The nine following drugs, viz. Trikatu, Trijata, Musta, Vidanga and Amalaka taken in equal parts, and eight parts of Trivit, and two parts of Danti roots should be separately pulverised and sieved through a piece of thin linen. The powders thus prepared should be pounded together and mixed with six parts of sugar and a little quantity of honey and rock salt.* Cold water should be given to the patient after he had taken the medicine, which proves curative in colic pain in the bladder (Vasti-Shula), thirst, fever, vomiting, anasarca (Shotha), chlorosis and vertigo. It does not entail any strict regimen of conduct like other purgatives and acts as a good eliminator of poison. The compound is called the Trivridashtakam and is specially recommended in Pittaja affections. Persons, suffering from diseases due to the action of the deranged Pittam and Kapham, should take the medicine through the vehicle of milk. The medicine should be prescribed for rich persons, owing to its dietetic character.

* The term little (Ishat) in the present instance stands for a quarter part.

Purgative Barks

The external skin of the Lodhra bark, to the exclusion of its inner lining, should be taken and pulverised. The powder, thus prepared, should be divided into three equal parts, two of which should be soaked in a decoction of the same (Lodhra) bark and filtered twenty-one times according to the process laid down in connection with the preparation of alkalis. The remaining third part of the powders should be soaked in the aforesaid filtered decoction and subsequently dried in the sun, and again soaked in a decoction of the drugs, which collectively go by the name of Dashamulam. The medicine should be prescribed in forms (wines, electuaries, etc.) previously described in connection with the Trivrit compounds.

The mode of preparing and administering purgative medicines out of barks endued with similar virtues has been described. We shall presently deal with those made with purgative fruits.

Fruit Purgatives

Sound and stoneless Haritakis administered in the way of Trivrit compounds prove curative in all forms of disease and in malignant sores and internal abscesses. They are the best of elixirs and improve the intellectual faculties. Haritaki and Vidanga, as well as rock salt, Nagaram, Trivrit and Maricha mixed in equal parts and taken with cow's urine, act as good purgatives. Similarly, powders of Haritaki, Bhadra-daru, Kushtham, Puga-phalam, Saindhava salt and Shringaveram taken through the medium of cow's urine, act as good purgative. For purgative purposes, a man should lick a compound consisting of the powders of Nilini fruits, Nagara, Abhaya and treacle and subsequently drink a good draught of warm water. A compound composed of Haritakis pasted with a decoction of the drugs constituting the group of Pippalyadi and a bit of Saindhava salt, exerts an instantaneous purgative action.

Haritakis eaten with Nagaram or treacle and with a bit of rock salt added to it, is an excellent stomachic. The specific virtue of Haritaki consists in restoring the normal condition of the bodily Vayu (laxative), in rejuvenating an used up or exhausted frame, and in soothingly invigorating the sense organs. Haritaki destroys all diseases, which are due to the use of sweet or richly cooked dishes (Santarpanam) such as, thirst, etc. Amalakam is cooling, and refrigerent; it subdues Pittam and Kapham and is antifat in its virtues. Vibhitakam is cooling; it subdues Pittam and Kapham. The group of medicinal fruits known as the Triphala consists of Haritaki, Amalakam and Vibhitakam, which are collectively marked by an acid-astringent taste with a shade of bitter and sweet. Powdered Triphala regularly taken with clarified butter of a three quarter part of its own weight acts as a regular panacea and is endued with a rejuvenating virtue.

All fruits possessed of purgative properties, should be used in the manner described in connection with Haritaki with the exception of Chaturangulas. The Chaturangula fruit should be collected in the proper season, and then kept buried for a week in a bed of sand. After that, they should be unearthed and dried in the sun, and their stones or seeds (lit. marrow) should be taken out. Then the essential oil of the seeds should be extracted by pressing them in an oil-mill like the seeds of sesamum, or by boiling them with water (hot expression). The oil is a good purgative for a child up to its twelfth year.

Hot water taken after having licked a compound consisting of Castor oil saturated with powdered Kushtha and Trikatus, acts as a good purgative. Castor oil taken with a decoction of Triphalas, double its own measure, or with milk or extract of meat, acts as a good purgative, which should be prescribed for infants, old men, or persons debilitated from the effects of ulcer cachexia, or of delicate constitution.

I have finished describing the preparation and application of fruit purgatives. Now hear me, O Sushruta, discourse on similar milky exudations of plants and trees, etc. which are possessed of purgative properties. The milky juice of a Sudha plant is the strongest of all purgatives, which being imprudently used by a medical ignoramus, may be attended with dangerous consequences, while the same in the hands of a judicious physician proves strong enough to disintegrate a mighty accumulation of deranged humours and to successfully combat many an irremediable distemper.

One part of the decoction of each of the drugs constituting the group of major Panchamulam and Vrihati, etc. should be mixed with one part of the milky juice of a Sudha plant (thus forming an eighth part of the whole compound). After having boiled it over a charcoal fire, the compound should be taken with two Tola (kola) weights of any acid liquid (such as wine, sour rice gruel, cream of curd, etc.) in the manner of Trivrit compounds. A gruel made of rice saturated with the milky exudation of a Mahavriksha, or a sweetened, porridge-like preparation of the same substance (Utkarika) made with treacle, should be deemed as possessed of purgative properties. As an alternative, an electuary composed of sugar, clarified butter and the milky juice of a Snuhi plant, should be used for purgative purposes.

Powders of Pippali soaked in the milky juice of the same plant should be used with rock salt for moving the bowels. Powdered Kampillakam made into boluses with Snuhi juice may be as well prescribed for the same end. Powders of Saptala, Shankhini, Danti, Trivrit and kernel of Aragvadham, should be saturated with cow's urine and then soaked in the milky juice of a Snuhi plant successively for seven consecutive days. * A smell of the powder thus prepared and strewn over the flower-garlands, and clothes worn by a man whose bowels are easily moved, acts as a mild purgative.

The use and preparation of purgative remedies concocted with roots, barks and milky exudations of plants, etc. have been described, which should be prescribed after carefulfy considering the nature of the case under treatment and according to their specific indications.

A compound consisting of three Shana weights (one tola and a half) of powdered Trivrit, three

The Mode Of Preparing The Porridge Is As Follows

First the wheat should be saturated with the milky juice of a Maha-Vriksha and then macerated. The powder should be then cooked with milk and treacle and made into a thick porridge.

Shana weights of powdered Triphala pulp, and three Shana weights of powdered Vidanga, Pippali and Yavakshara, mixed and pounded together, should be licked with honey and clarified butter, or they should be made into a confection with treacle for purgative purposes. The medicine does not entail any strict regimen of diet and conduct. It is one of the most effective remedies (of our pharmacopoeia) and proves curative in Gulmas, enlargement of the spleen, cough, Halimakam (chlorosis), non-relish for food and in diseases due to the action of the deranged Kapham and Vayu. A wise and intelligent physician should administer purgative medicines through the vehicles of clarified butter, oil, milk, Madya (wine) cow's urine, meat essence, or through the expressed juice of drugs, or through articles of food, or in forms of electuary. The six kinds of purgatives are the milky exudations, expressed juices, pastes, decoctions, cold infusions and powders of medicinal drugs or herbs, and each of these preceding factors should be deemed stronger than the one immediately following it in the order of enumeration.

Thus ends the forty-fourth Chapter of the Sutrasthanam in the Sushruta Samhita, which treats of the choice of purgatives.