The Compendium of Caraka 8

English (machine translation) 8

Language: English

8.1 — 64 parts
8.2 — 31 parts
8.3 — 72 parts
8.4 — 58 parts
8.5 — 21 parts
8.6 — 97 parts
8.7 — 68 parts
8.8 — 49 parts
8.9 — 125 parts
8.10 — 50 parts
8.11 — 39 parts
8.12 — 112 parts

8.1.1

Now we shall explain the chapter on Successful Formulation.

What formulation is stated for the five procedures, what is the order, and what are the signs / in proper, deficient, and excessive performance; what is the count, what are the properties, and which enema in which [conditions]?

8.1.4

What is to be avoided during each procedure, or how long is the period of avoidance when completed? / And administered, why does an enema not go in, why does it return quickly, or why after a long time?

8.1.5

And why do some curable diseases not subside when their pacifying remedies are applied? / Thus properly questioned by the foremost disciple Agniveśa, the best of physicians,

8.1.6

Punarvasu, the knower of the treatise, spoke to him this, out of a desire for the welfare of all living beings: / A man, unctuated, should be fomented for three days at minimum and seven days at maximum; this is stated.

8.1.7

They do not prescribe unction beyond this, for beyond seven days it becomes habitual. / Unction destroys vāta, softens the body, and breaks up the adherence of wastes.

8.1.8

Fomentation brings the doṣa, hidden in the subtle channels of an unctuated [patient], to liquidity. / One who is to vomit should be excited [in kapha] with meat broths of domestic, aquatic, and marshland animals and with milk.

8.1.9

Likewise, one who is to be purged [should be prepared] with broths of arid animals, with pulse soups, unctuous and not increasing kapha; / for one with prominent kapha vomits without distress, and one with diminished kapha purges properly.

8.1.10

When kapha is deficient below, an emetic causes purgation; when kapha is increased, a purgative likewise causes vomiting above. / An emetic should be given as described to one who is unctuated, and after vomiting, the sequential regimen of gruel and so forth [is applied].

8.1.11

To one who is unctuated and properly fomented in body, the most suitable purgative should be administered as prescribed. / Then, three times, twice, or once, [he should consume] thin gruel, thick gruel, unseasoned and seasoned soup, and meat broth,

8.1.12

in order, a person whose body has been purified, purified by superior, middling, or inferior evacuation. / Just as a tiny fire, being rekindled gradually with grass, cow-dung, and the like,

8.1.13

becomes great, stable, and digestive of all things, just so does the internal fire of a cleansed [patient] by means of gruel and so forth. / In inferior, middling, and superior [evacuation], four, six, and eight bouts are desired in emesis;

8.1.14

in purgation, they are ten, two times [ten], and three times [ten], and the prastha [measure] is likewise twofold, threefold, and fourfold. / Emesis is desired to end in pitta; purgation is said to be half that of emesis [in output of unevacuated drug] and to end in kapha.

8.1.15

In purgation, the measure is taken after setting aside two or three bouts containing stool; but in emesis, [it is measured after setting aside] what was drunk. / One from whom kapha, then pitta, and then vāta come out sequentially is considered properly vomited.

8.1.16

When purity of the heart, flanks, head, and sensory pathways and also lightness are perceived, [emesis is proper]. / In deficient vomiting, there are eruptions, urticaria, itching, lack of purity in the heart and body-cavities, and heaviness of the limbs;

8.1.17

and in excessive emesis there would be thirst, confusion, fainting, aggravation of vāta, loss of sleep, strength, and so forth. / Purity of channels, clarity of the sense organs, lightness, energy, digestive fire, freedom from disease,

8.1.18

and the sequential passing of stool, pitta, kapha, and vāta occur in one who has purged properly. / There would be aggravation of kapha, pitta, and vāta, weakness of the digestive fire, heaviness, catarrh,

8.1.19

drowsiness, vomiting, lack of appetite, and absence of the downward movement of vāta in one who has purged deficiently. / Arising from vāta caused by depletion of kapha, blood, and pitta, there are numbness, body aches, exhaustion, trembling, and the like,

8.1.20

loss of sleep and strength, entry into darkness, delirium, and hiccough in one who has purged excessively. / To one who has returned to normal diet, on the ninth day, he should give ghee to drink or administer an oily enema.

8.1.21

Then, to one whose body is anointed with oil and who is not overly hungry, he should give an un-oily enema after three days. / When it has returned, he should be fed with broth of arid animals, or suitably, having examined the strength of the doṣas.

8.1.22

Then, having rested, a man who is fit for an oily enema and not overly fed should be given an oily enema. / In cold weather and in spring, he should be given an oily enema by day; in autumn, summer, and the arrival of rainclouds, at night,

8.1.23

guarding against those very faults that were proclaimed earlier for the drinking of unctuous substances. / And when the oily enema has returned, food should be given during the day to one who has fasted overnight.

8.1.24

And food [is given] in the evening; after that, on the second day, on the third day, or on the fifth day he should receive an oily enema; / or every three days or on the fifth day he should administer an oily enema after an un-oily enema.

8.1.25

One or three in a disorder born of kapha, five or seven in one consisting of pitta, / or nine or eleven in vāta: a skilled [physician] should administer odd numbers of enemas.

8.1.26

A man who has been purged must avoid the administration of an un-oily enema for seven days; / and one cleansed by an un-oily enema [must avoid] purgation, for that would dilate his emptied body.

8.1.27

Enema maintains youth, brings happiness, longevity, strength, digestive fire, intellect, voice, and complexion; / it achieves all purposes for the child, the aged, and the youth, is free from danger, and removes all diseases.

8.1.28

Drawing forth stool, kapha, pitta, vāta, and urine, bringing firmness, bestowing semen and strength, / driving out the accumulation of doṣas situated everywhere, an un-oily enema pacifies all disorders.

8.1.29

In a body whose passages have been cleansed by an un-oily enema, it causes unction and bestows complexion and strength. / There is no substance superior to the administration of oil, especially for one afflicted with vāta.

8.1.30

Destroying the dryness of vāta by its unctuousness, lightness by its heaviness, and coldness by its heat, / oil quickly bestows clarity of mind, virility, strength, complexion, and nourishment of the digestive fire.

8.1.31

For just as a tree watered at the root becomes green-leaved, possessing the finest tender sprouts, / and in time grows large, bearing flowers and fruit, so a man becomes through an oily enema.

8.1.32

Those who are stiff, those who are contracted, those who are lame, those who are crippled and broken, / and those in whose limbs vāta roams: for them enema is especially praised.

8.1.33

In flatulence, hard-knotted stool, colic, and aversion to food, / and in diseases of such kind that occur in the abdomen, an enema is desired.

8.1.34

And women afflicted by disturbances caused by vāta who do not conceive when united with men, / and men whose faculties are wasted and who are emaciated: for them enema is praised above all.

8.1.35

They declare cold [enemas] for those overcome by heat, and comfortably warm [enemas] for those overcome by cold. / Enemas formulated with drugs antagonistic to those [causes] should be applied everywhere according to distribution.

8.1.36

A physician should not administer nourishing enemas in diseases requiring evacuation, / in skin diseases, obstinate urinary diseases, and so forth, in obese men, and in those who require evacuation.

8.1.37

He should not administer evacuating [enemas] to the depleted and injured, nor to the consumptive, nor to the exceedingly weak, / nor to the swooning, nor to those who have been evacuated, and those whose life is bound to the doṣas.

8.1.38

Diseases situated in the limbs, situated in the gut, and arising in the vital points, above, in all bodily parts and limbs: / whatever there are, there is indeed no other cause superior to vāta for their origin.

8.1.39

Because it causes the dispersal and accumulation of the receptacles of wastes such as stool, urine, and pitta, / there is no medicine whatsoever other than enema for the pacification of it when excessively aggravated.

8.1.40

Therefore, they call enema half of all treatment, while some say it is the whole of treatment.
Having reached the umbilical region, hips, flanks, and belly, churning up the accumulation of stool and doṣas,

8.1.41

and unctuating the body, that which emerges properly and with ease along with feces and doṣas is an enema.
The elimination of stool, urine, and flatus; increase of appetite and digestive fire; lightness of the viscera;

8.1.42

pacification of disease, restoration to one's natural state, and strength: that would be the sign of a properly administered non-unctuous enema.
There would be pain in the head, heart, rectum, bladder, and penis, swelling, catarrh, griping,

8.1.43

nausea, obstruction of flatus and urine, and dyspnea when it is not properly administered as a non-unctuous enema.
Whatever the sign of one excessively purged may be, precisely that belongs to one excessively treated with a non-unctuous enema.

8.1.44

The unctuous substance returning unhindered along with feces; clarity of blood and the other [tissues], intellect, and senses;
continuance of sleep, lightness, strength, and urges properly discharged: these would occur when one is well treated with an unctuous enema.

8.1.45

Pain in the lower body, abdomen, arms, back, and flanks; rough and coarse limbs;
and retention of feces, urine, and flatus: these occur in one improperly treated with an unctuous enema.

8.1.46

Nausea, bewilderment, fatigue, exhaustion, fainting, and cutting pain occur in one excessively treated with an unctuous enema.
The man in whom the unctuous substance is retained for three yāmas would have a cleansed body.

8.1.47

When it comes out quickly, another unctuous substance must be administered, for it does not unctuate if it does not stay.
Thirty enemas are considered a karmabasti, half of that a kālabasti, and half of that a yogabasti.

8.1.48

Together with unctuous enemas, non-unctuous enemas are indeed twelve: first one unctuous enema, and five at the end;
in kālabasti there are three at the end and likewise one at the beginning, and there should be six unctuous enemas interposed with non-unctuous enemas.

8.1.49

In yogabasti only three non-unctuous enemas are to be given, and five unctuous enemas, at the end, beginning, and middle.
They declare three or five, or four, or six unctuous enemas for [conditions of] vāta and the others.

8.1.50

Having administered unctuous substances, the physician should soon prescribe non-unctuous enemas for clearing the channels.
Then, for one whose body has been cleansed, successively having unctuated and palm-fomented the head,

8.1.51

he should purge [it] three times, twice, or once, observing the threefold strength of the wastes.
Lightness of chest and head, clarity of the senses, and purity of the channels occur in one who is cleansed;

8.1.52

stickiness of the throat, heaviness of the head, and spitting occur in one who is deficiently purged;
pain and pricking in the head, eyes, temples, and ears, and seeing darkness occur when one is excessively cleansed.

8.1.53

In that case, the restorative measure should be mild and liquid, but for one who has been unctuated, sharp [cleansing] should not be used again in application.
Such an application gives comfort to the sick and healthy, produces an increase of strength and lifespan, and destroys disease.

8.1.54

The period of avoidance should be twice as long as the time that elapsed during enema and the other [treatments].
Excessive sitting, standing, talking, riding, sleeping by day, sex, suppression of urges,

8.1.55

cold regimens, sun, grief, and anger one should avoid, as well as untimely and unwholesome eating.
When the pipe is blocked or inserted irregularly, or the passage is obstructed by hemorrhoids, kapha, or stool,

8.1.56

an enema does not pass in nor does it come out easily, if it is enveloped by doṣas, small in quantity, or of low potency;
when an urge for stool, flatus, or urine has arrived, when vāta is exceedingly aggravated, or when the rectum is weak,

8.1.57

and when it is exceedingly hot or sharp, or in a soft bowel, the enema comes out immediately after being administered.
Vāta obstructed by fat and kapha causes colic, numbness of the limbs, and swelling;

8.1.58

an unwise physician who applies an unctuous substance to him merely increases those disorders.
Likewise, other diseases whose pathways are blocked by one another when unconsidered,

8.1.59

and corrupted by other dhātus, do not subside with their own medicines.
And every procedure for the pacification of disease that is deficient, excessive, or performed at an inappropriate time,

8.1.60

and through improper management, would not bring that disorder to pacification even if wholesome [measures] are applied.

8.1.60_1

Here is a verse:

8.1.60_2

These twelve questions concerning the five procedures in this 'Successful Formulation',

8.1.61

for the welfare of living beings, the venerable and foremost of ṛṣis, the son of Atri, properly explained with profound meaning.

8.1.61_1

Thus ends the first chapter, named 'Successful Formulation', in the Siddhisthāna of the compendium composed by Agniveśa, redacted by Caraka, and, where unavailable, restored by Dṛḍhabala.

8.2.1

Now we shall expound the chapter on success in the five procedures.

8.2.2

Thus spoke the venerable Ātreya.

8.2.3

To whom and for what reason one should not administer the five procedures, O Agniveśa, / and to whom one should administer them—all that will be explained in full.

8.2.4

Fierce, reckless, timid, ungrateful, agitated, / a hater of the virtuous, kings, and physicians, hated by them, afflicted with grief,

8.2.5

unpredictable, wishing to die, destitute of resources, / hostile, pretending to know medicine, lacking faith, overly suspicious,

8.2.6

and disobedient to physicians: these should not be treated by a knowledgeable physician; / treating these, a physician would incur many faults.

8.2.7

Men other than these should be treated with all procedures. / Having classified their condition, what is to be avoided and what is to be done will be stated.

8.2.8

To begin with, those not to be vomited are: the injured and depleted, the exceedingly obese, the exceedingly emaciated, children, the elderly, the weak, the fatigued, the thirsty, the hungry, those overcome by heavy labor, travel, fasting, sexual intercourse, study, exercise, and constant anxiety, the emaciated, the pregnant, the delicate, those with constricted bowels, those difficult to vomit, those suffering from upward bleeding, continuous vomiting, upward vāta, those who have received an asthāpana enema or an anuvāsana enema, and those afflicted with heart disease, udāvarta, suppression of urine, spleen disease, abdominal swellings, enlargement of the abdomen, prostate enlargement, impairment of voice, timira, and aching in the head, temples, ears, and eyes.

8.2.9

Therein, in the injured, excessive flow of blood would occur due to further wounding; in the depleted, exceedingly obese, emaciated, children, elderly, and weak, obstruction of vital breath [would occur] due to inability to endure the strength of medicine; likewise in the fatigued, thirsty, and hungry; in those worn out by constant heavy labor, travel, fasting, sexual intercourse, study, exercise, and anxiety, there would be danger of vāta, bleeding, laceration, or wound due to dryness; in the pregnant woman, serious disease would be incurred due to affliction of the fetus or premature abortion; in the delicate, excessive discharge of blood upwards or downwards [would occur] due to traction on the heart; in those with constricted bowels and those difficult to vomit, the stirred-up doṣas, due to excessive straining, produce internal erysipelas, stiffness, stupor, distraction, or death in the internal viscera; in one suffering from upward bleeding, [vomiting] would destroy the vital breath by thrusting upward the udāna [vāta] and cause excessive flow of blood; likewise in one vomiting incessantly; in those with upward vāta and those who have received an asthāpana enema or an anuvāsana enema, excessive upward movement of vāta [would occur]; in one suffering from heart disease, obstruction of the heart; in one with udāvarta, a more terrible udāvarta would occur that kills more swiftly; in those afflicted with suppression of urine and the like, appearance of sharper pain; in those afflicted with timira, extreme increase of timira; in those suffering from headache and the like, extreme increase of pain; therefore these are not to be vomited.

8.2.9_1

However, even among all these, [emesis] is not forbidden in cases caused by poisoning, artificial poison, unwholesome diet, or indigestion of food and āma, because of their more rapid action.

8.2.10

The rest, however, are to be vomited; especially those suffering from catarrh, kuṣṭha, acute fever, rājayakṣma, cough, dyspnea, obstruction of the throat, goitre, elephantiasis, meha, sluggish digestive fire, unwholesome and undigested food, visūcikā, alasaka, ingestion of poison and artificial poison, bites, arrow wounds with poisoned tips, downward bleeding, excessive salivation, hemorrhoids, nausea, anorexia, indigestion, apacī, epilepsy, insanity, diarrhea, swelling, pāṇḍuroga, stomatitis, vitiated breast milk, and the like; especially the diseases of śleṣman, and those stated in the Chapter on Major Diseases; for among these, emesis has been declared foremost, just as, when a field's embankment is breached, there is no withering of rice and the destruction of defects.

8.2.11

Those not to be purged, however, are: the prosperous, those with an injured rectum, those with an open sphincter, those suffering from downward bleeding, those weakened by fasting, those with weak faculties, those with poor digestive fire, those who have received a nirūha enema, those occupied with passion and the like, those suffering from indigestion, those with acute fever, those with alcoholism, those with distended abdomen, those afflicted with foreign bodies, those traumatized, the exceedingly unctuous, the dry, those of cruel bowels, and those beginning with the injured up to the pregnant woman.

8.2.12

Therein, in the prosperous, the fault mentioned for the delicate would occur; in one with an injured rectum, it would produce pain causing obstruction of vital breath in the injured rectum; it would kill one with an open sphincter by excessive discharge; likewise one suffering from downward bleeding; those weakened by fasting, with weak faculties, poor digestive fire, and those who have received a nirūha enema could not endure the force of medicine; in one whose mind is agitated with passion and the like, it does not act, or, acting with difficulty, it would produce the faults of insufficient evacuation; in one with indigestion, disorder of āma would occur; in one with acute fever, it would not expel the unripened doṣas and would only aggravate vāta; in one with alcoholism, vāyu would cause obstruction of vital breath in the body depleted by alcohol; in one who is distended or becoming distended, vāyu accumulated in the bowel, spreading, would suddenly produce severe flatulence or death; in those afflicted with foreign bodies and traumatized, vāyu lodging in the wound would destroy life; in the exceedingly unctuous, there would be fear of excessive evacuation; in the dry, vāyu would produce stiffness of the limbs; in one of cruel bowels, the doṣas stirred up by purgation would kill the vital breath after producing cardiac pain, cutting pain in the joints, abdominal distension, body ache, vomiting, fainting, and exhaustion; in those beginning with the injured up to the pregnant woman, the faults mentioned for vomiting would occur; therefore these are not to be purged.

8.2.13

The rest, however, are to be purged; especially those suffering from kuṣṭha, fever, meha, upward bleeding, fistula-in-ano, abdominal disease, hemorrhoids, inguinal hernia, enlargement of the spleen, gulma, tumors, goitre, glandular enlargement, visūcikā, alasaka, suppression of urine, intestinal worms, erysipelas, pāṇḍuroga, headache, pain in the flanks, udāvarta, burning of the eyes and mouth, heart disease, melasma, nīlikā, discharge from the eyes, nose, and mouth, halīmaka, dyspnea, cough, jaundice, apacī, epilepsy, insanity, vātarakta, disorders of the female and male reproductive elements, cataract, anorexia, indigestion, vomiting, edema, abdominal swelling, eruptive boils, and the like; especially diseases of pitta, and those stated in the Chapter on Major Diseases; for among these, purgation is declared foremost, just like [quenching fire] in an ignited house for the pacification of fire.

8.2.14

Those not to be given an āsthāpana enema, however, are: those with indigestion, the exceedingly unctuous, those who have drunk fat, those with stirred-up doṣas, those with low digestive fire, those fatigued from vehicular travel, the exceedingly weak, those afflicted with hunger, thirst, and fatigue, the exceedingly emaciated, those who have eaten food, those who have drunk water, those who have vomited, those who have purged, those who have undergone errhine therapy, the angry, the frightened, the intoxicated, the fainted, those suffering from continuous vomiting, excessive spitting, dyspnea, cough, hiccough, baddhagudodara, chidrodara, dakodara, abdominal distension, alasaka, visūcikā, the recently delivered woman with āma, those suffering from diarrhea with āma, madhumeha, and kuṣṭha.

8.2.15

Therein, in those with indigestion, the exceedingly unctuous, and those who have drunk fat, dūṣyodara, fainting, or swelling would occur; in those with stirred-up doṣas and sluggish digestive fire, severe anorexia; in one fatigued from vehicular travel, the enema, ruined by agitation, would quickly dry up the body; in the exceedingly weak and those afflicted with hunger, thirst, and fatigue, the aforementioned fault would occur; in the exceedingly emaciated, it would again produce emaciation; in those who have eaten food and drunk water, vāyu, becoming aggravated and casting the enema upward or downward, would quickly produce dreadful disorders; in those who have vomited and purged, however, a nirūha enema would burn their dry body just like alkali on a wound; in one who has undergone errhine therapy, it would cause disorientation and severely obstruct the channels; in the angry and the frightened, the enema would rush upward; in the intoxicated and the fainted, their consciousness being deeply disturbed, a complication would occur due to affliction of the mind; in those afflicted with continuous vomiting, excessive spitting, dyspnea, cough, and hiccough, the upward-turned vāyu would lead the enema upward; in those afflicted with baddhagudodara, chidrodara, dakodara, and abdominal distension, the enema, causing severe distension, would destroy the vital breath; in those suffering from alasaka, visūcikā, the recently delivered woman with āma, and those with diarrhea with āma, faults caused by āma would occur; in those with madhumeha and kuṣṭha, recurrence of the disease would result; therefore these are not to be given an āsthāpana enema.

8.2.16

The rest, however, are to be given an āsthāpana enema; especially those suffering from diseases of the entire body, of a single limb, or of the abdomen; retention of flatus, stool, urine, and semen; loss of strength, complexion, flesh, and semen; tympanites caused by doṣas; numbness of limbs; intestinal worms; udāvarta; non-bloody diarrhea; pain in the small joints; internal burning; enlargement of the spleen; gulma; abdominal colic; heart disease; fistula-in-ano; insanity; fever; inguinal hernia; pain in the head and ears; stiffness in the cardiac region, flanks, back, and hips; tremors; convulsive seizures; heaviness; excessive lightness; amenorrhea; irregular digestive fire; pain, wasting, and stiffness in the buttocks, knees, calves, thighs, ankles, heels, forefeet, vagina, arms, fingers, inter-mammary region, teeth, nails, joints, and bones; intestinal rumbling; cutting pain in the rectum; evacuation [of stool] little by little, with sound, and of fierce odor; and particularly the vāta diseases declared in the 'Chapter on Major Diseases.' In these, an āsthāpana enema is said to be the foremost, like felling a tree at its root.

8.2.17

Those indeed who are unfit for āsthāpana would be unfit for anuvāsana; especially those who have not eaten food, and those suffering from acute fever, pāṇḍuroga, jaundice, prameha, hemorrhoids, catarrh, anorexia, sluggish digestive fire, weakness, splenic enlargement, kaphodara, urustambha, loose stools, poison, ingested artificial poison, abhiṣyanda of pitta and kapha, heavy bowels, elephantiasis, goitre, apacī, and intestinal worms.

8.2.18

Therein, in one who has not eaten food, the fat moves exceedingly upward because the passage is unobstructed; in those with acute fever, pāṇḍuroga, jaundice, and prameha, it would stir up the doṣas and cause abdominal enlargement; in one with hemorrhoids, it would cause excessive secretion in the hemorrhoids and produce tympanites; in one afflicted with anorexia, it would further destroy desire for food; in the weak with sluggish digestive fire, it would make the digestive fire even more sluggish; in those with catarrh, splenic disease, etc., whose doṣas are severely stirred up, it would increase the doṣa all the more; therefore, these are not to be given an anuvāsana enema.

8.2.19

Those indeed who are fit for āsthāpana are fit for anuvāsana; especially those who are dry, those with sharp digestive fire, and those afflicted with purely vāta diseases; for in these an anuvāsana enema is said to be the foremost, like watering a tree at its root.

8.2.20

Those unfit for head evacuation, however, are: those with indigestion, those who have eaten food, those who have drunk fat, alcohol, or water, or wish to drink them, one who has washed the head, one who wishes to wash the head, those afflicted with hunger, thirst, or fatigue, the intoxicated, the fainted, those struck by weapon or stick, those fatigued from intercourse, exercise, or drinking, those afflicted with acute fever or grief, the purged, the given an anuvāsana enema, the pregnant woman, those suffering from acute catarrh, outside the proper season, and on a cloudy day.

8.2.21

Therein, in those with indigestion and those who have eaten food, the doṣa, obstructing the channels flowing upward, would produce cough, dyspnea, vomiting, and catarrh; in those who have drunk fat, alcohol, or water, and in those who drink them after it is performed, it would produce discharge from the mouth and nose, film over the eyes, timira, and diseases of the head; in one who has washed the head, and from washing the head after it is performed, [it would produce] catarrh; in one afflicted with hunger, aggravation of vāta; in one afflicted with thirst, further increase of thirst and dryness of the mouth; in those afflicted with fatigue, the intoxicated, and the fainted, it would produce the harm described for the āsthāpana enema; in those struck by weapon or stick, it would produce more severe pain; in those fatigued from intercourse, exercise, or drinking, distress in the head, shoulders, eyes, and chest; in those afflicted with acute fever or grief, the heat, following the vessels of the eyes, would cause timira and increase of fever; in one who has been purged, vāyu would cause impairment of the sense faculties; in one given an anuvāsana enema, kapha would produce heaviness of the head, itching, and worm disorders; in a pregnant woman, it would stiffen the fetus, and it is born one-eyed, with a crippled arm, paralyzed in one half, or a paraplegic; in one suffering from acute catarrh, it would vitiate the channels; and outside the proper season and on a cloudy day, it would produce cold-disorders, putrid rhinitis, and head disease; therefore, these are not fit for head evacuation.

8.2.22

The rest, however, are fit; especially those with stiffness of the head, teeth, and nape; lockjaw; chronic coryza; uvulitis; tonsillitis; corneal opacity; timira; diseases of the eyelids; melasma; epiglottitis; hemicrania; diseases of the neck, shoulder, scapula, mouth, nose, ears, eyes, cranium, and head; facial paralysis; apatantraka; apatānaka; goitre; toothache, hypersensitivity, and looseness; red streaks in the eyes; tumors; hoarseness of voice; speech arrest; stammering; stertorous breathing; and other disorders of vāta, etc., located above the clavicles that are fully matured. In these, head evacuation is said to be the foremost, for having penetrated into the supreme organ, it draws out entirely the disease-causing doṣa adhering there, like an internal stalk from muñja grass.

8.2.23

In seasons other than the rainy season, autumn, and spring, one should administer the errhine in emergency diseases by supplying artificial qualities: in the forenoon during summer, at midday in cold [weather], and on a non-cloudy day during the rains.

8.2.24

Here are the verses—

8.2.24_1

Thus the fivefold procedure has been shown in detail,
for whom which procedure is not beneficial and why, and for whom which is beneficial.

8.2.25

Nor should the wise physician adhere unconditionally
even to a stated matter; here the intelligent physician must also deliberate for himself.

8.2.26

For such a condition may arise with regard to place, time, and strength,
in which what should not be done becomes to be done, and what should be done is to be avoided.

8.2.27

In their own therapeutics, emesis is prescribed for vomiting, heart disease, and gulma,
upon reaching a [particular] stage, as is enema therapy for those with kuṣṭha.

8.2.28

Therefore, even when there is an explicit instruction, one should act after reasoning with one's own intellect;
for success achieved without reasoning is merely success by chance.

8.2.28_1

Thus, in the Siddhisthāna of the treatise composed by Agniveśa, redacted by Caraka, and, being incomplete, filled up by Dṛḍhabala, the second chapter named 'Successful Application of the Five Procedures' is concluded. //2

8.3.1

Now we shall explain the chapter on Successful Formulation of Enemas.

8.3.2

Thus spoke the venerable Ātreya.

8.3.3

To Punarvasu, who, having leisure, was seated in a charming part of the excellent mountain
beside the abode of the Lord of Wealth, surrounded by hosts of great sages, Agniveśa asked with cupped hands:

8.3.4

"In consideration of what should an enema be given to men so that it is successful? Of what material should its pipe be made,
of what dimension, shape, and properties? For whom, and of what origin and properties should the enema-bladder be?

8.3.5

What is the procedure for nirūha, what is the dosage for administration of fat, or what is the rule regarding the bed?
Which enemas are beneficial in which [conditions]?" Hearing this, the great sage spoke the replying words:

8.3.6

"An enema administered after considering the doṣas, drugs, place, time, suitability, digestive fire, mental constitution, age, and strength,
will invariably lead to benefit, and all procedures will be successful.

8.3.7

The pipes should be made with gold, silver, tin, copper, brass, bell-metal, bone, weapon-wood, bamboo, ivory,
reeds, horns, and various gems, and provided with three rings.

8.3.8

They should measure six, twelve, and eight finger-breadths
for those aged six, twenty, and twelve years;
their orifices should allow a mudga bean, a jujube fruit, and a pea to pass, and should be plugged with a wick.

8.3.9

According to age, their circumferences at base and tip should match the thumb and the little finger;
they should be straight, shaped like a cow's tail, smooth, and have rounded, pill-like tips.

8.3.10

There should be one ring at the fourth part from the tip, and two rings at the base to tie the bladder.
The bladder should be of an old bull, a buffalo, a deer, a boar, or a goat.

8.3.11

Firm, thin, devoid of veins, free of foul odor, tanned with astringent decoction, very soft, and thoroughly cleansed,
it should be attached to the pipes according to the age of the patients, with its urinary canal tightly bound.

8.3.12

In the absence of a bladder, the neck-skin of a swimming bird, or a spotted deer's foot, or a very dense cloth may be used.
Having examined a person fit for a non-unctuous enema, the expert in procedure, on an auspicious day in the bright fortnight,

8.3.13

under an auspicious asterism and muhūrta, when food has digested, should attend to the focused patient:
balā, guḍūcī, triphalā along with rāsnā, and both pañcamūlas, each measured at one pala,

8.3.14

eight [madana] fruits, and half a tulā of goat's meat should be boiled in water until a fourth remains;
[the decoction], strained, is combined with pastes of yavānī, [madana] fruit, bilva, kuṣṭha, vacā, śatāhvā, ghana, and pippalī,

8.3.15

pleasantly warm, in the measure of a picu, along with jaggery, honey, ghee, and oil;
one pala of jaggery, a two-prasṛti dose of unctuous substance, and honey and rock salt appropriately.

8.3.16

Having poured it into the bladder, churned it with a churning stick, tied it tightly, inflated it, and freed it of folds,
covering the orifice with the center of the thumb, and having removed the wick placed at the tip of the pipe,

8.3.17

the person, his limbs smeared with oil, having passed urine and feces, not overly afflicted by hunger, on a bed
that is level or slightly lowered at the head, not too high, and furnished with a good mattress,

8.3.18

lying comfortably on his left side, making his body straight, with his own arm as a pillow,
flexing his right leg and extending the left one, he should then administer it to him.

8.3.19

Into the unctuous rectum, a fourth part of the pipe, lubricated, straight, slowly, along the vertebral column,
while demonstrating the virtues of the hands, such as absence of trembling, absence of shaking, and lightness,

8.3.20

and pressing it, given with a single squeeze, he should then withdraw the pipe slowly.
If introduced obliquely, the stream does not flow; if the pipe moves, an ulcer forms in the rectum.

8.3.21

Administered slowly, the enema does not reach the receptacle; overly compressed, it rushes to the throat.
Cold, it produces excessive stiffness; excessively hot, it causes a burning sensation and fainting.

8.3.22

Overly unctuous, it causes excessive sluggishness; rough, it provokes vāta; thin, deficient in dose, or deficient in salt, it yields inadequate action;
in excessive dose, it causes excessive action; thick, it causes emaciation and emerges after a very long time.

8.3.23

With too much salt, it produces burning and diarrhea; therefore, one should give it properly balanced.
First, indeed, one should put in honey and rock salt, then unctuous substance after churning, next the paste;

8.3.24

churning them together, one should then combine them with liquids, churn with a churning stick, and place into the bladder.
Because the duodenum and rectum lie on the left side, one lying on that side attains comfort.

8.3.25

Thus the rectal folds yield; therefore, one lying on the left side is fit for the administration of an enema.
And if an urge for feces or flatus arises when half is given, he should withdraw it, and once released, administer the remainder.

8.3.26

He should lie supine with a pillow arranged; thus its potency pervades his body.
The first enema draws out vāta from its passage; the second, pitta; and the third, kapha.

8.3.27

When it has returned, sprinkled with warm water, he should eat śāli rice with thin meat soup.
When digested in the evening, having eaten lightly and in small measure, he is to be given an unctuous enema for nourishment.

8.3.28

With oil equal to a fourth part of the non-unctuous enema, prepared with sour and vāta-destroying drugs,
having administered it, he should slap the buttocks with the palm of his hand to prevent the rapid exit of the unctuous substance.

8.3.29

He should pull slightly the pair of big toes; he should rub the soles of him lying supine
with unctuous substance, as well as the heels, toes, calves, and whichever parts of his body are afflicted with pain.

8.3.30

And he should gently massage them; thereafter, having arranged a pillow, he should take rest in sleep.
The parts of the decoction are five; in [predominance of] pitta, the unctuous substance is a sixth, and also when dosas are in their normal state;

8.3.31

in aggravated vāta, it is a fourth part; in kapha, the dose in non-unctuous enemas is an eighth part.
The dose of a non-unctuous enema is half a prasṛti in the first year; thereafter, an increase of half a prasṛti [per year]

8.3.32

up to twelve years; there should be an increase of one prasṛti [per year] up to eighteen; beyond twelve, there are [increases],
up to seventy years, that prescribed measure holds; beyond that, it should be administered as for a sixteen-year-old.

8.3.33

The dose of a non-unctuous enema is one prasṛti in measure; in the child and in the aged, mildness is the special rule.
A bed that is neither too high nor too low at the feet, provided with a footstool, is praised,

8.3.34

furnished with an excellent, soft mattress, head facing east, with a white cloth covering.
The diet, moreover, having considered the disease, should be arranged accordingly with vegetable soup, milk, meat soup, and the like.

8.3.35

One should know this primary procedure in all cases; henceforth I shall describe further enemas.
The juice of both pañcamūlas, combined with sour substances, with goat's meat broth, and with the aforementioned paste,

8.3.36

combined with three fats, is declared an excellent non-unctuous enema that removes all vāta diseases.
Of the group beginning with sthirā, combined with balā, paṭola, trāyantikā, eraṇḍa, and barley,

8.3.37

one prastha of decoction, combined with half a prastha of goat's meat soup, is to be cooked down again until it equals one prastha;
combined with pastes of priyaṅgu, kṛṣṇā, and ghana, along with oil, ghee, honey, and rock salt,

8.3.38

this enema stimulates digestion, gives flesh and strength, and also imparts strength to the eyes.
Three palas of castor root, palāśa, and those that are the five minor roots,

8.3.39

rāsnā, aśvagandhā, atibalā, guḍūcī, punarnavā, āragvadha, and devadāru,
in parts of one pala each, combined with eight madana fruits, boiled in two kaṃsas of water until an eighth remains;

8.3.40

the pastes are śatāhvā, hapuṣā, priyaṅgu, together with pippalī, madhuka, and balā,
rasāñjana, seeds of vatsaka, and musta, each part in the measure of an akṣa, combined with a portion of salt,

8.3.41

together with honey, combined with oil and with urine, this enema stimulates digestion and scrapes tissue in men.
Pain in the calves, thighs, feet, sacrum, and back, obstruction by kapha, suppression of wind,

8.3.42

retention of feces, urine, and flatus with pain, tympanites, urinary calculus and gravel,
flatulence, hemorrhoids, and disorders of the duodenum—the eraṇḍa enema, when administered, pacifies these.

8.3.43

From half a śata of goat's meat fried in four palas of oil and ghee, the broth, soured with curd and pomegranate,
combined with pastes, bestows strength, flesh, complexion, semen, and digestive fire, and is praised for blindness and head ailments.

8.3.44

Having boiled eight palas of palāśa in two kaṃsas of water until the decoction is reduced to half an āḍhaka,
combined with pastes of vacā and māgadhikā, one pala each, and two palas of śatāhvā,

8.3.45

with rock salt, with honey, and with oil, this non-unctuous enema should be administered; it produces strength and complexion,
and destroys abdominal distension, lateral thoracic disorders, afflictions of the female genital tract, abdominal lumps, udāvarta, and pain.

Linked texts (1)

Carakasaṃhitā — Agniveśa (Āyurveda) & Caraka, Sanskrit

The Compendium of Caraka 8

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