तद्यथा- दृढं निवातं प्रवातैकदेशं सुखप्रविचारमनुपत्यकं धूमातपजलरजसामनभिगमनीयमनिष्ठानां च शब्दस्पर्शरसरूपगन्धानां सोदपानोदूखलमुसलवर्चःस्थानस्नानभूमिमहानसं वास्तुविद्याकुशलः प्रशस्तं गृहमेव तावत् पूर्वमुपकल्पयेत्||                                                                                                                                  (Cha. Su. 15/6)

The Vamana building should be well built with good ventilation, comfortable moving space and at a distance from big buildings.It should be devoid of smoke, excess wind, sunlight, moisture, dust, undesirable noise, contacts, taste, sight and smell. The building should be equipped with a water reservoir or water  pot, mortar – pestle, latrine, bathroom and kitchen.

SambhāraSangraha

ĀturaParīkṣā

• Carefully examine the patient and asses the condition whether the patient is Yogya or Ayogya for Vamana.
• Ekādaśa, Daśavidha and AṣṭavidhaParīkṣā should done prior to the procedure
• GIT , RS, CVS & CNS examinations should done.
• Pulse, Blood Pressure, temperature and respiratory rate should be monitored before, during and after the procedure.
• To rule out the suspected cardiac disease involvement, then pathological, biochemical and ECG investigations can be used.

Mātrā Nirṇaya

DĪPANA PĀCANA

पाचनैर्दीपनैःस्नेहैस्तान्स्वेदैश्चपरिष्कृतान्||
शोधयेच्छोधनैःकालेयथासन्नंयथाबलम्|                  (A. H. Su. 13/29)

Vitiated Doṣas should be expelled from the body in the state of Nirāma only, after administering thecarminative and digestive drugs. Then oleation, sudation and followed by purificatory measures inaccordancewith thelocation and strength of theDoṣas .

सर्वदेहप्रविसृतान् सामान् दोषान् न निर्हरेत्|
लीनान् धातुष्वनुत्क्लिष्टान् फलादामाद्रसानिव||
आश्रयस्य हि नाशाय ते स्युर्दुर्निर्हरत्वतः|                         (A. H. Su. 13/28)

Doṣas should not be eliminated forcefully in conditions like Doṣas are mixed with Āma, and are circulating all over the body and may be accumulated in the tissues and also not in the state of UtkliṣṭaAvasthā. such an attempt is similar to taking the juice from an unripe fruit, which cause harm to the body.

ĀcāryaVāgbhaṭa opined that by ŚodhanaAuṣadhī, if removing Doṣas in the presence of Āma it will destroy the body. Therefore prior to the Snehapāna/Śodhana,Pācana – Dīpana should be carried out. Mainly Yogas like TrikaṭuCūrṇa, ŚuṇṭhīCūrṇa, CitrakādiVati, AgnitundiVati are using.

अजीर्णे वर्धते ग्लानिर्विबन्धश्चापि जायते|
पीतं संशोधनं चैव विपरीतं प्रवर्तते||                    (Cha. Si. 6/14)

If administering SamśodhanaAuṣadhīs in the conditions of Ajīrṇa it will leads to Vibandha and Glāni. Proper Śodhana can’t achieve in the presence of Āma.

मांसला मेदुरा भूरिश्लेष्माणो विषमाग्नयः||
स्नेहोचिताश्च ये स्नेह्यास्तान् पूर्वं रूक्षयेत्ततः|
संस्नेह्य शोधयेदेवं स्नेहव्यापन्न जायते||                         (A. H. Su. 16/36)

In persons having Māṃsala, Medura, Bahu Kapha, Viṣamāgni and Sneha Sātmya, beforeĀbhyantaraSnehapāna, Rūkṣanahas to bedoneto preventSnehaVyāpat.

मन्दाग्निंक्रूरकोष्ठंचसक्षारलवणैर्घृतैः||
सन्धुक्षिताग्निंविजितकफवातंचशोधयेत्|                                 (A. H. Su. 18/52)

Those who are having weak digestive power and costive bowels (KṛuraKoṣṭha) should be givengheeprocessedwithalkaliesandsaltspriortotheadministrationofpurificatorydrugstorestorethepowerof digestion as well as toconquer Kaphaand Vāta.

विषाभिघातपिटिकाकुष्ठशोफविसर्पिणः|
कामलापाण्डुमेहार्तान्नातिस्निग्धान्विशोधयेत्||

सर्वान्स्नेहविरेकैश्च,रूक्षैस्तुस्नेहभावितान्|                                 (A.H. Su. 18/56)

Persons who are suffering from Viṣa (poison), Abhighāta (injury), Pitika (boils), Kuṣṭha (skindisorders), Śopha (swelling), Visarpa (herpes), Kāmala (jaundice), Pāndu (anemia), Meha (diabetes)etc.should beadministered śodhanadrug after mild oleation.

All the above should be given SnigdhaVirecana and those who are unctuous should be given RūkṣaVirecana

कर्मणांवमनादीनांपुनरप्यन्तरेऽन्तरे||
स्नेहस्वेदौप्रयुञ्जीत,स्नेहमन्तेबलायच|                            (A. H. Su. 18/57)

In between emesis and other purificatory therapies oleation and sudation should be conducted and at the end of purification again oleation is advised to gain strength

DIET DURING SNEHAPĀNA

भोज्योऽन्नंमात्रयापास्यन्श्वःपिबन्पीतवानपि|
द्रवोष्णमनभिष्यन्दिनातिस्निग्धमसङ्करम्||                           (A. H. Su. 16/25)

Take proper quantity of food which is simple, hot and liquid in nature, containing only little fat  and not obstructing the channels.

SNEHANA AND SVEDANA

स्नेहमग्रे प्रयुञ्जीत ततः स्वेदमनन्तरम्|
स्नेहस्वेदोपपन्नस्य संशोधनमथेतरत् ||                                (Cha. Su. 13/99)

Snehana is required to be administered first, then fomentation therapy is to be administered, finally Śodhanatherapyis to be administered after the administration of Snehana and Svedana.

स्निग्धात् पात्राद्यथा तोयमयत्नेन प्रणुद्यते|
कफादयः प्रणुद्यन्ते स्निग्धाद्देहात्तथौषधैः||                                       (Cha. Si. 6/11)

Ācārya Caraka says that by proper Snehana and Svedana prior to the Śodhana helps the vitiated KaphaDoṣās to easily reaches the Koṣṭha, like how water moves easily through the vessel coated with layer of Sneha Dravya.

ĀcāryaCakrapāṇi opined that the Snehana guna helps to increase “DravaGuṇa” to transfer the vitiated Doṣās.

स्नेहस्वेदावनभ्यस्य यस्तु संशोधनं पिबेत् |
दारु शुष्कमिवानामे देहस्तस्य विशीर्यते ||                          (Su. Chi 33/46)

ĀcāryaSuśruta says that, without proper Pūrvakarmas like Snehana and Svedana the Samśodhana Auṣadhi and the hazardous afflictions produced by the procedure can destroy the body easily like the dried wood.

मलो हि देहादुत्क्लेश्य ह्रियते वाससो यथा||
स्नेहस्वेदैस्तथोत्क्लिष्टः शोध्यते शोधनैर्मलः|                         (A. H. Su.18/58)

Ācārya Vāgbhaṭa says that during Śodhana the Doṣās are removed from the body by Snehana and Svedanain the same way as dirt in the cloth is removed with the help of soap and hot water.

स्नेहनैर्व्याधितस्थानाद्रसैश्चाभ्यधिकीकृता।

स्वेदैर्मृदुकृतास्सन्तःस्रोतसाचसमागता॥

मृदुसर्वाङ्गकोष्ठस्यभेषजैश्शुचिभिस्तदा।

दोषास्सुनिर्हराजन्तोर्वमन्तीतिविनिश्चयः॥                                       (Bhela Samhita)

It is very certain that in a person all the morbidities become easily removable, when these aredisplaced by unction, made augmented by assimilable essence of the food, rendered softened by sudation and thus reached from everywhere to the channels and made cleansed up by medicines.

MānasaUpacāra

• Counselling before Vamana
• It helps to clarify the misleads regarding the procedure Vamana, by that physician can carry out the procedure of Vamana smoothly.
• Before Vamana instructions regarding the procedures like DīpanaPācana, SnehanaSvedana should be clearly given to the patient.
• Patient should be educated with the benefits of Vamana procedure.

Vamana Pūrvā BhojanaVyavastha

श्वश्छर्दयितव्यमिति ग्राम्यानूपौदकमांसरस-क्षीर-दधि-माष-तिल-शाकादिभिः समुत्क्लेशितश्लेष्माणं …||                                                                                                                 (Cha. Ka. 1/9)

The meat of the animals of Grāmya, Anūpa, and Audaka origin, the diets prepared out of milk and its by products; Tila, black gram, curds, milk , jaggery, fishes, Māmsarasacan be given to the patient. These above mentioned UtkleśakaraĀhārahelps Doṣas which are provoked due to proper Snehana and Svedana to move towards Koṣṭha due to their similar nature with these diet. This diet also has the property to excite Kaphādi Doṣa and to minimize the pain and discomfort during Vamana.