अथातोवमनविरेचनव्यापत्सिद्धिं नामाध्यायंव्याख्यास्यामः । इतिहस्माहुरात्रेयादयोमहर्षयः ।।१।।
We will now expound the chapter named Vamana-virechana vyapat siddhi-successful management of complications arising during emesis and purgation therapies; thus said Atreya and other great sages. (1)
Vamana Vyapat
अतिक्षुधितेनातिमृदुकोष्ठेनाल्पलेष्मणा दुर्वमेन हीनमात्रमतिमात्रं तीक्ष्णमतिशीतमजीर्णे वापीतं वमनमधो गच्छति । तत्रेप्सितानवाप्तिर्दोषोत्क्लेशश्च । तं पुनराशु स्नेहयित्वा यौगिकैर्मात्राकालाद्यपेक्षं वामयेत् । व्यापत्कराणिच पूर्वोक्तमतिक्रमं स्मरन् परिहरेत् || २ ||
The emetic recipe-consumed by persons who are very hungry,who have very soft bowel movements ( by constitution ), who have very little ( aggravation) of slesma (kapha), who vomit with difficulty, the dose of the drug being either less or very high, the drugs possessing strong actions, very cold (potency) or very fresh, or consumed during indigestion, travels downwards, does not yeild the desired effect and bouts but produces increase of the doshas.In such conditions, the patient should be given quick oleation therapy and made to vomit by administering once again, the emetic recipe which is appropriate in its dose, to the season, person etc. The factors responsible for creating complications, mentioned above, should be prevented from occuring, by adopting suitable measures. (2)
अजीर्णिनः लेष्मवतोऽत्युष्णतीक्ष्णलवणमतिमात्रमहृद्यं वा विरेचनमन्यद्वा भेषजमूर्ध्वं प्रवर्तते । तत्रपूर्वोक्ताव्यापत्साधनंच तत ऊर्ध्वमप्युत्तिष्ठति हृद्यलेहवटकवर्ज्यमौषधंन तृतीयमवचारयेत् ।।३।।
The purgative recipe and even other drugs, consumed by persons having indigestion, more increase of slesma ( kapha), drugs possessing very hot (potency), penetrating properties, very salty in taste, large in dose, and which are unpleasant (disliked) travels upwards. In such a condition the methods to control the complications are the same as described above (patient given quick oleation therapy, administered a suitable purgative recipe and avoiding complications). If, even the second dose (of purgative recipe) moves upwards, the third dose of (purgative) medicine should not be given except in the form of pleasant (tasty) confections or pills. ( 3 )
क्रूरकोष्ठस्यातितीक्ष्णाग्नेरल्पमल्पवीर्यं वा भेषजमूर्ध्वभागिकमधोभागिकं वा भक्तवदुपैति
पाकम् । तत्र समुदीर्णा दोषा यथाकालमनिर्हियमाणा विभ्रमं कुर्वन्ति । तं स्निग्धकोष्ठमनल्पममन्दं चौषधंपाययेत् ॥ ४ ॥
The medicines (recipes) having upward movement or downward movement (emetics and purgatives respectively) administered to persons of hard bowel movements by constitution), who possess very powerful, digestive activity, in small dose and consisting of very mild properties-undergo digestion just like food. Then the aggravated doshas, not being eliminated at the proper time, produce severe giddiness; such persons should be given lubrication of his alimentary tract (internal oleation therapy) and then administered recipes in higher dose and of strong potency. (4)
कषायमल्पमप्रत्यग्रं रूक्षं वा भेषजमस्त्रिग्धस्विन्त्रेन वा पीतं शीतोपचारेण वा स्तब्धं दोषविग्रथितमयोगी भवति । तत्र वमने भूयोवामयेत् । विरेचनेस्निग्धस्विन्नंपुनर्विरेचयेत् । उत्क्लिष्टभूरिदोषं वातृतीयेऽहनि । उभयोश्च संशोधनयोर्लवणतैलाभ्यक्तं पिण्डप्रस्तराभ्यां स्वेदयेत् ॥५॥
Recipes become unproductive if they are astringent, small in dose, not well prepared, and dry (moistureless), consumed by persons who have not undergone oleation and sudation therapies, or bouts of evacuations prevented by indulging in cold things; made hard, (obstructed in their function) by the doshas become unproductive. If it is an emetic recipe, the person should be made to vomit again many times; if a purgative recipe, the person should be administered oleation and sudation therapies and then made to purge; if the excited doshas are profound, then even on the third day. In case of both purification therapies, the person should be anointed with salted oils and administered pindasveda and prastarasveda (kinds of sudation therapy vide chapter 26 of sutrasthana). (5)
Virechana Vyapat
स्त्रिग्धस्विन्नस्य च वमनमकृत्वा विरेचनं पीतवतः सामस्य वा मृदु वा विरिक्तस्याभागेत्यर्थगुरुस्तब्धोदरता शूलो वातमूत्रपूरीषसङ्गश्च भवति । तमप्ययोगिनं समूत्रैस्तीक्ष्णैरास्थाप्य जाङ्गलरसैश्च भोजयित्वा फलदारु पिप्पलीसिद्धेन तैलेनानुवास्य वातहरैश्च स्नेहैरुपस्नेह्य पुनस्तीक्ष्णैर्विरेच॥६॥
If the purgative recipe, is administered to a person who has undergone oleation and sudation therapies but not emesis therapy, or administered to a person who has symptoms of ama in the body or when bouts of purgation are very less, such persons develop severe heaviness of the lowerparts of the body, loss of movement of the abdomen, pain in the abdomen and obstruction to the movement of flatus, urine and faeces. Even in such conditions of inadequacy, the patient should be administered asthapana (decoction enema) using cows urine and strong drugs (for preparing decoctions), then made to eat food along with juice of meat of animals of desert-like regions; next treated with anuvasana (oil-enema) using oil processed with phala, daru and pippali; anointing the body with oil (processed with drugs) which subdues vata. After these therapies, he should be made to purge by administering strong drugs. (6)
कफोल्बणस्यातिस्निग्धस्य गुरुकोष्ठस्य मन्दाग्नेर्वा मृदुप्रणीतमौषधं भृशमुत्क्लेश्य दोषान् जाड्यतन्द्रादौर्बल्याङ्गसादान् जनयति । तच्छीघ्रमुल्लिखेत् । लङ्घनेन च सन्धुक्षिताग्निं पुनः स्निग्धं तीक्ष्णोष्णैर्विशोधयेत् ।।७॥
Medicines (purificatory recipes) administered to the perso who has increase of kapha, who has excess of oleation therapy, who has hard bowels (by constitution ), who has weak digestive activity, and recipe prepared by mild drugs greatly excite the doshas and produces lassitude, stupor, debility and weakness of the body. Then such recipes should be removed out of the body quickly. The digestive activity should be augmented by langhana (fasting), oleation therapy administered again and then purifications done by using drugs which possess penetrating and heat producing properties (strong and quick acting purgatives). (7)
सशेषान्नाय वात श्रेष्मवते रूक्षाय सोदावर्ताय मन्दाग्नये वा शीतं रूक्षं वा दत्तमौषधं भृशमाध्मानं करोति । तत्र मलसङ्गात् समुन्नह्यत्युदरमन्तः शूलं दृतिवत् पार्श्वयोरापूर्णता शिरः पृष्ठरुजा श्वासकासौ पायुबस्तिनिस्तोदश्च भवति । तमुदावर्तानाहहराभ्यङ्गस्वेदवर्तिदीपनचूर्णबस्तिक्रियाभिरुपचरेत् ।।८।।
Medicines administered to the person who has residue of food, (increase of) vata and slesma (kapha), dryness and upward movement of vata or weakness of digestion, the recipes being either cold or dry (non-unctous) produce severe flatulence. The abdomen becomes distended due to obstruction of the faeces, associated with pain internally, fullness of the sides of the abdomen like a bellow, pain in the head and back, dyspnoea, cough and pricking/piercing pain in the anus and bladder. Such a patient should be treated with oil massage, sudation, rectal suppositories, powders which increase hunger, enemas and such other therapies which relieve upward movement of vata and distention of the abdomen. (8)
Parikartika
क्षामेणाल्पबलेन मृदुकोष्ठाग्निना रूक्षेणास्निग्धेन वा स्विन्नेन सामेन वा बलवदौषधमुपयुक्तं सपित्तमनिलं प्रदूष्य परिकर्तिकामापादयति । तत्र नाभिबस्तिगुदमेढे सदाहपरिकर्तनमनिलसङ्गो विष्टभश्च ॥ ९ ॥
Powerful medicines administered to the person who is emaciated, of poor strength, of soft bowels, poor digestive activity, who is dry, who has not undergone oleation and sudation therapies or who has (symptoms of) ama in the body, cause vitiation (increase) of anila (vata) along with pitta and produces parikartika; in that condition there is piercing pain in the abdomen in the areas of the umbilicus, bladder, rectum and penis, associated with burning sensation, non-movement of flatus and long stasis of undigested food. (9)
तं कृष्णतिलमधुकमधुयुक्तैः पिच्छाबस्तिभिरास्थापयेत् । क्षीरिवृक्षशृतक्षीरेण वा । शीताम्बु – परिषिक्तं चैनंपयसा भुक्तवन्तंघृतमण्डेन यष्टीमधुकतैलेन वानुवासयेत् । क्षामस्य च मधुरोबृंहणश्च सर्वो विधिरिष्ट ॥१०॥
Such a patient should be administered a piccha basti (enema with slimy materials) with krsnatila,madhuka and madhu (honey), or with milk boiled with bark of trees yeilding milky sap. He should be given cold water bath, made to take his food along with milk, and then administered oil-enema, either with the scum of ghee or yastimadhuka taila. For the emaciated persons all regimen (foods, drinks etc ) which were sweet and stoutening are desirable. (10)
सामे लङ्घनदीपनं च लघुरूक्षोष्णं चान्नपानम् । निरामीभूतेऽनुबन्धे लघु क्षाराम्लम् । सवाते दधिसाराम्लं दाडिमत्वचा युक्तं भोजने पाने च प्रयुञ्जीत सदाडिमरसं च सर्पिः पिबेदुष्णाम्बुना वा तिलदेवदारुकल्कम् ।। ११ ।।
If symtoms of ama are present, fasting and drugs which increase hunger, and foods and drinks which are easily digestable, dry (non-unctous) hot (heat producing) should be administered; when he gets relieved of ama but the doshas are still persisting, foods and drink which are easily digestable, alkaline and sour should be given; if vata is associated, sour whey, mixed with the bark of dadima, be used with food and drinks, or juice of dadima mixed with ghee should be consumed or the paste of tila and devadaru along with warm water. (11)
Parisrava
क्रूरकोष्ठस्य बहुदोषस्याल्पमल्पगुणं मृदुस्निग्धं वा शोधनमवचारितमुत्क्लेश्य दोषान् न निर्हरति । अल्पाल्पं च पित्तकफसंसृष्टं परित्रवति । विष्टम्भगौरवशोफकण्डूपाण्डुताङ्गसादगुल्मशूलानि चापादयति ॥ १२ ॥
Purifactory recipe administered to the person who has difficult bowel movements, has profound (increase of ) doshas, the medicine being either small in dose of mild properties, soft and unctous, will only excite the (increase ) doshas, will not expel them out (in bulk), but eliminates them little by little (parisrava) mixed with pitta and kapha, and produces long stasis of food inside the abdomen, feeling of heaviness of the body, oedema, itching, yellowish-white, discolouration, weakness of the body, abdominal tumor and pain in the abdomen. (12)
तं तिनिशधवाश्वकर्णपलाशबलानियूहैर्मधुयुक्तैरास्थापयेत् । उपशान्तपरित्रवं च पुनरुपस्त्रिग्धं तीक्ष्णैः शोधयेत् । शुद्धे च दीपनांश्चूर्णासवारिष्टादीन् योजयेत् ||१३ ॥
He should given decoction enema therapy with the decoction of tinisa, dhava, asvakarna, palasa and bala mixed with honey; after the exudations stop he should be given mild oleation therapy and then strong purifactory recipes. After purifications powders, fermented infusion, fermented decoction etc, which promote hunger should be administred. (13)
Pravahika
पीतौषधो यदा वेगमुदीरयति निगृह्णाति वा । तदा प्रवाहिकास्य जायते । तस्यां सदाहशूलं सपिच्छं श्वेतं कृष्णं रक्तं वा भृशं प्रवाहमाण: कफमुपविशति । तं परित्रवविधिनोपचरेत् ॥ १४ ॥
When the person who has consumed the medicine either initiates the bouts (prematurly) or suppresses it by force, then he develops Pravahika (tenesmus). He will eliminate faeces with burning sensation and pain, which is slimy, white, black or red, mixed with kapha and only after great straining. He should be treated in the same way as treating parisrava (described in para 12). (14)
Hridgraha – hridayo pasarana
पीतौषधस्य भेषजोद्गारच्छर्द्यादीनां निग्रहाद्वातादयः कुपिता हृदयमुपसृत्य हृद्ग्रहं घोरमावहन्ति ।
ततः प्रधानमर्मोपतापाद्वेदनाभिरत्यर्थमातुरः पीड्यते ।
मोहहिधमाकासलालापार्श्वशूलयुतो वेपथुमान् नष्टसंज्ञो दन्तान् कटकटापयत्युद्वृत्ताक्षो जिह्वां खादति । तं हृदयोपसरणमाहुः ॥ १५ ॥
If the person who has consumed the medicine, suppresses the urge of belching of drug, vomiting, etc, vata and others ( doshas) get aggravated, invade and heart and produce severe Hrdgraha-sudden catching pain in the heart; then follow severe distress of the vital organ (heart), severe pain, etc which cause great suffering, delusion, hiccup, cough, salivation, pain in the flanks and rigors, he becomes unconscious, grinds the teeth,eyes are wide open and bulging out and he bites his tongue, this condition is named as Hrdayopasarana. (15)
तस्मै भिष्क शीघ्रममुह्यन्नभ्यङ्गपूर्वं धान्यस्वेदेन परिस्वेद्य तीक्ष्णमवपीडं दद्यात् । यष्टीमधुकमिश्रेणतण्डुलाम्बुना वमनम् । कटुभिर्वाकफोत्तराय । ततो दोषशेषं पाचनीयैः पाचयेद्यथादोषोच्छ्रयं चबस्तीन्वितरेत् ।।१६ ॥
For such a person, the physician without becoming nervous, should give oilmassage and then administer sudation therapy quickly, using grains, followed by avapida (nasal drops) with powerful drugs; make him vomit by administering rice-wash mixed with yastimadhuka; or if kapha is predominant, with drugs of pungent taste; the residual doshas made to undergo digestion by using digestive drugs and administration of enema therapy appropriate to the predominant doshas. (16)
अस्निग्धस्विन्नेनाब्रह्मचारिणा वेगधारिणा मृदुकोष्ठेन सुकुमारेण वा रूक्षमौषधमतिमात्रं
प्रयुक्तमतिविरेकाद्वायुं कोपयति । तेन सर्वांङ्गप्रग्रहो भवति । तस्य विशेषात् पार्श्वपृष्ठश्रोणिमन्यामर्मसु शूलमूर्च्छाभ्रमकम्पस्तम्भो निस्तोदो भेद उद्वेष्टनं संज्ञानाशश्च स्यात् । तमभ्यज्य धान्यैः स्वेदयित्वा यष्टीमधुकविपक्वेन तैलेनानुवासयेत् । वातहरंचान्नपानम् ।।१७।।
Medicines (purifctory recipes) administered to those who have not undergone oleation and sudation therapies, who do not observe chastity, (celebacy), who suppress the natural urges of the body, who have soft bowel movements or tender constitution, medicines which are dry (non-unctous) or administered in high doses, cause aggravation of vayu (vata) by producing too many purgations. There will be severe stiffness of all the parts of the body, especially pain in the flanks, back, pelvis, sides of the neck and vital spots, fainting, giddiness, tremors, rigidity, tingling, cutting and twitching pain and loss of consciousness. Such a patient should be given an oil massage, sudation by using grains and oil-enema using oil cooked with yastimadhuka. He should be provided with foods and drinks which subdue vata. (17)
Ativirechana
स्निग्धस्विन्नस्यातिमृदुकोष्ठस्य क्षुधितस्य वा तीक्ष्णमतिभूरि वा प्रयुक्तमौषधं सर्वशो निर्हत्य मलान् धातूनपि द्रवीकृत्य विस्त्रावयेदतियोगेन । तं शतधौतघृतेनाभ्यज्य कषायस्वादुशीतैः प्रदेहपरिषेकावगाहान्नपानैः शर्करामधुमद्भिश्च लेहैः स्तम्भयेत् ॥ १८ ॥
Medicine which are powerful, large in quantity and of high dose administered to persons who have undergone oleation and sudation therapies, who have of very soft bowel movements (by constitution) or when they are hungry, it expels out of all the doshas from all over the body, liquifies the tissues also and produces large number of purgations. Such a patient should be given a message with satadhauta ghrita. Application of paste, pouring liquids (decoctions) over the body and immersion of the body in liquids which are astringent, sweet and cold, given food also of the same properties, and confections mixed with sugar and honey; by these methods the purgations should be controlled. (18)
चन्दनाञ्जनोशीरच्छागासृक्शीतोदकैर्लाजसक्तून्पाययेत् । पिच्छाबस्तींश्चास्मै दद्यान्मधुरवर्गसिद्धं चक्षीरसर्पिः सर्पिर्मण्डोऽनुवासनम् । रक्तपित्तविधानं च कुर्यात् ॥ १९ ॥
He should be made to drink solution of flour of laja (fried paddy) processed with chandana, anjana, usira, blood of goat and cold water, administered piccha basti ( enema with slimy materials) and anuvasana (enema with fatty materials) with ghee or scum of ghee-all processed with drugs of madhura varga (chapter 18 of sutrasthana), and also other methods of treatment prescribed in bleeding disease. (19)
Ativamana
विशेषेण वमनातियोगे सघृतसिताक्षौद्रं फलरसैर्मन्थं पिबेत् । क्षीरिवृक्षशुङ्गसिद्धां वा समाक्षिकां पेयां क्षीरंवासंग्राहिद्रव्यसिद्धं च क्षीरं भोजनेऽवचारयेत् || २० ||
In case of excess vomiting, the person should especially drink mantha (thin paste of flour) mixed with ghee, sugar, honey and fruit juices or peya (gruel) or milk boiled with tender sprouts of trees yeilding milky sap, mixed with honey; for his food the milk prepared with drugs which cause absorption of water a should be used. (20)
Atiudgara
सोद्गारायां च छर्द्या धनिकामधूकमधुरसामुस्ताञ्जनांनि मधुना लिह्यात् । वाक्सङ्गे हनुसङ्गेऽनिलार्तौ च घृतमांसरससिद्धाणतण्डुलांपेयां पिबेत् । स्नेहस्वेदौ चावचारयेत् ||२१ ॥
If vomitings are associated with belching,then he should lick (the powder of) dhanika, madhuka, madhurasa, musta, anjana with honey; if there is loss of voice, stiffness of the lower jaw and pain due to vata, then peya (thin gruel) with ghee, meat juice, and very little of rice grains should be consumed; oleation and sudation therapies should be administered. (21)
जिह्वाप्रवेशेस्निग्धाम्ललवणान् कवलगण्डूषान् हृद्यांश्चाजमांसरसान् । पुरतश्चास्य फलान्यम्लानि खादयेत् ||२२||
If the tongue has gone in, the patient should be administered kavala (mouth gargle) and gandusa (filling the mouth with liquids) with liquids which are unctous, sour and salty, and juice of goats meat. Other persons sitting in front of this patient should eat sour fruits. ( 22 )
निर्गतां तु जिह्वां तिलद्राक्षाकल्कलिप्तां व्योषलवणचूर्णप्रघृष्टां वा प्रवेशयेत् । अक्षिणी व्यावृत्ते घृताभ्यक्ते पीडयेद्विसंज्ञंसामवेणुगीतशब्दान् श्रावयेत् ॥ २३ ॥
If the tongue has protuded out, it should be rubbed with a paste of tila, draksa, or with a powder of vyosa and lavana and pushed inside. If the eyes, are distorted, irregular, sunken or protruded they should be massaged with ghee. If the patient is unconscious, he should be made to hear chanting of Samaveda hymns, music from flute and sweet singing. ( 23 )
विरेचनातियोगे तण्डुलाम्भसा मधुमिश्रेण वमेत् प्रियङ्वादिं च तण्डुलोदकेन पिबेद्रोवरसाञ्जनदाडिमत्वचो वा । सोमवल्ककट्फलोत्पलसमङ्गापद्मकेसराणि वा । क्षौद्रशर्करामधुकौदुम्बरत्वचो वा । रक्तातिसारक्रियांचकुर्वीत ॥ २४॥
In case of excess of purgation, the patient should be made to drink rice-wash mixed with honey and made tovomit (by tickling the throat etc ), then drink rice-wash with powder of drugs of priyangvadi gana (chapter 16 of sutrasthana), or those of lodhra, rasanjana and bark of dadima; or with those of somavalka, katphala, utpala, samanga and padmakesara; or drink a mixture of sugar, madhuka, and bark of audumbara; also (administer) other therapies prescribed in bleeding diarrhoea. (24)
Gudabhramsa
गुदं निःसृतमभ्यज्य स्वेदयित्वा कषायैश्चस्तम्भयित्वा प्रवेशयेत् । पूर्ववच्च वाक्सङ्गादीन् साधयेत् ॥ २५ ॥
The rectum which has prolapsed should be anointed with fats, given fomentation,made to shrink by using astringent washes and then pushed inside.
Loss of voice etc should be treated as described earlier (in para 21 ). (25)
Jivarakta pariksa
उभयत्र च जीवरक्तपित्तयोर्ज्ञानार्थं रक्ते शुक्लं पिचुं प्लोतं वा क्षिपेत् । तस्मिन्नावाने कोष्णाम्बुक्षालितशुद्धे जीवरक्तम् ।
विवर्णे तु रक्तपित्तं विद्यात् । अन्नं वा तद्विमिश्रं शुने काकाय वा दद्यात् । तस्मिन् भुक्ते जीवं वदेदभुक्ते पित्तम् ॥ २६ ॥
In both the conditions (excess vomiting and purging) (if bleeding occurs), then in order to determine jivarakta (life sustaining pure blood) or rakta pitta (blood vitiated by pitta), a swab of cotton or piece of white cloth should be soaked in the blood, and washed in lukewarm water; if they become clean (without retaining any stain) then it is decided as jivarakta (pure blood) and if they are discoloured (retain in the stain) it is blood vitiated by pitta. Boiled rice mixed with blood should be given to either dogs or crows to eat, if they consume it then it should be decided as pure blood and if they do not, it is to be decided as pitta (blood vitiated by pitta). (26)
आमरणाच्च तस्य तृण्मूर्छामदार्तस्य क्रियां पित्तघ्नीमतियोगोक्तां च कुर्यात् । दिरुधिरं वातिस्स्रुतरक्तोक्तविधिना सक्षौद्रं शीघ्रमुपयुञ्जीत । तद्धि सद्यो जीवमभिसन्दधाति । श्यामाकाश्मर्यमधुकदूर्वोर्शीरैर्वा शृतं पयो घृतमण्डाञ्जनयुक्तं शीतं बस्तौ निषेचयेत् ॥२७॥
The patient suffering from (bleeding) thirst, unconsiousness and toxicity should be administered all the remedial measures which subdue pitta till his death. He should be made to drink the blood of the antelope etc, mixed with honey; and also all other therapies described in connection with severe haemorrhage (chapter 36 of sutrasthana), should be administered quickly; these measures help in maintaing life. Milk boiled with syama, kasmarya, madhuka, durva or usira mixed with scum of ghee and anjana made cold, should be introduced into the rectum (as decoction enema therapy). (27)
शेषेष्वपि चासम्यक्प्रयुक्तवमनविरेचनोपद्रवेषु यथामयं दोषादीनपेक्ष्य प्रतिकुर्याद्वस्तिव्यापसिद्धिंचेक्षेत |॥ २८ ॥
Even for others who have developed complications due to improper administration of emesis and purgation therapies, treatment should be done appropriate to the disease and the doshas etc and referring to the chapter basti vyapat siddhi (chapter 6 of kalpasthana) also (for any guidance needed). (28)
एवमुभयतोभागेऽपिशोधने यथावस्थमुत्तिष्ठेत । यातुविरेचने परिकर्तिका तद्वमने कण्ठक्षणनम् । यदधः परित्रवः स कफप्रसेको यदधःप्रवाहणं स शुष्कोद्गारइति । भवति चात्र ॥ २९ ॥
In this manner, attempts should be made to render appropriate treatments, at all stages of purificatory therapies of both directions. Parikartika (pricking pain in the alimentary tract) of the purgation therapy is similar to kanthaksanana of emesis therapy; the downward parisrava (lischarge of fluids etc) is similar to kapha praseka (excess salivation) the downwardpravahana (straining) is similar to suskodgara (dry belching).(29)
Some verses more –
अतिमात्रमकालेऽल्पंतु,ल्यवीर्यरभावितम् । असम्यक्संस्कृतं जीर्णं व्यापद्येतौषधंध्रुवम् ।।३०।।
छर्दनं न तु दुश्छर्दं दुर्विरेच्यं नरेचनम् । पाययेदौषधं भूयस्तनिहन्ति तथा हितौ ॥ ३१ ॥
Medicines (purifactory recipes) which is of large dose, administered at improper time, small in quantity (dose), not soaked in juices of identical potency,not properly processed and that which is old are sure to create complications.
Medicines (purifactory recipes) which produce emesis and purgation should not be administered again, to persons who are unfit for emesis and purgations (respectively), because both of these are going to kill ( such persons). ( 30-31)
यस्योध्वं कफसंसृष्टंपीतं यात्यानुलोमिकम् । वमितं कवलैः शुद्धं लङ्घितंपाययेत्तुतम् ॥ ३२ ॥
विबद्धेऽल्पे चिराद्दोषेत्रवत्युष्णं पिबेज्जलम् । तेनाध्मानं वमिस्तृष्णा विबन्धश्चाशुशाम्यति ||३३ ||
If medicines of downward movement (purgatives) comes out in upward direction (vomiting) mixed with kapha, then the mouth of the patient should be cleaned by kavala (mouth wash), he should be made to fast and then drink the recipe (purgative). If there happens to be mild obstruction to the movement or purgations occur in small quantities after a long time, then he should drink hot water. By that, flatulence, vomiting, thirst and obstruction of bowels subside quickly. (32-33)
भेषजं दोषरुद्धं चेन्नोर्ध्वं नाधः प्रवर्तते । सोद्गारं साङ्गशूलं वा स्वेदं तत्रावचारयेत् ॥ ३४ ॥
Medicines (purifactory recipes) obstructed by the doshas do not move either in upward direction nor in downward but cause belchings and pain in the body parts; then fomentations (sudation therapy) should be administered. ( 34 )
सम्यग्विरिक्तस्योद्गारे भेषजंक्षिप्रमुल्लिखेत् । अजीर्णमप्रवृत्तौ तु सुशीतैः स्तम्भयेद्भिषक् ॥ ३५ ॥
Even after satisfactory purgation therapy, if the patient gets belchings accompanied with the medicine, then that undigested medicine should be removed out (by emesis therapy) and if it does not come out it should be made inactive by resorting to cold regimen (drinking cold water, bathing in cold water etc). (35)
कदाचिच्छ्लेष्मणा रुद्धं तिष्ठत्युरसि भेषजम् । क्षीणे श्रेष्मणि सायाह्ने रात्रौ वा तत्प्रवर्तते ॥३६॥
Sometimes the medicines (purgative recipe) remains in the chest only being obstructed by kapha; when the kapha decreases (in quantity) the medicine (getting into the alimentary tract) produces purgations either in the evening or at night.(36)
रुक्षानाहारयोर्जीर्णे तिष्ठत्यूर्ध्वं गतेऽपि वा । वायुना भेषजे त्वन्यत् सस्त्रेहलवणं पिबेत् ॥३७॥
The medicine (purgative recipe) administered to a patient who is dry (not undergone oleation therapy) who has not taken any food,or if the medicine undergoes digestion (without producing purgations) of if expelled out in the upward direction by vayu (vata), then the medicines (purgatives) should be administered (once again on the same day) mixed with fats and salt.(37)
तृण्मोहभ्रममूर्छाद्याः स्युर्जीर्यति च भेषजे । पित्तघ्नं स्वादु शीतं च भेषजं तत्र शस्ते ॥ ३८ ॥
Thirst, delusion, giddiness, fainting etc develop if the medicine (purgative) undergoes digestion; then medicines which are sweet and cold in potency which subdue pitta are ideal. (38)
लालाहृल्लासविष्टम्भरोमहर्षाः कफावृते । भेषजं तत्र तीक्ष्णोष्णं कट्वादि कफनुद्धितम् ॥ ३९ ॥
Profuse salivation, oppression in the chest, long stasis of food in the alimentary tract and horripilations develop if the medicine (purgative) gets enveloped by kapha; the treatment for these is medicines possessing penetrating, heat producing and pungent properties which subdue kapha. (39)
Vyapat sankhya – Twelve complications
प्रतिकूला गति: पाको ग्रथितत्वं सगौरवम् । दोषोत्क्लेशो भृशाध्मानं परिकर्तः परित्रवः ॥ ४० ॥
प्रवाहिका हृद्ग्रहणं सर्वगात्रपरिग्रहः । सह धातुत्रवेणैता द्वादशोक्ताः ससाधनाः । . व्यापदो विधिविभ्रंशात्द्विविधेऽपि विरेचने । ॥४१ ।।
Pratikula gati (activity in opposite direction). Paka (digestion of medicine without producing the effect). Grathitatva – (solidifation of medicine). Gaurava – (feeling of heaviness of the body). Dosotklesa – (excitation of the doshas but not their expulsion). Adhmana – (severe flatulence). Parikartika – (pricking pain of the rectum, alimentary tract). Parisrava – (discharge of liquids, faeces etc). Pravahika – (tenesmus / straining at stools). Hrdgraha – (catching pain in the region of heart). Gatragraha – (catching pain all over the body) and Sadhatusravana – (evacuations mixed with the tissues of the body) these twelve complications arising from improper administration of the two kinds of purgations (emesis and purgation therapies) and also their treatments were described so far. (40-41)
उत्पद्यमानासु च तासु तासु व्यापत्सु संशोधनविभ्रमेण । दिशानयैवाशु यतेत सिद्ध्यै ज्योतिर्हि शास्त्रं नयदुर्नयानाम् ॥ ४२ ॥
The physician should strive to attain success in the treatment of complications arising from improper purifactory therapies, by following the above methods quickly; because in this difficult task of deciding the right path the science is only a guiding light. ( 42 )
।। इतितृतीयोऽध्यायः ।।
Thus ends the Third chapter.
