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

* The "Valli" and the "Kantaka" here evidently mean the *'Valli- pancha-mula" and the 'Kantaka-Pancha-mula" respectively for wrhich see chapter XXXVIII. wSutra-Sthanam.

|- Dallana explains *'S''yama" as "Vriddha-ddraka" and "Renu' as "Pat jataka".

Chap. XXXVII.] CHIKITSA STHANAM. 6l 3

Nichula ( Jala-Vetasa), Ndgara^ S'atdahvd, Nilini, Rdsnd^
Kadaliy Vdsaka, Renu, Vtlva, Ajamoda, Pippali, Danti,
Chavya, Naradhipa (Aragvadha) with the decoction
of the drugs of the Mushkakddi group, should be cooked
with an adequate quantity of sesamum or castor
oil. The use of this oil in the manner of an Anuvdsana-
vasti (enema) speedily proves curative in cases of
Plihodara (enlargement of the spleen), obstinate con-
stipation of the bowels, Vdta-Rakta, Gulma, retentions
of stool and urine with a flatulent distention of the
abdomen, in diseases due to the action of the deranged
Kapha, in urinary complaints, gravels in the bladder
(Sarkara) and in haemorrhoids. 12.

An Anuv^sna-vasti may be applied in all parts of
the day and night and even (if necessary) without
any previous exhibition of emetics and purgatives,
in the case of a patient in whose system the Vdyu has
been incarcerated and extremely aggravated. The
application of a Nirudha-vasti (enema) should, 'however,
be made in respect of a person of an extremely dry
temperament, or in whose system the deranged and
aggravated Vdyu extremely predominates, only after
his system had been made sufficiently emulcent
(Snigdha) by two or three injections with an Anu-
vdsana-vasti. But if his system be agitated only with
an extremely aggravated condition of his bodily Vdyu,
a Nirudha-vasti (enema\ charged with a medicinal solu-
tion and with a profuse quantity of Sneha added therewith,
may be applied even before applying a Sneha (Vasti).
On finding that the Nirudha-vasti has fully acted,
the physician should treat the patient with medicinal
solutions of oils prepared with Yashti-madhu and
Madana fruit respectively in the manner of an Anuvdsa-
na-vasti in cases of the aggravations of Vayu, etc. 13.

6l4 THE SUSHRUTA SAMHITA. [Chap. XXXVII.

A Vast! should not be applied in the night since the Doshas of the system are (generally) aggravated at this time and since the Sneha (of the Vasti; owing to its potency is likely to give rise to a distention of the abdomen attended with fever and heaviness of the limbs. The mouths of the internal ducts of the body remain dilated and the Doshas remain in their proper places {i.e., are not generally agitated), and the digestive fire remains surcharged with the essence of the diges- tive food during the day time, hence the potency (Ojas) of a Sneha-vasti employed during the day time easily spreads through the ducts of the body. An Anuvasana- vasti may be applied during (the early part of) the night in summer in a case marked by a preponderance of the deranged Pitta and a (consequent) weakness of the Kapha, and an extremely parched condition of the orga- nism, as well as in cases of the affections of Vdyu (Vdta-roga). Unfavourable symptoms such as a burning sensation in the body, etc., arise from the application of a Vasti in the day time during a preponderance of the Pitta, or in summer. The physician should, therefore, make such applications in the evening (Pradosha) in such instances. 14.

Proper time for the application Of the

Sneha-vasti: — A Sneha-vasti should be employed
during the day in spring and winter and in the evening
during summer and the rainy season, with a view to ward
off the dangers due to the misapplication in the internal
use of a Sneha.* It may, however, be applied at any
time during the day, or in the night in a case marked
by a preponderance of the deranged bodily VAyu. 15.

In the serious stage of a disease an Anuvdsana- enema should be applied after the patient has partaken

* See Chapter XXXI , Chikitsita-Sthanam.

Chap. XXXVII.] CHIKITSA STHANAM. 61$

of a second meal, having already digested his previous
one. The use of a Sneha-vasti is forbidden in an
empty stomach as it might otherwise send the injected
fluid higher up into the intestines owing to the empti-
ness and cleansed * (unencumbered) state of the sto-
mach. An application of the Anuvasana-vasti should be
made just after a meal, since the application of a Vasti
made during the continuance of a partially digested
or undigested meal in the stomach brings on feven
An Anuv^sana enema should not, however, be applied
after the patient had taken his meal, richly saturated
or cooked with a Sneha (oil or clarified butter), since the
double introduction of the Sneha into the system
through the medium of food and the Vasti brings on
vertigo and epilepsy. The strength and complexion
of the patient suffer much by the application of an
Anuvasana-vasti after he has taken a dry (Ruksha) meal
containing no Sneha. A patient should, therefore, be
first fed with a diet saturated with a moderate quantity
of an oleaginous substance before being treated with an
AnuvcLsana-vasti. The patient before being treated
with an Anuvasana vasti should be fed with Mudga-
soup f, cow's milk and meat-essence to a quarter part J
less than the quantity he can ordinarily take. i6.

* Gayadasa reads *' ^J^^Tc^fT " ^" P^^^" °^ "^•^cMIfT" ^"'^ explains it to mean "owing to the potency of the Sneha in traversing through the minutest channels of the body."

t Dallana explains that the Mudga soup should be taken without being mixed with any Sneha. He further says that the patient should be given Mudga-soup, cow's milk and meat -essence in accordance with the aggravation of the deranged Kapha, Pitta and Vayu respectively.

X Dallana, on the authority of the older Commentators explains that the patient should not be fed to his fill but only to three- fourths, half and one-fourth of what he can ordinarily take according to his digestive capacity.

6l6 THE SUSHRUTA SAMHITA. [Chap. XXXVII.

The mode of applying a Sneha-

vasti : — The body of the patient to be treated with
an Anuvasana vasti should be first anointed (with
a Sneha) and gently fomented with hot water. Then he
should be advised to take his meal in the prescribed
way and made to take a short walk. Then having
passed stools and urine, he should be treated with
the Sneha-vasti. The mode of applying (the apparatus)
is described under that of Niruha-vasti. He should
be kept silently lying on his back as long as it
would take to count a hundred words (V^k). The
potency (Virja) of the injected Sneha spreads through the
entire organism in the event of one's lying with
outstretched limbs in the above manner after the
application of a Sneha-vasti. The patient should be
gently struck* three times on each of the soles and the
palms of his hands and on the buttocksf . The (patient
with his) bedding should be thrice raised (and shaken
with gentle jerks). After that he should be laid on a
bed stretched out at full length and be advised to speak
and exert himself as little as possible and conform to
a strict regimen of diet and conduct. 1719.

A quantity of S'atdhvd and Saindhava should be
mixed with the Sneha (to be used in the Vasti) and (the
whole compound) applied lukewarm, inasmuch as the in-
jected Sneha would thereby easily flow back (without pro-
ducing any pain and burning sensation, etc.) and dribble

* Dallana explains that the patient should be caught hold of by his wrists and ankles and given the gentle jerks so as to allow the potency of the Sneha spread through the organism.

t Some explain that the buttocks of the patient should be raised up with his bedding and his couch. At any rate his buttocks should be raised up in order to enable the injected Sneha to remain inside the intestines and not to come out instantly.

Chap. XXXVII. J CHIKITSA STIIANAM. 617

down in due time after the application. If at any
time a quantity of the Sneha injected into the bowels
in the manner of an Anuvdsana enema (Vasti) is instant-
ly driven back by the pressure of the incarcerated
abdominal V^yu, or the V^yu (air) of the bladder (Vasti\
or by an excessive heat, keenness (in potency;, or an
over-dose of the injected fluid itself, or by the over dose
of the medicines (subsequently) added thereto, a Sneha-
vasti charged with a smaller dose of the Sneha should be
again applied, since a Sneha un-retained in the abdomen
fails to produce any emulsive effect. 20-21.

Retention of stool, urine and Vayu (flatus) is pro-
duced by using an insufficient quantity of Sneha in
an Anuvdsana-vasti. A burning sensation in the body,
diarrhoea (Prav^ha") and fatigue accompanied with pain
set in as the natural resultants of an excessive Anuvisana
enema. The satisfactory nature of the application of
an Anuv^sana-vasti should be inferred from the timely
discharge of the injected Sneha with flatus and foecal
matter* out of the bowels of a patient without giving
rise to any distressing symptoms such as burning
and sucking f sensations, etc. 22.

The patient may be given a light t meal or diet in the evening, in case he is possessed of a keen digestive capacity§, subsequent to the digestion of a previous meal and (should he feel hungry) after the discharging of the injected Sneha. Tepid water boiled with Dhanydka

* It should be noted that the particle "^" in the text means that on the satisfactory action of an Anuvdsana-Vasti, the injected S neha may come out with urine as well.

t Dallana explains *'^^^" to mean thirst.

X "Light" means both light in quantity as well as in quality.

§ Some commentators explain this couplet to mean that a patient of ordinary digestive capacity should be given a light food, whereas a patient of keen digestive capacity may take a full one,

6l8 THE SUSHRUTA SAMHITA. [Chap. XXXVI I-

and S'unthi should be given hot to the patient on the
(following) morning as it would sharpen his appetite
and produce a fresh relish for food. 23.

This is the procedure of applying a Sneha-vastl.
Six, seven, eight or nine applications of Sneha-vastis
should in this manner be made in succession alternately
with those of a Nirudha-vasti. 24-A.

The Successive actions of the

Vastis:— The first application of the Vasti per-
meates the pelvic and the inguinal regions with the
emulcent essence of the injected Sneha. The second
tends to restore the Vayu in the cephalic part of the
body to its normal condition. The third contributes
to the improvement of bodily strength and complexion.
The fourth permeates the Rasa (lymph chyle) with its
own oily essence. In this way the fifth application
of a Vasti permeates the blood, the sixth the
flesh, the seventh the fat, the eighth the bones, and
the ninth the marrow with the oily essence. This
series of Vasti-applications repeated twice tends to
purify the semen from all its impure or unhealthy
constituents. 24.

A person treated with eighteen series (three hun-
dred and twenty-four in number) of such Sneha-vastis
and Niruha-vastis in the above mentioned way and
observing the prescribed rules of diet and conduct is
enabled to develop a muscular strength in no way
inferior to that of an elephant, and to live a sinless
life a thousand years, in the full enjoyment of his
intellectual faculties, god-like beauty and horse-like
swiftness. 25.

An excessive application of only one kind of Vasti,
either of a Sneha-vasti, or of a Niruha vasti, should be
avoided, since an excess of the first (Sneha-vasti) tends to

Chap. XXXVII.] CHIKITSA STHANAM. 619

impair the di'^estive capacity* and to bring on an aggravation of the deranged Kapha, while an excess of the second (Niruhavasti) tends to aggravate the bcdily Vayu. Hence an application of the Sneha-vasti should I be followed by one of the Niruha-vasti and vice vers a ^ in order to avoid all apprehension of an aggravation of Pitta, Kapha and Vayu. Daily applications of a Sneha- vasti are not forbidden in respect of a person of parched or dry (Ruksha) and Vaya-predominating temperament, while in other instances they should be made on each fourth day, so that the digestive capacity might not bj thereby imp lire d. The application of a moderate quantity of Sneha with a Sneha-vasti is always beneficial to persons of pirched or dry temperament. Similarly, an application of the Niruha vasti in a small quantity always proves beneficial to the persons who have been already treated with a Sncha (Vasti). 26.

Distresses from Sneha-vasti : — Now

we shall describe the distresses which are found to attend
(an abuse or excess of) a Sneha vasti. Various kinds of
distressing symptoms are produced by the application
of a Sneha vasti of a mild or weak potency in the case
of a patient whose stomach is filled with the aggravated
Doshas so that the Snehi cannot flow back, being over-
whelmed, as it would be, by the aggravated Doshas. 27.
Specific Symptoms :— An astringent taste
in the mouth, yawning, shivering and Vishama-Jvara
with the peculiar V^yu origined distempers such as, pain
(in the limbs) are the symptoms which mark the reten-
tion of the injected Sneha in the bowels over-whelmed