The Sushruta Samhita — trans. Bhishagratna

[Chap. XXXIII.

of the flesh of any J^ngala animal.* A person treated with emetics (at regular intervals) by cough, accumulation of Kapha in the throat, loss of voice, somnolence, drowsiness, fetid smell in the mouth, evil effects of poisoning (other supervening distresses of Kapha — D. R.}, water-brash and lienteric diarrhoea (Grahani). The (accumulated) Kapha of the system having been ejected by vomiting under a course of emetic treatment the possibility of all Kapha-origined affections is removed, just as a felled tree soon dries up together with all its twigs, fruits and flowers. 9-10.

Cases where emesis is forbidden: —

Emesis or the exhibition of emetics is forbidden in cases of Timira (cataract, upward determination of the V^yu in the body (Urdhva-vata), Gulma, Uddvarta, abdominal dropsy, enlargement of the spleen, worms (in the intestines) and urinary complaints, as well as in respect of fatigued, corpulent, thirsty, hungry, emaciated and too old persons and of infants, Kshata« kshina patients and those suffering from a loss of voice and in respect of those also who are of studious habits or are capable of being treated with a strong emetic and that only with the greatest difficulty. It should be never resorted to in cases of Hoemoptysis and obstinate constipation of the bowels and in the case of an enciente and after the application of a Niruha-vasti, It should not be applied in an extremely dry or parched condition of the organism^* as well as in simple diseases due to the Vdyu. 11.

* The diet of the patient who has taken an emetic should be very carefully prescribed inasmuch as his digestive capacity is liable to become very weak in such cases.

t Persons afflicted with cataract or blindness, Gulmi, facial paralysis, convulsion (Akshepaka), jaunJice, ascites, hoemorrhoids and corpulency

Chap. XXXIII.] CHIKITSA STIIANAM. 569

To induce vomiting with an emetic medicine in the (aforesaid) diseases in which it ought not to have been resorted to is likely to give an irrecoverable turn to those diseases. Emetics should not, therefore, be applied in such cases. To induce vomiting, however, with the help of the decoction of Madhuka (Yashti-madhu)* is not forbidden even in these cases, if the patient be suffering from indigestion or from an extremely aggravated condition of the deranged Kapha as well as from poisoning symptoms. 11-12.

Cases where emesis is recommend-i

11-12.

Cases where emesis is recommend-i

ed : — On the other hand, vomiting or the exhibition of an emetic is recommended in cases of poisoning, in wasting diseases (S'osha), in the derangements of the breast-milk, in precarious or sluggish (Vishama) appetite, in Insanity, in Apasmara (hysteric convulsions), in Elephantiasis (S'lipada), in Vidarik^, in tumours (Arvuda), in obesity, in Meha (urinary complaints), in cases of slow chemical poisoning (Gara-dosha^ in the system, in fever, in aversion to food, in scropfula (Apachi), in mucous dysentery, in heart-disease, in distraction of the mind, in erysipelas, in inflammatory abscesses (^Vidradhi), in indigestion, in water-brash, in nausea, in asthma, in cough, in Pinasa (catarrh), in fetid smell of the nostrils (Putl-ndsa), in inflammations of the lips, throat and mouth,f in (fetid) discharges from the ears, in Adhi-jlhvika, Upa-jihvik^ and Gala-s'undik^ as well as extremely old men and Kshata-kshina patients should not be treated with emetics (lit. should not be caused to vomit). —D. R.

* Jejjata explains Madhuka to mean honey. He means to say that vomiting should be induced with honey and water.

t Some read here **Kushtha, Galaganda, Prameha and S'opha (swelling)" but as Meha is mentioned above separately it seems to us that that reading is not a good one. — Ed.

7?

p. 570

(affections of the glottis and the thorax), in haermorrhage from the lower channels, in the derangements due to the bodily Kapha and in all affections of the location of Kapha*. 13.

lYIode of administering purgatives : —Purgatives should also be administered to a patient after the due application of Sneha (oil, etc.) and Sveda (for a second time) after the administration of an emetic. O.i the day before the administration of the purgative, the patient should be told that a purgative should be given to him the next morning. He should at this time be provided with a light repast followed by potions of hot water and (the expressed juice of) acid fruits. On the next morning an adequate dose of the (purgative) medicine should be administered after clearly ascertaining that the patient's body has been cleansed of all mucous ^Sleshma) accumulations and in the manner laid down in the Aturopakramaniya chapter (Chapter XXXV. of tho Sutra-sthana). 14.

Classification of Koshtha : — Koshtha

of tho Sutra-sthana). 14.

Classification of Koshtha : — Koshtha

(bowels) may be grouped under three heads as mild or easily movable (Mridu), middling or moderately constipated (Madhya^ and hard or constipated (Krura). The first kind (Mridu) of the Koshtha should be ascribed to the abundance of Pitta therein and can be moved even with milk only ; the last (Krura) is ascribable to the action of an abundance of Vatyu and Kapha and can be moved only with the greatest difficulty ; while the second, Madhayama, should be held as the product of a condition of equilibrium among the (three) Doshas and this is the most general type. Purgatives

* Dallana says that some commentators do not read this part, but they say that the necessity of applying emetics is mentioned in each particular case where required.

p. 571

should be administered in small doses to persons of lax bowels (Mridu Koshtha), in moderate doses to those of moderately constipated bowels (Madhayama Koshtha), and in large doses to persons of extremely constipated bowels (Krura Koshtha), After having taken a purgative the patient should think of nothing else but purging and when passing his stool he should not go far from his bed-side. 15.

Metrical Texts :— He should at this time lie in a windless chamber, foregoing the use of cold water and exposure to cold wind, and should not repress any urging (towards stool) nor should he strain. Emission of urine, stool, Pitta, the (purgative) medicine and lastly of Kapha consecutively follow under a course of purgative, in the same manner as an emission of saliva, the (emetic) drug, Kapha, Pitta and lastly of V^yu are consecutively ejected uider the course of an emetic. 16-17.

IVIemorable Verses :— An aggravation of the

Kapha and Pitta, a burning sensation in the body, an aversion to food, heaviness of the limbs and impaired digestion (lassitude — D. R.) are the effects of an improper application of a purgative. Heaviness of the Kukshi and of the heart, itching and burning sensation, and the retention of stool and urine are the symptoms which follow in the wake of a purgative medicine which has failed to satisfactorily open and cleanse the bowels. Loss of consciousness, prolapsus of the anus, aggravation of the bodily Kapha and Sula colic pain in the intestines) result from an act of over-purging. A sense of lightness about the region of the umbilicus* and hilarity of the wind due to the discharge of the dis-