The Compendium of Caraka 1.15: pañcadaśo 'adhyāyaḥ

Now we shall expound the chapter on equipment.

Thus spoke the venerable Ātreya.

Here indeed, by a physician who wishes to administer emesis or purgation to a king, a king's equal, or another person of ample wealth, the provisions must be arranged well before the drinking of the medicine, so that they may be used when the medicine operates properly; for when an emergency has arisen at the immediate moment, even though money is available for purchase, it is not easy to quickly collect medicines properly.

To the venerable Ātreya who was speaking thus, Agniveśa said: "Is it not so, venerable sir, that a knowledgeable [physician] should arrange things from the very beginning in such a way that, once arranged, the medicine must inevitably succeed? For the success of all actions is held to result from correct application, and complication results from incorrect application. But if an action begun correctly or incorrectly succeeds or fails without any definite rule, then knowledge is equal to ignorance."

To him the venerable Ātreya said: "It is possible for us or for those like us, Agniveśa, to arrange things in such a way that, once arranged, the medicine must inevitably succeed, and to instruct properly in that excellence of application; yet there is no one who would be able to comprehend it when instructed in this way, or having comprehended it, to practice it or apply it accordingly. For subtle are the transitional states of the doṣas, medicines, habitat, season, strength, body, diet, suitability, mind, constitution, and age, which, when reflected upon, would confound the intellect even of one with a clear and broad intellect, let alone one of small intellect. Therefore we shall properly instruct in both: the correct application of medicines, and later, in the [section on] successes, the remedies for complications when they have gone wrong.

For now, we shall instruct briefly even on the various provisions, as follows: first of all, one skilled in the science of architecture should arrange a praised house itself—strong, sheltered from wind, with one part well-ventilated, comfortable for movement, not at the foot of a mountain, inaccessible to smoke, sunlight, water, and dust, as well as to undesirable sounds, touches, tastes, sights, and smells, possessing a water well, a mortar and pestle, a latrine, a bathing place, and a kitchen.

Then, attendants endowed with good character, cleanliness, conduct, affection, skill, and dexterity, skilled in nursing, thoroughly accomplished in all actions, cooks of soup and boiled rice, bathers, massagers, lifters, bed-layers, and medicine-grinders, unhindered in all actions; likewise companions skilled in vocal music, instrumental music, pleasant conversation, verses, songs, tales, historical narratives, and ancient lore, perceptive of intentions, agreeable, and knowing the place and time; likewise quail, francolin, hare, blackbuck, spotted deer, black-tailed deer, barking deer, and sheep; a milch cow that is well-behaved, free from disease, with a living calf, and provided with well-arranged grass, shelter, and water; and bowls, rinsing vessels, water tubs, small water jars, pots, kettles, wide-mouthed pots, small earthen jars, large jars, basins, saucers, ladles, mats, bailers, cooking pots, churns, skins, cloth, thread, cotton, wool, and the like; and beds, seats, and the like, supplied with spittoons and bedpans, equipped with well-laid spreads, upper sheets, and pillows, with bolsters, comfortable for the service of lying down, sitting, oleation, sudation, anointing, thick poultice, affusion, inunction, emesis, purgation, non-unctuous enema, unctuous enema, head-purgation, and urine and stool evacuation; and well-washed grindstones with very smooth upper stones of medium size; and surgical instruments for equipment; and a smoking tube, an enema nozzle, a urethral catheter, a kusha-grass brush, a balance, and measuring vessels; and ghee, oil, muscle fat, marrow, honey, treacle, salt, fuel, water, madhu wine, sīdhu wine, surā liquor, sauvīraka, tuṣodaka, maireya, medaka, curd, curd-whey, buttermilk, sour gruel, and urines; and likewise śāli rice, ṣaṣṭika rice, mung bean, black gram, barley, sesame, horse gram, jujube, raisins, kāśmarya, parūṣaka, harītakī, āmalakī, bibhītaka, and various substances serving as equipment for oleation and sudation; and likewise the medicines known as upward-cleansing, downward-cleansing, operating both ways, astringent, appetising, digestive, pacifying, and vāta-alleviating; and whatever other equipment one may know to be for counteracting complications after calculating them, and whatever is for [regular] use—all that one should arrange.

Then one should prepare that person appropriately with the oleation and sudation as stated. If in the meantime any severe mental or bodily disease should suddenly attack him, one should first strive to turn away that very [disease] of his; then, having turned it away, one should attend to him for that very duration with that same kind of procedure.

Then, observing that person prepared with oleation and sudation, unhindered in mind, well-rested, with his food well-digested, having bathed his head, anointed his limbs, wearing a garland, clothed in clean garments, having worshipped the deities, the fire, the twice-born, the elders, the aged, and the physicians, on an auspicious constellation, lunar day, half-tithi, and muhūrta, having caused the brāhmaṇas to recite auspicious benedictions, one should make him drink a dose of madanaphala decoction consecrating it with recited blessings, combined with honey, madhuka, rock salt, and treacle.

The measure of the dose of madanaphala decoction, indeed, and the measure of the dose of all cleansing procedures, must be determined with respect to each individual person; for that amount which, when drunk by a person, serves to eliminate the morbid doṣas and does not lead to excessive action or deficient action, should be known as the measure of his dose.

After he has drunk it, indeed, one should wait for a muhūrta. When one knows that the doṣa is attaining liquefaction through the appearance of sweat, has moved from its seats through horripilation, has entered the belly through the swelling of the belly, and has turned upward through nausea and salivation, then one should give him a comfortable seat of knee-height, unconfined, equipped with a well-laid spread, upper sheet, and pillow, with a backrest, to sit on, and provide spittoons; and trustworthy, agreeable friends who cause no embarrassment should endeavor to hold his forehead, support his flanks, press his navel, and massage his back.

Then one should instruct him: “Opening your lips, palate, and throat, without excessive exertion, bringing forth the urges when they have arisen, bending slightly the neck and upper body, inducing the urges when they have not commenced, touching the throat with two fingers having well-trimmed nails or with stalks of the blue lotus, white water lily, or fragrant water lily, bring [the emesis] forth with ease.” He should act accordingly. Then, attentively, one should observe his urges collected in the spittoon; for by observing the nature of the urges, a skilled [physician] recognizes proper action, deficient action, and excessive action. Observing the nature of the urges, he furthermore understands what should be done as appropriate according to the signs; therefore, he should attentively observe the urges.

Here, these are the signs for knowing deficient action, proper action, and excessive action, namely: Non-commencement in any respect, or the slipping out of only the drug alone, and the obstruction of the urges—these are the signs of deficient action. Timely commencement, pain that is not excessively great, expulsion of the doṣas in their proper order, and spontaneous cessation—these are the signs of proper action. According to the proper action and the particular measure of the doṣas, the classification into strong, mild, and moderate should be understood. But by excess of action, the coming forth of frothy blood containing shining red specks—these are the signs of excessive action.

There, one should recognize these complications caused by excessive action and deficient action: distension, cutting pain, excessive discharge, displacement of the heart, stiffness of the limbs, discharge of pure blood, displacement, rigidity, and exhaustion—these are the complications.

Seeing that he has vomited with proper action, after his hands, feet, and mouth have been well washed, having comforted him for a muhūrta, and having had him inhale according to his capacity any one of the unctuous, purgative, or soothing smokes, one should again have him sip water.

And after he has sipped water, having led him into a windless room, having laid him down, one should instruct him: “Loud speaking, overeating, prolonged standing, excessive walking, anger, grief, frost, sun, dew, strong winds, traveling in a carriage, sexual intercourse, not sleeping at night, sleeping by day, foods that are incompatible, undigested, unwholesome, untimely, scanty, excessive, deficient, heavy, or uneven, and suppressing or forcing the urges—not indulging even in mind in these things, pass the entire day.”

He should do so.

Then, in the evening or on the next day, after he has been sprinkled with comfortably warm water, considering the strength of his digestive fire, one should make him drink comfortably warm gruel made of old red śāli rice, well-cooked, preceded by the clear scum; likewise at the second and third mealtime. But at the fourth mealtime, one should feed him well-steamed thick gruel of the very same kind of śāli rice, accompanied by hot water, without unctuous substance and salt, or with little unctuous substance and salt; likewise at the fifth and sixth mealtime. But at the seventh mealtime, one should feed him two prasṛtas of well-steamed boiled rice of the very same kind of śāli, accompanied by hot water as a post-prandial drink, with thin soup of mudga beans prepared with a small amount of unctuous substance and salt; likewise at the eighth and ninth mealtime. But at the tenth mealtime, one should feed him with meat broth of any of the common quail, grey partridge, and so forth, cooked with water and salt, not excessively rich, accompanied by hot water as a post-prandial drink; likewise at the eleventh and twelfth mealtime. Thereafter, partaking gradually of the qualities of food, within seven nights he should return to his normal diet.

Then, preparing him again with oleation and sudation, seeing that his mind is unhindered, that he has rested well, that his food is well-digested, that he has performed the fire offerings, animal offerings, auspicious rites, prayers, and expiations, on an auspicious lunar day, constellation, half-tithi, and muhūrta, having caused the brāhmaṇas to recite auspicious benedictions, one should make him drink a paste of trivṛt to the measure of an akṣa dissolved in a suitable liquid vehicle, having carefully examined the varying states of the doṣa, the medicine, the place, the season, the strength, the body, the diet, the wholesome suitability, the mental disposition, the constitution, and the age, as well as the morbid alterations. And when he has been properly purged, one should treat him according to the procedure stated for emesis, excluding the smoke, until he regains his strength, complexion, and normal constitution. And seeing him endowed with strength and complexion, unhindered in mind, well-rested, with his food well-digested, having bathed his head, anointed his limbs, wearing a garland, clothed in clean garments, adorned with suitable ornaments, having shown him to his friends and shown him to his kinsmen, one should then release him to his desires.

And here are [the verses]: / By this procedure, a king, or one of royal status, / or he who has abundant wealth, is fit for cleansing.

A poor man, however, having met with affliction, when the time for cleansing has arrived, / may drink it at will, even without gathering the provisions that are hard to obtain.

For not all men possess all accessories, / and yet severe diseases do not spare even the poor.

Whatever medicine a man is able to prepare in an affliction, / that very thing, along with clothing and food, should be used according to one's capacity.

Having properly drunk cleansing [medicine], which removes impurities, dispels diseases, / and clears the strength and complexion, one is endowed with long life.

Here are the summary verses: / Emesis along with purgation for lords and wealthy men, / what provisions [are needed] and for what purpose, bringing which one should administer them;

How and what dose should be administered; what the sign of deficient action is, / and what belongs to proper action and excessive action; what the faults and complications are;

What should be avoided by one who has been cleansed, and what the regimen of dietary transition is— / all that Punarvasu explained in the chapter on equipment.

Thus ends the fifteenth chapter, named “On Equipment,” in the Ślokasthāna of the treatise composed by Agniveśa and redacted by Caraka.