A grown up female patient, (under the circumstances), should be laid on her back with arched and up-drawn knees, and an injection should be made into her vaginal canal (Yoni) by an experienced physician (D. R. - carefully). The pipe should be most gently pressed in the case of a girl before menstruation. For the purpose of purifying the uterus (Garbhasaya) double the ordinary (one Prasrita) quantity of Sneha should be injected into the vaginal canal (by means of a Vasti) with a pipe having three Karnikás (protuberance) attached to it. 42-43.
In case the injected fluid does not come back (within the prescribed time), a fresh Vasti (enema) should be again applied with (the decoctions of) the S'odhana * (purifying) drugs, or a Varti (plug) prepared with the Sodhana drugs should be injected into the rectum. As an alternative, an indicator (Eshani) should be inserted into the mouth of the bladder, or the region of the abdomen below the umbilicus, and be firmly pressed with a close fist, or medicinal plugs or sticks (Varti) of the size of a Mudga-pulse, cardamom-seed (Ela), or mustard-seed should be made up of Saindhava and the leaves of the Aragvadha pasted with the expressed juice of Nirgundi and cow's urine, and these plugs (Varti) should, according to the age of the patient, be inserted (into the mouth of the bladder) with (the top-end of) a rod or an indicator (Saláká) for the out-flow of the injected fluid, Another alternative is to use a stick (Varti) made up of the pendant soot of a room (Agára-dhuma) Vrihati, Pippali, Madana fruit, Saindhava salt and S'unthi pasted with S'ukta (a sort of Kanjika) and cow's urine (in the preceding manner). Other (similar) measures should be adopted for the successful action of an Anuvasana enema (Vasti). 44-A.
A cold decoction of Yashti-madhu saturated with honey and sugar † or a decoction of the (bark of the) milk-exuding trees(Kshiri-Vriksha) or cold milk, should again be injected into the bladder, in the event of there being a burning sensation in that organ. 44.
Diseases such as derangements of the semen, or of ovum, or difficult menstruation, excess or suppression of the monthly flow, diseases of the uterus and of the vaginal canal, non-falling of the placenta, strangury and other diseases of the urine, gravel, stones (As'mari), spermatorrhea (S'ukrotseka), cramps in the bladder, in the groins and in the urethra and all other severe diseases of the bladder other than Meha, will all yield to the application of an Uttara-vasti (urethral enema). Symptoms which mark, or dangers which attend, a judicious or an injudicious application of an Uttara-vasti are respectively identical with those which characterise or attend those of a Sneha-vasti. 45-46.
* The S'odhana drugs here are the Trina-pancha-mula and such other drugs. - Dallana.
† According to Dallana a quantity of sugar and honey should be added in each of the three cases, viz,, (1) the decoction of Yashti-madhu, (2) that of the Kshiri-trees, and (3) milk.
Thus ends the Thirty-seventh Chapter of the Chikitsita Sthánam in the Sus'ruta Samhitá which deals with the Anuvásana-vasti and the Uttara-vasti.