An emetic is a substance that induces vomiting when ingested. Emetics have traditionally been employed to empty the stomach after certain kinds of poisoning, but have other cultural applications as well. These have been variously used for medicinal or even spiritual purposes across a diversity of cultures. Although the American Academy of Pediatrics (AAP) no longer recommends that emetics be routinely administered for poisoning accidents in children, study of ethnobotanical use of emetic plant species has potential to uncover new pharmaceutical treatments.
Ethnobotanical emetic use is well documented. The preparation ayahuasca from Banisteriopsis caapi, a native South American plant, is an integral part of physical and spiritual medicine in certain indigenous cultures. Use of the preparation frequently involves violent vomiting followed by hallucinogenic experiences. The cleansing and purifying effect of the emetic has been identified as a significant aspect of the spiritual process of ayahuasca use. Interestingly, Western medicine has identified compounds in Banisteriopsis caapi to be effective in the treatment of intestinal parasites, supporting the medicinal value of the purification ceremony.
The most common emetic used in Western medicine is syrup of ipecac. This is a solution prepared from the root of the South American ipecacuanha shrub. Upon ingestion, vomiting usually occurs within minutes, and continues until the full contents of the stomach has been purged. It is important to note that ipecac should only be administered under the advice of a poison control center, as certain types of poisoning are contraindicated for emetic treatment. Similarly, victims who are unconscious or otherwise incapacitated should never be induced to vomit, unless under the advice of a medical professional.
In 2010, the AAP rescinded advice that parents keep a one-ounce (30 ml) container of syrup of ipecac as part of home first-aid kits. Traditionally, parents were advised to induce vomiting in cases of accidental poisoning. The revised guidelines put forth by the AAP assert that there is, in fact, no empirical evidence to support this practice, and that no studies have shown induced vomiting to significantly influence mortality rates in poisoning cases.
As an alternative, the AAP recommends parents focus on poison prevention, by keeping any potentially toxic substances out of reach of children. In case of emergency, activated carbon, which binds to toxic substances and prevents absorption into the bloodstream, should be used in place of emetics. Whenever possible, a poison control center or other medical professional should always be consulted before attempting home treatment.
