The Sushruta Samhita — trans. Bhishagratna

p. 622

Whereas, if digested, it produces but very little benefit to the patient. The retention of the whole or of any portion of the Sneha injected into the bowels of a patient without producing any special physical discomfort should be ascribed to an extremely parched or dry condition of his organism, and would not require any special medical treatment. 35-36.

In case of a Sneha not flowing out from the bowels within a period of twenty-four hours of its introduction (and in case of its producing any supervening symptoms), corrective (S'odhana) remedies should be employed and all subsequent applications of Sneha should be stopped. Thus we have finished describing the diseases (Vy^pat and symptoms which result from the injudicious use of Sneha (-Vastis) together wi;h the nature of the medical treatment to be employed in each of them. 37,

Uttara-vastiS : — Now we shall describe the mode of applying an Uttara-vasti (injection into the urethra of a male or of a female patient^. The pipe to be used for the purpose i^in the case of a male patient) should be made to measure fourteen fingers in length, measured by the patient's own fingers. It should be shaped like the stem of a Mdlati flower (in girth) at its top-end and provided with an aperture admitting the passage of a mustard seed. Several authori ies hold that the leng h of the pipe should be equal to that of the penis (of the patient). The largest dose of a Sneha to be used in connection with an urethral injection Uttara-vasti) is only one Kuncha Pa I a) ; and this should be determined with discretion in respect of patients below twenty-five years of age. There should be (two; Karnikas (protrusions) in the middle part of the pipe (Netra) in the case of a male.

I

Chap. XXKVII ] CHIKITSA STHANAM. 623

In the case of a ferrale patient, however, the Karnikis should be placed above a space of four fingers (from its end). Th^ whole pipe should be ten fingers in length and should be made to suit the urethral channel (of the patient) with an aperture sufficient to allow a Mudgapulse to pass through it. 38.

Th^ whole pipe should be ten fingers in length and should be made to suit the urethral channel (of the patient) with an aperture sufficient to allow a Mudgapulse to pass through it. 38.

In the case of a vaginal douche or injection (Vasti), the pipe of the Uttara-vasti should be introduced to the extent of four fingers only into the vaginal canal. Two fingers only of the entire length of the pipe should be inserted into the channel of the urethra in the case of an adult woman, whereas, in the case of a young girl of tender years, the pipe should be introduced to the length of one finger only. Here it should be noted that these measures are to be determined by the standard of the patient's own fingers. A Prasrita measure of the Sneha by which is meant a quantity that would be contained in the hollow of the palms of the patient's hand extending to the roots of the phalanx is the largest dose to be used in both these instances. In the case of pitients of tender years the dosage should be determined with discretion in each case. 39.

The Vasti (bladder of the enema) should be made of the bladder of a hog, lamb, or, a goat, or in its absence, of the skin of the neck of a bird, or of the leg of a Driti \2l leathern bag for holding water), or of any other soft skin. 40.

Mode of application :— The body of the patient should be first treated with a Sneha and with fomentation (Sveda\ and his bowels (As'aya) should be cleansed. He should then be ^nade to putake of a gruel (Vavdgu) mixed with milk and clarified butter according to his digestive capacity. He should be made to sit on a cushion placed on even ground and as high as his

p. 624

He should be made to sit on a cushion placed on even ground and as high as hisp. 624 knee-joints. Lukewarm oil should be rubbed over the region of the neck of the bladder, and the penis should be (artificially) excited and made steady and straight. The orifice or the channel of the urethra should be first (dilated and) searched with the help of an indicator (S'alaka), and then the pipe of the Uttara-vasti, lubricated with clarified butter, should be gently and gradually inserted therein to the extent of six fingers. The Sneha should be injected into the urethra by gently pressing the bladder of the Uttaravasti, and the pipe should then be gradually withdrawn from the urethra. The patient should be made to partake of a moderate quantity of boiled rice with milk, Yusha (Mudga-soup, etc.), or meat-soup* in the evening after the dribbling out of the injected Sneha. Three or four injections should be thus made with the help of an urethral enema (Uttaravasti). 41.

Vaginal Uttara-vasti :— A grown up female patient, (under the circumstances), should be laid on her back with arched and up-drawn knees, and an injection should be made into her vaginal canal (Yoni) by an experienced physician (D. R. — carefully). The pipe should be most gently pressed in the case of a girl before menstruation. For the purpose of purifying the uterus (Garbh^saya), double the ordinary (one Prasrita) quantity of Sneha should be injected into the vaginal canal (by means of a Vasti) with a pipe having three Karnikds (protuberance) attached to it. 42-43.

In case the injected fluid does not come back (within the prescribed time), a fresh Vasti (enema) should be

* Milk, Yusha and meat-soup should be prescribed in cases of the predominance of Kapha, Pitta and Vayu respectively.— Dallana.

p. 625