The Compendium of Bheḷa 8.5

Physicians praise the administration of enema when a meal has been digested; / other doctors [praise it] in those who have purged; yet other people, in one evacuated by a non-unctuous enema.

The experts say that these three are inferior, and do not praise them. / I shall properly refute their opinion with reasons.

For one who is constantly purged, the digestive fire becomes cold, / and the channels residing in the heart, rectum, and abdomen [become empty].

Wind, increased in him, rushes to the colon; / it cools the body-fire and drags down his strength.

If an enema is given when the channels are partially cleansed and partially uncleansed, / it, having gone deep into the body, does not return completely.

It may produce vomiting, thirst, heart disease, pallor, and swelling here; / therefore, indeed, one should not give an unctuous enema to one who has purged.

Moreover, for an embodied being who has had a mixed meal, in whom the humors have arisen, / and whose channels are smeared with waste, unction would be useless.

For an embodied being who has been evacuated by a non-unctuous enema with a sharp or other [formula], / an unctuous enema is not praised when the humors are agitated.

And some praise an unctuous enema for a body / that has rested overnight, whose humors have calmed down […].

Hear from me, however, the procedure of enema administration free from complications, / for one who has been oleated properly and purged according to the formulary,

and likewise after eating a light diet, and oleated again: / after five nights, one should have an unctuous enema administered to him.

An unctuous enema must not be given above an abdomen that is not unctuous; / for the wind, forced upwards, settles in his heart.

One should feed him only half the measure of his customary meal, / with thin mung-bean soup or meat broth of wild animals.

Having eaten, taken rest, and passed feces and urine, / a man should lie down on a level bed on his left side.

He should contract the right thigh and extend the left; / the man should make a left-side pillow placed beneath his head.

Then one should comfortably administer the enema into him along the vertebral column, / according to the strength of the procedure, neither swiftly nor slowly.

An enema that is smooth, soft, and has its air removed [should be used]; / one with dense entrapped air is not praised for him in the enema procedure.

Holding the nozzle at the mouth of the enema bladder properly with one hand, / one should press with the other, and not shake the hands.

Having first smeared the rectum, the instrument, and both hands, the man / should insert it; then one should turn him supine or extend his legs.

When the enema has been comfortably given, he should not suppress it for a muhūrta; / thereafter, he should not hold back the urges that have arrived.

It succeeds without obstruction, with flatus, and with feces. / But for one whose oil enema returns immediately after being given,

it is said not to be effective; one should have another administered to him. / If he is thirsty at night, he should drink hot water in the early morning.

And enema should be given on alternate days, not continuously to men; / massage, rubbing down, pouring over with lukewarm water,

and an after-drink of warm water are praised in enema therapy. / When three or four [enemas have been given], or until unctuousness appears again,

after unctuous enemas have been administered, the physician should then perform a non-unctuous enema; / when the channels are moistened by the administered unction,

he should comfortably administer non-unctuous enemas according to proper method for cleansing the channels. / An unctuous enema applied in an uncleaned, soiled abdomen

[…] / And the regimen of purgation should be observed during enema therapy.

One should avoid drinking gruel in enema therapy. / Twenty-four non-unctuous enemas along with unctuous enemas are counted;

this is specified as a course [of therapy]; one should administer it in upward wind. / In mild, moderate, and sharp diseases, the skilled physician

should perform mild, moderate, and sharp enema therapy. / The meat of domestic, marsh, and aquatic [animals], foods made of flour, sesame paste, yogurt,

sour vegetable preparations, various fried cakes, / drinking cold water, and cold bathing,

and heavy foods and drinks should be avoided during enema therapy; / and one should provide śāli rice, ṣaṣṭika rice, and mung beans for food.

Hare, partridge, and quail should be given as cooked meat. / A person who is knowledgeable, eats measured food, attends upon a physician, / and undergoes enema therapy will live for a hundred autumns. / Thus said the venerable Ātreya. / Thus ends the fifth chapter in the Siddhisthāna of Bheḷa. / Sixth Chapter. / Now we shall explain the successful management of equipment, thus spoke the venerable Ātreya.