Of all emetic fruits the Madana (seeds) should be deemed as the best (most active). Madana fruits should be dried in the sun and powdered. Then a Pala weight (eight tolas) of the powder should be stirred in a decoction of Pratyakpushpi, Sada-Pushpi, or Nimva, and given to the patient with honey and Saindhava salt, for emesis. As an alternative, a potion consisting of the powders of raw Madana fruits, stirred in a decoction of Vakula and Ramyaka, and heated in fire, should be' administered with the addition of honey and rock-salt. A gruel, consisting of sesamum rice and powders of green Madana fruits, boiled together, should be given to the patient. Likewise matured though not ripe Madana fruits should be stored in a box made of the blades of Kusha grass. The box should be plastered over with a composition of cowdung and clay and kept buried in a bushelful of Yava, Tusha, Mudga, Masha pulse or Shali rice for eight consecutive nights. Then having extracted them, fully burst out, with the heat of the covering grain, their kernels should be separated from their seeds and dried in the sun. Then having pasted them with curd, honey and the levigated paste of sesamum they should be again dried in the sun, after which they should be kept in a clean vessel. A Pala weight of the aforesaid prepared powder should be pounded in a decoction of Yastimadhu or of any of the drugs of the Kovidaradi group over night, and given to the patient on the following morning, through the medium of honey and Saindhava salt. The patient should take it looking towards the north or the east, and the following benedictory Mantra should be recited on the occasion.

Metrical Texts

"May the gods Bramha, Daksha, Ashvis, Rudra, Indra, the earth goddess, the moon, the sun, the fire, the wind, the concourse of holy sages (Rishis) and the material elements with the curative properties of drugs they originate and nourish, preserve thee. May the potion prove wholesome to you, as the elixirs prove wholesome to the Rishis, the nectar to the gods, and ambrosia to the good Nagas."

This emetic medicine should be specially employed in cases of catarrhal fever, catarrh, and internal abscess. In case of insufficient or unsatisfactory action of the potion, the drugs known as Pippali, Vacha, and a paste of Gaura-Sarsapa and Saindhava salt should be added to it. It should be administered warm and in repeated doses until the symptoms of emesis would fully appear. In the alternative, powders of Madana kernels soaked in and saturated with their decoction and subsequently dried, should be administered through the same vehicle (decoction of the Madana kernels); or milk cream boiled with the kernels of Madana fruits should be administered with honey; or a barley gruel made with milk prepared as above should be prescribed for the purpose. This emetic measure should be resorted to in cases of Haematemesis or in Haemorrhage from the bowels or generative organs and burning sensation in the heart due to the action of the deranged Pittam.

Milk, boiled with the kernel of a Madana fruit, should be curdled, and the cream of the curd or the curd itself so prepared should be used for emetic purposes in cases of water-brash, vomiting, syncope and dyspnoea. The essence (Rasam) of the seed pulps of Madana fruits should be pressed out and condensed in the manner indicated in connection with the extraction of oil (Sneha) of Bhallataka, and the patient should be made to lick that condensed essence in cases where the Pittam would be found to have shifted into the natural seats of Kapham. Sun-dried and pulverised Madana fruits, mixed with a decoction of Jivanti, may be administered in its stead.

A decoction of the kernels of Madan seeds (Majja), saturated with powders of Pippali, Yadi or a potion consisting of the same powder mixed with a decoction of Nimva or Rupika, should be prescribed in cases of lymphatic (Kaphaja) diseases due to acts of Santarpanam (use of emollient remedies), or the emesis in such cases should be effected with a decoction of Madhukam, Kashmari and Draksha saturated with the aforesaid powder. Thus the emetic remedies made of Madana fruits are discharged.

Pulverised Jimutaka flowers may be used in the same manner and through the same medium or with the same adjuvants and for same purposes, as the preceding (Madana fruit). Jimutaka fruits should be pulverised in their raw or unripe state and dried in the sun, and a gruel made with milk boiled with the same powder should be given to a patient for emesis; or milk-cream, boiled with the powder of Jimutaka fruits (lit: - flowers *) powdered in their mature or hardened (Romesha) state, should be given; or the surface cream of milk boiled with the powders of full grown (Aromasha), greenish yellow Jimutaka fruits, or a Sura (wine) made of their decoction should be prescribed. These emetic remedies should be used in cases of disinclination for food through the action of deranged Kapham (lymphatic derangements), cough, dyspnoea, jaundice and in phthisis as well, like the compounds of Madana fruits described before. Mature Kutaja or Kritavedhana fruits may be used for emetic purposes in similar combinations and through similar mediums as the Madana fruits described before. Powders of Ikshaku fruits (Kushuma), similarly prepared with milk, curd, etc., may be used for emetic purposes in cases of cough, asthma, vomiting and non-relish for food due to the action of deranged Kapham (lymphatic disorders).

* Fruits include flowers.

The emetic compounds of Dhamargava flowers are identical with those of the kernels of Madana fruits, the former being regarded as specifically indicated in cases of chemical poisoning, Gulma (internal gland), abdominal dropsy, cough, asthma, as well as in diseases due to the action of deranged Kapham (lymphatic disorders). The pulps or kernels of Kritavedhana seeds should be soaked in the expressed juice of emetic drugs and subsequently reduced to powder. The powder, so prepared, should be strewn over an Utpala or any other flower and the patients should be made to smell it in the case where the Kapham would be found to have changed its seat with the bodily Vayu. Likewise, in cases of excessive derangement of the bodily humours, the patient should be given a stomachful of barley gruel and then made to eject the contents of his stomach by causing him to smell such a medicated flower. Sternutatoric (Shiro-virechanam) or emetic or purgative drugs prove most efficacious after being soaked in or saturated with the expressed juice of their own.

Authoritative Verses On The Subject

Thus a general outline of the leading characteristics of the emetic drugs in general has been given. An intelligent physician should choose an emetic remedy in consideration of the season of the year and the strength of the disease, and should try to set in the process of ejection in a patient either with the help of the expressed juice, paste or powder of the prescribed drug duly administered through the medium of an article of food or drink, or through an electuary.

Thus ends the forty-third Chapter of the Sutrasthanam in the Sushruta Samhita which deals with the choice and mode of administering emetics.