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

X Both Vrinda and Chakrap^ni read "^jsj*' >" place of "^<g ' which means that the newly spilt blood of a goat should be added to the list and hen's egg should be eliminated therefrom.

§ Vala-Taila has been mentioned in the treatment of Mudha-garbha (Chapter XV, Chikitaita Sthdnam) and the Traivrita-Ghtila has been described in the treatment of Maha-Vattvyadhi (Chapter V, Chikilsita Slhiinam).

642 THE SUSHRUTA SAMHlTA. [Chap. XXXV

patients, and those of moderate potency should
employed in respect of persons possessed of a middl
sort of bodily strength, while weak persons should
treated with Vastis (enemas) of mild potency,
experienced physician should thus apply Vastis (enen
with due regard to the nature of the season, the stren
of the patient, the nature and intensity of the disc
under treatment and of the Doshas involved the:
and to the nature of the potency of the ingredit
to be used in charging the Vasti (enema),^ 34.

Loosening or disintegrating (Utkles'ana — lit.
tating) enemas {j,e., those possessed of the virtue of
lodging and disintegrating the accumulated Doshas in
system) should be employed at the outset and correc
ones (Dosha-hara) should then be employed, while tl
exerting a soothing influence on the organism (S
s'amana) should be employed last of all towards
close of the treatment. 35.

Different Vastis :— An Utkles'ana (disi

grating) Vasti consists of castor seeds, Yashti-mat
Pippali^ Saindhavay Vacha^ Hahushd and Phala (Tripl
— Madana-phala, according to others) pasted toget
A Dosha-hara-vasti (corrective enema) consists ((
solution) of Yashti-madhu, Kutaja seeds and Made
phala with Kdnjika and cow's urine. A Sams'odha
Vasti |(soothing enema) consists of Priyangu^ Yas
mad/iUj Musta and Rasdnjana with cow's milk. 36—

lYIadhu-Tailika Vasti :— Now we shall

scribe in short the process of applying a Ma(dhu-Tai

* S'ivaddsa, the commentator of Chakradatta, quotes two addil lines as being incorporated in Sus'ruta's text which, when trans! would be as follows -.—Better use a Vasti of milder potency but nevt on of strong potency than what is necessary and this is recomnK especially in cases of delicate persons.— ^of.

:hap. XXXVIII.] CHIKITSA STHANAM. 643

^asti (^enema) which should be lesorled to only in
espect of kings or king-like personages as well as in
aspect of women, old men, infants and persons of
elicate constitutions for the purposes of eliminating the
)oshas (accumulated in the organism j and of improving
ae strength and complexion. The use of this remedy
oes not entail any strict observance of continence
r of any particular rules, diet, conduct, or conveyance
1 the part of the patient, nor is it attended with any
Dssible complication though it is quite on a par with
ly other kind of Vasti as regards its excellent and
'ghly beneficial therapeutic virtues. It may thus be
Dplied at any time by an experienced physician in the
lanner of a Nirudha- Vasti (enema) whenever the patient
ishes to be treated therewith. Equal parts of honey,
;l and the decoction of castor roots, half a Pala of
'ata-pushpdy a quarter Pala of Sanidhava, and one
itire Madana fruit should be mixed together by stirring"
le whole with a ladle. The whole compound thus
repared should be injected lukewarm into the rectum
I the patient. This measure is called the Ma'dhu-
ailika- Vasti. * 39-
Yukta-ratha & Dosha- hara Vast is :—

he Yukta-ratha Vasti consists in injecting a medicinal
)lution surcharged with Vacha^ Madhuka (honey),f oil,
leat-essence, Saindhava^ Pippali^ Madana fruit, and the
scoction (of Eranda) into the bowels of a patient.

* The quantity of the fluid should be nine Prasritas in all cases of the aidllU-Tailika Vasti and such-like Vastis (enemas).— Z)a//a«a.

t Vacha, salt, Madana-phala, Pippali, each should be one Karsha ; ney and oil four Prasritas and two Karshas each, and the decoction of anda roots four Prasritas and two Karsha?. — Dallana.

In the text we find "Madhuka" which generally means Yashti-madhu. ;re, however, it should mean "Jioney". This is evident from Dallana's mmentary.

644 THE SUSHRUTA SAMHITA, [Chap. XXXVIII.

A compound of Deva-ddru, Vara (Triphald), Rdsnd,
S'ata'pushpd, Vacha, honey, asafoetida and Saindhava
salt, used together as a Vasti, is called the Dosha-hara
Vasti. 40-41.

Siddha-Vasti :— This Vasti should be prepared
with the decoction of Pancha-mula, mixed with oil,
honey and a paste of S'atdhvd, Pippali and Saindhava
salt. Similar Vastis consisting of a decoction of Yava,
Kola and Kulattha, and mixed with a paste of Pippali,
Saindhava, Yashti-madhu and honey may also be used.
This kind of Vasti is called a Siddha- Vasti. 42-43.

IVIUStadika- Vasti :— A Pala measure of each
of the following drugs, viz., Mustd, Pdthd, Amritd
(Guduchi), Tiktd, Vald, Rdsnd, Punarnavd, Manjishthd,
Aragvadha, Us'ira, Trdyamdnd, Gokshura as well as
of those included within the group of minor (Svalpa)
Pancha-mula, and eight Madana fruits should be boiled
with an Adhaka measure of water down to its quarter
part. The decoction thus prepared should again be
boiled with the admixture of a Prastha measure of
milk. The boiling should be continued till the watery
part is completely evaporated and the milk alone is left
behind. It should be then strained (through a piece of
cloth). This (cooked) milk should be mixed with honey,
clarified butter,* and the extract of meat of any Jdngala
animal, each measuring a quarter of the (above-prepared
milk) and a Karsha measure each of the following
drugs, viz.y powdered S'atdhvd, Phalini (Priyangu\
Yashti-madhu, Vatsaka, Rasdnjana and Saindhava.
The application of the above in the manner of a Vasti
proves curative in Vdta-rakta, urinary complaints
(Prameha), Edema, Haemorrhoids, Gulma, retention

* According to Dallana, however, a Pala measure of each of honey and clarified buUer should b^ added.

Chap. XXXVIII.J CHIKITSA STHANAM. 64$

of urine, Haemorrhage (Rakta-Pitta), Erysipelas, fever, and a looseness of the bowels. It acts as an aphrodisiac and vitalising tonic ; it also invigorates the eye-sight and is anti colic in its action. It is known as the Musta'di- Vasti and is the best of all the Asthapana enemas. 44.

A judicious physician may prepare, in the light
of the principle laid down in connection with the
preparation and application of Vastis in general,
hundreds of different other kinds of Vastis (enemas)
with a due consideration of the virtues of their re-
spective ingredients i^drugs) and the nature of the
disease under treatment. Applications of Vastis are
forbidden during the continuance of an undigested meal
in the stomach. Proper rules of diet and conduct should
be observed, and day-sleep should not be indulged in,
after being treated with a Vasti. 45-46.

The compound Ma'dhu-Tailika Vasti is so called
from the facts of its being principally composed of
Madhu (honey) and Taila (oil). The term Yukta-Ratha
Vasti owes its nomenclature to the fact of its imposing
no restriction as regards riding in cariiages (Rathas),
or on horses and elephants after their application. The
Siddha-Vasti derives its name from the uniform success
(Siddhi) which attends its application in a large
number of cases of bodily distempers and from its
irresistible power in improving the strength and com-
plexion of the body. Ma'dhu-Tailika Vastis are recom-
mended to persons of easy and luxurious habits as well
as in respect of those whose bowels can be easily moved,
or who are in the habit of being daily treated with
emulsive measures (Sneha-karma) and whose organisms
are marked by scanty accumulations of the bodily
Doshas. A Siddha-Vasti does not produce any distress
or discomfort, since it is mild in potency and is applied

646 THE SUSHRUTA SAMHITA. [Chap XXXVIII.

in only three quarters of the usual dose (nine Prasritas
only) and does not entail any strict observance of the
regimen of diet and conduct (such as the previous
administration of emetics and purgatives, etc.), and
since it produces a satisfactory result by a single appli-
cation. 47.

Thus ends the Thirty-eighth Chapter of the Chikitsita Sthanam in the Sus'ruta Samhita which deals with Niruha-Vastis.

CHAPTER XXXIX.

Now we shall discourse on the treatment of distress- ing symptoms* which are manifested in a patient

(Aturopadrava-Chikitsitam). i.

The digestive fire (Kaiyaigni) of a person naturally grows dull*)- after the exhibition of emetics and purga- tives, after the administration of a Niruha-Vasti, after the internal application of a Sneha and after blood-letting. It is further lessened by the eating of extremely heavy (difficult of digestion) articles of fare, just as a low or dull fire is extinguished by a heavy load of fuel. Light meals taken in small quantities, on the other hand, in- crease the digestive fire under these circumstances, just as light fuel in small quantities serves to re-kindle a low fire. 2.

The quantity of diet should be proportionate to the
Dosha (morbific diathesis) eliminated from the organism.
The quantity of the Dosha or Doshas eliminated consists
of three measures, viz.^ one Prastha,]: half an Adhaka
or an Adhaka (at most). The first is the lowest, the
second is the intermediate and the last named measure
(one Adhaka) should be deemed as the highest quantity
(of the Dosha that can be eliminated under the circum-
stances). 3.

Yavagu (gruel) prepared with a small quantity of rice (Tandula) should be given once, twice or thrice respect-

* By "dislressing symptoms" nre generally meant those complications that follow the exhibition of emetics, purgatives, Vaslis, etc.

t We have been toKl that the digestive fire is kindled by the exhibition of emetics, purgatives, etc., but here we are told just the reverse. The solution is that the digestive fire is ultimately kindled by these measures, whereas, immediately after the exhibition, it becomes dull and sluggish.

X The Prastha measure here means thirteen Palas and a half.

648 THE SUSHRUTA SAMHITA. [Chap. XXXIX.

ively in cases of the eliminated Dosha being a Prastha, half an Adhaka or an Adhaka in quantity. 4.

After this a quarter part of the quantity of rice or grain otherwise deemed proper and adequate for the patient, should be cooked in the form of Vilepi. The rice or the grain (used in the preparation) should be well boiled, without the addition of any Sneha (oil or clarified butter) or salt. 5.

It should then be (passed through a piece of cloth and) made non-slimy, and should be taken in the above-prescribed manner with a clear (pure) soup of Mudga-^ulse, The patient should then be given a diet measuring half the quantity of his usual one. The food, in this case, should be well saturated with any oleaginous substance (Sneha). The meal of the patient in the next stage should consist of well-boiled rice measuring three parts only of his usual diet and should be made palatable to the taste and sufficient to stimulate the sense-organs. The meal in this case, should be taken with the trans- parent surface of clarified butter {Ghrita-mandd), After this period the patient should be allowed to take his full meal with well-prepared soups of venison, etc. 6-7.

The above order of taking one-fourth, half and three-
fourths of the usual meal applies in cases of deficient,
intermediate (moderate), or satisfactory action of a
purgative. 8.

Peyds, taken in an aggravated condition of the de-
ranged Pitta, and Kapha, or by a person addicted to
drinking habits or subsequent to a deficient exhibition
of emetics and purgatives, may give rise to an increased
(mucous) secretion (Abhishyanda) in the organism.
Tarpana measures (demulcent food) should, therefore, be
deemed beneficial in these instances. 9.

A person is likely to fast from any of the following

Chap. XXXIX. j CHIKlTSA StHANAM. 649

causes, e, g.^ pain, unattainment of wished-for objects,
penance, bereavement, and mental distraction. Rules
enjoined to be observed after a course of purgatives
should as well be adhered to in such cases, 10.

An Adhaka, half an Adhaka and a Prastha measure should similarly be the quantity of excretion in con- nection with a course of purgatives under the three different degrees of its action. But some are of opinion that there may be no fixed quantity of excretion in this case, since purgation should not be considered satisfactory until the S'leshma (^mucus) of the system has come out. * A purgation should be considered satisfactory when the S'leshmd comes out and in that case no more purgative should be given. The strength (Bala) of a patient has been laid down to be of three degrees, consequently the rules of diet and conduct should be similarly determined. A strong patient should observe the regimen of diet only once, one of middling strength (Madhya-bala) twice, while a weak patient thrice. Certain authorities, however, assert that this order of diet should be observed by the patients with an impaired, intermediate and keen digestion, ir.

Lest the Doshas might become aggravated by the
appetite already kindled by the observation of the rules
of diet prescribed for the purpose, the patient should
be made to take his meal in the following order at this
stage. Sweet and bitter articles of fare should be
partaken of at the outset of a meal, followed by olea-
ginous, acid, saline and pungent food. After this, sweet,
acid and saline food should again be taken followed by