An English Translation of the Sushruta Samhita (Bhishagratna ed.)

* Dallana recommends that a strong purgative or emelic should be n ployed.

588 THE SUSHRUTA SAMHITA. [Chap. XXXlV.

gushing his teeth and biting his tongue. An inexperienc- ed physician usually abandons such a patient as lost, whereas the remedy in such cases consists in anointing his body with a Sneha (oil or clarified butter) and fomenting it with half-boiled and unhusked paddy (Dhanya-Sveda). Gil cooked with Yashti-madhu should be employed in the manner of an Anuvdsana Vasti, and strong errhines (Nasya) should also be administered. After that the patient should be made to vomit with draughts of the washings of rice mixed with Yashti-madhu and Vastis* should be employed in consideration of the preponder- ance of the Dosha or Doshas involved in the case. 19.

Vlbandha (retention of flatus, stool and urine): — Use of cold water, exposure to cold winds and re- sorting to cool places and such other conduct during the action of an emetic or a purgative remedy in a person tend to thicken the Doshas loosened and dis- lodged from their seats by virtue of its potency, arrest their out-flow, make them adhere to the internal passages through which they pass and, by affecting the ex- cretions, give rise to a suppression of stool, urine and Vayu (flatus), attended with rumbling in the intestines, fever, burning sensation and excruciating pain. The patient should in such a case f be made to speedily vomit the contents of his stomach, and the concomitant symptoms (such as fever, etc.) should be treated with appropriate medicinal remedies (as in the case of their actual and respective attacks). Drugs efficacious in subduing the Doshas confined in the lower cavity (abdomen) of the body {Adhohhdga-hara) \ should be employed for purgative purposes with the admixture of

' * Dallana recommends boih Niruha and Snaihika Vastis in such cases* t This evidently refers to the case of an abuse of an emetic. X See Chapter XXXIX., Sutra-Sthanam.

Chap. XXXIV.] CHIKITSA STHANAM. 589

Saindhava, Kdnjika and cow's urine in cases of the
retention of the stool, etc., due to an abuse of a purgative.
Proper Asthapana and Anuvdsana Vastis should be
prescribed in consideration of the nature and intensity
of the Doshas involved in the case. The nature of the
diet should be judiciously determined according to the
nature of the Doshas. The supervening distresses in
both the cases should be remedied with due considera-
tion of the nature of the Doshas originating them. 20.

The cutting pain in the anus in connection with
purging corresponds to the digging in the throat in a
case of vomiting. The oozing out of the faecal matter
downward (Parisrdva) in connection with a purgative
corresponds to the water-brash in the case of an emetic.
What diarrhoea (Pravdhikd) is to purging, a dry eruc-
tation is to vomiting. 21.

IVIemorable Verse ".-—The fifteen kinds of

distempers (Vydpat) described in the present chapter
originate through an excessive, injudicious or insufficient
use of purgatives or emetics. 22.

Thus ends the Thirty-fourth Chapter of the Chikitsita Sthdnam in the Sus'ruta Samhitd which deals with the treatment of the disorders resulting from an injudicious use of purgatives and emetics.

CHAPTER XXXy.

Now we shall discourse on the dimensions and
classifications of a Netra and a Vasti (pipes, nozzles and
apparatus) with their therapeutic applications (Netra-
Vasti-Pramaina-Pravibhsiga-Chikitsitam). i.

Sages of authority hold an application of the Vasti to be the best of all measures such as, the application of a Sneha^ etc.; and why ? Because on account of its varied functions and of its being composed of the various kinds of medicinal drugs a Vasti helps to restrain (Samgraha\ pacify (Sams'amana) and cleanse (Sams'o* dhana) the different Doshas (morbific principles) of the body. It helps the recreation and growth of fresh semen, contributes to the building up of an emaciated frame, reduces corpulency, invigorates eyesight, arrests premature old age and tends to rejuvenate. A regular and proper use of a Vasti tends to improve one's com- plexion and bodily strength, imparts longevity, contri- butes to the growth of the body, ensures the enjoyment of sound health and guards against the inroad of any disease whatever. Applications of Vastis are highly efficacious in cases of fever, dysentery, cataract, catarrh, diseases of the head, Adhimantha, vomiting, facial paralysis, epileptic fits, convulsions^ (Akshepaka), hemi- plegia, locomotor ataxy (Ekdnga) and paraplegia (Sarvanga-Roga\ tympanites, ascites or abdominal dropsy, Sarkara (gravels or urinary concretions), gastralgia (Sula), scrotal tumours (including hydro- cele, hernia, etc.), Upadams'a, retention of stool and urine (Aniha), strangury (Mutra krichchhra), Gulma, Vdta-rakta, upward coursing of urine, stool and Vdyu,

Chap. XXXV.] CHIKirSA STHANAM. 59I

loss of semen, breast-milk and of catamanial fluid,
Hrid-graha (catching pain in the chest), Manydgraha
(wryneck), Hanu-graha (numbness of the jaws), haemor-
rhoids, As'mari (stone) and Mudha-garbha (false pre-
sentation and difficult labour). 2.

IVlcmorablC Verse :— Applications ofVasti
are always efficacious in diseases due to the action of
the deranged Vayu, Pitta and Kapha, in those due to
the vitiated condition of blood and in those brought on
by the concerted action of any two or all of them. 3.

Dimensions of the pipe :— The length of

the pipe of a Vasti should be made six fingers in respect of an infant of one year and eight and ten fingers in respect of a boy of eight and an adult of sixteen years respectively, the girth of its calibre being respectively equal to those of the small finger, the ring finger and the middle finger respectively in the three afore-named instances. The pipe should have Karnikas * or bulb- like protrusions attached to it at one of the ends above a space of one finger and a half, two fingers, and two fingers and a half respectively in the three afore-said forms of the apparatus. The girth of their mouths (to be introduced into the rectum) should be respectively made to equal those of the calibres of feathers of a crow, a falcon and a peacock, and the girth of the channels of the main body of the pipes should respectively be such as to let a j^^^/^'"^ pulse, a. Mds/ia pulse and a Kaldya pulse to pa£S through them. The quantity of the fluid with which an Asthapana-Vasti should be charged is equal respectively to two, four, and eight Prasritasf

* The Karnikas are attached to the pipes for guarding against their being thrust into the rectum.

t A Prasrita measure is generally equal to two Palas, i e.^ sixteen Tolds. But he^re it has the particular meaning as given in the text.

592 THE SUSHRUTA SAMHITA. [Chap. XXXV.

(in volume). A Prasrita measure being here equal to
what can be contained in the hollow of the patient's
own palms (in each particular case). 4.

Memorable Verse :— The length of the pipe

and the quantity of the fluid to charge with should
•be gradually increased with the progress of the patient's
^ge and in consideration of his strength and bodily
capacity. 5.

The pipe of a Vasti in respect of an adult above twenty-five years of age, should be made twelve fingers in length having a girth equal to that of his thumb at its base and a girth equal to that of the small finger at its mouth. At a distance of three fingers from above the mouth the Karnikds should be fixed. The b )re should be such as to allow a feather of a vulture to pass through it, while the fissure at the mouth would have a girth to allow the stone of a Kola fruit or of a boiled Kaldya pulse. The pipe should in all cases be supplied with two Karnikas at its root, for the purpose of firmly securing it to the mouth of the Vasti (bladder). The quantity of the fluid to charge with in the case of an Astha'pana Vasti is twelve Prasritas. The length of the pipe in respect of persons above seventy years of age should be like that in the preceding case but the quantity of the fluid to charge with should be made as in the case of a youth of sixteen. 6.

Materials of the pipes :— The pipe should

be made either of gold, silver, copper, iron, brass, ivory, horn, gems or wood. It should be straight, smooth and firm, tapering at the top like the tuft of hair in the tail of a cow, and bulbular {ji.e , not pointed) at its mouth. The Vasti * should be (prepared with) the

* The Vasti is so called from its being prepared with the bladder (Vasti) of an animal. Dallana notes in this connection that the bladder

Chap. XXXV.] CHIKITSA STHANAM. 593

bladder (Vasti) either of a full-grown ox, buffalo or a
sheep nor should it be soft (flexible) and firm, neither too
thick nor too thin and of adequate dimensions. J.

Metrical Text : — In the absence of a pipe, a
reed, bamboo, or horn might serve the purpose. In the
absence of the bladder of any of the foregoing animals,
the Vasti should be made of skin or of thick linen. 8.

Construction of the Vasti :— The bladder

(of which a Vasti should be made) should be cleansed,
tanned and dyed (disinfected). It should be softened
and repeatedly lubricated with a Sneha. It has
generally a wide mouth which should be bent and lightly
fitted to the butt end of the pipe (Netra). The mouth
of the bladder should then be tied above the (Karnikd).
The whole bladder should be heated with a piece of hot
iron (in order to polish the surface and remove the pores
therein, if any). The mouth of the bladder should then
be folded and again tied (below the Karnikd). The
whole should then be carefully preserved. The Asthd-
pana or the oily (Snaihika) Vasti should be applied,
as the case may be, with the help of such a Vasti. A
mild Vasti should be applied specially to infants and
old men, since a strong one is likely to injure their
health and strength. 9.

Vastis may be grouped under two heads — NairuMka
(dry or oilless) and Snaihika (oleaginous). The term
Asthdpana is synonymous with Niruha. The Vasti known
as the Madhu-Tailika is only an alternative of a Niruha-
vasti. The terms Ydpana, Yukta-ratha, and Siddha-vasti
convey also the same meaning. A Niruha-vasti is so
called from the fact of its expelling the Doshas (morbific

of an ox, buffalo, or a hog, should be used in the Asthapana and Anuva- Sana measures, and the bladder of a goat or a sheep should be used in the Uttara-vasti.

594 THE SUSHRUTA SAMHITA. [Chap. XXXV.

diatheses) from the system and from its curing the diseases of the body ; while Astha(pana is so named from its virtue of rejuvenating the organism or producing longevity. The process of Madhu-tailika would be described in connec- tion with the mode of applying a Niruha-vasti. lO.

The Anuva^sana is only an alternative of a Sneha- Vasti, but (with this difference that) the quantity of the fluid to charge with should be three-fourths, and the amount of the good effect therefrom would also be three- fourths. An Auuvaisana-vasti is so called from the fact of its not injuring the system even in the event of its being retained in the bowels a whole day, or from the fact of its being adapted to daily application. The Mattrs^-vasti again which is applicable in all cases, is an alternative to an Anuvasana-vasti, but should be charged with only a half part of the fluid of that used in an Anuvdsana-vasti. 1 1 .

Metrical Texts :— A Niruha-vasti acts as
a cleanser of the system (S'odhana). It is anti-fat
(Lekhana), emulsive (Snehana) and constructive (Vrim-
hana). Oleaginous matter (Sneha) may freely enter into
the organism when all its ducts and channels have been
previousiy cleansed by the application of a Niruha-
vasti. As water will freely run through channels
previously cleansed of all refuse matter, so does an Anu-
vdsana tend to cleanse the organism of all Doshas
(morbific diatheses) and to increase the vitality of the
organism. A Sneha-vasti should, therefore, be applied
to a person previously purged of all Doshas by the
application of a Niruha-vasti. 12.

Both the Anuvdsana and the AsthapAna Vastis should be regarded as forbidden in cases of insanity, in the mental conditions of terror and grief, of a thirsty state of the body, of aversion to food and of indigestion, jaundice

Chap. XXXV. J CHIKITSA STHANAM. 595

. (Pdndu), giddiness, delirium, epilepsy, vomiting, Kushtha, Meha, ascites, obesity, asthma, cough, dryness of the throat and oedema as well as in respect of a Kshata- Kshina patient and a pregnant woman in (and before) the third or the fourth month of her gestation, in the case of a person suffering from dulness of appetite, impatient and incapable of bearing the least pain as well as in respect of infants, old men and persons emaciated by a bodily distemper other than one due to Vayu 13.

IVIctrical Text :— The Asthdpana-vasti should
be exclusively applied in cases of ascites, urinary
complaints (Meha), Kushtha and obesity. The appli-
cation of an Anuvdsna-vasti is entirely forbidden
in those cases inasmuch as it might make the disease
run into an incurable type, and a great amount of lassi-
tude of the organism would be the consequence. 14.