Qayah (קָיָה) is a rare verb meaning to vomit — to expel from within. It appears in Leviticus 18 and 20 in the striking metaphor of the land "vomiting out" its inhabitants due to moral corruption. The land itself becomes nauseated by sin.
Leviticus 18:25 states: "Even the land was defiled; so I punished it for its sin, and the land vomited out its inhabitants." This is extraordinary: the land is a moral participant, responsive to righteousness and sin. It can be defiled (tameh) and it can purge itself. The Canaanites were expelled not merely by military conquest but by the land's own revulsion at their practices. Israel was warned: keep the land's laws or face the same fate (18:28). The imagery recurs in Revelation 3:16 where God threatens to "spit out" the lukewarm church — the same divine qayah.
The body's rejection response serves as a theological metaphor for God's rejection of sin. Jonah was vomited by the fish onto dry land (1:17; 2:10) — a picture of God's mercy through judgment: the prophet is expelled from death's belly, given a second chance. The land's qayah in Leviticus is less mercy, more moral logic: sustained defilement triggers expulsion. The land is not neutral; creation has ethical sensitivities built in.