Vomiting, also called emesis, is a symptomatic response to any number of harmful triggers. Vomiting is a forceful expulsion, and is different from regurgitation—the effortless return of stomach contents to the mouth. Although unpleasant, vomiting is an important function because it rids the body of harmful substances.

Vomiting is a complex process resulting from the coordinated interaction of nerve pathways, the brain, and muscles of the gastrointestinal system. The primary vomiting trigger point in the brain is called the area postrema. If through any means this centre is activated then vomiting occurs.

The physical act of vomiting is controlled by multiple sites of the brain stem. When activated, these structures send signals to the throat, diaphragm, and abdominal muscles. These signals result in the simultaneous contraction of these muscles, which brings the stomach contents up through the oesophagus and out the mouth.

Ayurvedic Concept:
In Ayurvedic language, vomiting is known by two diffrent names:
    1.    Chardi- It is a natural vega which should not be suppresed in the body. If suppressed it causes many symptoms like headache, giddiness, feeling uncomfortable, stiffness in the body, etc.
    2.    Vaman: It is a procedure in the Panchakarma therapy. It has been considered under pradhan karma by Acharaya Charak and Acharaya Sushruta. This procedure is basically done in kapha disorders. So, it can be said as Induced vomiting.

Vaman can be performed in almost all the age groups by making a little difference, e.g
    •    In women:  In the state of normalcy, there may not be much difference in the treatment but in general, women being soft and tender in constitution, vigorous therapies should be avoided. e.g intensity of the vaman should be reduced. It should be avoided in state of pregnancy.
    •    In children: The children being very soft, tender, fast growing and developing individuals, any therapy should be given with due caution. This therapy should be avoided in the children below 12 years of age.
    •    In elderly: Some Panchkarma therapies for the elderly act as a therapy for the rejuvenation to retard aging. An apparently normal elderly person should undergo periodical Panchkarma therapy followed by rasayana in order to promote his overall health and to avert the effect of aging.

Types:
As a reflex action to some foreign particle etc.
Induced vomiting as in food poisoning etc.
Vomiting in some physiological processes like pregnancy etc.
Vomiting in some diseases like migraine etc.

Ayurvedic Pathology
Chardi:
The main doshas involved in samprapti of chardi is vayu and kafa. Due to excess nidan sewan like excess intake of liquid and snigdh padarth (heavy foods), akal bhojan (having meals at any time), asatmaya bhojan ( food which does not suits the body) etc dosha vayu gets vitiated (prakupit) in the GIT and it also vitiates kafa dosha in GIT leading to chardi.
 
It can also be represented through a chart:
 
nidan sewan----------> prakupit vayu-----------> prakupit kapha in mahasrotasa (GIT)--------> chardi.
 
Vaman:
Vaman is a procedure and not a disease. That's why it does not have any pathology but a procedure. Basically vamana is done to treat kapha diseases like leprosy, tuberculosis, cough, asthma, goitre, elephantiasis, diabetes etc.
 
This procedure has some basic points like purva karam, pradhan karma and paschat karma.  In purva karma Oleation (internal and external) as well as sweating is done.
 
In pradhan karma the patient is made to have a Yoga made of vamak aushadh among which main is  madanphal yoga. After that automatically the dosha gets affected and vamana (vomiting) occurs.
 
In paschat karma a specific diet regimen is followed so as to prevent the repeted vitiation of the dosha. It is called Sansarjan karma. 

 
Causes:
Vomiting is caused by Vayu, Pitta, Kapha, tridosha, and unpleasant sensory experiences. From the Western view, it is caused by
    •    MEDICATIONS:  It includes cancer drugs, pain killers, diuretics, anti boitics, antihistamines etc.
    •    INFECTIONS: It is more common in infants and young adults. It includes bacterial, viral, parasitic, otitis media, ear infections, meningitis, hepatitis etc.
    •    GIT DISORDERS: It includes blockage of stomach or small intestine, peptic ulcers, Ca stomach, indigestion, worm infestations, inflammation of the appendix, gall bladder etc.
    •    NERVOUS SYSTEM DISORDERS:  It includes motion sickness, migraine, any unpleasant memories, psychogenic, any bad smell or taste etc.
    •    HORMONES AND PHYSIOLOGICAL CONDITIONS: It includes pregnancy, parathyroidism, hyperthyroidism, diabetic keto acidosis etc.
    •    POST OPERATIVE: It includes the condition after the operations especially after anesthesia and pain medications etc.
    •    POISONS: It includes arsenic poisoning, weed killers or if any other harmful thing swallowed.
    •    MISCELLANEOUS: It includes excessive alcohol consumption etc.


Symptoms:
Includes four main stages which are described under:
    1.    The prodrome phase signals that an episode of nausea and vomiting is about to begin. This phase, which is often marked by abdominal pain, can last from just a few minutes to several hours. Sometimes taking medicine early in the prodrome phase can stop an episode in progress. However, sometimes there is no warning: A person may simply wake up in the morning and begin vomiting.
    2.    The episode phase consists of nausea and vomiting; inability to eat, drink, or take medicines without vomiting; paleness; drowsiness; and exhaustion.
    3.    The recovery phase begins when the nausea and vomiting stop. Healthy color, appetite, and energy return.
    4.    The symptom-free interval phase is the period between episodes when no symptoms are present.

Some other general symptoms are described under:
    •    Abdominal Pain.
    •    Nausea.
    •    Fever.
    •    Muscle pain.
    •    Feeling sluggish.
    •    Diarrheal.
    •    Neck stiffness.
    •    Headache.
    •    Vision changes.
    •    Dehydration.
    •    Low blood pressure.


Therapies:
    •    Dietary and Life changes
    •    Home remedies
    •    Ayurvedic remedies

Dietary & Lifestyle Changes
    •    Avoid triggering foods.
    •    Reduce stress.
    •    Quit smoking and alcohol.
    •    Avoid doing exercise with a full stomach.
    •    Avoid overeating.
    •    Avoid taking too much coffee.
    •    Do at least one meal fasting if the symptoms appear.
    •    A low fat and liquid diet should be preferred after small intervals.
    •    Fluids, juice etc should be given to the patient as the patient feels. If this is not possible then IV infusion of fluids should be done to replenish the loss of fluids in the body.
 
Home Remedies:
    •    Patient should be given yogurt containing cardamom and honey.
    •    Juices like pineapple, apple, and carrots etc should be given to the patient in small quantities at small intervals.
    •    Patient should chew cardamom seeds to make the taste better of the mouth.
    •    Mix equal quantity of ginger juice and onion juice and give it to the patient. It will reduce the symptoms.
    •    Boil a cup of water with one cinnamon stick in it.  Add 1 tablespoon of honey for sweeting.
    •    Patient should take a tablespoon of onion juice every two hours.
    •    Heat 2 cardamoms on a dry tava. Powder them and add a tsp honey and take frequently.
    •    Take a mixture of 1 tsp mint juice with 1 tsp lime juice and 1/2 tsp ginger juice along with a tsp honey.
    •    Lime juice is an effective remedy for vomiting. Take a glass of chilled limejuice and sip slowly.
    •    In 1 glass water, add some honey and drink sip by sip.
    •    Ginger tea is very useful for vomiting.
    •    Raspberry tea is very useful for vomiting.

Ayurvedic Remedies:
    •    Amlapittantak Lauh  – 1-2 tab with honey BD
    •    Avipattikar Churna  – 1 TSF with water BD
    •    Vomiteb  – 2 tab TDS          

             
Conclusion: As we have seen that vomiting may be fatal. But if these easy things and tips are taken into consideration during treatment then  the it helps in recovery of the patient and provides quick relief.

*      NOTE – Don’t take any medication or any asana without the advice of a doctor.
*      Queries if any may please be addressed to dr_upneet@yahoo.co.in