Ashtangasamgraha 12.4

12.4

te punarapakarṣaṇādayo dvividhāḥ bāhyābhyantarabhedena |

tatra bāhyamapakarṣaṇaṃ granthyarbudopapakṣmakrimiśalyādiṣu śastrahastayantrādibhiḥ |

ābhyantaraṃ punarvamanavirecanādibhiḥ |

prakṛtivighātaḥ saṃśamanam |

tat bāhyamabhyaṅgasvedapradehapariṣekopamardanādi |

ābhyantaraṃ yadantaramanupraviśyāvikṣobhayaddoṣān śamayati |

nidānatyāgo yathādoṣaṃ śītoṣṇaśanavyāyāmādīnāṃ varjanaṃ snigdharukṣādyanabhyavahāraśca |

tatra śastrādisādhye bheṣajamanukramate na tu bheṣajasādhye śastrādi ||

ghṛtodakādidravasamapi sthamātiśītastabdhaḥ pratyuṣasi śleṣmāmaye 'śubhaḥ |

pittāmaye tu śubhaḥ |

tathā setubhaṅge chardimehātisārādiṣvaśubhaḥ setubandhe tu śubhaḥ |

tathā madhyāhnobhayasandhyārddharātricaturthīṣaṣṭhīnavamīparvadineṣu grahoparāgotpātadarśanabhraṇīkṛttikārdrāśleṣāmaghāmūlapūrvāsu cāśubho yaśca vaidyaṃ suptaṃ nagnaṃ ca bhūmau śayānamabhyaktaṃ muktakeśaṃ dakṣiṇābhimukhaṃ viklavaṃ chindantaṃ bhindantamagnipitṛkāryapravaṇamaśastaṃ cintayantaṃ kathayantaṃ vopatiṣṭhati |

yo vā diśaṃ yāmyāṃ pratikṛtāñjalirviṣamaikapādasthaḥ |

yasmin vyādhitāśrayaṃ kathayati dūte bhiṣagaśubhamindriyārthamupalakṣayet saṅkalpayedvā taṃ ca nānuyāyāt |

ato 'nyathā punaḥ karuṇāpeśalena manasā saumanasyavatā mātāpitṛsamenāturasyātyantamārogyamāśasamānena prayātavyam ||

peyāṃ vā nāgarātiviṣābhyāṃ takradāḍimavṛkṣāmlāmlām pāne ca takramastvāra nālamadirāriṣṭānatīsāranirdiṣṭaṃ cāmbu |

yavānīpathyāmalakamaricāni tripalikāni lavaṇapañcakaṃ ca palāṃśakamekataścūrṇayitvā kaṃse sadyomathitasyāsunuyāt |

tato vyaktāmlakaṭukaṃ jātaṃ pibet |

eṣa takrāriṣṭaḥ paramagnidīpano 'rśogulmajaṭharaśvayathukṛmipramehaharaḥ ||

Those, moreover, beginning with extraction, are twofold through the division into external and internal.

Among them, external extraction is performed on swellings, tumors, ingrown eyelashes, parasitic worms, foreign bodies, and the like, by means of surgical instruments, the hands, blunt instruments, and so on.

Internal, on the other hand, is through emesis, purgation, and the like.

Destruction of the underlying nature is pacification.

Externally, that consists of massage, sudation, poultices, affusion, kneading, and so forth.

Internally, it is that which, having entered within, pacifies the doṣas without agitating them.

Avoidance of etiology is the abstention from cold and hot food, exercise, and the like according to the doṣa, and non-ingestion of unctuous, dry, and similar substances.

Among them, medicine succeeds in what is curable by surgery and the like, but surgery and the like do not succeed in what is curable by medicine.

Standing in a liquid such as clarified butter or water, extremely cold and stiff at dawn, [a messenger] is inauspicious in diseases of śleṣman,

but auspicious in diseases of pitta.

Likewise, when a bridge breaks, he is inauspicious in vomiting, urinary disorder, diarrhea, and the like; but when a bridge is built, he is auspicious.

Likewise, at midday, at both twilights, at midnight, on the fourth, sixth, and ninth lunar days, on days of conjunction, during an eclipse or appearance of portents, under Bharaṇī, Kṛttikā, Ārdrā, Āśleṣā, Maghā, Mūla, and the Pūrvā constellations, he is inauspicious; and he who approaches the physician while the physician is asleep, naked, lying on the ground, anointed with oil, with disheveled hair, facing the south, distressed, cutting, splitting, occupied with rites for the sacred fire or the ancestors, or thinking of or speaking about inauspicious things;

or who, facing the southern direction, stands with folded hands resting unevenly on one foot.

When a messenger describes the abode of the diseased, if the physician observes or imagines an inauspicious sensory object, he should not follow him.

Otherwise, however, he should set out with a mind gentle with compassion, cheerful, like a mother and father, hoping for the absolute recovery of the patient.

Or thin gruel made with dry ginger and ativiṣā, soured with buttermilk, pomegranate, and vṛkṣāmla; and for drink, buttermilk, whey, fermented gruel, madirā wine, fermented tonics, and the water prescribed for diarrhea.

Having powdered together three pala each of yavānī, pathyā, āmalaka, and black pepper, and one pala each of the five salts, one should ferment it in a bronze vessel of freshly churned buttermilk.

Then, when it has become distinctly sour and pungent, one should drink it.

This is takrāriṣṭa, an excellent stimulator of the digestive fire, which removes piles, abdominal swelling, abdominal enlargement, swelling, parasitic worms, and urinary disorder.