Cakradatta (Cikitsasangraha) 72: Adhikāra 72

Having administered an unctuous enema to one whose body is oleated, one should administer a non-unctuous enema on the third day, / when midday has slightly passed, auspicious offerings having been made, // 1

to him who has been massaged, fomented, has evacuated feces, and is not overly hungry. / In the order of honey, unctuous substance, paste, decoction, and additive, respectively: // 2

three, six, two, ten, and three palas in vāta diseases; / in pitta: four, four, two, ten, and four; // 3

and in kapha: six, three, two, ten, and three [palas] of non-unctuous enema. / Having first added an akṣa of rock salt and two prasṛtas of honey, // 4

and thoroughly churned them, he should then add two prasṛtas of unctuous substance; / when the unctuous substance has become blended, he should add one prasṛta of paste; // 5

he should then add the decoction, thoroughly combined, measuring five prasṛtas; / at the end, he should give the additive measuring two prasṛtas. // 6

Filtered through a cloth, and likewise warmed by the steam of a pot of hot water, / the enema prepared in this manner amounts to twelve prasṛtas. // 7

The medicine does not run off the hand, nor does it stick and coat it, / and it does not form a line: that non-unctuous enema is properly prepared. // 8

He should have the rectal enema administered according to the procedure stated earlier; / having retained the enema for thirty mātrās, he should then assume a squatting posture, // 9

encircling his knees, assisted by the right hand; / when the nozzle has been withdrawn, he should remain without straining for a hundred snaps of the fingers. // 10

A second, or a third, or a fourth [enema may be given] according to need; / when, however, the signs of a proper non-unctuous enema are attained, he should stop the enema. // 11

Discharge of feces, urine, and flatus; / relish, increase of digestive fire, and lightness of the viscera; / subsidence of disease, return to normal state, / and strength: that is the sign of a properly administered non-unctuous enema. // 12

Deficient action and excessive action of a non-unctuous enema are like those of a purged patient. // 13

One enema that is unctuous, warm, and containing meat soup [is prescribed] in vāta; / two that are sweet and cool, with milk, in pitta; // 14

In kapha, three decoction enemas with urine, pungent, warm, and dry, should be administered, not more.

The first draws vāta from its path, the second pitta, and the third kapha. (15)

Within a watch or within a muhūrta, the wise [physician] should extract the non-eliminated decoction enema
with evacuating decoction enemas combined with alkali, urine, and sour substances. (16)

A decoction enema staying too long, obstructed by abnormal vāta,
causes colic, restlessness, fever, abdominal distension, or death. (17)

An evacuating enema should not be administered to one who has eaten; this is the rule.
For it would draw down the undigested food that was eaten and aggravate vomiting and other doṣas. (18)

In administering an evacuating enema, the stage-wise procedure must also be carefully performed.
An enema pressed too forcefully passes beyond the receptacle [of the colon], and then, (19)

impelled by vāta, it emerges through the nostrils or through the mouth,
and produces vomiting, nausea, fainting, and the like, as well as a burning sensation. (20)

In that case, one should promptly compress the throat and also shake [the patient],
and administer sharp errhines, sharp purgations, and cold sprinklings. (21)

When the decoction enema has acted properly, having bathed in warm water and eaten rice with meat broth,
[the physician] should administer an unctuous enema according to the prescribed rule. (22)

On that day, there is considered to be a strong risk to him from vāta;
therefore, rice with meat broth and an unctuous enema on that day are recommended. (23)

With the decoction of Daśamūla, one should administer an akṣa of dill,
an akṣa of rock salt, two palas of honey, and two palas (24)

of oil, combined together with one pala of madana fruit.
This enema, known as 'ardhamātṛka', should be given like a decoction enema. (25)

There is no unction, no sudation, nor any rule of avoidance [required].
Indeed, approved by Ātreya, this alleviates all diseases. (26)

It especially destroys phthisis, destroys colic, and destroys worms;
it generates semen and cures vātarakta;
it confers strength and complexion, is aphrodisiac, and is the supreme enema for obtaining male offspring. (27)

Unctuous substances, jaggery, meat broth, milk,
sour substances, urine, honey, rock salt, (28)

and these substances even when not mentioned, and fruit of madana,
should be included in the decoction enema formulation. (28)

One should administer a karṣa of salt and one pala of madana [fruit];
in vāta [add] jaggery; in pitta, sugar; in kapha, mustard seeds and the like. (29)

Taking an akṣa of rock salt and likewise an akṣa of dill,
eight palas of cow's urine, two palas of decoction, (30)

and two palas of jaggery, stirring everything thoroughly,
strained through a cloth and pleasantly warm, the discerning [physician] should administer the enema. (31)

Employed, it promptly destroys colic, retention of feces, abdominal distension, severe dysuria,
worms, upward movement of wind, abdominal lumps, and the like. (32)

With a pala of tamarind, a śukti of jaggery, a karṣa of rock salt, and a kuḍava of cow's urine,
this enema combined with oil cures colic, abdominal distension, and āmavāta. (33)

The Vaitaraṇa and alkali enemas are administered even after eating. (34)

Sprouts of badarī, airāvatī, śelu, śālmalī, and dhanvana,
well prepared with milk and accompanied by blood, become mucilaginous enemas. (35)

Fresh blood of a boar, buffalo, sheep, cat, deer, or fowl,
or goat's blood, should be given in mucilaginous enemas. (36)

The enemas taught by thousands in Caraka and other texts
are mostly not in common practice; therefore, they are not recorded here. (37)

The enema preserves youth; produces a happy life,
strength, digestive fire, intellect, voice, and complexion; (38)

accomplishes all purposes for children, the aged, and the young;
is free from danger, and relieves all diseases. (38)