षट्त्रिंशोऽध्यायः । अथातो नेत्रबस्तिव्यापच्चिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः । ॥ १ ॥
Now we shall discourse on the medical treatment of the mishaps which are consequent on an injudicious application of the pipe and of the basti (Netrabasti vaypad chikitsa). 1
अथ नेत्रे विचलिते तथा चैव विवर्तिते । गुदे क्षतं रुजा वा स्यात् तत्र सद्यःक्षतक्रियाः ॥ २ ॥
अत्युत्क्षिप्तेऽवसन्ने च नेत्रे पायौ भवेद्गुजा । विधिरत्रापि पित्तघ्नः कार्यः स्नेहैश्च सेचनम् ॥ ३ ॥
तिर्यक् प्रणिहिते नेत्रे तथा पार्वावपीडिते । मुखस्थावरणाद् बस्तिर्न सम्यक् प्रतिपद्यते । ऋजु नेत्रं विधेयं स्यात् तत्र सम्यग्विजानता ॥ ४ ॥
Metrical Text: A displacement of retro-version of the pipe during the application of a Basti produces a painful and bleeding ulcer in the rectum, which should be treated as a recent or incidental ulcer. An extremely up-turned or down-turned posture of the pipe at the time gives rise to a pain in the rectum which should be treated with Pittasubduing remedies and sprinkled with Snehas (oil, clarified butter, etc.) A slanting or one-sided posture of the pipe after its introduction into the rectum causes its mouth to be closed and thus prevents a complete and satisfactory injection of the fluid (into the bowels). Hence its mouth should be held straight (and steady) by an experienced physician. 2-4
अतिस्थूले कर्कशे च नेत्रे चावनते तथा । गुदे भवेत् क्षतं रुक् च साधनं पूर्ववत् स्मृतम् ॥ ५ ॥
आसन्नकर्णिके नेत्रे भिन्नेऽणौ वाप्यपार्थकः । अवसेको भवेद् बस्तेस्तस्माद् दोषान् विवर्जयेत् ।। ६ ।।
प्रकृष्टकर्णिके गुदमर्मप्रपीडनात् । रक्तं क्षरत्यत्रापि पित्तघ्नो विधिर्बस्तिश्च पिच्छिलः ॥ ७ ॥
ह्रस्वे त्वणुस्त्रोतसि च क्लेशो बस्तिश्च पूर्ववत् । प्रत्यागच्छंस्ततः कुर्याद्रोगान् बस्तिविघातजान् ।
दीर्घे महास्त्रोतसि च ज्ञेयमत्यवपीडवत् ।।८॥
The use of an excessively thick or rough pipe or of one with a down-turned or bent mouth, produces a bleeding and painful ulcer in the rectum which should be remedied in the manner mentioned above. The injection of a Basti proves abortive in the event of the Karnika (attached to the pipe) being too near the end of the pipe or itself being broken or too small. These defects should, therefore, be carefully avoided. In a case of the Karnika (attached to the pipe ) being at a greater distance from the mouth of the pipe, it would hurt the Guda marma (marma at the anus) and produce a considerable bleeding therefrom. Pitta-subduing remedies and Picchila-Bastis should be employed in such a case. The application of a Basti with a pipe of small length or narrow calibre produces pain, and the injected fluid dribbles out (without entering into the rectum), thus occasioning all the maladies¹ which attend an insufficient or abortive use of a Basti². In the event of the pipe being large and wide-calibred one, the result would be that a large quantity of the fluid would be at once injected into the bowels just as in a case of Avapida-dosa (constant pressing). 5-8
प्रस्तीर्णे बहले चापि बस्तौ दुर्बद्धदोषवत् । बस्तावल्पेऽल्पता वापि द्रव्यस्याल्पगुणा मताः ।
दुर्बद्धे चाणुभिन्ने च विज्ञेयं भिन्ननेत्रवत् ।। ९ ।।
1. These are strangury (Mutra-krcchra), suppression of urine (Mutra-ghata),etc. 2. According to Dalhana the remedy in this case would be that applicable in a case of Mutraghata, etc.; but Jejjata holds that the remedy lies in applying a Picchala Basti as in the preceding case. Disorders resulting from a defective bladder : The effects which result from the use of a bladder (Basti) too large or too thick are identical with those which follow from an imperfect fitting of its neck with the pipe. A (proportionately) smaller efficacy is obtained from the use of a small bladder capable (necessarily) of injecting a smaller quantity of the medicinal fluid. An imperfectly fixed bladder or the one with small pores therein produces effects similar to those resulting from the use of a cracked pipe. 9
अतिप्रपीडितो बस्ति: वातेरितो नासिकाभ्यां प्रयात्यामाशयं ततः । मुखतो वा प्रपद्यते ।।१०।।
तत्र तूर्णं गलापीडं कुर्याच्चाप्यवधूननम् । शिरः कायविरेकौ च तीक्ष्णौ सेकांश्च शीतलान् ॥ ११ ॥
शनै: प्रपीडितो बस्तिः पक्वाधानं न गच्छति । न च सम्पादयत्यर्थांस्तस्माद् युक्तं प्रपीडयेत् ।। १२ ।।
भूयोभूयोऽवपीडेन वायुरन्तः प्रपीड्यते । तेनाध्मानं रुजश्चोग्रा यथास्वं तत्र बस्तयः ॥ १३ ॥
कालातिक्रमणात् क्लेशो व्याधिश्चाभिप्रवर्धते । तत्र व्याधिबलघ्नन्तु भूयो बस्तिं निधापयेत् ॥ १४ ॥
An injection made with considerable force by a Basti (Enemasyringe) enters the stomach (amasaya) which being forced higher up by the up-coursing Vayu in the organism is emitted through the mouth and the nostrils. Under such circumstances, the patient should be immediately pressed by the neck and (his body) shaken. Strong purgatives and errhines should be administered, and sprinkling him with cold water should be prescribed. If a Basti be applied with lesser force, the medicinal fluid of the Basti cannot reach the intestines (Pakvasaya) and (consequently ) fails to produce the desired effect. Hence it should be duly pressed. If it be pressed at intervals, the wind (Vayu) in the abdomen becomes enraged, and gives rise to tympanitis (Adhmana) and excruciating pain therein. The medicinal treatment in such a case should be the applications of proper Bastis in consideration of the nature of the aggravated Dosas involved therein. If the pipe be retained for an (unnecessarily) long time in the rectum during the application of a Basti, it tends to increase the pain, and bring about an aggravation of the disease. This should be remedied by a second application of the Basti charged with proper antidotal solutions sufficient to cope with the intensity of the disease. 10-14
1. An additional reading says that it causes vomiting, nausea, epileptic fits and a burning sensation of the body. Vrnda supports this additional reading.
गुदोपदेहशोफौ तु स्नेहोऽपक्वः करोति हि । तत्र संशोधनो बस्तिर्हितञ्चापि विरेचनम् ॥ १५ ॥
हीनमात्रावुभौ बस्ती नातिकार्यकरौ मतौ । अतिमात्रौ तथाऽनाह-क्लमातीसारकारकौ ।। १६ ।।
मूर्च्छा दाहमतीसारं पित्तञ्चात्युष्णतीक्ष्णकौ । मृदुशीतावुभौ वात- विबन्धाध्मानकारकौ ।। १७ ।।
तत्र हीनादिषु हितः प्रत्यनीकः क्रियाविधिः । तत्र सान्द्रे तनुं बस्तिं तनौ सान्द्रञ्च दापयेत् ।। १८ ।।
स्निग्धोऽतिजाड्यकृद्रुक्षः स्तम्भाध्मानकृदुच्यते । बस्तिं रूक्षमतिस्निग्धे स्निग्धं रूक्षे च दापयेत् ।। १९ ।।
The use of an insufficiently cooked Sneha (in a Basti) leaves a slimy sticky deposit on the inner lining of the rectum accompanied by a local swelling which should be remedied by the application of a Samsodhana-basti and the exhibition of purgatives. The application of a Basti of either kind (Asthapana and Anuvasana) charged with a deficient or inadequate quantity of a medicinal solution, proves abortive in all instances; whereas diarrhoea (Atisara), fatigue and Anaha (distension of the abdomen with the retention of stool, urine, etc.) result from the application of one charged with an excessive quantity of the fluid. The application of a Basti charged wih an extremely warm or strong solution produces fainting, a burning sensation, diarrhoea and (an aggravated condition of the) Pitta. The use of any exremely cold or mild medicine for the purpose of a Basti arrests the emission of the flatus (Vayu), and produces Adhmana (distension of the abdomen). Antidotal measures should be adopted retained for an (unnecessarily) long time in the rectum during the application of a Basti, it tends to increase the pain, and bring about an aggravation of the disease. This should be remedied by a second application of the Basti charged with proper antidotal solutions sufficient to cope with the intensity of the disease. 10-14
1. Gayadasa reads and recommends that the purgatives to be used in such a case should be devoid of any oleaginous substances (Sneha).
2. An additional reading says that a dry (thickend) Niruha-basti produces a slimy deposit in the rectum and in the pelvic region, while one with its fluid of an extremely thin consistency would produce only a little effect and might produce diarrhoea. in cases of the deficient or excessive quantity, etc. The fluid to be used in charging a Basi should be thickened in the event of its extremely attenuated consistency and vice versa. The application of a Basti charged with a fluid consisting of an excessive quantity of Sneha would produce a general inertness of the organism, (dullness of organic functions), while one entirely bereft of any Sneha would produce numbness of the organism and a distension of the abdomen. The remedy in either case consists in employing a Basti of the opposite kind (viz., an oily or non-oily Basti respectively). 15-19
अतिपीडितवदोषान् विद्धि चाप्यवशीर्षके । उच्छीर्षके समुन्नाहं बस्तिः कुर्याच्च मेहनम् ।
तत्रोत्तरो हितो बस्ति : सुस्विन्नस्य सुखावहः ।। २० ।।
न्युब्जस्य बस्तिर्नाप्नोति पक्वाधानं विमार्गगः । हृद्गुदं बाधते चात्र वायुः कोष्ठमथापि च ।। २१ ।।
उत्तानस्यावृते मार्गे बस्तिर्नान्तः प्रपद्यते । नेत्रसंवेजनभ्रान्तो वायुश्चान्तः प्रकुप्यति ।। २२ ।।
देहे सङ्कुचिते दत्तः सक्थ्नोरप्युभयोस्तथा । न सम्यगनिलाविष्टो बस्तिः प्रत्येति देहिनः ॥ २३ ॥
स्थितस्य बस्तिर्दत्तस्तु क्षिप्रमायात्यवाङ्मुखः । न चाशयं तर्पयति तस्मान्नार्थकरो हि सः ॥ २४ ॥
नाप्नोति बस्तिर्दत्तस्तु कृत्स्नं पक्वाशयं पुनः । दक्षिणाश्रितपार्श्वस्य वामपार्श्वानुगो यतः ।। २५ ।।
न्युब्जादीनां प्रदानञ्च बस्तेनैव प्रशस्यते । पश्चादनिलकोपोऽत्र यथास्वं तत्र कारयेत् ॥ २६ ॥
The application of a Basti to a patient with his head downward is attended with symptoms similar to an act of over-pressing (the bladder of the Basti), and the remedy also would be similar. The application of a Basti to a patient with his head held up high and erect would block the urethra, i.e., would suppress the urine, in which case the patient should be treated first with Sveda and then with an Uttarabasti (urethral syringe) which would give the patient much relief. The injected fluid goes astray (within the abdomen) and fails to enter into the intestines (Pakvasaya) in the event of the patient lying in a stooping posture during the application of a Basti. The Vayu in such a case becomes aggravated and gives rise to pain in the regions of the heart, abdomen and rectum. The injected fluid fails to penetrate into the bowels in the event of the patient lying on his back during the application of a Basti owing to the consequent obstruction of the passage. The bodily Vayu becomes in this case agitated and enraged by the (introduction of the) pipe (of the Basti). A contracted position of the body or of both the thighs flexed, during the application of a Basti prevents the full outflow of the injected medicine from the intestines, owing to its being acted upon by the bodily Vayu. In a case of the application of a Basti to a patient in a sitting posture, the fluid rolls down without entering into the bowels; it cannot consequently soothe the Asaya and thus proves abortive. The injected medicine cannot fully enter into the Pakvasaya (intestines), when the Basti is applied to a patient lying on his right side, since the Pakvasaya is situated on the left side (of the abdomen). The application of a Basti is not recommended when the patient lies on his face or in another posture since it is followed by an aggravation of the bodily Vayu, which should be remedied by medicines chosen according to the exigencies of each case. 20-26
1. Jejjata’s reading of this passage does not include the application of Sveda but means that the Uttara-basti should be applied with a Sneha.
व्यापद: स्नेहबस्तेस्तु वक्ष्यन्तेऽत्र चिकित्सिते । अयोगाद्यास्तु वक्ष्यामि व्यापदः सचिकित्सिताः ।। २७ ।।
We shall describe hereafter (in the next chapter) the dangers (Vyapad) which attend the misapplication of a Sneha basti and the course of the medical treatment to be adopted in each. The dangers (Vyapad) attending a deficient application (Ayoga) or a (Niruha) Basti with their respective treatment are described here in this chapter. 27
अनुष्णोऽल्पौषधो हीनो बस्तिनैति प्रयोजितः । विष्ठम्भाध्मानशूलैश्च तमयोगं प्रचक्षते ।
तत्र तीक्ष्णो हितो बस्तिस्तीक्ष्णञ्चापि विरेचनम् ॥ २८ ॥
Ayoga Cramps or colic pains (Sula) in the intestines and heaviness and distension of the abdomen result from the application of a Basti charged with a medicinal solution either cold inadequate in quantity, or deficient in its therapeutic virtues. All these symptoms are included within the term Ayoga or deficient application of a Basti which should be remedied by a strong Basti and a strong purgative. 28
सशेषान्नेऽथवा भुक्ते बहुदोषे च योजितः । अत्याशितस्यातिबहुर्बस्तिर्मन्दोष्ण एव च ।। २९ ।।
अनुष्णलवणस्नेहो ह्यतिमात्रोऽथवा पुनः । तथा बहुपुरीषञ्च क्षिप्रमाध्मापयेन्नरम् ॥ ३० ॥
हृत्कटीपार्श्वपृष्ठेषु शूलं तत्रातिदारुणम् । तत्र तीक्ष्णतरो बस्तिर्हितञ्चाप्यनुवासनम् ।। ३१ ।।
Distension of the abdomen and consequently an excruciating pain (sula) in the regions of the sides, back, waist and the heart result from the applications of a Basti to a person who has taken a second meal before the digestion of a previous one, or in the event of the presence of a large accumulation of Dosas (in his body). If the Basti be applied in a tepid state and in a large quantity just after a heavy meal, the result would be the same. Similar results would follow injections of cold medicinal solutions in large doses saturated with only a small quantity of salt and Sneha (oil or clarified butter) as well as from those in a person with a large accumulation of foecal matter (in his bowels). The remedy in all these cases should consist in the application of a Basti charged with stronger medicinal solutions as well as of an Anuvasana-basti. 29-31
अतितीक्ष्णोष्णलवणो रुक्षो बस्तिः प्रयोजितः । सपित्तं कोपयेद् वायुं कुर्याच्च परिकर्तिकाम् ॥ ३२ ॥
नाभिबस्तिगुदं तत्र छिनत्तीवाति देहिनः । पिच्छाबस्तिर्हितस्तत्र स्नेहश्च मधुरैः शृतः ॥ ३३ ॥
The Pitta and the Vayu of the body are conjointly aggravated by the application of a Basti charged with extremely parching, hot and saline solutions which give rise to the distress, known as Parikartika, attended with a sort of cutting pain in the pelvis and about the anus and the region of the umbilicus. Applications of the Piccha-basti of a medicated Sneha cooked with the drugs of the Madhura group should be the remedies in these cases. 32-33
अत्यम्ललवणस्तीक्ष्णः परित्रावाय कल्पते । दौर्बल्यमङ्गसादश्च जायते तत्र देहिनः ॥ ३४ ॥
परिस्त्रवेत् ततः पित्तं दाहं सञ्जयेद् गुदे । पिच्छाबस्तिर्हितस्तत्र बस्ति: क्षीरघृतेन च ।। ३५ ।।
The distress known as Parisrava attended with loss of strength, and bodily lassitude results from the application of a Basti charged with solutions of extremely strong, acid and saline substances. Pitta begins to secrete at this stage, and produces a consequent burning sensation in the anus. Applications of a Piccha-basti as well as a Basti of clarified butter churned from milk should be the remedy in these cases. 34-35
प्रवाहिका भवेत् तीक्ष्णान्निरूहात् सानुवासनात् । सदाहशूलं कृच्छ्रेण वासक तत्रोपवेश्यते ।। ३६ ।।
पिच्छाबस्तिर्हितस्तत्र पयसा चैव भोजनम् । सर्पिर्मधुरकैः सिद्धं तैलञ्चाप्यनुवासनम् ॥ ३७॥
The distress known as Pravahika or the passing of bloody stools or painful motions, attended with colic (sula) and a burning sensation. is the effect of an excessively strong Asthapana or Anuvasana Basti. This disorder should be remedied by the application of a Picchabasti, a diet of boiled rice saturated with milk and with injections into the bowels, in the manner of an Anuvasana Basti, of a medicated Sneha (oil or clarified butter) cooked with the drugs of the Madhura group. 36-37
अतितीक्ष्णो निरूहो वा सवाते चानुवासनः । हृदयस्योपसरणं कुरुते चाङ्गपीडनम् ।। ३८ ।।
दोषैस्तत्र रुजस्तास्ता मदो मूर्च्छाऽङ्गगौरवम् । सर्वदोषहरं बस्तिं शोधनं तत्र दापयेत् ।। ३९ ।।
he distress known as Hrdayopasarana, accompanied with such symptoms as, aching pains in the limbs, semi-consciousness, unconsciousness and heaviness of the body and all other discomforts similar to the action of the deranged Vayu, originates from the application of a Niruha-basti charged with extremely parching solutions as well as from those of an Anuvasana-basti in the complicated diseases of the deranged bodily Vayu. The remedy in these cases consists in applying the Sodhana Basti charged with solutions efficacious in subduing the actions of all the Dosas of the body. 38-39
रुक्षस्य बहुवातस्य तथा दुःशयितस्य च । बस्तिरङ्गग्रहं कुर्याद्रूक्षो मृद्वल्पभेषजः ॥ ४० ।।
तत्राङ्गसादः प्रस्तम्भो जृम्भोद्वेष्टनवेपकाः । पर्वभेदन तत्रेष्टा: स्वेदाभ्यञ्जनबस्तयः ॥ ४१ ।।
A breaking pain in the joints and the limbs, numbness (Angagraha), yawning, shivering and lassitude are the symptoms which follow the applications of a Basti inadequately charged, or charged with medicinal solutions which are either too mild or too Ruksa (dry) in their potency, or applied in the case of a patient having laid in any of the objectionable postures at the time of the application, or possessed of a dry or Vayu-predominating temperament. The remedy in these cases should consist in applying Sveda, anointments and appropriate Bastis. 40-41
अत्युष्णतीक्ष्णोऽतिबहुर्दत्तोऽतिस्वेदितस्य च । अल्पदोषस्य वा बस्तिरतियोगाय कल्पते ॥ ४२ ॥
विरेचनातियोगेन समानं तच्चिकित्सितम् । पिच्छाबस्तिप्रयोगश्च तत्र शीतः सुखावहः ॥ ४३ ॥
Symptoms which are known as Atiyoga, following applications of Bastis charged with an inordinate quantity of medicinal fluid or with extremely hot or strong solutions as well as the application of Bastis after an excessive application of Sveda (fomentation) and in slight derangements of the bodily Dosas should be treated identically as in cases laid down in connection with an Atiyoga (excessive use) of purgatives. The use of a Piccha-Basti in a cold state is also recommended, as it would give the patient much relief. 42-43
अतियोगात् परं यत्र जीवादानं विरिक्तवत् ।
देयस्तत्र हितश्चापि पिच्छाबस्तिः सशोणितः ॥ ४४ ॥
Measures and remedies mentioned in respect of Jivadana (haemorrhage of the bowels) in connection with an excessive use of purgatives should be employed in the case of similar symptoms (Jivadana) following the excessive use of a Basti. Applications of Piccha-basti charged with blood are likewise recommended in these cases. 44
नवैता व्यापदो यास्तु निरूहं प्रत्युदाहृताः । स्नेहबस्तिष्वपि हि ता विज्ञेया कुशलैरिह ॥ ४५ ॥
इत्युक्ता व्यापदः सर्वाः सलक्षणचिकित्सिताः । भिषजा च तथा कार्यं यथैता न भवन्ति हि ॥ ४६॥
The foregoing nine kinds of distressing symptoms (Vyapad) resulting from an injudicious application of a Niruha-basti are also found to result from the injudicious application of a Sneha-basti. All the distresses (of the injudicious applications of a Basti) with their symptoms and the course of medical treatment to be adopted (in each case) have thus been described. A discrete and experienced physician should so act as not to induce these distresses (Vyapad) in connection with the applications of a Basti. 45-46
पक्षाद् विरेको वान्तस्य ततश्चापि निरूहणम् । सद्यो निरूढोऽनुवास्यः सप्तरात्राद् विरेचितः ।। ४७ ।।
A purgative should be given after the lapse of a fortnight from the date of the exhibition of an emetic drug. An Asthapana-basti should be applied a week after the date of purging. An Anuvasana-basti should also be applied on the very same day. 47
इति सुश्रुत संहितायां चिकित्सितस्थाने नेत्रबस्तिव्यापच्चिकित्सितं नाम षट्त्रिंशोऽध्यायः ।। ३६ ।।
Thus ends the Thirry-sixth Chapter of the Chikitsa Sthana in the Susruta Samhita which treated of the medical treatment of the diseases consequent on the injudicious applications of a Basti.
