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बहुदोषः संशोध्यः कुष्ठी बहुशोऽनुरक्षता प्राणान्। दोषे ह्यतिमात्रहृते वायुर्हन्यादबलमाशु ॥४१॥
Patients with excessive vitiated dosha should be given shodhana therapy repeatedly; taking care about their prana (strength). Excessive elimination of dosha may increase vata dosha which may bring about weakness and in rare condition endanger the life of patient.
english translation
स्नेहस्य पानमिष्टं शुद्धे कोष्ठे प्रवाहिते रक्ते। वायुर्हि शुद्धकोष्ठं कुष्ठिनमबलं विशति शीघ्रम् ॥४२॥
After shodhana and letting of blood, sneha should be administered since after shodhana, vata dosha enters the shuddha koshtha of patient and is cause for immediate bala kshaya.
english translation
दोषोत्क्लिष्टे हृदये वाम्यः कुष्ठेषु चोर्ध्वभागेषु। कुटजफलमदनमधुकैः सपटोलैर्निम्बरसयुक्तैः ॥४३॥
[Various formulations] If dosha are utklishta and located in hridaya or kushtha is manifested in the upper part of body, then vamana should be administered with help of fruit of kuthaja, madanaphala and madhuka along with juice of patola and nimba.
english translation
शीतरसः पक्वरसो मधूनि मधुकं च वमनानि। कुष्ठेषु त्रिवृता दन्ती त्रिफला च विरेचने शस्ता ॥४४॥
Sheeta rasa (cold effusion), pakva rasa(decoction), honey and madhuka should be used for vamana. Trivrita, danti and triphala are to be used for virechana in kushtha.
english translation
सौवीरकं तुषोदकमालोडनमासवाश्च सीधूनि। शंसन्त्यधोहराणां यथाविरेकं क्रमश्चेष्टः ॥४५॥
Sauviraka, tushodaka, alodhana, asava, sidhu are types of aushadi kalpana to be used in virechana. Further sansarjana karma should be followed as per order.
english translation