Vamana Therapy – Right Method, Side Effects, Management

If you are prescribed Vamana therapy by your doctor, it means that they are planning to induce a controlled vomiting in you. Controlled vomiting means – it is planned, it is induced and vomiting is expected to run for a definite amount of time and then it is planned to stop. 

Panchakarma therapy

Purpose of Vamana

Vamana treatment is targeted to expel increased Kapha Dosha out of the body. When Kapha dosha gets increased, it causes certain types of diseases – such as cold, cough etc. If the extent of Kapha increase is less, then some oral medicines can be given to suppress it. But if it has increased to a large extent and if it has moved from its natural place to other places, then it needs to be expelled out of the body.  By expelling it out, the disease gets cured, often completely. Since Kapha is situated in the chest region, expelling it from the oral route is very easy. Hence, Vamana treatment is designed. To expel it out, first the Kapha Dosha needs to be forcefully brought from the extremities and different organs into the stomach, and then vomiting is induced.

Advantages of Vaman

Vitiated and aggressive Kapha dosha is expelled out of the body, leading to cure of disease.
The digestion and metabolism power gets enhanced,
Normal health is restored;
The sense organs, mind, intelligence, and complexion become clear and gain strength;
The person gains strength, nourishment and immunity,
It improves the chances of fertility, virility and sexual power.
It helps to slow down aging process.
One can live healthily for long time.

Indications

Indications for Vaman Panchakarma treatment –
Vomiting therapy should be administered in two Kapha conditions –
When Kapha Dosha is increased aggressively causing a disease.
Kapha is associated with Pitta dosha and they together cause disease, but Kapha (aka Shleshma) is the dominant Dosha. 

Persons suitable for Vamana

Persons suitable for Vamana procedure – Vamana Arha
People suffering with-
fever of recent origin,
diarrhea, dysentery
Pitta imbalance in lower part of abdomen
Bleeding disorder due to Pitta imbalance
cough, cold, Asthma, chronic Respiratory disorder,
skin diseases, with itching and burning sensation such as herpes
diabetes, urinary tract disorders
Goiter, tumour, fibroid, thyroid disorders
Elephantiasis, Filariasis
Schizophrenia
Shwasa – Chronic Respiratory tract disease,
indigestion, continuous nausea, Anorexia, lack of taste,
Vitiated breast milk
Kapha disorders affecting neck, ear, nose eyes, and throat
obesity
Anemia
heaviness of the body
eruption of pimples, urticaria, itching
lethargy, laziness, lack of inclination for work, lack of co-ordination in sense organs,
Fatigue, Weakness, tiredness without any reason.
Foul smell of the body,
sleeplessness or excessive sleep,
drowsiness, weak sense organs,
impotency,
loss of strength and complexion in spite of the intake of nutritious diet.

Persons unsuitable for Vamana

Persons not suitable for Vamana Panchakarma – 
Basically, person who has Kapha deficiency – like dryness, lightness etc symptoms is not suitable for Vamana.
Pregnant woman – she already will be having
Rooskha – persons who are dry
Person who has not undergone oleation therapy – because, without oleation treatment (procedure of consuming ghee / oil, ahead of Vamana, explained in detail below), Kapha does not get extracted into the gut.
who have strong digestive activity, person who is hungry – here, usually Pitta is dominant. If a person is really hungry, then chances are there that he will digest the medicine that is being given to induce vomiting and hence, vomiting might never happen.
Constantly grief-stricken,
children, old persons, the emaciated, highly obese
patient with heart disease, the wounded, weak, debilitated,
who are having bouts of vomiting,
enlargement of spleen, blindness,
intestinal parasites
upward movement of vata, bloating,
hematemesis (blood vomiting), nasal bleeding
Soon after administration of Vamana,
who have loss of speech, dysuria,
ascites, intestinal obstruction,
tumor of the abdomen,
who faced difficulties during Vamana therapy in earlier attempts,
hemorrhoids
upward movement of air – reverse peristalsis,
Giddiness / Dizziness – enlargement of the prostate,
pain in the flanks and diseases caused by vata;

Before Vamana therapy

Before Vamana therapy, you may be given a digestive medicine such as Trikatu churna, Chitrakadi Vati, Hingwashtaka Churna etc. for up to three days.
Then you may be asked to drink a specific type of ghee or oil for 3 – 7 days. It is usually gradually increased day by day. In emergency conditions,  the ghee or oil consumption may be advised for 1 day only, in which case, it is usually mixed with rock salt. This process of drinking ghee is called as Snehakarma or oleation therapy – click to read more.  

After 3 – 7 days of oil / ghee consumption, you will be advised to undergo oil massage with sweating treatment. At that day, night, you will be given with Kapha increasing diet such as sweet curds, black gram ,Vada etc.

On the day before Vamana

Kapha Dosha is excited in the patient by administering drink / thin gruel prepared from fish, black gram, Sesame etc. added with little quantity of fats, in morning.

Administration of Vamana medicines

Administering medicine for Vamana – emesis therapy –
The patient is made sure that he has slept well the previous night.
Patient is made sure that his previous food is well digested
The patient is made to take hot water bath.
He is either maintained on empty stomach or a little quantity of ghee is given.
The aged, children, the debilitated, VIPs and cowards, should be made to drink wine, milk, sugarcane juice or meat juice added with honey and Saindhava salt, appropriate to the disease, to their maximum capacity.
Determining the nature the nature of his bowels (Intestines – Koshta), the emetic drug is administered.
The physician should administer a dose of the decoction  (Kashaya) of the fruit of Madanaphala (Randia dumetorum Lam). Along with Honey, Rock salt, Phanita ( a preparation of Sugar cane juice) and the  powder of Madhuka– (Licorice – Glycyrrhiza glabra)

Dose of emetics

Dose of emetics (Vamana Dravya) –
The Dosage of the Kashayam of the fruit of Madana (Randia Dumetorum Lam) and of all the other drugs used in elimination therapy should be determined according to the individual needs. The quantity, which when taken brings about the desired effect in the form of elimination of the vitiated Doshas which does not cause over- elimination or inadequate elimination, is to be regarded as the proper dose for the patient.

Adjuvants for Vamana drug

In case of increase of Kapha, vomiting should be induced with drugs having properties like penetrating, hot and Pungent
In case of Pitta with drugs of sweet and cold properties and
In case of association of Vata with Kapha, with drugs of Unctuous, sour and salt properties.

Examples

Examples of combination of herbs for inducing Vamana:
The decoction of Madanaphala – Randia dumetorum mixed with Pippali – long pepper- piper longum and Sarshapa is used for emetic therapy. – Charaka Chikitsa Sthana 15th chapter.

Vamana procedure

Vamana Vidhi – Procedure of Vamana therapy-
After consuming the medicine, he should await for one Muhurta – 48 minutes for the commencement of vomiting, with keen intent.
With the appearance of oppression in the chest and salivation he should try to vomit.
Patient is instructed not to exert too much, but allow the vomiting urge to be fully manifested.
If the bouts are not coming up easily, he should tickle his throat either with his fingers or a soft tube without injuring the throat,
Sitting on a seat of the height of one knee, the bouts of vomiting should be held supported by another person.
His umbilical region and back should be massaged in upward direction.

The physician should  very carefully observe the vomit in the spittoon, ascertain the number of urges and should conclude therapy as to whether the therapy has been well administered, inadequately administered or administered in excess. It is from this observation that the physician can determine the further line of action. So he should very carefully observe the vomiting urges.
If bouts are insufficient, they should be induced again and again by drinking water boiled with long pepper,Amla, mustard and rock salt.

Signs and symptoms

Signs and symptoms indicating the proper action of the drug:  
The first effect of the administration of decoction would be perspiration which indicates that the Dosha has started melting.
After that, the patient would have horripilation which shows that the Dosha has started moving from its own position.
In the third stage patient will have distension of the abdomen indicative of the Doshas having shifted to  the intestine.
Nausea and salivation which occur in the fourth stage are indicate that the Dosha has started moving upwards.

Position of patient

Position of patient during vomiting:
It is at this stage that the patient should be asked to sit on a bed of knee height comfortably, well covered and equipped with bed-sheet, towel, pillow and cushion. A  spittoon should be kept nearby. The caretaker of the patient should support his head, sides, press the navel and massage the back of the patient.

Number of bouts

How many bouts of vomiting?
Heenayoga – Minimum bouts – 4 bouts
Madhyama vega – Moderate – 6 bouts
Atiyoga – Maximum bouts – 8 bouts
Vomiting should be allowed till the appearance- coming out of Pitta. This is appreciated by expulsion of bile or yellow sticky material, at the end. Coming out of Pitta indicates complete expulsion of Kapha Dosha.

Ayoga – inadequate bouts – Non – commencement of bouts, bouts coming on with hindrance or elimination of the medicine only- are the features of inadequate bouts; from it arise, excess of expectoration, itching, appearance of skin rashes, fever etc.

Signs of proper Vamana

Signs of proper administration of Vamana therapy:
Manifestation of the vomiting urges in time
Absence of too much pain
Elimination of Doshas in proper order. Kapha, Pitta and vata coming out in successive order, without any hindrance,
The urge for vomiting will recede on its own, after the Doshas are properly eliminated.
Calmness of the mind and cessation of vomit bouts on its own,
Absence of features of inadequate bouts and
Feeling of not too much of discomfort are the features of samyakyoga- proper bout.

 In Atiyoga- excess bouts the vomited materials will be frothy,  with glistering particles and blood;
The patient will experience weakness, burning sensation, dryness of the throat, giddiness, powerful disease of vata origin and even death due to discharge of life supporting blood.

Signs of inadequate Vamana

Inadequate administration of Vamana therapy: 
Absence of vomiting or occasional vomiting
Vomiting of the drug material only, without the vitiated Kapha Dosha
Excretion of the drug material through purgation
Obstruction to the vomiting urges.
Management: While the therapy is going on, if inadequate symptoms are observed, then patient can be given with repeated dose of Madana phala Kashaya or Yashtimadhu phanta (licorice infusion), so as to induce vomiting. If that also fails, then the patient is made to follow Samsarjana krama (see below), and again within a few days, a quick Vamana therapy is planned.

Over administration of Vamana

Over-emesis may cause the diseases of the head and neck due to the vitiation of Vata and disturbance of speech.
Appearance of foam in the vomit
Appearance of blood streaks in vomit.

Complications of Vamana

The following complications arise out of over administration or inadequate administration of the therapy;
Distension of abdomen,
sawing type of pain,
salivation,
palpitation,
rigidity, and
blood vomiting,
displacement of viscera of the body,
stiffness,
and exhaustion.

Post emesis management

Post emesis management – Care after vomiting therapy
After the therapy has been well-administered, the hands, feet and face of the patient should be washed with warm water
The patient should be consoled.
Made to undergo herbal smoking 
He should then enter into a room which is not exposed to the wind and should lie down there.

Activities to avoid

The patient should abstain from the following for the whole day –
Speaking aloud,
Excess eating,
Sitting at one place for long time,
Walking long distances,
Anger and grief,
Exposure to sun, dew and stormy wind,
Travelling,
Indulging in sexual  intercourse,
Waking up at night, avoiding sleep
sleeping during day time,
foods with opposite qualities, wrong food combinations and
Foods that may cause indigestion,
Intake of diet exclusively having one taste, intake of diet deficient in nutritive value, or heavy or irregularly mixed up
Suppression or forcible initiation of natural urges.

Diet regimen after Vamana

Diet regimen after Vamana treatment
It is also called as Samsarjana Krama. Soon after emesis, the digestive capacity of the patient is very low. Hence, all of a sudden regular diet cannot be introduced. In stead, liquid diet should be started and gradually turning to solids. 
In the same evening or the next day after Vamana, patient should take bath in lukewarm water.

He should be given like- warm gruel (Manda) prepared with well cooked old rice. The gruel should be very thin. This is to be given with due regard to the power of digestion, for three meal-times.
For the fourth meal- time, gruel prepared with rice (Vilepi), well-cooked, warm and devoid of oil / ghee and salt altogether or with oil / ghee and salt in small  quantity is to be given. Warm water is to be taken after the  intake of gruel.

The same type of diet is to be continued for the fifth and sixth meal-times.
For the seventh meal-time again, well-cooked porridge (odana) prepared with the same type of rice of two Prasruta along with a very thin green gram soup (Mudga yusha),  added with oil / ghee and salt in small quantity is to be given.

Warm water should be taken after the intake of the porridge. The same diet is to be repeated for the eight and ninth meal-times. For the tenth meal-time, thin meat-soup  (Mamsarasa) prepared with water and salt should be given. Warm water is to be taken after this.
This is again to be repeated for the eleventh and twelfth meal times. Thereafter, the patient should take food having different tastes  and he should start taking his normal diet from the seventh night.

Another method of Samsarjana

Persons who have had the maximum, medium and minimum purificatory therapies, should consume
Peya- thin Gruel,
Vilepi- thick Gruel,
Akruta Yusa- soup not processed with fat, salt, sours etc.
Krutayusa- Soup processed with fat, salt and Sours and
Rasa- meat juice- in Successive order, for three, two and one Annakala- time of meal respectively.

Note:
Eating periods = Anna Kala.
Each day has two anna kala. – morning and evening.
If the maximum vomiting bouts were observed (Ati Yoga), Then, the patient should take Peya, Vilepi, Akruta Yusha, Kruta Yusha and Mamsarasa – three eating periods (Annakala) each. The patient will not have any food except these. Likewise, for the medium vomiting bouts, the number of eating periods Is two each and for lesser bouts (Heena Yoga), the number of eating periods (Anna kala) is one each.

Benefits of Samsarjana Karma

Just as a spark of fire after being fed by grass, powder of dry cow dung etc, gets augmented gradually and becomes great, steady, and capable of burning everything, similarly, the internal digestion fire, by the Samsarjana regimen, in the patient who has undergone Vamana karma, gains strength.
So, this is how Vamana treatment is administered in patients.

Vamana therapy for a normal person:
It is a must for people with Kapha body type, to undergo Vamana treatment occasionally. Even for other people, Kapha Dosha gets naturally aggravated during spring season. At that time, Vamana is recommended as part of spring cleansing to all.
References:
Charaka Samhita Sutrasthana 15th chapter
Ashtanga Hrudaya Sutrasthana 18th chapter
 

24 thoughts on “Vamana Therapy – Right Method, Side Effects, Management”

  1. Please do write what we should do if there is excessive vomiting after vamanakarma and if the vomiting is more than 15 times. What care should be taken immediately?

    Reply
    • Hi, if there is excess vomiting, Chardi – line of treatment with anti emetics – Sutashekhara Rasa, Eladi Vati, Shankha bhasma etc medicines are administered. Once after vomiting is brought under control, all measures to improve digestion strength of the patient is taken up.

      Reply
  2. Sir /mam plz tell me which karma should I do for pcod with weight gain even though I do exercise & diet restrictions ….I am asked to do vamana…should I do it.??

    Reply
  3. I followed all pre waman kriya and got waman administered by renowned and experienced doctor. However no vomiting took place. Even no vomiting sensation. What is reason what is next action.
    Please advise

    Reply
    • Hi, it can happen sometime. Another vamana should be planned in about 7 days time, with stronger medicines. Consult the same doctor or some other, as per your convenience.

      Reply
  4. Charaka recommends vamana for Udavarta in Trimarmeeya Chikitsasthana Ch26-26. But you as well as Ashtanghridaya contra-indicate vamana for upward movement of air. Upward movement of air could be because of several root causes. When it is caused by suppression of appetite [https://www.easyayurveda.com/2014/05/13/udavarta-reverse-movement-of-vata-dosha-causing-disease/] then cause is likely to be kapha aggravation: accumulation of mucous in stomach. Then, I think vamana is the natural option for treatment. Do you think without vamana treatment of udavarta or reverse movement can be efficient, fast, and complete?

    Thanks,
    Satyan

    Reply
    • Hi, Charaka Chi. 26/26 –
      For Anaha with Ama, along with other Kapha conditions, Vamana is recommended.
      हृत्स्तम्भ मूर्धामय गौरवाभ्यामुद्गा रसङ्गेन सपीनसेन|
      आनाहमाम प्रभवं जयेत्तु प्रच्छर्दनै र्लङ्घन पाचनैश्च||२६||
      hṛtstambha mūrdhāmaya gauravābhyāmudgā rasaṅgena sapīnasena|
      ānāhamāma prabhavaṃ jayettu pracchardanai rlaṅghana pācanaiśca||26||

      Anaha (constipation with bloating) caused by Ama (product of improper digestion), and associated with Hrut stambha (stiffness in the chest), Shiro roga (diseases of the head) Gaurava (heaviness) is treated with Chardana (emesis), Langhana (fasting therapy) and pachana (carminatives)

      Whether diagnosed as anaha or Udavarta, if it is associated with ama and kapha symptoms such as excess heaviness, Vamana can be adopted.

      Reply
  5. Hi, after vamana on 2nd day i ate puran poli a maharashtrian sweet which was not recommended to eat.. what can be the side effects…

    Reply
    • Once after Sansarjana karma is over,
      Avoid –
      tamarind, potato, horse gram, black gram, sour yogurt, radish, excess quantity of milk, Soda, junk foods, aerated drinks, refined sugar, processed foods, orange, lemon, lime, vinegar, mayo, paprika, Tabasco sauce, Worcestershire sauce, and ketchup
      Avoid direct sunlight. Use an umbrella.
      Avoid plastic and metal contact to skin.

      Have more of
      green gram, ghee, wheat, grapes, raisin, drum stick, banana, barley, buttermilk, lentil, nutmeg, rice.
      Wear cotton cloths and avoid synthetic ones.

      Please note that stress, a virus attack etc increase the chances of recurrence. Hence, having controlled diet and disciplined lifestyle with simple Yoga and Pranayama exercises will be crucial in avoiding recurrent attacks.

      Practice Pranayama for 3 minutes everyday – easyayurveda.com/2010/08/28/how-to-do-pranayama-a-simple-pranayama-technique/

      Reply
  6. First time i did vaman at home and there was little blood during vaman.
    Is there any reason to worry.

    Reply
  7. I’m pcos with fibroid patient , dey asked me to do vamana, is it good for me bcz I want to get pregnant soon , vil it help me in getting pregnant aftr dis treatment in Ayurvedic centre ?

    Reply
  8. Thanku doctor. I have tried all English medicine , treatment iui too fr 3yrs , still cudnt get pregnant. Later my ovaries stopped ovulating evn thru medicine n formed follicular cysts to hemorrhagic. It’s so frustrating . My last hope s thru Ayurvedic, I jus hope it works, can u suggest me what treatment s best fr me along wd vamana?

    Reply
  9. Hello Doctor, I appreciate all of you knowledge. I am curious as to why you recommend specifically “meat juice” be introduced back into the system once one has cleared it of its’ Ama? This would seem to be a perfect time to separate the patient from these tamasic foods and place them on a diet that is going to be more physically and spiritually beneficial. Especially all that we know now, although we knew much on a spiritual level about consumption of animals for thousands of years, now we have modern medical proof that this is without doubt a major cause of most of our chronic diseases. There are many substitutions for Rasa or if you simply been nourishing broth that would provide not just simply calories, fat in the form of cholesterol and animal protein, but could provide many beneficial phytonutrients and antioxidants without the cholesterol or harmful animal proteins.

    Reply

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