पीतवन्तं तु खल्वेनं मुहूर्तमनुकाङ्क्षेत, तस्य यदा जानीयात् स्वेदप्रादुर्भावेण दोषं प्रविलयनमापद्यमानं, लोमहर्षेण च स्थानेभ्यः प्रचलितं, कुक्षिसमाध्मापनेन च कुक्षिमनुगतं, हृल्लासास्यस्रवणाभ्यामपि चोर्ध्वमुखीभूतम्, अथास्मै जानुसममसम्बाधं सुप्रयुक्तास्तरणोत्तरप्रच्छदोपधानं सोपाश्रयमासनमुपवेष्टुं [१] प्रयच्छेत्, प्रतिग्रहांश्चोपचारयेत्, लालाटप्रतिग्रहे पार्श्वोपग्रहणे नाभिप्रपीडने पृष्ठोन्मर्दने चानपत्रपणीयाः सुहृदोऽनुमताः प्रयतेरन्||                                               (Cha. Su 15/11)

After administration of the decoction, the patient should be observed for one Muhūrta (approximately 48 minutes). The first noticeable effect will be perspiration indicating liquification of Doṣa. Thereafter, the patient would exhibit horripilation showing movement of Doṣa from its own position. The third stage will produce distension of the abdomen indicative of the Doṣas having shifted to the gut. Nausea and salivation occur in the fourth stage, indicating the upward movement of Doṣa.

अथास्मैजानुसममसम्बाधंसुप्रयुक्तास्तरणोत्तरप्रच्छदोपधानंसोपाश्रयमासनमुपवेष्टुंप्रयच्छेत्, प्रतिग्रहांश्चोपचारयेत्, लालाटप्रतिग्रहेपार्श्वोपग्रहणेनाभिप्रपीडनेपृष्ठोन्मर्दनेचानपत्रपणीयाःसुहृदोऽनुमताःप्रयतेरन्||११||

(Cha. Su. 15/11)

After the administration of Vamana drug, the patient is allowed to sit on a comfortable knee height chair which is furnished well with bed-spreads, coverlets, cushions and pillows.  Spittoons should be laid nearby and during the whole process he should be watched carefully. Affectionate and sympathetic friends before whom the patient is free from shyness, should endeavor to hold his forehead, to support his sides, to press his navel and to massage his back to facilitates emesis.

अथैनमनुशिष्यात्- विवृतोष्ठतालुकण्ठोनातिमहताव्यायामेनवेगानुदीर्णानुदीरयन्किञ्चिदवनम्यग्रीवामूर्ध्वशरीरमुपवेगमप्रवृत्तान्प्रवर्तयन्सुपरिलिखितनखाभ्यामङ्गुलिभ्यामुत्पलकुमुदसौगन्धिकनालैर्वाकण्ठमभिस्पृशन्सुखंप्रवर्तयस्वेति, सतथाविधंकुर्यात्; ततोऽस्यवेगान्प्रतिग्रहगतानवेक्षेतावहितः, वेगविशेषदर्शनाद्धिकुशलोयोगायोगातियोगविशेषानुपलभेत, वेगविशेषदर्शीपुनःकृत्यंयथार्हमवबुध्येतलक्षणेन; तस्माद्वेगानवेक्षेतावहितः ||                                                                                                               (Cha. Su. 15/12)

Then, he should be instructed to vomit without straining excessively by aiding the activated urge for vomiting, by opening wide the lips, the palate and the throat, by slightly bending the upper part of the body, by exciting the dormant urge, by tickling the throat with two well-manicured fingers or with stalks of blue lily, night lotus or white water lily; and the patient should do as bidden.

Next, the physician should carefully examine the vomited matter collected in the spittoon, because the expert finds out the particulars of the proper, improper or over administration by carefully examining the vomited matter. He who has examined the particulars of the vomited matter, knows from its nature, the necessary after-treatment. Therefore, the vomited matter should be carefully examined.

Vega Nirīkṣaṇa and Nirṇaya

जघन्यमध्यप्रवरे तु वेगाश्चत्वार इष्टा वमने षडष्टौ||
दशैव ते द्वित्रिगुणा विरेके प्रस्थस्तथा द्वित्रिचतुर्गुणश्च|
पित्तान्तमिष्टं वमनं विरेकादर्धं कफान्तं च विरेकमाहुः||
द्वित्रान् सविट्कानपनीय वेगान्मेयं विरेके वमने तु पीतम्|                 (Cha. Si. 1/13-14)

The desirable number of Vega (bouts) in Vamana Karma are 8, 6 and 4 in PravaraŚuddhi, MadhyamaŚuddhi and AvaraŚuddhi respectively, and they are 30, 20 and 10 in case of Virecana.

In terms of quantity, it is 2 Prastha, 1 ½ Prastha and 1 Prastha in case of Vamana and 4 Prastha, 3 Prastha and 2 Prastha in Virecana.

Vamana should be conducted till the appearance of pitta as well as getting proper signs and symptoms of emesis. Similarly Virecana should be conducted till the appearance of Kapha as well as getting proper signs and symptoms of purgation. While counting the number of bouts in case of Virecana, one has to start counting by leaving the first 2-3 bouts. In case of Vamana the counting of bouts should be started after the expulsion of the emetic drug.

सुख़ादागतःप्रतिगाहप्राप्तोवेगउच्यते||                    (A. S. Su. 27/17, Indu commentary)

Vega is defined as the bout which is collected in a bowl after an effortless vomiting.

उपवेगंवेगसमीपम् |                                (Cha. Su. 15/12, Chakrapani commentary)

Upavega is nearer to Vega.

The Vega and Upavegacan be differentiated by the quantity of vomitus, force of vomiting and duration ofvomiting.MorequantityofvomitusseeninVegaandlessquantityinUpavega.Vegaiseffortlessandeasy expulsion of vomitus, Upavegais expulsion of vomitus with effort. In Vega, bouts come in a breakless stream suddenly in a very little time whereas in Upavega slow expulsion of vomitus with interval.

In case of Vamana the counting of bouts should be started after the expulsion of the emetic drug. The Vega which is induced immediately after the drug administration is due to Hṛllasaand ĀsyaSrāva. Hence thisVegashould notbetaken.

Pratigraha is a bowl in which the vomitus is collected. After Vamana it is weighed by pouring into a vessel with measurement.