Ashtangasamgraha 28

English (machine translation) 28

Language: English

28.1

Now we shall explain the chapter named 'Procedure for Enemas'; / thus spoke Ātreya and the other great sages. / Thus spoke Ātreya and the other great sages.

The enema is administered in doṣas dominated by vāta; / it is called basti because it is given by means of a bladder (basti) or because it enters the bladder first. / And remaining in a windless place at night, with the head anointed, one should drink ghee or oil followed by an anupāna of milk; / or one should eat black gram with ghee, followed by an anupāna of hot milk; / or mung beans in the same manner.

28.3

And it is the most foremost of all therapeutic measures, because it quickly effects nourishment and the like, and because it eradicates deranged vāta. / Then at dawn one should perform sprinkling with lukewarm milk boiled with the Ten Roots (daśamūla); / and with milk-rice prepared with them, a bolus sudation or an ointment.

28.4

For vāta is the leader of the doṣas; / the sole cause of all bodily movements; / pervading the major and minor limbs by virtue of its fivefold nature; / the disposer of diverse external and internal states; the cause of origin, sustenance, and dissolution, and of diseases arising from the three pathways. / And likewise, ghee and oil cooked together with milk, having an interior paste of madhuka, jīvaka, ṛṣabhaka, and punarnavā, in a decoction of the Five Roots, balā, and the two sārivās.

28.5

And precisely because of its comfort, the enema is prescribed for children, the elderly, the emaciated, the obese, those with depleted bodily tissues and senses, women, those who are barren due to an affliction of vāta, and those who have difficult deliveries; / likewise, it bestows digestive fire, strength, complexion, intellect, voice, longevity, and ease, stabilizes youth, and is beneficial in lameness, stiffness of the thighs, fractures, contractions, distension due to vāta, colic, loss of appetite, upward movement of wind, gripping pain, and so forth. / Likewise, cinnamon bark, patra, sugar, and seeds of śigru and karañja; / likewise, an ointment with sandalwood, water lily, tagara, and kuṣṭha along with ghee; / and with devadāru, kuṣṭha, coraka, yaṣṭīmadhuka, lotus, blue water lily, cardamom, and prapauṇḍarīka.

28.6

And that enema is of three kinds: / non-unctuous enema (āsthāpana), unctuous enema (anuvāsana), and urethral or vaginal douche (uttarabasti). / Among them, the non-unctuous enema is prepared from combinations of various substances according to the doṣas, the tissues affected (dūṣya), and so forth. / Its varieties are: / mobilizing (utkleśana), purifying (saṃśodhana), pacifying (saṃśamana), scraping (lekhana), nourishing (bṛṃhaṇa), aphrodisiac (vājīkaraṇa), slimy enema (picchābasti), honey-and-oil enema (mādhutailika), and so forth. / The synonyms of mādhutailika are yāpana, yuktaratha, doṣahara, and snigdhabasti; / their nature is declared by their very names. / And here one should not let blood out of fear of aggravating vāta; / one should inhale unctuous smoke; / one should practice head enema (śirobasti); / and one should perform enema therapy.

28.7

It is called āsthāpana because it stabilizes youth (vayaḥsthāpana) or stabilizes the doṣas (doṣasthāpana); it is called an evacuating enema (nirūha) because it ascends into the body, removes doṣas, and because—due to its inconceivable potency—it is that in which no conjecture (ūhā) is possible.

28.8

The unctuous enema (anuvāsana) is unctuous substance prepared with appropriate drugs for the purpose of oleation; and it is stated to be of four kinds in the chapter on oleation. / Its variety is the dose-enema (mātrābasti); / that is equal to the small dose of drinkable unctuous substance. / And juice of nirguṇḍī leaves with ghee-scum and rock salt is a nasal medication (nasya); / or the roots and fruits of śirīṣa; / an ointment of sārivā, water lily, kuṣṭha, vacā, madhuka, and pippalī with oil and sour liquid; / if it does not subside, one should counteract it considering the secondary doṣa involved.

28.9

And it may always be used, like the mādhutailika; / it is comfortable, strengthening, complexion-promoting, promotes elimination of waste products, and destroys doṣas without requiring strict regimens, for children, the elderly, those exhausted by travel, carrying loads, vehicles, exercise, worry, and constant indulgence in women, for women, kings, lords, the delicate, the weak, those broken by vāta, and those with weak digestive fire; nevertheless, neither of the two should be administered during indigestion, nor should daytime sleep be indulged in; / and it is called anuvāsana because, while remaining (anuvasat) alongside the food, it does not do harm, or because it is given day after day (anuvāsaram).

28.10

The uttarabasti also is an unctuous substance like the anuvāsana; some say it is also a purifier like the nirūha; it is called uttarabasti because it is given after (uttaram) the nirūha, or by the upper (uttara) route. / And one should purge the body; / one should sprinkle and coat the head and face with very cold substances mixed with hundred-times-washed ghee.

28.11

Those who should receive the āsthāpana are those suffering from abdominal swelling, splenic enlargement, abdominal distension, colic, uncomplicated diarrhea, chronic fever, coryza, gout, spasms of the heart, belly, and flanks, joint pain, burning sensation of the flanks and vagina, numbness of the limbs, emaciation, tremors, heaviness, excessive lightness, intestinal rumbling, retention of flatus, feces, urine, and semen, urinary calculi, urinary gravel, scrotal enlargement, loss of semen, menstrual fluid, or breast milk, depletion of menstrual fluid, insanity, defects of semen, parasites in the alimentary tract, irregular digestive fire, loud, scanty, and foul-smelling bowel evacuations, and so forth, as well as the vāta diseases mentioned in the chapter on classification of doṣas; for these especially are eradicated preeminently by the enema, like a tree cut at its root. / Butter extracted from milk boiled with the Vitalizer group (jīvanīya), cooked with a decoction and paste of the Vitalizer group, and administered as a drink, in food, as nasal drops, massage, and enemas, cures all disorders arising from pitta and blood; / or ghee prepared with the Vitalizer group in sixteen times its amount of milk.

28.12

Those who should not be given an evacuating enema, however, are: those who are excessively unctuous; those whose doṣas are aggravated; those with chest injury; the severely emaciated; those who have not eaten; those who have undergone emesis, purgation, or nasal therapy; those afflicted with persistent vomiting, spitting, cough, dyspnoea, hiccough, haemorrhoids, intestinal obstruction, intestinal perforation, ascites, abdominal distension, sluggish digestion (alasaka), cholera-like disease (viṣūcikā), acute diarrhoea with undigested material, anorexia, weakened digestive fire, anal swelling, cutaneous affections, or diabetes mellitus (madhumeha); / and a pregnant woman before she has entered the eighth month. / Among them, in one who is excessively unctuous or whose doṣas are aggravated, an evacuating enema would disturb the doṣas and produce abdominal swelling, fainting, or swelling. / In one with a chest injury and one who is severely emaciated, [the enema], having agitated [the body], would quickly harm the body. / The case of one who has not eaten will be explained [later]. / In those who have undergone emesis or purgation, it would burn the empty body like caustic alkali on a wound. / An unctuous enema, on the other hand, immediately depresses the digestive fire and leads to diseases of śleṣman. / Milk boiled with the Añjanādi group [is used as] an evacuating enema.

28.13

In one who has undergone nasal therapy, it would cause dislocation of the disease-process because the upper bodily channels are opened. / An unctuous enema, moreover, would cause aggravation of the doṣas. / In those with persistent vomiting and the like, vāta would carry the evacuating enema upward; / and so too an unctuous enema. / In one with haemorrhoids, because the passage is obstructed, the enema, not returning, would destroy life. / The unctuous substance, furthermore, by being channel-blocking to the haemorrhoids, would lead to abdominal distension. / In those [with conditions] starting from intestinal obstruction and ending with abdominal distension, death [occurs] due to even severer abdominal distension. / In those afflicted with sluggish digestion (alasaka) and the like, [harm occurs] due to āma-doṣa. / In those afflicted with anorexia and the like, there is an increase of their respective disease. / In a pregnant woman, the aforementioned fault occurs. / And as in the case of erysipelas (visarpa). / Especially, however, a poultice with black sesame, śatāvarī, blue water-lily, mūrvā, and punarnavā [is applied].

28.14

Only those who are fit for an evacuating enema are fit for an unctuous enema. / Particularly those who are dry, those with excessively blazing digestive fires, and those afflicted purely with vāta. / These are supremely nourished by an unctuous enema, / as a tree is by watering its roots. / Only those who are unfit for an evacuating enema are unfit for an unctuous enema. / Likewise, those who have not eaten; those with fresh fever, anaemia, jaundice, urinary disorders, catarrh, splenic disease, abdominal swelling due to kapha, thigh stiffness (ūrustambha/āḍhyavāta), diarrhea; those who have drunk poison or synthetic poison; those with channel-blocking of pitta or kapha; those with a heavy alimentary tract; those who are excessively obese; those with elephantiasis, cervical lymphadenitis, scrofula; and those with worms in the alimentary tract. / Among them, the specific faults of those who are excessively unctuous and the rest have been described individually. / Furthermore: / Or one should induce emesis in him after oleating him with aged ghee; / sudation [is done] with a dry bolus; / or tube-sudation with a decoction of śigru, nimba, and castor.

28.15

An unctuous enema administered on an empty stomach to one whose alimentary tract is vacant, / by virtue of its fluid, far-reaching, and subtle qualities, quickly moves upward. / A poultice [is applied] with barley powder, yaṣṭīmadhu, sandalwood, turmeric, kuṣṭha, priyaṅgu, dill, and devadāru, combined with oil and goat's milk along with rock salt.

28.16

Thereby, there would be no subjugation of vāta, for it does not stay in the seat of vāta; / and there would be swift destruction of the bodily fire, particularly because of its non-return. / And a medicated wick for smoking [is prepared] with these very [drugs].

28.17

When the stomach is blocked by recently eaten food, the unctuous substance destroys vāta located in the colon; and being situated in the colon, it slips down through the digestion of food. / And oil cooked with those very [drugs is used as] a marśa or pratimarśa nasal therapy.

28.18

Both the evacuating enema and the wind have sharp velocity. / Confounded together with food and sharpened, they may come down together with the food, / [or] sharp mouthwashes [are given]; smoke [is inhaled] of realgar, nalada, tutthaka, and sulphate of iron powder along with ghee; / and constant smelling of nalada powder.

28.19

or they may move upward together with the feces, or remain right in the alimentary tract; / obstructed by undigested food mixed with waste, they would swiftly take life away.

28.20

Therefore, one who has eaten should receive an unctuous enema, but one who has eaten should not receive an evacuating enema. / In those afflicted with anaemia and the like, an unctuous enema, having agitated the doṣas, would produce abdominal disease; / in those having catarrh and the like, it would only further increase the doṣa. / Having lubricated and fomented [the patient], and having massaged his head and ears with oil cooked with devadāru, pūtīka, kaṭabhī, mustard, viḍaṅga, and kaṇṭakārī with sesame, one should apply sudation.

28.21

The nozzle for the two, however, should be made of metals such as gold, jewels, conch, horn, ivory, bone, bamboo, reed, or the hard heartwood of trees such as khadira, kadara, tiniśa, or tinduka; smooth, unwrinkled, shaped like a cow's tail, with a rounded pellet-like tip; measuring five, six, seven, eight, nine, and twelve fingers' breadths in length for those under one year, one year old, seven, twelve, sixteen years, and from twenty years onward, respectively; / in circumference, [equal to] the patient's thumb at the base and little finger at the tip; with an entrance-aperture at the base extending from half a finger's breadth, increasing by half-finger intervals up to three fingers' breadth; with an exit-aperture at the tip capable of admitting a wild mung bean, a mung bean, a māṣa bean, a pea, a soaked pea, and a jujube fruit; with ears positioned according to their respective sizes near the tip at a distance of the measure of the fingers of the base aperture; and with a thick cloth plug covering the tip held within a thread tied inside the ear. / At the base, at an interval of two fingers' breadth, one should make two ears. / In the intervening years, observing the age, strength, and body, one should increase the size of the nozzle. / Then the worms, having emerged due to intoxication from the smell of blood, fall out when sprayed immediately with the juice of the bark or flower of saptacchada.

28.22

Then, taking [the urinary bladder] derived from any of a goat, sheep, boar, deer, cow, or buffalo, softened with unctuous mudga beans, devoid of holes, veins, knots, or fat-bands, not overly round, soft, strong, reddish-brown from decoctions, capable of easily holding the measure of medicine, bent downwards, and with an open mouth; fitting the bladder onto the ears [of the nozzle], tying it firmly and evenly with a strong thread, turning it inside out, and tying on another thread to bind the mouth of the bladder, one should store it carefully in a safe place. / Or seeds of viḍaṅga ground with horse urine, or seeds of śirīṣa ground with goat urine; / or seeds from the centre of a lotus.

28.23

In the absence of a bladder, one should affix one of the following: a water-hen's crop, a goat's foot-skin, or a thick, fine woven cloth smeared with beeswax. / Then one should irrigate with a decoction of leaves of nimba, arka, bamboo, surasā, kuṭaja, karañja, and karavīra, / or with lukewarm goat urine; / and fumigations combined with putrid fish [are applied].

28.24

The dose of an evacuating enema, however, is one prakuñca in the first year. / Thereafter, each year one should increase it by one prakuñca up to six prasṛtas. / And above that, the increase is by a prasṛta. / For those who have reached eighteen up to seventy, it is twelve prasṛtas. / And beyond that, only ten. / Others, however, desire eight prasṛtas even where twelve prasṛtas [is prescribed].

28.25

The respective dose of a non-unctuous enema reduced by one quarter should be used in the mādhutailika [enema]. / But in an unctuous enema, it is indeed one quarter of the non-unctuous enema. / For when blood has been consumed in the head by parasites, untoward death may occur from draining blood again. / And one should attend to the treatment of parasites.

28.26

Then, one should first administer an unctuous enema to a patient fit for an evacuating enema who has been treated with oleation and sudation, has undergone emesis and purgation, has observed the dietary regimen of thin gruel and so forth, has gained strength, and is fit for an unctuous enema, / during the day in winter and spring, or otherwise at night, having examined the doṣas and other factors; / for otherwise the disorders mentioned regarding oleation will arise.

28.27

However, the followers of Dhanvantari say: / One should not administer an enema at night, for agitation by oil arises from the night; / during the day, when the doṣas reside in their proper places and the digestive fire is endowed with the essence of food, / and having anointed [him] and fomented [him], one should apply a poultice so that burning does not occur. / In the event of burning, the treatment is like that for an abscess.

28.28

Because the oil spreads through the body whose channel-openings are dilated, / [it should be given to one who has] little pitta and kapha, is ununctuous, and is severely afflicted with pain from vāta. / When the eruptions have become ulcerated, an oil cooked with neem, turmeric, liquorice, and āmalakī fruit is purifying and healing.

28.29

One may readily administer an unctuous enema at night to one who has eaten and whose food is digested; / but one afflicted by pure wind, even if unpurified and of unascertained strength, should be given an unctuous enema because of the emergency of the disease. / Its procedure is: far more than for emesis, auspicious rites having been performed, comfortably anointed, bathed in warm water, having eaten an unctuous, light, and hot meal preceded by liquids, reduced by one quarter from the customary amount, accompanied by an after-drink, having walked around, having evacuated feces and urine, his hands still moist from food, attended by dependable attendants, one should have him lie down in a windless room upon an extended bed that is not too high, well covered, with the foot end raised slightly, on his left side with his head to the east. / For in one who has eaten an excessively unctuous meal, from connection with both channels, the unctuous substance produces intoxication, fainting, depression of the digestive fire, and nausea; / in one who has eaten ununctuous food, it produces obstruction of the bowels or loss of strength and complexion; / in one who has eaten a small amount of liquid food, when feces and urine have been evacuated, from being enveloped by that which is unobscured, it produces a complication; / in one who has eaten long before, when the food is on the verge of causing a burning sensation, it produces fever; / and because the sites of the digestive fire, the duodenum, and the orifices of the rectal folds depend upon the left side, they are downward in one lying on that side, and therefore the medicine enters and exits without hindrance. / And having him lie down, one should make his body straight, resting on his own arm as a pillow, his left thigh extended and the other bent, and his right arm stretched out over that same [thigh]. / And ghee prepared with these very [drugs] is [for use as] nasal drops. / But when healed, if the skin on the abscess becomes as if numb, then one should induce vomiting, / and having gently oleated [him], one should purge him.

28.30

Earlier, the physician, having placed the nozzle over a vessel with its front opening well plugged with a wick, pressing above the ring with the big toe and toes of his right foot so that there is no obstruction, sprinkled with powder of dill and rock salt, recited over with mantras beforehand as previously before touching the nozzle, having poured into the enema-bladder the unctuous substance appropriately cooked with suitable medicines, lukewarm, free of folds and breaths, with air bubbles expelled, wrapping the mouth of the bladder twice or thrice with thread at the end of the medicine, should stand placing the nozzle upon his right hand. / Then, into the anus anointed with ghee, the area of entry having been anointed with the forefinger of the left left hand, the wick having been removed, the tip covered with the palm-side of the thumb of the upturned left hand, the ring held by the middle and index fingers, straight along the backbone, comfortably, with single-mindedness, with lightness, steadily, neither quickly nor slowly, he should insert the nozzle up to the ring. / The patient too should relax, letting it go down. / And then, not releasing the mouth of the bladder with the thumb and forefinger of his right hand and not moving the nozzle, with both hands upturned in a single grip, leaving a little bit remaining as the seat of wind, he should squeeze it gradually without haste. / For otherwise complications arise; / they, along with their remedies, will be explained in the Successful Treatments [section]. / Having remained for a short time, washed with one of warm water or sour gruel, one should smear it with viḍaṅga, the three pungents, lac, soot from the house, realgar, cedar, rāsnā, añjana, and the two turmerics; / or with sesame soot combined with snuhī latex; / or with madhuka, blue water lily, sesame, castor, and eclipta leaves; / or with drumstick, radish, and mustard seeds ground with cow's urine; / or with vālaka, āmalaka, dry ginger, radish, and mustard seeds ground with milk; / or with siris bark and liquorice; / or with aged oil cake and chicken dung.

28.31

Others say that the time of pressing is thirty mātrās. / And while the enema is being administered, one should not sneeze, cough, laugh, yawn, or twitch. / But upon the urge for feces, urine, or flatus, having withdrawn the nozzle, one should administer the remainder at the end of the urge. / And at the end, one should strike the buttocks of the [patient] lying on his back three or four times with the palm of the hand; / likewise with his heels; / and from the feet, one should raise the bed three times; / and for him resting on a pillow with all limbs stretched out, one should strike the two heels with the fist; / likewise the heels, toes, soles, and calves; / and one should gently massage the painful limb with an unctuous substance against the grain of the hair for about a hundred utterances. / In this way, the oil does not quickly return, / and it permeates the vessels completely; / thereafter, one should follow the conduct prescribed for oleation. / And likewise, the aforementioned Citrakādi oil is an unguent; / oil prepared with dantī, pāṭhā, kośātakī, citraka, ativiṣā, and mahālāṅgalakī is an unguent for wounds.

28.32

When the digestive fire is blazing, one should feed [the patient] light food in the evening.

Indeed, on the second day, one should not [administer food] if the unctuous substance has not returned.

And one should not administer an unctuous enema to him.

The maximum time for its return is three yāmas.

Beyond that, if it does not return, one should wait for a day and a night.

If it still does not return even then, one should purify [him] with fruit suppositories or with sharp enemas consisting mostly of salt and fermented rice-water.

And one should look to the section on the successful treatment of complications of unctuous substances.

If it does not return due to excessive dryness, but does not cause complications such as dullness, it is nevertheless to be disregarded.

If, however, it returns quickly without waste matter, as pure unctuous substance, one should administer another unctuous enema again.

For staying [inside] does not accomplish its work [if expelled immediately].

And when he has rested comfortably, having had emesis, purgation, or a non-unctuous enema performed, one should generally have him drink a decoction of dry ginger and coriander, or another [kind of] warm water, to digest the remainder of the unctuous substance and to pacify vāta and kapha.

If they do not subside in this manner, one should perform emesis, fumigation, and purgation of the head.

28.33

Then, at the time for food, he should eat the prescribed food.

And one should not make one who has received an unctuous enema drink thin gruel,

for that causes oozing in him whose bowels contain unctuous substance.

And on the third or fifth day, one should administer an unctuous enema again,

or whenever the digestion of the unctuous substance has occurred; and for those who have a blazing digestive fire, are rough, have an excess of vāta, or are habituated to regular exercise, every day.

Thus, according to this sequence, when he has been well-oleated by three or four unctuous enemas in accordance with the doṣas and other factors, one should administer a cleansing non-unctuous enema for the sake of purifying the channels.

If, however, he is un-oleated due to an excess of vāta, [one should administer a non-unctuous enema] with oleating properties.

And he should habituate himself to massage, bathing, and nasal therapies. A paste of priyāla seeds, madhuka, kuṣṭha, black gram, and mustard seeds along with honey [is applied].

Washing is done with an alkaline water of kodrava straw.

28.34

Then, on the third or fifth day, when midday has slightly declined, after auspicious benedictions have been performed for him, his body anointed and fomented, his waste products eliminated, not having eaten, but observed to be not overly hungry—having honored the noble lord Avalokita, the noble Tārā, the self-born Creator, the Aśvins, Indra, Ātreya, the seven sages, the king of Kāśi, the lord of Videha and others, and the treatise-makers headed by Agniveśa, assigning them their shares with lamps, scents, fruits, offerings, and incenses as in a sacrifice, and having worshipped the medicinal herbs, elder physicians, and the twice-born—[the physician,] accompanied by experts in that [science], should prepare an enema according to appropriateness based on the strength of the doṣas, drugs, and other factors.

Or he should massage with oil prepared with bhadradāru and kuṭannaṭa, or with citraka, karavīra, naktamāla, and mālatī.

28.35

In that case, one should cook twenty palas of medicines and eight madanaphala fruits according to the rule for decoctions.

One should add an unctuous substance equal to a fourth part of the decoction in vāta, a sixth part in pitta and the healthy regimen, and an eighth part in kapha.

And the paste should be an eighth part of the whole, as much as would not make it overly thin or dense.

One should add a pala of jaggery, and honey and rock salt with propriety, and the remaining [ingredients] as suitable.

28.36

And after heating all [the ingredients] together over the steam of a pot of hot water, churning them with a churning stick, and pouring them into the bladder, one should administer the non-unctuous enema like an unctuous enema:

not overly hot or cold, not overly mild or sharp, not overly unctuous or dry, not overly thin or dense, not deficient or excessive in quantity, not unsalted or overly salted, and not overly sour.

There, from the mere heat of the steam, burning does not occur in the medicine.

And through churning with the stick, the decoction, unctuous substance, and other ingredients, when properly combined, initiate their action properly.

Otherwise, the dominant one among the decoction and other ingredients would provoke its corresponding doṣa.

Moreover, the particular complications and treatments for the overly hot and other [faulty enemas] will be taught later in the [section on] successful treatments.

Or [an oil] cooked with leaves of mārkava and flowers of sahacara [is used].

Oil cooked with eggplants and mixed with honey and collyrium is an ointment.

Or the juice of small eggplant mixed with honey [is used].

Or a thick [solution of] palāśa alkali [is applied] for water-born colic.

28.37

Furthermore:

For if it is administered obliquely, the stream does not flow; and if the nozzle moves, an ulcer forms in the rectum;

an enema given slowly does not reach the reservoir, but if pressed too hard, it surges up to the throat.

Or one should apply an ointment of ashes of a turtle shell smeared with the juice of surasā,

or with ivory soot combined with oil.

Or leaves of pūtīkarañja with rock salt make a paste.

Or long pepper, collyrium, extract of berberis, bākucī, ironwood fruits, and iron dust ground with cow’s urine [make a paste].

And one should employ [the treatments] prescribed for baldness.

One should avoid sprinkling with water until the hair emerges.

28.38

An overly mild and cold [enema] causes stiffness; a hot, sour, and sharp one causes dizziness, burning sensation, and confusion;

an unctuous one causes excessive dullness, a dry one causes vāta, and a thin, small-dosed, and unsalted one causes deficient action.

28.39

An enema with an excessive dose causes excessive action; a dense one causes agitation and returns after a very long time;

an overly salted one causes burning sensation and diarrhea; therefore, one should give an evenly combined [enema] with perfect precision.

28.40

For a healthy person, one should make the measure of the unctuous substance and honey three palas each,
half a karṣa of rock salt, and two palas of paste.

28.41

One should prepare ten palas of all the remaining liquids.
In sequence: honey, salt, unctuous substance, paste, and decoction.
In this very manner, [one may prepare it] with a paste of the sweet group of drugs.

28.42

One should add [them]: this is the rule in combining non-unctuous enemas.

28.43

As soon as it has been given, he should lie on his back with a pillow, attentive, so that the potency of the non-unctuous enema pervades the body.

And when the urge arises, he should squat and evacuate.

The maximum time for its return is one muhūrta.

For if it does not return then, it may cause swift death.

Therefore, in that case, one should administer another laxative enema, unctuous, sharp, and hot, consisting of unctuous substance, alkali, urine, and sour liquid;

and fruit suppositories, sudation, fright, intimidation, and so forth.

And one should look to the section on the successful treatment of enema complications.

Then, for him, a nasal therapy and massage with aṇu oil, as described for facial paralysis, [should be given].

28.44

When it has returned on its own, one should give a second, a third, and a fourth [enema] as before, or until he is properly purged with non-unctuous enema.

Or with sesame, āmalaka, honey, and oil;

or with blue vitriol, mango seed, jambu seed, green vitriol, and sugar;

or with powders of sairyaka flowers, indigo, triphalā, and bhṛṅgarāja, ground with black goat’s urine.

28.45

There, the first pulls vāta from its pathway;

the second, pitta;

the third, śleṣman.

This very procedure also applies to sairīyaka.

28.46

Its inadequate, proper, and excessive administration are just like those of purgation.

When one is properly evacuated by enema, however, he should be sprinkled with lukewarm water and fed with thin soup of wild game animals.

Once he has bathed and eaten, the remaining mobile doṣas settle into their own places.

28.47

Then, one should administer an unctuous enema with oil cooked with Daśamūla and other drugs according to the appropriate [doṣa, such as] vāta, to a patient suffering from vāta, or to one requiring nourishment, or to another of such sort, either immediately after eating or again in the evening after he has eaten lightly and sparsely.

Its inadequate, proper, and excessive administration are like those of drinking oleaginous substances.

28.48

The distinction, however, is that when properly administered as an unctuous enema, the unctuous substance stays for a short time and then comes forth accompanied by feces and followed by flatus.

And here it is said:

Then, one should smear the hair and scalp, which have been washed after being coated with lotus silt dissolved in the aforementioned juice.

Then, having covered it with lotus silt, one should wrap it with silk cloth.

And on the third day, having washed it, one should do the same again.

In this way, hairs black as a swarm of bees adorn the head.

And here it is said:

28.49

Thus, in kapha one should administer one or three unctuous enemas;
five or seven in pitta; nine or eleven in vāta.
One should treat [the patient] with nasal therapies, facial and head anointings, and poultices.

28.50

Then further odd-numbered ones after that, and then again non-unctuous evacuating enemas.
In conditions of kapha, pitta, and vāta, [one should administer] food with vegetable broth, milk, and meat soup respectively.

28.51

Endowed with decoction of vāta-destroying medicines, trivṛt, and rock salt,
one enema is unctuous, sweet, sour, hot, and combined with meat juice in vāta.
A prastha of oil, a kuḍava of [decoction], along with a pala of yaṣṭīmadhu.

28.52

Two [enemas] combined with a decoction of the Nyagrodhādi group, Padmakādi drugs, and sugar,
sweet and cold, with ghee, milk, sugarcane juice, and honey in pitta.
It should be a nasal therapy...

28.53

Three enemas combined with a decoction of Āragvadhādi and Vatsakādi drugs,
unctuous-free, with honey and cow's urine, sharp, hot, and pungent in kapha.
Having plucked the gray hair, two [enemas] destroying graying of hair should be given in the rectum.

28.54

And three enemas destroy the doṣas successively even in a combined vitiation of all three;
hence, according to Master Caraka, no enema is considered beyond three,
for there is no fourth doṣa against which it would be given again.
Fruit, kṛṣṇa, hemp-leaf, surasā, yaṣṭī, and mārkava.

28.55

Exciting, purifying, and pacifying the doṣas respectively:
others also declare that one should design the enema in threefold manner only.
One should determine all this according to the strength of doṣas, medicines, and the like.
Prapauṇḍarīka, mañjiṣṭhā, lodhra, kṛṣṇāgaru, and blue water lily.

28.56

One should not desist, however, without noticing the signs of proper evacuation by enema.
Nīlī, bhallātaka seeds, kāsīsa, and madayantikā.

28.57

One unctuous enema first, five at the end, and twelve non-unctuous evacuating enemas
interspersed with unctuous enemas: this procedure of thirty enemas is called Karma-basti.
Flowers of arjuna and kāśmarya, unripe jambū fruits, and antimony collyrium.

28.58

Kāla-basti consists of fifteen enemas: here, one unctuous enema first, and three likewise at the end.
One should cook an āḍhaka of vibhītaka oil with that in an ārmaṇa of āmalakī juice.

28.59

Six [non-unctuous enemas] and five unctuous enemas intervening. Yoga-basti consists of eight enemas here:
three evacuating enemas and [three] unctuous enemas, with two unctuous enemas at the beginning and the end.
Then filtered into an iron vessel, the Mahānīla oil is applied.

28.60

One should not repeatedly practice solely an unctuous enema or an evacuating enema alone;
from unctuous enema comes nausea and loss of digestive fire, and from evacuating enema comes fear of vāta.
It destroys all diseases above the clavicle, especially graying of hair;
and with these very medicaments, one should smear the head and face.

28.61

Therefore, one who has received an evacuating enema should be oleated, and one who has received an unctuous enema should be evacuated by enema.
In this way, through the combined application of oleation and purification, the enema procedure conquers all three doṣas.
Black [substances applied as] a facial paste are beneficial for tawny facial hair and wrinkles.

28.62

A man who makes use of eighteen sets of eighteen enemas
according to the prescribed rule becomes free from aging and free from disease.
And this nourishes and colors the hair through smearing on the head.

28.63

Attaining a lifespan of a thousand years, retaining what he hears, freed from sins, radiant like an immortal,
with the speed of a horse, the strength of an elephant, and with steadfast intellect, senses, and digestive fire.
When the cleansed, unctuous-free head is smeared with it and left for the night,
and then washed in the morning with Triphalā, the hair becomes black and glossy.

28.64

In disease of the bladder, and in disorders of the vaginal canal and uterus of women,
one should administer the urethral or vaginal douche to those who have been purified by two or three non-unctuous evacuating enemas.

28.65

Its nozzle should be twelve aṅgulas long by the patient's own finger measurement,
round like a cow's tail, with rings made at its root and middle.
Submerged in powder, meat fat of goat, cow, and buffalo,
kept in an iron vessel and placed underground for a month, then taken out,
this destroys premature graying and baldness resembling a mirror through anointing.

28.66

Its tip should allow the entry of a mustard seed, smooth, made of gold or the like,
firm, and resembling the flower stalk of kunda, oleander, or jasmine.
That oil produces supreme blackness of hair by nasal instillation and head-anointing, and completely destroys pain in the head, nose, eyes, teeth, ears, and throat.

28.67

Its enema bladder should be soft and light, its dose a śukti, or adapted according to judgment.
And cooked with jīvaka, ṛṣabhaka, grapes, and sugar.

28.68

Now, for this patient who has bathed and eaten according to the rule for unctuous enemas,
seated upright and comfortably on a soft stool equal in height to the knees,
[it serves as] a nasal therapy dispelling all diseases of vāta and pitta arising above the clavicle.

28.69

When the penis is erect and held straight, in order to cleanse the passage,
[using a probe] having the thickness of the tip of a jasmine flower stalk, solid, straight,
combined with Daśamūla, balā, rāsnā, madhuka, and Triphalā;

28.70

one should slowly insert a smooth probe; when it is cleansed by it along the perineal seam,
the nozzle should be inserted without shaking, up to the end of the urinary tract, like in the rectum.
With sweet substances made into paste, it cures all diseases above the clavicle,
when routinely applied as drinks, enemas, ointments, and nasal instillations.

28.71

When the enema bladder is pressed and the unctuous substance has entered, the regimen of unctuous enema is beneficial.
By this procedure, one should administer three or four enemas,
with four times the quantity of milk and these pastes weighing one karṣa each;

28.72

one should consider all the rest of its procedure to be just like that of an unctuous enema.
With samaṅgā, cavikā, bhārṅgī, kāśmarī, and karkaṭāhvā;

28.73

In women, however, at the time of menstruation, the vagina receives [the douche] because it is open;
therefore, one should administer it then, and also at non-menstrual periods in an emergency;
with lotus stalk, lotus rhizome, dates, yaṣṭīmadhu, and jīvaka;

28.74

in uterine prolapse, vaginal pain, vaginal disorders, and menorrhagia.
With mūrvā, aśvadaṃṣṭrā, ṛṣabhaka, śṛṅgāṭaka, and kaśeruka.

28.75

The tube should be ten fingers long, permitting the entry of a mung bean, [and inserted] four fingers / into the birth canal; it should be two fingers [long] in the urinary passage. / [Medicated oil prepared] with punarnavā, tavakṣīrī, kākolī, and dhanvayāsa

28.76

in disorders of dysuria, but for children, merely a śukti [in dose]. / This ‘great pea-sized’ recipe is superior in qualities even to the Māyūra recipe.

28.77

For a woman lying on her back, having well drawn up her thighs / and with knees raised, one should administer [it] three or four times in a day and night. / It is praised in disorders of the vaginal tract, menstrual fluid, and semen, and grants a son to a barren woman.

28.78

For three nights one should thus [give] enemas, increasing the dose of unctuous substance; / and having rested thus for three days, one should apply [it] again for three days.

28.79

Purgation is [administered] a fortnight after emesis, and an evacuating enema a fortnight after that; / immediately after an evacuating enema, an unctuous enema should be given, and purgation seven nights after that. / [Thus] without confusion between one another, [the course] has been illuminated in detail.

28.80

Just as a cloth extracts color from water mixed with safflower and the like, / so an enema extracts waste products from a body that has been liquefied; / therefore one should swiftly conquer diseases that strike at the root.

28.80_1

Thus ends the twenty-eighth chapter.

Commentaries (1)

Śaśilekhā — Indu, Sanskrit

Linked texts (1)

Aṣṭāṅgasaṃgraha — Vāgbhaṭa, Sanskrit