This section is from the book "The Sushruta Samhita", by Kaviraj Kunja Lal Bhishagratna. Also available from Amazon: The Sushruta Samhita.
A Sneha-vasti should be employed during the day in spring and winter and in the evening during summer and the rainy season,with a view to ward off the dangers due to the misapplication in the internal use of a Sneha.* It may, however, be applied at any time during the day, or in the night in a case marked by a preponderance of the deranged bodily Vayu. 15.
In the serious stage of a disease an Anuvásana-enema should be applied after the patient has partaken of a second meal, having already digested his previous one. The use of a Sneha-vasti is forbidden in an empty stomach as it might otherwise send the injected fluid higher up into the intestines owing to the emptiness and cleansed * (unencumbered) state of the stomach. An application of the Anuvasana-vasti should be made just after a meal, since the application of a Vasti made during the continuance of a partially digested or undigested meal in the stomach brings on fever. An Anuvásana enema should not, however, be applied after the patient had taken his meal, richly saturated or cooked with a Sneha (oil or clarified butter), since the double introduction of the Sneha into the system through the medium of food and the Vasti brings on vertigo and epilepsy. The strength and complexion of the patient suffer much by the application of an Anuvásana-vasti after he has taken a dry (Ruksha) meal containing no Sneha. A patient should, therefore, be first fed with a diet saturated with a moderate quantity of an oleaginous substance before being treated with an Anuvásana-vasti. The patient before being treated with an Anuvásana vasti should be fed with Mudga-soup †, cow's milk and meat-essence to a quarter part ‡ less than the quantity he can ordinarily take 16.
* See Chapter XXXI (Medicinal Uses (Both Internal And External) Of The Snehas , I.e., Oleaginous Substances (Snehaupayogika-Chikitsita) . Chikitsiia-Sthanam.
* Gayadasa reads
in placa of
and explains it to mean "owing to the potency of the Sneha in traversing through the minutest channels of the body."
† Dallana explains that the Mudga soup should be taken without being mixed with any Sneha. He further says that the patient should be given Mudga-soup, cow's milk and meat-essence in accordance with the aggravation of the deranged Kapha, Pitta and Vayu respectively.
‡ Dallana, on the authority of the older Commentators explains that the patient should not be fed to his fill but only to three-fourths, half and one-fourth of what he can ordinarily take according to his digestive capacity.
The body of the patient to be treated with an Anuvásana vasti should be first anointed (with a Sneha) and gently fomented with hot water. Then he should be advised to take his meal in the prescribed way and made to take a short walk. Then having passed stools and urine, he should be treated with the Sneha-vasti. The mode of applying (the apparatus) is described under that of Niruha-vasti. He should be kept silently lying on his back as long as it would take to count a hundred words (Vak). The potency (Virja) of the injected Sneha spreads through the entire organism in the event of one's lying with outstretched limbs in the above manner after the application of a Sneha-vasti. The patient should be gently struck * three times on each of the soles and the palms of his hands and on the buttocks †. The (patient with his) bedding should be thrice raised (and shaken with gentle jerks). After that he should be laid on a bed stretched out at full length and be advised to speak and exert himself as little as possible and conform to a strict regimen of diet and conduct. 17-19.
A quantity of S'atáhva and Saindhava should be mixed with the Sneha (to be used in the Vasti) and (the whole compound) applied lukewarm, inasmuch as the injected Sneha would thereby easily flow back (without producing any pain and burning sensation, etc.) and dribble down in due time after the application. If at any time a quantity of the Sneha injected into the bowels in the manner of an Anuvasana enema (Vasti) is instantly driven back by the pressure of the incarcerated abdominal Vayu, or the Vayu (air) of the bladder (Vasti) or by an excessive heat, keenness (in potency), or an over-dose of the injected fluid itself, or by the over dose of the medicines (subsequently) added thereto, a Sneha-vasti charged with a smaller dose of the Sneha should be again applied, since a Sneha un-retained in the abdomen fails to produce any emulsive effect. 20-21.
* Dallana explains that the patient should be caught hold of by his wrists and ankles and given the gentle jerks so as to allow the potency of the Sneha spread through the organism.
† Some explain that the buttocks of the patient should be raised up with his bedding and his couch. At any rate his buttocks should be raised up in order to enable the injected Sneha to remain inside the intestines and not to come out instantly.
Retention of stool, urine and Vayu (flatus) is produced by using an insufficient quantity of Sneha in an Anuvásana-vasti. A burning sensation in the body, diarrhoea (Pravaha) and fatigue accompanied with pain set in as the natural resultants of an excessive Anuvásana enema. The satisfactory nature of the application of an Anuvásana-vasti should be inferred from the timely discharge of the injected Sneha with flatus and fœcal matter * out of the bowels of a patient without giving rise to any distressing symptoms such as burning and sucking † sensations, etc. 22.
The patient may be given a light ‡ meal or diet in the evening, in case he is possessed of a keen digestive capacity §, subsequent to the digestion of a previous meal and (should he feel hungry) after the discharging of the injected Sneha. Tepid water boiled with Dhanyáka and S'unthi should be given hot to the patient on the (following) morning as it would sharpen his appetite and produce a fresh relish for food. 23.
* It should be noted that the particle
in the text means that on the satisfactory action of an Anuvásana-Vasti, the injected S neha may come out with urine as well.
† Dallana explains
to mean thirst.
‡"Light" means both light in quantity as well as in quality.
§ Some commentators explain this couplet to mean that a patient of ordinary digestive capacity should be given a light food, whereas a patient of keen digestive capacity may take a full one.
This is the procedure of applying a Sneha-vasti. Six, seven, eight or nine applications of Sneha-vastis should in this manner be made in succession alternately with those of a Nirudha-vasti. 24-A.
 
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