Chapter 5 - Complications of Enema-tube (netra-basti-vyapad-siddhi)

1. We shall now expound the chapter entitled ‘The Success in Treatment of the Complications arising from the Defects in the Enema Apparatus or in the Technique of Administration of the Enema [netra-basti-vyapad-siddhi]’.

2. Thus declared the worshipful Atreya.

Avoidable tubes and their evils

3. Now listen to the description of the enema tube [netra-basti] and the enema receptacle that are to be avoided in this procedure and to the exposition of the complications which arise from such apparatus as well as from the administration of enema by an inexperienced person, as also the treatment of these complications,

4-5. The physician should avoid eight kinds of enema tubes viz., those that are too short, too long, too thin, too thick, worn out or loosely fixed, which have holes on the sides or are tortuous Not reaching the destination, penetrating too far up, shaking in the rectum, injury to the rectum, fluid leaking out, pain in the rectum, oblique flow of the fluid—these are, respectively the harmful effects of the above described defective conditions of the enema tube.

Evils of wrongful enemas and their administration

6-7. The physician should avoid eight kinds of enema receptacles in this procedure viz., those that are irregular, fleshy, torn, thick, which have many perforations, which are bubbled inside, sticky and worn out. Irregular flow, fleshy odor, leakage of fluid, difficulty to grasp, absence of flow, frothiness of fluid slipping away from the hand and difficulty of holding are respectively the results of the above mentioned defective conditions of the receptacle.

8 The following are the defects resulting from the defective technique of the enema administrator. The air may be pushed into the rectum, enema may be given too hurriedly, the tube may be pushed too high, or it may be introduced obliquely; he may do repeated compression or he may shake the tube while introducing or he may do frequent insertion of the tube or he may not be able to insert it in the rectum, or he may compress the receptacle either too slowly or too forcibly.

9-9½. If the enema hag has been fixed without the air in it being pushed out, or if all the enema fluid has been pushed in without leaving any residue, the air entering the rectum and provoking the Vata there, causes colicky and piercing pain. In such a condition, inunction and sudation of the anus, and food and drink curative of Vata are indicated.

Treatment

10-11. If the enema tube has been introduced too hurriedly or if it is pushed very high, there will occur pain in the waist, rectum and legs, rigidity of the bladder and pain in the thighs. In such a condition, inunction, sudation procedures, enemata and diet that are curative of Vata, are indicated.

12. If the enema tube is introduced obliquely or is obstructed by the anal folds or is blocked by substances in the enema fluid itself, the enema fluid will not flow. The enema tube then should be taken out, cleansed and properly re-introduced.

13-13½. If there are interruptions in the act of compression resulting in repeated compression, the Vata in the rectum being thus struck repeatedly, becomes highly provoked and causes pain in the chest, head and thighs, and also asthenia. In such a condition, is indicated the enema prepared from the bael group of drugs, emetic nut aud the black turpeth group of drugs mixed with cow’s urine.

14-4½. If the rectum is injured by the shaking of the tube, there will be burning, sense of heat and edema. In such conditions, astringent, sweet and cold affusions and enemata are indicated.

1546. If the anal valves are hurt by excessive penetration of the enema tube, there will be pain, burning, rectalgia and the discharge of fecal matter. In such a condition the use of ghee, sweet milk and mucilageuous enema are recommended.

17. The inadequately compressed enema does not reach the destination and returns too soon In such conditions, unctuous enema should be properly administered again, by one desiring success in treatment.

18. If over-forcibly administered, the enema is retained in the stomach or goes up and Teaches the throat. In such conditions, enema, purgation and pressure on the neck etc., are the requisite measures of treatment.

Summary

Here is the recapitulatory verse.

19. The wise physician who has a knowledge of these complications with regard to the enema tube [netra-basti], receptacle as well as the ineptness of the enema administrator and the treatment of these complications, should be engaged to give the treatment.

5. Thus, in the Section on Success in Treatment, in the treatise compiled by Agnivesha and revised by Caraka,the fifth chapter entitled ‘The Success in Treatment of the Complications arising from the Defects in the Enema Apparatus or in the Technique of Administration of the Enema [netra-basti-vyapad-siddhi]’, not being available, the same as restored by Dridhabala, is completed.