Astanga Hrudaya

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अस्निग्धस्विन्नदेहस्य गुरुकोष्ठस्य योजितः। शीतोऽल्पस्नेहलवणद्रव्यमात्रो घनोऽपि वा॥१॥

If an enema is administered to a person whose body has not undergone proper unctuousness (asnigdha) and sudation (asvinna) therapies, or who has a sluggish, heavy digestive tract (guru-koṣṭha), and the enema fluid itself is cold (śīta), contains insufficient amounts of fats, rock salt, and medicinal herbs (alpa-sneha-lavaṇa-dravya-mātra), or is excessively thick in consistency (ghanaḥ), it triggers complications.

english translation

asnigdhasvinnadehasya gurukoSThasya yojitaH। zIto'lpasnehalavaNadravyamAtro ghano'pi vA॥1॥

hk transliteration by Sanscript

बस्तिः सङ्क्षोभ्य तं दोषं दुर्बलत्वादनिर्हरन्। करोत्ययोगं तेन स्याद्वातमूत्रशकृदग्रहः॥२॥

Such an enema lediglich agitates the morbid doṣas (saṅkṣobhya taṃ doṣam) but, due to its deficient potency and lack of strength (durbalatvāt), fails to expel them out (aniharan). This results in ayoga (incomplete or failed evacuation of the enema), which subsequently causes the retention and non-expulsion of flatus, urine, and feces (vāta-mūtra-śakṛd-grahaḥ).

english translation

bastiH saGkSobhya taM doSaM durbalatvAdanirharan। karotyayogaM tena syAdvAtamUtrazakRdagrahaH॥2॥

hk transliteration by Sanscript

नाभिबस्तिरुजा दाहो हृल्लेपः श्वयथुर्गुदे। कण्डूर्गण्डानि वैवर्ण्यमरतिर्वह्निमार्दवम्॥३॥

This state of ayoga leads to acute pain in the regions of the umbilicus and urinary bladder (nābhi-basti-rujā), systemic burning sensations (dāha), a feeling as though the cardiac region is coated or heavily oppressed (hṛd-lepa), swelling in the rectum and anus (śvayathur-gude), localized itching (kaṇḍū), the eruption of inflammatory nodules or boils (gaṇḍāni), skin discoloration (vaivarṇya), profound restlessness (arati), and a severe suppression or weakening of the digestive fire (vahni-mārdavam).

english translation

nAbhibastirujA dAho hRllepaH zvayathurgude। kaNDUrgaNDAni vaivarNyamaratirvahnimArdavam॥3॥

hk transliteration by Sanscript

क्वाथद्वयं प्राग्विहितं मध्यदोषेऽतिसारिणि। उष्णस्य तस्मादेकस्य तत्र पानं प्रशस्यते॥४॥

To treat this complication, it is highly recommended (praśasyate) to orally administer one of the two therapeutic decoctions previously detailed for managing diarrhea associated with a moderate aggregation of doṣas (madhya-doṣe-'tisāriṇi). The selected decoction must be consumed comfortably warm (uṣṇasya pānam).

english translation

kvAthadvayaM prAgvihitaM madhyadoSe'tisAriNi। uSNasya tasmAdekasya tatra pAnaM prazasyate॥4॥

hk transliteration by Sanscript

फलवर्त्यस्तथा स्वेदाः कालं ज्ञात्वा विरेचनम्। बिल्वमूलत्रिवृद्दारुयवकोलकुलत्थवान्॥५॥

Furthermore, the physician should deploy medicated rectal suppositories prepared from irritating fruits (phala-vartyaḥ), administer appropriate sudation/fomentation therapies (svedāḥ), and, carefully assessing the clinical timing and strength of the patient (kālaṃ jñātvā), induce therapeutic purgation (virecanam). Following this, a corrective enema should be prepared using a decoction of bilva-mūla (roots of Aegle marmelos), trivṛt (Operculina turpethum), devadāru (Cedrus deodara), yava (barley), kola (jujube), and kulattha (horse gram).

english translation

phalavartyastathA svedAH kAlaM jJAtvA virecanam। bilvamUlatrivRddAruyavakolakulatthavAn॥5॥

hk transliteration by Sanscript