Vata-S'ula (Flatulent colic) :— The bodily Vdyu become enraged or agitated by the use of parching (Ruksha) medicines by a person who has not been treated with a previous application of Sneha and Sveda or by one who does not observe a total abstinence in sexual matters. The Vayu thus enraged tends to produce a kind of pain (S'ula) in the sides, waist (S'roni), back, tendons and the (principal) Marma (heart) and brings on vertigo, epileptic fits and loss of consciousness. The remedy under such circumstances consists in anointing the patient's body with oil or clarified butter, fomenting it with (hot and half-boiled ) paddy (Dh^nya-Sveda) . An oil cooked with Yashti-madhu should then be employed as an Anuvdsana-Vasti. 8-A.
AyOgca (Partial and deficient medication): — A mild or an insufficient dose of an emetic or purgative, administered without a previous application of Sneha and Sveda to the patient, fails to find an outlet either through the upper or the lower fissures of the body and hence brings about an aggravation of the Doshas incarcerated in the organism and produces a loss of strength (Bala), as well as tympanites with a catching pain in the chest (Hridaya-graha), thirst, epileptic fits and a burning sensation in the body. This is called Ayoga. The remedy in such cases should consist in inducing, without any delay, vomiting with powered Madana
Chap. XXXIV.] CHIKITSA STHANAM. 581
fruit dissolved in a saline solution, or in moving the
bowels with a stronger purgative in the shape of
decoctions. 8-B.
The bodily Doshas are aggravated through deficient or scanty vomitings under the action of an emetic drug and expands through the entire organism, giving rise to itching, swelling, cutaneous affections, pustular erup tions, fever, aching of the limbs, piercing pain and such- like symptoms. The remaining or uneliminated Doshas should then be expelled with (adequate) medicines of strong potency (Mahaushadhi). Similarly, insufficient purgiiigs under the action of a mild purgative, ad- ministered without a previous application of Sneha and Sveda to the patient, produce a numbed and drum- like distension of the abdomen below the umbilicus, causing a retention of the stool and flatus, and produce (colic) pain (S'ula), itching and urticarious eruptions (Mandala). The remedy under these circumstances should consist in employing emulsive measures (Sneha) and a stronger purgative after having employed an Asthdpana-Vasti . Draughts of hot water should be given to the patient and the abdomen and the sides should be fomented with the heated palms of the hands for exciting or inducing purging in the event of an unsatis- factory purging and of obnoxious matter not being expelled from the .system. The purging (of Dosha) would thus be induced. A second dose of a purgative should be again administered in the evening with a due consideration to the strength of the patient when the first would be found to have been digested before produ- cing a sufficient purging if the system of the patient be still full of Doshas and rrorbid matter. In case of failure of this also to remove the Doshas (excreta), the system of the patient should be first treated with
582 THE SUSHRUTA SAMHITA. [Chap. XXXIV.
Sneha and Sveda after the lapse of ten days and should
then be again cleansed with a further dose of a purgative*.
Patient-5 in whom purging can be induced only with
the greatest difficulty should be first treated with
Asthapana. Sneha should again be applied and a strong
purgative should then be administered. 8.
Ati-yOga (Over-drugging with purgatives, etc.): —
Women, merchants, persons attending a king and
pious Brahmanas learned in. the Vedas (S'rotriya) are
often subjected to the necessity of repressing their
natural urgings of the body towards micturition, etc.,
out of a sense of delicacy, fear or greed. The Vdyu in
their systems remains consequently aggravated and
accordingly purgatives fail to easily produce any effect
in their organism. Hence their system should be clean-
sed with purgatives preceded by Sveda (fomentations)
and a copious application of Sneha. An over-dose of a
purgative or a strong one administered to a person
copiously treated with Sneha and Sveda or to one
whose bowels are easily moved would exhibit the symp-
toms of an over-dosage (Ati-yoga) of purgatives.
Excessive emission of Pitta (bile), loss of strength
(Bala) and an aggravation and augmentation of the
deranged Vdyu follow from the over dosage (Ati-yoga)
of an emetic medicine. In such cases, the body of the
patient should b^ anointed with clarified butter and he
should be bathed in cold water and made to take a
lambativef with sugar and honey with a due consider-
ation of the nature and intensity of the Doshas involved.
An over-dose of a purgative may bring on excessive
* Dallana says that the system of the patient, in this case, should be cleansed with an emetic or a purgative as the case may be.
t A different reading says that the patient should be fomented with washings of rice mixed with honey.
Chap. XXXIV.] CHIKiTSA STHANAM. 583
emission of Kapha (mucus) mixed even with blood in
the end. In this case, too, loss of strength (Bala) and en-
ragement of the bodily Vdyu would be the consequence.
The patient in such a case should be sprinkled over
with or bathed in very cold water and vomiting should
be induced with potions of cold washings of rice mixed
with honey. Applications of Fichchhd-vasti and of
Anuv^sana enemetas with milk and clarified butter are
rccommendc 1. The patient should also be made to
drink potions of the washings of rice mixed with the
drugs of the Priyaft^vddi gvoup The diet should con-
sist of boiled rice with milk or meat soup. 9-10.
Jivadana (Haemorrhage) due to excessive vomit-
ing : — In the event of an excessive use of an emetic
the patient may spit or vomit blood. In such a case
the tongue hangs out (of the mouth) and the eyes seem
to expand, and numbness of the jaws, thirst, hiccough,
fever and faintness are found to supervene. A potion of
goat's blood, red Chandana, Us'ira, A.njana and the
powders of fried paddy mixed with water and sugar,
should be administered in these cases. As an alternative,
the patient should be made to take his food in the Peyd
form with the expressed juice of fruits (such as the
Dadimha, etc.:) and with clarified butter, honey and
sugar, or a Peya prepared with the sprouts of Vata, etc.
with honey, or one cooked with any drug having ihe
power of producing costiveness ; or he should be made
to take his food with milk or with the soup of the meat
of a Jangala animal. Measures laid down in respect
of excessive bleeding or haemorrh.dgc should also be
resorted to 11.
In a case of excessive protrusion or hanging down
of the tongue, the organ should be rubbed with pow-
dered Trikatu and rock-salt or pasted with a plaster of
584 THE SUSHRUTA SAMHITA. [Chap. XXXIV.
sesamum and grapes (Drcikshdi and re-introduced into
its proper place and position after which some other
men should bs made to taste any acid article in the
sight of the patient. In a case of the expansion of the
eyes they should be rubbed with clarified butter and
(gently) pressed. Errhines and fomentations [of the part
with drugs) antidotal to the deranged Vayu and Kapha,
are recommended in a case of a numbness or catching
pain of the jaw-bones in such cases. The other super-
vening distresses such as thirst, etc, should be treated
with appropriate medicinal remedies. A faintness (under
the circumstances) should be broken with the (sweet)
sounds of a lute or a lyre. 12.
Jivsidatua (Haemorrhage) due to excessive purging : - An excess (Ati-yoga) of purging is marked, at the outset, by a flow of watery mucus through the rectum, lesembling the crest of a peacock's plume in colour, This is followed by an emission of shreddy and blood- streaked mucus resembling the washings of meat, succeeded by an oozing out of actual red blood attended with a shivering, protrusion of the anus and all the supervening distresses of emetics. The treatment in such cases should be as in those of haemorrhage. The protruded anus should be first lubricated (with a Sneha) and subsequently fomented and re-introduced into its proper place or it should be treated according to the directions laid down in the chapter of Kshudra- Roga*. The shivering should be treated with remedies laid down in connection with Vata-vyadhi. Remedies in cases of a protrusion of the tongue, etc., have been already described. Milk boiled (according to the K^^hira- pdka-vidhi) with Kds'mari fruit, Vadari fruit, Us' it a
* The remedial measures for the treatment of Guda-bhrams'a, etc., under the Kshudra-Roga, should be employed in such cases.
Chap. XXXIV.] CHIKITSA STHANAM. 58$
and Durvd grass subsequently cooled and mixed with
the cream of clarified butter and Anjana, should be
syringed into the rectum in the manner of an Asthd-
pana-Vasti in the case of an excessive flow of red
blood (lit. life-blood) from the bowels. Vasti should
be employed in such cases, with a decoction of the
drugs of the Nyagrodhddi group mixed with milk,
clarified butter, expressed juice of sugar-cane and (goat's)
blood. Remedies mentioned under haemoptysis (Rakta-
pitta) and bloody dysentery should be employed in cases
marked by spitting of life-blood (Jiva-sonita). Decoc-
tions of the drugs of the Nyagrodhddi gvou"^ should be
given with food and drink. 13.
Jiva-^onita, how to be known :— A
piece of a linen or cotton should be soaked in (and dyed
with) the emitted blo?d where any doubt would arise
whether it is a case of arterial blood (Jiva-s'onita')
or one of Rakta pitta. The continuance of the dye or
red stain on the linen even after being washed with hot
water would conclusively establish its identity with the
arterial blood or Jiva-sonita, As an alternative^ the
discharged blood mixed with barley-powder or any
other kind of food should be given to a dog to eat. If
it is eaten by the dog, it would at once establish the
identity of the emitted blood with the healthy arterial
blood of the organism. 14.
AdhmaCna (flatulent distention of the abdomen):—
If a person who is suffering from a plethora of the
Doshas in his system and who has not previously been
treated with a Sneha and whose bowels still contain the
undigested residue of a previous meal and (consequently)
an abundance of Vayu therein, takes a (purgative or an
emetic) which is neither emollient nor hot, the medicine
is likely to produce a flatulent distention of his abdo-
586 THE SUSHRUTA SAMHITA. [Chap. XXXIV.
men (Adhmana). It arrests the emission of flatus
(Vayu), stool and urine, makes the abdomen distended,
produces a breaking pain in the sides, a pricking pain
in the anus (Guda) and in the urinary bladder (Vasti)
2ls well as a disrelish for food. This is called Adhmsina.
rThe patient, in such a case^ should be treated with
, Andha-varti, appetising medicines and with Vasti
measures. 15.
Parikartika (cutting pain in the anus, etc.) :—
The Vayu and Pitta in the organism of an enfeebled
' person or of a person whose bowels can be easily moved
:or of one of a dry and arid temperament or afflicted
with impaired digestive capacity, are deranged and
-aggravated by the use of any extremely sharp, hot,
^saline or dry (emetic or purgative) which give rise to
:a sort of cutting, sawing pain (Parikartikd) in the
anus, penis, umbilical region and the neck of the
bladder (Vasti). The emission of flatus is arrested,
-the Vdyu (wind) lies incarcerated in the abdomen and
relish for food vanishes. The remedy consists in em*
'ploying a Pichchha'- Vasti with Yashti-madhu and black
'sesamum pasted together and dissolved in clarified butter
and honey. The patient should be laved in cold water
■ and be given his food with milk. Anuvdsana-Vasti»
with the cream of clarified butter or with oil cooked
with Yashti-madhu should be employed. 16.
Parisrava (^Dysenteric stools) : — The Doshas and
the morbid matter accumulated in the system of a man
of extremely constipated bowels and almost saturated
•with a plethora of Doshas (morbific diathesis) are stirred
up but are not fully emitted under the action of a mild
* In cases of a Pitta-predominance, the Vasti should be employed with the cream of clarified butler and in c^ses of a VsCyu predominancy, with oi^.
Chap. XXXIV.] CIIIKITSA STIIANAM. 587
(emetic or purgative) medicine. The Doshas (conse- quently) try to pass out of the body constantly but in small quantities and bring on weakness, numbness and rigidity of the abdomen, aversion to food and lassitude of the limbs. The deranged Pitta (bile) and Kapha (mucus) are constantly emitted with pain (through the anus) in such a case, and the disease is called ParisraVa. Asthapana-vasti with a decoction of Ajakafna, DJiava^ Tinis'a and P aids' a saturated with honey is recommended in such cases. After the subsidence of the bodily Doshas involved in the case, the patient should be treated with Sneha and Sams'odhana * (emetic or purgative) remedies should again be employed. 17.
Pravahika (Diarrhoea) : — A medicine (purgative
)r emetic) administered to a person who has been
xcessively treated with Sveda or with Sneha produ-
es Pravathika^ in him by making him pass his stool
md flatus without any straining or by restraining
iltogether those natural urgings respectively. Constant
)assing of slimy, black, white or red-coloured mucus
Kapha) with cramps, loud flatus and burning sensation
orm the chief characteristics of this disease. Its medical
reatment should be similar to that of a case of
'arisr^va. 18.
Hridayopasarana (Overwhelming the heart):
—Urgings towards vomiting or purging being injudi-
iously checked by a person from ignorance, causes
downward or upward coursing of the Doshas of the
)0dy to and in the heart, thus pressing the greatest of the
larmas and giving rise to an excruciating pain in that
reality. The patient, in such a case, drops down
nconscious in a swoon with upturned eyes, violently
