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

four objectionable features (Pidana-dosha), viz., overpressure (pressing the injection into the rectum with an injuriously excessive force), under-pressure, repeated pressures and pressure at long intervals. The eleven defects in the ingredients of the Vasti (Dravya-dosha) are insufficient cooking, excessive or insufficient quantity, extreme coldness, excessive heat, extreme keenness of potency, excessive mildness, excess or want of oiliness (Sneha), extreme thickness of consistency and overfluidity. Lying with the head raised up or hung down or in a bent or sitting posture or resting on one's back or in a contracted posture or on one's right side are the seven defective postures (Sayya'-dosha) in which a patient should never be laid during the application of a Vasti. These are the twenty-four defects which attend the wrong application of a Vasti owing to the ignorance or inexperience of a physician, while those which are the effects of the injudiciousness of a patient are fifteen in number and would be described in the chapter on AturopadravaChikitsita (Chapter XXXIX, Chikitsita-sth^na). i6.

The Sneha injected into the bowels by a Vasti is obstructed in its passage and cannot consequently leave the system but is retained in it through any of the following eight causes, viz , obstruction of the food by the three Doshas, its admixture with the foecal matter (accumulated in the bowels), its being injected too high up into the intestines, an omission to foment (the patient's body), using the Sneha in a cold state or in a small quantity and lastly use of no meals or of scanty meals by the patient previous to the application of a Vasti. These (retentive conditions) are due to the indiscretion of both the physician and the patient. Nine distressing symptoms (Vydpad) namely

p. 598

as a defective application of either the Anuvdsana or the Asthdpana Vastis, distension of the abdomen, (AdhmdnaX a cutting pain in the region of the anus, (Parikartikd) Dysenteric stools (Parisrava), diarrhcea (Pravdhikd), affecting the heart (Hridayaopasarana), catching pain in the limbs, over-dosage, haemorrhage manifest themselves in consequence of any act of indiscretion of the physician in attendance. 17.

IVIcmorabIC Verse :— The seventy six kinds of the distressing symptoms (Vydpad) have been briefly described above. Their symptoms and treatment would be described in the following chapter. 18.

Thus ends the Thirty-fifth Chapter in the Chikitsita Sth^nam in the Sub'ruta Samhita which deals with the dimensions, classifications ai.d therapeutical applications of a Netra and a Vasti.

CHAPTER XXXVI.

Now we shall discourse on the medical treatment of the mishaps which are consequent on an injudicious application of the pipe and of the vasti

(Netravasti-Vaypach-Chikitsitam). i.

IVIetrical Text ; — A displacement or retroversion of the pipe during the application of a Vasti produces a painful and bleeding ulcer in the rectum, which should be treated as a recent or incidental ulcer. An extremely up-turned or down-turned posture of the pipe at the time gives rise to a pain in the rectum which should be treated with Pitta-subduing remedies and sprinkled with Snehas (oil, clarified butter, etc.\ A slanting or one-sided posture of the pipe after its introduction into the rectum causes its mouth to be closed and thus prevents a complete and satisfactory injection of the fluid (into the bowels). Hence its mouth should be held straight (and steady) by an experienced physician. The use of an excessively thick or rough pipe or of one with a downturned or bent mouth, produces a bleeding and painful ulcer in the rectum which should be remedied in the manner mentioned above. The injection of a Vasti proves abortive in the event of the Karnikd (attached to the pipe) being too near the end of the pipe or itself being broken or too small. These defects should, therefore, be^carefully avoided. In a case of the Karnikd (attached to the pipe) being at a greater distance from the mouth of the pipe, it would hurt the Guda marma (marma at the anus) and produce a considerable bleeding therefrom. Pitta-subduing remedies and

6oo THE SUSHRUTA SAMHITA. [Chap. XXXVI.