The Compendium of Caraka 8.10: daśamo 'adhyāyaḥ/

Now we shall explain the success of enemas.

Thus spoke the venerable Ātreya:

Listen, O Agniveśa, as I speak of the success of effective enemas commended in various diseases, / which confers success upon physicians.

When properly applied after distinguishing strength, doṣas, season, disease, and constitution / with their respective groups of drugs, they curb their respective diseases.

There is no procedure equal to the enema, because of its quick and comfortable purification, / because of its capability for rapid depleting and nourishing, and because of its harmlessness.

Even though it removes doṣas, in purgation, owing to taking pungent, sharp, and hot medicine, / there may be distressful eructation, nausea, unpalatability, and abdominal pain.

A child and an old man should not be purged, as they have unformed or depleted bodily strength; / for both of them, non-unctuous enema alone is the supreme procedure that accomplishes all purposes.

It quickly gives strength, complexion, cheerfulness, softness, and unctuousness of the body to men; / it is threefold: unctuous enema, non-unctuous enema, and urethral/vaginal enema.

It is commended for those afflicted by vāta in the limbs, those contracted, stiff, fractured, or disabled, / and in retention of feces, abdominal distension, anorexia, cutting pain, and the like.

For those afflicted by heat, cold [enemas], and for those afflicted by cold, comfortably warm ones, / prepared with suitable medicaments, should be administered after deliberation.

One should not give nourishing enemas in diseases that are to be purified; / also fat people are to be purified, as well as men suffering from obstinate skin diseases and obstinate urinary disorders.

One should not administer purifying enemas to those whose bodies are wasted, injured, weak, fainting, emaciated, or dried up, / or those whose life depends on the doṣas.

For virilisation, and in [disorders of] blood and pitta, [enemas] combined with honey, ghee, and milk [are indicated]; / and in kapha and vāta, those with oil, urine, sour fermented gruel, and salt are recommended.

One should employ sour substances, urine, milk, surā, and decoctions as substances in enemas, / and warm water, because it is harmless to the dhātus and is the source of rasas.

Suradāru, śatāhvā, elā, kuṣṭha, madhuka, pippalī, honey, fats, / upward- and downward-purging [drugs], together with mustard seeds, sugar, [and] rock salt,

are the additives of enemas; whichever among them are to be used / combined with decoctions, those I shall explain hereinafter.

In chronic, hard, and strong diseases, sharp [enemas are to be used], and in the opposite, mild ones; / decoction enemas and unctuous enemas should indeed be administered along with their additives and decoctions.

Now listen to the enemas successful in various diseases in every respect, [described] by half-verses, / with parts equal in potency, and with appropriate churned additives:

Bilva, agnimantha, śyonāka, kāśmarya, and pāṭali; / śālaparṇī, pṛśniparṇī, the two bṛhatīs, vardhamānaka;

barley, kulattha, kola fruits, and sthirā: these three [groups] are praised in vāta / when containing the four fats and combined with meat juice.

Nala, vañjula, vānīra, lotuses, śaivala, / mañjiṣṭhā, sārivā, anantā, payasyā, madhuyaṣṭikā,

sandalwood, padmaka, uśīra, tuṅga: these three [groups] of enemas in paittika [disorders] / are beneficial when containing sugar, honey, ghee, and milk.

Arka, and likewise alarka, ekāṣṭhīlā, punarnavā, / turmeric, triphalā, musta, pītadāru, kuṭannaṭa,

pippalī, and citraka: these three [groups] are beneficial in patients with śleṣman / when containing alkali, honey, and cow's urine, and not excessively unctuous.

Madana fruit, jīmūtaka, ikṣvāku, dhāmārgava, vatsaka, / śyāmā, triphalā, sthirā, dantī, and dravantī;

prakīryā, udakīryā, nīlinī, kṣīriṇī, / saptalā, śaṅkhinī, lodhra, and the fruit of kampillaka:

these four [groups], prepared with urine, purify the colon; / (these four formulations are taught both individually and collectively).

Kākolī, kṣīrakākolī, mudgaparṇī, śatāvarī, / vidārī, named madhuyaṣṭī, śṛṅgāṭaka, kaśeruka,

ātmaguptā fruit, māṣa, along with wheat, barley, / and meat of aquatic and marshland animals: these increase semen and muscle tissue.

Jīvantī, agnimantha, flowers of dhātakī, vatsaka, / pragraha, khadira, kuṣṭha, śamī, piṇḍītaka, barley,

priyaṅgu, raktamūlī, taruṇī, svarṇayūthikā, / vaṭa and others, kiṃśuka, and lodhra: these are considered bowel-binding.

In discharge, milk boiled with vṛścīra and punarnavā [is useful], / or with ākhuparṇikā combined with taṇḍulīyaka.

With kālaṅkataka, kāṇḍekṣu, darbha, poṭagala, and sugarcane, / a burning-dispelling [enema] prepared with ghee and milk [is given]; a second one with utpala and others.

With karbudāra, āḍhakī, nīpa, and vidula prepared with milk, / a cold enema with honey and sugar should be administered by the physician.

Similarly in cutting pain [at the anus], an enema [prepared] with the stalks of śrīparṇī and kovidāra / (should be given by good physicians who know the proper procedures).

An enema of śālmali stalks boiled in milk and combined with ghee / is beneficial in tenesmus; likewise with the exudates of the śālmali tree.

With aśvāvarohikā, kākanāsā, and rājakaśeruka / prepared in milk, [enemas] combined with honey, rasāñjana, and ghee are [indicated] in excessive evacuation.

And another one with the four [trees] beginning with nyagrodha by the very same method. / Bṛhatī, kṣīrakākolī, pṛśniparṇī, śatāvarī,

kāśmarya, badarī, dūrvā, and likewise uśīra, and priyaṅgu: / in loss of blood, two enemas boiled in milk, combined with ghee and rasāñjana,

should be administered by the physician, cold, with honey and sugar, / or with milk of cow, sheep, goat, and buffalo combined with jīvanīya [drugs].

An enema of freshly collected blood of rabbit, deer, cock, cat, / buffalo, sheep, or goat, churned, is praised in loss of blood.

With madhūka, madhuka, drākṣā, dūrvā, kāśmarya, and sandalwood, / by that very method an enema should be given with honey and sugar.

Likewise with mañjiṣṭhā, sārivā, anantā, payasyā, and madhuka, / [or] with sugar, sandalwood, drākṣā, honey, dhātrī fruit, and utpala / in raktapitta; but in obstinate urinary disorders, a decoction of somavalka [is used].

In abdominal swellings, diarrhoea, upward movement of vāyu, stiffness, contractures, and the like, / in diseases affecting all limbs or one limb, and in diseases of such kind,

a wise [physician] should give enemas prepared with their respective medicaments, / making distinct formulations according to the procedure stated before.

Here are the verses:

Three triplets for vāta and the others, and another three quartets / for the purification of the colon; aphrodisiacs, and likewise bowel-binding ones;

two each are held to be [indicated] in discharge, in burning, in cutting pain, in tenesmus, / and in excessive evacuation; and likewise three in loss of blood;

two in raktapitta and in urinary disorders: those thirty-seven / enemas, whose medicaments are easily obtained with little trouble, possess the best properties.

Thus ends the tenth chapter, titled “Successful Treatment by Enemas”, in the Siddhisthāna of the treatise composed by Agniveśa, redacted by Caraka, and, being unavailable, completed by Dṛḍhabala.