The Sushruta Samhita — trans. Bhishagratna

25-26,

A purgative should be administred to a patient of impaired digestive capacity and extreme habitual constipation of the bowels (Krura-koshtha) after having improved his digestion with the admixture of rock-salt, Yava-kshdra and clarified butter arid after applying Sneha and Sveda (as usual). A purgative remedy used after a due application of Sneha and Sveda to the body, leads to the looseness and dislodgment per force of the aggravated Doshas from their seats, since they do not adhere to the internal channels and passages just as a drop of water does not adhere to a pot or vessel saturated with a Sneha. An oleaginous purgative should not be given to persons who have already taken internally* an abundant quantity of Sneha, as it would tend to make the aggravated Doshas of the body dislodge from their seats and again adhere to the internal channels and passages. 27-28.

An excessive quantity of Sneha should be used in cases of poisoning, hurt, pustular eruptions (Pidakd),

* Vrinda reads *'^f%^^T?(^" in place of "^fWf ^?T^". This means that the Sneha might have been used both inletnally and externally.

576' THE SUSIIRUTA SAMHITA. [Chap. XXXIII.

oedema and cutaneous affections before the application of purgatives or emetics. The body of a patient, habituated to the use of oleaginous articles (Sneha), should be first made dry (Ruksha). Sneha should then be used again as usual and purgatives or emetics applied. The aggravated Doshas would be thereby expelled from the system and the patient would grow stronger*. 29-30.

Mild emetics and purgatives should be given at the outset to a person to be treated with such medicines, who had never taken any purgative or emetic before- Emetics and purgatives should then again be administered to him, after thus finding out the state and nature of his Koshtha (bowels). An emetic or purgative medicine of tested efficacy and which is pleasant, aromatic, agreeable and small in dose but of mighty potency should be given to a king; (in addition to these qualities) the medicine should be such as would not produce any serious injury. 31-32.

The body (health) of a patient to whom a purgative or emetic medicine is administered without first applying Sneha and Sveda thereto breaks up like a piece of sapless wood at the time of bending it. The aggravated Doshas dislodged from their seats in the organism through the effects of Sneha and Sveda and stirred by emollient foodf are easily expelled by emetics and purgatives. 33.

The aggravated Doshas dislodged from their seats in the organism through the effects of Sneha and Sveda and stirred by emollient foodf are easily expelled by emetics and purgatives. 33.

Thus ends the Thirty-third Chapter of the Chikitsita Sthanam in the Sus'ruta Samhita which deals with the treatment of diseases amenable to the use of emetics and purgatives.

* Vrinda reads "^'f^a^sTl" »" P^^c- of '^^^f^f ?rT"- This means that the Doshas, so long obstructed by Snchi, are thereby expelled, t Some explain '*i;^\ t%Tât" to mean "with emollient meat/soup".

CHAPTER XXXIY.

Now we shall discourse on the treatment of the disorders resulting from an injudicious use of emetics or purgatives (Vamana-Virechana-Vygtpach- Chikitsitam). i.

Their Classes : ^Fifteen different kinds of disorders may result from an injudicious use of emetics and purgatives owing to the ignorance of the physician or of the patient. Of these (fifteen), the upward coursing in casesof purgatives and the downward coursing in cases of emetics are peculiar to each of them respectively. The fourteen other remaining disorders (Vy^pat) are common to both. They are Sstvaseshaushadhatva (continuance of the drug in the stomach), Jirnaushadhatva (complete digestion of the medicine), Hinadosha(pahritatva (insufficient elimination of the Doshas from the system) Adhika-doshaipahritatva (excessive elimination of the Doshas from the system), Vsita-sula (Vdtaja colicX Ayoga (insufficient dosage\ Ati-yoga (over dosage), Jivsidatna (haemorrhage), Adhm^na (tympanites), Pari-kartik^i (cutting pain in the anus, etc.), Parisraiva (oozing out of stools), Prav^hika( (diarrhoea), Hridayopasarana (rising of the Doshas towards the heart) and Vibandha (suppression of stool and urine). 2.

Causes and Treatment :— An emetic taken by a hungry or a weak person or by one possessed of a very keen digestive capacity (Tikshndgni) or of lax bowels (Mridu koshtha), naturally drops down into the intestines in virtue of the identical nature and intensity of their attributes, in the event of its being retained in the stomach, even for a short while. A failure of the medicine to produce the wished-for resultp. 73p. 578 and a further stirred or agitated condition of the aggravated Doshas are the effects thereof. In such a case Sneha (and Sveda) should be again applied and a stronger emetic administered. 3.

[Chap. XXXlV.

and a further stirred or agitated condition of the aggravated Doshas are the effects thereof. In such a case Sneha (and Sveda) should be again applied and a stronger emetic administered. 3.

An obnoxious and large-dosed purgative taken by a person with a residue of a previous meal remaining undigested (in the stomach) or with an aggravated Kapha or with a disordered stomach (Amds'aya), is forced upward and is ejected through the mouth. In a person of disordered stomach the accumulations (Kapha) in the stomach should be first speedily ejected with an emetic and a stronger purgative should then be administered. A case where the food remains still undigested (in the intestines) should be treated (with fastings and digestants) as in a case of mucous diarrhoea. A pleasant or tasteful purgative should be given in a moderate dose in the event of a previous one having been ejected on account of its obnoxious taste and abnormal dosage. A third dose should not be given in the event of the second also b^ing not retained in the stomach. At this stage; purging should be effected with the help of a lambative (Leha) prepared with honey, clarified butter and treacle. 4.

SaCvas'eshaudhatva (Evils of an unpurged residue of a purgative or emetic) : — A small dose of medicine, whether an emetic or a purgative, if it is absorbed by the deranged Doshas of the body and retained in the system, cannot produce the wished-for result of cleansing the system. In such a case, it gives rise to thirst, pain in the sides, vomiting, epileptic fits, nausea, piercing or breaking pain in the joints, aversion to food, impure eructations, and such like symptoms. The patient in such a case should be made to vomit the contents of his stomach with draughts of

Chap. XXXIV.] CIIIKITSA STHANAM. 579

hot water. When a least residue of a purgative medicine previously administered would be found to have been retained in the stomach of a strong patient and with extremely aggravated Doshas of the body, the patient, if there be an insufficient purging, should be similarly made to vomit. 5.