The Compendium of Kāśyapa 8.8

Now we shall explain the [chapter on] specifics of enemas.

Thus spoke the venerable Kaśyapa.

There is no treatment superior to the administration of an enema for bringing comfort to the limbs. / Diseases residing in the extremities, the trunk, or pervading the whole body or half the body—

there is no cause other than vāta for their arising. / Likewise, in the propulsion and dispersion of kapha,

of pitta, of the wastes, and of the chyle, wind alone is the cause here; / and for conquering it when it has become aggravated, nothing is equal to the enema.

Therefore it constitutes half of medicine, indeed the entire treatment of vāta. / Karma, kāla, and yoga are the three terms in due order;

I shall state them according to etymology, indication, number, and variation of humours. / […] is termed karma;

it is to be employed according to rule when strength is exceedingly elevated. / From taking half of that, it is kāla; for it is indicated when moderate strength is present,

and should be administered by the knowledgeable physician when wind is combined with pitta. / Because of the smallness of unctuous enemas, it is yoga, due to lightness of application;

it should be employed when [wind] is combined with kapha and the wind is not excessively fierce in strength. / In karma there are twenty-four unctuous enemas and six decoction enemas;

in kāla there are twelve unctuous enemas, and three decoction enemas here;

in yoga there are only three decoction enemas and five unctuous enemas. / The count of enemas beginning with karma is shown to be fifty-three.

Five unctuous ones are at the beginning in karma, and four at the end; between these two, / in the intervals among the six decoction enemas, there are three each;

at the beginning, at the end, and in the middle, in kāla there are three unctuous ones each; / in yoga, three are interspersed with decoction enemas, and two at the end, in due order.

The exposition of the division has been stated; now hear the variation thereof. / In vāta, seven, five, or three at the beginning are censured;

in pitta and kapha these very two are occasionally lowest. / Having observed this and that stage dependent upon humour, time, and strength,

the physician should increase or decrease the enemas or the substances. / One should likewise make an increase in yoga, but a reduction in karma;

and in kāla, both, having observed the strength and weakness of the humours. / In vāta, a decoction enema is equal-part, unctuous, hot, and with oil for drinking;

in pitta, two [enemas] have a one-sixth unctuous portion, with milk, sweet, and cooling; / in kapha, three are with cow's urine, sharp, hot, with eight parts of oil.

Applied once, it drives out the vāta residing in the digestive tract; / along with pitta and kapha, twice or thrice; beyond this is not commended.

Here, the dietary regimen of meat broth, milk, and pulse soup is commended in sequence; / or according to strength, time, digestive fire, region, constitution, and wholesome adaptation.

These applications of enemas culminating in humoral variations have been indicated. / And this is another procedure, known as 'the fourfold auspicious' (caturbhadra):

four enemas initially, and exactly four at the end, / and decoction enemas between the two; this is a procedure free from complication.

Performed twice or thrice as required, it brings comfort. / In one tormented by fevers and the like, whose complexion, strength, and vital essence are diminished,

when the stage for an unctuous enema has arrived, [enemas] that enhance strength, virility, and digestive fire / should be given in odd numbers, never in even numbers.

Uneven diseases are destroyed only by uneven [numbers of] enemas: / one or three in a kapha-born condition; in a pitta condition, five or seven;

in vāta, nine or eleven, or whatever reaches equality. / Thus the subtle and diverse matter has been stated in detail and in brief;

understanding this, it should be administered as I shall state hereafter. / For one whose wastes have penetrated deep, accumulated gradually,

are vitiated, dominated by vāta, and curable particularly by enemas, / who is well-nourished and patient—karma is the sovereign remedy;

for a moderate [patient], kāla should be [applied], and for an inferior [patient], the inferior [yoga] likewise. / For one endowed with oleation and sudation, and made to vomit in due sequence,

and who, having been unctuated and sweated again, has undergone purging in due course, / and has been given an unctuous enema properly—then after three days,

when he is rested and at ease, one should look to a decoction enema. / For one who has received three unctuous enemas, thereafter seven days [is the interval] in karma and kāla;

decoction enema is to be administered again; yoga would be on the fifth day. / To one whose body has been well massaged and sweated, in the morning, before breakfast,

whose unripe humours have been driven to the digestive tract from the extremities, and who has been well massaged, / the wise physician, furnished with all equipment, should apply a decoction enema.

In a well-polished, smooth vessel of gold, silver, or bell-metal, / throwing in one by one the substance that will be prescribed in sequence,

the physician, facing east and well composed, should churn the decoction enema. / First of all, two prasṛtas of honey should be cast therein,

and half a karṣa of rock salt, and oil equal to the honey; / and then a prasṛta of paste, and decoction four times the paste,

two prasṛtas of meat juice, and one prasṛta of urine: / thus an enema of twelve prasṛtas is stirred with a churning stick;

and it is to be administered properly and appropriately by the discerning [physician]. / If there should be a desire to state something regarding the addition of substances:

In that regard, the reason for this reversed order of combination must be stated: / Being auspicious, honey is poured in first for the sake of auspiciousness.

Because of its sharpness, salt breaks down the sliminess, / the thickness, and the astringency in honey, and it restrains coagulation.

Therefore, the portion of salt is poured in immediately after honey.

Then, oil added [thereto] is capable of becoming homogeneous.

The paste is mixed in quickly, and the decoction attains uniformity. / When the blending of the unctuous substance, the paste, and the decoction has thus been performed,

urine brings about potency and also arouses the active potency. / Being thus properly churned together, it [draws out] kapha and vāta from the microchannels,

liquefies pitta, and also eliminates them swiftly. / Churned otherwise than this, it does not attain cohesion.

Improperly churned and clotted, the enema is not fit to accomplish its purpose. / Therefore, this order is observed in the preparation of a non-unctuous enema.

And the standard quantity of the highest [dose] that has been stated in terms of handfuls— / an increase beyond that quantity is desired according to age and strength.

A decrease, however, should be made after considering age and strength, / but in terms of properties, [adjustment is made] in both ways after observing the strength and weakness of the disease.

One should decrease with that component by which one increases. / One should arrange the substances as cold, hot, unctuous, or dry.

In a vāta-disease, the physician should make an increase, not excessively, / of sweet, sour, salty, and hot [substances], and should prescribe an unctuous substance.

And [he should bring about] a reduction of dry substances and those of cold potency appropriately. / In a disease characterized by a predominance of pitta, the physician

should make an increase of sweet, bitter, and astringent [substances], but a decrease of sharp and hot ones according to suitability; / but where kapha is predominant, [he should make] an increase of sharp, hot, and dry substances,

and in reverse conditions, he should prescribe the reverse of the properties. / When the humours are combined, he should employ substances of combined properties.

An evacuating enema improperly administered becomes like venomous serpent; / that very same enema, when properly administered here, is like nectar to living beings.

Since an abundance of benefits is generally observed from proper application, / an intelligent [physician] should therefore perform enema therapy without negligence.

For no other procedure of such kind exists / for the swift destruction of disease or [if wrongly done] for the generation of diseases.

The strength of the disease, the patient, the digestive fire, and the medicament, as well as the constitution, / age, body, habituation, delicacy, and endurance—

having weighed these with his intellect, the discerning [physician] should carry out the application of each procedure / properly and unweariedly in each particular condition.

Neither too cold nor too hot, neither too sharp nor the opposite, / neither too dry nor too unctuous, neither too thick nor too thin,

neither excessive in measure nor too meager should he prepare the non-unctuous enema. / [An enema that is] too cold, clotted on account of extreme chill and encompassed by the strength of vāta,

severely stiffens the body and returns with difficulty. / One that is too hot causes burning sensation, fainting, and comes out quickly.

Similarly, one that is too sharp causes discharge of blood; / a sluggish one does not remove the humours but merely vitiates them.

One that is too dry emaciates and provokes vāta; / one that is too unctuous produces extreme torpor and extinguishes the digestive fire.

One that is too thick causes emaciation or does not exit from the nozzle; / one that is too dilute leads to non-operation because of its weak potency.

One of too small a measure does not emerge, or it returns with difficulty; / one of excessive measure leads to excessive evacuation; therefore, these are censured.

Properly churned, smooth, pleasant to take, warm, salty, balanced, / [such an enema] brings forth vaginal burning in girls who have dry and cracked lips and tongues;

reaching the pelvis, bladder, waist, flanks, root of the navel, and abdomen, / it properly attains full pervasive elevation by its potency.

Forcibly driven by the upward movements like fire by the winds, / surpassing the seat of pitta, it draws forth a small amount of kapha.

A sharp [enema] is retained beyond one hundred measures of time, one not too sharp is administered [likewise]; / a mild one does not stay, or a sustaining enema stays longer.

Due to the downward direction of the apāna wind and because of the strong retraction of the rectum, / a second or third one [stays] for a shorter time in that manner.

The humours, both gross and subtle, even those gone into deep recesses, / it liquefies when obstructed, and drags them forth along with the feces.

It does not produce any complications, and it returns with ease; / when administered by a skilled physician, that enema is highly praised.

It stabilizes age, promotes virility, and improves voice, complexion, strength, and digestive fire; / it eliminates vāta, pitta, and kapha, as well as the waste products.

It is supremely invigorating without delay for children, the elderly, and the youthful; / it brings about clarity of all the senses and softness of the limbs.

Thus these benefits and flaws of the non-unctuous enema have been fully proclaimed. / When feces, vāta, pitta, and kapha gradually

come forth, along with froth resembling a conch or crystal, / it produces supreme softness of the limbs of one who has been properly purged by non-unctuous enema.

Desire for food, clarity, lightness, or softness, / the easy passage of feces, urine, and wind, and serenity of the sensory faculties [occur].

In the case of inadequate evacuation, there would be the opposite; in excessive evacuation, excessive passage / of kapha, pitta, and blood, or of a fluid resembling the washings of meat [occurs];

and hiccup, tremor, thirst, languor, body-ache, darkness of vision, exhaustion, / loss of sleep, and delirium also arise in that condition.

When properly cleansed by non-unctuous enema, comforted, and sprinkled with pleasantly warm water, / one should feed him a light meal or [a meal] with the broth of wild animals.

And when he has eaten, one should administer an unctuous enema with a handful of oil; / by that means the vāta displaced by the non-unctuous enema is pacified.

This evacuating enema cools the rectum of a person; / thereafter, an unctuous enema as described [is given] on alternate days.

In a person of blazing digestive fire, of firm body, afflicted with upward movement of wind and false pathways, / and when vāta is located in the pelvis and groin, it is recommended day after day.

For him, the wind residing in the colon, being powerful / when the digestive fire is powerful, clears the dose of unctuous substance like water.

And there is no substance superior to oil for removing vāta; / because of its unctuousness it overcomes dryness, and because of its heaviness it overcomes the lightness of vāta,

and by its heat it quickly destroys coldness; and oil produces nourishment, / mental serenity, unctuousness, as well as strength and complexion.

Just as a tree watered at the root comes to have glossy branches and trunk, / tender shoots and sprouts, and yields flowers and fruit in season,

even so a man given an unctuous enema has a firm body, produces strong offspring, / and is not overcome by the previously mentioned disorders consisting of vāta.

There should be an āḍhaka and a half of the five roots, an āḍhaka of madana fruits, / and three kuḍavas separately of barley, jujube, and horse gram.

Having boiled these in eight times their quantity of water until one-fourth remains, / one should then cook a prastha of oil with an āḍhaka of whey.

With an akṣa-weight of each: of costus, dill, sweet flag, liquorice,
seeds of indrajava, and seeds of emetic nut;

of carom seed, long peppers, hareṇu pea, Himalayan cedar,
bilva, clove, rāsnā, nutgrass;

and of cardamom and priyaṅgu in equal parts of an akṣa each,
[the oil] is properly cooked with salt, filtered, and stored in a clean vessel.

This is excellent for those who have had a mild non-unctuous enema and in complications of enemas;
it is renowned as 'fruit-oil' (phalataila), dispelling upward movement of vāta (udāvarta).

Likewise, it is successful for those with abdominal enlargement, phantom tumours (gulma), intestinal parasites,
and when vāta is disordered in the back, pelvis, thighs, and calves.

Whatever afflictions are proclaimed to be curable by non-unctuous enema (nirūha),
one should conquer them with this enema, and it destroys retention of urine.

Castor root, triphalā, balā, rāsnā, punarnavā,
guḍūcī, cassia fistula, cedar, flame-of-the-forest, emetic nut;

ashwagandha root, and the minor five roots—
these, in the measure of a pala each, one should boil down in a droṇa of water.

When reduced to an eighth part, one should take it strained;
one should prepare pastes finely ground, in the measure of a karṣa each, of:

dill, liquorice, nutgrass, priyaṅgu, hapuṣā, sweet flag,
rasāñjana, antimony, long pepper, and indrajava fruit.

Churned with a churning stick, lukewarm, with oil, honey, and rock salt,
with urine and meat broth, this non-unctuous enema (nirūha), properly administered,

is scraping, stimulates digestion, grants strength, and cures disorders of assimilation (grahaṇī) and piles;
it remedies pain in the flanks, back, and hips, and aching in the flanks, calves, and thighs.

The castor enema pacifies vāta enveloped by kapha.
With proper warmth and salt, an unctuous enema (snehabasti) is prescribed.

In brief, it is of two kinds; its dosage is declared:
A prakuñca is the smallest dose, and half again as much is the medium dose.

Two palas is the maximum dose; but in a retention enema (mātrābasti), O descendant of Bhṛgu,
for a child off the breast, half a pala is harmless and free from danger.

Three karṣas for a three-year-old, and indeed a pala for a four-year-old;
for a six-year-old child, his own handful (prasṛta) is traditionally taught.

Two each for twelve-year-olds; and four handfuls likewise
are to be given to those aged sixteen and upward, in the morning or between meals,

up to middle age; but in old age one should reduce it step by step,
having examined the body, humours, strength of digestive fire, and constitution.

Whatever the measure of unctuous substance in an enema, the non-unctuous enema is three times that.
For those addicted to excessive sex, exercise, drinking, riding, and travel on foot,

who are in the prime of life, habituated to unctuous substances, whose strength of digestive fire is robust,
whose vāyu is aggravated in the lower body, and who are of vāta constitution—

in them the wise physician should administer the maximum dose of unctuous substance;
for men who are in an intermediate state between these, the medium dose;

and the other dose for others, with regard to age, disease, and strength.
Thus the triad of enemas beginning with karma-basti has been explained,

as well as the specification, variation, and classification in full,
and what should be prescribed in which case, and which dosage is employed for whom,

the application of non-unctuous enemas, unctuous substances, and non-unctuous enemas have been proclaimed.
Thus spoke the venerable Kaśyapa.

Thus ends the eighth chapter named 'Distinction of Enemas' in the Supplementary Section.