The Compendium of Caraka 8.12: dvādaśo 'adhyāyaḥ/

Now we shall explain the Successful Treatment by Urethral and Vaginal Enemas.

Thus spoke the venerable Ātreya.

Now indeed, the physician should protect the patient who has been thoroughly purified by emesis and other procedures, / who is weak, emaciated, of low digestive fire, with loosened joints and ligaments,

whose wind, feces, urine, kapha, and pitta have been evacuated, whose viscera are depleted, / whose body is empty, and who cannot tolerate therapeutic interventions,

just like an unhatched egg, or just like a vessel full of oil, / or like a herdsman with a staff [protecting] cows from all transgressions.

In order to kindle the digestive fire, however, the physician, skilled in the regimen, / should manage him first with thin gruel and the like, followed by meat soup in due order.

Then with items that are unctuous, sour, sweet, and pleasing to the heart; then with sour and salty tastes; / then again with sweet and bitter, and then with astringent and pungent tastes.

By the alternating use of tastes that are mutually opposed, / and of unctuous and non-unctuous things, the physician should restore him to his normal constitution.

One capable of enduring everything, unattached, cheerful, with stable sense faculties, / strong, and endowed with mental fortitude, should be known to have returned to his normal constitution.

Not having reached this normal constitution, he should avoid all prohibited things, / but especially these eight which produce great disorders:

speaking loudly, shaking from a carriage, excessive walking and sitting, / meals during indigestion and unwholesome foods, daytime sleep, and sexual intercourse.

Diseases born of them arise, respectively, in the upper body, all parts, lower body, and middle;
and disorders arise from āma, from phlegm, and from depletion.

I shall explain in detail their symptoms and the medicament for each one,
according to rule, as well as proven yāpana enemas.

Among those, from speaking loudly and speaking excessively there may be: burning sensation of the head, piercing pain in the temples and ears, obstruction of hearing, dryness of the mouth, palate, and throat, dimness of vision, thirst, fever, bronchial asthma, lockjaw, stiffness of the nape of the neck, spitting, chest and flank pain, hoarseness of voice, hiccough, dyspnoea, and so forth.

From shaking from a carriage: looseness of joints and knuckles, ache and piercing pain in the jaw, nose, ears, and head, agitation in the belly, rumbling and gurgling in the intestines, distension, obstruction of the heart and senses, pain in the buttocks, flanks, groins, testicles, waist, and back, weakness in the joints, shoulders, and neck, feverish heat in the limbs, swelling, numbness, and tingling in the feet, and so forth.

From excessive walking: pain in the feet, calves, thighs, knees, groins, pelvis, and back, prostration and piercing pain in the lower legs, cramps in the calves, body ache, burning sensation in the shoulders, throbbing of the veins and arteries, dyspnoea, cough, and so forth.

From excessive sitting: those born of shaking from a carriage, [especially] pain in the buttocks, flanks, groins, testicles, waist, back, and so forth.

From indigestion and eating while food is undigested: dryness of the mouth, distension, colic, piercing pain, thirst, prostration of the limbs, vomiting, diarrhoea, fainting, fever, tenesmus, disorders of toxic āma, and so forth.

From irregular and unwholesome eating: aversion to food, debility, discolouration, itching, eczema, exhaustion of the limbs, and disorders of the grahaṇī, haemorrhoids, and so forth born of the aggravation of vāta and other doṣas.

From daytime sleep: anorexia, indigestion, loss of digestive fire, feeling of being covered with a wet cloth, pallor, itching, eczema, burning sensation, vomiting, body ache, tightness in the cardiac region, torpor, drowsiness, excess of sleep, emergence of swellings, debility, red urine and eyes, and coating of the palate.

From sexual intercourse there may be: rapid loss of strength, prostration of the thighs, pain in the head, bladder, rectum, penis, groins, thighs, knees, calves, and feet, palpitations of the heart, ache in the eyes, looseness of the limbs, discharge of blood through the seminal passage, cough, dyspnoea, spitting of blood, loss of voice, weakness in the waist, disorders in a single limb or all limbs, swelling of the scrotum, retention of flatus, feces, and urine, involuntary discharge of semen, stiffness, trembling, deafness, depression, and so forth; the rectum feels as if torn out, the penis as if struck, the mind feels as if sinking, the heart trembles, the joints ache, and darkness seems to be entered.

Thus, from these eight improper conducts, these complications appear.

Their successful treatment [is as follows]:—There, for those born of speaking loudly and speaking excessively, [the remedy is] massage, fomentation, poultice, smoking, errhine, drinking unctuous substances after a meal, meat broth, milk, and so forth—every procedure that pacifies vāta—and silence.

For those born of shaking from a carriage, excessive walking, and excessive sitting: oleation, fomentation, and every other procedure that pacifies vāta, and avoidance of the causative factors.

For those born of indigestion and eating while food is undigested: vomiting completely without remnant, dry fomentation, and administration of medicines that lighten, digest, and stimulate the digestive fire.

For those born of irregular and unwholesome eating: treatments that pacify the respective doṣas.

For those born of daytime sleep: smoking, lightening therapy, emesis, errhines, exercise, dry diet, fermented liquors, use of medicines that stimulate the digestive fire, friction-rubbing, unction-massage, sprinkling, and every procedure that pacifies phlegm.

For those born of sexual intercourse: the use of milk and clarified butter prepared with vitalising herbs, likewise fomentation, massage, and poultices that pacify vāta, aphrodisiac food and unctuous substances, methods of oleation, yāpana enemas, and unctuous enemas; and in urinary disorders and bladder pain, an uttarabasti should be [administered with] oil prepared with the vidārīgandhādi group, the vitalising herbs, and milk.

And yāpana enemas may be given at all seasons; we shall explain them:—Mustā, uśīra, balā, āragvadha, rāsnā, mañjiṣṭhā, kaṭurohiṇī, trāyamāṇā, punarnavā, bibhītaka, guḍūcī, and the sthirādi pañcamūla, one pala each, cut into pieces, and eight madanaphala fruits washed and boiled in an āḍhaka of water down to one quarter remaining; this decoction, combined with two prasthas of milk, boiled again down to the milk remaining, with one quarter part of wild animal meat broth, equal amounts of honey and clarified butter, made into a paste with śatakusumā, madhuka, kuṭaja seeds, rasāñjana, and priyaṅgu, with saindhava salt, [administered] comfortably warm as an enema, produces semen, flesh, and strength, and cures chest wounds, wasting, cough, abdominal lump, colic, irregular fever, inguinal hernia, rectal prolapse, upward movement of wind, belly ache, dysuria, menorrhagia, erysipelas, dysentery, headache, stiffness of knees, thighs, calves, and bladder, urinary calculi, insanity, haemorrhoids, urinary disorders, flatulence, vātarakta, and diseases of pitta and phlegm; it immediately produces strength and is a rasāyana.

Six palas of castor root and palāśa, [along with] śāliparṇī, pṛśniparṇī, bṛhatī, kaṇṭakārikā, gokṣura, rāsnā, aśvagandhā, guḍūcī, varṣābhū, āragvadha, and devadāru, one pala each, cut into pieces, and eight fruits [of madanaphala], washed, should be boiled in an āḍhaka of water and a quarter-part of milk.

The decoction reduced to a quarter, strained, pasted with the additives śatakusumā, kuṣṭha, mustā, pippalī, hapuṣā, bilva, vacā, vatsakaphala, rasāñjana, priyaṅgu, and yavānī, combined with honey, clarified butter, oil, and rock salt, comfortably warm, should be given as a non-unctuous enema, once, twice, or thrice.

It is praised for all, especially for the delicate, tender, those exhausted by sexual indulgence, the injured, the aged, those with chronic haemorrhoids, and those desiring offspring.

Likewise, [an enema prepared] with milk boiled with sahacara, balā, darbha root, and sārivā [is administered].

Likewise, an enema [is given] as before with milk boiled with bṛhatī, kaṇṭakārī, śatāvarī, and guḍūcī, pasted with madhuka, madana, and pippalī.

Likewise, [an enema prepared] with milk boiled with balā, atibalā, vidārī, śāliparṇī, pṛśniparṇī, bṛhatī, kaṇṭakārikā, darbha root, parūṣaka, kāśmarya, bilva fruit, and barley, pasted with madhuka and madana, combined with honey, clarified butter, and sauvarcala salt, immediately produces strength and is a rasāyana for those afflicted by cough, fever, abdominal lump, spleen disease, facial paralysis, women, and wine.

Balā, atibalā, rāsnā, āragvadha, madana, bilva, guḍūcī, punarnavā, eraṇḍa, aśvagandhā, sahacara, palāśa, devadāru, and the two pañcamūlas, one pala each, two prasṛtas of barley, kola, horse gram, and dried radishes, boiled in a droṇa of water down to the amount suitable for a non-unctuous enema; the decoction, strained, pasted with madhuka, madana, śatapuṣpā, kuṣṭha, pippalī, vacā, vatsakaphala, rasāñjana, priyaṅgu, and yavānī, combined with jaggery, clarified butter, oil, honey, milk, meat broth, sour fermented gruel, and rock salt, comfortably warm, should be administered as an enema in retention of semen, urine, and feces, and in vāta-born abdominal lump, heart disease, flatulence, inguinal hernia, stiffness of the flanks, back, and waist, loss of consciousness, and depletion of strength.

Half a kuḍava of hapuṣā and twice as much crushed barley, boiled with milk and water down to the milk, combined with honey, clarified butter, oil, and salt, is beneficial for vātarakta spreading through all the limbs, retained stool and urine, and fatigue from women; it relieves vāta and produces intellect, retention, digestive power, and strength.

A decoction of the minor pañcamūla boiled with milk and water, pasted with pippalī, madhuka, and madana, together with jaggery, clarified butter, oil, and salt, is an enema for one emaciated by irregular fever.

A decoction of balā, atibalā, apāmārga, and ātmaguptā—eight palas in all—with an añjali of crushed barley, combined with jaggery, clarified butter, oil, and salt, [administered] as an enema like the previous one, is most wholesome for the aged, the weak, and those with depleted semen and blood.

Having cooked a decoction with balā, madhuka, vidārī, darbha root, mṛdvīkā, and barley, along with goat's milk, pasted with madhuka and madana, with honey, clarified butter, and rock salt, one should give an enema to those suffering from fever.

A decoction prepared from śāliparṇī, pṛśniparṇī, gokṣuraka root, kāśmarya, parūṣaka, date fruit, and madhūka flowers, with a prastha each of goat's milk and water, pasted with pippalī, madhuka, and utpala, with clarified butter and rock salt, is commended as an enema for one with weakened senses and emaciated by irregular fever.

Goat's milk boiled with five palas of the sthirādi pañcamūla and five prasṛtas of śāli, ṣaṣṭika, barley, wheat, and māṣa, reduced to one-fourth, combined with rooster-egg fluid, equal parts of honey and clarified butter, sugar, rock salt, and sauvarcala, is an enema that is extremely aphrodisiac and produces strength and complexion.

Thus ends [the group of] twelve yāpana enemas.

This procedure may also apply with the egg fluid of peahens, gonardas, geese, and sārasa cranes.

With partridge, with peacock, and with royal goose, prepared with pañcamūla and milk, pasted with śatapuṣpā, madhuka, rāsnā, kuṭaja, madana fruit, and pippalī, combined with clarified butter, oil, jaggery, and rock salt, this enema produces strength, complexion, and semen, and is a rasāyana.

Milk prepared with the two pañcamūlas and rooster meat-juice, reduced to one-fourth, pasted with pippalī, madhuka, rāsnā, and madana, combined with sugar, honey, and clarified butter, is an enema that produces strength for those overly desirous of women.

Having cooked a peacock devoid of bile, feathers, feet, mouth, and entrails, with one pala each of sthirā and the rest, in milk together with water down to the milk, pasted with madana, pippalī, vidārī, śatakusumā, and madhuka, combined with honey, clarified butter, and rock salt, one should give an enema; it produces strength and complexion for those excessively attached to women and with depleted faculties.

And this procedure may apply to scratching birds, pecking birds, raptors, and aquatic animals; and without milk, to fish such as the rohita.

Ten-pala portions of the meat of monitor lizards, mongooses, cats, mice, and porcupines, cooked with pañcamūla in milk; that milk, combined with a paste of pippalī and madana fruit, rock salt, sauvarcala, sugar, honey, clarified butter, and oil, is a strengthening enema and a rasāyana, produces union in the emaciated and wounded, and is most beneficial for those crushed in the chest, injured by chariots, elephants, or horses, with vātābhyāsaka and the like, upward movement of vāyu, and retention of urine, feces, and semen.

Milk prepared with the meat of any one among turtles and the like, mixed with the fluid of eggs of bulls, elephants, horses, crocodiles, geese, and roosters, honey, clarified butter, sugar, rock salt, and a paste of ikṣuraka and ātmaguptā fruit, is an enema that produces strength even in the aged.

Crab soup combined with sparrow-egg fluid, with honey, clarified butter, and sugar, is an enema; these enemas are supremely aphrodisiac: when accompanied by food and drinks boiled with uccaṭā, ikṣuraka, and ātmaguptā, they make a man capable of approaching a hundred women.

Milk prepared with the testicles of bulls, he-goats, boars, crabs, and sparrows, combined with uccaṭā, ikṣuraka, ātmaguptā, honey, clarified butter, and rock salt, lightly salted, is an enema.

Five prasṛtas from a decoction of daśamūla, peacock, goose, and rooster, combined with four prasṛtas of oil, clarified butter, muscle fat, and marrow, pasted with śatapuṣpā, musta, and hapuṣā, with salt, is an enema that removes vāta disorders of the feet, ankles, thighs, knees, calves, sacrum, groins, bladder, and testicles.

Enemas using game animals, scratching birds, marsh animals, and burrow-dwelling animals should be given by this very same method.

An enema of two prasṛtas of honey and clarified butter, with an equal amount of warm water, half a pala of śatapuṣpā, and half an akṣa of rock salt, is extremely aphrodisiac and removes dysuria, pitta, and vāta.

Four prasthas of fresh clarified butter, oil, muscle fat, and marrow, half a pala of hapuṣā, and half an akṣa of rock salt, is an enema that is extremely aphrodisiac, removes dysuria and pitta diseases, and is a rasāyana.

Four prasṛtas of honey and oil, half a pala of śatapuṣpā, and half an akṣa of rock salt, is an enema that stimulates digestion, nourishes, produces strength and complexion, is free of complications, is extremely aphrodisiac, is a rasāyana, and removes worms, skin disease, upward movement of vāyu, abdominal lump, hemorrhoids, inguinal swelling, splenic disorder, and urinary disease.

Likewise, an enema equal in milk to honey and clarified butter, with the previous paste, produces strength and complexion, is extremely aphrodisiac, free of complications, removes inflammation of the bladder and penis, cutting pain, dysuria, and pitta diseases, and is a rasāyana.

Likewise, with honey and clarified butter equal to meat broth, with an akṣa of musta, an enema like the previous one removes disorders of vāta and kapha, tingling of the feet, abdominal lump, and pain in the sacrum, thighs, knees, contracture of the thighs, bladder, testicles, penis, sacrum, and back.

Seven prasṛtas of surā liquor, sauvīraka vinegar, horse gram, meat broth, honey, clarified butter, and oil, pasted with musta and śatāhvā, with salt, is an enema that removes all vāta diseases.

A decoction of the two pañcamūlas, triphalā, bilva, and madana fruit, prepared with cow's urine, pasted with kuṭaja, madana fruit, musta, and pāṭhā, combined with rock salt, barley ash, honey, and oil, is an enema to be given in kapha diseases, distension of the bladder, obstruction of vāta and semen, anemia, indigestion, visūcikā, and alasaka.

Hereafter we shall explain the supreme aphrodisiac unctuous substances: / One should take one prastha each of the press-extracted juices of śatāvarī, guḍūcī, sugarcane, vidārī, āmalaka, drākṣā, and dates; likewise two [prasthas] each of clarified butter, oil, cow's milk, buffalo's milk, and goat's milk; and having added a paste of jīvaka, ṛṣabhaka, medā, mahāmedā, tvakkṣīrī, śṛṅgāṭaka, madhūlikā, madhuka, uccaṭā, pippalī, lotus seeds, blue water-lily, kadamba flowers, and lotus filaments, and a prastha each of the meat broth, muscle fat, and marrow of spotted deer, hyena, rooster, sparrow, cakora, mattākṣa, peacock, jīvañjīva, kuliṅga, and goose eggs, one should cook it.

When it is accomplished, amidst the sounds of Vedic chants, conches, paṭahas, and kettledrums, shaded by a white umbrella, having worshipped Lord Śiva, one should mount it upon the shoulders of an elephant; then, with one-third honey added to that unctuous substance, accompanied by auspicious blessings, hymns, and worship of deities, one should administer the enema.

One should know this as the most wholesome, supreme rasāyana, destroyer of wrinkles and graying hair, for men who indulge in women, whose semen is lost, who suffer from consumption due to chest wounds, emaciation, and irregular fevers; and for women whose reproductive organs are disordered, who are barren, who have blood gulma, whose children have died, who lack menstruation, and whose muscle tissue and blood are depleted.

Having crushed one hundred [palas] each of balā, gokṣura, rāsnā, aśvagandhā, śatāvarī, and sahacara, they should be boiled in one hundred droṇas of water. When one droṇa of water remains in that decoction, strained through a cloth, one should add one prastha each of the fresh juice of vidārī and āmalaka, meat broth and fat of goat, buffalo, boar, bull, rooster, peacock, swan, kāraṇḍava, and sarus crane, and ghee and oil, and eight prasthas of milk; and adding a paste of candana, madhuka, madhūlikā, tvakkṣīrī, lotus stalks, lotus filaments, blue water-lily, paṭola, ātmaguptā, cooked rice, palm heart, dates, mṛdvīkā, tāmalakī, kaṇṭakārī, jīvaka, ṛṣabhaka, kṣudrasahā, mahāsahā, śatāvarī, medā, pippalī, hrībera, and cinnamon, one should prepare it.

When it is accomplished according to the rite with Vedic chants and so forth, one should administer the enema.

By means of this, [a man] can approach a hundred women; nor is there any restriction here regarding regimen and diet.

This is aphrodisiac, strength-giving, nourishing, life-prolonging, dispelling wrinkles and graying hair, and most wholesome for those afflicted with consumption due to chest wounds, emaciation, loss of semen, and irregular fevers, as well as for disordered reproductive organs.

Having boiled one hundred palas of sahacara in four droṇas of water, when one droṇa remains in the well-strained decoction, one should prepare it with one prastha each of the juice of vidārī and sugarcane, eight times that amount of milk, one prastha of ghee and oil, and pastes measuring one akṣa each, along with double the amount of sugar, of balā, madhuka, madhūka, candana, madhūlikā, sārivā, medā, mahāmedā, kākolī, kṣīrakākolī, payasyā, aguru, mañjiṣṭhā, vyāghranakha, śaṭī, sahacara, sahasravīryā, varāṅga, and lodhra.

When it is accomplished according to the rite with Vedic chants and so forth, one should administer the enema.

This cures all diseases, is a rasāyana, best for refined individuals and women of the harem, cures chest wounds, consumption, vāta and pitta pain, dyspnea, and cough; mixed with one-third honey, it removes wrinkles and graying hair and increases complexion, beauty, strength, muscle tissue, and semen.

Thus, these rasāyana unctuous enemas, if resources permit, should be processed a hundred times or a thousand times to instill potency and strength.

And here are [verses] —

Thus these enemas and unctuous substances called yāpana have been spoken of; / they are non-contradictory for the healthy, the sick, and the aged;

giving semen, muscle tissue, and strength to those habituated to excessive sexual intercourse, / pacifying all diseases, and suitable in all seasons.

They grant offspring to childless women and also to men; / they are seen to fulfill both purposes of an unctuous enema and a non-unctuous enema.

Exercise, sexual intercourse, alcohol, types of honey, cold water, / heavy meals, and the shaking of a carriage are censured during these enemas.

There [are the summary] verses —

Three enemas [are made] like the rooster enema with eggs of peacock, gonarda, and swan; / twenty with gallinaceous birds, thirty with peckers, nine with raptors,

and twenty, as well as twenty-seven with aquatic birds; / and nine with fish and the like, enemas following the rooster procedure;

ten enemas with crab and the like, along with a paste of tortoise; / seventeen with forest animals, nineteen with gallinaceous birds, ten

with marsh animals, like the rooster and peacock, and fourteen with burrowing animals; / thus twenty-nine, together with the unctuous substances, in brief,

have been spoken; divided in detail, they are two hundred and sixteen. / Combined with honey, they make a man exceedingly virile.

They do not cause excess action nor deficient action, and they retain [the urges]. / But if, due to their mildness, they do not return in someone to whom they have been administered,

he should quickly be given a non-unctuous enema with sharp enemas containing urine. / Swelling, loss of digestive fire, anemia, colic, hemorrhoids, cutting pain [at the anus],

fever, and diarrhea may arise from excessive use of yāpanas. / There, digestive-fire-stimulating treatment beginning with ariṣṭas, milk, and sīdhu is desired.

Therefore, one should consume yāpanas judiciously, not out of addiction. / Thus, the complications [beginning with the pipe] preceded by loud speaking, together with their treatments,

have been explained separately in detail; one should always protect a man from them. / The section wherein the means of rectifying complications resulting from the improper performance

of procedures beginning with emesis is stated, that is called the Siddhisthāna. / Thus this hundred and twentieth chapter, words of the sage Ātreya,

was spoken for the benefit of living beings by the wise Agniveśa. / Long life, fame, health, and abundant trivarga,

and unequalled success in the world does one obtain who recites it according to rule. / He expands what is stated concisely, and condenses what is excessively detailed;

a redactor makes an ancient tantra new again. / Therefore this best of tantras, redacted by Caraka of supreme intellect,

complete in truth, is seen to lack one-third. / Having propitiated Śaṅkara, the lord of beings, Dṛḍhabala,

born in the city of Pañcanada, to make the meaning complete, / having gathered the gleanings and fallen ears of corn from many tantras,

completed it with seventeen chapters on treatment, along with the Kalpa[sthāna] and Siddhi[sthāna]. / This [work] of undeficient words and meaning, devoid of faults of a tantra,

is adorned with thirty-six diverse tantrayuktis. / Among them: topic, application, reason, meaning of a word,

partial statement, brief statement, detailed statement, ellipsis, purpose, / precept, cause, extension, presumption, conclusion,

context, certainty, uncertainty, exception, reverse, / objection, rule, assent, explanation, doubt,

reference to the past, reference to the future, technical term, deduction, conjunction, / illustration, derivation, injunction, option,

rebuttal, summarising, and possibility are the tantrayuktis. / Indeed, these occur entirely in a tantra stated both concisely and in detail;

they are seen in part where stated concisely. / Just as the sun is to a lotus bed, just as a lamp is to a house,

for awakening and illumination, so are the yuktis to a tantra. / He whose intellect has gained a foothold even in a single treatise here

understands another treatise also quickly because he knows the yuktis. / Even though studying treatises, a physician without the tantrayuktis / does not grasp the meanings of the treatises, just as [one fails to grasp] riches when good fortune wanes.

A treatise badly grasped ruins the ignorant man just like a weapon; / that very treatise and weapon, properly grasped, protects the wise one.

(Therefore, these will be explained again in detail in the Uttaratantra, / for the sake of true knowledge of this very tantra, according to its merits and demerits.)

Having studied this entirely, he who reflects well upon the meanings, unswerving in mind and constant in practice, / becomes a giver of happiness and life to men, enriched with fortitude, memory, intellect, and virtue.

In whose heart stays this compendium of twelve thousand [verses], / he knows the meanings, he knows the deliberations, and he is skilled in therapy.

Why would he not understand the diseases and their treatments, / [he who knows] the therapy of Vahniveśa regarding the welfare of the healthy and the sick?

Whatever is here is elsewhere; what is not here is nowhere else. / In the treatise composed by Agniveśa and redacted by Caraka,

when that eighth Siddhisthāna was unavailable, by Dṛḍhabala, however, / the Siddhisthāna was completed in brief for its own realization.)

Thus, in the treatise composed by Agniveśa, redacted by Caraka, and completed by Dṛḍhabala where unavailable, in the Siddhisthāna, the twelfth chapter named "Successful Treatment by Urethral and Vaginal Enemas" [is concluded]. // 12

Concluded is this treatise of Caraka.