तानेव जनयेद्रोगानयोगः सर्व एव सः| विज्ञाय मतिमांस्तत्र यथोक्तां कारयेत् क्रियाम्||४१||
Because of the above mentioned causes, the earlier mentioned conditions like vibhramsha will happen. These come under ayoga. The intelligent physician must understand the same and treat accordingly.
निरूढं च रसैर्धान्वैर्भोजयित्वाऽनुवासयेत्| फलमागधिकादारुसिद्धतैलेन मात्रया||४३||
Here the taila (oil) processed with lavana (salt) has to be applied and made to undergo prastara and sankara kind of sudation. Once the medicine for vamana or virechana must be administered again or else kashaya basti (decoction enema) with cow’s urine has to be done.
निरूढं च रसैर्धान्वैर्भोजयित्वाऽनुवासयेत्| फलमागधिकादारुसिद्धतैलेन मात्रया||४३||
After the administration of kashaya basti, food with meats of animals of arid regions (jangala mamsa rasa) should be taken and should be followed by administration of sneha basti (oil enema).
स्निग्धं वातहरैः स्नेहैः पुनस्तीक्ष्णेन शोधयेत्| न चातितीक्ष्णेन ततो ह्यतियोगस्तु जायते||४४||
Sneha basti can be done by oil processed with madana (Randia dumetorum), pippali (Piper longum), devadaru (Cedrus deodara), in proper dose. Once adequate oleation happens, elimination must be done with a recipe containing teekshna drugs. However, the medicines that are ati-teekshna should not be given, as it may result in atiyoga.
[Signs of excess elimination and management] When a patient who is with mridukoshtha, who is affected with hunger, is provided with an exceedingly strong vamana or virechana, it results in the quick elimination of not only the faecal matter, pitta and kapha, but also the drava-dhatu (liquid content of the body).