Purgatives should also be administered to a patient after the due application of Sneha (oil, etc.) and Sveda (for a second time) after the administration of an emetic. On the day before the administration of the purgative, the patient should be told that a purgative should be given to him the next morning. He should at this time be provided with a light repast followed by potions of hot water and (the expressed juice of) acid fruits. On the next morning an adequate dose of the (purgative) medicine should be administered after clearly ascertaining that the patient's body has been cleansed of all mucous ,Sleshmá) accumulations and in the manner laid down in the Aturopakramaniya chapter (Chapter XXXV (Dimensions And Classifications Of A Netra And A Vasti (Pipes, Nozzles And Apparatus) With Their Therapeutic Applications (Netra-Vasti-PramáNa- PravibháGa-Chikitsitam)). of tho Sutra-sthana). 14.
Koshtha (bowels) may be grouped under three heads as mild or easily movable (Mridu), middling or moderately constipated (Madhya) and hard or constipated (Krura). The first kind (Mridu) of the Koshtha should be ascribed to the abundance of Pitta therein and can be moved even with milk only; the last (Krura) is ascribable to the action of an abundance of Vayu and Kapha and can be moved only with the greatest difficulty; while the second, Madhayama, should be held as the product of a condition of equilibrium among the (three) Doshas and this is the most general type. Purgatives
* Dallana says that some commentators do not read this part, but they say that the necessity of applying emetics is mentioned in each particular case where required, should be administered in small doses to persons of lax bowels (Mridu Koshtha) in moderate doses to those of moderately constipated bowels (Madhayama Koshtha), and in large doses to persons of extremely constipated bowels (Krura Koshtha). After having taken a purgative the patient should think of nothing else but purging and when passing his stool he should not go far from his bed-side. 15.
He should at this time lie in a windless chamber, foregoing the use of cold water and exposure to cold wind, and should not repress any urging (towards stool) nor should he strain. Emission of urine, stool, Pitta, the (purgative) medicine and lastly of Kapha consecutively follow under a course of purgative, in the same manner as an emission of saliva, the (emetic) drug, Kapha, Pitta and lastly of Váyu are consecutively ejected under the course of an emetic. 16-17.
An aggravation of the Kapha and Pitta, a burning sensation in the body, an aversion to food, heaviness of the limbs and impaired digestion (lassitude - D. R.) are the effects of an improper application of a purgative. Heaviness of the Kukshi and of the heart, itching and burning sensation, and the retention of stool and urine are the symptoms which follow in the wake of a purgative medicine which has failed to satisfactorily open and cleanse the bowels. Loss of consciousness, prolapsus of the anus, aggravation of the bodily Kapha and Sula colic pain in the intestines) result from an act of over-purging. A sense of lightness about the region of the umbilicus * and hilarity of the wind due to the discharge of the distempers connected with the Kapha (mucus, stool, etc.) and restoration of the bodily Váyu to its normal condition due to the discharge of the (deranged, Váyu (from the system) are the symptoms which mark the satisfactory action of a purgative medicine. 18-A.
* In place of some readwhich means "a sense of lightness and lassitude".
Diet: - No liquid food or Peyá should be given to the patient on the day in the event of his not being properly purged and not being feebled (with pur-ging) and in the event of his impaired digestion (after the use of a purgative) A light and lukewarm Peyá should, however, be given to him in small doses, whenever he would feel weak and thirsty after the proper exhibition of a purgative medicine. 18-B,