Vamana is therapeutic emesis: medically supervised vomiting, brought on by herbal preparations, that clears excess Kapha from the stomach and the upper respiratory tract. It is the first of the five purification procedures of Panchakarma. Classical Ayurveda calls it the main treatment for disorders rooted in Kapha, the dosha of heaviness, mucus and fluid retention.
In Sri Lanka, Vamana is performed only at Ayurvedic hospitals and treatment centres, under a qualified physician. It is never a spa treatment and never a do-it-yourself detox.
What is Vamana used for?
Classical texts recommend Vamana when Kapha has built up and settled in the chest and stomach. Physicians most often consider it for:
- chronic respiratory complaints such as recurrent bronchitis, asthma that is not in an acute attack, and persistent congestion
- allergic rhinitis and chronic sinus congestion
- skin conditions associated with Kapha, including some forms of psoriasis and eczema
- sluggish digestion, loss of appetite and nausea after heavy food
- weight gain and metabolic conditions that Ayurveda groups under prameha
Kapha naturally rises in spring, so that is the classical season for Vamana. In practice, the physician decides the timing for each patient.
How is Vamana prepared?
Vamana always comes after a preparatory phase (purvakarma) that loosens accumulated Kapha and moves it towards the stomach:
- Internal oleation (snehapana): rising doses of medicated ghee, taken each morning for about three to seven days, until the physician sees the signs of adequate oleation.
- External oleation and sweating: a full-body oil massage (abhyanga, see Ayurveda body massage) followed by herbal steam (swedana, see Ayurveda herbal steam bath).
- The evening before: a deliberately Kapha-increasing meal, such as curd, rice or black gram, so that the Kapha is ready to be expelled.
What happens on the day of treatment?
Vamana is done early in the morning, the time of day classically associated with Kapha. After another massage and steam, the patient drinks generous amounts of milk, sugarcane juice or a liquorice decoction to fill the stomach. The physician then gives the emetic preparation. Its principal herb is madanaphala, the fruit of Catunaregam spinosa, usually combined with liquorice (Glycyrrhiza glabra) and sweet flag (Acorus calamus), with honey and rock salt.
Within a short time the patient vomits several times. The physician counts the bouts (vega), checks what is brought up, and stops when Kapha is followed by bile. Classical texts grade the result: eight bouts for a full response, six for a moderate one and four for a mild one. Pulse, blood pressure and general strength are watched throughout.
What happens after Vamana?
Recovery is part of the treatment. Afterwards the patient rests, may inhale medicated smoke (dhumapana) to clear the remaining Kapha from the head and throat, and then follows a graded diet (samsarjana krama) for several days. The diet starts with thin rice gruel and moves slowly to soups, soft rice and normal meals as digestion recovers. Cold drinks, heavy food, daytime sleep, exertion and long journeys are avoided during this period. See also Ayurvedic diet.
Who should not have Vamana?
Vamana is one of the more demanding Panchakarma procedures, so the exclusions are strict. Physicians generally do not prescribe it for young children, the elderly or frail, pregnant women, or people with heart disease, uncontrolled high blood pressure, bleeding disorders, recent gastrointestinal bleeding, hernia, or severe weakness or emaciation. A full consultation, often with pulse diagnosis and a review of current medicines, comes first.
This page describes a traditional medical procedure for general information. It is not medical advice. Vamana should only ever be performed by a registered Ayurvedic physician.
Where can I have Vamana in Sri Lanka?
Residential Panchakarma programmes at Ayurvedic hospitals and resorts include Vamana when the physician judges it suitable. A full course, with preparation, the procedure and recovery, usually needs at least ten to fourteen days, so it is best planned as part of a longer stay. Browse Ayurveda tours and Ayurvedic doctors, or read about Sri Lanka's own healing tradition in Hela Wedakama.
The five Panchakarma therapies
This page is part of our guide to Panchakarma, Ayurveda's five purification therapies:
