अथातः स्नेहादिव्यापत्सिद्धिं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ।। १ ।।
We will now expound-Snehadi vyapat siddhi-successful management of complications of oil-enema and other therapies; thus said atreyaand other great sages.(1)
स्नेहबस्तौ मरुत्पित्तकफात्याशविडावृते । अभुक्ते शूनपाय्वामदत्तेऽष्टौ व्यापदः स्मृताः || २ ||
Oil-enema material becoming covered/obstructed by marut (vata), pitta, kapha, too much of food and faeces; enema administered when the person has not taken his food; when there is swelling of the rectum and using uncooked/raw oil for enema, these eight are the complications of oil-enema therapy. (2)
शीतोऽल्पो वाधिके वाते पित्तेत्युष्णः कफे मृदुः । अतिभुक्ते गुरुर्वर्चः सञ्चयेऽल्पबलस्तथा ।
दत्तस्तैरावृतः स्नेहो नायात्यभिभवादपि || ३ ||
Enema material being cold and of small quantity in condition of great aggravation of vata; being very hot (in potency) in conditions of pitta aggravation; being mild (in potency) in kapha aggravation; being very strong when administered after over-eating; being of poor strength when administered in accumulation of faeces, gets covered by these substances and does not come out in spite of mingling with them. (3)
स्तम्भोरुसदनाध्मानज्वरशूलाङ्गमर्दनैः | पार्श्वरुग्वेष्टनैर्विद्याद्वायुनास्त्रेहमावृतम् । ॥ ४ ॥
स्निग्धाम्ललवणोष्णैस्तंरास्नापीतद्रुतैलिकैः । सौवीरकसुराकोलकुलत्थयवसाधितैः ॥५॥
निरूहैर्निर्हरेत् सम्यक् समूत्रैः पाञ्चमूलिकैः । ताभ्यामेव च तैलाभ्यां सायं भुक्तेऽनुवासयेत् ॥ ६ ॥
By the appearance of stiffness and weakness of the thighs, flatulence, fever, pain in the abdomen, pain all over the body, pain in the flanks, and twistings (pain), it should be understood that the enema material is covered/obstructed by vata.
Then, this enema (material) should be removed by administration of decoction enema prepared from drugs which are unctous, sour, salty, and hot in potency such as oil of rasna and pitadru; or with the decoction of panchamula, kola, kulattha, yava, mixed with sauviraka (fermented liquor) sura (beer) and cows urine. Another oil-enema should be administered with the oil of the above two drugs (rasna and pitadru) after the evening meal. (4-6)
तृड्दाहरागसम्मोहवैवर्ण्यतमकज्वरैः । विद्यात् पित्तावृतं स्वादुतिक्तैस्तं बस्तिभिर्हरेत् ॥ ७ ॥ ।
By (the appearance of ) thirst, burning sensation, redness, delusion, discolouration, unconsciousness/and fever, it should be understood theat the obstruction of the material is by pitta. Then, it should be removed by decoction-enema prepared from sweet and bitter drugs. (7)
॥ ८ ॥ कषायतिक्तकटुकैः सुरामूत्रोपसाधितैः । फलतैलयुतैः साम्लैर्बस्तिभिस्तंविनिर्हरेत् ॥ ९ ॥
तन्द्राशीतज्वरालस्यप्रसेकारुचिगौरवैः ।
समूर्छाग्लानिभिर्विद्याच्छ्लेष्मणास्त्रेहमावृतम्
By (the appearance of ) stupor, fever with cold, lassitude, salivation, anorexia, feeling of heaviness of the body, fainting, tiredness of the sense organs should be understood the obstruction s by slesma (kapha); then it should be removed by enemas prepared from astringent, bitter and pungent drugs, added with sura (beer) cows urine, oils of fruits (oil seeds), and sour materials. ( 8-9)
छर्दिमूर्छारुचिग्लानिशूल निद्राङ्गमर्दनैः । आमलिङ्गैः सदाहैस्तं विद्यादत्यशनावृतम् ।। १० ।।
कटूनां लवणानां च क्वाथैश्चूर्णैश्चपाचनम् । मृदुर्विरेकः सर्वं च तत्रामविहितं हितम् ।।११ ।।
By (the appearance of ) vomiting, fainting, anorexia, tiredness of sense organs, pain in the abdomen, too much of sleep, pain in the body, symptoms of ama and burning sensation, it should be understood, the obstruction is by over-eating. It should be treated with pacana (digestive decoctions), powders of drugs which are pungent and salty, with mild purgatives and all other measures which are suitable for removal of ama. (10-11)
विण्मूत्रानिलसङ्गार्तिगुरुत्वाध्मानहृद्ग्रहैः । स्नेहं विडावृतं ज्ञात्वा स्नेहस्वेदैः सबस्तिभिः ।। १२ ।।
श्यामाबिल्वादिसिद्धैश्चनिरूहैः सानुवासनैः । निर्हरेद्विधिना सम्यगुदावर्तहरेणच ।।१३।।
By (the appearance of) distress due to obstruction of faeces, urine and flatus, feeling of heaviness of the body, flatulence, catching pain in the (region of) heart, it should be understood, the material is obstructed by faeces. It should be treated with oleation, sudation and enema therapies using decoction of syama, bilva etc for decoction enema and also for preparing the oil for oil-enemas; other treatment which relieve upward movement of vata and should also be adopted (to remove the obstruction) (12-13)
अभुक्ते शूनपायोर्वा पेयामात्राशितस्य वा । गुदे प्रणिहितः स्नेहो वेगाद्धावत्यनावृतः ॥ ऊर्ध्वकायं ततः कण्ठादूर्ध्वेभ्यः खेभ्यएत्यपि ।।१४।।
मूत्रश्यामात्रिवृत्सिद्धो यवकोलकुलत्थवान् । तत्सिद्धतैलो देयः स्यान्निरूहः सानुवासनः ।।१५।।
कण्ठादागच्छतः स्तम्भकण्ठग्रहविरेचनैः । छर्दिघ्नीभिः क्रियाभिश्च तस्य कुर्यान्निवर्तनम् ।।१६ ।।
Oil-enema administered to persons who have not taken food, who have swelling of the rectum or who have consumed only peya (thin gruel) the enema material without getting obstructed, quickly runs upwards to the upper parts of the body and comes out of the throat and other orifices. This should be treated with decoction-enemas and oilenemas using decoction and oil prepared from cows urine, syama, trivrit, yava, kola and kulattha. The oil coming out from the throat should be reversed (made to come out from the rectum) by pressing the throat, use of purgatives and by therapies which prevent vomiting. (15-16)
नापक्वं प्रणयेत् स्नेहं गुदं स ह्युपलिम्पति । ततः कुर्यात् सरुभोहकण्डूशोफान् क्रियात्र च ।
तीक्ष्णो बस्तिस्तथा तैलमर्कपत्ररसे श्रुतम् ॥१७॥
Uncooked oil should not be used for enema, because it gets coated to the rectum and produces pain, delusion, itching and swelling; this (condition) should be treated with strong (decoction) enemas and with oil boiled with leaves of arka. (17)
Basti netra dosha – defects of enema nozzle
ह्रस्वं दीर्घं तनु स्थूलं जीर्णं शिथिलबन्धनम् । पार्श्वच्छिद्रं तथा वक्रमष्टौ नेत्राणि वर्जयेत् ॥ १८ ॥
अप्राप्त्यतिगतिक्षोभकर्षणक्षणनस्त्रवाः । गुदपीडागतिर्जिह्या तेषां दोषा यथाक्रमम् ।।१९ ।।
Enema nozzle which is either very short, very long, very thin, very thick, old (worn out) with loose knots, punctured in the sides and curved-these eight defects should be rejected.
Not reaching the destination, going beyond the destination, tremors inside the colon, prolapse of rectum, laceration (during pulling out), fluid spilling out (before the bag is pressed), pain of the rectum and irregular movement of the fluid-these are the bad effect of such nozzles respectively. (18-19)
Basti putaka dosha-defects of enema bag
मांसलस्निग्धविषमजालवत्स्थूलवातलाः । छिन्नः क्लिन्नश्च तानष्टौ बस्तीन् कर्मसुवर्जयेत् ||२०||
गतिवैषम्यदौर्गन्ध्यजिह्यत्वस्स्रुतिदुर्ग्रहाः | फेनिलच्युत्यधार्यत्वं बस्तेः स्युर्बस्तिदोषतः ॥ २१ ॥
Enema bag which is very fleshy, greasy, irregular, having net work (of veins), thick, containing air, torn (or punctured) and moist-these eight kinds should be rejected in therapy.
Irregular movement (of fluid), offensive smell, wrong movement (spilling out from the sides),-oozing out (from the openings of veins or punctures), incapacity to accomodate (the fluid), formation of froth in the fluid inside, leaking of the fluid from the tear or hole and difficulty for holding the bag are the bad effects of such enema bags respectively. (20-21 )
Unsuitable postures
उच्चकैरत्यवाक्शीर्षन्युब्जं सङ्कुचितंस्थितम् । उत्तानं दक्षिणंपार्श्वंसप्तशय्याः परित्यजेत् ।। २२ ।।
मूत्राघातोऽतिसम्प्राप्तिरप्राप्तिः साधुनागतिः । आश्वागतिर्मरुत्कोपस्तृप्तिः पक्वाशयस्य च । तद्दोषाः स्युर्विद्यातव्यंयथौपयिकमत्रच ॥ २३ ॥
These seven kinds of body postures should be avoided; keeping the head very high or very low, lieing face downwards, lieing with the body contracted, sitting, lieing with face upwards and lieing on the right side.
Retention of urine, more accumulation (of the enema fluid) inside, not reaching the destination, fluid not moving easily, quickmovement (of the fluid) outwards, aggravation of maruta (vata), and unusual feeling of contentment of the pakvasaya (feeling of fullness of the colon even before the full quantity of the fluid is pushed inside). These are the bad effects of the seven body postures respectively. Appropriate remedial measures should be adopted for these conditions. (22-23)
Pranetru dosha
सवातातिद्रुतोत्क्षिप्ततिर्यगुल्लुप्तकम्पिताः |अतिमन्दकबाह्यातिवेगदोषाः प्रणेतृतः ॥ २४ ॥
अनुच्छ्रवास्य तु बद्धे वा दत्ते नि:शेष एव वा । प्रविश्य क्षुभितो वायुः शूलतोदकरो भवेत् ॥
तत्राभ्यङ्गो गुदे स्वेदो वादघ्नान्यशनानि च ॥ २५ ॥
Pressing the enema bag along with air, pressing it very quick, in upward direction, inward direction, pressing with trembling hands, very slowly, very outward— these are the defects/mistakes of pressing the bag.
By not forcing out the air before administration or by pressing out the contents of bag completely, the air getting into the body produces pain and pricking, this should be treated with anointing and fomenting the rectum and use of foods which subdue vata. (24-25)
द्रुतं प्रणीते निष्कृष्टे सहसोत्क्षिप्त एव वा । स्यात् कटीगुदजङ्घोरुबस्तिस्तम्भार्तिभेदनम् ।।
भोजनं तत्र वातघ्नं स्वेदाभ्यङ्गाः सबस्तयः ।।२६ ।।
Inserting and withdrawing the nozzle very quickly gives rise to stiffness, pain and tearing-like pain in the waist, rectum, calves, thighs and urinary bladder. For this, the patient should be given foods which subdue vata, sudation, oil-massage and enema therapies. (26)
तिर्यग्वल्यावृते द्वारे बद्धे वापि न गच्छति | नेत्रे तदृजु निष्कृष्य संशोध्य च पुनर्नयेत् ॥ २७ ॥
When the orifice of the nozzle is pointing sidewards or when it is covered (blocked), the fluid does not get into the body by pressing. Then it should withdrawn, made straight and cleared of its blockage and inserted again. (27)
पीड्यमानेऽन्तरामुक्ते गुदे प्रतिहतोऽनिलः । उरः शिरोरुजं सादमूर्वोश्च जनयेद्वली ।।
बस्तिः स्यात्तत्रबिल्वादिः फलश्यामादिमूत्रवान् ॥ २८ ॥
While pressing the bag, if it is leftoff in the middle (for a short time) vata getting obstructed in the rectum moves upwards and produces pain in the chest and head and weakness of the thighs. For this conditions, enema with bilvadi panchamula, phala, drugs of syamadi gana ( chapter 16 of sutrasthana) mixed with cows urine should be administered.(28)
स्याद्दाहो दवथुः शोफः कम्पेनाभिहते गुदे । कषायमधुराः शीताः सेकास्तत्र सबस्तयः ॥ २९ ॥
By shaking the nozzle during pressing, burning sensation in the alimentary tract and in the sense organs swelling of the rectum manifest. For this, pouring cold decoctions of astringent and sweet drugs and enemas are beneficial. (29)
अतिमात्रप्रणीतेन नेत्रेण क्षणनाद्वलेः । स्यात् सार्तिदाहनिस्तोदगुरुवर्चः प्रवर्तनम् ॥ तत्र सर्पि: पिचुः क्षीरंपिच्छाबस्तिश्चशस्यते ॥३०॥
By inserting the nozzle very deep, there will be trauma to the folds of the rectum, which in turn produces pain, burning sensation, pricking and elimination of faeces with difficulty. For this (consuming of) medicated ghee, insertion of pad of cloth soaked in ghee into therectum, drinking of milk and enema with slimy materials are preferable. (30)
न भावयति मन्दस्तु बाह्यश्चाशु निवर्तते । स्नेहस्तत्र पुनः सम्यक् प्रणेयः सिद्धिमिच्छता ॥ ३१ ॥
By pressing the bag mildly, the oil does not get into the body, if the nozzle is inserted very little and the bag pressed, the oil quickly comes out (of the rectum). The physician desirous of success should introduce the nozzle again properly and administer the enema. (31)
अतिप्रपीडितः कोष्ठे तिष्ठत्यायाति वा गलम् । तत्र बस्तिर्विरेकश्च गलपीडादि कर्मच |॥ ३२ ॥
वमनाद्यैर्विशुद्धं च क्षामदेहबलानलम् । यथाण्डं तरुणं पूर्णं तैलपात्रं यथा तथा ।। भिषक् प्रयत्नतो रक्षेत् सर्वस्मादपचारतः ||३३ ||
By pressing the bag too much (inserting the nozzle very deep) the enema fluid remains inside the alimentary canal or reaches the throat. This condition should be treated with enemas, purgatives and pressing of the neck and such other measures.
The person who has been purified by emesis etc (other purifactory therapies) will have become weak in strength of the body and also of digestive activity. The physician should protect him from all types of wrong acts just like protecting a young (immature) egg or a vessel filled with oil upto its brim. (32-33 )
दद्यान्मधुरहृद्यानि ततोऽम्ललवणौ रसौ । स्वादुतिक्तौ ततो भूयः कषायकटुकौतत्ः ॥३४॥
अन्योन्यप्रत्यनीकानां रसानां स्त्रिग्धरूक्षयोः । व्यत्यासादुपयोगेन क्रमात्तं प्रकृतिं नयेत् ।। सर्वसह: स्थिरबलोविज्ञेयः प्रकृतिंगतः ||३५ ।।
First he should be given foods which are pleasant and sweet, then of sour and salt tastes, next of sweet and bitter and last, of astringent and pungent (tastes). By using (foods etc) of tastes which are mutually opposite, also of the dry and unctous qualities, he should be brought back to his normal health. Only after he becomes capable of with standing all ( hardship) and steadfast in strength, he should be considered as normal. (34-35)
अत्रान्तरेत्यजेदष्टौ भाष्यादीनि विशेषतः | उच्चैर्भाष्याच्छिरोरोगतिमिरोरः स्वरव्यथाः ||३६ ॥
रक्तनिष्ठीवतमकज्वराद्यास्तत्र साधनम् । अभ्यङ्गस्वेदनस्याधोभक्तस्त्रेहोपसेवनम् ॥ मौनं विधिर्वातहरो यथास्वं च विकारजित् ॥३७॥
During that period, he should especially avoid the eight activities such as speaking in high pitch etc; by indulging in those activities disease of the head, blindness, pain in the chest, disorders of speech spitting of blood, loss of consciousness (or bronchial asthma), fever, etc, arise. The treatment of these are oil-massage, sudation, nasal medication, drinking (medicated) oil after meal, observing silence, remedial measures which subdue vata and other treatments which cure these diseases. (36-37)
Notes-Indu, commentator enumerates the eight activities as speaking loud, excess of sleep, riding on vehicles, excess of walking, eating uncooked foods, unsuitable foods, sleeping during day and sexual intercourse, which are detailed further.
अत्यास्यायानयानाभ्यांसन्धिमूर्धत्रिकादिरुक् । अतिचङ्क्रमणात्पादजङ्घोरुसदनादयः ॥ ३८ ॥
तेषां वातहरं सर्वस्त्रेहस्वेदादि शस्यते । अजीर्णभोजनादामविषच्छर्दिज्वरादयः ||३९ ||
तत्र मात्राशितीयोक्तो विधेयो विधिरामहा । अहितान्नाद्यथादोषं रोगाः स्युर्भेषजानि च ॥४०॥
Too much indulgence in sleep and riding, produces pain in the joints, head, upper back etc, excess of walking produces weakness in the feet, calves and thighs, etc. For these all remedial measures which subdue vata, oleation and sudation therapies are ideally suited.
By partaking uncooked foods, production of amavisa (metobolictoxiins), vomitings, fever etc occur. Then all the regimen which remove ama as described in matrasitiya (chapter 11 of sutrasthana) should be adopted.
Indulgence in unsuitable foods produces diseases born from the respective doshas aggravated thereby and they should be treated suitably. (38-40)
हलीमकादयः प्रोक्तादिवास्वप्नात् पुरा गदाः । विदध्यात् कफजित्तेषु धूमरूक्षान्नलङ्घनम् ॥ ॥४१॥
Halimaka (complication of jaundice) and other diseases mentioned previously (in chapter 9 of sutrasthana) which arise from sleeping during day. For these, inhalation of smoke, dry (non-fatty) foods, fasting and such other measures which subdue kapha should be done. (41)
व्यवायाज्जीवितभ्रंशस्तैस्तैरस्यानिलामयैः । गुदोऽवलुप्यत इव भ्रमतीव च चेतना ॥ ४२ ॥
मेढ्रं धूमायति मनस्तमसीव प्रवेश्यते । जीवनीयवृतक्षीरसर्पिषोरुपसेवनम् ॥
आहारो बृंहणस्तत्र वृष्यास्ते ते च वस्तयः ॥ ४३ ।।
By indulgence in sexual intercourse, diseases which cause danger, to life, diseases caused by aggravated anila (vata), pain in the rectum as though being torn, feeling as though consciousness is fleeting, feeling as though hot smoke is coming out from the penis, mind getting into darkness etc. arise. These should be treated with use of milk and ghee cooked with drugs of jivaniya gana (chapter 16 of sutrasthana), foods which stoutening the body and enemas which are apphodisiac. (42-43)
वेगरोधोर्ध्ववातत्वात् प्रागुक्ता ये सदातुराः । तेषाः विबद्धे पवने सर्वदेहोपतापिनि ॥
फलवर्तिं पुरा दद्यादथ बस्तिं चलापहम् ॥४४॥
Persons who are mentioned previously as being “patients always” (chapter 27 of sutrasthana) by indulging in suppression of the natural urges of the body, develop the disease urdhva vata (upward movement of vata) which troubles the entire body from obstruction of pavana (vata). This condition should be treated first with the use of rectal suppositories made of fruits and later with enemas which subdue chala (vata). (44)
निकुम्भकुम्भाग्न्युरुबूकधावनीपुनर्नवं दारु महच्च पञ्चकम् । फलं च मूत्रे क्वथितं समस्तु तत् घृतं सतैलं लवणानिपञ्च च ॥ ४५ ॥
Nikumbha, kumbha, agni, urubuka, dhavani, punarnava, daru, mahat panchamula and phala are boiled in cows urine ( and filtered); to this decoction, are added mastu (whey), ghrita (ghee), taila (oil) and pancha lavana and enema administered. He should be made to take food along with juice of meat of animals of desert-like regions. After meals he should be administered an oil-enema also. (45)
निरूहितं धन्वरसेन भोजयेन्निकुम्भतैलेन ततोऽनुवासयेत् । बलां सरास्त्रां फलबिल्वचित्रकान् द्विपञ्चमूलं कृतमालकातूफलम् ।।४६ ।।
यवान् कुलत्थांश्च पचेज्जले रसः समुस्तपाठेन्द्रयवैश्च कल्कवान् । सतैलसर्पिर्गुडसैन्धवो हितः सदातुराणां बलपुष्टिवर्णदः ॥४७॥ तथानुवास्यं मधुकेन साधितं फलेन बिल्वेन शताह्वयाथवा । सजीवनीयस्तु रसोऽनुवासने निरूहणे चालवणः शिशोर्हितः ।।४८ ।।
Bala, rasna, phala, bilva, chitraka, the two panchamula, fruits of krtamalaka, yava (barley) and kulattha, are cooked in water and decoction prepared. To this is added the paste of musta, patha and indrayava, oil, ghee, guda (jaggery) and saindhava and medicated oil prepared. This is best for those who are “patients always”, gives them strength, nourishment and colour (complexion). They should be administered oil-enema with this oil processed either with madhuka, phala, bilva or satahva, juice of meat along with drugs of jivaniya gana (chapter 16 of sutrasthana), without salt; it is suitable for children both for decoction-enema and oil-enema therapies. (46-48)
निरूहबस्तेर्नैवान्यत्पथ्यं स्थविरबालयोः । बलाङ्गवर्धनं शीघ्रमादृतो योजयेदतः । ॥४९॥
For the aged and the children there is no other treatment except administering decoction-enema therapy, which bestows strength and development of the body; hence it should be adopted soon. (49)
।। इति सप्तमोऽध्यायः ॥
Thus ends the Seventh chapter.
