The principal maxims to be followed are to augment the loss or deficiency, to pacify the aggravation and reduce the increment of the Doshas and maintain them in a state of healthy equilibrium. Emetics and purgatives are the principal remedies in cleansing the system of all the Doshas (morbific principles). Now hear me, therefore, discourse on the mode of their administration. 2.
The body of the patient should be first anointed with a Sneha (oil, etc.) and Sveda should then be applied thereto. He should then be made to partake of meals which would produce internal secretions from the system, so that all the Doshas (morbific diathesis, etc.) accumulated in the organism would be loosened and dislodged from their seats. Thus having observed the liquefaction and dislodgment of the Doshas (morbific diathesis) from their locations, the physician should feed the patient to his satisfaction, if he be found to be sufficiently strong with a strong digestive capacity and habituated to the use of emetics, but troubled with a plethora of Doshas and subject to serious diseases (Mahá-vyádhi), telling him at the same time that an emetic medicine will be given to him on the day following. 3.
Memorable Verse I - An emetic medicine does its fullest action, when given to a man after having applied a Sneha and Sveda (to him) and after having stirred up the Doshas of his body with the help of a soft mucilaginous (Kapha-producing) * fluid and emollient food so as to accelerate their easy expulsion from the system 4.
On the next morning, when it is neither too hot nor too cold † the patient should be made to vomit with an adequate dose of an emetic in any of the following forms, viz., powder, parte, decoction, (medicated) oil or Ghrita as the case may be. Such things as have a fetid or an obnoxious smell or sight should be used for emetic purposes having regard to the characteristic nature of the patient's stomach (Koshtha), the contrary being the rule in respect of the use of purgatives. 5.
Infants, old men, weak and timid persons as well as those who are of a delicate constitution should be first made to drink their full of milk, curd, milk-curd (Takra) or a gruel (Yavágu) ‡, in diseases amenable to emetics and in such quantities that the patient feels it rising up to the throat. After the emetic has been administred, the body of the patient should be (gently) fomented for a short time with the heated palms of the hands and the effect (of the emetic observed.) The dislodgment and passing of the Doshas from their respective seats into the Kukshi (stomach?) should
be inferred from the flow of perspiration (Sveda) that would ensue. The patient should then be made to sit on a seat as high as his knees and as soon as he would feel the least tendency to vomit, the attendants should be told to catch hold of his waist, sides, back, throat and forehead. Then a finger or the stem of (a leaf of) a castor plant or of a lotus should be inserted down his throat and the patient should be made to fully eject the contents of his stomach until the symptoms of satisfactory vomiting would fully appear. 6.
* Vrinda reads in place ofbut they would ultimately mean almost the same thing.
† Dallana says that some explains to mean "in the proper seasons, viz., the rainy season, the Autumn and the Spring."
The symptoms of an imperfect emesis are water-brash (Kaphapraseka), sticking secretion or sensation of impurity in the regions of the Hridaya (heart) and itching sensations. An excessive discharge of the Pitta, the loss of consciousness, pains in the throat and in the region of the heart are the features which mark excessive or over-vomiting. The indications which characterise the perfect and satisfactory action of an emetic remedy are the free emission of Pitta after that of Kapha, a light and pleasing sensation in the heart, the throat and the head, a lightness of the body and the complete cessation of the emission of Kapha (mucus). 7.
Thus having observed the symptoms of a satisfactory emesis, the patient should be advised to inhale the fumes (Dhuma) of a (burning) drug of either the Snehana, Vairechana or Sámana (soothing) virtues in such doses as he could conveniently take and to observe the proper regimen of diet and conduct. 8.
Then having washed his body with tepid water and having perceived him to be in a pure state of mind and body the patient should be advised to take his evening meal with the soup of Kulattha or of Mudga or of Adhaki or with the soup of the flesh of any Jángala animal. * A person treated with emetics (at regular intervals) by cough, accumulation of Kapha in the throat, loss of voice, somnolence, drowsiness, fetid smell in the mouth, evil effects of poisoning (other supervening distresses of Kapha - D. R.), water-brash and lienteric diarrhoea (Grahani). The (accumulated) Kapha of the system having been ejected by vomiting under a course of emetic treatment, the possibility of all Kapha-origined affections is removed, just as a felled tree soon dries up together with all its twigs, fruits and flowers. 9-10.