An English Translation of the Sushruta Samhita, Vol. II — trans. Kaviraj Kunja Lal Bhishagratna (1911)

(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 ¥ayu 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 recjuired.

Chap. XXXIII.] CHIKITSA STHANAM. 5/1

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 urme, 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 Vdyu are consecutively ejected uider the course of an emetic. 16-17.

Memorable 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 disp. 572tempers connected with the Kapha (mucus, stool, etc."* and restoration of the bodily Vayu to its normal condition due to the discharge of the (deranged^ Vayu (from the system) are the symptoms which mark the satisfactory action of a purgative medicine. 18-A.

* In ijlace of "?fi«jT ^f^" some read "i^ii^ ^fc^" which means "a sense of lightness and lassitude".

Diet ; — No liquid food or Peya should be given to the patient on the day in the event of his not being properly purged and not being feebled (with purging'l and in the event of his impaired digestion (after the use of a purgative\ A light and lukewarm Peya should, however, be given to him in small doses, whenever he would feel weak and thirsty after the proper exhibition of a purgative medicine. T?-B,

Benefits of proper purgation :— Clearness and expansion (Prasada) of the intellect, firmness of the organs and of the Dhatus (root-principles) of the body, increase of energy (Bala)*, improved digestive capacity and a lata or delayed old age are the blessings which follow a proper administration of purgative remedies. The deranged Pitta of the system, having been fully removed (with the help of a purgative), precludes the possibility of the existence of any Pitta-origined complaint, just as the waters of a tank or any other reservoir of water, having been fully baled out, bar against the possibility of the existence of all aquatic animals and plants living therein. 18.

Persons who should not be purged :

— Exhibition of purgatives are prohibit d in respect of persons of impaired digestion, or of those treated with an excessive application of any emulsive remedy (SnehaKarma\ or of those who are exceedingly corpulent, too old, fatigued, thirsty or intoxicated, or of those suffering from any ulcer. They are similarly prohibited in * Vrinda does not include "Bala" (energy) in the list.

p. 573