ततस्तं पुरुषं स्नेहस्वेदोपपन्नमनुपहतमनसमभिसमीक्ष्य सुखोषितं सुप्रजीर्णभक्तं शिरःस्नातमनुलिप्तगात्रं स्रग्विणमनुपहतवस्त्रसंवीतं देवताग्निद्विजगुरुवृद्धवैद्यानर्चितवन्तमिष्टे नक्षत्रतिथिकरणमुहूर्ते कारयित्वा ब्राह्मणान् स्वस्तिवाचनं प्रयुक्ताभिराशीर्भिरभिमन्त्रितां मधुमधुकसैन्धवफाणितोपहितां मदनफलकषायमात्रां पाययेत्|| (Cha. Su. 15/9)

The Vāmaka Yoga  should be administered on an auspicious day, Karaṇa and Muhūrta after the patient has undergone Abhyaṅga and Svedana procedures, patient had a sound sleep with peaceful mind, patient has digested previous day’s food well, anointed his body, taken head bath, worn a garland and untorn cloth, worshipped  the Deity, fire, Brāhmana, Guru, elders and the physicians, being blessed by the chanting of the brahmins

अथ च्छर्दनीयमातुरं द्व्यहं त्र्यहं वा स्नेहस्वेदोपपन्नं श्वश्छर्दयितव्यमिति ग्राम्यानूपौदकमांसरस–क्षीर–दधि–माष–तिल–शाकादिभिः समुत्क्लेशितश्लेष्माणं व्युषितं जीर्णाहारं पूर्वाह्णे कृतबलिहोममङ्गलप्रायश्चित्तं निरन्नमनतिस्निग्धं यवाग्वा घृतमात्रां पीतवन्तं, (Cha. Ka 1/14)

Abhyaṅga followed by Svedana should be done for 2 or 3 days before Vamana. The patient should be fed with gramya, anupa and audaka mamsarasa, ksheera, dadhi, masha, tila and saka in the night prior to vamana, in order to excite kapha. Next day when the diet on previous day get digested properly, after performing offering, oblations, auspicious and expiatory rites, he should be in empty stomach or can take Yavāgu mixed with Ghṛta which is not too unctuous.

AKAṆṬHAPĀNA

वृद्धबालाबलक्लीबभीरून् रोगानुरोधतः|
आकण्ठं पायितान्मद्यं क्षीरमिक्षुरसं रसम्|| (A. H. Su. 18/14)

If the patient is aged, child, delicate, coward, having fear of Vamana ask him to drink either wine, milk, sugarcane juice, or mutton soup for Akaṇṭhapāna.

तासां फलपिप्पलीनामन्तर्नखमुष्टिं यावद्वा साधु मन्येत जर्जरीकृत्य यष्टिमधुकषायेण कोविदार–कर्बुदार–नीप–विदुल–बिम्बी–शणपुष्पी–सदापुष्पी–प्रत्यक्पुष्पी–कषायाणामन्यतमेन वा रात्रिमुषितं विमृद्य पूतं मधुसैन्धवयुक्तं सुखोष्णं कृत्वा पूर्णं शरावं मन्त्रेणानेनाभिमन्त्रयेत्

Antarnakhamuṣṭi Pramāna of Madanaphala should be soaked in the Kvātha of Vamanopaga drugs such as Yaṣṭīmadhu (Glycyrrhiza glabra), Kovidāra (Bauhinia purpurea), Karbudāra (Bauhinia varigata), Nīpa (Anthocephalus cadamba), Vidula (Barringtonia acutangula), Bimbi (Coccinia indica), Śaṇapuṣpī (Crotalaria verrucose), Sadāpuṣpi (Calotropis gigantea), Pratyakpuṣpi (Achyranthes aspera).

पीतवन्तं तु खल्वेनं मुहूर्तमनुकाङ्क्षेत, तस्य यदा जानीयात् स्वेदप्रादुर्भावेण दोषं प्रविलयनमापद्यमानं, लोमहर्षेण च स्थानेभ्यः प्रचलितं, कुक्षिसमाध्मापनेन च कुक्षिमनुगतं, हृल्लासास्यस्रवणाभ्यामपि चोर्ध्वमुखीभूतम्…. (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.

अथास्मै जानुसममसम्बाधं सुप्रयुक्तास्तरणोत्तरप्रच्छदोपधानं सोपाश्रयमासनमुपवेष्टुं प्रयच्छेत्, प्रतिग्रहांश्चोपचारयेत्, लालाटप्रतिग्रहे पार्श्वोपग्रहणे नाभिप्रपीडने पृष्ठोन्मर्दने चानपत्रपणीयाः सुहृदोऽनुमताः  प्रयतेरन्||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– विवृतोष्ठतालुकण्ठो नातिमहता व्यायामेन वेगानुदीर्णानुदीरयन् किञ्चिदवनम्य ग्रीवामूर्ध्वशरीरमुपवेगमप्रवृत्तान् प्रवर्तयन् सुपरिलिखितनखाभ्यामङ्गुलिभ्यामुत्पलकुमुदसौगन्धिकनालैर्वा कण्ठमभिस्पृशन् सुखं प्रवर्तयस्वेति, स तथाविधं कुर्यात्; ततोऽस्य वेगान् प्रतिग्रहगतानवेक्षेतावहितः, वेगविशेषदर्शनाद्धि कुशलो योगायोगातियोगविशेषानुपलभेत, वेगविशेषदर्शी पुनः कृत्यं यथार्हमवबुध्येत लक्षणेन; 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)