A displacement or retroversion of the pipe during the application of a Vasti produces a painful and bleeding ulcer in the rectum, which should be treated as a recent or incidental ulcer. An extremely up-turned or down-turned posture of the pipe at the time gives rise to a pain in the rectum which should be treated with Pitta-subduing remedies and sprinkled with Snehas (oil, clarified butter, etc.) A slanting or one-sided posture of the pipe after its introduction into the rectum causes its mouth to be closed and thus prevents a complete and satisfactory injection of the fluid (into the bowels). Hence its mouth should be held straight (and steady) by an experienced physician. The use of an excessively thick or rough pipe or of one with a down-turned or bent mouth, produces a bleeding and painful ulcer in the rectum which should be remedied in the manner mentioned above. The injection of a Vasti proves abortive in the event of the Karnika (attached to the pipe) being too near the end of the pipe or itself being broken or too small. These defects should, therefore, be carefully avoided. In a case of the Karniká (attached to the pipe) being at a greater distance from the mouth of the pipe, it would hurt the Guda marma(marma at the anus) and produce a considerable bleeding therefrom. Pitta-subduing remedies and Pichchhila-Vastis should be employed in such a case. The application of a Vasti with a pipe of small length or narrow calibre produces pain, and the injected fluid dribbles out (without entering into the rectum), thus occasioning alt the maladies * which attend an insufficient or abortive use of a Vasti †. In the event of the pipe being large and wide-calibred one, the result would be that a large quantity of the fluid would be at once injected into the bowels just as in a case of Avapida-dosha (constant pressing). 2.
The effects which result from the use of a bladder (Vasti) too large or too thick are identical with those which follow from an imperfect fitting of its neck with the pipe. A (proportionately) smaller efficacy is obtained from the use of a small bladder capable (necessarily) of injecting a smaller quantity of the medicinal fluid. An imperfectly fixed bladder or the one with small pores therein produces effects similar to those resulting from the use of a cracked pipe. 3.
An injection made with considerable force by a Vasti (Enema-syringe) enters the stomach (Ámásaya) which being forced higher up by the up-coursing Vayu in the organism is emitted through the mouth and the nostrils. ‡ Under the circumstances, the patient should be immediately pressed by the neck and (his body) shaken. Strong purgatives and errhines should be administered, and sprinkling him with cold water should be prescribed. If a Vasti be applied with lesser force, the medicinal fluid of the Vasti cannot reach the intestines (Pakvásaya) and (consequently fails to produce the desired effect Hence it should be duly pressed. If it be pressed at intervals, the wind (Váyu) in the abdomen becomes enraged, and gives rise to tympanites (Ádhmana,) and excruciating pain therein. The medicinal treatment in such a case should be the ap plications of proper Vastis in consideration of the nature of the aggravated Doshas involved therein If the pipe be retained for an (unnecessarily) long time in the rectum during the application of a Vasti, it tends to increase the pain, and bring about an aggravation of the disease. This should be remedied by a second application of the Vasti charged with proper antidotal solutions sufficient to cope with the intensity of the disease. 4.
* These are strangury (Mutra-krichchhra), suppression of urine (Mutrá-ghata), etc.
† According to Dallana the remedy in this case would be that applicable in a case of Mutraghta, etc.; but Jejjata holds that the remedy lies in applying a Pichchhila Vasti as in the preceding case.
‡ An additional reading says that it causes vomiting, nausea, epileptic fits and a burning sensation of the body. Vrinda supports this additional reading.
The use of an insufficiently cooked Sneha (in a Vasti) leaves a slimy sticky deposit on the inner lining of the rectum accompanied by a local swelling which should be remedied by the application of a Sams'odhana-vasti and the exhibition of purgatives. * The application of a Vasti of either kind (Ásthapana and Anuvásana) charged with a deficient or inadequate quantity of a medicinal solution, proves abortive in all instances; whereas diarrhoea (Atisára), fatigue and Anáha (distension of the abdomen with the retention of stool, urine, etc.) result from the application of one charged with an excessive quantity of the fluid. The application of a Vasti charged with an extremely warm or strong solution produces epileptic fits, a burning sensation, diarrhoea and (an aggravated condition of the Pitta. The use of any extremely cold or mild medicine for the purpose of a Vasti arrests the emission of the flatus (Váyu) and produces Ádhmána (distension of the abdomen). * Antidotal measures should be adopted in cases of the deficient or excessive quantity, etc The fluid to be used in charging a Vasti should be thickened in the event of its extremely attenuated consistency and vice versa. The application of a Vasti charged with a fluid consisting of an excessive quantity of Sneha would produce a general inertness of the organism, (dulluess of organic functions), while one entirely bereft of any Sneha would produce numbness of the organism and a distension of the abdomen. The remedy in either case consists in employing a Vasti of the opposite kind (viz., an oily or non-oily Vasti respectively). 5.
* Gayadása reals and recommends that the purgatives to be used in such a case should be devoid of any oleaginous substances (Sneha).
The application of a Vasti to a patient with his head downward is attended with symptoms peculiar to an act of over-pressing (the bladder of the Vasti), and the remedy also would be similar. The application of a Vasti to a patient with his head held up high and erect would block the urethra, i.e., would suppress the urine, in which case the patient should be treated first with Sveda and then with an Uttara-vasti (urethral syringe † which would give the patient much relief. The injected fluid goes astray (within the abdomen)