Astanga Sangraha, Kalpasthana III: Translation and Notes

[By Kenneth Gregory Zysk]

[Thus (begins) the third chapter.] Henceforth we shall expound the chapter called the successful treatment of mishaps from emetics and purgatives. So indeed declared the great sages beginning with Atreya. A severe or very cold emetic, given in insufficient dose or in excessive dose, goes downward when, in the case of the "peccant" humours being accompanied by undigested food, it is consumed by one who is very hungry, by one with very weak bowels, by one with slight [excitement] of phlegm, [or] by one who responds poorly to emetics. In that case, the desired [effects] are not attained and the "peccant" humours move from their seats. After having again quickly oiled that [patient], one should make [him] vomit by means of the [most] appropriate measure, according to the proper dosage and at the proper time, etc.; and duly noting the previous failure, [the physician] should avoid those things which cause mishaps. In the case of one suffering from indigestion (ajirna) [or] one with an abundance of phlegm, a very hot, very severe or too saline purgative, or another [purgative] medicine that is either unpleasant or [given] in excessive dose, proceeds upward. In that case, the mishap and [its] remedy are as previously mentioned [for the mishap of an emetic (i.e., oiling followed by proper purgation)]. If, afterwards, [the purgative] comes up, one should not administer a third dose, unless it is a pleasant linctus or pill. In the case of one who has hard bowels (i.e., who is constipated) [or] one who has a very strong digestive fire, a medicine [given] in small [dose] or with little potency undergoes digestion like food in the upper or lower part [of the body]. In that case, the aroused humours, which are not expelled in due For the list of abbreviations and references, see pp.320 f. of my translation of Chapter II in Journal of the European Ayurvedic Society 3.1993, pp.319-351.

K.G. Zysk, Astangasangraha, Kalpasthana III 27 5 6 7 course, cause uneasiness [in the patient]. One should make him, whose bowels have been [first] oiled (i.e., lubricated), consume a large [dose] of a strong medicine. A medicine which is astringent, small [in quantity], not fresh, or dry, consumed by [a patient] who has not been oiled or sweated, or [a medicine] which has become fixed by cold treatments [and] one inhibiting [the dissolution of] the "peccant" humours, becomes an ineffective remedy. Therefore, in the case of [such an ineffective] emetic, one should once again make [the patient] vomit. In the case of [such an ineffective] purgative, one should make [the patient], who has been oiled and sweated, purge. Or, [one should make an oiled and sweated patient], who has an excess of a humour moving from its seat, [purge or vomit] on the third day. In both cleansing treatments, one should sweat [the patient], who has been smeared with oil mixed with salt, by both the hot poultice-method (pinda) and the bed-method (prastara). And when an emetic has not been administered to one who has been oiled and sweated, or when a weak purgative [is administered] to one being purged, who has consumed [the purgative] and whose "peccant" humours are accompanied by undigested food, there is, in the lower region, excessive heaviness (guru) and stiffness (stabdha) of the abdomen, piercing pain (sula), and the retention (sanga) of wind, urine and faeces. Having administered to him who has been given the ineffective treatment a non-oily enema with severe [medicines] accompanied by [cow's] urine, having given [him] food with the meat broth of wild (i.e., jungle) animals, having administered an oily enema with oil prepared with [madana-]phala, daru and pippali, and also having oiled [him] with wind-destroying oils, one should again make [him] purge with severe [medicines]. In the case of one who has an excessive amount of phlegm, one who is over-oiled, one who has hard bowels [i.e., one who is constipated], or one who has a weak digestive fire, a weakly prepared drug, after having made the humours move quickly from their seat, produces stiffness (jadya), drowsiness (tandra), diminished strength, and improper function of the limbs. [The

8 9 110 patient] should quickly vomit that [weak drug]. And one should cleanse with sharp and hot [medicines that patient] who has been oiled anew and whose digestive fire has been kindled by fasting. A cold or dry drug, administered to one who has not completely digested one's food, to one who has [an accumulation of] wind and phlegm, to one whose body is dry, to one who has an accompanying condition of udavarta, or to one who has a weak digestive fire, causes severe tympanitis (adhmana). In that case, the abdomen, because of the retention of impurities, has internal piercing pain (sula) [and] swells up like a leather water-bag. There is fullness on both sides, pain in the head and the back, difficult breathing (svasa) and cough (kasa), and pricking pain (nistoda) in the anal region and in the bladder. One should treat that [patient] with cures for udavarta and obstructive abdominal swelling (anaha), oil massage, sudation, suppositories, powders which increase the appetite (dipana), and enema-therapy. A strong drug, consumed by one who is emaciated (ksama), who has little strength, who has soft bowels or weak digestive fire, who is dry, who has not been oiled, or by one who has been sweated, although his "peccant" humours are accompanied by undigested food, after having corrupted the wind along with the bile, causes cutting pain in the rectum (parikartika). In that case, [there is] cutting pain in the rectum (parikartana), along with burning (daha) in the region of the navel, in the bladder, in the rectum, and in the penis, retention (sanga) of wind, and restraint of impurities (vistambha). One should administer to that [patient] non-oily enematherapy with slimy enemas combined with black sesamum (tila), madhuka and honey, or with the decocted milky sap of trees with milky sap. And to him who has been bathed with cold water [and] who has taken a meal with milk, one should administer oily enema-therapy with the clear part of clarified butter or with oil [prepared with] yastimadhuka. And in the case of one who is emaciated (ksama), every treatment that is sweet and promotes strength is prescribed.

11 12 12 K.G. Zysk, Astangasangraha, Kalpasthana III 29 29 When the "peccant" humours are accompanied by undigested food, fasting and appetisers, as well as light, dry and hot food and drink [are prescribed]. When the "peccant" humours are not accompanied by undigested food, light, alkaline and acidic [food and drink are prescribed]. When the "peccant" humours are accompanied by [excess] wind, one should employ sour gruel mixed with the bark of dadima in food and in drink; and one should drink clarified butter, followed by the juice of dadima, or the paste of sesamum seeds and devadaru with warm milk. A low dose of a weak purifying [drug] or a mild oiling administered to one with hard bowels (i.e., who is constipated) [and] with excess "peccant" humours, after having made the humours move from their seats, does not [completely] expel [them]. Becoming [only] very slightly mixed with bile and phlegm, [that drug] flows continuously and causes restraint of the impurities (vistambha), heaviness (gaurava), morbid swellings (sopha), itching (kandu), morbid pallor (panduta), decay of the limbs (angasada), internal tumours (gulma) and piercing pain (sula). 13 In that case, one should administer a non-oily enema with the decoctions of tinisa, dhava, asvakarna, palasa, and bala, mixed with honey. One should cleanse with strong [drugs the patient] whose continuous discharge [of "peccant" humours] (parisrava) has been appeased and who has been freshly oiled. And when cleansed, one should use appetisers beginning with powders, and asava- and arista-drinks. 14 14 15 If, after having drunk the [purgative] drug, one either increases or suppresses the urge to evacuate, then dysentery (pravahika) is produced. In that case, the one suffering from dysentery (pravahamana) violently passes slimy white, black, or bloody red phlegm, accompanied by burning (daha) and piercing pain (sula) [in the lower regions]. One should treat him with the methods prescribed for continuous discharge (parisrava). Because of the suppression [of the urges to evacuate] (nigraha), beginning with vomiting (chardi) and the ejection of medicine, in one who has consumed a [purgative] drug, [the

"peccant" humours], beginning with wind, become provoked and, after having attained the chest, bring about violent seizure in the chest (hrdgraha). In that case, due to the burning pain (upatapa) in the principal vulnerable spot (i.e., the chest), the patient is exceedingly oppressed by aches (vedana). Afflicted with mental confusion (moha), hiccough (hidhma), cough (kasa), [excessive] salivation (lala), piercing pain along the sides [of the chest] (parsvasula), he, trembling (vepathu) [and] losing consciousness (nastasamjna), grinds his teeth; having his eyes turned up, he bites his tongue. [Those experts in seizure in the chest] call this [condition] 'Congestion [of the "peccant" humours] in the chest (hrdayopasarana)'. After having sweated with the pulse-sudation [the patient] who was previously given an oil-massage, the physician, not being confused, should immediately administer to him a strong avapida head-purgation [and] an emetic with rice (tandula) water, mixed with yastimadhuka; or, when there is a predominance of phlegm, [an emetic] with pungent [emetic drugs]. Afterwards, he should remove the remaining "peccant" humours with digestives (pacaniya), and should apply enemas in accordance with the increased humour. An overdose of a dry medicine, used by one who was not oiled or sweated, who does not observe celibacy (abrahmacarin), who suppresses the urge to evacuate, who has weak bowels, or who is very tender, agitates the wind because of overpurgation. Therefore, there is seizure of all the limbs. Because of that, there should be piercing pain (sula) along the sides, in the back, in the pelvic region, in the nape of the neck and in the vulnerable spots, as well as fainting (murcha), dizziness (bhrama), trembling (kampa), stiffness (stambha), pricking pain (nistoda), splitting pain (bheda), cramps (udvestana) and loss of consciousness (samjnanasa). After having massaged that [patient] with oil [and] sweated [him] with pastes, one should administer an oily enema with oil decocted with yastimadhuka, and [give him] a regimen of wind-destroying food and drink. The over-abundance of a severe drug, administered to one who has been oiled and sweated, who has a very delicate con-

19 20 20 21 21 22 22 K.G. Zysk, Astangasangraha, Kalpasthana III 31 stitution, or who is hungry, after having been completely expelled and after having liquefied the impurities and principal elements (dhatu), causes them to issue forth by means of the over-action [of the drug]. After having given that [patient] an oil massage with the recipe of a hundred-fold cleansing clarified butter (satadhautaghrta), one should check [the flow] with unctions, moistenings, immersion-baths and a regimen of food and drink, which are astringent, savoury and cold, and with linctuses, mixed with sugar and honey. One should make [that patient] consume the course meal of parched paddy (lajasaktu) [combined] with candana, anjana, usira, goat's blood and cold water. And one should administer to him a slimy enema and an oily enema of clarified butter [obtained] from milk, or of the scum of clarified butter prepared with [drugs] from the sweet group. Likewise, one should employ medical prescriptions [effective in the treatment of] haemorrhagic disorders (raktapitta). [However,] especially in the case of an over-action of an emetic, one should consume, along with clarified butter, white sugar and honey, the mantha-beverage with fruit juices. Or else, [one should consume,] along with honey, a liquid gruel or milk prepared with the new sprouts of the trees with milky sap. And in food, one should give milk prepared with the drugs which cause constipation. And in the case of vomiting (chardi) along with eructation (udgara), one should lick [the powder of] dhanika, madhuka, madhurasa, musta and anjana, with honey. In the case of the obstruction of speech (vaksanga), closing of the jaw (hanusanga) and affliction of wind, one should consume a weak (i.e., thin) rice-gruel, prepared with clarified butter and meat-broth, and administer oiling-therapy and sudation. In the case of the inaccessibility (i.e., retraction) of the tongue [due to excessive vomiting], [one should give] oily, sour and salty gargles and mouth-washes, and savoury broths [made] of goat's meat. In addition, one should make [another person] eat sour fruits in front of that [patient].

23 24 26 26 But [in the case of the over-action of an emetic], one should push back in a protracted tongue, after it has been anointed with the paste of sesamum and draksa, or, after it has been smeared with the powder of the three pungents (vyosa) [mixed with] salt. One should press back the two protruded eyes, after they have been anointed with clarified butter. [And] one should make one who is unconscious listen to sounds of chants, reed-flutes and songs. In the case of the over-action of a purgative, one should vomit, after having consumed rice-water mixed with honey. And one should consume with rice-water [drugs from the group] beginning with priyangu, the barks of rodhra or dadima mixed with rasanjana, the stamens of somavalka, katphala, utpala, samanga, or padma, or the barks of udumbara-wood or madhuka mixed with honey and sugar. And one should perform the cure for bloody diarrhoea (raktatisara). 25 [In the case of the over-action of a purgative], after having lubricated, sweated and stiffened with astringent [drugs] a prolapsed (nihsrta) rectum (guda), one should [carefully] push it back into [position]. And one should treat [the afflictions] beginning with the obstruction of speech (vaksanga), as previously [mentioned in the case of the over-action of an emetic]. And in both cases (i.e., the over-action of an emetic and of a purgative), for the sake of distinguishing between life[-blood] and haemorrhagic [blood] [when there is the issuance of blood], one should dip a white cotton swab or a [white] piece of cloth in the blood. When it has dried, if, after being washed with tepid water, it becomes pure white [as before], one should consider it as life-blood; but if it becomes [slightly] discoloured, it is haemorrhagic [blood]. Or, one may give food mixed with that [blood] to a dog or a crow. If it is eaten, it is called life[-blood]; if it is not eaten, [it is] haemorrhagic [blood] ([rakta]pitta). 27 27 And in the case of one [passing blood], who is afflicted with thirst (trs), fainting (murcha) and narcosis (mada), one should administer, until the last moment of life, the remedy destructive of bile and that mentioned in the case of the over-action

28 28 29 29 30 31 32 32 K.G. Zysk, Astangasangraha, Kalpasthana III 33 [of a drug]. Or, (And,) one should quickly consume, along with honey, the blood of animals beginning with the black antelope (ena), according to the method in the excessive issuance of blood (atisrutarakta). For it at once unites with the life[-blood]. Or, one should administer, in the form of a [non-oily] enema, milk boiled with syama, kasmarya, madhuka, durva and usira, mixed with the clear part of clarified butter and anjana, [and then] cooled. And also with respect to the remaining mishaps resulting from improperly administered emetics and purgatives, one should, after having scrutinised the "peccant" humours, etc., carry out a treatment appropriate to the affliction. And one should keep in mind [the chapter on] the successful treatment of mishaps of enemas (i.e., AsKa 6). And thus with respect to both forms of purification (i.e., emetic and purgative), one should proceed according to the circumstances. For, cutting pain in the rectum (parikartika) after a purgative is burning pain in the throat (ksanana) after an emetic; continuous discharge (parisrava) in the lower region is the phlegmatic discharge (kaphapraseka) [in the upper region]; dysentery (pravahana) in the lower region is dry heaves (suskodgara) [in the upper region]. And on this subject, there exist [the following verses:] A drug, [taken in] overdose [or in] low [dose], [taken] at the wrong time, not infused with [drugs] of equal strength, incorrectly processed, [or] old, will inevitably fail. Indeed, one should not make [a patient experiencing] difficult vomiting, consume an emetic drug, nor [should one make a patient experiencing] difficult purging (or: a patient difficult to purge) [consume] a purgative drug. For in that case, it again destroys those two [resultant actions (i.e., purgation and emesis)]. In the case of one who has consumed a prescribed [purgative drug] which comes up mixed with phlegm, one should indeed make [the patient] who has vomited, cleansed his mouth with

34 34 33 34 35 m 36 37 37 38 38 Journal of the European Ayurvedic Society 4 (1995) gargles, and has fasted, [again] consume [that prescribed purgative drug]. In the case of an obstructed "peccant" humour which has a weak flow over a long period of time, one should consume warm water. Tympanitis (adhmana), vomiting (vami), thirst (trsna) and obstruction [of "peccant" humours] (vibandha) are quickly pacified by that [warm water]. If a [purifying] medicine, checked by the "peccant" humours, proceeds neither upward nor downward [and if there is tympanitis], along with eructation (udgara) or piercing pain (sula) in the limbs, then one should administer sudation. In the case of eructation (udgara) by one incorrectly purged, one should immediately evacuate the medicine. But in the case of the suppression of the urge to evacuate (apravrtti), the physician should check the indigestion (ajirna) [caused by the medicine] with very cold [moistenings, etc.]. At the time it is taken, medicine obstructed by phlegm becomes situated in the chest. When the phlegm is weakened, it proceeds [to the bowels] in the evening or at night. When a [purgative] medicine has been digested [even without wind] by one who is both dry and abstaining from food, or else has come up indeed by [the action of] wind, it becomes situated [in the upper region of the body]. One should [immediately] drink another [medicine], along with a mixture of oil and salt. If, when a [purifying] medicine is digested, there occur [morbid conditions] beginning with thirst (trs), mental confusion (moha), dizziness (bhrama) and fainting (murcha), then [another] medicine, which is sweet, cooling and destructive of bile, is recommended. 39 If, when [a medicine] is over-spread with phlegm, there occurs [excessive] salivation (lala), dislodging of "peccant" humours from their seats in the chest (hrllasa), restraint of the impurities (vistambha), and horripilation (romaharsa), then, a

40-41 42 42 K.G. Zysk, Astangasangraha, Kalpasthana III 35 medicine, which is strong, severe, pungent, etc., and destructive of phlegm, is beneficial. Opposite (pratikula) movement (gati) [of purifying drugs], [incomplete] digestion (paka), obstruction [of impurities] (grathitva) along with heaviness (gaurava), movement of the humours from their seats (dosotklesa), severe tympanitis (adhmana), cutting pain in the rectum (parikarta), continuous discharge (parisrava), dysentery (pravahika), seizure in the chest (hrdgrahana), general seizure in all the limbs (parigraha), together with the discharge of the principal elements (dhatusrava) these are called the twelve mishaps due to the various failures in the two types of evacuation (i.e., purgatives and emetics). They [have been] followed by their [appropriate] cures. And when various [other] mishaps are produced by an error in [the application of] purifying measures, one should endeavour to make [the treatment of] these comply precisely with this example [of the course of treatment]. Indeed, for the successful treatment [of mishaps], the textbook is the beacon of knowledge for both the [right] and the wrong methods. [Thus (ends) the third chapter called the successful treatment of mishaps from emetics and purgatives.] Notes to Chapter III Verse 1 Variants: AhKa 3(.1); cf. Mooss, 72; CaSi 6.1-2; SuCi 34.1-2. Tarte omits namadhyayam and iti... maharsayah. Ca omits namadhyayam and states that the teaching was declared by Lord Atreya; Ah reads vamana... siddhikalpam (var. as As); Su has cikitsita 'treatment' for siddhi, and states that the teaching was propounded by Lord Dhanvantari. A defines vyapad 'mishap' as 'the arising of disease from the two procedures (i.e., emesis and purgation) not [carried out] according to the teaching.' Verse 2 Variants: AhKa 3.1-2; cf. Mooss, 72-73; SuCi 34.4. Tarte reads mrdukosthena 'by one with soft bowels', adds durbalena 'by one who is weak', and has atitiksnam 'very severe' for atimatram

tiksnam, mala 'bodily impurities' for dosa, vyapatkaranani for karani, and purvam 'previous' for purvoktam. The translation follows Indu who understands that 'the non-attainment of the desired [effects]' (ipsitanavapti) means 'the accomplishment of the cessation of the disease by means of emesis'. Ah: 'A very severe or cold emetic, given in small dose, progresses downward when, in the case of an accompanying condition of indigestion, it is consumed by one with weak bowels, by one who is hungry, by one with slight [excitement] of phlegm, or by one who responds poorly to emetics (var.: by one who is weak; cf. Su). In this case, there is the absence of the desired [effects] and the accumulation of the bodily impurities (mala). Considering the previous failures, one should again make that [patient], who has been oiled, vomit.' Su: 'Therefore, an emetic, being retained by one afflicted by hunger, by one whose digestive fire is very sharp, or by one who is weak, goes downward due to its having the same qualities [as a purgative (D)]. In that case, the desired [effects] are not attained and the "peccant" humours move from their seats. After having quickly oiled that [patient], one should again make him vomit with more severe [drugs].' As is closer in wording to Su in numerous places. Verse 3 Variants: AhKa 3.3-5 a; cf Mooss, 74; SuCi 34.5. Tarte reads lavanamatram for lavanam atimatram, ato 'py for tato, and hrdyavalekhana° (read: avalehana°?) for hrdyaleha°. The translation follows Indu who states that 'one should not administer a third purgative, save a drug with qualities that are pleasing, etc. Indeed, one should administer only such a third type [of purgative].' Ah: 'In the case of one suffering from indigestion [or] one with an abundance of phlegm, a very severe, very hot or too saline purgative, or [a purgative] that is either unpleasant or [given] in excessive dose, proceeds upward. In that case, the mishap and [its] cure (siddhi) are as previously mentioned. Even then if [the purgative] does not remain in the stomach, one should not administer a third [dose], unless the medicine [to be administered] is agreeable in nature, pleasing and harmless.' Su (following D): 'An unpleasant purgative or one taken in high dose, consumed by one whose stomach is not cleansed, one whose phlegm has moved from its seat, or one whose food remains together [in the stomach], goes upward. In that case, the desired [effects] are not attained and the "peccant" humours move from their seats. Therefore, after having immediately made [the

K.G. Zysk, Astangasangraha, Kalpasthana III 37 patient] with an unclean stomach or an abundance of phlegm vomit, one should again purge [him] with severe [purgatives]. But if there is the connection with undigested food, the management is the same as indigestion (ama). If [the drug] is unpleasant and [is given] in very high [dose], a proper dose of a pleasant [ drug should be given]. Even then if the drug moves upward, one should not make [the patient] drink a third [dose of the purgative]. But in that case, one should purge him with linctuses prepared with honey, clarified butter and treacle.' As contains material found in both Ah and Su. Verse 4 Variant: SuCi 34.7. Tarte reads tam susnigdhakostham 'him, whose bowels have been well lubricated (i.e., oiled)', and has anannam 'non-food' for amandam. Su: 'In the case of one who has hard bowels (i.e., who is constipated) [or] one who has a very strong digestive fire, a medicine [given] in small [dose] or with little potency, undergoes digestion like food. In that case, the excited humours, which are not expelled in due course, produce uneasiness in the patient and [cause his] loss of strength. One should make him drink a large [dose] of a strong medicine.' D states that this passage explains the failure of a digested (jina) drug, that the uneasiness in the patient (vyadhivibhrama) is 'characterised by a disturbance in the bowels', and that the loss of strength is 'characterised by the loosening of the joints'. Verse 5 Variants: Wanting; cf. AhKa 3.5 b-10; Mooss, 75-77; CaSi 6.40-44; SuCi 34.8. Tarte reads stabdhadosam vigrathitam... virecanam snigdhasvinnam. The translation follows Indu who says that such a medicine 'amounts to a non-remedy because of the stability of the "peccant" humours'. He glosses apratyagra 'not fresh' as 'not palatable' (asampanna) and explains that 'when both the emetic and the purgative have become ineffective, one should sweat that [patient] who has been anointed with oil, by the poultice-method and by the bed-method, which are taught in the sutras, etc.' Pinda and prastara are two types of hot vapour sudation (usmasveda). Pinda is also known as sankara-sudation; and prastara is called samstara-sudation (See CaSu 14.25-27,39-42; AsSu 24.5-6, wanting in Ah, but cf. AhSu 17.6-7 a and A and H to these verses). Both Ca and Ah contain information found in AsKa 3.4-5. At CaSi 6.42 a and Ahka 3.9 a, it is stated that the patient, after have been anointed with oil

mixed with salt, is to be sweated by the samstara- (Ca and var. to Ah: prastara-) and sankara-methods. Su has information similar to As and states that a medicine with a small amount of evacuative qualities should be given on the third day to a large person who has an abundance of aroused humours. D states that some understand that the man was previously oiled and sweated on the third day, while others understand that he should be vomited or purged on the third day from when he was originally given the emetic or purgative. Verse 6 Variants: H to AhKa 3.10; cf. AhKa 3.7 b-10; Mooss, 76-77; CaSi 6.40-44; SuCi 43.10. Atrideva: vamanakrtva (?); Tarte and H: vatapurisasangas; H (var.): sulam for sulo. The translation follows Indu. Ah states that among those requiring this treatment is one who has been oiled and sweated, and that when the drug has been digested, its action is impeded, among other things, by previously consumed food which has not been digested (so also Ca). Concerning the remedy, both Ca and Ah state: 'After having given [the patient], who has been purged by a non-oily enema, food with the meat-broth of jungle animals (Ca: of land beasts; Cakra: and birds), one should administer an oily enema with the oil prepared with [madana]phala, magadhika and daru, in proper measure. One should again cleanse him who has been oiled with wind-destroying drugs with severe [medicines].' Ca adds: 'not with excessively severe [medicines] because an excessive effect is produced'. Su: 'In the case of one who has not been oiled or sweated, being improperly purged, there is stiffness and fullness (purna) of the abdomen below the navel, piercing pain, the retention of wind and faeces, or Having purged him and having again oiled [him], one should make [him] purge with severe [medicines].' D glosses asthapya with niruhya. Verse 7 Variant: H to AhKa 3.14. Tarte and H: langhitam '[the patient] ... who has fasted'; H: tiksnosnarvisodhayet (?); H (var.): snigdharuksosnair 'with dry (or: rough) and sharp [medicines]'. The translation follows Indu. Jadya has two meanings: 1. stiffness or heaviness of the limbs and body (SuCi 24.14;38.9 and D), and 2. 'stupefying of the sense faculties' (see also CaSu 26.79,84). Here the former meaning is more appropriate. On tandra, see Susa 4.49; D at SuSu 15.24;45.3; cf. CaSu 20.17, where it is a phlegmatic condition, 28.9, and Si 9.21-24.

K.G. Zysk, Astangasangraha, Kalpasthana III Verse 8 39 Variants: AhKa 3.11-13; cf. Mooss, 77; H to AhKa 3.14; CaSi 6.58-60; SuCi 34.15. Tarte and H (var.): malasangat samunnahya dahyaty udaram antahsulam 'the abdomen, because of the retention of impurities, having swelled up ..., burns with internal piercing pain'; Tarte and H have svasah for svasakasau, and H has upacaret for upacaret. According to Indu, udavarta is a cause (nidana) of haemorrhoids (arsas). It is an affliction of the wind in the bowels (i.e., 'bowels overcome with wind', AsNi 7.20) and is frequently connected with haemorrhoids (AsNi 7.20, Ci 10.50; cf. CaSu 7,passim; 19.3-4 and SuUt 55). See also AsKa 2.34 and notes. Tympanitis or flatulence (adhmana) is also an abdominal wind-disease closely connected with udavarta and arsas (see AsNi 7.16; CaSu 15.13;16.7; SuNi 1.88, where D glosses it as satopa, 'puffing up'; see below). Similarly, obstructive abdominal swelling (anaha) is an abdominal wind disorder where the wind is stationary in the stomach (CaSu 18.32), causing the accumulation of undigested food (ama) and faeces (sakrt) (SuUt 53.20, see also vv. 21-27 and MadhNi, 444,501). Ca and Ah: 'In the case of one who has an excess of the "peccant" humours, who is dry, who has a weak digestive fire (Ah like As: mandagni, Ca: hinagni), and who has an accompanying condition of udavarta, a drug [given] in low dose, after having aroused the humours [and] obstructed the bodily channels, produces severe tympanitis (adhmana) in the navelregion, and causes pain in the back, along the sides, and in the head, difficult breathing and severe retention (sanga) of faeces, urine and wind. Beginning with oil massage, sudation and suppositories, every treatment which cures udavarta, along with a non-oily and an oily enema, is suitable.' Su: 'A not warm or non-oily drug, drunk by one who has not completely digested one's food, who is dry, or who has wind in the abdomen produces tympanitis (adhmana). In that case, there is the retention of wind, urine and faeces, the abdomen becomes swollen, there is pain along the sides, pricking pain in the rectum and in the bladder, and aversion to food. One calls that "tympanitis" (adhmana). One should sweat that [patient] [and] treat [him] with remedies for obstructive abdominal swelling (anaha), with suppositories, with appetisers and with enema-therapy.' Appetisers include triphala (see SuSu 38.56-57). As combines Ca and Su. Verse 9 Variants: CaSi 6.61-62; SuCi 34.16; H to AhKa 3.16 a; cf. AhKa 3.15-16 a; Mooss, 79-81.

Tarte and H: ruksena snigdhena va ('who is dry or who had been oiled') sadaham parikartanam. Atrideva omits svinnena samena va. Indu explains parikarti (parikartana) as pain in the abdomen like cutting on all sides (cf. H at Ah). Ca: 'In the case of one whose "peccant" humours are accompanied by undigested food, a strong drug consumed by one who has been oiled, who has strong bowels, or who is emaciated, who has soft bowels, who is fatigued and who has little strength, after having travelled to the rectum and having quickly expelled the "peccant" humour along with the undigested food, causes severe piercing pain [and] cutting pain in the rectum, along with a slimy discharge.' Su: 'An excessively severe, hot, salty or dry drug, consumed by one who is emaciated, who has very soft bowels, who has a weak digestive fire, or who is dry, after having corrupted (pradusya) both the bile and the wind, causes cutting pain in the rectum. In that case, there is cutting pain in the rectum, along with burning in the rectum, in the region of the navel, in the penis, and in the head, retention of wind, blockage of wind and loss of appetite.' As combines Ca and Su, with vocabulary closer to Su. Verse 10 Parallel: H at AhKa 3.16 a. Variants: CaSi 6.63 b; SuCi 34.16 (part). H (var.): vainam for cainam. Tarte: yastimadhukatailenanuvasayet; H (var.) has canuvasayet. The translation follows Indu who states that the trees with milky sap (ksiravrksa) are those beginning with vata. According to Cakra (at CaCi 11.56), who refers to the list of five in the Salakya, they include vata, udumbara, asvattha, madhuka and plaksa. According to D (at SuCi 2.65), who refers to Jejjata, they are nyagrodha, udumbara, asvattha, plaksa and gardabhanda. Ca: 'In the case of one who is emaciated, every treatment that promotes strength and is sweet [is prescribed].' Su: 'In that case, a slimy enema, combined with yastimadhuka, the paste of black sesamum, honey and clarified butter [should be administered]. And to him who has been bathed with cold water [and] who has taken a meal with milk, one should administer oily enema-therapy with the clear part of clarified butter or with oil prepared with yastimadhuka.' As combines Ca and Su. Su, however, predominates. Verse 11 Variants: CaSi 6.63 a,64-66 a; H to AhKa 3.16 a; cf. AhKa 3.14-16 a; Mooss, 79-81.

K.G. Zysk, Astangasangraha, Kalpasthana III 41 Tarte and H: langhano dipanas ca; H: vate 'dhike 'where there is abundant wind'; niramibhute canubandhe; Tarte: vatanubhandha (?). The translation follows Indu who takes laghuksaramla to modify the previously mentioned food and suggests that the last two prescriptions should be combined: 'One should drink clarified butter, followed by the juice (sap) of dadima, with the paste of sesamum seeds and devadaru, ....' Cakra, on the other hand, understands ksaramla to refer to a specific remedy mentioned at CaCi 19.43, and states that the prescription is to be taken in small doses (laghumatra). Ca: 'When the "peccant" humours are accompanied by undigested food, fasting [and] measures which promote digestion [as well as] dry, hot and light food [are prescribed]. If, when [food is] digested, the "peccant" humours are [still] accompanied by undigested food, an alkali and acid [recipe] is prescribed in small doses (following Cakra). When there is abundant wind, one should consume clarified butter, followed by the juice of dadima, mixed with iron sulphate (puspakasisa), with barley-alkali, or with salt. One should consume sour gruel mixed with the bark of dadima in food and in drink, or the paste of devadaru and sesamum seeds with warm water.' Verse 12 Variants: CaSi 6.68-69 b; SuCi 34.17 (part); H to AhKa 3.16 a. Tarte: alpamatragunam... sophakothakandu... angasadasulani 'morbid swellings, skin-rash (kotha), itching, ... decay of the limbs and piercing pain'; H: sophakothakandu... angasadagudasulani 'morbid swellings, skin-rash, itching, ... decay of the limbs and piercing pain in the rectum'. The translation is tentative and follows Indu. Ca: 'Indeed, a low dose of medicine [administered] to one with excess "peccant" humours, after having made the humours move from their seat, causes [them] to flow very slightly, [and] causes itching, morbid swellings, skin affliction (kustha), heaviness, decay of the digestive fire, movement [of "peccant" humours] from their seats (utklesa), a sensation of bodily wetness (staimitya), loss of appetite (aruci) and paleness. This [condition] is called "continuous discharge (parisrava)".' Su: 'A mild drug administered to one with a strong constitution [and] excess "peccant" humours, after having made the humours move from their seats, does not completely expel [them]. Therefore, those [remaining] "peccant" humours cause a continuous discharge (parisrava). In that case, there is diminished strength, restraint of impurities in the abdomen, loss of appetite and

decay of the bodily limbs. Bile and phlegm flow out of that [patient] accompanied with pain. That [condition] is called "continuous discharge (parisrava)".' As combines Ca and Su. Verse 13 Variants: CaSi 6.69 b-70; SuCi 34.17 (part); H to Ahka 3.16 a. Var. to H has parisravam for parisravam. The principal difference between asava and arista appears to be that the drugs used in the former are unboiled, while those employed in the latter are boiled. On these two medicated drinks, see MadhNi, 441 f. and 445 f. Cf. also AsSu 6.119,127 a and AsKa 2.5 with notes. Ca: 'One should appease that humoral [condition] or else make [the patient] vomit. Or, one should make [the patient], after being oiled, consume a strong purgative. When he is cleansed, one should give [him] prepared powders, asava-drinks and arista-drinks.' Cakra explains that appeasement-therapy should be used when there is slight accumulation of the "peccant" humours and emetictherapy should be applied when there is large accumulation of the "peccant" humours, i.e., 'when the humour goes up', and that the prepared powders, etc. are known in the treatment of chronic diarrhoea (grahani) and haemorrhoids (arsas). Su: 'In that case, one should administer a non-oily enema with the astringent decoctions of ajakarna, dhava, tinisa, palasa and bala, mixed with honey. One should once more cleanse [the patient] whose "peccant" humours have been appeased and who has been oiled.' D glosses upasantadosa as upasantaparisrava, and states that the patient once again oiled should be cleansed with strong cleansing drugs. He follows Caraka's explanation of the use of appeasementtherapy and emetic-therapy. As combines Ca and Su. Verse 14 Variants: SuCi 34.18; H to AhKa 3.16 a. Tarte and H have saraktam 'mixed with blood' for ratham. The translation follows Indu who understands the drug to be a purgative (virecana). On pravahika 'dysentery', see Madh Ni, 208 f.,618 f., and Mooss, 79-81. Su: 'If a medicine, administered to one with a very dry [constitution], or to one with a very lubricated [i.e., oily] [constitution] stimulates the evacuation of wind and faeces, unattained [ (?) by the urge to do so], or by the suppression of the urge to evacuate, then there occurs dysentery (pravahika). In that case, the one suffering from dysentery (pravahamana) violently passes thick, slimy, white, black or bloody phlegm, accompanied with wind, with burning, and with piercing pain. One should treat

K.G. Zysk, Astangasangraha, Kalpasthana III 43 this [condition] by the methods prescribed for continuous discharge.' D explains that dysentery with effortless evacuation occurs when medicine is given to one with a very dry (constitution), while dysentery with the suppression of the urge to evacuate occurs when medicine is given to one with a very lubricated (i.e., oily) (constitution). Verse 15 Variants: AhKa 3.16 b-18 a; cf. Mooss, 81-82; CaSi 6.71-72; SuCi 34.19 (part). Tarte and H: katakatayati; Tarte has uddhrtaksa 'having his eyes drawn up' and does not break after ahuh. The translation follows Indu at As. Ca and Ah (following Indu and A): 'Because of the suppression of the urges to evacuate, [the "peccant" humours], beginning with wind, become provoked [and], after having gone to the chest region, cause violent seizure in the chest. [The patient, afflicted] with hiccough (hikka) (Ca: cough), pain along the sides (parsvaruj; Ca: parsvarti), depression (dainya), [excessive] salivation and agitation [or rolling] of the eyes (aksivibhrama; H: 'having his eyes drawn up'), trembles, looses consciousness (nihsamjna), grinds his teeth and bites his tongue.' Su: 'Of him who, out of ignorance, checks the urges to evacuate the [purgative] drug which had begun [to move] upward or downward, the "peccant" humours cause a congestion (upasarana) in the chest. In that case, due to the burning pain (santapa) in the principal vulnerable spot (D: the chest), [the patient], being exceedingly oppressed by painful sensations, grinds his teeth; [his] eyes have rolled up; he bites his tongue; he faints [and] becomes unconscious.' As combines Ca and Su; Ah follows Ca. Verse 16 Variants: AhKa 3.18 b-20 a; Mooss, 81-82; CaSi 6.73-74; SuCi 34.19 (part). The translation follows Indu to As. Pulse-sudation is a means of sweating, using heated pulses of plants beginning with masa (D at SuCi 2.25, 34.9). The avapida head-purgation is a type of nasal-therapy using an oily paste (kalka) (see AsSu 29.7 and Indu). Ca and Ah: 'In this case, the physician should not get confused and should immediately make that [patient] vomit. [He should make the patient,] fainting (murcha) because of bile, [vomit] with sweet [drugs], [and the patient,] fainting because of phlegm, [vomit] with pungent [emetic drugs]. Afterwards, [the physician] should remove his remaining "peccant" humours with digestives and should increase (Ah: abhipravardhayet, Ca: utthapayet 'arouse') gradually his digestive fire and strength.' Indu glosses kaphamurchita 'fainting because of phlegm' as kaphottara 'excess of phlegm'.

Su: 'Foolish [physicians] avoid that [patient afflicted with congestion of the "peccant" humours in the cardiac region] (D: because they consider him about to die). After giving [the patient] an oil-massage, one should sweat [him] with the pulse-sudation, should apply an oily enema with oil prepared with yastimadhuka, and should administer to him a strong head-purgation (sirovirecana). Afterwards, he should make [the patient] vomit with rice-water mixed with yastimadhuka, and should treat him with enemas according to the excited humour.' D: 'He should make the patient, afflicted with fainting due to bile, vomit with rice-water mixed with yastimadhuka, and should make the patient, afflicted with fainting due to phlegm, vomit with a decoction of pungent drugs.' As combines Ca and Su; Ah follows Ca. Verse 17 Variants: SuCi 34.9; H to AhKa 3.23 a; cf. AhKa 3.21 b-23 a; Mooss, 83-84; CaSi 6.76-77. Reading follows Tarte and H: marmasu sulam murcha bhramah kampah stambho. Su: 'A dry medicine, used by one who was not oiled or sweated, who does not observe celibacy, agitates the wind. Thereupon, the agitated wind causes pain along the sides, in the back, in pelvic region, in nape of the neck and invulnerable spots, as well as fainting, dizziness, narcosis (mada) (D: by the betel-nut, etc.) and loss of consciousness. This [condition] is called "piercing pain due to wind" (vatasula). After having massaged that [patient] with oil [and] sweated [him] with pastes, one should apply an oily enema with oil decocted with yastimadhuka.' Ca and Ah: 'In the case of one who has consumed the [purgative] drug, wind is very obstructed by the suppressions of the urges to evacuate or by phlegm; or else in the case of one who has been cleansed, [wind] seizes the bodily limbs with stiffness, trembling (vepathu), pricking pain, decay [of the limbs] ([anga]sada), cramps (udvesta), and churning pain (mantha; Ah: bhedana "splitting pain"). In this case, one should use every wind-destroying [treatment], beginning with oiling and sudation (Ah: every wind-destroying [treatment] is recommended).' Cakra understands that the "peccant" humour obstructed by the suppression of the urges to evacuate or by phlegm, seizes the bodily limbs; or, in the case of one who has been cleansed, the provoked wind seizes the bodily limbs. The use of the term brahmacarin seems to indicate Brahmanical influence. As follows Su. Verse 18 Parallel (to second part): H at Ahka 3.39.

K.G. Zysk, Astangasangraha, Kalpasthana III 45 Variant: Suci 34.11 (part); cf. AhKa 3.23 b-25; Mooss, 84-86; CaSi 6.45-48. Tarte: tiksnavegam atibhuri... sravayed atiyogi bhavati. Su: 'A very strong drug or one in very large dose, administered to one who has been over oiled and sweated [or] who has a very delicate constitution, causes overaction [of the drug]. In that case, in the over-action of an emetic, there occurs over-manifestation of bile, loss of strength and strong agitation of wind. After having given that [patient] an oil-massage with clarified butter [and] having immersed [him] in a bath of cold water, one should treat [him] with linctuses mixed with sugar and honey, according to the humours involved.' Ah: 'A very strong medicine [administered (Indu)] to one who is hungry [or] to one who has a delicate constitution, after having removed faeces, bile and phlegm [and] having liquefied the principal elements (dhatu), causes [them] to flow. Therefore, in the case of over-action [of a purgative], one should make the [patient] vomit the remaining medicine with sweet [drugs]. In the case of the over-action of an emetic, one should be given a purgative; and in the case of [the overaction of] a purgative, a mild emetic should be administered (Indu). One should check that [flow] with very cold moistenings, and immersion baths, etc.' Ca is the same as Ah in first part, but then has: 'And [very strong medicine] causes loss of strength and voice, parched throat, dizziness, and thirst. Therefore, one should make [the patient] vomit the remaining medicine with sweet [drugs]. In the case of [the over-action of] an emetic, there should be purgation, while in the case of [the overaction of] purgation, there should be emesis. One should check that [flow] with very cold moistenings and immersion-baths, etc., and with sweet and cold food, drink and medicines, and by [the methods for] removing haemorrhagic disorders (raktapitta) and diarrhoea (atisara), and [for] destroying burning sensation [in the body] (daha) and fever (jvara).' As is largely original, but combines information from Ca and Su. Verse 19 Variants: AhKa 3.26; cf. Mooss, 85; CaSi 6.48 b-49; SuCi 34.12 (part). Following Tarte's reading: ksirasarpih sarpirmando va. He also has madhurasiddham for madhuravargasiddham. The translation follows Indu. Here anjana is the same as sroto'njana, or the inorganic galena (Plumbi sulphuratum) (D at Su). Ca (for 48 b, see previous vs.): 'One should drink a mantha-beverage [with] anjana, candana, usira, marrow and blood, sugar and [cold] water, combined with the coarse powder of parched paddy. It is an excellent cure for the over-action [of a drug].'

Ah 26 follows Ca 49; however, following Indu, H and As, read ajasrk 'goat's blood' for majjasrk 'marrow and blood'. Indu states that this is used in the case of the over-action of a purgative. Su: 'One should make that [patient] drink a stirred beverage [prepared with] goat's blood (ajasrj), candana, usira, and coarse powder of parched paddy, together with sugar and water.... One should treat [him] with medical prescriptions [effective in the treatment of] excessive flowing of blood [i.e. haemorrhagic disorders] (atisrutasonita).' As combines Ca and Su. Compare next verse. Verse 20 Variants: AhKa 3.27; cf. Mooss, 86; CaSi 6. 50-52; SuCi 34. 12 (part). Following Tarte who reads: visesena tu vamanatiyoge. The translation follows Indu who states that the fruit juices are 'the juices of the plants beginning with draksa'. He also glosses ksiravrksa as those plants beginning with vata (cf. Ca, below), and takes the first ksiram 'milk' to be modified by the implied vatasungasiddham 'prepared with the new shoots of vata'. The plants beginning with vata are those of the nyagrodhagana (see AsSu 16.33, AhSu 15.41, and SuSu 38.48-49). The drugs which cause constipation (sangrahidravya) are the same as those which obstruct faeces (varcahsangrahika), found in Ca and Su (see below). They are, according to AsSu 16.29 (AhSu 15.37), the following: priyangu (var. Ah: priyangupuspa), puspa (var. Ah: puspanjana), anjanayugma, padma, padmad rajas, yojanaval(1)i, ananta, saladruma (var. Ah: saradruma, manadruma), mocarasa, samanga, punnaga (var. Ah: punnama), sita, madaniyahetu (cf. CaSu 4.15(31) and SuSu 38.45; see below notes to vs.24). Ca: 'Or one should give [the patient], along with honey and milk, liquid gruel prepared with the bud-sheaths of the plants beginning with vata, and food prepared with [drugs] which obstruct faeces. Or, food with a meat-broth of wild (i.e., jungle) animals and a slimy enema are recommended. Likewise, an oily-enema is to be administered with clarified butter [obtained] from milk prepared with sweet [drugs].' Cakra states that the [drugs] which obstruct faeces (varcahsangrahika) are those beginning with priyangu and ananta, mentioned in the chapter on the 600 purgatives, i.e., CaSu 4.15(31). Ah (following A and Indu): 'However, in the case of the over-action of an emetic, [the patient], after having been sprinkled with cold water, should drink, the manthabeverage with fruit juices (Indu: of draksa, etc.), combined with clarified butter, honey and sugar.' Su: 'Or, [one should make (the patient) con-

K.G. Zysk, Astangasangraha, Kalpasthana III 47 sume a mantha-beverage] with fruit juices (D: of dadimi), combined with clarified butter, honey and sugar, or a liquid gruel prepared with the bud-sheaths of vata, etc., along with honey, or [prepared] with [drugs] which obstruct faeces. Or, one should eat food with milk and meat-broth of wild (i.e., jungle) animals.' D understands mantha and tarpana to be synonyms (see above notes to AsKa 2.10, etc.) and glosses mantha as 'barley groats smeared with clarified butter and water' (at SuUt 64.44). Cakra defines mantha as 'barley groats combined with clarified butter [and] immersed in cold water', and states that it is 'neither transparent nor dense' (at CaSu 6.28). As combines Ca and Su. Cf. previous verse. Verse 21* Variants: AhKa 3.28; cf. Mooss, 86, 87; CaSi 6. 53, 56; cf. SuCi 34.12 (part). Tarte and Atrideva have madhurasa for madhurasa. Tarte has hanusamhanane 'in the case of shutting of the jaw' for hanusange. The translation follows Indu and is based on Ca and Ah. The affliction vaksanga occurs at CaSu 20.11 and AsSu 20.9 as an affliction of wind. At SuNi 1.70, it is glossed by D as 'the non-issuing of speech' (vaco 'nirgamah)', and at AhSu 8.9, H glosses it as 'the stammering of speech (vacah skhalanam)'. At AhKa 3.31, Indu glosses vaggraha 'seizure of speech' as vaksanga. Cf. also AsSu 27.19, where it is found next to hanusamhanana in the list of problems from the over-action of an emetic. Based on Tarte's reading and AsSu 27.19, hanusanga and hanusamhanana would appear to be synonyms. The latter occurs at SuCi 34.12, where it is glossed by D as 'the shutting of the jaw, [i.e.] lack of movement (hanusamhatih saranabhavah)'. Ca and Ah: 'In the case of excessive vomiting along with eructation [and] in the case of fainting (Ah omits), one should lick the powder of dhanya and musta, along with madhuka and anjana, mixed with honey. In the case of the seizure of speech and [or] the afflictions of wind, the prudent one (Ah: the one who knows the correct time for application) should give a thin (H: accha 'clear') gruel boiled with clarified butter and meat-broth and [should administer] oiling and sudation.' Su: 'In the case of the closing of the jaw (hanusamhanana), one should give nasal-therapy (nasya), destructive of wind and phlegm, and sudation.' As combines Ca and Su, but is closer to Ca. Verse 22 Variants: Ahka 3.29-30 a; cf. Mooss, 87; CaSi 6.54-55 a; cf. SuCi 34.12 (part).

Tarte has kavalagrahagandusa for kavalaganddusa (cf. Ca and Ah). Indu explains that mouth-washes with the medicines are to be held in the front of the mouth of one whose tongue is inaccessible and that gargles are to be held in one part of the mouth of one whose tongue is accessible. He goes on to say that the physician should make another person eat sour fruits in front of him whose tongue has retracted inside [the mouth], for by observing that, the [patient's] mouth becomes moist and [his] tongue assumes its normal form (cf. Indu at Ah). Ca and Ah: 'In the case of the tongue retracting inside during vomiting (Ah: due to vomiting), gargles with oily, sour, salty, savoury vegetable soups, milk and [meat-]broths are beneficial (Ah: gargles with oily, sour and salty [substances], savoury vegetables, and meat-broths, are beneficial). In addition, other men should eat sour fruits in front of him (A: whose tongue has retracted inside).' Su: 'In the case of the [tongue (D)] retracting inside, others should eat sour [fruits (D)] in front of him.' D: When the mouth becomes moist because of observing this, the tongue, having become soft, returns to its natural place. As combines Ca and Su; D seems to follow Indu. Verse 23 Variants: AhKa 3.30 b, 39 b; cf. Mooss, 87, 91; CaSi 6.55 b, 85 b; SuCi 34.12 (part). Tarte omits tu. The translation follows Indu. On the three pungents (vyosa), see AsKa 2.5 and notes. Ca: 'But (Cakra: in the case of the over-action of an emetic]), one should push back in a protracted tongue, after it has been smeared with the paste of sesamum and draksa. In the case of that [patient's] loss of consciousness (samjnanasa), one should utter chants (saman) (Cakra: santvana 'soothing sound') and sound of the Gandharvas (Cakra: gita 'song').' Cakra explains that the latter treatment is mentioned as a remedy for failure (vibhramsa), having the form of the loss of consciousness. Ah 30 b is identical to Ca 55 b, but Ah 39 b is slightly different: 'One should make one who has lost consciousness (visamjna) listen to the sounds beginning with the chants of the Sama- [veda (Indu), A (var.): Samaveda], reed-flutes, and songs.' Su: 'One should press back in a protracted tongue (lit.: a tongue that has crept out; cf. D), after it has been anointed with the powder of sharp and salty [substances], or, after it has been smeared with sesamum and draksa. One should press back the two protruded eyes (D: two eyes which are opened wide), after they have been anointed with clarified butter. In the case of one who has lost consciousness (visamjna), one

K.G. Zysk, Astangasangraha, Kalpasthana III 49 should make [him] listen to sound of reed-flutes, lutes (vina), and songs.' As combines Ca and Su. Note that Su omits chants (saman) in the list of auspicious sounds. Verse 24 Variants: H to AhKa 3.39; cf. SuCi 34.11 (part). Tarte has misrena for madhumisrena and kamalotpalasamangapadmakesarani 'the stamens of kamala, utpala, samanga, and padma'. H includes part of this verse in his comments at AhKa 3.39, with the following reading: visesena tu virecanatiyoge... vamayet (var. vamet) 'but especially in the case of the over-action of a purgative, one should cause [the patient] to vomit (var. one should vomit) ...', with priyangvadikam for priyangvadim, with katphalotpalasamangapadmakesarani 'the stamens of katphala, utpala, samanga, and padma', and with madhukodumbara for madhukaudumbara. H's version provides a better reading in general. Tarte's list of stamens is redundant (kamala = padma). The translation, however, follows Indu who glosses katphala as somavalka, making somavalka redundant. It, therefore, lends support to the readings of Tarte and H. The compound rodhrarasanjanadadimatvaco could be understood as 'the barks of rodhra or dadima [both] mixed with rasanjana'. Su: 'In the case of the over-action of a purgative, [there occurs] an excessive issuance of phlegm, and, after a while, of [phlegm] with blood. Also in that case, there is loss of strength and strong agitation of wind. After having moistened that [patient] or immersed [him] in a bath with very cold water, one should make [him] vomit with cold rice-water mixed with honey, should administer to him a slimy enema, should give him an oily enema with milk and clarified butter, and should make him drink with rice-water drugs beginning with priyangu. [Finally,] one should make him take meals with milk or meat broth (rasa).' According to SuSu 38.45, the priyangugana is priyangu, samanga, dhataki, punnaga, nagapuspa, candana, kucandana, mocarasa, rasanjana, kumbhika, srotoja, padmakesara, yojanavalli, and dirghamula. On bloody diarrhoea (raktatisara), see CaSu 2.21, Ci 19.70 and Cakra; and on the priyangugana, see above notes to verse 20. Verse 25 Variants: AhKa 3.39 b; cf. Mooss, 91; CaSi 6.85 a; SuCi 34.13 (part). The translation follows Indu who states that the stiffening (or perhaps constricting) of the prolapsed rectum refers to the removal of its flaccidity (parityajitasaithilya). The treatment for the afflictions beginning

with the obstruction of speech occurs at AsKa 3.21 (above). Ca and Ah: 'And, after having stiffened a prolapsed (bhrasta) rectum with astringent [drugs] (A: with decoction prepared with astringents), one should push [it] back into [position].' Su: 'In the case of a prolapsed rectum (nihsarpitaguda) (lit.: a rectum which has crept out), after having oiled and sweated the rectum, one should press [it] back [into position]. Or, [a remedy according to the chapter on] the treatment of minor diseases (i.e., SuCi 20) may be appropriate.' The commentators agree that kasaya in this verse refers to the astringent taste (kasayarasa) rather than to a medicinal decoction (see Cakra, A, and H). As combines Ca and Su. Verse 26 Variants: AhKa 3.32-34; cf. Mooss, 87-88; CaSi 6.78-80; SuCi 34.14. Tarte has raktam for jivaraktam, and vaivarnya for vivarna. The translation follows Indu. Ca: 'A very harsh medicine [given] to one with a delicate constitution (i.e., soft bowels) and with a small accumulation of "peccant" humours, after removing the "peccant" humours and churning (Cakra: agitating) the life-blood, eliminates [the life-blood]. One should give food mixed with that [blood] to a crow or a dog. If it is eaten, it is called life[-blood], if it is not eaten, it is called haemorrhagic [blood] ([rakta]pitta, so Cakra), Or, a white piece of cloth soaked [in the blood], dried, [then] washed with tepid water should become [slightly] discoloured in the case of haemorrhagic [blood] ([rakta]pitta, so Cakra).' Cakra defines this condition as jivadana 'the taking away of life'. Ah: 'And due to over-action, that medicine which removes the life-blood is called jivadana, since it takes away what is living. One should give food mixed with that blood to a dog or a crow. If it is eaten or not eaten, it is called [respectively] life [-blood] or haemorrhagic [blood] sent by the medicine. Or, a piece of white cloth soaked [in the blood], dried, [and then] washed with tepid water becomes [slightly] discoloured in the case of haemorrhagic [blood], but pure white in the case of [life-]blood.' A and Indu state that since there is a similarity between the smell and colour of both blood and bile, a test is given to remove the uncertainty between blood and bile. H calls the life-blood (jivasonita) vital fluid (ojas), the vital power of the elements (from AhSu 11.37). Su: 'For the sake of desiring to known [the distinction] between life-blood and haemorrhagic [blood], one should dip a cotton swab or a piece of cloth in [the blood]. If it stains the cloth, after it has been washed with hot water, it is known as life-blood (!). And one may give it with food or

K.G. Zysk, Astangasangraha, Kalpasthana III 51 mixed with barley-groats to a dog. If he eats it, it is known as life-blood (!); otherwise, it is haemorrhagic [blood] (!).' D: If the white (cloth), after having been washed with hot water, becomes free of red colour (ragarahita), it is life-blood; if it is discoloured, it is haemorrhagic (blood). Su's first test by the use of white cloth dipped in the blood contradicts the other versions. It is, however, corrected by D. As combines Ca and Su, following Ca in meaning and Su in order and vocabulary. Verse 27 = Variants: AhKa 3.35-38; cf. Mooss, 88-89; CaSi 6.81-84; SuCi 34.13 (part). Tarte: khadgadirudhiram ca 'and [one should take] the blood of animals beginning with the rhinoceros', and tad... abhisandadhat is wanting. The translation follows Indu. On the group of animals beginning with ena, see AsSu 7.104. Ena is probably the male of Antelope cervicapra Linn., the black antelope (see MadhNi, 450). On the method mentioned for excessive issuance of blood, see SuUt 45.28 (and D) and AsCi 3.42 ( AhCi 2.30 b-31 a), and cf. CaCi 4.72 a. All these references occur in the chapter which deals with the treatment of haemorrhagic disorders (raktapitta). Ca: 'In the case of one [passing blood (Cakra)], who is afflicted with thirst, fainting and narcosis, one should administer, until the last moment of life, every remedy destructive of bile and those which are beneficial in the over-action [of a drug] (Cakra: one should stabilise him with very cold moistenings and immersion-baths, etc.). One should drink the fresh blood of living animals [as] deer, crow, buffalo and goat, which is the connection with the [life-]blood; for it goes (i.e., combines) immediately to [with] the life [-blood] (cf. Cakra). One should give precisely that blood, mixed with the extract of darbha-grass, as an enema. One should give as an enema milk, boiled with syama, kasmarya, badari, durva, and usira, mixed with the scum of clarified butter and anjana, [and then] cooled. Or, [one should give] a very cold, slimy enema or a non-oily enema with the scum of clarified butter.' Ah follows very closely Ca, but states: 'One should administer, the remedy destructive of haemorrhagic disorders (raktapitta) and diarrhoea (atisara), that immediately restores his life-breath.... One should give in the form of an enema precisely that blood mixed with the powder (so H) of [newly sprouted (A)] darbha-grass.' In place of badari, Ah has madhuka. H understands that the animal's blood 'completes the deficient part of the life-blood (jivasonitanyunamsapurana).' Su: 'In the ...9

case of the excessive issuance of life-blood, one should apply a non-oily enema with milk, boiled with the fruits of kasmari[ya], badari (D: kasmari, madana-fruit), durva, and usira, mixed with the clear part of clarified butter and anjana, [and then] well-cooled." As combines Ca and Su. Verse 28 Variant: H at AhKa 3.39. Tarte has dosan apeksya 'after having scrutinised the "peccant" humours'. H has dosadin alaksya 'after having observed (or: scrutinised) the "peccant" humours, etc.'. The translation follows Indu, who states that the chapter on the successful treatment of mishaps of enemas is mentioned for the sake of ascertainment of the proper treatments of these types of mishaps, and that it is in regard to the removal of the "peccant" humours in the lower region because of the resemblance between enemas and purgatives. Verse 29 Variants: SuCi 34.21; H at AhKa 3.39. H (var.) has upatistheta 'one should attend to [the patient]' for uttistheta. Tarte and H have yah parisravah yat pravahanam. The translation follows Indu who states that there is a resemblance between the two means of purification in the effects produced in the respective parts of the body: because of the process of purification involved with the overaction of purgatives and emetics, there is a resemblance respectively between sharp pain in the rectum and injury to the throat; and because of the vitiation of the "peccant" humours by the loss of the action of the purgative and the emetic, there is a resemblance respectively between continuous discharge and (phlegmatic) discharge, and between flatulence (?) (nistanana) and dry heaves (suskodgara). Su: 'For, cutting pain in the rectum (gudaparikartika) after purgation is burning pain in the throat (kanthaksanana) after emesis; continuous discharage (parisrava) in the lower region is phlegmatic discharge (slesmapraseka) in the upper region; indeed, dysentery (pravahika) in the lower region is dry heaves (suskodgara) in the upper region.' Verse 30 Variants: CaSi 6.28; H at AhKa 3.39. H has the variant dhrtam 'eventually' for dhrutam. The translation follows Indu who glosses dhruta with avasya 'certainly; inevitable'. Ca: 'A drug [taken] at the wrong time, [taken in] overdose [or in] low dose (so

K.G. Zysk, Astangasangraha, Kalpasthana III 53 Cakra), which is old, not infused (Cakra: with its own juices or with [drugs] of equal strength: svarasais tulyaviryair va), or incorrectly processed, will inevitably fail.' The similarity between As and Cakra's gloss is remarkable. Verse 31 Variants: CaSi 6.37; H to AhKa 3.39. Following Tarte and H, who read tu durvirecanam. For tau, they have te. The reading durvirecyam refers to a patient difficult to be purged. This is grammatically and logically inconsistent with duschardam, a patient having difficulty in vomiting. Ca: 'Indeed (tu), one should not make [a patient experiencing] difficult vomiting consume an emetic drug, nor [should one make a patient experiencing] difficult bowel movements (duskostha, var. mrdukostha weak bowels or constitution') [consume] a purgative (virecana) drug. For the consumed [drug] once again will destroy those two [results].' Verse 32 Parallel: H at AhKa 3.39. Variants: Cf. perhaps CaSi 6.32 and SuCi 34.5. H (var.) has payayet tatah and payayed drutam. The translation follows Indu. Verse 33 Variant: H at Ahka 3.39. H has 'lpam for 'lpe, H (var.) has canu for casu. The translation follows Indu. The verse does not concern a mishap due to the administration of either an emetic or a purgative. Hence it appears to be out of place. Only the reference to vomiting (vami) allows it to be included here. Verse 34 Parallel: H at AhKa 3.39. H (var.) has yan for cen. The translation follows Indu. Verse 35 Parallel: H at Ahka 3.39. Tarte has viriktasyodgarabhesajam. The translation follows Indu who states that if the vomiting of the medicine is not stopped, there occurs, due to the distress from over-application of the medicine, indigestion causing vomiting. The physician should check the suppression of the urge to evacuate caused by the emetic with very cold moistenings, etc. He should in no way purge the patient a second time.

54 5.4 Journal of the European Ayurvedic Society 4 (1995) Verse 36 Variant: H at AhKa 3.39. H has nisi for ratrau. Indu states that the medicine is fixed; and, because it does not reach the bowels, it does not bring about purgation. When the phlegm is weakened due to the sharpness of the drug, it brings about purgation in the evening or at night, after it has reached the bowels. Verse 37 Variant: H at Ahka 3.39. Tarte has ruksann aharayej 'one should eat because of emaciation', and urdhvagate. H has ksaran aharayej 'one should eat because of the caustic [medicine (?)]'. The translation follows Indu. Verse 38 Parallel: H at AhKa 3.39. H (var.) has pittaghne for pittaghnam. The translation follows Indu. Verse 39 Parallel: H at Ahka 3.39. Tarte and H (var.) have harsan. The translation follows Indu. According to tradition, the compound hrllasa refers to the dislodging of "peccant" humours from their seat in the chest, accompanied by expectoration; see in particular Indu at AsSu 6.33 and 10.23-27, H at AhSu 4.17, D at SuSu 24.9 (read perhaps hrdayotklesah), and SuSu 26.10. Verses 40-41 Variants: Wanting. Tarte has payor grathitvam 'impediment of the anus' (this reading permits only eleven mishaps), sarvadhatusravena '[together] with the discharge of all principal elements', and yogavibhramsad 'due to failure in the applications (i.e., overdose and low dose)', which is perhaps a better reading. The translation follows Indu to vv. 39-41, who states that the opposite movement refers to the going down of an emetic and the coming up of a purgative. Ca enumerates ten mishaps (CaSi 6.29-30), and Su fifteen (SuCi 34.3 and 22). Verse 42 Variants: Wanting. Tarte has siddhau (?) for siddhyai. The translation follows Indu.