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Vamana Virechana Vyapat Siddhi (view source)

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{{#seo:

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|title=Vamana Virechana Vyapat Siddhi

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|titlemode=append

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|keywords=Vamana (therapeutic emesis), Virechana (therapeutic purgation), Vyapad (complications), Shodhana (purification therapy)

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|description=Siddhi Sthana Chapter 6. Management of complications of improper therapeutic emesis and purgation

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}}

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<big>'''[[Siddhi Sthana]] Chapter 6. Management of complications of improper therapeutic emesis and purgation'''</big>

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===Sanskrit text, Transliteration and English Translation===

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अथातो वमनविरेचनव्यापत्सिद्धिम् व्याख्यास्याम: ||१||

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असम्यकृतयोश्चैव दोषान् वक्ष्यामि सौषधान् ||३||

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AthAto vamanavirechana vyApatsiddhim vyAkhyAsyAmah I

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Asamyak krutayohshchaiva doshAn vakshyAmi SaushadhAn II

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</div></div>

Now we shall explore the chapter on the ‘complications of improper therapeutic emesis and purgation and their successful management’. Thus said Lord Atreya.

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==== Seasons for purification ====

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अत्युष्णवर्षशीता हि ग्रीष्मवर्षाहिमागमाः|

तदन्तरे प्रावृडाद्यास्तेषां साधारणास्त्रयः||४||

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atyuṣṇavarṣaśītā hi grīṣmavarṣāhimāgamāḥ|

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tadantare prAvRuDAdyAsteShAM sAdhAraNAstrayaH||4||

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</div></div>

Excess heat, rain and cold are the signature features of summer (''greeshma''), rainy (''varsha'') and winter (''hemanta'') seasons respectively. The three seasons viz., the period between summer and rains (''pravrita''), autumn (''sharada'') and spring (''vasanta''), which come in between the above mentioned are known as general seasons (''sadharana ritu''). [4]

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प्रावृट् शुचिनभौ ज्ञेयौ शरदूर्जसहौ पुनः|

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स्वस्थवृत्तमभिप्रेत्य व्याधौ व्याधिवशेन तु||६||

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prāvr̥ṭ śucinabhau jñēyau śaradūrjasahau punaḥ|

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svasthavRuttamabhipretya vyAdhau vyAdhivashena tu||6||

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</div></div>

The months ''Shuchi'' (''Aashadha'', Mid June to Mid July) and ''Nabha'' (''Shravana'', Mid July to Mid August) together are known as ''Pravrita ritu''. The months ''Urja'' (''Kartika'', Mid October to Mid November) and ''Saha'' (''Margashersha'' –Mid November to Mid December) are known as ''Sharada ritu''. The months ''Tapasya'' (''Phaalguna'' -Mid February to Mid March) and ''Madhu'' (''Chaitram''- mid March to mid April) are known as ''Vasanta ritu''. These seasons are specially mentioned here for the sake of administration of ''shodhana'' therapy (purificatory procedures). The physician shall select an appropriate purificatory procedure to preserve the health after determining the exact season. However, in case of disease, it has to be done with respect to the nature of the clinical condition in any of the seasons.[5-6]

==== Importance of oleation in [[Panchakarma]] ====

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कर्मणां वमनादीनामन्तरेष्वन्तरेषु च|

स्नेहस्वेदौ प्रयुञ्जीत स्नेहं चान्ते प्रयोजयेत्||७||

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karmaṇāṁ vamanādīnāmantarēṣvantarēṣu ca|

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snehasvedau prayu~jjIta snehaM cAnte prayojayet||7||

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</div></div>

In between the sequential administration of purificatory procedures like ''vamana'' (emesis) etc., ''snehana'' (oleation) and ''swedana'' (sudation) therapies need to be administered and ''snehana'' (oleation) shall be administered at the end (also). [7]

==== Indications of purification ====

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विसर्पपिडकाशोफकामलापाण्डुरोगिणः |

अभिघातविषार्तांश्च नातिस्निग्धान् विरेचयेत्||८||

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visarpapiḍakāśōphakāmalāpāṇḍurōgiṇaḥ |

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abhighAtaviShArtAMshca nAtisnigdhAn virecayet||8||

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</div></div>

In case of clinical conditions like ''visarpa, pidaka, shopha, kamala, pandu'' as well as in trauma and toxication, and in those who are not excessively oleated purification therapies shall be administered. [8]

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नातिस्निग्धशरीराय दद्यात् स्नेहविरेचनम्|

स्नेहोत्क्लिष्टशरीराय रूक्षं दद्याद्विरेचनम्||९||

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nātisnigdhaśarīrāya dadyāt snēhavirēcanam|

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snehotkliShTasharIrAya rUkShaM dadyAdvirecanam||9||

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</div></div>

The individual with excessively oleated body should never be given an unctuous or ''snigdha virechana''. The body with excessive oleation should be given un-unctuous or ''ruksha virechana''.[9]

==== Procedure of taking purgatives for therapy ====

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स्नेहस्वेदोपपन्नेन जीर्णे मात्रावदौषधम्|

एकाग्रमनसा पीतं सम्यग्योगाय कल्पते||१०||

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snēhasvēdōpapannēna jīrṇē mātrāvadauṣadham|

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ekAgramanasA pItaM samyagyogAya kalpate||10||

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</div></div>

The person after undergoing ''snehana'' (oleation) and ''swedana'' (sudation procedures) can have the medicine for elimination with fully concentrated mind. In addition, it should be ensured that the medicine is taken only after the full digestion of previous food. Only then, the proper elimination ensues.[10]

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स्निग्धात् पात्राद्यथा तोयमयत्नेन प्रणुद्यते|

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स्नेहस्वेदैस्तथोत्क्लेश्य शोध्यते शोधनैर्मलः ||१३||

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snigdhāt pātrādyathā tōyamayatnēna praṇudyatē|

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snehasvedaistathotkleshya shodhyate shodhanairmalaH || 13||

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</div></div>

Like how water gets out of a vessel smeared with oil, similar is the removal of ''doshas'' from a properly oleated body. Just like the fire propels the water out from the wet log wood, similarly the sudation propels out the stable ''doshas'' from the pre-oleated body. The way in which the clothes adhered with dirt is cleaned using water, which removes the dirt, similarly the stable ''malas'' that are liquefied after oleation and sudation are removed by proper purificatory therapies.[11-13]

==== Consequences if medicines taken during indigestion ====

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अजीर्णे वर्धते ग्लानिर्विबन्धश्चापि जायते|

पीतं संशोधनं चैव विपरीतं प्रवर्तते||१४||

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ajīrṇē vardhatē glānirvibandhaścāpi jāyatē|

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pItaM saMshodhanaM caiva viparItaM pravartate||14||

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</div></div>

If the medicine for purification is administered before the digestion of the previous meal, it will lead to ''glani'' (tiredness), ''vibandha'' (obstruction of feces and urine), and an action that is opposite to that intended by elimination therapy. (''virechana oushadha'' will lead to ''vamana'' and vice versa.)[14]

==== Characteristics of appropriate dosage of medicine ====

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अल्पमात्रं महावेगं बहुदोषहरं सुखम्|

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गन्धवर्णरसोपेतं विद्यान्मात्रावदौषधम्||१६||

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alpamātraṁ mahāvēgaṁ bahudōṣaharaṁ sukham|

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gandhavarNarasopetaM vidyAnmAtrAvadauShadham||16||

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</div></div>

The following properties are characteristic to the appropriate dosage of medicines prescribed for purification:

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==== Careful administration of medicine with mental concentration ====

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विधूय मानसान् दोषान् कामादीनशुभोदयान् |

एकाग्रमनसा पीतं सम्यग्योगाय कल्पते||१७||

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vidhūya mānasān dōṣān kāmādīnaśubhōdayān |

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ekAgramanasA pItaM samyagyogAya kalpate||17||

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</div></div>

The individual who drinks the medicine leaving away the negative mental feelings like lust etc. concentrating only on the medicines and the administration of the therapy, will bring the proper action of the medicine or therapy. [17]

==== Diet before purification therapy ====

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नरः श्वो वमनं पाता भुञ्जीत कफवर्धनम्|

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उत्क्लिष्टाल्पकफत्वेन क्षिप्रं दोषाः स्रवन्ति हि|१९|

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naraḥ śvō vamanaṁ pātā bhuñjīta kaphavardhanam|

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utkliShTAlpakaphatvena kShipraM doShAH sravanti hi|19|

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</div></div>

The individual scheduled to undergo ''vamana'' on the next day should have foods which are easily digestible, rich in fluids and will increase the ''kapha dosha''. Similarly, the individual scheduled to undergo ''virechana'' should have foods which are light and hot. Since the first diet leads to vitiation and second diet leads to reduction of ''kapha'', the ''doshas'' are removed quickly and completely. [18-18½]

==== Signs of proper elimination ====

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पीतौषधस्य तु भिषक् शुद्धिलिङ्गानि लक्षयेत्||१९||

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हृतदोषं वदेत् कार्श्यदौर्बल्ये चेत् सलाघवे||२०||

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pītauṣadhasya tu bhiṣak śuddhiliṅgāni lakṣayēt||19||

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hRutadoShaM vadet kArshyadaurbalye cet salAghave||20||

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</div></div>

The physician who had administered medicines for purification must be in observation for the following symptoms:

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When ''doshas'' are eliminated, the patient will experience emaciation, weakness and lightness of body.[19-20]

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वामयेत्तु ततः शेषमौषधं न त्वलाघवे|

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आलाघवात्तनुत्वाच्च कफस्यापत् परं भवेत्|२२|

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vāmayēttu tataḥ śēṣamauṣadhaṁ na tvalāghavē|

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AlAghavAttanutvAcca kaphasyApat paraM bhavet|22|

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</div></div>

If after the completion of the purificatory procedures, there is presence of residual medicines, ''vamana'' must be administered. If there is no feeling of lightness, then also ''vamana'' should be performed. ''Vamana'' must be specifically performed, when there is ''staimitya'' (a feeling of wet covering), obstruction of ''vayu'' and absence of belching. ''Vamana'' should be continued till there is lightness of the body and reduction of ''kapha''. If continued, it can result in serious consequences. [21-21½]

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वमिते वर्धते वह्निः शमं दोषा व्रजन्ति हि||२२||

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तानि दृष्ट्वा तु पेयादिक्रमं कुर्यान्न लङ्घनम्||२३||

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vamitē vardhatē vahniḥ śamaṁ dōṣā vrajanti hi||22||

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tAni dRuShTvA tu peyAdikramaM kuryAnna la~gghanam||23||

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</div></div>

The one who has been purified by ''vamana'' will have augmented ''agni'', leading to the alleviation of ''dosha''. He need to undergo fasting till the signs of proper digestion of drugs for ''vamana'' is seen. For one having those signs, ''peyadi kramam'' (regulatory diet regimen) has to be initiated. He should not undergo further ''langhana'' (fasting). [22-23]

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संशोधनाभ्यां शुद्धस्य हृतदोषस्य देहिनः|

यात्यग्निर्मन्दतां तस्मात् क्रमं पेयादिमाचरेत्||२४||

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saṁśōdhanābhyāṁ śuddhasya hr̥tadōṣasya dēhinaḥ|

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yAtyagnirmandatAM tasmAt kramaM peyAdimAcaret||24||

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</div></div>

The individual who is purified after elimination therapy and removal of ''dosha'' from the body, has his ''agni'' diminished. Hence it is highly pertinent to institute dietary regimen termed ''peyaadi kramam''. [24]

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कफपित्ते विशुद्धेऽल्पं मद्यपे वातपैत्तिके|

तर्पणादिक्रमं कुर्यात् पेयाऽभिष्यन्दयेद्धि तान्||२५||

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kaphapittē viśuddhē'lpaṁ madyapē vātapaittikē|

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tarpaNAdikramaM kuryAt peyA~abhiShyandayeddhi tAn||25||

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</div></div>

When there is little elimination of ''kapha'' and ''pitta'' through purification therapy, in alcoholics and in persons with predominance of ''vata'' and ''pitta dosha'', the dietary regimen called ''tarpanaadi kramam'' need to be started instead of ''peyaadi kramam'', as ''peyadi'' may increase ''kapha'' causing ''abhishyandam'' (clogging of the channels of circulation).[25]

==== Signs of digested and undigested medicine ====

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अनुलोमोऽनिलः स्वास्थ्यं क्षुत्तृष्णोर्जो मनस्विता|

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अरतिर्बलहानिश्च सावशेषौषधाकृतिः||२७||

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anulōmō'nilaḥ svāsthyaṁ kṣuttr̥ṣṇōrjō manasvitā|

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aratirbalahAnishca sAvasheShauShadhAkRutiH||27||

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</div></div>

The signs of properly digested medicine include:

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*Restlessness

*Loss of strength

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अकालेऽल्पातिमात्रं च पुराणं न च भावितम्|

असम्यक्संस्कृतं चैव व्यापद्येतौषधं द्रुतम्||२८||

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akālē'lpātimātraṁ ca purāṇaṁ na ca bhāvitam|

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asamyaksaMskRutaM caiva vyApadyetauShadhaM drutam||28||

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</div></div>

The drug of the following nature may result in quick complication:

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==== Ten complications of emesis and purgation ====

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आध्मानं परिकर्तिश्च स्रावो हृद्गात्रयोर्ग्रहः|

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प्रेष्यभैषज्यवैद्यानां वैगुण्यादातुरस्य च||३०||

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ādhmānaṁ parikartiśca srāvō hr̥dgātrayōrgrahaḥ|

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preShyabhaiShajyavaidyAnAM vaiguNyAdAturasya ca||30||

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</div></div>

The ten cardinal complications arising out of improper administration of emesis and purgation are:

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==== Three types of purification according to its signs ====

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योगः सम्यक्प्रवृत्तिः स्यादतियोगोऽतिवर्तनम्|

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अयोगसञ्ज्ञे, कृच्छ्रेण याति दोषो नवाऽल्पशः||३४||

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yōgaḥ samyakpravr̥ttiḥ syādatiyōgō'tivartanam|

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ayogasa~jj~je, kRucchreNa yAti doSho navA~alpashaH||34||

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</div></div>

The three types of outcome for ''Vamana'' and ''Virechana'' are:

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==== Various conditions and management ====

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पीतौषधो न शुद्धश्चेज्जीर्णे तस्मिन् पुनः पिबेत्|

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अयोगे मृदु वा दद्यादौषधं तीक्ष्णमेव वा||३६||

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pītauṣadhō na śuddhaścējjīrṇē tasmin punaḥ pibēt|

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ayoge mRudu vA dadyAdauShadhaM tIkShNameva vA||36||

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</div></div>

If after intake of medicine for elimination, the medicine is digested and there is no elimination, then the medicine should be taken again.

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One has to understand the nature of ''koshtha'' (whether ''guru'' or ''laghu'') and the strength of the body for giving either mild (''mridu'') or potent (''teekshna'') medicine. [35-36]

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वमनं न तु दुश्छर्दं दुष्कोष्ठं न विरेचनम्|

पाययेतौषधं भूयो हन्यात् पीतं पुनर्हि तौ||३७||

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vamanaṁ na tu duśchardaṁ duṣkōṣṭhaṁ na virēcanam|

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pAyayetauShadhaM bhUyo hanyAt pItaM punarhi tau||37||

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</div></div>

Never give emetic drug to people who are unsuitable for ''vamana; virechana'' to those with unsuitable ''koshtha'', if medicine intake happens in such conditions it may even lead to death.[37]

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अस्निग्धास्विन्नदेहस्य रूक्षस्यानवमौषधम्|

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पिण्डिकोद्वेष्टनं कण्डूमूर्वोः सादं विवर्णताम्||३९||

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asnigdhāsvinnadēhasya rūkṣasyānavamauṣadham|

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piNDikodveShTanaM kaNDUmUrvoH sAdaM vivarNatAm||39||

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</div></div>

''Ayoga'' happens when ''asnigdha'' (under-oleated) and ''asvinna'' (under-sudated) person with ''ruksha'' nature of the body, is administered a recipe, which is stored for long duration. Here, the drug is unable to remove ''doshas'' from the body by creating ''dosha-utklesha''. Such a condition will lead to symptoms like ''vibhramsha'' (''virechana oushadha'' will lead to ''vamana'' and vice versa), swelling, hiccups, black-out, cramps in calf muscle, itching, fainting and discoloration.[38-39]

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स्निग्धस्विन्नस्य चात्यल्पं दीप्ताग्नेर्जीर्णमौषधम्|

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न चातितीक्ष्णेन ततो ह्यतियोगस्तु जायते||४४||

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snigdhasvinnasya cātyalpaṁ dīptāgnērjīrṇamauṣadham|

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na cAtitIkShNena tato hyatiyogastu jAyate||44||

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</div></div>

''Ayoga'' happens in the following conditions too :

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==== Signs of excess elimination and management ====

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अतितीक्ष्णं क्षुधार्तस्य मृदुकोष्ठस्य भेषजम्|

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मधुरैरनुवास्यश्च सिद्धेन क्षीरसर्पिषा||५१||

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atitīkṣṇaṁ kṣudhārtasya mr̥dukōṣṭhasya bhēṣajam|

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madhurairanuvAsyashca siddhena kShIrasarpiShA||51||

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</div></div>

When a patient who is with ''mridukoshtha'', who is affected with hunger, is provided with an exceedingly strong ''vamana'' or ''virechana'', it results in the quick elimination of not only the faecal matter, ''pitta'' and ''kapha'', but also the ''drava-dhatu'' (liquid content of the body). Consequently, there will be sudden depression of strength and voice, dryness of throat, giddiness and thirst. In such a condition, it is preferable to eliminate the residual drug in the ''koshtha'' using the drugs of ''madhura gana'' (mentioned in sweet category).

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For ''ati-yoga'' of ''virechana, sharkarodakam'' (sugar syrup) added with ''rasaanjana'' (Berberis aristata), ''chandana'' (Santalum album), ''usheera'' (Vetivera zizanoides), blood of goat, cornflake powder etc. can be taken to stop excessive loss of fluid. Then ''peya'' made from ''vata shunga'' (leaf buds of banyan tree) added with honey, milk or porridge processed with samgraahi substances (that which pacifies excess bowel movements) like the priyangvaadi gana, food added with jaangala maamsa rasam (meat soup of animals from arid region), picchha basti mentioned in rakta-arshas, sneha basti using ghee made out of milk processed with madhura aushadha (sweet drugs).[46-51]

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वमनस्यातियोगे तु शीताम्बुपरिषेचितः|

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यवागूं तनुकां दद्यात् स्नेहस्वेदौ च बुद्धिमान्||५६||

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vamanasyātiyōgē tu śītāmbupariṣēcitaḥ|

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yavAgUM tanukAM dadyAt snehasvedau ca buddhimAn||56||

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</div></div>

In ''atiyoga'' of ''vamana'', the whole body irrigation must be done with cold water. ''Mantha'' must be prepared with ghee, honey and sugar.

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==== Importance of diet after purification ====

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वमितश्च विरिक्तश्च मन्दाग्निश्च विलङ्घितः|

अग्निप्राणविवृद्ध्यर्थं क्रमं पेयादिकं भजेत् ||५७||

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vamitaśca viriktaśca mandāgniśca vilaṅghitaḥ|

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agniprANavivRuddhyarthaM kramaM peyAdikaM bhajet ||57||

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</div></div>

''Peyadi krama'' (''peyadi'' diet regimen) must be followed by those who undergo ''Vamana'' and ''Virechana'', who have diminished ''agni'' and who is under fasting for improving the ''jatharaagni'' ( digestion and metabolism) and ''prana shakti''(vitality)

==== Complication of ''adhmana'' (abdominal distension) and its management ====

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बहुदोषस्य रूक्षस्य हीनाग्नेरल्पमौषधम्|

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उदावर्तहरं सर्वं कर्माध्मातस्य शस्यते||६०||

+

bahudōṣasya rūkṣasya hīnāgnēralpamauṣadham|

Line 933: Line 1,026:

udAvartaharaM sarvaM karmAdhmAtasya shasyate||60||

+

</div></div>

If medicine with low potency and in small quantity is given in patients with excessively vitiated ''dosha'', excess dryness in body, low digestive power and ''udavarta'' then it leads to further aggravation of ''dosha'' resulting in obstruction in channels, severe abdominal distension in umbilical region, pain in the back, flanks and head, severe dyspnea, retention of urine, feces and flatus. This condition shall be treated with ''abhyanga'' (oil massage), ''swedana'' (sudation), ''varti'' (use of suppositories), ''niruha'' along with ''anuvasana'' (decoction and oil enema) and all the treatment that cure ''udavarta''. [58-60]

==== Complication of ''parikartika'' (fissure in ano) and its management ====

+

−

स्निग्धेन गुरुकोष्ठेन सामे बलवदौषधम्|

+

स्निग्धेन गुरुकोष्ठेन सामे बलवदौषधम्| <br />

−

क्षामेण मृदुकोष्ठेन श्रान्तेनाल्पबलेन वा||६१||

+

क्षामेण मृदुकोष्ठेन श्रान्तेनाल्पबलेन वा||६१|| <br />

−

पीतं गत्वा गुदं साममाशु दोषं निरस्य च|

+

पीतं गत्वा गुदं साममाशु दोषं निरस्य च| <br />

−

तीव्रशूलां सपिच्छास्रां करोति परिकर्तिकाम्||६२||

+

तीव्रशूलां सपिच्छास्रां करोति परिकर्तिकाम्||६२|| <br />

−

लङ्घनं पाचनं सामे रूक्षोष्णं लघुभोजनम्|

+

लङ्घनं पाचनं सामे रूक्षोष्णं लघुभोजनम्| <br />

−

बृंहणीयो विधिः सर्वः क्षामस्य मधुरस्तथा||६३||

+

बृंहणीयो विधिः सर्वः क्षामस्य मधुरस्तथा||६३||<br />

+

−

snigdhēna gurukōṣṭhēna sāmē balavadauṣadham|

+

snigdhēna gurukōṣṭhēna sāmē balavadauṣadham| <br />

−

kṣāmēṇa mr̥dukōṣṭhēna śrāntēnālpabalēna vā||61||

+

kṣāmēṇa mr̥dukōṣṭhēna śrāntēnālpabalēna vā||61|| <br />

−

pītaṁ gatvā gudaṁ sāmamāśu dōṣaṁ nirasya ca|

+

pītaṁ gatvā gudaṁ sāmamāśu dōṣaṁ nirasya ca| <br />

−

tīvraśūlāṁ sapicchāsrāṁ karōti parikartikām||62||

+

tīvraśūlāṁ sapicchāsrāṁ karōti parikartikām||62|| <br />

−

laṅghanaṁ pācanaṁ sāmē rūkṣōṣṇaṁ laghubhōjanam|

+

laṅghanaṁ pācanaṁ sāmē rūkṣōṣṇaṁ laghubhōjanam| <br />

−

br̥ṁhaṇīyō vidhiḥ sarvaḥ kṣāmasya madhurastathā||63||

+

br̥ṁhaṇīyō vidhiḥ sarvaḥ kṣāmasya madhurastathā||63|| <br />

−

snigdhena gurukoShThena sAme balavadauShadham|

+

snigdhena gurukoShThena sAme balavadauShadham| <br />

−

kShAmeNa mRudukoShThena shrAntenAlpabalena vA||61||

+

kShAmeNa mRudukoShThena shrAntenAlpabalena vA||61|| <br />

−

pItaM gatvA gudaM sAmamAshu doShaM nirasya ca|

+

pItaM gatvA gudaM sAmamAshu doShaM nirasya ca| <br />

−

tIvrashUlAM sapicchAsrAM karoti parikartikAm||62||

+

tIvrashUlAM sapicchAsrAM karoti parikartikAm||62|| <br />

−

la~gghanaM pAcanaM sAme rUkShoShNaM laghubhojanam|

+

la~gghanaM pAcanaM sAme rUkShoShNaM laghubhojanam| <br />

−

bRuMhaNIyo vidhiH sarvaH kShAmasya madhurastathA||63||

+

bRuMhaNIyo vidhiH sarvaH kShAmasya madhurastathA||63|| <br />

+

</div></div>

If potent (purification) medicine is given in properly oleated patients, with ''guru koshtha''(heavy bowel), in cases of ''ama dosha'', body being lean with ''mridu koshtha'' (soft bowel), fatigued and less strength, then ''doshas'' reach ''guda'' (rectum) in ''sama'' condition and get expelled out immediately. It results in ''parikartika'' (fissure in ano) with severe pain, mucous and bloody secretions. In ''amadosha'' or ''sama'' conditions, fasting (''langhana''), digestive (''pachana''), drying (''rukshana''), should be done and easily digestible (light) and hot food must be taken. For those whose body is emaciated, every ''brimhana'' (nourishing) measure like food with ''madhura rasa'' (sweet taste) dominance must be taken. [61-63]

+

−

आमे जीर्णेऽनुबन्धश्चेत् क्षाराम्लं लघु शस्यते|

+

आमे जीर्णेऽनुबन्धश्चेत् क्षाराम्लं लघु शस्यते| <br />

−

पुष्पकासीसमिश्रं वा क्षारेण लवणेन वा||६४||

+

पुष्पकासीसमिश्रं वा क्षारेण लवणेन वा||६४|| <br />

−

सदाडिमरसं सर्पिः पिबेद्वातेऽधिके सति|

+

सदाडिमरसं सर्पिः पिबेद्वातेऽधिके सति| <br />

−

दध्यम्लं भोजने पाने संयुक्तं दाडिमत्वचा||६५||

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दध्यम्लं भोजने पाने संयुक्तं दाडिमत्वचा||६५||<br />

−

देवदारुतिलानां वा कल्कमुष्णाम्बुना पिबेत्|

+

देवदारुतिलानां वा कल्कमुष्णाम्बुना पिबेत्| <br />

−

अश्वत्थोदुम्बरप्लक्षकदम्बैर्वा शृतं पयः||६६||

+

अश्वत्थोदुम्बरप्लक्षकदम्बैर्वा शृतं पयः||६६|| <br />

−

कषायमधुरं शीतं पिच्छाबस्तिमथापि वा|

+

कषायमधुरं शीतं पिच्छाबस्तिमथापि वा| <br />

−

यष्टीमधुकसिद्धं वा स्नेहबस्तिं प्रदापयेत्||६७||

+

यष्टीमधुकसिद्धं वा स्नेहबस्तिं प्रदापयेत्||६७|| <br />

+

−

āmē jīrṇē'nubandhaścēt kṣārāmlaṁ laghu śasyatē|

+

āmē jīrṇē'nubandhaścēt kṣārāmlaṁ laghu śasyatē|<br />

−

puṣpakāsīsamiśraṁ vā kṣārēṇa lavaṇēna vā||64||

+

puṣpakāsīsamiśraṁ vā kṣārēṇa lavaṇēna vā||64|| <br />

−

sadāḍimarasaṁ sarpiḥ pibēdvātē'dhikē sati|

+

sadāḍimarasaṁ sarpiḥ pibēdvātē'dhikē sati| <br />

−

dadhyamlaṁ bhōjanē pānē saṁyuktaṁ dāḍimatvacā||65||

+

dadhyamlaṁ bhōjanē pānē saṁyuktaṁ dāḍimatvacā||65|| <br />

−

dēvadārutilānāṁ vā kalkamuṣṇāmbunā pibēt|

+

dēvadārutilānāṁ vā kalkamuṣṇāmbunā pibēt| <br />

−

aśvatthōdumbaraplakṣakadambairvā śr̥taṁ payaḥ||66||

+

aśvatthōdumbaraplakṣakadambairvā śr̥taṁ payaḥ||66|| <br />

−

kaṣāyamadhuraṁ śītaṁ picchābastimathāpi vā|

+

kaṣāyamadhuraṁ śītaṁ picchābastimathāpi vā| <br />

−

yaṣṭīmadhukasiddhaṁ vā snēhabastiṁ pradāpayēt||67||

+

yaṣṭīmadhukasiddhaṁ vā snēhabastiṁ pradāpayēt||67||<br />

−

Ame jIrNe~anubandhashcet kShArAmlaM laghu shasyate|

+

Ame jIrNe~anubandhashcet kShArAmlaM laghu shasyate| <br />

−

puShpakAsIsamishraM vA kShAreNa lavaNena vA||64||

+

puShpakAsIsamishraM vA kShAreNa lavaNena vA||64|| <br />

−

sadADimarasaM sarpiH pibedvAte~adhike sati|

+

sadADimarasaM sarpiH pibedvAte~adhike sati| <br />

−

dadhyamlaM bhojane pAne saMyuktaM dADimatvacA||65||

+

dadhyamlaM bhojane pAne saMyuktaM dADimatvacA||65|| <br />

−

devadArutilAnAM vA kalkamuShNAmbunA pibet|

+

devadArutilAnAM vA kalkamuShNAmbunA pibet| <br />

−

ashvatthodumbaraplakShakadambairvA shRutaM payaH||66||

+

ashvatthodumbaraplakShakadambairvA shRutaM payaH||66|| <br />

−

kaShAyamadhuraM shItaM picchAbastimathApi vA|

+

kaShAyamadhuraM shItaM picchAbastimathApi vA| <br />

−

yaShTImadhukasiddhaM vA snehabastiM pradApayet||67||

+

yaShTImadhukasiddhaM vA snehabastiM pradApayet||67|| <br />

+

</div></div>

If ''parikartika'' continues even if the ''ama'' got digested, light food added with ''kshara'' (alkalizing) and ''amla'' (sour) is good. For aggravated ''vayu'', ghee medicated with pomegranate juice, ''puspa-kaaseesa'' (green vitriol- Ferrous sulphate), ''kshara'' (alkalies), ''lavana''(salts) and ''dadima'' (Punica granatum) can be used. The powder of skin of ''dadima'' along with sour curd can be taken or with other food. The paste made of ''devadaru'' (Cedrus deodara) and ''tila'' (sesame) can be taken in hot water. Milk processed with the skin of ''ashwatha'' (Ficus bengalensis), ''udumbara'' (Ficus glomerata), ''plaksha'' (Ficus lacor) and ''kadamba'' (Anthocephalus kadamba) can be taken. ''Pichchha basti'' can be done using ''madhura rasa'' (drugs with sweet taste) and cooling ingredients and ''sneha basti'' with oil processed with ''yashti madhu'' (Glycerrhiza glabra) can be done.[64-67]

==== Complication of ''paristrava'' (discharge) and its management ====

+

अल्पं तु बहुदोषस्य दोषमुत्क्लिश्य भेषजम्|

Line 1,018: Line 1,119:

शुद्धे चूर्णासवारिष्टान् संस्कृतांश्च प्रदापयेत्||७०||

+

alpaṁ tu bahudōṣasya dōṣamutkliśya bhēṣajam|

Line 1,042: Line 1,144:

shuddhe cUrNAsavAriShTAn saMskRutAMshca pradApayet||70||

+

</div></div>

In the patients with excessively vitiated ''doshas'', when only a small dose of medicine is given, the ''dosha'' get aggravated and discharged out in little quantity frequently. This result in ''alpa shopha'' (swelling), ''kandu'' (itching), ''kushtam'' (skin diseases), ''gauravam'' (heaviness), ''agni naasham'' (destruction of digestive power), ''utklesham'' (nausea), ''staimityam'' ( feeling of body covered with wet cloths), ''aruchi'' (ageusia) and ''pandu'' (anemia). The entire spectrum is called ''parisravam''. In this condition, the aggravated ''dosha'' must either be alleviated or removed out by emesis. Otherwise after oleation, potent ''virechana'' medicine can be given again for purification after which ''arishta'' (alcoholic medicated preparations) processed with drugs that enhance ''agni'' (digestive power) can be used. [68-70]

==== Complication of ''hridgraha'' (chest congestion) and its management ====

+

पीतौषधस्य वेगानां निग्रहान्मारुतादयः|

Line 1,066: Line 1,170:

तस्मै स्निग्धाम्ललवणं दद्यात् पित्तकफेऽन्यथा||७५||

+

pītauṣadhasya vēgānāṁ nigrahānmārutādayaḥ|

Line 1,106: Line 1,211:

tasmai snigdhAmlalavaNaM dadyAt pittakaphe~anyathA||75||

+

</div></div>

After taking (emetic) medicine, if one restricts the urges (of vomiting bouts), ''vata'' etc. ''dosha'' get aggravated and located in precordium, resulting in severe chest congestion. This leads to hiccups, pain in flanks, cough, fatigue, salivation, perplexion of eyes/rolling of eyes, fainting with tongue bite and severe grinding of teeth. In this case, without getting confused, the physician must immediately make the patient to vomit. For ''pitta murchita'' (fainting due to aggravation of ''pitta''), ''madhura rasa'' (sweet taste) medicines need to be used and for ''kapha murchita'' (fainting due to aggravation of ''kapha''), ''katu rasa'' (pungent taste) need to be used.

Line 1,112: Line 1,218:

==== Complication of ''gatra-graha'' (body stiffness) and its management ====

+

पीतौषधस्य वेगानां निग्रहेण कफेन वा|

Line 1,120: Line 1,227:

तत्र वातहरं सर्वं स्नेहस्वेदादि कारयेत् ||७७||

+

pītauṣadhasya vēgānāṁ nigrahēṇa kaphēna vā|

Line 1,136: Line 1,244:

tatra vAtaharaM sarvaM snehasvedAdi kArayet ||77||

+

</div></div>

After taking (emetic) medicines, if one restricts the urges (vomiting bouts) or get obstructed because of vitiated ''kapha'', then the excessively vitiated ''vata'' causes body stiffness. This results in stiffness, tremor, pricking pain, fainting, cramps and fatigue. This condition shall be managed with all ''vata'' alleviating treatments like oleation, sudation etc. [76-77]

==== Complication of ''jeevadana'' (bleeding) and its management ====

+

अतितीक्ष्णं मृदौ कोष्ठे लघुदोषस्य भेषजम्|

Line 1,168: Line 1,278:

पिच्छाबस्तिं सुशीतं वा घृतमण्डानुवासनम्||८४||

+

atitīkṣṇaṁ mr̥dau kōṣṭhē laghudōṣasya bhēṣajam|

Line 1,224: Line 1,335:

picchAbastiM sushItaM vA ghRutamaNDAnuvAsanam||84||

+

</div></div>

If in the individual with ''mridu koshtha'' (soft bowel), and less aggravated ''dosha'', highly potent (''virechana'') medicine is administered, that will result in the removal of ''dosha'' after which bleeding ensues and then finally lead to evacuation of ''jeeva rakta'' (pure, functioning blood).

Line 1,236: Line 1,348:

==== Complication of ''gudavibhramsha'' (rectum prolapse) and its management ====

+

गुदं भ्रष्टं कषायैश्च स्तम्भयित्वा प्रवेशयेत्|

Line 1,248: Line 1,361:

स विभ्रंशो मतस्तत्र स्याद्यथाव्याधि भेषजम्||८७||

+

gudaṁ bhraṣṭaṁ kaṣāyaiśca stambhayitvā pravēśayēt|

Line 1,272: Line 1,386:

sa vibhraMsho matastatra syAdyathAvyAdhi bheShajam||87||

+

</div></div>

If there is rectal prolapse, it should be positioned by using ''kashaya dravya'' (astringent drugs) and pushed in its own location. If there is loss of consciousness, then he should be consoled and exposed to music therapy.

Line 1,278: Line 1,393:

==== Complication of ''stambha'' (stiffness) and its management ====

+

पीतं स्निग्धेन सस्नेहं तद्दोषैर्मार्दवाद्वृतम्|

Line 1,286: Line 1,402:

तीक्ष्णं बस्तिं विरेकं वा सोऽर्हो लङ्घितपाचितः||८९||

+

pītaṁ snigdhēna sasnēhaṁ taddōṣairmārdavādvr̥tam|

Line 1,302: Line 1,419:

tIkShNaM bastiM virekaM vA so~arho la~gghitapAcitaH||89||

+

</div></div>

Unctuous medicine for ''virechana'' when given to a person with an oleated body, because of the mild nature of ''doshas'', they are not let out and cause occlusion in its own site. Because of the obstructed ''vayu'', there will be obstruction and pain in the rectum and there will be frequent expulsion of ''doshas'' in little quantity.

Line 1,308: Line 1,426:

==== Complications and its management ====

+

रूक्षं विरेचनं पीतं रूक्षेणाल्पबलेन वा|

Line 1,316: Line 1,435:

स्नेहस्वेदादिकस्तत्र कार्यो वातहरो विधिः||९१||

+

rūkṣaṁ virēcanaṁ pītaṁ rūkṣēṇālpabalēna vā|

Line 1,332: Line 1,452:

snehasvedAdikastatra kAryo vAtaharo vidhiH||91||

+

</div></div>

Individual with un-unctuous body and who is weak, when given an un-unctuous ''virechana'' recipe, will result in severe vitiation of ''vayu'' and cause serious complications. Vitiated ''vayu'' results in whole body stiffness and colicky pain. Here oleation and sudation therapies along with protocol for management of ''vata'' needs to be adopted. [90-91]

==== ''Klama'' (fatigue without exertion) and its management ====

+

स्निग्धस्य मृदुकोष्ठस्य मृदूत्क्लिश्यौषधं कफम्|

Line 1,344: Line 1,466:

लङ्घनं पाचनं चात्र स्निग्धं तीक्ष्णं च शोधनम्||९३||

+

snigdhasya mr̥dukōṣṭhasya mr̥dūtkliśyauṣadhaṁ kapham|

Line 1,360: Line 1,483:

la~gghanaM pAcanaM cAtra snigdhaM tIkShNaM ca shodhanam||93||

+

</div></div>

For those with unctuous and ''mridu koshtha'', if mild purificatory medicine is given, there is aggravation of ''kapha'' causing obstruction to ''pitta'' and ''vata'' resulting in fatigue, heaviness of body, loss of strength, excruciating pain. Here the medicine must be given to vomit immediately. Then accordingly ''langhana'' (fasting) and ''pachana'' (digestive medicine) need to be done followed by purification with strong and unctuous medicines. [92-93]

==== Summary ====

+

तत्र श्लोकौ-

Line 1,374: Line 1,499:

दद्यात् संशोधनं सम्यगारोग्यार्थी नृणां सदा||९५||

+

tatra ślōkau-

Line 1,394: Line 1,520:

dadyAt saMshodhanaM samyagArogyArthI nRuNAM sadA||95||

+

</div></div>

Thus the features of complications that may arise due to ''vamana'' and ''virechana'' by un-skilled physician and their management are described. Intelligent ones must always properly understand these states and administer proper purification therapy in the persons desiring health. [94-95]

Agnivesha

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