VAMANA KARMA (THERAPEUTIC EMESIS) IN AYURVEDA: CLASSICAL RATIONALE, PROCEDURE, CLINICAL EVIDENCE AND CONTEMPORARY RELEVANCE – A NARRATIVE REVIEW
Background: Vamana Karma is the Panchakarma procedure of therapeutic emesis, classically indicated for conditions dominated by Kapha. Although widely practised, its evidence base is scattered across case reports, small observational studies and a few protocols. Objective: To summarise the classical rationale and procedural framework of Vamana and to appraise the contemporary clinical literature on its safety and effects. Methods: A narrative review based on a PubMed search and on consultation of classical texts. Studies were synthesised descriptively. Findings: Classical texts describe Vamana as a staged procedure of preparation (Deepana-Pachana and Snehapana), the main emesis, and graded post-procedure diet. In a seasonal Vamana study, 89 persons were registered and 69 underwent classical Vamana without major complications. Studies of the preparatory oleation phase report weight and abdominal circumference reduction without adverse effects on total cholesterol, HDL or LDL. Published clinical outcomes in psoriasis and chronic urticaria come from single case reports, and an exploratory trial on Vamana and Virechana in healthy ageing adults is under way. Conclusion: Available evidence supports the procedural feasibility and short-term tolerability of Vamana but cannot establish efficacy. Controlled trials with standardised protocols and validated outcome measures are needed.