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 XXXVIII - The treatment with a Nirudha-vasti

Now we shall discourse on the mode of applying as well as on the treatment with a Nirudha-vasti (Nirudhopakrama-Chikitsita). 1.

The mode of preparing a Vasti:—

The application of an Anuvasana-vasti (enema) should be followed by that of one of the asthapana class. The body of the patient should be first anointed (with a Sneha) and fomented. Previous to the application of a vasti, the bowels and bladder should be relieved of all (fecal) accumulations (flatus and urine). The clyster (Vasti)should be applied at noon in a well-cleansed chamber, devoid of any gust of wind, and the patient should be laid on his left side on a spacious bed not furnished with any pillows, but a little raised up there where his buttocks would rest, and there should be attendants at his feet. The patient should continue in a. cheerful mood with his left thigh held in an outstretched posture and the right one flexed, and should refrain from speaking to any body. The digestion of the ingested food taken by the patient is necessary (before the application of the Vasti). The physician having placed the pipe of the enema (Vasti) upon his left foot should firmly press its Karnika with the first and the second toes of his right foot. One half of the mouth of the Vasti should be kept contracted by pressing it with the small and ring finger of his left hand and the (other) half should be stretched with the aid of his thumb, index and middle fingers, and thus the medicinal solution should be poured into the bladder (Vasti). The pipe should be held with the middle and the index finger of the right hand. Care should be taken not to let the medicinal solution overflow from the surface of the pipe, nor to admit of even a bubble of air into the bladder (of the enema), nor to produce its over-contraction nor dilatation during the process (of pouring the medicine). The bladder filled with the proper quantity of medicinal solution should then be held in the left hand, and washed with the right hand. It should then be firmly tied (at the neck) just over the (surface of the) medicinal solution with ligatures of two or three rounds of thread. 2-A.

The mode of applying a Vasti:—

The Vasti should then be held up on the palm of the right hand, its pipe gripped with the middle and index fingers of the left hand, and the orifice closed with the thumb of the same hand. The neck of the pipe should be previously lubricated with clarified butter, and gently introduced into the rectum of the patient up to its Karnika (protuberance) along the line of spinal column and with its mouth up-turned. The patient should be asked to take the same with care. 2.

Metrical Text:—

The physician should then hold the enema (Vasti) with his left hand and press its bladder with his right. The injection (of the medicinal solution contained in the enema) should be made at once, neither too slowly nor too hurriedly. 3.

The pipe should then be withdrawn and removed, and the patient should be asked to remain in the same position for a period sufficient to utter thirty Matras[1] from the time of injection. The patient should then be asked to get up and sit on his legs for the full outflow of the injected solution. The period of a Muhurta (about forty-eight minutes) is usually required for a complete outflow of the Niruha-vasti (from the bowels). 4.

Metrical Texts:—

This method of applying the Vasti should be continued three or four times as required in each case by the physician, experienced in the application of the same. It should be discontinued after certain characteristic symptoms had been fully developed and manifested (in the system of the patient). Less is better than excess (in respect of Vasti-applications and more so particularly in the case of a patient of a delicate constitution. 5.

Symptoms of an inadequate and excessive application of a Vasti:—

The emission of only a small quantity of flatus (Vayu), fecal matter and (of the medicinal solution applied in) the Vasti, as also the appearance of the supervening distresses of urinary disorders, an aversion to food and physical lassitude indicate the inadequacy of the application of the Vasti. Symptoms which have been described before[2] as marking an excessive use of purgatives are also said to result from an excessive application of a Niruha-vasti. 6 A.

Symptoms of a satisfactory application o f a Vasti:—

A lightness of the body, experienced in consequence of the successive and satisfactory evacuations of stool,[3] Pitta (bilious matters), Kapha (mucus) and Vayu (flatus) from the bowels, are the salient features of a satisfactory application of a Niruha-vasti (Su-nirudha). After the manifestation of the foregoing symptoms the patient should be advised to bathe (in hot water) and to take meat-soup (Rasa), milk and pulse-soup (Yusha) in diseases due to the action of the deranged Vayu, Pitta and Kapha respectively. The essence (Rasa) of the meat of any Jangala animal may, however, be prescribed in all cases under the circumstances, since it would produce no harm. Only a quarter, a half or three-quarter part of the usual diet should be prescribed according to the digestive capacity of the patient, and the nature and intensity of the Doshas involved in each case. 6-B.

The subsequent treatment should consist in applying a Sneha-vasti (oleaginous enema) according to the nature and intensity of the underlying Doshas in each case. A lightness of the body, sprightliness of the mind, amelioration or abatement of the disease, an emulsive condition of the organism, are the features which mark the satisfactory application of an asthapana as well as of an Anuvasana-vasti. 6-C.

The patient should be made to partake of his meal with meat-soup on the day of his being treated with a (Niruha) Vasti; since there is an apprehension of the Vayu being greatly deranged and aggravated (by the application of the Vasti). He should then be treated with an Anuvasana (Vasti) on the same day. Thereafter the application of the Sneha-vasti should be regulated[4] with a regard to the state of the appetite and the intensity of the deranged Vayu, and in the event of the Koshtha (stomach) being found to have been stuffed with food. 6

A fresh and stronger Nirudha injection (Vasti), composed of Yava-kshara, cow’s urine, Kanjika and the Shodhana (purifying) drugs, should be applied (into the bowels) in the event of the previous one not passing out within a Muhurta, since a Nirudha injection (Vasti) long retained in the bowels by the enraged and aggravated Vayu causes Shula (colic), an aversion to food, fever and Anaha271 (distension of the abdomen with suppression of stool and urine), or may ultimately have a fatal termination. 7.

The application of an asthapana enema is forbidden after a meal as it may bring on an attack of Visuchika[5] (D. R.—ama), or of vomiting, or may tend to aggravate the Doshas of the body. Hence an asthapana-vasti (enema) should be applied only on an empty stomach. The Doshas (in the system) of a person lie in a free and potent state at the close of the process of digestion, and are easily and spontaneously eliminated from the system (by the application of the asthapana-vasti), when the stomach (Ashaya) is not further oppressed or stuffed with food. The digestive fire (Jatharagni) can not digest the food, if scattered or diffused by the application of an asthapana-vasti (into the bowels). Hence it is that an asthapana injection should be made on an empty stomach. The application of a Niruha-vasti (which is not applicable in all cases) should, however, be determined with a regard to the exigencies of the case, since the strength of the aggravated Doshas of the body abate with the evacuations of the bowels (as well as with the elimination of all filthy matters from the system). 8.

Drugs to be used in a Niruha-vasti:—

The following drugs and articles, or as many of them as would be available, such as, all kinds of milk, acid group (Kanjika, etc.), urine, Sneha (oleaginous substances), the drug decoctions (Kashaya), meat- soup (Rasa), salts, Phala (Triphala), honey, Shatahva, Sarshapa, Vaca, Ela, Trikatu, Rasna, Sarala, Deva- daru, Rajani, Yashti-madhu, Hingu, Kushtha, the drugs of the Samshodhana (corrective) group (Trivrit, etc.), Katuka, Sugar, Musta, Ushira, Chandana, Shathi, Manjishtha, Madana, Chanda Trayamana, Rasanjana, (dried) Vilva fruit, Yamani, Phalini, Indrayava, Yava, Kakoli, Kshira-kakoli, Jivaka, Rishabhaka, Meda, Maha- meda, Riddhi, Vriddhi and Madhulika, should be used in charging a Nirudha-vasti. 9.

Formula of the Niruha-vasti:—

In the case of a healthy person (marked by an equilibrium of Vayu, Pitta and Kapha), the solution to be injected should be composed of four parts of the decoction of drugs[6] and one part (a fifth part of the entire compound) of the Sneha (any oleaginous substance). In any case marked by a preponderance of the deranged Vayu, the Sneha should measure a quarter part of the whole, one-sixth in a case of a preponderance of the deranged Pitta and an eighth part in a case of the deranged Kapha. In a case of aggravation of all the (three) Doshas, the Kalka should measure an eighth part (of the entire quantity of the medicinal solution to be injected), and the following drugs or articles, viz., salt, honey, cow’s urine, Phala (Madana), milk, acid group (Kanjika, etc.) and extract of meat, in charging a Nirudha-Vasti should, as regards dosage, be determined by a due consideration of the requirements in each case. When the Kalka, the Sneha, and the decoction would be well mixed together, the solution for injection should be considered to have been well prepared The application of such a solution would be supposed to produce the wished-for results. 10-A.

The process of preparation:—

An Aksha measure (two Tolas) of Saindhava salt should be first mixed with the palms of the hand on a plate with two Prasrita (thirty-two Tolas) measures of honey, to which Sneha (oil, etc.) should be gradually added. When well dissolved, the pastes of (Madana) Phala should be added thereto. The drugs to be used as the Kalka in proportion to the prescribed parts should then be finely powdered and mixed with the preceding compound. The whole should then be well stirred in a deep vessel with a ladle (Khaja)[7] so as not to make it too thick, nor too thin. The compound thus prepared should be mixed with five Prasrita measures of the well-filtered drug decoction (prescribed in each case) and with cow’s urine, meat-essence, milk and acid articles (Kanjika, etc.) according to the nature of the Doshas involved in the case. 10.

Dva-dasa Prasriti:—

Now we shall describe the (recipe and preparation of) Vastis (technically) called the “Dva-dasha Prasrita” (weighing twelve Prasritas). An Aksha measure (two Tolas) of Saindhava salt should be rubbed with two Prasritas (thirty-two Tolas) of honey to which should be added three Prasritas of a Sneha (oleaginous substance). The whole should then be stirred and when the Sneha would be well mixed, a Prasrita measure of a medicinal Kalka, four Prasritas of a decoction, and two Prasritas of medicinal after-throws (powdered drugs thrown to or cast in a medicinal compound at the close of its decoction) should be added to it. In this way an enema solution should be made to measure twelve Prasritas in all and is hence called “Dva-dasha-Prasrita”. This should be regarded as the rule in respect of a full dose and the physician may reduce the numbers of Prasritas (if required). This kind of variation according to the age of the patient, in the quantity of each drug of a Niruha-Vasti which commences with the Saindhava salt and ends with the liquid (viz., Kashaya) has always been observed by the physician aspiring after success (in prescribing a Vasti). 11.

Classification of Vastis according to the range of their therapeutic applications:—

Now we shall deal with the classification of (Nirudha) enemas (according to the difference in their therapeutic ranges) which, when applied with due consideration of the aggravated Doshas (acting as the exciting factors), will conquer many a disease. 12.

A decoction should be prepared with one Pala of each of Sampaka, Ruvu, Varshabhu, Ashva-gandha, Nisha-cchada (Shathi), Panca-mula, Vala, Rasna, Guduci and Deva-daru and Madana fruit eight (two Palas) in number (boiled together and reduced to a quarter part of the original quantity of water). After that a paste (Kalka) composed of Magadhika, Ambhoda, (Musta), Havusha, Misi (anisi), Saindhava, Vatsahva, Priyangu, Ugra (Vaca), Yashtyahva, and Rasanjana being mixed with honey, etc.,[8] should be dissolved in the preceding medicinal decoction and injected lukewarm (into the bowels) in the manner of an asthapana-Vasti. Pain in the back, the thighs and in the regions of the sacrum (Trika), stone, retention of stool, urine and flatus, diarrhea (Grahani), Hemorrhoids and diseases due to the action of the deranged Vayu, readily yield to the curative efficacy of such injections, by which also, the blood, muscles and the strength are improved. 13.

A decoction duly prepared with Guduci, Triphala, Rasna, Dasha-mula and Vala weighing one Pala[9] each, and a pulverised compound consisting of Priyangu, Rasanjana, Saindhava, Shata-pushpa, Vaca, Krishna, Yamani, Kushtha, Vilva fruit and treacle each weighing an Aksha (two Tolas) and half a Pala of pulverised Madana fruit, should be injected into the bowels (in the manner of an Asthapana enema injection), stirred and mixed with an adequate quantity of honey, oil, clarified butter, milk, Shukta, Kanjika, Mastu (curd-cream) and cow’s urine[10]. Strength, energy, vigour, complexion, digestive capacity, verility and vital duration of the user would be increased by its application, and all derangements of the bodily Vayu would yield to its curative efficacy. It is one of the best rejuvenating agents. 14.

A decoction should be made by boiling together the drugs of the Kshudra-Panca-mula group, Musta, Tri-phala, Utpala, Vasaka, Sariva, Manjishtha, Rasna, Renu, and Parushaka each weighing one Pala. A compound of Shringataka, Atma-gupta, Gaja-pippali, Keshara, Aguru, Chandana, Vidari, Misi (anisi), Manjishtha, Shyama, Indra-yava, Saindhava-salt, Madana-Phala, Yashti-madhu, Padma-kashtha pasted together, should be dissolved in the preceding decoction which should be mixed and stirred with milk, honey and clarified butter and injected cold without the addition of any acid substance, in the manner of an asthapana enema (Vasti). It should be applied in liquid form. A burning sensation of the body, menorrhea (Asrig-dara), Hemorrhage, Pittaja-gulma, Pittaja-fever, yield to the curative efficacy of such a medicinal injection (Vasti). 15.

A decoction should be duly prepared with Lodhra, Rakta-chandana, Manjishtha, Rasna, Ananta, Vala, Riddhi, Sariva, Vrisha, Kashmaryya, Meda, Madhuka (Yashti-madhu), Padmaka, the drugs included in the Sthiradi (minor Panca-mula) and the Trina-Panca-mula groups, each weighing three Karshas (six Tolas). Then a paste composed of Jivaka, Rishabhaka Kakoli Kshira- Kakoli, Riddhi, Yashti-madhu, Utpala, Prapaundarika, Jivanti, Meda, Renu (Parpataka), Parushaka, Abhiru (Shatavari), Misi, Saindhava, Vatsaka, Ushira, Padmaka, Kasheru and sugar pasted together should be mixed with the preceding decoction made into a fluid solution with an adequate quantity of milk, honey, and clarified butter and other fluid substances[11] other than strong acid ones (Kanjika, etc.). It should then be injected well cooled in the manner of an asthapana- Vasti. It would undoubtedly prove curative in cases of Gulma, menorrhegia (Asrig-dara), heart diseases, Jaundice, Vishama jvara, Hemorrhage (Rakta-pitta), dysentery, and other Pittaja ailments. 16.

A compound of Vala, Madana fruit, Sarshapa, Saindhava, Deva-daru, Kushtha, Ela, Pippali, Vilva and Shunthi (weighing three Palas in all) pounded together and mixed with the decoction of Bhadra, Nimba, Kulattha pulse, Arka, Koshataki, Amrita, (Guduci), Deva-daru, Sariva, Vrihati, Patha, Murva, Aragvadha and Kutaja- seeds (weighing sixteen Palas in all) cooked with water (one hundred and twenty-eight Palas) should be injected in the manner of an asthapana-Vasti, with the addition of an adequate quantity of mustard oil, honey, alkali, cow’s urine, sesamum oil and water (three Palas). This would speedily conquer an attack of Chlorosis (Kamala), Jaundice, Meha, obesity, impaired digestion, aversion to food, goitre, slow poisoning, (Gara visha), elephantiasis, Udara, or of any disorders due to the deranged Kapha. 17.

Musta, Saindhava, Deva-daru, Patha, Pippali and Indra-yava, pounded together, and made into a paste with the admixture of the decoction prepared with such drugs as Dasha-mula, Haridra, Vilva, Patola, Triphala, and Deva-daru, should be stirred and saturated with oil, Yava-kshara and honey and reduced to a soluble fluidity by adding (an adequate quantity of) cow’s urine, Madana-phala and Kanjika. The solution thus prepared should be injected (into the rectum of the patient) in the manner of an asthapana enema-injection and this would prove curative in cases of Jaundice, deranged Kapha, alcoholism, lassitude, suppression of flatus (Vayu) and of urine, in cases of there being any rumbling sounds in the intestines (atopa), and Gulma and in diseases due to worms. 18.

Madana-phala, Yashti-madhu, Vaca, Deva-daru, Sarshapa, Pippali-mula, Saindhava salt (Sindhuttha), Yamani, Misi and Indra-yava should be pounded together and made into a paste with the admixture of the decoction prepared with a Pala measure each of Vasaka, Ashma bheda, Varshabhu, Dhanya, Eranda-mula, Dasha- mula, Vala, Murva, Yava, Kola, Nisha-cchada (Shathi), Kulattha, Vilva, and Bhu-nimba and dissolved in an adequate quantity of honey and the expressed juice of sugar-cane, milk, oil, clarified butter, meat-essence, and the urine (of a cow) by stirring them together. The solution thus prepared should be speedily injected in the manner of an asthapana injection into the rectum of a patient suffering from a disease marked by the concerted action of two or more of the deranged Doshas. Diseases such as Gridhrasi, Sharkara, Ashthila Tuni and Gulma may be rapidly cured with this injection (Vasti). 19.

Madana fruit, Yashti-madhu, Misi (anisi), Saindhava, Priyangu and Indra-yava pounded together and made into a paste with the decoction of the drugs, one Pala each of Rasna, Aragvadha, Varshabhu, Kaluka, Ushira, Mustaka, Trayamana, Amrita (Guduci), Rakta (Manjishtha), Panca-mula, Vibhitaka and Vala should be duly mixed with (an adequate quantity) of Rasanjana, extract of meat (Rasa), honey, Sauvira and the expressed juice of the Draksha. The solution thus prepared should be injected lukewarm into the bowels of the patient in the manner of an asthapana-Vasti. It adds to the growth of flesh, creates fresh semen and Ojas, improves the digestive capacity and the strength of the body, imparts longevity and cures and conquers the following diseases, viz., Gulma, Menorrhagia, Erysipelas (Visarpa), Strangury, Kshata-kshaya, Vishama-jvara, Hemorrhoids, Diarrhea (Grahani), Vata-kundali, catching pain due to the incarceration of the Vayu in the regions of the thighs, knee-joints, head and bladder (Vasti), obstinate constipation of the bowels, (Udavarta) and the other distempers of the bodily Vayu, Vata-rakta, Sharkara (gravels in the bladder), Ashthila, cramp in the groins, Udara, aversion to food, Rakta-pitta (Hemorrhage), affections of the deranged Kapha, Insanity, Prameha, distension of the abdomen (adhmana), catching pain at the heart (Hrid-graha). 20.

A Vasti composed of the decoction of the Vayu- subduing drugs mixed with Trivrit[12], Saindhava and Kanjika (or the expressed juice of acid fruits) should be applied lukewarm in cases due to the aggravation of the bodily Vayu. Similarly, a Vasti composed of the decoctions of the drugs included within the Nyagrodhadi group mixed with sugar, clarified butter, powders of those included within the Kakolyadi group should be applied in diseases due to the aggravation of the Pitta. A Vasti composed of the decoction of the drugs of the Aragvadhadi group saturated with the pulverised compound of those included within the Pippalyadi group, should be employed with (an adequate quantity of) cow’s urine, added thereto in a case of the aggravation of Kapha. A Vasti composed of a copious quantity of the decoction of Kshira-Vrikshas mixed with (an adequate quantity of) the expressed juice of the sugar-cane, milk, sugar, and clarified butter should be applied in a cold state in cases marked by a vitiated condition of the blood of the system. 21–24.

Shodhana (corrective) Vastis:—

The drugs of the Shodhana group (possessed of corrective therapeutic properties) should be pounded together and mixed with an admixture of their own decoction. The solution thus formed should be mixed with Saindhava and Sneha and stirred with ladle. It should then be injected into the bowels of the patient. This is called the Shodhana-Vasti[13]. 25.

Lekhana-Vasti:—

The powders of the drugs of the Ushakadi group should be mixed with the decoction of Triphala and with cow’s urine, honey and Yava-kshara. The whole solution should be applied as a Vasti and is called the Lekhana-Vasti. 26.

Vrimhana-Vasti:—

A paste composed of the drugs of the Madhura (Kakolyadi) group mixed with the decoction of the drugs possessed of tonic and constructive properties (Vrimhana drugs) should be injected into the bowels with clarified butter and the extract of meat added thereto. It is called the Vrimhana-Vasti. 27.

Vaji-karana-Vasti:—

The seeds of the Atmagupta should be pounded and mixed with the decoction of (the roots of) the Uccata together with (the contents of) the egg of a sparrow (Chataka) and an adequate quantity of milk, clarified butter and sugar. The solution should be injected into the bowels in the manner of a Vasti and is called the Vaji-karana-Vasti (aphrodisiac). 28.

Picchila-Vasti:—

Milk cooked with Vidari Airavati[14], Shelu, Shalmuli and the tender sprouts of Dhanvana should be used as a Vasti with the blood and honey (added to it);[15] it is called the Picchila- Vasti. The fresh blood of a buffalo, hog, sheep, or of a cat, or the contents of a newly laid (hen’s) egg[16] may be used for the purpose. 29-30.

Grahi-Vasti:—

A paste of the drugs of the Ambashthadi group, dissolved in a decoction of those of the Priyangvadi group and mixed with honey and clarified butter, may be used as a Vasti and is called the Grahi-Vasti. 31.

Sneha-Vasti:—

A Sneha-Vasti should be prepared by duly cooking the drugs of one or two of the above groups with a Sneha. 32.

Sterile women should be treated with a Vasti consisting of the Shata-paka-Vala-Taila or the Traivrita- Ghrita (as described before)[17] after being cleansed (Shodhana) in due succession. 33.

Strong enemas (possessed of keen medicinal potency) should be employed in respect of extremely strong patients, and those of moderate potency should (be?) employed in respect of persons possessed of a middle (?) sort of bodily strength, while weak persons should (be?) treated with Vastis (enemas) of mild potency. (?)experienced physician should thus apply Vastis (enem (?) with due regard to the nature of the season, the stren (?) of the patient, the nature and intensity of the dise (?) under treatment and of the Doshas involved the (?) and to the nature of the potency of the ingredie (?) to be used in charging the Vasti (enema).[18] 34.

Loosening or disintegrating (Utkleshana —lit. (?) tating) enemas (i.e., those possessed of the virtue of (?) lodging and disintegrating the accumulated Doshas in (?) system) should be employed at the outset and correc (?) ones (Dosha-hara) should then be employed, while th (?) exerting a soothing influence on the organism (S (?) shamana ) should be employed last of all towards (?) close of the treatment. 35.

Different Vastis:—

An Utkleshana (disi (?) grating) Vasti consists of castor seeds, Yashti-ma(?) Pippali, Saindhava, Vaca, Habusha and Phala (Tripl(?)—Madana-phala, according to others) pasted toget (?) A Dosha-hara-vasti (corrective enema) consists ((?)solution) of Yashti-madhu, Kutaja seeds and Mad (?) phala with Kanjika and cow’s urine. A Samshodha Vasti (soothing enema) consists of Priyangu, Yas (?) madhu, Musta and Rasanjana with cow’s milk. 36–(?)

Madhu-Tailika Vasti:—

Now we shall (?) scribe in short the process of applying a Madhu-Tai(?) (?)asti (enema) which should be resorled to only in (?)respect of kings or king-like personages as well as in (?)respect of women, old men, infants and persons of (?)delicate constitutions for the purposes of eliminating the (?)Doshas(accumulated in the organism; and of improving (?)the strength and complexion. The use of this remedy (?)does not entail any strict observance of continence (?)or of any particular rules, diet, conduct, or conveyance (?)on the part of the patient, nor is it attended with any (?)possible complication though it is quite on a par with (?)any other kind of Vasti as regards its excellent and (?)highly beneficial therapeutic virtues. It may thus be (?)appplied at any time by an experienced physician in the (?)manner of a Nirudha-Vasti (enema) whenever the patient (?)wishes to be treated therewith. Equal parts of honey, (?)and the decoction of castor roots, half a Pala of (?) ata-pushpa, a quarter Pala of Sanidhava, and one (?)entire Madana fruit should be mixed together by stirring (?)the whole with a ladle. The whole compound thus (?)prepared should be injected lukewarm into the rectum (?)of the patient. This measure is called the Madhu- (?)T ailika-Vasti.[19] 39.

Yukta-ratha and Dosha-hara Vastis:—

(?) T he Yukta-ratha Vasti consists in injecting a medicinal (?)ablution surcharged with Vaca, Madhuka (honey),[20] oil, (?)heat-essence, Saindhava, Pippali, Madana fruit, and the (?)decoction (of Eranda) into the bowels of a patient.  A compound of Deva-daru, Vara (Triphala), Rasna, Shata-pushpa, Vaca, honey, asafetida and Saindhava salt, used together as a Vasti, is called the Dosha-hara Vasti. 40 - 41.

Siddha-Vasti:—

This Vastishould be prepared with the decoction of Panca-mula, mixed with oil, honey and a paste of Shatahva, Pippali and Saindhava salt. Similar Vastis consisting of a decoction of Yava, Kola and Kulattha, and mixed with a paste of Pippali, Saindhava, Yashti-madhu and honey may also be used. This kind of Vasti is called a Siddha-Vasti. 42-43.

Mustadika-Vasti:—

A Pala measure of each of the following drugs, viz., Musta, Patha, Amrita (Guduci), Tikta, Vala, Rasna, Punarnava, Manjishtha, Aragvadha, Ushira, Trayamana, Gokshura as well as of those included within the group of minor (Svalpa) Panca-mula, and eight Madana fruits should be boiled with an Adhaka measure of water down to its quarter part. The decoction thus prepared should again be boiled with the admixture of a Prastha measure of milk. The boiling should be continued till the watery part is completely evaporated and the milk alone is left behind. It should be then strained (through a piece of cloth). This (cooked) milk should be mixed with honey, clarified butter,[21] and the extract of meat of any Jangala animal, each measuring a quarter of the (above-prepared milk) and a Karsha measure each of the following drugs, viz., powdered Shatahva, Phalini (Priyangu), Yashti-madhu, Vatsaka, Rasanjana and Saindhava. The application of the above in the manner of a Vasti proves curative in Vata-rakta, urinary complaints (Prameha), Edema, Hemorrhoids, Gulma, retention of urine, Hemorrhage (Rakta-Pitta), Erysipelas, fever, and a looseness of the bowels. It acts as an aphrodisiac and vitalising tonic; it also invigorates the eye-sight and is anti colic in its action. It is known as the Mustadi- Vasti and is the best of all the asthapana enemas. 44.

A judicious physician may prepare, in the light of the principle laid down in connection with the preparation and application of Vastis in general, hundreds of different other kinds of Vastis (enemas) with a due consideration of the virtues of their respective ingredients ^drugs) and the nature of the disease under treatment. Applications of Vastis are forbidden during the continuance of an undigested meal in the stomach. Proper rules of diet and conduct should be observed, and day-sleep should not be indulged in, after being treated with a Vasti. 45-46.

The compound Madhu-Tailika Vasti is so called from the facts of its being principally composed of Madhu (honey) and Taila (oil) The term Yukta-Ratha Vasti owes its nomenclature to the fact of its imposing no restriction as regards riding in carnages (Rathas), or on horses and elephants after their application. The Siddha-Vasti derives its name from the uniform success (Siddhi) which attends its application in a large number of cases of bodily distempers and from its irresistible power in improving the strength and complexion of the body. Madhu-Tailika Vastis are recommended to persons of easy and luxurious habits as well as in respect of those whose bowels can be easily moved, or who are in the habit of being daily treated with emulsive measures (Sneha-karma) and whose organisms are marked by scanty accumulations of the bodily Doshas. A Siddha-Vasti does not produce any distress or discomfort, since it is mild in potency and is applied in only three quarters of the usual dose (nine Prasritas only) and does not entail any strict observance of the regimen of diet and conduct (such as the previous administration of emetics and purgatives, etc.), and since it produces a satisfactory result by a single application. 47.

 

Thus ends the Thirty-eighth Chapter of the Chikitsita Sthana in the Sushruta Samhita which deals with Niruha-Vastis.

Footnotes and references:

1.

According to Agnivesha the time necessary for the tips of the fingers to fall down upon the right thighs, i.e., the time required for a twinkling of the eye (Nimesha) is called a Matra. Parashara says that the time necessary to close and open the eye-lids (Nimesha and Unmesha) once, while throwing the arm around the right thigh is called a Matra. He has prescribed one hundred such Matras in respect of a patient of constipated bowels, and thirty-seven in respect of a patient of lax bowels.—Dallana. The period of a Matra has elsewhere been defined as that required to utter a short vowel. —Ed.

2.

See Chapter XXXIII, Para. 18, Chikitsita Sthana.

3.

Satisfactory urination should also be understood as one of the symptoms of the satisfactory application of a Niruha-vasti.—Ed.

4.

A second application of the Sneha-vasti should be made, if necessary, on the 2nd, 3rd, or 5th day with a due regard to the symptoms mentioned in the text.

5.

Both Vrinda and Chakradatta read “Atopa” (rumbling sounds in the intestines) in place of “Anaha.”

6.

Dallana means to say that of the whole compound weighing twelve Prasrita measures (twenty-four Palas), there should be four Prasrita weights (8 Palas) of the docoction, and so on.

7.

The hand would serve the purpose of a ladle best in this case.

8.

Honey, Sneha, milk, Kanjika, cow’s urine, meat-juice, etc., should be taken.

9.

Dallana takes Pala in the sense of meat mamsam (Mamsam).

10.

The quantity of honey, oil, and clarified butter, should be as before, that of Shukta, Kanjika, Mastu and urine half a Pala each, and that of milk two Palas.—Dallana.

11.

Dallana recommends the use of meat-juice (one Pala) and sugar-cane juice (two Palas) as the liquefacient agents in this preparation. It should also be noted that coldness and non-addition of any acid substances are recommended as the injection is to be applied in cases of diseases due to the derangement of Pitta.

12.

According to Dallana, “Trivrit” should be understood to mean the same as “Traivrita” mentioned in the treatment of Maha-vata-vyadhi (see Chapter V., Para. 25, Chikitsita Sthana).

13.

According to Dallana, four Pala weights of honey, one Pala of milk, one Pala and a half of cow’s urine, and four Pala and a half of Kanjika, should be added to this solution.

14.

Both Vrinda and Chakrapani read “Vadari” in place of “Vidari”, and their annotators mean to say that the tender sprouts of all trees, viz., Vadari, etc., should be used.

15.

Vrinda does not recommend the addition of honey; he reads “sushītaḥ” (i.e., the Vasti should be in a cold state), in place of “kṣaudrayutaḥ”. But it is evident from the reding of Dallana’s commentary, as quoted by Shrikantha Datta, that honey should be added.

16.

Both Vrinda and Chakrapáni read “ajaṃ” in place of “aṇdaṃ” which means that the newly spilt blood of a goat should be added to the list and hen’s egg should be eliminated therefrom.

17.

Vala-Taila has been mentioned in the treatment of Mudha-garbha (Chapter XV, Chikitsita Sthána) and the Traivrita-Ghrita has been described in the treatment of Mahá-Vátavyádhi (Chapter V, Chikitsita Sthána).

18.

Shivadasa, the commentator of Chakradatta, quotes two additional(?) lines as being incorporated in Sushruta’s text which, when trans(?) would be as follows:—Better use a Vasti of milder potency but neve (?) on of strong potency than what is necessary and this is recomm (?) especially in cases of delicate persons.—Ed.

19.

The quantity of the fluid should be nine Prasritas in all cases of the (?) M adhu -Tailika Vasti and such-like Vastis (enemas).—Dallana.

20.

Vaca, salt, Madana-phala, Pippali, each should be one Karsha; (?)ho ney and oil four Prasritas and two Karshas each, and the decoction of (?) anda roots four Prasritas and two Karshas.—Dallana.

In the text we find “Madhuka” which generally means Yashti-madhu. (?) ere, however, it should mean “honey”. This is evident from Dallana’s (?)co mmentary.

21.

According to Dallana, however, a Pala measure of each of honey and clarified butter should be added.

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