The Váyu and Pitta in the organism of an enfeebled person or of a person whose bowels can be easily moved or of one of a dry and arid temperament or afflicted with impaired digestive capacity, are deranged and aggravated by the use of any extremely sharp, hot, saline or dry (emetic or purgative) which give rise to a sort of cutting, sawing pain (Parikartiká) in the anus, penis, umbilical region and the neck of the bladder (Vasti). The emission of flatus is arrested, the Váyu (wind; lies incarcerated in the abdomen and relish for food vanishes. The remedy consists in employing a Pichchhá-Vasti with Yashti-madhu and black sesamum pasted together and dissolved in clarified butter and honey. The patient should be laved in cold water and be given his food with milk. Anuvásana-Vasti * with the cream of clarified butter or with oil cooked with Yashti-madhu should be employed. 16.
TheDoshas and the morbid matter accumulated in the system of a man of extremely constipated bowels and almost saturated with a plethora of Doshas (morbific diathesis) are stirred up but are not fully emitted under the action of a mild (emetic or purgative) medicine. The Doshas (consequently) try to pass out of the body constantly but in small quantities and bring on weakness, numbness and rigidity of the abdomen, aversion to food and lassitude of the limbs. The deranged Pitta (bile) and Kapha (mucus) are constantly emitted with pain through the anus) in such a case, and the disease is called Parisráva Asthápana-vasti with a decoction of Aja-karna, Dhava, Tints'a and Palás'a saturated with honey is recommended in such cases. After the subsidence of the bodily Doshas involved in the case, the patient should be treated with Sneha and Sams'odhana * (emetic or purgative) remedies should again be employed. 17.
* In cases of a Pitta-predominance, the Vasti should be employed with the cream of clarified butter and in cares of a Váyu predominance, with oil.
A medicine (purgative or emetic) administered to a person who has been excessively treated with Sveda or with Sneha produces Praváhiká in him by making him pass his stool and flatus without any straining or by restraining altogether those natural urgings respectively. Constant passing of slimy, black, white or red-coloured mucus (Kapha) with cramps, loud flatus and burning sensation form the chief characteristics of this disease. Its medical treatment should be similar to that of a case of Parisrava. 18.
Hridayopasarana (Overwhelming the heart)! - Urgings towards vomiting or purging being injudiciously checked by a person from ignorance, causes a downward or upward coursing of the Domas of the body to and in the heart, thus pressing the greatest of the Marmas and giving rise to an excruciating pain in that locality. The patient, in such a case, drops down unconscious in a swoon with upturned eyes, violently gushing his teeth and biting his tongue. An inexperienced physician usually abandons such a patient as lost, whereas the remedy in such cases consists in anointing his body with a Sneha (oil or clarified butter) and fomenting it with half-boiled and unhusked paddy (Dhánya-Svcda). Oil cooked with Yashti-madhu should be employed in the manner of an Anuvásana Vasti, and strong errhines (Nasya) should also be administered. After that the patient should be made to vomit with draughts of the washings of rice mixed with Yashti-madhu and Vastis * should be employed in consideration of the preponderance of the Dosha or Doshas involved in the case. 19.
* Dallana recommends that a strong purgative or emetic should be employed.