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[[Kalpa Sthana]] contains the descriptions of ''Vamaka'' and ''Rechaka'' drugs (Emetics and Purgatives). Six drugs i.e. ''Madanaphala, Jimutaka, Ikshvaku, Dhamargava, Kutaja'' and ''Kritavedhana'' are denoted for emesis while nine drugs namely ''Shyama, Trivrit, Chaturangula, Tilvaka, Mahavrikshaka, Saptala, Sankhini, Danti'' and ''Dravanti'' are described for purgation.  

[[Kalpa Sthana]] contains the descriptions of ''Vamaka'' and ''Rechaka'' drugs (Emetics and Purgatives). Six drugs i.e. ''Madanaphala, Jimutaka, Ikshvaku, Dhamargava, Kutaja'' and ''Kritavedhana'' are denoted for emesis while nine drugs namely ''Shyama, Trivrit, Chaturangula, Tilvaka, Mahavrikshaka, Saptala, Sankhini, Danti'' and ''Dravanti'' are described for purgation.  

Atreya formulated 600 emetic and purgative recipes from 15 drugs. Emetic drugs predominantly constituted by ''agni'' and ''vayu mahabhutas''. ''Rechana'' drugs constituted by ''prithvi'' and ''jala mahabhutas''. It is also observed that drugs with these ''panchabhautika'' compositions may not exert either emetic or purgative action and the activity is attributed to general principle of drug action known as ''prabhava''. ''Virya'' (a principle responsible for each and every drug action) is augmented by ''Deshasampat'' (quality of soil in which plant grows), ''Kalasampat'' (Ideal season for collecting the plant), ''Gunasampat'' (enrichment of principles of drug action) and ''Bhajanasampat'' (suitability of storage containers) contributing to maximum therapeutic effect.<ref>Ram Karan Sharma and Vaidya Bhagwan Dash, Caraka Samhita, Vol VI, Kalpasthana, Chap 1, shlok no.7, edition 2nd 2005,Chaukhamba Sanskrit Series Office, Varanasi, pp. 6.</ref> Chakrapani comments that container to be used for storing drugs should have ''guna'' (attributes) similar to the stored drugs. Different adjuvants (''anupana'') are required to be used in accordance with ''doshas'' involved in the pathogenesis of disease during the administration of drugs. Recipes are prepared basing on the ''dravya'' (Nature of drug), ''deha'' (Physique), ''dosha'' (factor for causation of diseases), ''prakriti'' (Constitution), ''bala'' (Strength), ''satmya'' (Homologation), ''rogavastha'' (stage of the disease), ''vaya'' (age), ''agni'' (digestive and enzymatic complexes) etc<ref>Ram karan Sharma and Vaidya Bhagwan Dash, Caraka Samhita, Vol VI, Kalpasthana, Chap 1, shlok no.12, edition 2nd 2005,Chaukhamba Sanskrit Series Office, Varanasi, pp. 10.</ref>. Before the administration of emetic therapy ''snehana'' (oral oleation therapy) and ''svedana'' (fomentation) are mandatory. Administered drug first reaches the heart and circulated all over the body through ''dhamani'' (Blood vessels) and liquefy morbid matter (''mala'') and separate it from channels and bring them to ''koshtha''. Emetic and purgative drugs facilitate the expulsion of ''malas'' brought into ''koshtha'' from rest of the body.

Atreya formulated 600 emetic and purgative recipes from 15 drugs. Emetic drugs predominantly constituted by ''agni'' and ''vayu mahabhutas''. ''Rechana'' drugs constituted by ''prithvi'' and ''jala mahabhutas''. It is also observed that drugs with these ''panchabhautika'' compositions may not exert either emetic or purgative action and the activity is attributed to general principle of drug action known as ''prabhava''. ''Virya'' (a principle responsible for each and every drug action) is augmented by ''Deshasampat'' (quality of soil in which plant grows), ''Kalasampat'' (Ideal season for collecting the plant), ''Gunasampat'' (enrichment of principles of drug action) and ''Bhajanasampat'' (suitability of storage containers) contributing to maximum therapeutic effect.<ref>Charak. Kalpa Sthana, Cha.1 Madana Kalpa Adhyaya verse 07. In: Ram Karan Sharma and Vaidya Bhagwan Dash, Editors. Charak Samhita.2nd ed. Varanasi: Chaukhamba Sanskrit Series Office;2005. p.6.</ref> Chakrapani comments that container to be used for storing drugs should have ''guna'' (attributes) similar to the stored drugs. Different adjuvants (''anupana'') are required to be used in accordance with ''doshas'' involved in the pathogenesis of disease during the administration of drugs. Recipes are prepared basing on the ''dravya'' (Nature of drug), ''deha'' (Physique), ''dosha'' (factor for causation of diseases), ''prakriti'' (Constitution), ''bala'' (Strength), ''satmya'' (Homologation), ''rogavastha'' (stage of the disease), ''vaya'' (age), ''agni'' (digestive and enzymatic complexes) etc<ref>Charak. Kalpa Sthana, Cha.1 Madana Kalpa Adhyaya verse 12. In: Ram Karan Sharma and Vaidya Bhagwan Dash, Editors. Charak Samhita.2nd ed. Varanasi: Chaukhamba Sanskrit Series Office;2005. p.10.</ref>. Before the administration of emetic therapy ''snehana'' (oral oleation therapy) and ''svedana'' (fomentation) are mandatory. Administered drug first reaches the heart and circulated all over the body through ''dhamani'' (Blood vessels) and liquefy morbid matter (''mala'') and separate it from channels and bring them to ''koshtha''. Emetic and purgative drugs facilitate the expulsion of ''malas'' brought into ''koshtha'' from rest of the body.

Drugs for emesis which are ''ushna'' (hot), ''tikshna'' (sharp/penetrating),''sukshma'' (subtle), ''vyavayi'' (pervading), and ''vikashi'' (loosening), by virtue of their own potency (''swa viryena''), reach the heart and circulate throughout the body through vessels. It liquefies the mass of impurities by its ''agneya'' nature (dominance of ''agni mahabhuta'') and due to ''tikshna guna''(penetrating property) separate the adhered ''doshas'' situated in gross and subtle channels of the entire body. Consequently the separated mass floating in the oleated body like honey kept in a fat smeared vessel reaches the stomach because of its nature to move through subtle channels (''anumarga sancharitwat'') and to flow towards gastrointestinal tract (''koshta gamanonmukhatwam''). Because of the predominance of ''agni'' and ''vayu mahabhutas'' in these drugs, their specific action ( due to ''prabhava'') to move upwards and by action of ''udana vata'', the morbid matter gets expelled through the upward tract (mouth)<ref>Ram karan Sharma and Vaidya Bhagwan Dash, Caraka Samhita, Vol VI, Kalpasthana, Chap 1, shlok no.5, edition 2nd 2005,Chaukhamba Sanskrit Series Office, Varanasi, pp. 8,9</ref>.   

Drugs for emesis which are ''ushna'' (hot), ''tikshna'' (sharp/penetrating),''sukshma'' (subtle), ''vyavayi'' (pervading), and ''vikashi'' (loosening), by virtue of their own potency (''swa viryena''), reach the heart and circulate throughout the body through vessels. It liquefies the mass of impurities by its ''agneya'' nature (dominance of ''agni mahabhuta'') and due to ''tikshna guna''(penetrating property) separate the adhered ''doshas'' situated in gross and subtle channels of the entire body. Consequently the separated mass floating in the oleated body like honey kept in a fat smeared vessel reaches the stomach because of its nature to move through subtle channels (''anumarga sancharitwat'') and to flow towards gastrointestinal tract (''koshta gamanonmukhatwam''). Because of the predominance of ''agni'' and ''vayu mahabhutas'' in these drugs, their specific action ( due to ''prabhava'') to move upwards and by action of ''udana vata'', the morbid matter gets expelled through the upward tract (mouth)<ref>Charak. Kalpa Sthana, Cha.1 Madana Kalpa Adhyaya verse 05. In: Ram Karan Sharma and Vaidya Bhagwan Dash, Editors. Charak Samhita.2nd ed. Varanasi: Chaukhamba Sanskrit Series Office;2005. p.8,9.</ref>.   

Vomiting is a complex process that consists of a pre-ejection phase (gastric relaxation and retro peristalsis), retching (rhythmic action of respiratory muscles preceding vomiting and consisting of contraction of abdominal and intercostals muscles and diaphragm against a closed glottis), and ejection (intense contraction of abdominal muscles and relaxation of the upper oesophageal sphincter). The process appeared to be coordinated by a central emesis centre in the lateral reticular formation of the mid brain-stem adjacent to both the chemoreceptor trigger zone (CTZ) in the area postrema at the bottom of the fourth ventricle and the solitary tract nucleus (STN). The lack of blood-brain barrier allows the CTZ to monitor blood and cerebrospinal fluid constantly for toxic substances and to relay information to the emesis centre to trigger nausea and vomiting. The emesis centre also receives information from the gut, principally by the vagus nerve (via the STN) and also by splanchnic afferents via the spinal cord. The CTZ has high concentrations of receptors for serotonin (5-HT3), dopamine (D2), and opioids; the STN is rich in receptors for enkephalin, histamine, and Ach, and also contains 5-HT3 receptors.In the emetic response fundus and body of stomach, eosophageal sphincter and esophagus relax, while duodenum and pyloric stomach contract in a retrograde manner. Rhythmic contractions of diaphragm and abdominal muscles then compress the stomach and evacuate its contents via mouth<ref>K D Tripathi, Essentials of Clinical Pharmacology, 6th edition, Jaypee Brothers Medical Publishers, 639.</ref>.

Vomiting is a complex process that consists of a pre-ejection phase (gastric relaxation and retro peristalsis), retching (rhythmic action of respiratory muscles preceding vomiting and consisting of contraction of abdominal and intercostals muscles and diaphragm against a closed glottis), and ejection (intense contraction of abdominal muscles and relaxation of the upper oesophageal sphincter). The process appeared to be coordinated by a central emesis centre in the lateral reticular formation of the mid brain-stem adjacent to both the chemoreceptor trigger zone (CTZ) in the area postrema at the bottom of the fourth ventricle and the solitary tract nucleus (STN). The lack of blood-brain barrier allows the CTZ to monitor blood and cerebrospinal fluid constantly for toxic substances and to relay information to the emesis centre to trigger nausea and vomiting. The emesis centre also receives information from the gut, principally by the vagus nerve (via the STN) and also by splanchnic afferents via the spinal cord. The CTZ has high concentrations of receptors for serotonin (5-HT3), dopamine (D2), and opioids; the STN is rich in receptors for enkephalin, histamine, and Ach, and also contains 5-HT3 receptors.In the emetic response fundus and body of stomach, eosophageal sphincter and esophagus relax, while duodenum and pyloric stomach contract in a retrograde manner. Rhythmic contractions of diaphragm and abdominal muscles then compress the stomach and evacuate its contents via mouth<ref>K D Tripathi, Essentials of Clinical Pharmacology, 6th edition, Jaypee Brothers Medical Publishers, 639.</ref>.

Administration of drugs in emetic or purgative therapies and rest of the [[Panchakarma]] procedures, complication arising out of their improper administration and their successful management dealt in [[Siddhi Sthana]] (section on successful administration of therapeutic measures) in detail. Indications and contraindications of emetic and purgative therapies are described by Charak in [[Siddhi Sthana]] (Chap.2/8-13)<ref>Ram karan Sharma and Vaidya Bhagwan Dash, Caraka Samhita, Vol VI, Sidhhisthana, Chap 2, shlok no.8-13, edition 2nd 2005,Chaukhamba Sanskrit Series Office, Varanasi, pp. 177-188.</ref>. Appearance of ''pitta'' at the end of emesis and ''kapha'' at the end of purgation though described under signs of proper elimination, Chakrapani opines that they may also occur in inappropriate purification (''asamyakshudhhi''). Therefore additionally associated signs like emaciation (''karshya''), weakness (''daurbalya'') and lightness of the body (''laghavata'') only indicate appropriate purification.

Administration of drugs in emetic or purgative therapies and rest of the [[Panchakarma]] procedures, complication arising out of their improper administration and their successful management dealt in [[Siddhi Sthana]] (section on successful administration of therapeutic measures) in detail. Indications and contraindications of emetic and purgative therapies are described by Charak in [[Siddhi Sthana]] (Chap.2/8-13)<ref>Charak. Kalpa Sthana, Cha.2 Jimutaka Kalpa Adhyaya verse 8-13. In: Ram Karan Sharma and Vaidya Bhagwan Dash, Editors. Charak Samhita.2nd ed. Varanasi: Chaukhamba Sanskrit Series Office;2005.pp. 177-188.</ref>. Appearance of ''pitta'' at the end of emesis and ''kapha'' at the end of purgation though described under signs of proper elimination, Chakrapani opines that they may also occur in inappropriate purification (''asamyakshudhhi''). Therefore additionally associated signs like emaciation (''karshya''), weakness (''daurbalya'') and lightness of the body (''laghavata'') only indicate appropriate purification.

In seminar held on the topic of “Determination of appropriateness of medicaments for enema” (Siddhi 11). Saunaka said “Amongst the fruits, ''Jimutaka'' is the foremost in efficacy for ''basti'' (medicated enema) because of its effect to eliminate ''kapha'' and ''pitta''”. Atreya concluded that ''Jimutaka'' is useful for the treatment of ''kushtha'' (skin diseases including leprosy), while ''Madanaphala'' is not contraindicated in any disease. He further writes that there is no drug that is absolutely free from any side effects - good or bad. One has to think of a drug which possesses more of good attributes in the treatment of a particular ailment.<ref>Ram karan Sharma and Vaidya Bhagwan Dash, Caraka Samhita, Vol VI, Sidhhisthana, Chap 11, shlok no.5, 6, 10-14, edition 2nd 2005,Chaukhamba Sanskrit Series Office, Varanasi, pp. 382-84.</ref> To make it more explicit the physician has to judiciously evaluate ''rogibala'' (strength of patient) and ''rogabala'' (severity of disease) to draft suitable therapeutic regimens.

In seminar held on the topic of “Determination of appropriateness of medicaments for enema” (Siddhi 11). Saunaka said “Amongst the fruits, ''Jimutaka'' is the foremost in efficacy for ''basti'' (medicated enema) because of its effect to eliminate ''kapha'' and ''pitta''”. Atreya concluded that ''Jimutaka'' is useful for the treatment of ''kushtha'' (skin diseases including leprosy), while ''Madanaphala'' is not contraindicated in any disease. He further writes that there is no drug that is absolutely free from any side effects - good or bad. One has to think of a drug which possesses more of good attributes in the treatment of a particular ailment.<ref>Charak. Siddhi Sthana, Cha.11 Phalamatra Sidhi Adhyaya verse 5-14. In: Ram Karan Sharma and Vaidya Bhagwan Dash, Editors. Charak Samhita.2nd ed. Varanasi: Chaukhamba Sanskrit Series Office;2005. pp. 382-84.</ref> To make it more explicit the physician has to judiciously evaluate ''rogibala'' (strength of patient) and ''rogabala'' (severity of disease) to draft suitable therapeutic regimens.

Atreya enumerated three synonyms of ''Jimutaka'' i.e. ''garagari, veni'' and ''devatadaka''. Bhavamishra described ''Jimutaka'' (''Guduchyadivarga'') with synonyms like ''Devadali, Karkati'' and ''Vrittakosha'' in addition to Charaka’s descriptions. He has also quoted another variety known as ''Peetadevadali'' with synonyms ''Kharasparsha, Vishaghni'' and ''Garanashini''. ''Devadali'' is attributed with ''vamaka'' activity and its fruit is mentioned as ''Samsrana''. Indications include ''Arsha, Pandu, Kshaya, Hikka, Jwara, Krimi, Gulma'' and ''Shoola''. The recipe with ''Jimutaka'' as nasal drops in the management of ''Kamala'' is very popular and scientific validation has been produced for its claim. Botanical source of ''Jimutaka'' are Luffa echinata and Luffa graveolens (yellow variety).

Atreya enumerated three synonyms of ''Jimutaka'' i.e. ''garagari, veni'' and ''devatadaka''. Bhavamishra described ''Jimutaka'' (''Guduchyadivarga'') with synonyms like ''Devadali, Karkati'' and ''Vrittakosha'' in addition to Charaka’s descriptions. He has also quoted another variety known as ''Peetadevadali'' with synonyms ''Kharasparsha, Vishaghni'' and ''Garanashini''. ''Devadali'' is attributed with ''vamaka'' activity and its fruit is mentioned as ''Samsrana''. Indications include ''Arsha, Pandu, Kshaya, Hikka, Jwara, Krimi, Gulma'' and ''Shoola''. The recipe with ''Jimutaka'' as nasal drops in the management of ''Kamala'' is very popular and scientific validation has been produced for its claim. Botanical source of ''Jimutaka'' are Luffa echinata and Luffa graveolens (yellow variety).