Sushruta Samhita, volume 4: Cikitsasthana

by Kaviraj Kunja Lal Bhishagratna | 1911 | 123,229 words

This current book, the Chikitsa-sthana (english translation), deals with therapeutics, surgical emergencies, geriatrics, aphrodisiacs and various other subjects. The Sushruta Samhita is the most representative work of the Hindu system of medicine. It embraces all that can possibly appertain to the science of medicine. Susruta-samhita is recognized...

Chapter XXXV - Description of a Netra and a Vasti (pipes, nozzles and apparatus)

Now we shall discourse on the dimensions and classifications of a Netra and a Vasti (pipes, nozzles and apparatus) with their therapeutic applications (Netra-Vasti-Pramana-Pravibhaga-Chikitsita). 1.

Sages of authority hold an application of the Vasti to be the best of all measures such as, the application of a Sneha, etc.; and why? Because on account of its varied functions and of its being composed of the various kinds of medicinal drugs a Vasti helps to restrain (Samgraha), pacify (Samshamana) and cleanse (Samshodhana) the different Doshas (morbific principles) of the body. It helps the recreation and growth of fresh semen, contributes to the building up of an emaciated frame, reduces corpulency, invigorates eyesight, arrests premature old age and tends to rejuvenate. A regular and proper use of a Vasti tends to improve one’s complexion and bodily strength, imparts longevity, contributes to the growth of the body, ensures the enjoyment of sound health and guards against the inroad of any disease whatever. Applications of Vastis are highly efficacious in cases of fever, dysentery, cataract, catarrh, diseases of the head, Adhimantha, vomiting, facial paralysis, epileptic fits, convulsions, (Akshepaka), hemiplegia, locomotor ataxy (Ekanga) and paraplegia (Sarvanga-Roga), tympanites, ascites or abdominal dropsy, Sharkara (gravels or urinary concretions), gastralgia (Shula), scrotal tumours (including hydrocele, hernia, etc.), Upadamsha, retention of stool and urine (Anaha), strangury (Mutra kricchra), Gulma, Vata-rakta, upward coursing of urine, stool and Vayu, loss of semen, breast-milk and of catamanial fluid, Hrid-graha (catching pain in the chest), Manyagraha (wryneck), Hanu-graha (numbness of the jaws), hemorrhoids, Ashmari (stone) and Mudha-garbha (false presentation and difficult labour). 2.

Memorable Verse:—

Applications of Vasti are always efficacious in diseases due to the action of the deranged Vayu, Pitta and Kapha, in those due to the vitiated condition of blood and in those brought on by the concerted action of any two or all of them. 3.

Dimensions of the pipe:—

The length of the pipe of a Vasti should be made six fingers in respect of an infant of one year and eight and ten fingers in respect of a boy of eight and an adult of sixteen years respectively, the girth of its calibre being respectively equal to those of the small finger, the ring finger and the middle finger respectively in the three afore-named instances. The pipe should have Karnikas[1] or bulblike protrusions attached to it at one of the ends above a space of one finger and a half, two fingers, and two fingers and a half respectively in the three afore-said forms of the apparatus. The girth of their mouths (to be introduced into the rectum) should be respectively made to equal those of the calibres of feathers of a crow, a falcon and a peacock, and the girth of the channels of the main body of the pipes should respectively be such as to let a Mudga pulse, a Masha pulse and a Kalaya pulse to pass through them. The quantity of the fluid with which an Asthapana-Vasti should be charged is equal respectively to two, four, and eight Prasritas[2] (in volume). A Prasrita measure being here equal to what can be contained in the hollow of the patient’s own palms (in each particular case). 4.

Memorable Verse:—

The length of the pipe and the quantity of the fluid to charge with should be gradually increased with the progress of the patient’s age and in consideration of his strength and bodily capacity. 5.

The pipe of a Vasti in respect of an adult above twenty-five years of age, should be made twelve fingers in length having a girth equal to that of his thumb at its base and a girth equal to that of the small finger at its mouth. At a distance of three fingers from above the mouth the Karnikas should be fixed. The bore should be such as to allow a feather of a vulture to pass through it, while the fissure at the mouth would have a girth to allow the stone of a Kola fruit or of a boiled Kalaya pulse. The pipe should in all cases be supplied with two Karnikas at its root, for the purpose of firmly securing it to the mouth of the Vasti (bladder). The quantity of the fluid to charge with in the case of an Asthapana Vasti is twelve Prasritas. The length of the pipe in respect of persons above seventy years of age should be like that in the preceding case but the quantity of the fluid to charge with should be made as in the case of a youth of sixteen. 6.

Materials of the pipes:—

The pipe should be made either of gold, silver, copper, iron, brass, ivory, horn, gems or wood. It should be straight, smooth and firm, tapering at the top like the tuft of hair in the tail of a cow, and bulbular (i.e., not pointed) at its mouth. The Vasti[3] should be (prepared with) the bladder (Vasti) either of a full-grown ox, buffalo or a sheep nor should it be soft (flexible) and firm, neither too thick nor too thin and of adequate dimensions. 7.

Metrical Text:—

In the absence of a pipe, a reed, bamboo, or horn might serve the purpose. In the absence of the bladder of any of the foregoing animals, the Vasti should be made of skin or of thick linen. 8.

Construction Of the Vasti:—

The bladder (of which a Vasti should be made) should be cleansed, tanned and dyed (disinfected). It should be softened and repeatedly lubricated with a Sneha. It has generally a wide mouth which should be bent and lightly fitted to the butt end of the pipe (Netra). The mouth of the bladder should then be tied above the (Karnika). The whole bladder should be heated with a piece of hot iron (in order to polish the surface and remove the pores therein, if any). The mouth of the bladder should then be folded and again tied (below the Karnika). The whole should then be carefully preserved. The Asthapana or the oily (Snaihika) Vasti should be applied, as the case may be, with the help of such a Vasti. A mild Vasti should be applied specially to infants and old men, since a strong one is likely to injure their health and strength. 9.

Vastis may be grouped under two heads—Nairuhika (dry or oilless) and Snaihika (oleaginous). The term asthapana is synonymous with Niruha. The Vasti known as the Madhu-Tailika is only an alternative of a Niruha - vasti. The terms Yapana, Yukta-ratha, and Siddha-vasti convey also the same meaning. A Niruha-vasti is so called from the fact of its expelling the Doshas (morbific diatheses) from the system and from its curing the diseases of the body; while asthapana is so named from its virtue of rejuvenating the organism or producing longevity. The process of Madhu-tailika would be described in connection with the mode of applying a Niruha-vasti. 10.

The Anuvasana is only an alternative of a Sneha- Vasti, but (with this difference that) the quantity of the fluid to charge with should be three-fourths, and the amount of the good effect therefrom would also be three- fourths. An Anuvasana-vasti is so called from the fact of its not injuring the system even in the event of its being retained in the bowels a whole day, or from the fact of its being adapted to daily application. The Matra-vasti again which is applicable in all cases, is an alternative to an Anuvasana-vasti, but should be charged with only a half part of the fluid of that used in an Anuvasana-vasti. 11.

Metrical Texts:—

A Niruha-vasti acts as a cleanser of the system (Shodhana). It is anti-fat (Lekhana), emulsive (Snehana) and constructive (Vrimhana). Oleaginous matter (Sneha) may freely enter into the organism when all its ducts and channels have been previously cleansed by the application of a Niruha- vasti. As water will freely run through channels previously cleansed of all refuse matter, so does an Anuvasana tend to cleanse the organism of all Doshas (morbific diatheses) and to increase the vitality of the organism. A Sneha-vasti should, therefore, be applied to a person previously purged of all Doshas by the application of a Niruha-vasti. 12.

Both the Anuvasana and the Asthapana Vastis should be regarded as forbidden in cases of insanity, in the mental conditions of terror and grief, of a thirsty state of the body, of aversion to food and of indigestion, jaundice (Pandu), giddiness, delirium, epilepsy, vomiting, Kushtha, Meha, ascites, obesity, asthma, cough, dryness of the throat and edema as well as in respect of a Kshata- Kshina patient and a pregnant woman in (and before) the third or the fourth month of her gestation, in the case of a person suffering from dulness of appetite, impatient and incapable of bearing the least pain as well as in respect of infants, old men and persons emaciated by a bodily distemper other than one due to Vayu 13.

Metrical Text:—

The asthapana-vasti should be exclusively applied in cases of ascites, urinary complaints (Meha), Kushtha and obesity. The application of an Anuvasna-vasti is entirely forbidden in those cases inasmuch as it might make the disease run into an incurable type, and a great amount of lassitude of the organism would be the consequence. 14.

Medicine duly injected (through the rectum) with the help of a Vasti remains in the intestines (Pakvashaya), in the region of the pelvis and below the umbilical region. The potency of the Vasti (medicine) spreads over the whole organism from the intestines (Pakvashaya), just as the potency of the water poured at the root of a tree tends to permeate the whole tree (through its minutest cells and fibres). The liquid part of the Vasti is emitted out through the rectum either by itself or with the fecal matter, etc.[4], but its potency acts over the whole organism through the intervention of the Apana and the other Vayus. The potency of the Vasti in the Pakvashaya acts on the whole organism from top to toe, like the sun in the heavens acting on the humidity (Rasa) of the earth below. The Vasti, if duly applied, tends to eliminate completely from the system all the Doshas (morbific diatheses) accumulated in the regions of the back, waist and the abdomen (Koshtha). 15-A.

As the aggravation of all the Doshas (morbific principles) of the body is principally dependent on the derangement of the bodily Vayu; an aggravated condition of the latter may hence lead to the dissolution of the body, and consequently the application of a Vasti, and nothing else, is the only means of coping with the aggravation of the Vayu (by subduing and restoring it to its normal condition), just as the sea-coast is the only barrier to the swollen and wind-agitated surf of the sea. A well-applied Vasti contributes to the growth, health, strength and longevity of the body and to the improvement in its complexion. 15.

The different defects of a Vasti:—

Now we shall deal with the defects and the evil effects which are consequent upon the wrong and injudicious application of a Vasti. The defects of wrongly handling a Vasti (Pranidhana-dosha) are six in number, viz., the pipe may shake or revolve; it may also be pressed side- wise or thrown upwards; and it may sink down or may be pressed slantingly. Excessive thickness, coarseness, bending down, narrowness, cleavage, nearness or distance of the tying bands (Karnika), narrowness or excessive width of its internal aperture, excessive length or extreme shortness are the eleven defects which the pipe of a Vasti (Netra-dosha) may have. The five objectionable features in the bladder (Vasti-dosha) are an excessive flabbiness, narrowness, width of its internal aperture, leakiness and an imperfect bending at its mouth (neck). Variation in pressures put upon a Vasti (Enema syringe) during its application may be attended with any of the four objectionable features (Pidana-dosha), viz., overpressure (pressing the injection into the rectum with an injuriously excessive force), under-pressure, repeated pressures and pressure at long intervals. The eleven defects in the ingredients of the Vasti (Dravya-dosha) are insufficient cooking, excessive or insufficient quantity, extreme coldness, excessive heat, extreme keenness of potency, excessive mildness, excess or want of oiliness (Sneha), extreme thickness of consistency and over- fluidity. Lying with the head raised up or hung down or in a bent or sitting posture or resting on one’s back or in a contracted posture or on one’s right side are the seven defective postures (Shayya-dosha) in which a patient should never be laid during the application of a Vasti. These are the twenty-four defects which attend the wrong application of a Vasti owing to the ignorance or inexperience of a physician, while those which are the effects of the injudiciousness of a patient are fifteen in number and would be described in the chapter on aturopadrava- Chikitsita (Chapter XXXIX, Chikitsita-sthana). 16.

The Sneha injected into the bowels by a Vasti is obstructed in its passage and cannot consequently leave the system but is retained in it through any of the following eight causes, viz, obstruction of the food by the three Doshas, its admixture with the fecal matter (accumulated in the bowels), its being injected too high up into the intestines, an omission to foment (the patient’s body), using the Sneha in a cold state or in a small quantity and lastly use of no meals or of scanty meals by the patient previous to the application of a Vasti. These (retentive conditions) are due to the indiscretion of both the physician and the patient. Nine distressing symptoms (Vyapad) namely as a defective application of either the Anuvasana or the asthapana Vastis, distension of the abdomen, (adhmana), a cutting pain in the region of the anus, (Parikartika) Dysenteric stools (Parisrava), diarrhea (Pravahika), affecting the heart (Hridayaopasarana), catching pain in the limbs, over-dosage, hemorrhage manifest themselves in consequence of any act of indiscretion of the physician in attendance. 17.

Memorable Verse:—

The seventy-six kinds of the distressing symptoms (Vyapad) have been briefly described above. Their symptoms and treatment would be described in the following chapter. 18.


Thus ends the Thirty-fifth Chapter in the Chikitsita Sthana in the Sushruta Samhita which deals with the dimensions, classifications and therapeutical applications of a Netra and a Vasti.

Footnotes and references:


The Karnikas are attached to the pipes for guarding against their being thrust into the rectum.


A Prasrita measure is generally equal to two Palas, i.e., sixteen Tolas. But here it has the particular meaning as given in the text.


The Vasti is so called from its being prepared with the bladder (Vasti) of an animal. Dallana notes in this connection that the bladder of an ox, buffalo, or a hog, should be used in the Asthapana and Anuvasana measures, and the bladder of a goat or a sheep should be used in the Uttara-vasti.


Srikantha Dutta in his commentary quotes this sloka, but he reads there “sakapha” (with Kapha) in. the place of “samala” (with the fecal matter, etc.). The reading in the text, however, is preferable inasmuch as Kapha is included in Mala.

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