Complications of medicinal procedures
भेषजकर्मोपद्रव · उत्तरतंत्र
Opening line of chapter 22, whose running head names it the section on treating complications of medicinal procedures (भैषजकर्मोपद्रवचिकित्साधिकार). After the invocation it takes up the complications of oleation, sweating, emesis and purgation.
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Headings from the book in reading order. Open a topic for its summary and the knowledge it refers to.
Bowing to the Jina, honoured by all people, the author promises to set out by the authoritative method the well-known and serious disorders that arise when oleation, sweating, emesis and…
- Diseases from procedures such as oleation not done properlyस्नेहनादि कर्म यथावत् न होने से रोगों की उत्पत्तिPrinciplep. 495
During any procedure such as oleation or sweating, diseases arise when the physician's ignorance lets the procedure go wrong or out of sequence, or through the patient's lack of restraint…
Ghee drinking, when properly applied, is always a rasayana; the same ghee becomes a cause of many disorders when its use is deficient (ayoga) or excessive (atiyoga).
Opening line of chapter 22, whose running head names it the section on treating complications of medicinal procedures (भैषजकर्मोपद्रवचिकित्साधिकार). After the invocation it takes up the…
- Disorders from undigested ghee and their treatmentघृत के अजीर्ण जन्य रोग व उसकी चिकित्साConditionp. 496
If drunk ghee is not digested it produces anorexia, fever, prameha, insanity, kushtha and fainting. The patient is then given hot water with rock salt to drink, or the physician makes him…
After ghee drinking, the ghee is understood to be digested when the body feels light, appetite returns, the mind is clear, speech, urine, stool and flatus move properly, belching is clean…
Once the drunk ghee is digested, the person is given yavagu cooked with coriander and neem, or a yavagu prepared with drugs suited to the dosha, or light warm food with soups of horse gram,…
A person undergoing oleation drinks ghee or sesame oil, increasing the amount step by step, for three, five or seven days. Taken longer it becomes habituated (satmya), so it is not to be…
In pitta disorders ghee is drunk with sugar, in vata disorders with rock salt and hot water, and in kapha disorders mixed with trikatu and alkali (kshara); the commentary calls this the…
A strong, steady person burdened by hardship who wishes to undergo oleation should, in the cold season (hemanta and shishira), drink ghee alone; drinking plain ghee (accha, without sugar or…
The right amount of ghee is the amount that digests well by midday without causing mada, fatigue, languor, burning, fainting or loss of appetite; the commentary notes this measure is held…
Children, people of delicate constitution, the obese, the very weak, the thirsty, those who dislike ghee, those with anorexia or a burning body, and similar patients are given ghee mixed…
Preparations for quick oleation that remove dryness: ghee with long pepper, rock salt and whey (mastu); sugared ghee with milk; ghee mixed into a milk gruel with a little rice; sugared ghee…
For kings, the elderly, women, the weak, and people with much heat, mild digestive fire or few doshas, the physician should use the excellent quick-oleation preparations just described. A…
A dry person passes very dry, hard stool with great difficulty, does not digest food well, feels burning in the chest, has a discoloured body and an abdomen full of wind, is weak and has a…
Signs of proper oleation: stools that definitely carry oil, aversion to drinking ghee and to food, and languor of the limbs. The author then announces the signs of excessive oleation.
Signs of an over-oleated person: burning at the anus, excessive passing of stool (diarrhoea), anorexia, kapha coming from the mouth, dysentery (pravahika), burning of the limbs and fainting.
The over-oleated patient drinks dry ginger mixed in hot water and is promptly fed rice with mung soup; or he is given a gruel (yavagu) with ajamoda, chitraka and rock salt.
Ghee is a delightful rasayana for people; for those who drink it with care, hot water is always wholesome, and so is a warm gruel made with a little rice. Both are their pathya.
Having described the treatment of disorders from excessive oleation, the author turns to sweating and the disorders from its improper use. Sweating is almost always most beneficial for the…
Properly used (yoga), sweating destroys or pacifies many diseases; overdone (atiyoga), it produces many kinds of disease. Hence the correct method of sweating is described next.
Sweating is of four kinds: heat (tapa), steam (ushma), bandage or poultice (bandhana, upanaha) and liquid (drava). Tapa sweating warms the lying patient with heated cloth, palms and the…
Bandhana (upanaha) sweating is a poultice such as payasa cooked with heating drugs, covered with leaves or cloth and tied on. Drava sweating is seating the patient in a large vessel such as…
Heat and steam sweating chiefly pacify kapha, poultice sweating destroys vata, and liquid sweating suits vata or kapha mixed with raktapitta. Sweating helps only an oleated body, so it is…
The doshas that always dwell in the tissues, loosened by oleation and spread into the channels, become liquid through proper sweating and gradually reach the abdomen; expelled from there…
Sweating always increases the digestive fire and destroys great diseases of kapha and vata. Properly applied, it quickly brings on good sweating and the patient comes to desire cold things.
Sweating applied too intensely aggravates pitta and blood and quickly causes blisters, giddiness, mada, fever, burning and fainting; the skilled physician then applies very cooling measures.
Despite its printed heading, this verse gives after-care: a patient overcome by mada and burning whose body has been continually troubled by cold water drops is bathed with warm water and,…
Having described sweating, the author will now set out the great diseases that arise from excessive and wrong use (atiyoga, mithyayoga) of purification by emesis and purgation, their…
Depleted doshas are to be increased, agitated doshas pacified, doshas in their normal state protected, and greatly increased doshas expelled from the body at once by purification; this is…
In purification, emesis and purgation are the best-known means of removing doshas from the body, as the sages state in the authoritative texts; of the two, emesis is described first and in…
If the physician has decided to give emesis the next day, he should feed the patient well and promptly on the previous evening (with abhishyandi, mostly liquid food, as the commentary…
Those to be fed well beforehand, and so fit for emesis, are patients with strongly aggravated, abundant doshas, a sharp digestive fire, strength of mind and body, and a body seized by a…
In the moderate season (neither very cold nor very hot: the early rains, autumn and spring, per the commentary), on the morning after the meal, the physician gives emetic drugs in a proper…
For emesis, drugs that are foul-smelling, unpleasant to look at, ugly, disgusting and unaccustomed are to be used; for purgation, the opposite: pleasant, attractive drugs.
Children, the very old, those afraid of medicine, women and the very weak are given the auspicious emetic drug mixed with suitable liquids such as milk, gruel or buttermilk; their body is…
When the patient who has drunk the emetic begins to feel nausea and salivate, the physician seats him at once on a (knee-high) seat and, to bring on the urge, touches the inside of his…
Emesis has gone well when the drug, kapha and pitta come out in that order, the heart and chest feel cleansed, body and mind feel light, and the flow of kapha stops properly.
After proper emesis the kapha lodged in the head is quickly cleared with nasal drops, gargles, eye salve and fluids; the patient is bathed with hot water and, in the evening, fed suitable…
When emesis removes kapha, the diseases it caused perish, just as lotuses perish when a broken dam drains away the water they depend on. So the physician who knows the method should learn…
Purgation is especially beneficial for one who has first had emesis, so upward cleansing comes first and downward cleansing once the body is clean. If purgation is given without emesis,…
When a patient properly oleated, sweated and given emesis is to be purged the next day, he is fed beforehand (in the morning of the previous day, per the commentary) a small, unctuous,…
On the next day, before sunrise, the physician considers whether the previous day's food has been digested and examines the patient's digestive power and the soft or hard nature of the…
A soft bowel gets a mild dose, a hard (krura) bowel a sharp dose and a medium bowel a medium dose, as the experts have laid down. Once the purgative is taken, a coming urge must not be held…
After the purgative, flatus, urine, stool, pitta, the medicine and kapha come out in order; when the doshas have left and vata moves downward, purgation is proper. The well-cleansed person…
If the purged patient's fire has become weak, if he is strong and free of thirst, if much dosha remains or purgation was poor, he is not given yavagu that day. The benefits of proper emesis…
Purifying medicine is very sharp, hot, mobile (sara) and vikasi (the verse also seems to name subtlety), and by these it cleanses upward or downward. The emetic carries the unripe doshas…
A person with weak digestive fire (and a hard bowel) is given a sharp medicine after oleation; a sharp purgative in a soft bowel moves quickly but fails to clear all the doshas. Medicine…
In a weak person whose doshas are greatly increased and moving, they are removed little by little and repeatedly; slight moving doshas are pacified; ripe, moving doshas are removed…
If a person who has drunk much fat then takes an unctuous purgative such as purgative ghee, the doshas loosened from their seats become fixed again by the fat. Such a person should…
A physician who knows the kinds of bowel gives a fitting dosha-removing purifier to a patient whose bowel he knows, and a gentle, mild one where it is unknown. The best purifier is proven…
Fifteen complications (vyapad) of emesis and purgation are named, arising from errors of the physician, patient or attendant: the emetic going down or the purgative going up; medicine…
A purgative given to someone who has not had emesis and has abundant kapha and ama, or one that is very foul-smelling and disagreeable, or given in too large an amount, goes upward and is…
An emetic given to a very hungry person with a soft bowel and sharp digestive fire stays in the stomach, is digested and goes downward. The intended action fails and the doshas increase;…
When the whole dose cannot be drunk because of ama, the medicine's bad taste, its repulsive look and the like, the patient is first treated with measures that destroy ama and then given…
An unsuitable purifying medicine that has gone partly up and partly down and cannot remove the remaining doshas causes great disorders: fainting, vomiting, anorexia, thirst, impure…
- Residual medicine and digested medicine, and their treatmentसावशेष औषध व जीर्ण औषध का लक्षण व उसकी चिकित्साConditionp. 511
If medicine remains in the stomach while the doshas are slight and the patient weak, it is digested with pachana measures; if much dosha remains and is moving, the patient strong and…
- Scanty removal of doshas and vata colic, with treatmentअल्पदोषहरण, वातजशूल का लक्षण एवं उसकी चिकित्साConditionp. 511
Too small or weak an emetic does not remove all the doshas, causing headache, worsening of the disease and nausea, and a strong patient is made to vomit again; a purgative that fails causes…
In a dry person not prepared by oleation and sweating, a dry, weak or very small dose goes neither up nor down (ayoga); it stirs the doshas and causes bloating, seizure of the heart,…
People who habitually suppress the urge to pass stool are hard to purge: those around the king and servants (from fear), women (from shyness), merchants (from greed), the sensual and others…
Very sharp medicine given to someone thoroughly oleated and sweated with a very soft bowel causes atiyoga. Excessive emesis brings out too much pitta with exhaustion, loss of strength and…
Having dealt with complications such as protrusion of the tongue, the text gives the test for life-blood: blood that, smeared on a cloth and washed with hot water, does not wash out, and…
- Loss of life-blood, bloating and cutting pain, with treatmentजीवादान, आध्मान, परिकर्तिका लक्षण व उनकी चिकित्साConditionp. 517
If the purifying medicine brings out life-giving blood (jivadana), cooling treatment and cold, blood-stopping drugs are used. A dry purifier taken by someone with indigestion and much vata…
A small or mild purgative given to a person with a dry, hard bowel and many doshas cannot expel them and only stirs them up. The text says this brings weakness, loss of taste, fatigue and…
Parisrava is treated with the stopping (samgrahika) drugs mentioned before, such as nutmeg according to the commentary, and with the stopping asthapana enemas described later. The patient…
A very unctuous or very dry person who, after a purgative, strains forcibly when stool does not come, or holds back stool that is coming, passes white, red or black kapha with burning and…
Pravahika is treated with an asthapana enema of the parisrava drugs, purgation and warm water with fire-kindling drugs. Holding back the urges of an emetic or purgative causes…
In emesis, throat soreness (galakshati) takes the place of the anal parikartika of purgation, dripping of kapha (kaphapraseka) the place of downward discharge (parisrava), and dry belching…
An enema given properly according to the rules of the science brings many great and inconceivable benefits, while one given carelessly by an ignorant physician brings many harms.
- Undertaking to describe the treatment of enema complicationsबस्तिव्यापच्चिकित्सा वर्णन प्रतिज्ञाPrinciplep. 521
The indications and prohibitions of enema were stated earlier. Now the complications arising from faults of the nozzle, the bag, the insertion and the like are to be described with their…
- Treatment when the nozzle shakes or twists during insertionबस्तिप्रणिधान में चलितादि व्यापच्चिकित्साMethodp. 521
If the nozzle shakes, twists or goes in obliquely while being inserted, it wounds the anus. The physician treats it by the method for wounds and then applies fomentation to the anal region.
If the nozzle tilts upward, the drug with wind and froth is thrown upward at once and the groin region is injured. The patient is quickly warmed by sweating and given a niruha and then an…
If the nozzle tilts downward during application, the fluid falls too far downward and quickly burns the receptacle. An asthapana enema of milk, decoction of milky trees and licorice is then…
An oblique nozzle lets no fluid in and must be straightened; a very thick, rough nozzle injures the anus; a split one or one with the ring too near lets the fluid flow back; a ring too far…
A very thick and spread-out bag acts like a badly tied one and the drug does not reach properly; a weak bag bursts when pressed; a holed bag lets the fluid out quickly before it reaches its…
- Complications from faulty pressing of the enema and their treatmentपीडनदोषजन्य व्यापत्ति व उसकी चिकित्साMethodp. 523
Pressing too hard drives the fluid out through the mouth and nostrils; it is checked at once, sharp head and body purgatives are given, cold water is sprinkled and the fluid is carefully…
Too little oil in an enema does nothing, and too much drug quickly brings on pravahika, treated as pravahika. A very cold drug provokes vata disorders such as retention and bloating, a very…
- Complications from faulty posture during enema and their treatmentशय्यादोषजन्य व्यापत्ति व उसकी चिकित्साMethodp. 524
Lying with the head low during an enema gives faults like over-pressing and is treated the same way. Lying with the head raised fills the bladder with the ghee and oil and yellow, oily…
The causes, signs and treatment of ayoga and the other enema complications are announced next. Because this is the uttara tantra, matters not stated before or stated unclearly are also to…
An enema of very cold, weak or too little drug causes ayoga: it goes upward and does not come out, with severe bloating and pain, and a sharp enema with suitable purgation is given. A large…
An enema of very dry, very sharp, very hot or too salty drugs provokes vata with pitta and causes parikartika, a pulling or cutting pain over the whole anus, navel and bladder region.…
An enema of very sharp, sour and salty drugs causes the great disease parisrava, with marked weakness and bodily fatigue and a discharge of pitta.
A very sharp asthapana or anuvasana enema acts in excess and causes pravahika: while straining, the person passes much kapha that is red or blood-mixed and black, with burning and colic.
For both, a niruha of ghee and decoction of sweet drugs is given first, then an anuvasana of ghee or oil combined with slimy and cooling drugs, and the patient is fed with milk only.
If a very sharp enema is pressed in forcefully in a patient with aggravated vata, the provoked doshas go to the heart and attack it (hridayopasarana), bringing at once fainting, insanity,…
A niruha enema with cleansing drug groups that act against all three doshas is given, followed by an anuvasana enema.
- Angagraha and atiyoga after enema: signs and treatmentअंगग्रह, अतियोग लक्षण व चिकित्साConditionp. 527
In a person full of vata, dry by nature or lying improperly, an enema of weak drugs causes hard-to-cure angagraha (stiffness of the limbs) with fatigue, yawning, tremor and other vata…
When atiyoga increases, the life-blood (jivashonita) flows out in excess; the Jinas call this jivadana. It is treated by the method given for atiyoga of purgation.
The enema complications in their many varieties and their treatments have now been set out carefully. Although the enema procedure was described before, it will be described again in…
When seven days have passed after a good purgation and the patient has regained strength, the physician skilled in the science gives wholesome food and then the sneha (anuvasana) enema…
- Quantity of the oil enema and its prohibition on an empty stomachअनुवासन बस्ति की मात्रा व खाली पेट में बस्ति का निषेधMethodp. 528
The sneha for an anuvasana enema is half the measure of fluid given for niruha. It must never be given on an empty stomach, where it rises upward and causes faults, so the patient is first…
A physician should never give an anuvasana enema to one who has eaten very unctuous food, because sneha taken from both sides, by mouth and by the anus, causes fainting, thirst,…
Considering the patient's usual diet, he is fed with milk, khala and similar foods a quarter less than his usual measure, and then the anuvasana enema is given by the rule.
Anuvasana should not be given to a person whose body has not been cleansed: strong wastes block the passage and the potency of the oil spreads upward. The body must therefore be cleansed…
A person with a dry body and strongly aggravated doshas is given two, three or more anuvasana enemas with attention to the doshas; once the body has become unctuous, the physician weighs…
For a person whose body is made impure by strong wastes and afflicted by strong vata, the text says the anuvasana enema, being suited to pacifying the doshas, is to be given always, by…
The patient is first well oiled and bathed in warm water, then fed by the rule, and the anuvasana with rock salt and shatapushpa powder is given. He lies on his back with limbs spread for…
Given by the rule, the first oil enema oils the groin region, the second removes vata from the whole body, the third brings lustre, colour and strength, the fourth and fifth oil rasa and…
The text says a person who uses three hundred and twenty-four oil enemas by the rules becomes by his qualities like a second god, as attractive as an incomparable Kamadeva to the hearts,…
- Signs of a proper oil enema and its complicationsसम्यगनुवासित के लक्षण व स्नेह बस्ति के उपद्रवConditionp. 532
When the oil enema is given properly, the oil comes back out together with strong vata and stool. If a weak oil is given in small measure to one whose bowel has strong doshas, it is…
Oil overpowered by vata brings an astringent mouth, dryness, irregular fever and vata pains; by pitta, a pungent mouth, pitta fever and yellowness of body, stool and urine; by kapha, a…
Even a proper oil enema given to a patient who has eaten a full meal is overpowered by the food and does not come out, causing heart pain, breathlessness, cough, hoarseness, loss of taste,…
- Complications when the oil mixes with stool in an uncleansed bowelअशुद्धकोष्ठ के मल मिश्रित स्नेह के उपद्रवConditionp. 533
In a person whose bowel has not been cleansed by purgation and niruha, even a proper oil enema mixes with stool and does not come out, causing heaviness and colic in the colon, fatigue of…
If the nozzle is pressed with too much force, the oil rises too high, causing breathlessness, cough, loss of taste, much spitting, heaviness of the head and excessive sleep; the mouth…
- Complication of oil given to an unprepared bodyअसंस्कृतशरीरी को प्रयुक्त स्नेह का उपद्रवConditionp. 533
A weak, small or very mild oil enema given to one whose body has not been prepared by sweating, purgation and the like does not come back; the oil stays in the belly and causes heaviness,…
An oil enema in small measure given to a patient who ate very little, even if beneficial and properly given, does not come out at once and causes languor, distaste in the mouth, heaviness…
A very hot or very sharp oil enema with water and wind, given in excess, flows out very quickly and serves no purpose, so the anuvasana is given again properly. If the oil comes out within…
Thus the oil enema with its many kinds of complications and their proper treatments has been described. Next the niruha enema, though stated earlier, will be explained in detail.
When the physician is about to give an oil or niruha enema, the patient is quickly oiled and sweated and made to pass stool and urine. Then, in a windless house with the qualities described…
When, after a niruha, the fluid, stool, pitta, kapha and vata come out in order, the disease subsides and the body feels light, the niruha is to be understood as properly done.
Subsidence of the disease for which the enema was given, thorough cleansing of wastes, and contentment of the senses, self and mind are the signs of a proper oil enema and of a proper…
When aggravated vata has produced many disorders, comfortably warm niruha enemas of paste and decoction of vata-removing drugs with oil, ghee, rock salt and sour drugs are said to bring…
For disorders of aggravated pitta, a cold enema of the decoction of milky trees, lotus, blue water lily and the kakolyadi group, mixed with sugar, ghee and milk, is said to be beneficial. A…
A comfortably warm enema of the decoction and paste of aragvadha, kutaja, the three pungents and vacha, with alkaline water, cow urine and the salts beginning with rock salt, is said to…
Enemas prepared from liquids and pastes of cleansing drugs with oil and rock salt are called cleansing (shodhana) enemas and are suited to cleansing the body.
An enema of triphala decoction with pungent drugs, alkali and cow urine, a paste of the ushakadi group and salts is called a scraping (lekhana) enema, because it scrapes out the doshas of…
An enema of the decoction of nourishing drugs such as ashvagandha, shatavari and vajralata with a paste of sweet drugs and buffalo curd, milk and ghee is called a nourishing (brimhana)…
An enema of the decoction of milky trees, sweet drugs and cooling drugs, with a paste of the same drugs and sugar, sugarcane juice, milk and ghee, is called a pacifying (prashamana) enema,…
An enema of the decoction of uchchata (utangan) seeds, ikshuraka (talmakhana), gokshura, licorice, black gram and kapikacchu seeds, with their paste, ghee, sugar and milk, is called a…
Enemas prepared from water boiled with the slimy group, such as shleshmataka (lisoda), shalmali, vidari, jujube and nagabala, with ghee, milk and pastes, are called slimy (picchila) enemas.
An enema of the decoction and paste of priyangu, musta, hribera (sugandhavala), manjishtha and pishtaka, mixed with goat milk, is called a binding (samgrahika) enema, which checks the stool.
An oil enema of oil cooked a hundred times with the decoction and paste of bala (kharaiti), given to childless women and men who have been prepared by oleation, sweating, emesis and…
For kings, wealthy men who live like kings, the very old, children, delicate persons and women, who by nature cannot bear the enema procedures above, the jaggery-and-oil (gudatailika)…
While this jaggery-and-oil enema is used there is no restriction on food, drink, sleeping, sitting, sexual intercourse and the like; it can be given wherever and whenever wanted, and its…
Jaggery and sesame oil in equal parts with castor-root decoction, and a paste of vacha (jatila), long pepper, madanaphala and rock salt, make the enema called vasu-yuktaratha (yuktaratha).…
A paste of devadaru, shatapushpa, rasna, asafoetida and rock salt with jaggery, sesame (oil) and castor-root decoction, given as an enema, is said to destroy severe colic; it is called the…
An enema of the decoction of jujube, barley and horse gram with a paste of long pepper, licorice and rock salt, mixed with old jaggery and sesame oil, is called the siddha enema and is said…
A niruha in which jaggery and oil are put in equal measure is called gudatailika; combined with a decoction of castor root it is said to remove all severe doshas. A footnote says the…
Enemas of old jaggery and sesame oil in equal measure with the stated liquid and various drugs, which remove various doshas, are to be given properly many times. The physician may use these…
- Closing verse and colophon of chapter 22इत्युग्रादित्याचार्यविरचिते कल्याणकारके भेषजकर्मोपद्रवनाम द्वितीयोऽध्यायः आदितो द्वाविंशः परिच्छेदःOtherp. 540
The closing verse calls the work a drop drawn from the great ocean of scripture that came from the mouth of the Jina, full of waves of all substances, with two shining shores that are the…