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Charaka Samhita, Siddhisthana 1.16
Vamane sramsane kapha pittam hridi sthitam / Shodhyate urdhvagati karma vamanamahurmunayah — Vamana eliminates Kapha and Pitta situated in the heart (chest region) through upward movement. The sages call this upward-moving elimination Vamana.

Classical indications

Charaka Samhita, Siddhisthana 1 documents Vamana as specifically indicated for: Kaphaja Kasa (Kapha-type cough), Shwasa (dyspnoea, particularly Kaphaja type), Kushtha (Kaphaja and Pittaja skin conditions), Prameha (metabolic conditions with Kapha involvement), Arsha (haemorrhoids from Kapha), Mukhapaka (oral conditions), eye and nasal diseases involving Kapha, and as the seasonal Vasanta procedure for all individuals with significant Kapha accumulation.

Preparatory procedures — Purvakarma for Vamana

3–7 days before

Internal Snehana — Snehapana

Progressive oral administration of medicated ghee (Ghrita) on empty stomach in increasing doses (typically 3–12 tablespoons over 3–7 days until Samyak Snigdha — complete oleation signs are present: unctuousness of skin and stool, loss of appetite for oily foods, and lightness). The ghee loosens Ama and Kapha from deep tissues, moving it into the gastrointestinal tract where Vamana can access it.

Daily before main procedure

External Snehana and Swedana

Full body Abhyanga (oil massage) followed by Sarvanga Bashpa Sweda (full-body steam) each day of Purvakarma. This opens the skin channels and moves the ghee-loosened Doshas progressively toward the GI tract.

Night before Vamana

Kapha-increasing meal

The evening before Vamana, the patient is given a Kapha-promoting meal — typically curd, milk, sweet foods, and Kapha-increasing substances. This draws accumulated Kapha into the stomach, making it maximally accessible for the next morning's emesis.

The Vamana procedure

Morning of Vamana

Administration of emetic preparation

The patient drinks the classical emetic preparation — typically Madanaphala (Randia dumetorum) decoction, or Yashtimadhu (licorice) decoction with honey, milk, and other specified ingredients per the classical formulation. These emetic herbs are specifically documented as producing vomiting through stimulation of the upper gastrointestinal mucosa rather than systemic toxicity.

During procedure

The Vega count

The procedure is measured in Vega (episodes of vomiting). Charaka Samhita documents: Pravara (maximum — 8 Vega, clear yellow bile visible, indicating complete Kapha elimination); Madhyama (moderate — 6 Vega); Avara (minimum — 4 Vega). The practitioner monitors and determines when to stop based on the quality and completeness of the emesis.

After Vamana

Dhoomapana — medicated smoke

After the procedure, the patient inhales medicated smoke through specially prepared tubes. Charaka Samhita documents Dhoomapana as clearing any residual Kapha from the upper respiratory channels and stabilising the post-emesis state.

Samsarjana Krama — dietary restoration
Charaka Samhita Siddhisthana documents the post-Vamana diet protocol in detail — progressing over 3–7 days from: Peya (thin rice gruel) → Vilepika (thick gruel) → Akrita Yusa (thin lentil soup) → Kritanna (soft cooked food) → normal diet. This sequence allows the Agni, which has been reset by Vamana, to rebuild progressively without being overwhelmed.
Contraindications
Charaka Samhita documents Vamana as contraindicated in: Vataja conditions (Vamana further depletes Vata); exhaustion; excessive hunger or thirst; immediately after meals; pregnancy; children under 12 and elderly over 70; severe emaciation; cardiac conditions; severe bleeding disorders; and active fever. These are absolute contraindications — the procedure should not be performed in these situations under any circumstances.