Astanga Hrudaya

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तस्मै स्निग्धाम्ललवणान् दद्यात्पित्तकफेऽन्यथा । पीतौषधस्य वेगानां निग्रहेण कफेन वा ॥ २१ ॥

the physician should administer formulations that are unctuous (snigdha), sour (amla), and salty (lavaṇa) in taste. Conversely, if the condition is driven by Pitta and Kapha, therapies possessing opposite properties (dry, sweet, bitter, or cold) should be provided. If, after consuming the medicine, the natural urges are forcefully suppressed, or if the channels are obstructed by an accumulation of Kapha,

english translation

tasmai snigdhAmlalavaNAn dadyAtpittakaphe'nyathA । pItauSadhasya vegAnAM nigraheNa kaphena vA ॥ 21 ॥

hk transliteration by Sanscript

रुद्धोऽति वा विशुद्धस्य गृह्णात्यङ्गानि मारुतः । स्तम्भवेपथुनिस्तोदसादोद्वेष्टार्तिभेदनैः ॥ २२ ॥

or if the patient has undergone excessive purification (ati-viśuddha), the highly aggravated Vata seizes and afflicts the body parts (gṛhṇāty-aṅgāni mārutaḥ). This manifests as stiffness (stambha), tremors (vepathu), constant pricking pain (nistoda), debility/fatigue (sāda), twisting cramps (udveṣṭa), general distress, and cutting/breaking pain (bhedana).

english translation

ruddho'ti vA vizuddhasya gRhNAtyaGgAni mArutaH । stambhavepathunistodasAdodveSTArtibhedanaiH ॥ 22 ॥

hk transliteration by Sanscript

तत्र वातहरं सर्वं स्नेहस्वेदादि शस्यते । बहुतीक्ष्णं क्षुधार्तस्य मृदुकोष्ठस्य भेषजम् ॥ २३ ॥

In this critical condition, all modalities that mitigate and balance Vata—such as oleation (sneha), sudation (sweda), and similar pacifying procedures—are highly recommended. If a highly potent or sharp (bahu-tīkṣṇa) medicine is administered to an individual who is afflicted with hunger (kṣudhārta) or who possesses soft bowels (mṛdu-koṣṭha), [it results in excessive elimination/hyper-purification (ati-yoga)].

english translation

tatra vAtaharaM sarvaM snehasvedAdi zasyate । bahutIkSNaM kSudhArtasya mRdukoSThasya bheSajam ॥ 23 ॥

hk transliteration by Sanscript

हृत्वाऽऽशु विट्पित्तकफान् धातूनास्रावयेद्द्रवान्। तत्रातियोगे मधुरैः शेषमौषधमुल्लिखेत्॥२४॥

it quickly expels the feces, Pitta, and Kapha, and then proceeds to deplete and drain the fluid components of the vital bodily tissues (dhātūn-āsrāvayed-dravān). In such a state of excessive administration (atiyoga), the remaining residual medicine should be brought out through vomiting induced by sweet (madhura) substances.

english translation

hRtvA''zu viTpittakaphAn dhAtUnAsrAvayeddravAn। tatrAtiyoge madhuraiH zeSamauSadhamullikhet॥24॥

hk transliteration by Sanscript

योज्योऽतिवमने रेको विरेके वमनं मृदु । परिषेकावगाहाद्यैः सुशीतैः स्तम्भयेच्च तम् ॥ २५ ॥

If there is excessive vomiting (ati-vamana), a mild purgation (reka) should be administered; if there is excessive purgation (ati-vireka), a mild emetic (vamana) should be given. Furthermore, the hyper-elimination should be checked and restrained (stambhayet) using intensely cold showers (pariṣeka), cold baths/immersions (avagāha), and other cooling measures.

english translation

yojyo'tivamane reko vireke vamanaM mRdu । pariSekAvagAhAdyaiH suzItaiH stambhayecca tam ॥ 25 ॥

hk transliteration by Sanscript