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 XXXVII - The treatment with an Anuvasana-vasti and an Uttara-vasti

Now we shall discourse on the treatment of an Anuvasana vasti and an Uttara vasti (Anuvasanottara-Vasti-Chikitsita). 1.

Metrical Texts:—

An Anuvasana-vasti should be applied to a patient fit to be treated therewith, seven days after the administration of a purgative and after he has regained his strength and taken his meal of rice. Three-quarter-parts of the medicinal solution enjoined to be used in connection with a Niruha-vasti (dry or oilless) in consideration of the age and temperament of the patient form the (full) dose of a Sneha-vasti An enema (Vasti) should be applied after the emission of stool, flatus and urine from the system, since they resist the penetration of the Sneha into the bowels. A Sneha- vasti (emulsive or oleaginous enema) should not be applied to a person whose organism has not been previously cleansed (by an appropriate emetic and purgative). The potency of the Sneha would be able to easily infiltrate into a system previously cleansed in the manner before indicated. 2.

Now we shall describe (the process of preparing) the several medicated oils in due order with reference to the different Doshas which should be used as drink and errhines and in charging a Sneha-vasti and which have the power of destroying a variety of diseases (if so used). 3-A.

First Taila:—

Drugs such as Shathi, Pushkara, Krishna, Madana, Deva-daru, Shatahva, Kushtha, Yashti-madhu, Vaca, Vilva and Citraka should be pounded together, made into a paste and duly cooked with oil (of four times their combined (weight) and milk weighing twice and water, four times as much as the oil. The use of this medicated oil as a Vasti-measure proves curative in pacifying the incarcerated Vayu and in cases of hemorrhoids, lienteric diarrhea (Grahani), tympanites with retention of stool and urine, Vishama-jvara and the affections of Vayu (nervous disorders) in the waist (lumbago), the thighs (sciatica), the back and the abdomen. 3.

Second Taila:—

Vaca, Pushkara, Kushtha, Ela, Madana, Deva-daru, Saindhava, Kakoli, Kshira-Kakoli, Yashti-madhu, Meda, Maha-meda, Naradhipa (Aragvadha), Patha,Jivaka, Jivanti, Bhargi, Chandana, Katphala, Sarala (white Trivrit), Aguru, Vilva, Valaka, Ashva- gandha, Citraka, Vriddhi, Vidanga, Aragvadha, Shyama Trivrit, Pippali and Riddhi should be pasted together and cooked with the proper quantity of oil, milk and the decoction of the drugs of the (major) Panca-mula group. Anuvasana-vastis of this kind are highly efficacious in cases of Gulma, tympanites with suppressed stool and urine, impaired digestion, hemorrhoids, lienteric diarrhea (Grahani), retentions of urine and diseases due to the action of the deranged Vayu. 4.

Third Taila:

Citraka, Ativisha, Danti, Vilva, Vaca, Amisha (Guggulu), Sarala (white Trivrit), Amshumati (Salaparni), Rasna, Nilini, Catur- angula (Aragvadha), Cavya, Ajamoda, Kakoli, the two kinds of Meda, Deva-daru, Jivaka, Rishavaka, Varshabhu, Aja-gandha, Shatahva, Harenu, Ashva-gandha, Manjishtha Shathi, Pushkara and Taskara (Choraka) should be pasted together and cooked with the proper quantity of milk and oil. The oil thus prepared is highly efficacious in the disorders of the deranged Vayu. Injected into the bowels in the manner of (an Anuvasana-vasti), it speedily cures Gridhrasi (sciatica), lameness, haunch-back, Adhya vata, urinary diseases, obstinate constipation of the bowels (Uda-varta), impaired digestion and weakness of the body. 5.

Fourth Taila:—

A decoction of the drugs Bhutika, Eranda, Varshabhu, Rasna, Vasaka, Rohisha, the drugs of the Dasha-mula group, Saha (Mudga-parni), Bhargi, Shad-granthi (Vaca), Deva-daru, Vala, Naga- vala, Murva, Ashva-gandha, the two Amrita (Guduci and Haritaki), Sahacara, Vari (Shata-vari), Shunthi, Kaka-nasa, Vidari Yava, Masha, Atasi, Kola and Kulattha should be cooked in an adequate quantity of oil with (a Kalka of) the drugs of the Jivaniya group and a quantity of milk weighing four times as much as the oil. The oil, if employed in the manner of a Vasti, would prove beneficial in cases of diseases due to the action of the deranged Vayu localised in the regions of the thighs, legs, coxcy (Trika), sides (Parsva), balls of the shoulders (Amsa) and in the hands, the head and Manya (nerves of the neck). 6.

Fifth Taila (with clarified butter):—

The drugs Jivanti, Ativala, Meda, the two kinds of Kakoli, Jivaka, Rishavaka, Ativisha, Krishna, Kaka-nasa, Vaca, Deva-daru, Rasna, Madana, Yashti-madhu, Sarala (white Trivrit), Shatavari, Chandana, Svayam-gupta with an adequate quantity of oil and clarified butter (in equal parts) with a quantity of milk weighing eight times as much as the combined weight of the oil and clarified butter. This oil should be employed in the manner of an Anuvasana-vasti in cases of Gulma and retentions of stool and urine with a distension of the abdomen. It conquers the deranged Vayu and Pitta of the body, acts as an invigorating and constructive tonic, improves digestion, increases strength and creates fresh semen. Used as an errhine or as a drink it tends to alleviate all affections confined to the regions above the clavicles. 7.

Sixth Sneha:—

Yashti-madhu, Ushira, Kashmarya, Katuka, Utpala, Chandana, Shyama[1] Padma- Kashtha, Jimuta, lndra-yava, Ativisha and Vala (in equal parts) should be pasted together and cooked with an adequate quantity of clarified butter and oil, the oil weighing a fourth part of the whole quantity of Sneha to which should be added a quantity of milk weighing eight times as much as the Sneha (oil and clarified butter added together) with a decoction of the drugs of the Nyagrodhadi group. This (medicated Ghrita), used as a Vasti proves efficacious in cases of Asrig-dara (menorrhagia), erysipelas (Visarpa), Vata-Rakta, abscess (Vidradhi), fever, burning sensations in the body and all other disorders due to the action of the deranged Pitta. 8.

Seventh Sneha:—

A paste of Mrinala, Utpala, Shaluka, the two kinds of Sariva, (Ananta-mula and Shyamalata), Naga-keshara, the two kinds of Chandana (red and white), Bhu-nimba, Padma-vija, Kasheruka, Patola, Katuka, Rakta (Manjishtha), Gundra, Parpataka and Vasaka (weighing one seer in all) should be cooked with (sixteen seers of) the decoction of Trina-mula[2] with (four seers of) oil and with milk twice as much as the oil. A variety of Pittaja diseases yields to the curative efficacy of this medicated oil, used as a Vasti, or as errhines, drink unguent. 9,

Eighth Sneha:—

A paste composed of Triphala, Ativisha, Murva, Trivrit, Citraka, Vasaka, Nimba, Aragvadha, Shad-grantha (Vaca), Sapta-parna, the two kinds of Haridra, (Haridra and Daru-haridra), Guduci, Indra-sura, (Indra-varuni), Pippali, Kushtha, Sarshapa and Nagara in equal parts (weighing one seer in all), should be cooked with an adequate quantity (four seers) of oil and (sixteen seers of) the decoction of the drugs of the Surasadi group. Obesity, a feeling of physical languor, itches, etc., as well as diseases due to the deranged condition of Kapha, readily yield to the use of this (medicated oil) employed as a medicinal snuff (Nasya), a gargle (Gandusha), a drink, or anointment, or as a Vasti. 10.

Ninth Sneha:—

A paste (weighing one seer in all) composed of Patha, Ajamoda, Sharmgashta, Pippali, Gaja-pippali, Shunthi, Sarala (D. R.—Saptala). Aguru, Kaliya, Bhargi, Cavya, Deva-daru, Marica, Ela, Haritaki, Katuka, Pippali-mula, Katphala pounded together and mixed with a decoction of the Valli[3] and the Kantaka each weighing twice as much as the weight of the oil, should be cooked with an adequate quantity of sesamum or castor oil (weighing four seers). All kinds of diseases due to a deranged condition of the bodily Kapha readily yield to the use of this (medicated) oil when employed in the manner of an Anuvasana enema (Vasti). 11.

Tenth Sneha:—

A pasted compound of Vidanga, Udicya, Saindhava salt, Shathi, Pushkara, Citraka, Katphala, Ativisha, Bhargi, Vaca, Kushtha, Deva-daru, Meda, Madana, Yashti-madhu, Shyama[4], Nichula (Jala-Vetasa), Nagara, Shataahva, Nilini, Rasna, Kadali, Vasaka, Renu, Vilva, Ajamoda, Pippali, Danti, Cavya, Naradhipa (Aragvadha) with the decoction of the drugs of the Mushkakadi group, should be cooked with an adequate quantity of sesamum or castor oil. The use of this oil in the manner of an Anuvasana- vasti (enema) speedily proves curative in cases of Plihodara (enlargement of the spleen), obstinate constipation of the bowels, Vata-Rakta, Gulma, retentions of stool and urine with a flatulent distention of the abdomen, in diseases due to the action of the deranged Kapha, in urinary complaints, gravels in the bladder (Sarkara) and in hemorrhoids. 12.

An Anuvasna-vasti may be applied in all parts of the day and night and even (if necessary) without any previous exhibition of emetics and purgatives, in the case of a patient in whose system the Vayu has been incarcerated and extremely aggravated. The application of a Nirudha-vasti (enema) should, however, be made in respect of a person of an extremely dry temperament, or in whose system the deranged and aggravated Vayu extremely predominates, only after his system had been made sufficiently emulcent (Snigdha) by two or three injections with an Anuvasana-vasti. But if his system be agitated only with an extremely aggravated condition of his bodily Vayu, a Nirudha-vasti (enema), charged with a medicinal solution and with a profuse quantity of Sneha added therewith, may be applied even before applying a Sneha (Vasti). On finding that the Nirudha-vasti has fully acted, the physician should treat the patient with medicinal solutions of oils prepared with Yashti-madhu and Madana fruit respectively in the manner of an Anuvasana-vasti in cases of the aggravations of Vayu, etc. 13.

A Vasti should not be applied in the night since the Doshas of the system are (generally) aggravated at this time and since the Sneha (of the Vasti j owing to its potency is likely to give rise to a distention of the abdomen attended with fever and heaviness of the limbs. The mouths of the internal ducts of the body remain dilated and the Doshas remain in their proper places ( i.e., are not generally agitated), and the digestive fire remains surcharged with the essence of the digestive food during the day time, hence the potency (Ojas) of a Sneha-vasti employed during the day time easily spreads through the ducts of the body. An Anuvasana- vasti may be applied during (the early part of) the night in summer in a case marked by a preponderance of the deranged Pitta and a (consequent) weakness of the Kapha, and an extremely parched condition of the organism, as well as in cases of the affections of Vayu (Vata-roga). Unfavourable symptoms such as a burning sensation in the body, etc., arise from the application of a Vasti in the day time during a preponderance of the Pitta, or in summer. The physician should, therefore, make such applications in the evening (Pradosha) in such instances. 14.

Proper time for the application of the Sneha-vasti:—

A Sneha-vasti should be employed during the day in spring and winter and in the evening during summer and the rainy season, with a view to ward off the dangers due to the misapplication in the internal use of a Sneha.[5] It may, however, be applied at any time during the day, or in the night in a case marked by a preponderance of the deranged bodily Vayu. 15.

In the serious stage of a disease an Anuvasana- enema should be applied after the patient has partaken of a second meal, having already digested his previous one. The use of a Sneha-vasti is forbidden in an empty stomach as it might otherwise send the injected fluid higher up into the intestines owing to the emptiness and cleansed[6] (unencumbered) state of the stomach. An application of the Anuvasana-vasti should be made just after a meal, since the application of a Vasti made during the continuance of a partially digested or undigested meal in the stomach brings on fever. An Anuvasana enema should not, however, be applied after the patient had taken his meal, richly saturated or cooked with a Sneha (oil or clarified butter), since the double introduction of the Sneha into the system through the medium of food and the Vasti brings on vertigo and epilepsy. The strength and complexion of the patient suffer much by the application of an Anuvasana-vasti after he has taken a dry (Ruksha) meal containing no Sneha. A patient should, therefore, be first fed with a diet saturated with a moderate quantity of an oleaginous substance before being treated with an Anuvasana-vasti. The patient before being treated with an Anuvasana vasti should be fed with Mudga-soup[7], cow’s milk and meat-essence to a quarter part[9] less than the quantity he can ordinarily take. 16.

The mode of applying a Sneha- vasti:—

The body of the patient to be treated with an Anuvasana vasti should be first anointed (with a Sneha) and gently fomented with hot water. Then he should be advised to take his meal in the prescribed way and made to take a short walk. Then having passed stools and urine, he should be treated with the Sneha-vasti. The mode of applying (the apparatus) is described under that of Niruha-vasti. He should be kept silently lying on his back as long as it would take to count a hundred words (Vak). The potency (Virja) of the injected Sneha spreads through the entire organism in the event of one’s lying with outstretched limbs in the above manner after the application of a Sneha-vasti. The patient should be gently struck[10] three times on each of the soles and the palms of his hands and on the buttocks[11]. The (patient with his) bedding should be thrice raised (and shaken with gentle jerks). After that he should be laid on a bed stretched out at full length and be advised to speak and exert himself as little as possible and conform to a strict regimen of diet and conduct. 17-19.

A quantity of Shatahva and Saindhava should be mixed with the Sneha (to be used in the Vasti) and (the whole compound) applied lukewarm, inasmuch as the injected Sneha would thereby easily flow back (without producing any pain and burning sensation, etc.) and dribble down in due time after the application. If at any time a quantity of the Sneha injected into the bowels in the manner of an Anuvasana enema (Vasti) is instantly driven back by the pressure of the incarcerated abdominal Vayu, or the Vayu (air) of the bladder (Vasti\ or by an excessive heat, keenness (in potency), or an over-dose of the injected fluid itself, or by the over dose of the medicines (subsequently) added thereto, a Sneha- vasti charged with a smaller dose of the Sneha should be again applied, since a Sneha un retained in the abdomen fails to produce any emulsive effect. 20-21.

Retention of stool, urine and Vayu (flatus) is produced by using an insufficient quantity of Sneha in an Anuvasana-vasti. A burning sensation in the body, diarrhea (Pravaha) and fatigue accompanied with pain set in as the natural resultants of an excessive Anuvasana enema. The satisfactory nature of the application of an Anuvasana-vasti should be inferred from the timely discharge of the injected Sneha with flatus and fecal matter[12] out of the bowels of a patient without giving rise to any distressing symptoms such as burning and sucking[13] sensations, etc. 22.

The patient may be given a light[14] meal or diet in the evening, in case he is possessed of a keen digestive capacity[15], subsequent to the digestion of a previous meal and (should he feel hungry) after the discharging of the injected Sneha. Tepid water boiled with Dhanyaka and Shunthi should be given hot to the patient on the (following) morning as it would sharpen his appetite and produce a fresh relish for food. 23.

This is the procedure of applying a Sneha-vasti. Six, seven, eight or nine applications of Sneha-vastis should in this manner be made in succession alternately with those of a Nirudha-vasti. 24-A.

The Successive actions of the Vastis:—

The first application of the Vasti permeates the pelvic and the inguinal regions with the emulcent essence of the injected Sneha. The second tends to restore the Vayu in the cephalic part of the body to its normal condition. The third contributes to the improvement of bodily strength and complexion. The fourth permeates the Rasa (lymph chyle) with its own oily essence. In this way the fifth application of a Vasti permeates the blood, the sixth the flesh, the seventh the fat, the eighth the bones, and the ninth the marrow with the oily essence. This series of Vasti-applications repeated twice tends to purify the semen from all its impure or unhealthy constituents. 24.

A person treated with eighteen series (three hundred and twenty-four in number) of such Sneha-vastis and Niruha-vastis in the above mentioned way and observing the prescribed rules of diet and conduct is enabled to develop a muscular strength in no way inferior to that of an elephant, and to live a sinless life a thousand years, in the full enjoyment of his intellectual faculties, god-like beauty and horse-like swiftness. 25.

An excessive application of only one kind of Vasti, either of a Sneha-vasti, or of a Niruha vasti, should be avoided, since an excess of the first (Sneha-vasti) tends to impair the digestive capacity[16] and to bring on an aggravation of the deranged Kapha, while an excess of the second (Niruha-vasti) tends to aggravate the bcdily Vayu. Hence an application of the Sneha-vasti should be followed by one of the Niruha-vasti and vice versa, in order to avoid all apprehension of an aggravation of Pitta, Kapha and Vayu. Daily applications of a Sneha- vasti are not forbidden in respect of a person of parched or dry (Ruksha) and Vayu-predominating temperament, while in other instances they should be made on each fourth day, so that the digestive capacity might not be thereby impaired. The application of a moderate quantity of Sneha with a Sneha-vasti is always beneficial to persons of parched or dry temperament. Similarly, an application of the Niruha vasti in a small quantity always proves beneficial to the persons who have been already treated with a Sneha (Vasti). 26.

Distresses from Sneha-vasti:—

Now we shall describe the distresses which are found to attend (an abuse or excess of) a Sneha vasti. Various kinds of distressing symptoms are produced by the application of a Sneha vasti of a mild or weak potency in the case of a patient whose stomach is filled with the aggravated Doshas so that the Sneha cannot flow back, being overwhelmed, as it would be, by the aggravated Doshas. 27.

Specific Symptoms:—

An astringent taste in the mouth, yawning, shivering and Vishama-Jvara with the peculiar Vayu origined distempers such as, pain (in the limbs) are the symptoms which mark the retention of the injected Sneha in the bowels over-whelmed by the action of the deranged Vayu. Fever, a burning ; sensation (of the body), thirst, perspiration, a pungent taste in the mouth and yellowness of the complexion, urine and the eyes are the features which are due to the retention of the injected Sneha in the bowels overwhelmed by the action of the deranged Pitta. Water- brash, a sweet taste in the mouth, heaviness of the limbs, vomiting, difficult breathing, catarrhal fever (Shita-Jvara) and an aversion to food are the indications due to the retention of the injected Sneha in the bowels overpowered by the action of the deranged Kapha. In these cases, applications of (Sneha) Vastis and such other remedial measures as are soothing to the Dosha or Doshas (giving rise to the retention of the Sneha in the bowels) should be adopted with due regard to the nature and intensity of each. 28-29.

Cramps (Shula) and heaviness in the stomach (Amashaya), suppression of the Vayu (flatus), affection of the heart, a bad taste in the mouth, difficult respiration, epileptic fits, vertigo and an aversion to food are the symptoms which attend a retention of the Sneha in the bowels owing to the pressure of food matter carried down into the abdomen of a person who has been so treated after a heavy meal, and they should be remedied first by fasting and then by appetising measures. 30.

A languid feeling in the limbs attended with a distension of the abdomen, colic (Shula), difficult breathing and a sense of heaviness in the intestines mark the retention of the injected Sneha surcharged with the fecal matter of a person previously uncleansed by proper remedies. The remedy in such cases consists in the application of Niruha-vastis as well as Sneha- vastis with the admixture of keen-potencied drugs. 31.

A scent of the Sneha in the mouth, cough, difficult breathing, an aversion to food and dullness of all sense-organs which become internally charged with a coating of oil and a glossy appearance of the skin (mouth—D. R.) mark an undesirably higher introduction of the Sneha injected into the system previously cleansed (with proper emetics and purgatives). Such a case should be treated as a case of Ati-pidita (over pressure on the bladder of the) enema and with the applications of Asthapana-vastis as well. 32.

An inadequate quantity of Sneha of a mild or weak potency, injected cold with the help of an enema, is not retained in the system, if not duly fomented and cleansed before, but gives rise to scanty stools, cramps (Shula), heaviness and distention in the region of the intestines (Pakvashaya) and (ultimate) suppression of stool, etc. Such cases should be speedily remedied by the application of an asthapana as well as by that of an Anuvasana-vasti. 33.

A small quantity of Sneha of mild potency, injected into the bowels of a patient taking only a small quantity of food, fails to flow therefrom and gives rise to a dullness of spirit, a tendency to vomit and a sense of lassitude which should be remedied by the application of Asthapana-vastis charged with (the decoction of) Shodhaniya (cleansing) drugs and by the application of Anuvasana enemas charged with Sneha boiled and cooked with those (Shodhaniya) drugs. 34.

The Sneha of a Vasti, if found to dribble down (from the system) after the lapse of even a whole day and night from the time of its application, without giving rise to any physical discomfort, does no mischief but exerts all the good effects of the application of the Vasti. Whereas, if digested, it produces but very little benefit to the patient. The retention of the whole or of any portion of the Sneha injected into the bowels of a patient without producing any special physical discomfort should be ascribed to an extremely parched or dry condition of his organism, and would not require any special medical treatment. 35-36.

In case of a Sneha not flowing out from the bowels within a period of twenty-four hours of its introduction (and in case of its producing any supervening symptoms), corrective (Shodhana) remedies should be employed and all subsequent applications of Sneha should be stopped. Thus we have finished describing the diseases (Vyapat) and symptoms which result from the injudicious use of Sneha (Vastis) together with the nature of the medical treatment to be employed in each of them. 37.


Now we shall describe the mode of applying an Uttara-vasti (injection into the urethra of a male or of a female patients The pipe to be used for the purpose (in the case of a male patient) should be made to measure fourteen fingers in length, measured by the patient’s own fingers. It should be shaped like the stem of a Malati flower (in girth) at its top-end and provided with an aperture admitting the passage of a mustard seed. Several authorises hold that the length of the pipe should be equal to that of the penis (of the patient). The largest dose of a Sneha to be used in connection with an urethral injection (Uttara-vasti) is only one Kuncha (Pala); and this should be determined with discretion in respect of patients below twenty-five years of age. There should be (two) Karnikas (protrusions) in the middle part of the pipe (Netra) in the case of a male. In the case of a female patient, however, the Karnikas should be placed above a space of four fingers (from its end). The whole pipe should be ten fingers in length and should be made to suit the urethral channel (of the patient) with an aperture sufficient to allow a Mudga - pulse to pass through it. 38.

In the case of a vaginal douche or injection (Vasti), the pipe of the Uttara-vasti should be introduced to the extent of four fingers only into the vaginal canal. Two fingers only of the entire length of the pipe should be inserted into the channel of the urethra in the case of an adult woman, whereas, in the case of a young girl of tender years, the pipe should be introduced to the length of one finger only. Here it should be noted that these measures are to be determined by the standard of the patient’s own fingers. A Prasrita measure of the Sneha by which is meant a quantity that would be contained in the hollow of the palms of the patient’s hand extending to the roots of the phalanx is the largest dose to be used in both these instances. In the case of patients of tender years the dosage should be determined with discretion in each case. 39.

The Vasti (bladder of the enema) should be made of the bladder of a hog, lamb, or, a goat, or in its absence, of the skin of the neck of a bird, or of the leg of a Driti (a leathern bag for holding water), or of any other soft skin. 40.

Mode of application:—

The body of the patient should be first treated with a Sneha and with fomentation (Sveda), and his bowels (Ashaya) should be cleansed. He should then be made to partake of a gruel (Yavagu) mixed with milk and clarified butter according to his digestive capacity. He should be made to sit on a cushion placed on even ground and as high as his knee-joints. Lukewarm oil should be rubbed over the region of the neck of the bladder, and the penis should be (artificially) excited and made steady and straight. The orifice or the channel of the urethra should be first (dilated and) searched with the help of an indicator (Shalaka), and then the pipe of the Uttara-vasti, lubricated with clarified butter, should be gently and gradually inserted therein to the extent of six fingers. The Sneha should be injected into the urethra by gently pressing the bladder of the Uttara- vasti, and the pipe should then be gradually withdrawn from the urethra. The patient should be made to partake of a moderate quantity of boiled rice with milk, Yusha (Mudga-soup, etc.), or meat-soup[17] in the evening after the dribbling out of the injected Sneha. Three or four injections should be thus made with the help of an urethral enema (Uttara- vasti). 41.

Vaginal Uttara-vasti:—

A grown up female patient, (under the circumstances), should be laid on her back with arched and up-drawn knees, and an injection should be made into her vaginal canal (Yoni) by an experienced physician (D. R.—carefully). The pipe should be most gently pressed in the case of a girl before menstruation. For the purpose of purifying the uterus (Garbhashaya), double the ordinary (one Prasrita) quantity of Sneha should be injected into the vaginal canal (by means of a Vasti) with a pipe having three Karnikas (protuberance) attached to it. 42-43.

In case the injected fluid does not come back (within the prescribed time), a fresh Vasti (enema) should be again applied with (the decoctions of) the Shodhana[19] (purifying) drugs, or a Varti (plug) prepared with the Sodhana drugs should be injected into the rectum. As an alternative, an indicator (Eshani) should be inserted into the mouth of the bladder, or the region of the abdomen below the umbilicus, and be firmly pressed with a close fist, or medicinal plugs or sticks (Varti) of the size of a Mudga- pulse, cardamom-seed (Ela), or mustard-seed should be made up of Saindhava and the leaves of the Aragvadha pasted with the expressed juice of Nirgundi and cow’s urine, and these plugs (Varti) should, according to the age of the patient, be inserted (into the mouth of the bladder) with (the top-end of) a rod or an indicator (Shalaka) for the out-flow of the injected fluid. Another alternative is to use a stick (Varti) made up of the pendant soot of a room (Agara-dhuma), Vrihati, Pippali, Madana fruit, Saindhava salt and Shunthi pasted with Shukta (a sort of Kanjika) and cow’s urine (in the preceding manner). Other (similar) measures should be adopted for the successful action of an Anuvasana enema (Vasti). 44-A.

A cold decoction of Yashti-madhu saturated with honey and sugar[20] or a decoction of the (bark of the) milk-exuding trees (Kshiri-Vriksha), or cold milk, should again be injected into the bladder, in the event of there being a burning sensation in that organ. 44.

Diseases such as derangements of the semen, or of ovum, or difficult menstruation, excess or suppression of the monthly flow, diseases of the uterus and of the vaginal canal, non-falling of the placenta, strangury and other diseases of the urine, gravel, stones (Ashmari), spermatorrhea (Shukrotseka), cramps in the bladder, in the groins and in the urethra and all other severe diseases of the bladder other than Meha, will all yield to the application of an Uttara-vasti (urethral enema). Symptoms which mark, or dangers which attend, a judicious or an injudicious application of an Uttara-vasti are respectively identical with those which characterise or attend those of a Sneha-vasti. 45-46.


Thus ends the Thirty-seventh Chapter of the Chikitsita Sthana in the Sushruta Samhita which deals with the Anuvasana-vasti and the Uttara-vasti.

Footnotes and references:


Dallana explains “Shyama” as “Priyangu” and “Jimuta” as “Mustaka.”


Dallana explains “Trina-mula” as “Trina-panca-mula” for which see Ch. XXXVIII, Sutra-Sthana.


The “Valli” and the “Kantaka” here evidently mean the “Valli- panca-mula” and the ‘Kantaka-Panca-mula” respectively for which see chapter XXXVIII. Sutra-Sthana.


Dallana explains “Shyama” as “Vriddha-daraka” and “Renu” as “Parpataka”(?).


See Chapter XXXI., Chikitsita-Sthana.


Gayadasa reads “sūkṣmatvat” in place of “shunddhatvat” and explains it to mean “owing to the potency of the Sneha in traversing through the minutest channels of the body.”


Dallana explains that the Mudga soup should be taken without being mixed with any Sneha. He further says that the patient should be given Mudga-soup, cow’s milk and meat-essence in accordance with the aggravation of the deranged Kapha, Pitta and Vayu respectively.


Gayadasa reads “sūkṣmatvat” in place of “śunddhatvat” and explains it to mean “owing to the potency of the Sneha in traversing through the minutest channels of the body.”


Dallana, on the authority of the older Commentators explains that the patient should not be fed to his fill but only to three-fourths, half and one-fourth of what he can ordinarily take according to his digestive capacity.


Dallana explains that the patient should be caught hold of by his wrists and ankles and given the gentle jerks so as to allow the potency of the Sneha spread through the organism.


Some explain that the buttocks of the patient should be raised up with his bedding and his couch. At any rate his buttocks should be raised up in order to enable the injected Sneha to remain inside the intestines and not to come out instantly.


It should be noted that the particle “ca” in the text means that on the satisfactory action of an Anuvasana-Vasti, the injected Sneha may come out with urine as well.


Dallana explains “coṣa” to mean thirst.


“Light” means both light in quantity as well as in quality.


Some commentators explain this couplet to mean that a patient of ordinary digestive capacity should be given a light food, whereas a patient of keen digestive capacity may take a full one.


Vrinda reads “snehat pittakaphotkleshau” in place of “snehadagnivadhotkleshau”. This means that the Pitta and the Kapha would be aggravated by an excessive use of a Sneha-vasti. The next couplet in the text would better support Vrinda’s reading.—Ed.


Milk, Yasha and meat-soup should be prescribed in cases of the predominance of Kapha, Pitta and Vayu respectively.—Dallana.


Vrinda reads “snehat pittakaphotkleśau” in place of “snehadagnivadhotkleśau”. This means that the Pitta and the Kapha would be aggravated by an excessive use of a Sneha-vasti. The next couplet in the text would better support Vrinda’s reading.—Ed.


The Shodhana drugs here are the Trina-panca-muja and such other drugs.—Dallana.


According to Dallana a quantity of sugar and honey should be added in each of the three cases, viz., (1) the decoction of Yashtimadhu, (2) that of the Kshiri-trees, and (3) milk.

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