Emesis

🌿 Understanding Emesis Therapy in Ayurveda

Emesis therapy (therapeutic vomiting) is an Ayurvedic detoxification procedure primarily used to eliminate excess Kapha dosha from the body. It helps with respiratory conditions, digestive disorders, and various Kapha-related ailments. The procedure involves proper preparation, administration of specific substances to induce vomiting, and important post-therapy care. While beneficial for certain conditions, emesis therapy is contraindicated in several situations and should be performed under proper guidance.

What is Emesis? 💫

Emesis refers to the therapeutic expulsion of malas (waste products) or doshas through the oral route via controlled vomiting. In Ayurvedic detoxification (Panchkarma), emetic substances are used to induce vomiting for cleansing the abdomen of toxins.

Timing Considerations ⏰

Seasonal Timing:

• Can be performed throughout the year
• Avoid during: Severe winter and extreme summer

Daily Timing¹:

• Best time: Morning (when Kapha dosha is naturally active)
• Should be done on an empty stomach
• Previous night's dinner should be light and easily digestible

Foods Permitted for Those Feeling Excessively Hungry Before the Procedure¹:

• Warm milk
• Rice gruel mixed with ghee
• Sugarcane juice
• Meat soup

Dosha Connection ⚖️

• Primary benefit: Best procedure for elimination of excess Kapha
• Secondary benefit: Can treat Pitta disorders

Therapeutic Uses 🌡️

Respiratory Conditions:

• Lung congestion causing cough
• Bronchial asthma
• Tonsillitis, cold
• Inflammation of nose and sinuses
• Pus formation in nose, mouth, lips and ears

Digestive Issues:

• Nausea
• Loss of appetite
• Indigestion
• Diarrhea

Other Conditions:

• Obesity-related diseases
• Anemia
• Dermatitis, boils, skin-related issues
• Urinary disorders
• Excessive sleeping, drowsiness
• Epilepsy and insanity

Pre-Emesis Preparation 🔄

Objective: To aggravate and liquefy Kapha in the body

1. One day before therapy:
   • Oleation Therapy (application of oils)
   • Fomentation therapy (heat application) on chest and back
   • Consume Kapha-increasing diet with adequate salt
   • Note: Oleation therapy is mandatory for this treatment¹

Emesis Procedure 🧪

Using Medicinal Herbal Paste¹:

Ingredients:

• Emetic Nut (Madana Phala) - 2 tsp
• Vacha - ½ tsp
• Pippali (Long Pepper) - 1 tsp
• Rock salt - ½ tsp
• Honey - 1 tsp (acts as catalyst)

Method:

1. Mix ingredients with warm water to make a thick paste
2. Sit on folded knees or a knee-height chair
3. Drink 4-5 glasses of milk quickly until feeling full
4. Drink one more glass of milk mixed with 1 tsp of the medicated paste
5. Vomiting should begin; if not, stimulate by inserting fingers into throat
6. Rinse mouth and face with warm water between episodes
7. Continue without excessive breaks until completion signs appear
8. Support may be needed for forehead, shoulders, and abdomen
9. Back massage may help during the process

Using Decoction of Emetic Substances:

Substance Selection Based on Dosha:

• For Kapha: Pungent, penetrating, hot potency substances
• For Pitta: Sweet and cold potency substances
• For Kapha-Vata: Sweet, salty, sour, and hot potency substances

Common Emetic Substances:

• Rock salt and honey
• Licorice root
• Margosa
• Bitter sponge/bottle gourd
• Long pepper
• Cardamom
• Bitter oleander

Dosage of Decoction:

• High dose: 7 liters
• Medium dose: 4.5 liters
• Low dose: 1.5 liters

Method:

1. Sit in recommended posture while drinking the decoction
2. When nausea begins, use middle and index fingers or a smooth castor twig to stimulate the tongue
3. Generally, 4-8 vomiting episodes occur

Signs of Completion¹ ✅

• Vomit becomes frothy with no visible mucus
• Sound produced during vomiting increases
• Yellowish bile becomes visible in vomit

When to Stop Early¹ ⚠️

• If the person feels excessively weak during the process

Signs That Vomiting Is About To Begin¹ 🔍

These signs typically occur in quick succession:

1. Sweating: Indicates toxins in deep tissues are melting
2. Horripilation (goosebumps): Toxins moving out of tissues
3. Abdominal distention: Toxins accumulating in the alimentary tract
4. Excess salivation: Toxins moving upward

Post-Emesis Care 🌱

Immediate Measures:

• Perform Dhuma Pana (medicated smoke inhalation) to clear mucus from eyes, ears, nose, and throat¹
• Take a warm shower¹
• Rest and sleep (even during daytime is permitted)¹
• When hungry, eat light, warm, lubricating foods:
  • Vegetable soup
  • Boiled rice
  • Green Gram

Follow These Guidelines for Several Days:

• Avoid cold drinks and cool substances
• Refrain from strenuous physical exercise and sexual activity
• Control anger
• Avoid exposure to extreme environments (sun, wind, cold, rain, pollution)¹
• No daytime sleeping (except on the day of emesis)¹
• Don't suppress natural urges (thirst, hunger, etc.)
• Eat proper meals at appropriate times without overeating¹
• Avoid speaking loudly

Contraindications ❌

Strictly Prohibited For:

• Children
• Elderly
• Debilitated or fragile individuals
• Fearful people

Other Contraindications:

• Emaciation, hunger
• Heart conditions
• Lung cavities
• Bleeding from upper body channels
• During menstruation or pregnancy
• While grieving
• Fear or difficulty in vomiting
• Dry body constitution
• Jaundice, worm infestation
• Vata-related disorders
• Loss of speech¹
• Abdominal tumors or enlargement¹
• Pulsating headaches¹
• Reverse peristalsis¹
• Burning sensations in the chest¹
• Recent enema therapy¹
• Prostate enlargement¹

Note: In cases of Kapha aggravation with these conditions, mild emesis may be considered, except in strictly prohibited cases.

Signs of Successful Therapy 🌟

• Body feels light, fresh, and energetic
• Lightness in heart, throat, head, and whole body
• May feel some tightness in the chest despite overall lightness¹

Benefits of Emesis¹ 💪

• Reduced depression and increased mental calmness
• Decreased heaviness and congestion
• Improved sensory function
• Enhanced digestion
• Relief from Kapha-related disorders
• Reduced body pain

Complications from Excessive Emesis¹ 🚫

• Dehydration
• Vomit color changing from yellow to green to red
• Throat inflammation and burning sensation
• Fainting
• Weakness
• Dizziness and darkened vision
• Various Vata disorders
• Insomnia
• Heart pain
• Potentially fatal if continued despite warning signs

Signs of Incomplete Emesis¹ ⚠️

• Persistent heaviness and dullness in the body
• Itching sensation on the skin
• Feverish feeling
• Channels remain impure
• Only medicine expelled in vomit

If Full Benefits Are Not Achieved¹ 🔄

• The procedure can be repeated after 15 days with proper preparation

Should Healthy People Undergo Emesis?¹ 🤔

• Generally, not recommended for completely healthy individuals
• Primarily indicated for Kapha aggravation conditions
• Exceptions are emergency situations

Emergency Indications¹ 🚨

In these cases, emesis can be performed without preparatory procedures:

• Poison ingestion
• Consumption of incompatible foods
• Indigestion causing body sluggishness
• Bleeding from lower body openings
• Chronic diarrhea

References:

Primary Source: Acharya Balkrishna: A Practical Approach to The Science of Ayurveda - A Comprehensive Guide for Healthy Living - Chapter - Treatment Methods 

1. School of Ayurveda and Panchkarma - Lectures and Notes