakriti (constitution of the individual), psychological state of the person, external environmental factors, etc. are assessed, and then the therapy.
• Deepana-Pachana (appetizers and digestives) are given to the patient to stimulate digestion and digest any undigested food in the gastrointestinal tract. This will prepare the person for the digestion of drugs for emesis and achieve the benefits of Vamana.
• Snehana – This is oleation therapy. Intake of medicated ghee and oil massage. Medicated ghee is advised on an empty stomach for 3, 5, or 7 days. The dosage of the ghee should start with a minimum dose and then gradually increase such that it gets digested within 24 hours. The ghee is advised with hot water. Snehapana is administered till the desired symptoms are achieved by 7 days. During this course, a warm, liquid, light diet in a suitable quantity is given to the patient.
• After the course of Snehapana, a day rest period is advised during which Abhyanga (oil massage), is done. The oil for the massage is selected based on the Prakriti and the condition of the patient. Abhyanga is also done in the morning on the day the Vamana is administered.
• Followed by an oil massage, Swedana (fomentation) is administered. Bashpa Sweda (fomentation in a steam chamber) is given.
• A day before Vamana treatment, the food items that can cause Kapha aggravation like Dahi wada, milk payasam, sweets, etc. are advised to the patient.

Pradhana karma

• The patient is asked to come on an empty stomach.
• On the day of the Vamana administration, Abhyanga and fomentation are given.
• The patient is made to sit in a comfortable position in a chair.
• Vamana medicines are given. A combination of Vacha, Madanaphala, Madhu, and Saindhava lavana.
• Wait and watch for one Muhurta (48 minutes).
• Salivation in the mouth and sweating over the forehead begin when the vitiated dosha starts moving upwards.
• The upper part of the body is slightly bent forward.
• The patient is asked to keep the mouth open with lips widened.
• To enhance the vomiting, the attendant can do a mild massage on the back from down to the upper back.
• Keep a vessel to collect the vomitus.
• The vomiting should not be forced and must be in a gentle way occurring on its own.
• The episodes of Vamana are said to be 4,6 and 8 Vegas (episodes) as Hina (low), Madhyama (moderate), and Uttama (maximum) respectively.
• The vomitus that ends with a greenish-yellow color which is Pittanta (comprising of Pitta dosha) is said to be the proper vomitus expelled from the body.
• This Vamana treatment is assessed in four stages of clinical manifestation:
• Aantiki – Pittanta Vamana, the vomitus that contains greenish-yellow-colored contents is said to be proper vomitus.
• Vaigiki – The episodes of Vamana treatment are graded as 4, 6, and 8 episodes as minimum, moderate, and maximum episodes respectively.
• Maniki – The amount of vomitus that is measured in terms of the minimum level of purification, moderate level of purification, and maximum level of purification and that is 1 liter, 1 ½ liters, and 2 liters respectively.
• Laingiki – The proper purification is assessed by the symptoms like clarity of thoughts, increased functioning of Indriya (sense organs), proper nourishment and stability of dhatu (tissues), and increased appetite.

Paschat karma

The dietary regimen to be followed by the patient after the administration is the intake of Peya, Vilepi, Akrita yoosha, Krita yoosha, Akrita Mamsa rasa, Krita Mamsa rasa, and then the normal diet. Avoiding excess talk, excess laugh, riding vehicles, exposure to dust, wind, and heat, day sleep, and controlling natural urges are some of the instructions to be followed after Vamana treatment.  

Conclusion

Vamana treatment is one of the Panchakarma (five purificatory procedures). This is indicated in the diseases of Kapha dosha or Kapha-Pitta dosha. Vasanta rutu (spring season) is the ideal season for the Vamana administration. Proper purification of Vamana treatment is assessed based on four types of clinical manifestations, Aantiki, Vaigiki, Maniki, and Laingiki Shuddhi.

References

1. REVIEW ON VAMANA KARMA (THERAPEUTIC EMESIS), International Ayurvedic Medical Journal, 2018, March, Volume 6, Issue 3, p.675-678.
2. VAMANAKARMA: AN ANCIENT AYURVEDIC CLEANSING THERAPY, Journal of Medical Pharmaceutical and Allied Sciences, Volume 10, Issue 3, 2021, May-June, p.2985-2988.
3. Bhatted S, Shukla VD, Thakar A, Bhatt NN. A study on Vasantika Vamana (therapeutic emesis in spring season) – A preventive measure for diseases of Kapha origin. Ayu. 2011 Apr;32(2):181-6. doi: 10.4103/0974-8520.92562. PMID: 22408299; PMCID: PMC3296337.
4. Gupta B, Mahapatra SC, Makhija R, Kumar A, Jirankalgikar NM, Padhi MM, Devalla RB. Physiological and biochemical changes with Vamana procedure. Ayu. 2012 Jul;33(3):348-55. doi: 10.4103/0974-8520.108821. PMID: 23723640; PMCID: PMC3665106.