The Compendium of Bheḷa 8.4

The intelligent physician should diligently formulate / medicines acting downwards and upwards, which are indeed like poisons or weapons.

Pungent, bitter, and astringent, burning and other types, / subtle, hot, sharp, liquefacient, and heavy—

these, having reached the heart and entering the vessels, / cause the humors to flow transversely, upwards, and downwards.

Due to their subtlety, they follow into the subtle parts of the body, / and they cause the bodily tissues of living beings to drain even along deviant paths.

They lead those excessively aggravated humors as it were to the heart; / having filled the stomach, [they expel] those arising in the upper region.

And likewise, the liquefacient medicines, having filled the stomach again, / proceed into the lower tract in the disorders here of embodied beings.

They liquefy the humors as long as they reside in living beings; / thereafter, they cleanse either upwards or downwards.

Ten complications arise from those [medicines] improperly administered, / misdirected, running disorderly, and from insufficient or excessive action:

continual oozing, flatulence, constipation, discharge from the anus, / heart disease, abdominal colic, and likewise cutting rectal pain,

loss of blood, head disease, and tenth, tenesmus. / Learn from me the management of each of those complications.

When the emetic taken comes up [insufficiently], he should drink a sharper one; / through successful administration of a post-drink, having cleansed the man, one should give him a non-unctuous enema.

When purgation does not succeed, one should administer an unctuous enema to him again; / when this also has undergone digestion, after three days he should drink ghee.

Provided with oleation and fomentation, and fed light food, / the man should drink a sharper purgative or emetic.

When a purgative taken results in vomiting, / such is the application traditionally taught for emesis as well as for purgation.

In a person devoid of oleation and fomentation and having a hard bowel, / medicine taken during indigestion causes him to swell with flatulence.

In one who has fasted, one who has eaten heavily, one who is un-unctuous, or one who has not eaten, / and in one unfomented, there occurs cutting pain, continual oozing, and coating.

In an embodied being devoid of oleation and fomentation who has a soft bowel, / the remaining humors generate tenesmus.

From extreme dryness, from excessive unctuousness, and from confusion of the drugs, / abdominal colic and severe rectal prolapse arise in men.

When an emetic or a purgative has been drunk and its urge is suppressed, / wind, bile, and phlegm become provoked and cause cardiac spasm.

His limbs droop, exhaustion and severe colic [occur], / as well as head seizure, abdominal distress, and he even becomes unconscious.

For a person who is fomented, has a soft bowel, and has been oleated, a purgative / medicine drunk in excess leads to loss of blood.

Together with feces he discharges white, black, or even blood, / or resembling the color of a lodhra flower, or appearing like a bhaṇḍī flower.

When one who has been purged resorts to cold treatment, / frequents cold shelters, and takes cold water,

the provoked wind stays obstructing his channels; / by that it becomes rough, [and] the humors of this embodied being coagulate.

Non-passage of flatus, urine, and feces, thirst, and fever [ensue]; / this obstruction has been explained [as arising] from confusion of the intellect of physicians.

When, however, a physician causes a non-unctuous person to drink dry medicine, / provoked wind seizes all his limbs.

When wind reaches the waist, back, head, / neck, and heart, then he falls into stupor and loss of consciousness.

These ten complications have been declared, each with diverse signs; / in them one should apply treatment according to the instruction of Ātreya.

There, having anointed one suffering from inadequate effect with oil and salt, / using saṅkara or prastara fomentations, or else tube fomentations,

properly evacuated by non-unctuous enema, rested, sprinkled with comfortable water, / one should feed him soft boiled rice with meat soup of arid animals alone.

Then one should administer an unctuous enema to him with lukewarm fruit-oil; / meteorism, cutting pain, and discharge are relieved.

Sāla, castor, triphalā, croton root, and plumbago— / and one should cause him to drink clarified butter cooked with these according to strength.

To him who has drunk that unctuous substance, is well oleated, and provided with the act of fomentation, / one should cause to drink sharp medicine, either an emetic or a purgative.

Heart disease, horripilation of the body, and seizure of the head and shoulders, / obstruction, cutting pain, and colic are relieved by this.

So that cutting pain and discharge are truly relieved, / one should administer a decoction enema or a slimy enema;

or one should give a milk enema [with] boiled honey and clarified butter, / and administer an unctuous enema with clarified butter prepared with the vitalising drugs.

Castor root, triphalā, grape, and kāśmarya— / one should give milk boiled with these, and may mix it with various [substances].

Barley ash, rock salt with amlavetasa, / asafoetida, pomegranate pulp, long pepper, and dry ginger—

[these] drunk with clarified butter, milk, liquor, or hot water, / turn back colic and severe cutting pain.

Devadāru with bilva, rāsnā, that called karkaṭaka, / castor too, and pūti—with these one should cook oil.

One should administer an unctuous enema with it, and then comfort ensues; / stiffness of the limbs, colic, and cutting pain are relieved.

If pacification of these complications is not found, / one should perform their treatment according to each specific therapy.

Thus the treatment for inadequate effect has been declared by me in detail; / but now I shall state the treatment of complications in excessive effect.

In excessive evacuation of emesis, one should employ purgation; / and when purgation is excessively applied, the physician should cause him to drink an emetic.

When emesis is excessively applied, a non-unctuous enema should be performed; / but in the excessive application of both, astringing therapy is said to be beneficial.

That man should scrape [the throat] with rice-water combined with honey; / and one should sprinkle his feet and hands, or bathe them.

With lāmajjaka, lotus stalk, sandalwood, and padmaka, / one should anoint all his limbs, and sprinkle them with astringent decoctions.

Dhātakī, madhuka, lodhra, lotus, and mocarasa, / blue water lily, samaṅgā, kaṭphala, and lotus filament—

with these, a very cool gruel of red rice cooked [and] / drunk combined with honey is an excellent arresting [measure] for him.

Lac, lodhra, samaṅgā, honey, lotus, and blue water lily, / drunk with goat's milk, is said to arrest bleeding.

One should cause him to drink juice of wood-apple leaves combined with honey; / a man should drink jujube with milk and grapes with honey.

Soups of arid animals seasoned with pomegranate pulp should be given; / milk enemas combined with clarified butter and pomegranate should be given.

When blood flows excessively, one should administer an unctuous enema with blood itself: / of rabbit, deer, sheep, goat, or buffalo.

Having crushed boiled rice with milk […] strained and with honey, / one should drink it, or again boiled rice crushed with sugarcane juice.

With sprouts produced from banyan, glomerous fig, plakṣa, vetasa, and sacred fig, / gruel [prepared] with their milk is an excellent arresting [measure].

Lotus, exudate of silk-cotton, samaṅgā, dhātakī, / pulp of rose apple and mango, madhuka, puffed grain, lac, and priyaṅgu—

milk boiled with these is to be drunk, or one should cause him to drink gruel; / or one should drink them combined with rice-water together with honey.

Boiled rice of kodo millet gathered as grain, with honey / and combined with guggulu, halts diarrhea.

Curd kept for seven nights combined with sesame oil, / eaten with boiled rice of kodo millet, destroys diarrhea.

In buttermilk kept for seven nights the physician should cook radish; / boiled rice of kodo millet is to be employed with it as a destroyer of diarrhea.

Sprouts of banyan, mocarasa, lodhra, mango seed stone, / tender bilva fruits, and dhātakī flowers—

one should make a soup with these in buttermilk kept for five nights; / boiled rice of kodo millet is to be employed likewise as a destroyer of diarrhea.

Blue water lily, black sesame, samaṅgā, and lodhra— / with these one should cook milk, which destroys diarrhea.

One should cook sesame oil, lodhra, and goat's milk; / tenesmus and rectal prolapse are all relieved by this.

Balā, atibalā, bilva, castor, and coraka— / with these one should cook milk that destroys phlegm and bile.

It should be drunk in lockjaw and in severe pain of hemorrhoids; / and with this very paste one should cover the head.

By that, fainting and dizziness of embodied beings are relieved; / and whatever other complications there are, their respective treatments [should be done].

Sugar, padmaka, uśīra, banyan, and glomerous fig— / with these one should cook milk that destroys thirst and burning sensation.

And one should administer a milk enema or a slimy enema; / cold ghee enemas are praised in excessive administration.

What was stated previously in the treatment of loss of blood / should be done for prolapse of the rectum; thus comfort is attained.

When wind-pain arises, however, one should apply / fomentations like saṅkara and prastara, as well as poultices, to those who have been well-anointed.

Prepared vacā, śvadaṃṣṭrā, pūtīkā, and pañcamūlī / […] if one should give a non-unctuous enema, and a pleasantly warm unctuous enema.

One should also treat him with alkalis and alkali-ghees that relieve colic, / or have him drink Dādhika or Ṣaṭpala ghee in proper dosage.

The physician should apply this very regimen in constipation too; / and regarding the complications that follow emesis and purgation,

the intelligent [physician] should treat them according to each one's therapy. / If an unctuous person partakes of the meat of domestic, marsh, or aquatic [animals],

when phlegm is increased, purgation quickly becomes emesis for him; / or if medicine has been drunk during indigestion, whether a little or much,

in nausea, in upward wind, or when the medicine has been improperly administered— / purgation drunk in this manner turns into emesis.

In an emaciated or dry person, or in a delicate person, or in severe [illness], / of an embodied being in whom phlegm has not arisen and who is not unctuous,

emetic medicine, administered agitated, turns into purgation. / Some say it is an after-drink there, but others [consider it] inappropriate.

For medicine in excessive measure leads to loss of blood. / Beyond ten days, having treated him with oleation and fomentation,

one should have him drink this very sharp medicine prepared according to the formulary. / This success of purgation and of emesis has been declared, / and the complications and their treatment, properly in sequence.
Thus spoke the blessed Ātreya.
Thus the fourth chapter in the Siddhisthāna of Bheḷa.
Chapter Five.
Now we shall explain the success [of enema] based on enema dosage—thus spoke the blessed Ātreya.