, Vrinda reads " ^^rf f^TfTOf^i^1■ " >" Pl^ce oi ' ^^T^U- •^^rf^^". This means that the Piila and the Kapha would be aggravat ed by an excessive use of a Sneha-vasti. The next couplet in the text woul I better support Vrinda'a reading. — Ed.

620 THE SUSHRUTA SAMHITA. [Chap. XXXVII

by the action of the deranged Vayu. Fever, a burning [ sensation (of the body), thirst, perspiration, a pungent taste in the mouth and yellowness of the complexion, urine and the eyes are the features which are due to the [retention of the injected Sneha in the bowels over- whelmed by the action of the deranged Pitta. Water- brash, a sweet taste in the mouth, heaviness of the limbs, vomiting, difficult breathing, catarrhal fever (^ita-Jvara) and an aversion to food are the indications due to the retention of the injected Sneha in the bowels over- powered by the action of the deranged Kapha. In these cases, applications of (Sneha) Vastis and such other remedial measures as are soothing to the Dosha or Doshas (giving rise to the retention of the Sneha in the bowels) should be adopted with due regard to the nature and intensity of each. 28-29.

Cramps (Sula) and heaviness in the stomach
(Am^saya), suppression of the Vdyu (flatus), affec-
tion of the heart, a bad taste in the mouth, difficult
respiration, epileptic fits, vertigo and an aversion to
food are the symptoms which attend a retention of
the Sneh in the bowels owing to the pressure of food
matter carried down into the abdomen of a person who
has been so treated after a heavy meal, and they should
be remedied first by fasting and then by appetising
measures. 30.

A languid feeling in the limbs attended with a dis-
tension of the abdomen, colic (S'ula), difficult breathing
and a sense of heaviness in the intestines mark the
retention of the injected Sneha surcharged with the
foecal matter of a person previously un cleansed by
proper remedies. The remedy in such cases consists
in the application of Niruha-vastis as well as Sneha-
vastis with the admixture of kecn-potencied drugs. 31.

Chap. XXXVII.] CHIKITSA STHANAM. 621

A scent of the Sneha in the mouth, cough, difficult breathing, an aversion to food and dullness of all sense- organs which become internally charged with a coating of oil and a glossy appearance of the skin (mouth — D. R.) mark an undesirably higher introduction of the Sneha injected into the system previously cleansed (with proper emetics and purgatives). Such a case should be treated as a case of Ati-pidita (overpressure on the bladder of the) enema and with the applications of Asth^pana-vastis as well. 32.

An inadequate quantity of Sneha of a mild or weak
potency, injected cold with the help of an enema,
is not retained in the system, if not duly fomented
and cleansed before, but gives rise to scanty stools,
cramps (Sula), heaviness and distention in the region
of the intestines (Pakvds'aya) and (ultimate) suppres-
sion of stool, etc. Such cases should be speedily
remedied by the application of an Asthapana as well
as by that of an Anuvdsana-vasti. n,

A small quantity of Sneha of mild potency, injected
into the bowels of a patient taking only a small
quantity of food, fails to flow therefrom and gives rise
to a dullness of spirit, a tendency to vomit and a
sense of lassitude which should be remedied by the
application of Asth&pana-vastis charged with (the
decoction of) S'odhaniya (cleansing) drugs and by the
application of Anuvasana enemas charged with
Sneha boiled and cooked with those (S'odhaniya)
drugs. 34.

The Sneha of a Vasti, if found to dribble down (from
the system) after the lapse of even a whole day and
night from the time of its application, without giving
rise to any physical discomfort, docs no mischief but
exerts all the good effects of the application of the Vasti.

622 THE SUSHRUTA SAMHITA. fChap. XXXVII.

Whereas, if digested, it produces but very little benefit to
the patient. The retention of the whole or of any por-
tion of the Sneha injected into the bowels of a patient
without producing any special physical discomfort
should be ascribed to an extremely parched or dry
condition of his organism, and would not require any
special medical treatment. 35-36.

In case of a Sneha not flowing out from the bowels
within a period of twenty-four hours of its introduction
(and in case of its producing any supervening symp-
toms), corrective (S'odhana) remedies should be employ-
ed and all subsequent applications of Sneha should be
stopped. Thus we have finished describing the diseases
(Vy^pat and symptoms which result from the injudi-
cious use of Sneha (-Vastis) together wi;h the nature of
the medical treatment to be employed in each of
them. 37,

Uttara-vastiS : — Now we shall describe the
mode of applying an Uttara-vasti (injection into the
urethra of a male or of a female patient^. The pipe
to be used for the purpose i^in the case of a male
patient) should be made to measure fourteen fingers
in length, measured by the patient's own fingers. It
should be shaped like the stem of a Mdlati flower (in
girth) at its top-end and provided with an aperture
admitting the passage of a mustard seed. Several
authori ies hold that the leng h of the pipe should
be equal to that of the penis (of the patient). The
largest dose of a Sneha to be used in connection with
an urethral injection Uttara-vasti) is only one Kun-
cha Pa I a) ; and this should be determined with discretion
in respect of patients below twenty-five years of age.
There should be (two; Karnikas (protrusions) in the
middle part of the pipe (Netra) in the case of a male.

Chap. XXKVII ] CHIKITSA STHANAM. 623

In the case of a ferrale patient, however, the Karnikis
should be placed above a space of four fingers (from its
end). Th^ whole pipe should be ten fingers in length
and should be made to suit the urethral channel (of the
patient) with an aperture sufficient to allow a Mudga-
pulse to pass through it. 38.

In the case of a vaginal douche or injection (Vasti),
the pipe of the Uttara-vasti should be introduced to the
extent of four fingers only into the vaginal canal. Two
fingers only of the entire length of the pipe should be
inserted into the channel of the urethra in the case of
an adult woman, whereas, in the case of a young girl
of tender years, the pipe should be introduced to the
length of one finger only. Here it should be noted
that these measures are to be determined by the
standard of the patient's own fingers. A Prasrita mea-
sure of the Sneha by which is meant a quantity that would
be contained in the hollow of the palms of the patient's
hand extending to the roots of the phalanx is the
largest dose to be used in both these instances. In the
case of pitients of tender years the dosage should be
determined with discretion in each case. 39.

The Vasti (bladder of the enema) should be made of
the bladder of a hog, lamb, or, a goat, or in its absence,
of the skin of the neck of a bird, or of the leg
of a Driti \2l leathern bag for holding water), or of
any other soft skin. 40.

Mode of application :— The body of the
patient should be first treated with a Sneha and with
fomentation (Sveda\ and his bowels (As'aya) should be
cleansed. He should then be ^nade to putake of a gruel
(Vavdgu) mixed with milk and clarified butter according
to his digestive capacity. He should be made to sit on
a cushion placed on even ground and as high as his

624 THE SUSHRUTA SAMHITA. [Chap. XXXVII.

knee-joints. Lukewarm oil should be rubbed over the
region of the neck of the bladder, and the penis should
be (artificially) excited and made steady and straight.
The orifice or the channel of the urethra should be first
(dilated and) searched with the help of an indicator
(S'alaka), and then the pipe of the Uttara-vasti, lubri-
cated with clarified butter, should be gently and
gradually inserted therein to the extent of six
fingers. The Sneha should be injected into the ure-
thra by gently pressing the bladder of the Uttara-
vasti, and the pipe should then be gradually with-
drawn from the urethra. The patient should be made
to partake of a moderate quantity of boiled rice
with milk, Yusha (Mudga-soup, etc.), or meat-soup*
in the evening after the dribbling out of the injected
Sneha. Three or four injections should be thus
made with the help of an urethral enema (Uttara-
vasti). 41.

Vaginal Uttara-vasti :— A grown up fe-
male patient, (under the circumstances), should be laid
on her back with arched and up-drawn knees, and an
injection should be made into her vaginal canal (Yoni)
by an experienced physician (D. R. — carefully). The
pipe should be most gently pressed in the case of a girl
before menstruation. For the purpose of purifying
the uterus (Garbh^saya), double the ordinary (one
Prasrita) quantity of Sneha should be injected into the
vaginal canal (by means of a Vasti) with a pipe having
three Karnikds (protuberance) attached to it. 42-43.

In case the injected fluid does not come back (within the prescribed time), a fresh Vasti (enema) should be

* Milk, Yusha and meat-soup should be prescribed in cases of the predominance of Kapha, Pitta and Vayu respectively.— Dallana.

(Irp. XXXVII.] CHIKITSA STHANAM. 625

again applied with (the decoctions of) the S'odhana* (purifying) drugs, or a Varti (plug) prepared with the Sodhana drugs should be injected into the rectum. As an alternative, an indicator (Eshani) should be inserted into the mouth of the bladder, or the region of the abdomen below the umbilicus, and be firmly pressed with a close fist, or medicinal plugs or sticks (Varti) of the size of a Mudj^a-pulsQ, cardamom- seed (Ela), or mustard-seed should be made up of Saindhava and the leaves of the Aragvadha pasted with the ex- pressed juice of Nirgundi and cow's urine, and these plugs (Varti) should, according to the age of the patient, be inserted (into the mouth of the bladder) with (the top-end of) a rod or an indicator (Saldkd) for the out-flow of the injected fluid. Another alternative is to use a stick (^ Varti) made up of the pendant soot of a room ( Agdra-dhuma\ Vrihati, Pippali, Madana'fru'it, Sain- dhava salt and S'unthi pasted with S'ukta (a sort of Kanjika) and cow's urine (in the preceding manner). Other (similar) measures should be adopted for the successful action of an Anuvjisana enema (Vasti). 44-A.

A cold decoction of Yashti-madhu saturated with
honey and sugart or a decoction of the (bark of the)
milk-exuding trees (Kshiri-Vriksha\ or cold milk, should
again be injected into the bladder, in the event of there
being a burning sensation in that organ. 44.

Diseases such as derangements of the semen, or of ovum, or difficult menstruation, excess or suppression

* The S'odhana drugs here are the Trina-pancha-muja and such other drugs. — Dallana.

t According to Dallana a quantity of sugar and honey should be added in each of the three cases, viz., (ij the decoction of Yashti- madhu, (2) that of the Kshiri-trees, and (3) milk.

626 THE SUSHRUTA SAMHlTA. tChap. XXXVlI.

of the monthly flow, diseases of the uterus and of the vaginal canal, non-falling of the placenta, strangury and other diseases of the urine, gravel, stones (As'mari), sper- matorrhea (S'ukrotseka), cramps in the bladder, in the groins and in the urethra and all other severe diseases of the bladder other than Meha, will all yield to the appli- cation of an TJttara-vasti (urethral enema). Symptoms which mark, or dangers which attend, a judicious or an injudicious application of an Uttara-vasti are respect- ively identical with those which characterise or attend those of a Sneha-vasti, 45-46.

Thus ends the Thirty-seventh Chapter of the Chikitsita Sthdnam in the Sus'ruta Samhitd which deals with the Anuvdsana-vasti and the UUara- v^stL

CH.\PTER XXXVIIT.

Now we shall discourse on the mode of applying as well as on the treatment with a Nirudha-vasti

(Nirudhopakrama-Chlkltsitam). i. The mode of preparing a Vasti :— The