* An additional reading says that a dry (thickend?) Niruha-vasti produces a slimy deposit in the rectum and in the pelvic region, while one with its fluid of an extremely thin consistency would produce only a Utile effect and might produce diarrhoea.

† Jejjata's reading of this passage does not include the application of Sveda but means that the Utiara-vasti should be applied with a Sneha.

and fails to enter into the intestines (Pakvás'aya) in the event of the patient lying in a stooping posture during the application of a Vasti. The Vayu in such a case becomes aggravated and gives rise to pain in the regions of the heart, abdomen and rectum. The injected fluid fails to penetrate into the bowels in the event of the patient lying on his back during the application of a Vasti owing to the consequent obstruction of the passage. The bodily Vayu becomes in this case agitated and enraged by the (introduction of the) pipe (of the Vasti) A contracted position of the body or of both the thighs, during the application of a Vasti prevents the full outflow of the injected medicine from the intestines, owing to its being acted upon by the bodily Vayu. In a case of the application of a Vasti to a patient in a sitting posture, the fluid rolls down without entering into the bowels; it, cannot consequently soothe the Ás'aya and thus proves abortive. The injected medicine cannot fully enter into the Pakvas'aya (intestines), when the Vasti is applied to a patient lying on his right side, since the Pakvás'aya is situated on the left side (of the abdomen). The application of a Vasti is not recommended when the patient lies on his face or in such other posture since it is followed by an aggravation of the bodily Vayu, which should be remedied by medicines chosen according to the exigencies of each case. 6.

We shall describe hereafter (in the next chapter) the dangers (Vyáfoat) which attend the misapplication of a Sneha-vastt and the course of the medical treatment to be adopted in each. The dangers (Vyápat) attending a deficient application (Ayoga) of a (Niruha) Vasti with their respective treatment are described here in this chapter. 7.

Ayoga: - Cramps or colic pains (Sula) in the intestines, and heaviness and distension of the abdomen result from the application of a Vasti charged with a medicinal solution either cold, inadequate in quantity, or deficient in its therapeutic virtues. All these symptoms are included within the term Ayoga or deficient application of a Vasti which should be remedied by a strong Vasti and a strong purgative. 8.

Distension of the abdomen and consequently an excruciating pain (Sula in the regions of the sides, back, waist and the heart result from the applications of a Vasti to a person who has taken a second meal before the digestion of a previous one, or in the event of the presence of a large accumulation of Doshas (in his body) If the Vasti be applied in a tepid state and in a large quantity just after a heavy meal, the results would be the same. Similar results would follow injections of cold medicinal solutions in large doses saturated with only a small quantity of salt and Sneha (oil or clarified butter as well as from those in a person with a large accumulation of fœcal matter (in his bowels . The remedy in all these cases should consist in the application of a Vasti charged with stronger medicinal solutions as well as of an Anuvasana-vasti. 9.

The Pitta and the Vayu of the body are conjointly aggravated by the application of a Vasti charged with extremely parching, hot and saline solutions which give rise to the distress, known as Parikartika, attended with a sort of cutting pain in the pelvis and about the anus and the region of the umbilicus. Applications of the Pichchhila-vasti of a medicated Sneha cooked with the drugs of the Madhura group should be the remedies in these cases 10.

The distress known as Parisráva attended with loss of strength, and bodily lassitude results from the application of a Vasti charged with solutions of extremely strong, acid and saline substances. Pitta begins to secrete at this stage, and produces a consequent burning sensation in the anus. Applications of a Pichchhila-vasti as well as a Vasti of clarified butter churned from milk should be the remedy in these cases, 11.

The distress known as Pravahika or the passing of bloody stools or painful motions, attended with colic (Sula) and a burning sensation, is the effect of an excessively strong Asthápana or Anuvasana Vasti. This disorder should be remedied by the application of a Pichchhila-vasti, a diet of boiled rice saturated with milk and with injections into the bowels, in the manner of an Anuvasana Vasti, of a medicated Sneha (oil or clarified butter) cooked with the drugs of the Madhura group. 12.

The distress known as Hridayopasarana, accompanied with such symptoms as, aching pains in the limbs, epilepsy, delirium, heaviness of the body and all other discomforts peculiar to the action of the deranged Vayu, originates from the application of a Niruha-vasti charged with extremely parching solutions as well as from those of an Anuvásana-vasti in the complicated diseases of the deranged bodily Vayu. The remedy in these cases consists in applying the Sodhana Vasti charged with solutions efficacious in subduing the actions of all the Doshas of the body. 13. A breaking pain in the joints and the limbs, numbness (Anga-graha), yawning, shivering and lassitude are the symptoms which follow the applications of a Vasti inadequately charged, or charged with medicinal solutions which are either too mild or too Ruksha (dry) in their potency, or applied in the case of a patient having lain in any of the objectionable postures at the time of the application, or possessed of a dry or Vayu-predominating temperament. The remedy in these cases should consist in applying Sveda, anointments and appropriate Vastis. 14.

Symptoms which are known as Atiyoga, following applications of Vastis charged with an inordinate quantity of medicinal fluid or with extremely hot or strong solutions as well as the application of Vastis after an excessive application of Sveda (fomentation) and in slight derangements of the bodily Doshas should be treated identically as in cases laid down in connection with an Atiyoga (excessive use) of purgatives. The use of a Pichchhila vasti in a cold state is also recommended, as it would give the patient much relief. 15.

Measures and remedies mentioned in respect of Jivádána (haemorrhage of the bowels) in connection with an excessive use of purgatives should be employed in the case of similar symptoms (Jivádána) following the excessive use of a Vasti. Applications of Pichchhila-vasti charged with blood are likewise recommended in these cases. 16.

The foregoing nine kinds of distressing symptoms (Vyápat) resulting from an injudicious application of a Niruha-vasti are also found to result from the injudicious application of a Sneha-vasti. All the distresses (of the injudicious applications of a Vasti) with their symptoms and the course of medical treatment to be adopted (in each case) have thus been described. A discrete and experienced physician should so act as not to induce these distresses (Vyapat) in connection with the applications of a Vasti. 17-18.

A purgative should be given after the lapse of a fortnight from the date of the exhibition of an emetic drug. An Ásthápana vasti should be applied a week after the date of purging. An Anuvásana-vasti should also be applied on the very same day. 19.

Thus ends the Thirty-sixth Chapter of the Chikitsita Sthánam in the Sus'rula Samhitá which treats of the medical treatment of the diseases consequent on the injudicious applications of a Vasti.