Charaka Siddhisthana Chapter 1 – Kalpanasiddhi

This article explains the first chapter of siddhisthana of Charaka samhita called ‘Kalpana siddhi Adhyaya’. In this chapter, basic concepts of Vamana, Virechana, Basti and Nasya treatments are explained.

Prologue
अथातः कल्पनासिद्धिं व्याख्यास्यामः||१|| इति ह स्माह भगवानात्रेयः||२||
athātaḥ kalpanāsiddhiṃ vyākhyāsyāmaḥ||1|| iti ha smāha bhagavānātreyaḥ||2||
Now we shall expound the chapter dealing with “the Procedure for successful administration of PanchaKarma”. Thus, said Lord Atreya. [1-2]

Queries of Agnivesha

Agnivesha, the foremost among the disciplines (of Punarvasu Atreya) puts his queries before his preceptor. They are as follows:
What is the prescribed procedure for the administration of Panchakarma (five specialised therapies)? [The answer will be provided in verse nos.6 2/4 – 2/4 10]
In which order these five therapies should be administered? [The answer will be provided in verse nos. 10 2/4- 2/4 15]
What are the signs of proper, improper and excessive administration of these therapies? [The answer will be provided in verse nos. 15 2/4 – 24, 40 2/4 – 2/4 47]
What number of enemas should be given? [The answer will be provided in verse nos. 25-26 and 47 2/4 – 50]
What are the therapeutic effects of medicated enema (Basti)? [The answer will be provided in verse nos. 27- 34, 38- 2/4 40]
What type of Basti (medicated enema) is useful for which type of disease? [The answer will be provided in verse nos. 36-37]
What should be avoided during the course of the treatment? [The answer will be provided in verse nos. 54 2/4- 2/4 55]
What is the interval between the administrations of different therapies? [The answer will be provided in verse no. 2/4 54]
What is the reason for the enema not entering into the rectum after having administered? [The answer will be provided in verse no. 55 2/4- 2/4 56]
What makes the recipe of enema to come out earlier than the scheduled time? [The answer will be provided in verse nos. 56 2/4 – 2/4 57]
What is the cause of delay in the evacuation of the administered recipe of medicated enema? And [the answer will be provided in verse no. 2/4 56]
Why do some diseases though curable do not get cured even when recipes for each are administered? [The answer will be provided in verse nos. 57 2/4- 2/4
59]
In relation to these questions, Punarvasu, who is the foremost among physicians who is well-versed in scriptures, replied as follows with a view of promoting the welfare of human beings. [3-2/4 6]

Duration of Snehana

त्र्यहावरं सप्तदिनं परं तु स्निग्धो नरः स्वेदयितव्य उक्तः ||६||
नातः परं स्नेहनमादिशन्ति सात्म्यीभवेत् सप्तदिनात् परं तु|७|

tryahāvaraṃ saptadinaṃ paraṃ tu snigdho naraḥ svedayitavya uktaḥ ||6||
nātaḥ paraṃ snehanamādiśanti sātmyībhavet saptadināt paraṃ tu|7|

Duration of Oleation therapy
To a person who has undergone snehana therapy, the swedana therapy should be administered. It should be administered continuously for a minimum of three days to a maximum period of seven days. Oleation therapy is not recommended after the seventh day because, by then the person’s body gets saturated / accustomed with it. [6 2/4- 2/4 7]

Effects of Snehana, Swedana

Therapeutic Effects of Oleation Therapy:
स्नेहोऽनिलं हन्ति मृदूकरोति देहं मलानां विनिहन्ति सङ्गम्||७||
sneho’nilaṃ hanti mṛdūkaroti dehaṃ malānāṃ vinihanti saṅgam||7||
Oleation therapy –
alleviates aggravated Vata Dosha,
softens the body and
disintegrates the adhered morbid material [in the channels of oleation] [7 2/4]

Therapeutic effects of Fomentation Therapy:
स्निग्धस्य सूक्ष्मेष्वयनेषु लीनं स्वेदस्तु दोषं नयति द्रवत्वम्|८|
snigdhasya sūkṣmeṣvayaneṣu līnaṃ svedastu doṣaṃ nayati dravatvam|8|
Fomentation liquefies the morbid material adhered even in the fine channels of the body of a person who has undergone oleation therapy. [2/4 8]

Food to cause Dosha Utklesha

Measures for Exciting Morbid material:
ग्राम्यौदकानूपरसैः समांसैरुत्क्लेशनीयः पयसा च वम्यः||८||
रसैस्तथा जाङ्गलजैः सयूषैः स्निग्धैः कफावृद्धिकरैर्विरेच्यः|९|
grāmyaudakānūparasaiḥ samāṃsairutkleśanīyaḥ payasā ca vamyaḥ||8||
rasaistathā jāṅgalajaiḥ sayūṣaiḥ snigdhaiḥ kaphāvṛddhikarairvirecyaḥ|9|
The person who is to be administered emesis is given milk and meat as well as meat-soup of domesticated animals and animals living in aquatic and wetlands in the form of food for causing excitation of kapha.
The person who is to be given purgation therapy is given soup of the meat of animals inhabiting arid zones and vegetable-soup added with fat to bring about the excitation of Pitta, which also do not cause aggravation of Kapha. [8 2/4 – 2/4 9]

Reasons for Vamana, Virechana Working in Opposite Ways

श्लेष्मोत्तरश्छर्दयति ह्यदुःखं विरिच्यते मन्दकफस्तु सम्यक्||९||
अधः कफेऽल्पे वमनं विरेचयेद्विरेचनं वृद्धकफे तथोर्ध्वम्|१०|
śleṣmottaraśchardayati hyaduḥkhaṃ viricyate mandakaphastu samyak||9||
adhaḥ kaphe’lpe vamanaṃ virecayedvirecanaṃ vṛddhakaphe tathordhvam|10|
A person with excessively aggravated kapha vomits without any difficulty, and the person having less aggravated Kapha purges well. However, if there is less of aggravated kapha, the emetic recipe causes purgation through the downward tract. Similarly, if there is aggravated kapha, the purgative recipe causes emesis through the upward tract. [9 2/4- 2/4 10]

Order of Administering Vamana, Virechana

स्निग्धाय देयं वमनं यथोक्तं वान्तस्य पेयादिरनुक्रमश्च||१०|| स्निग्धस्य सुस्विन्नतनोर्यथावद्विरेचनं योग्यतमं प्रयोज्यम् |११|
snigdhāya deyaṃ vamanaṃ yathoktaṃ vāntasya peyādiranukramaśca||10|| snigdhasya susvinnatanoryathāvadvirecanaṃ yogyatamaṃ prayojyam |11|
Emetic therapy is administered to a person according to the appropriate procedure (described in Kalpa 1:14) after his body has been subjected to oleation therapy.
After emesis, he is given systematic dietetic regimen (samsarjana-Krama) with Peya (thin gruel), etc.
Thereafter, the person who has undergone oleation and fomentation therapies, is administered the best suited purgation therapy appropriately (ref. Sutra 15:17) 10 2/4 – 2/4 11)

Post- therapeutic Measures (Samsarjana karma)

पेयां विलेपीमकृतं कृतं च यूषं रसं त्रिर्द्विरथैकशश्च||११|| क्रमेण सेवेत विशुद्धकायः प्रधानमध्यावरशुद्धिशुद्धः|१२|
peyāṃ vilepīmakṛtaṃ kṛtaṃ ca yūṣaṃ rasaṃ trirdvirathaikaśaśca||11|| krameṇa seveta viśuddhakāyaḥ pradhānamadhyāvaraśuddhiśuddhaḥ|12|
After the body is cleansed of the morbidities [by emesis and purgation therapies] the patient is given the below mentioned in the form of food –
Peya (thin gruel),
Vilepi (thick gruel),
Akrta as well as Krta yusa (unseasoned and seconded vegetable juice) and
Artaka as well as Krta-Rasa (unseasoned and seasoned meat-soup)
Each of these dietary items is given for three, two or one meal times to the person whose body is cleansed in accordance with either Pradhana Shudhi (maximum cleansing), Madhya Shudhi (moderate cleansing) or Avara Suddhi (minimum cleaning) respectively. [11 2/4 – 2/4 12]

Effects of Samsarjana Krama
यथाऽणुरग्निस्तृणगोमयाद्यैः सन्धुक्ष्यमाणो भवति क्रमेण||१२|| महान् स्थिरः सर्वपचस्तथैव शुद्धस्य पेयादिभिरन्तरग्निः|१३|
yathā’ṇuragnistṛṇagomayādyaiḥ sandhukṣyamāṇo bhavati krameṇa||12|| mahān sthiraḥ sarvapacastathaiva śuddhasya peyādibhirantaragniḥ|13|
Just like a small spark of fire gets kindled into a big and stable flame when fed gradually with dry grass, cow-dung cake, etc., the internal fire or the enzymes in the body responsible for digestion and metabolism [which was subdued because of purificatory measures] in a purified person grows to become strong and stable, and becomes capable of digesting all types of food by the [gradual] administration of Peya – thin gruel), etc. dietetic regimen. [12 2/4- 2/4 13]

3 levels of Shuddhi of Vamana, Virechana

जघन्यमध्यप्रवरे तु वेगाश्चत्वार इष्टा वमने षडष्टौ||१३||
दशैव ते द्वित्रिगुणा विरेके प्रस्थस्तथा द्वित्रिचतुर्गुणश्च| पित्तान्तमिष्टं वमनं विरेकादर्धं कफान्तं च विरेकमाहुः||१४||
द्वित्रान् सविट्कानपनीय वेगान्मेयं विरेके वमने तु पीतम्|१५|
jaghanyamadhyapravare tu vegāścatvāra iṣṭā vamane ṣaḍaṣṭau||13||
daśaiva te dvitriguṇā vireke prasthastathā dvitricaturguṇaśca| pittāntamiṣṭaṃ vamanaṃ virekādardhaṃ kaphāntaṃ ca virekamāhuḥ||14||
dvitrān saviṭkānapanīya vegānmeyaṃ vireke vamane tu pītam|15|

In Vamana –
in Jaghanya or Avara shudhi (minimum type of cleansing) – 4 Vegas (bouts of vomiting) with quantity of vomitus – 1 Prastha – 768 ml
In Madhya Shudhi (Moderate) – 6 vegas – quantity of vomitus – 1.152 liters
In Pravara Shudhi (maximum cleansing) – 8 bouts of vomiting – quantity of vomitus – 1.536 liters

In Virechana,
in Jaghanya or Avara Suddhi – 10 Vegas, with 2 Prastha mala (1.536 liters of quantity of stool)
Madhyama Shudhi – 20 Vegas with 3 Prastha mala (2.304 l)
Pravara Shudhi – 30 Vegas with 4 Prastha mala (3.072 l)

pittāntamiṣṭaṃ vamanaṃ – It is desirable that the emetic therapy should end up with the vomiting of Pitta (bile).
And the vomited material is half of what is described for purgative therapy [by implication, in the Jaghnya Shudhi, Madhya Shudhi and Pravara shudhi, the vomited material is one, one and a half, and two Prastha respectively.]

kaphāntaṃ ca virekam – The purgation therapy should end up with the voiding of Kapha (phlegm).
In the case of purgation therapy, the first two or three motions containing faeces should not be taken into account while measuring the quantity of voided material. Similarly, in the case of emetic therapy, the quantity of drugs taken for the therapy is excluded while measuring the vomited material. [13 ½ – 2/4 15]

Vamana Samyak, Mithya Yoga, Ayoga

क्रमात् कफः पित्तमथानिलश्च यस्यैति सम्यग्वमितः स इष्टः||१५||
हृत्पार्श्वमूर्धेन्द्रियमार्गशुद्धौ तथा लघुत्वेऽपि च लक्ष्यमाणे|१६|
kramāt kaphaḥ pittamathānilaśca yasyaiti samyagvamitaḥ sa iṣṭaḥ||15||
hṛtpārśvamūrdhendriyamārgaśuddhau tathā laghutve’pi ca lakṣyamāṇe|16|

Vamana Samyak Yoga:
Signs of appropriately Administered Emetic Therapy –
Below mentioned are the signs of properly administered emetic therapy –
– Expulsion of Kapha (Phlegm), pitta (bile) and Vayu (flatus and wind) in succession,
– Feeling of clarity in heart, sides of the chest, head and channels of circulation,
– Feeling of clarity of the sense organs,
– Feeling of lightness of the body,
– Feeling energetic,
– Promotion of Agni (power of digestion and metabolism),
– Freedom from diseases (caused by Doshas for which the purgation therapy was administered) and
– Expulsion of faeces, Pitta (bile), kapha (phlegm) and Vayu (flatus) in succession (that order)

Mithya Yoga of Vamana
दुश्छर्दिते स्फोटककोठकण्डूहृत्खाविशुद्धिर्गुरुगात्रतां च||१६||

Signs of Improperly Administered Emetic Therapy –
Improperly administered emetic therapy (i.e., with the recipe of small quantity), gives rise to
sphotaka (postural eruptions),
kotha (urticaria),
kandu (itching),
lack of clarity in the heart as well as
sense organs and heaviness of the body [16 2/4]

Ati Yoga of Vamana

तृण्मोहमूर्च्छानिलकोपनिद्राबलादिहानिर्वमनेऽति च स्यात्|१७|
tṛṇmohamūrcchānilakopanidrābalādihānirvamane’ti ca syāt|17|

Signs of Emetic Therapy Administered in Excess:
If there is excessive administration of emetic therapy, then the person suffers from –
thirst,
moha (unconsciousness),
murccha (fainting),
aggravation of Vayu,
insomnia,
debility, etc.

Virechana Samyak, Mithya Yoga and Ati Yoga

Signs of Appropriately Administered Purgation Therapy
स्रोतोविशुद्धीन्द्रियसम्प्रसादौ लघुत्वमूर्जोऽग्निरनामयत्वम्||१७|| प्राप्तिश्च विट्पित्तकफानिलानां सम्यग्विरिक्तस्य भवेत् क्रमेण|१८|
srotoviśuddhīndriyasamprasādau laghutvamūrjo’gniranāmayatvam||17|| prāptiśca viṭpittakaphānilānāṃ samyagviriktasya bhavet krameṇa|18|
If the purgation therapy is appropriately administered, the following signs are observed –
purity of the channels of circulation,
clarity of the sense organs,
lightness of the body,
feeling energetic,
promotion of Agni (power of digestion and metabolism),
freedom from diseases (caused by Doshas for which the purgation therapy was administered) and expulsion of feces, pitta (bile), kapha (phlegm) and Vayu (flatus) in succession

Virechana Mithya Yoga
Signs of Improperly administered Purgation Therapy:
स्याच्छ्लेष्मपित्तानिलसम्प्रकोपः सादस्तथाऽग्नेर्गुरुता प्रतिश्या||१८||
तन्द्रा तथा च्छर्दिररोचकश्च वातानुलोम्यं न च दुर्विरिक्ते|१९|
syācchleṣmapittānilasamprakopaḥ sādastathā’gnergurutā pratiśyā||18||
tandrā tathā cchardirarocakaśca vātānulomyaṃ na ca durvirikte|19|

Below mentioned are the signs of improperly administered purgation therapy (i.e., with the recipe of small quantity),
excessive aggravation of kapha, Pitta and Vata,
suppression of Agni (power of digestion and metabolism),
heaviness of the body,
coryza,
drowsiness,
vomiting,
anorexia and
absence of downward movement of the flatus [18 2/4- 2/4 19]

Virechana Atiyoga
Signs of Purgation Therapy Administered in Excess:
कफास्रपित्तक्षयजानिलोत्थाः सुप्त्यङ्गमर्दक्लमवेपनाद्याः||१९||
निद्राबलाभावतमःप्रवेशाः सोन्मादहिक्काश्च विरेचितेऽति|२०|
kaphāsrapittakṣayajānilotthāḥ suptyaṅgamardaklamavepanādyāḥ||19||
nidrābalābhāvatamaḥpraveśāḥ sonmādahikkāśca virecite’ti|20|

Below mentioned are the signs of excessive administration of purgation therapy –
ailments caused by the aggravation of vayu as a result of the diminution of kapha, blood as well as Pitta,
numbness,
malaise,
mental fatigue,
tremor, etc.,
insomnia,
debility,
fainting,
insanity and
hiccup [19 2/4- 2/4 20]

Spacing of Vamana, Virechana, Basti

संसृष्टभक्तं नवमेऽह्नि सर्पिस्तं पाययेताप्यनुवासयेद्वा||२०||
तैलाक्तगात्राय ततो निरूहं दद्यात्र्यहान्नातिबुभुक्षिताय| प्रस्यागते धन्वरसेन भोज्यः समीक्ष्य वा दोषबलं यथार्हम्||२१||
नरस्ततो निश्यनुवासनार्हो नात्याशितः स्यादनुवासनीयः |२२|
saṃsṛṣṭabhaktaṃ navame’hni sarpistaṃ pāyayetāpyanuvāsayedvā||20||
tailāktagātrāya tato nirūhaṃ dadyātryahānnātibubhukṣitāya| prasyāgate dhanvarasena bhojyaḥ samīkṣya vā doṣabalaṃ yathārham||21||
narastato niśyanuvāsanārho nātyāśitaḥ syādanuvāsanīyaḥ |22|

After Samsarjana-Krama, on the 9th day after Vamana, the patient is given a portion of ghee [if purgation therapy is intended to be given subsequently]. [Similarly, on the ninth day of purgation therapy, after Samsajana-Krama, anuvasana, i.e., unctuous enema is given subsequently].

For 3 days, thereafter, the body of the person is massaged with medicated oil, and then Niruha Basti is given when the person is not very hungry.
After the recipe of Niruha (evacuative enema) has come out, the patient is given meat-soup of Jangala type of animals (those inhabiting arid forest zone) or any other appropriate diet depending upon the nature of Doshas and the power of agni (enzymes responsible for digestion and metabolism).
Thereafter, when the patient has not taken a heavy meal in the night, Anuvasana Basti (fat enema) is given to him if the patient is fit for such Anuvasana therapy. [20 2/4- 2/4 22]

Time of Anuvasana Basti

शीते वसन्ते च दिवाऽनुवास्यो रात्रौ शरद्ग्रीष्मघनागमेषु||२२|| तानेव दोषान् परिरक्षता ये स्नेहस्य पाने परिकीर्तिताः प्राक्|२३|
śīte vasante ca divā’nuvāsyo rātrau śaradgrīṣmaghanāgameṣu||22|| tāneva doṣān parirakṣatā ye snehasya pāne parikīrtitāḥ prāk|23|
In Shishira and Vasanta Rutu – winter and spring seasons, Anuvasana basti is given during the day;
In Sharath and Greeshma and Varsha Rutus (autumn, summer, raining) it is administered during the night time.
Care is taken to avoid mistakes as described earlier (vide Sutra 13: 19-21) in respect of the administration of oleation therapy. [22 2/4 – 2/4 23]

Frequency of Anuvasana Basti
प्रत्यागते चाप्यनुवासनीये दिवा प्रदेयं व्युषिताय भोज्यम्||२३|| सायं च भोज्यं परतो द्व्यहे वा त्र्यहेऽनुवास्योऽहनि पञ्चमे व |
pratyāgate cāpyanuvāsanīye divā pradeyaṃ vyuṣitāya bhojyam||23|| sāyaṃ ca bhojyaṃ parato dvyahe vā tryahe’nuvāsyo’hani pañcame vā |

त्र्यहे त्र्यहे वाऽप्यथ पञ्चमे वा दद्यान्निरूहादनुवासनं च||२४||
tryahe tryahe vā’pyatha pañcame vā dadyānnirūhādanuvāsanaṃ ca||24||
After the administered Anuvasana medicine comes out of the anal tract, the patient should not take any food at night.
During the next day, breakfast and dinner is given.
Thereafter, on the 2nd, 3rd and 5th days, Anuvasana is given. After that, every third- or fifth-days Niruha type of medicated enema is given followed by Anuvasana. [23 2/4- 24]

Number of Anuvasana Basti based on Dosha
एकं तथा त्रीन् कफजे विकारे पित्तात्मके पञ्च तु सप्त वाऽपि| वाते नवैकादश वा पुनर्वा बस्तीनयुग्मान् कुशलो विदध्यात्||२५||
ekaṃ tathā trīn kaphaje vikāre pittātmake pañca tu sapta vā’pi| vāte navaikādaśa vā punarvā bastīnayugmān kuśalo vidadhyāt||25||
In Kaphaja diseases – 1-3 Bastis (medicated enema).
In Paittika diseases – 5-7 Bastis, and in
Vatika diseases -9-11 Bastis are administered.
In this way an expert physician should give Bastis in odd numbers. [25]

Niruha Anuvasana Time gap

Time Gap for Niruha After Virechana and for Virechana After Niruha:
नरो विरिक्तस्तु निरूहदानं विवर्जयेत् सप्तदिनान्यवश्यम्| शुद्धो निरूहेण विरेचनं च तद्ध्यस्य शून्यं विकसेच्छरीरम्||२६||
naro viriktastu nirūhadānaṃ vivarjayet saptadinānyavaśyam| śuddho nirūheṇa virecanaṃ ca taddhyasya śūnyaṃ vikaseccharīram||26||

After purgation, a person should avoid Niruha Basti, and after niruha basti one should avoid purgation therapy for seven days because it will have injurious effects on the body which is already empty [of nourishing material] by the earlier therapy. [26]

Effects of Niruha Basti

बस्तिर्वयःस्थापयिता सुखायुर्बलाग्निमेधास्वरवर्णकृच्च| सर्वार्थकारी शिशुवृद्धयूनां निरत्ययः सर्वगदापहश्च||२७||
विट्श्लेष्मपित्तानिलमूत्रकर्षी दार्ढ्यावहः शुक्रबलप्रदश्च| विश्वक्स्थितं दोषचयं निरस्य सर्वान् विकारान् शमयेन्निरूहः||२८||
bastirvayaḥsthāpayitā sukhāyurbalāgnimedhāsvaravarṇakṛcca| sarvārthakārī śiśuvṛddhayūnāṃ niratyayaḥ sarvagadāpahaśca||27||
viṭśleṣmapittānilamūtrakarṣī dārḍhyāvahaḥ śukrabalapradaśca| viśvaksthitaṃ doṣacayaṃ nirasya sarvān vikārān śamayennirūhaḥ||28||

Effect of Niruha Basti
Niruha Basti has the following effects:
It prevents aging process of the body;
It promotes happiness, longevity, strength, power of digestion and metabolism, intellect), voice and complexion
It accomplishes all the objects (including mutually contradictory ones like stability or plumpness and emaciation);
It is harmless for infants, old persons and youth;
It helps in curing all diseases
It helps in drawing out faeces, Kapha, Pitta, Vayu and urine;
It promotes sturdiness of the body
It enriches semen and promotes strength and
While eliminating accumulated Doshas (morbid matter) from the entire body, it (Niruha type of enema) alleviates all the diseases. [27-28]

Effects of Anuvasana Basti

देहे निरूहेण विशुद्धमार्गे संस्नेहनं वर्णबलप्रदं च| न तैलदानात् परमस्ति किञ्चिद्द्रव्यं विशेषेण समीरणार्ते ||२९||
स्नेहेन रौक्ष्यं लघुतां गुरुत्वादौष्ण्याच्च शैत्यं पवनस्य हत्वा| तैलं ददात्याशु मनःप्रसादं वीर्यं बलं वर्णमथाग्निपुष्टिम् ||३०||
मूले निषिक्तो हि यथा द्रुमः स्यान्नीलच्छदः कोमलपल्लवाग्र्यः| काले महान् पुष्पफलप्रदश्च तथा नरः स्यादनुवासनेन||३१||
dehe nirūheṇa viśuddhamārge saṃsnehanaṃ varṇabalapradaṃ ca| na tailadānāt paramasti kiñciddravyaṃ viśeṣeṇa samīraṇārte ||29||
snehena raukṣyaṃ laghutāṃ gurutvādauṣṇyācca śaityaṃ pavanasya hatvā| tailaṃ dadātyāśu manaḥprasādaṃ vīryaṃ balaṃ varṇamathāgnipuṣṭim ||30||
mūle niṣikto hi yathā drumaḥ syānnīlacchadaḥ komalapallavāgryaḥ| kāle mahān puṣpaphalapradaśca tathā naraḥ syādanuvāsanena||31|

Effects of Anuvasana Basti:
The channels of the body get cleansed by Niruha. Administration of \Snehana or Anuvasana basti to such a person promotes his complexion and strength.
There is no therapy better than the administration of oil (anuvasana basti) which is especially useful for the patient afflicted with diseases caused by Vata.

The oil by its unctuousness, heaviness and heating property counteracts the non-unctuousness (dryness), lightness and cooling attributes of Vata respectively. Because of this, administration of oil (Anuvasana-Basti) instantaneously produces clarity of mind, and promotes energy, strength complexion and Agni (power of digestion and metabolism). Just as a tree irrigated with water at the root produces blue leaves, becomes beautiful with tender leaves, and during the course of time grows to produce flowers and fruits, similarly, a person becomes [young and beautiful with procreative power]by the administration of Anuvasana or unctuous type of medicated enema. [29-31]

Effects of Niruha and Anuvasana in General:
स्तब्धाश्च ये सङ्कुचिताश्च येऽपि ये पङ्गवो येऽपि च भग्नरुग्णाः| येषां च शाखासु चरन्ति वाताः शस्तो विशेषेण हि तेषु बस्तिः||३२||
आध्मापने विग्रथिते पुरीषे शूले च भक्तानभिनन्दने च| एवम्प्रकाराश्च भवन्ति कुक्षौ ये चामयास्तेषु च बस्तिरिष्टः||३३||
याश्च स्त्रियो वातकृतोपसर्गा गर्भं न गृह्णन्ति नृभिः समेताः| क्षीणेन्द्रिया ये च नराः कृशाश्च बस्तिः प्रशस्तः परमं च तेषु||३४||
stabdhāśca ye saṅkucitāśca ye’pi ye paṅgavo ye’pi ca bhagnarugṇāḥ| yeṣāṃ ca śākhāsu caranti vātāḥ śasto viśeṣeṇa hi teṣu bastiḥ||32||
ādhmāpane vigrathite purīṣe śūle ca bhaktānabhinandane ca| evamprakārāśca bhavanti kukṣau ye cāmayāsteṣu ca bastiriṣṭaḥ||33||
yāśca striyo vātakṛtopasargā garbhaṃ na gṛhṇanti nṛbhiḥ sametāḥ| kṣīṇendriyā ye ca narāḥ kṛśāśca bastiḥ praśastaḥ paramaṃ ca teṣu||34||

Basti or medicated enema is especially useful for the following types of persons:
whose limbs have become stiff and contracted;
who are lame
who are afflicted with fractures and dislocations and
whose whole limbs are afflicted by the movement of different types of aggravated Vata
Basti is also useful for the treatment of the following ailments:
Distension of the abdomen by air
Scybalous stool
Colic pain
Disliking for food; and
Such other ailments affecting the pelvic region
Basti is an excellent therapy for women who are afflicted with the complications of Vata, and who are unable to conceive in spite of mating with their male partners. It is also extremely useful for men having seminal debility and emaciation of the body. [32- 34]

Selection of Basti for Different Type of Patients:
उष्णाभिभूतेषु वदन्ति शीताञ्छीताभिभूतेषु तथा सुखोष्णान्| तत्प्रत्यनीकौषधसम्प्रयुक्तान् सर्वत्र बस्तीन् प्रविभज्य युञ्ज्यात्||३५||
uṣṇābhibhūteṣu vadanti śītāñchītābhibhūteṣu tathā sukhoṣṇān| tatpratyanīkauṣadhasamprayuktān sarvatra bastīn pravibhajya yuñjyāt||35||
According to experts, [in the administration of Pancha-Karma therapy) cooling basti (medicated enema) is given to the patients suffering from diseases caused by hot ingredients. And lukewarm Basti is given to the patients suffering from diseases caused by cooling ingredients.
In all cases, different types of Basti containing ingredients having attributes opposite to the attributes of the etiological factors of diseases are administered. [35]

Contra indications for Anuvasana, Niruha

Contra indications for Anuvasana
न बृंहणीयान् विदधीत बस्तीन् विशोधनीयेषु गदेषु वैद्यः| कुष्ठप्रमेहादिषु मेदुरेषु नरेषु ये चापि विशोधनीयाः||३६||
na bṛṃhaṇīyān vidadhīta bastīn viśodhanīyeṣu gadeṣu vaidyaḥ| kuṣṭhapramehādiṣu medureṣu nareṣu ye cāpi viśodhanīyāḥ||36||
To the patients needing cleansing and detoxification should not be given Brumhaniya or Anuvasana) Basti. For example, people with Kushta, Prameha and obesity need Shodhana Basti, there we need to avoid Anuvasana. [36]

Contra indication for Niruha Basti
क्षीणक्षतानां न विशोधनीयान्न शोषिणां नो भृशदुर्बलानाम्| न मूर्च्छितानां न विशोधितानां येषां च दोषेषु निबद्धमायुः||३७||
kṣīṇakṣatānāṃ na viśodhanīyānna śoṣiṇāṃ no bhṛśadurbalānām| na mūrcchitānāṃ na viśodhitānāṃ yeṣāṃ ca doṣeṣu nibaddhamāyuḥ||37||

Niruha or evacuative type of Basti should not be given to patients suffering from Kshataksheena, (phthisis), Shosha (consumption), extreme debility and Murccha (fainting), and to those who have already undergone the process of purification, and to those life is dependent upon the holding up of Doshas (morbid matter). [37]

Importance of Basti Chikitsa

शाखागताः कोष्ठगताश्च रोगा मर्मोर्ध्वसर्वावयवाङ्गजाश्च|ये सन्ति तेषां न हि कश्चिदन्यो वायोः परं जन्मनि हेतुरस्ति||३८||
विण्मूत्रपित्तादिमलाशयानां विक्षेपसङ्घातकरः स यस्मात्| तस्यातिवृद्धस्य शमाय नान्यद्बस्तिं विना भेषजमस्ति किञ्चित्||३९||
तस्माच्चिकित्सार्धमिति ब्रुवन्ति सर्वां चिकित्सामपि बस्तिमेके|४०|
śākhāgatāḥ koṣṭhagatāśca rogā marmordhvasarvāvayavāṅgajāśca|ye santi teṣāṃ na hi kaścidanyo vāyoḥ paraṃ janmani heturasti||38||
viṇmūtrapittādimalāśayānāṃ vikṣepasaṅghātakaraḥ sa yasmāt| tasyātivṛddhasya śamāya nānyadbastiṃ vinā bheṣajamasti kiñcit||39||
tasmāccikitsārdhamiti bruvanti sarvāṃ cikitsāmapi bastimeke|40|

There is none other than Vayu which is the most important causative factor of diseases in
Shakha (peripheral tissue elements),
Kostha (Visceras of the Thorax and Abdomen) (the body), Sarvavayava (covering the entire body) and
Anga (individual parts of the body).

Vayu is responsible for the separation (Viksepa=Vibhaga) and combination (sanghata=Samyoga) of stool, urine, Pitta, (Kapha), including other excreta and tissue elements (Asaya: normally meaning receptacle, which has been interpreted by Chakrapani as tissue elements]. When vata gets exceedingly aggravated there is no remedy other than Basti for its alleviation.
Therefore, Basti is considered by physicians to be half of the entire therapeutic measures. Some physicians even go to the extent of suggesting that Basti represents (not half but) the whole of therapeutic measures. [38 – 2/4 40]

Definition of Basti, Samyak Basti Lakshana

नाभिप्रदेशं कटिपार्श्वकुक्षिं गत्वा शकृद्दोषचयं विलोड्य ||४०||संस्नेह्य कायं सपुरीषदोषः सम्यक् सुखेनैति च यः स बस्तिः |४१|
The therapy which while moving in the umbilical region, lumbar region, sides of the chest and pelvic region churns up the stool including all the other morbid matter located there, and appropriately, eliminates them (stool and other morbid material) with ease after nourishing (lit. oleating) the body is called Basti. [40 ½ – 2/4 41]

Signs of Appropriately Administered Niruha Basti:

प्रसृष्टविण्मूत्रसमीरणत्वं रुच्यग्निवृद्ध्याशयलाघवानि||४१|| रोगोपशान्तिः प्रकृतिस्थता च बलं च तत् स्यात् सुनिरूढलिङ्गम्|४२|
prasṛṣṭaviṇmūtrasamīraṇatvaṃ rucyagnivṛddhyāśayalāghavāni||41|| rogopaśāntiḥ prakṛtisthatā ca balaṃ ca tat syāt sunirūḍhaliṅgam|42|
The following signs are manifested if niruha basti is appropriately administered:
Appropriate elimination of stool, urine and flatus
Promotion of appetite and agni (power of digestion and metabolism)
Lightness of the Asaya (lit. Receptacle: tissue elements according to the earlier commentary of Cakrapani)
Alleviation of diseases and
Restoration of natural health and strength. [41 2/4- 2/4 42]

Signs of improperly Administered Niruha Basti:
स्याद्रुक्छिरोहृद्गुदबस्तिलिङ्गे शोफः प्रतिश्यायविकर्तिके च||४२||
हृल्लासिका मारुतमूत्रसङ्गः श्वासो न सम्यक् च निरूहिते स्युः|४३|
syādrukchirohṛdgudabastiliṅge śophaḥ pratiśyāyavikartike ca||42||
hṛllāsikā mārutamūtrasaṅgaḥ śvāso na samyak ca nirūhite syuḥ|43|

If the niruha or evacuative type of medicated enema is inappropriately administered (i.e., administered in a smaller dose), then this gives rise to the following signs and symptoms:
Pain in the head, cardiac region, anal region, urinary bladder and oedema of penis, coryza, gripping pain and nausea,
Retention of flatus and urine and
Dyspnoea [42 2/4- 2/4 43]

Signs and symptoms of Niruha Basti excessively administered
लिङ्गं यदेवातिविरेचितस्य भवेत्तदेवातिनिरूहितस्य||४३||
liṅgaṃ yadevātivirecitasya bhavettadevātinirūhitasya||43||
The signs and symptoms of Niruha Basti or evacuative type of medicated enema when used in excess quantity are the same as those caused by the excessive administration of purgation therapy (vide verse no 19 2/4- 2/4 20.

Signs and symptoms of properly administered Anuvasana Basti:
प्रत्येत्यसक्तं सशकृच्च तैलं रक्तादिबुद्धीन्द्रियसम्प्रसादः |स्वप्नानुवृत्तिर्लघुता बलं च सृष्टाश्च वेगाः स्वनुवासिते स्युः||४४||
pratyetyasaktaṃ saśakṛcca tailaṃ raktādibuddhīndriyasamprasādaḥ |svapnānuvṛttirlaghutā balaṃ ca sṛṣṭāśca vegāḥ svanuvāsite syuḥ||44||
Proper administration of Anuvasana Basti or unctuous type of medicated enema gives rise to the signs and symptoms as follows:
Return of the recipe containing oil, etc., with faecal matter without any obstruction;
Purity of the tissues, viz, blood, etc.
Clarity of intellect and senses
Good and continuous sleep;
Lightness and strength in the body; and
Proper manifestation of natural urges without any obstruction [44]

Signs and symptoms of improperly administered anuvasana basti
अधःशरीरोदरबाहुपृष्ठपार्श्वेषु रुग्रूक्षखरं च गात्रम् |
ग्रहश्च विण्मूत्रसमीरणानामसम्यगेतान्यनुवासितस्य ||४५||
adhaḥśarīrodarabāhupṛṣṭhapārśveṣu rugrūkṣakharaṃ ca gātram |
grahaśca viṇmūtrasamīraṇānāmasamyagetānyanuvāsitasya ||45||

Improper administration of Anuvasana Basti or unctuous type of medicated enema gives rise to signs and symptoms as follows:
Pain in the lower part of the body, abdomen, arms, back and sides of the chest;
Non-unctuousness (dryness) and roughness of the body; and
Obstruction in the passage of stool, urine and flatus [45]

Signs and Symptoms of excessively administered anuvasana basti:
हृल्लासमोहक्लमसादमूर्च्छाविकर्तिका चात्यनुवासितस्य|४६|
hṛllāsamohaklamasādamūrcchāvikartikā cātyanuvāsitasya|46|
Excessive administration of Anuvasana – Basti or unctuous type of medicated enema gives rise to nausea, unconsciousness, mental fatigue, exhaustion, fainting and gripping pain . [2/4 46]

Duration of retaining anuvasana basti

यस्येह यामाननुवर्तते त्रीन् स्नेहो नरः स्यात् स विशुद्धदेहः||४६||
आश्वागतेऽन्यस्तु पुनर्विधेयः स्नेहो न संस्नेहयति ह्यतिष्ठन्|४७|
yasyeha yāmānanuvartate trīn sneho naraḥ syāt sa viśuddhadehaḥ||46||
āśvāgate’nyastu punarvidheyaḥ sneho na saṃsnehayati hyatiṣṭhan|47|

If the unctuous material administered for Anuvasana Basti is retained for three Yamas then the body of the person gets cleansed of morbid material. If it comes out quickly (before nine hours) then another Anuvasana Basti or unctuous type of medicated enema is administered. If the unctuous material is not appropriately retained (in the rectum) then an appropriate unctuous effect is not produced in the body of the person. [46 2/4 – 2/4 47]

Different Types of Basti Therapy

त्रिंशन्मताः कर्म नु बस्तयो हि कालस्ततोऽर्धेन ततश्च योगः||४७||
सान्वासना द्वादश वै निरूहाः प्राक् स्नेह एकः परतश्च पञ्च| काले त्रयोऽन्ते पुरतस्तथैकः स्नेहा निरूहान्तरिताश्च षट् स्युः||४८||
योगे निरूहास्त्रय एव देयाः स्नेहाश्च पञ्चैव परादिमध्याः|४९|
triṃśanmatāḥ karma nu bastayo hi kālastato’rdhena tataśca yogaḥ||47||
sānvāsanā dvādaśa vai nirūhāḥ prāk sneha ekaḥ parataśca pañca| kāle trayo’nte puratastathaikaḥ snehā nirūhāntaritāśca ṣaṭ syuḥ||48||
yoge nirūhāstraya eva deyāḥ snehāśca pañcaiva parādimadhyāḥ|49|

In Karma(n) type, thirty Bastis or enema are administered. In the Kala type of Basti therapy, the number of enemas is half of the former [as explained in the commentary is sixteen in number, and not fifteen]. In the yoga type of Basti therapy, the number of enemas to be given is half of the former [eight according to Chakrapani].

In Karma-Basti, 12 Anuvasanas (unctuous type of enema) and 12 Niruhas are administered, one alternating with the other.
Before this, 1 Anuvasana Basti in the beginning, and 5 at the end are administered for the purpose of oleation. [Thus, in total, thirty Bastis are to be given for Karma Basti.

1=A	2 = A	3 = N	4 = A	5 = N	6 = A	7 = N	8 = A	9 = N	10 = A
11 = N	12 = A	13 = N	14 = A	15 = N	16 = A	17 = N	18 = A	19 = N	20 = A
21= N	22 = A	23= N	24 = A	25 = N	26 = A	27 = A	28 = A	29 = A	30 = AF

In Kala basti, 6 Anuvasanas and 6 Niruhas are given, one alternating with the other. Before this, in the beginning, one anuvasana is given for the purpose of oleation. [Thus, in total, sixteen bastis are to be given in Kala Type].

1=A	2 = N	3 = A	4 = N	5 = A	6 = N	7 = A	8 = N	9 = A	10 = N
11 = A	12 = N	13 = A	14 = A	15 = A

In Yoga basti, three Niruhas are to be given in the beginning, in the middle and at the end, five anuvasana bastis are to be given. [Thus, in this type, eight bastis in total are to be given]. [47 2/ 4- 2/4 49]

1=A

2 = N

3 = A

4 = N

5 = A

6 = N

7 = A

8 = A

Number of anuvasana basti for Snehana
त्रीन् पञ्च वाऽऽहुश्चतुरोऽथ षड्वा वातादिकानामनुवासनीयान् [१] ||४९||
स्नेहान् प्रदायाशु भिषग्विदध्यात् स्रोतोविशुद्यर्थमतो निरूहान्|५०|
trīn pañca vā”huścaturo’tha ṣaḍvā vātādikānāmanuvāsanīyān [1] ||49||
snehān pradāyāśu bhiṣagvidadhyāt srotoviśudyarthamato nirūhān|50|

Some hold the view that after giving three, five, four or six Anuvasana bastis for the purpose of oleation, to patients suffering from diseases caused by Vata (Pitta and Kapha) the physician should thereafter, administer Niruha Basti for the cleansing of the [obstructed] Srotas or channels of circulation. [49 2/4- 2/4 50]

Shiro virechana

विशुद्धदेहस्य ततः क्रमेण स्निग्धं तलस्वेदितमुत्तमाङ्गम्||५०||
विरेचयेत्त्रिर्द्विरथैकशो वा बलं समीक्ष्य त्रिविधं मलानाम्|
viśuddhadehasya tataḥ krameṇa snigdhaṃ talasveditamuttamāṅgam||50||
virecayettrirdvirathaikaśo vā balaṃ samīkṣya trividhaṃ malānām|

Errhine Therapy –
When the body of the patient is cleansed, his head is consecutively anointed and fomented with the help of the palm. After ascertaining the strength of the three types of Doshas, he is given errhine therapy, once, twice or thrice. [50 2/4 – 2/4 51]

Nasya Samyak, Mithya yoga and Ati yoga

Samyak Yoga
उरःशिरोलाघवमिन्द्रियाच्छ्यं स्रोतोविशुद्धिश्च भवेद्विशुद्धे||५१||
uraḥśirolāghavamindriyācchyaṃ srotoviśuddhiśca bhavedviśuddhe||51||

Signs and Symptoms of appropriately administered therapy –
Appropriately administered siro-virecana therapy gives rise to feeling of lightness of the chest and head, clarity of the senses and cleansing of the srotas (channels of circulation). [51 2/4]

Mithya Yoga
गलोपलेपः शिरसो गुरुत्वं निष्ठीवनं चाप्यथ दुर्विरिक्ते|
galopalepaḥ śiraso gurutvaṃ niṣṭhīvanaṃ cāpyatha durvirikte|

Signs and symptoms of inappropriately administered errhine therapy –
Inappropriate administration of Nasya therapy gives rise to
Gala Upalepa – adhesion of sticky material in the throat,
Gurutva Shiraso – heaviness of the head and ptyalism. [2/4 52]

Ati Yoga
शिरोक्षिशङ्खश्रवणार्तितोदावत्यर्थशुद्धे तिमिरं च पश्येत्||५२||
śirokṣiśaṅkhaśravaṇārtitodāvatyarthaśuddhe timiraṃ ca paśyet||52||

Signs and symptoms of excessively administered Errhine therapy –
Excessive administration of errhine therapy gives rise to cutting and aching pain in head, eyes temples and ears, and fainting. [52 2/4]

Management of Atiyoga of Nasya

स्यात्तर्पणं तत्र मृदु द्रवं च स्निग्धस्य तीक्ष्णं तु पुनर्न योगे|५३|
syāttarpaṇaṃ tatra mṛdu dravaṃ ca snigdhasya tīkṣṇaṃ tu punarna yoge|53|
For the management of conditions arising out of excessive Nasya therapy, the patient is given Tarpana drinks which are soft and Snigdha (containing fat)
For the management of conditions arising out of inappropriate administration of errhine therapy, the patient is given Sneha Karma and thereafter, Teekshna Nasya is given to the patient. [2/4 53]

Utility of PanchaKarma Therapy:
इत्यातुरस्वस्थसुखः प्रयोगो बलायुषोर्वृद्धिकृदामयघ्नः||५३||
ityāturasvasthasukhaḥ prayogo balāyuṣorvṛddhikṛdāmayaghnaḥ||53||
PanchaKarma (five purificatory therapies) described above bestow happiness to both the patients and healthy persons by promoting their strength and longevity, and also by curing their diseases. [53 2/4]

Interval period between two courses of therapy
कालस्तु बस्त्यादिषु याति यावांस्तावान् भवेद्द्विः परिहारकालः|५४|
kālastu bastyādiṣu yāti yāvāṃstāvān bhaveddviḥ parihārakālaḥ|54|
The interval between two courses of Basti (including emesis, purgation and errhine therapies) is double the period for which these therapies were originally administered. [2/4 54]

Prohibitions during Panchakarma Therapies

अत्यासनस्थानवचांसि यानं स्वप्नं दिवा मैथुनवेगरोधान्||५४|| शीतोपचारातपशोकरोषांस्त्यजेदकालाहितभोजनं च|५५|
atyāsanasthānavacāṃsi yānaṃ svapnaṃ divā maithunavegarodhān||54|| śītopacārātapaśokaroṣāṃstyajedakālāhitabhojanaṃ ca|55|
While undergoing panchakarma therapies, the patient should avoid the following:
Excessive sitting, standing, speaking and riding (over vehicles and horses)
Sleep during day time
Sexual intercourse
Suppression of the manifested natural urges
Cooling regimens
Exposure to hot Sun
Grief and anger and
Intake of urinary and unwholesome food

Factors inhibiting recipes of basti to enter and come out smoothly:
बद्धे प्रणीते विषमं च नेत्रे मार्गे तथाऽर्शःकफविड्विबद्धे ||५५||
न याति बस्तिर्न सुखं निरेति दोषावृतोऽल्पो यदि वाऽल्पवीर्यः|५६|
baddhe praṇīte viṣamaṃ ca netre mārge tathā’rśaḥkaphaviḍvibaddhe ||55||
na yāti bastirna sukhaṃ nireti doṣāvṛto’lpo yadi vā’lpavīryaḥ|56|

The recipe of Basti does not reach its destination because of the following:
If the nozzle is clogged or inserted obliquely; and
If the rectal passage is blocked by piles, mucus or hard stool
The recipe after enema does not come out with ease because of the following:
if the path in the enema is obstructed by Doshas
If the recipe of enema is less in quantity and
If the recipe is of low potency [55 2/4- 2/4 56]

Factors Responsible for Quicker Elimination of enema

प्राप्ते तु वर्चोनिलमूत्रवेगे वातेऽतिवृद्धेऽल्पबले गुदे वा||५६||
अत्युष्णतीक्ष्णश्च मृदौ च कोष्ठे प्रणीतमात्रः पुनरेति बस्तिः|५७|
prāpte tu varconilamūtravege vāte’tivṛddhe’lpabale gude vā||56||
atyuṣṇatīkṣṇaśca mṛdau ca koṣṭhe praṇītamātraḥ punareti bastiḥ|57|
The recipes of enema come out though the anus immediately after it is administered because of the following:
If there is sudden urge for voiding faeces, flatus or urine;
If there is excessive aggravation of vayu,
If there is lack of strength in the anal muscles to retain the recipe
If the recipe contains ingredients which are excessively hot and sharp and
If the person has lax bowel (mrdu kostha) [56 2/4- 2/4 57]

Incapability of Basti to Cure of curable Disease

मेदःकफाभ्यामनिलो निरुद्धः शूलाङ्गसुप्तिश्वयथून् करोति||५७||
स्नेहं तु युञ्जन्नबुधस्तु तस्मै संवर्धयत्येव हि तान् विकारान्|
रोगास्तथाऽन्येऽप्यवितर्क्यमाणाः परस्परेणावगृहीतमार्गाः||५८||
सन्दूषिता धातुभिरेव चान्यैः स्वैर्भेषजैर्नोपशमं व्रजन्ति|५९|
medaḥkaphābhyāmanilo niruddhaḥ śūlāṅgasuptiśvayathūn karoti||57||
snehaṃ tu yuñjannabudhastu tasmai saṃvardhayatyeva hi tān vikārān|
rogāstathā’nye’pyavitarkyamāṇāḥ paraspareṇāvagṛhītamārgāḥ||58||
sandūṣitā dhātubhireva cānyaiḥ svairbheṣajairnopaśamaṃ vrajanti|59|

If the Vayu gets occluded by Medas (fat) and Kapha), then it gives rise to colic pain, numbness of the body and oedema. When an ignorant physician administers Sneha (unctuous recipe in order to alleviate these ailments) then they actually get aggravated. Similarly, they produce other diseases which cannot even be imagined and which probably are difficult to cure. Apart from this, they vitiate blood and other tissues and cause many diseases which are incurable in spite of being administered with good and logical treatments. [57 2/4- 2/4 59]

Reasons for Failure of Chikitsa

सर्वं च रोगप्रशमाय कर्म हीनातिमात्रं विपरीतकालम्||५९||
मिथ्योपचाराच्च न तं विकारं शान्तिं नयेत् पथ्यमपि प्रयुक्तम्|६०|
sarvaṃ ca rogapraśamāya karma hīnātimātraṃ viparītakālam||59||
mithyopacārācca na taṃ vikāraṃ śāntiṃ nayet pathyamapi prayuktam|60|
All therapeutic measures administered to alleviate a disease even though wholesome and skilfully given fail to cure it, if they are used in lesser or excessive doses or at the wrong time or in the wrong manner. Therefore, the diseases get cured only when medicines are administered in the proper dose and proper time by wise and experienced physicians. [59 2/4 – 2/4 60]

तत्र श्लोकः- प्रश्नानिमान् द्वादश पञ्चकर्माण्युद्दिश्य सिद्धाविह कल्पनायाम्||६०||
प्रजाहितार्थं भगवान् महार्थान् सम्यग्जगादर्षिवरोऽत्रिपुत्रः||६१||
tatra ślokaḥ- praśnānimān dvādaśa pañcakarmāṇyuddiśya siddhāviha kalpanāyām||60||
prajāhitārthaṃ bhagavān mahārthān samyagjagādarṣivaro’triputraḥ||61||

To sum up: – Lord Atreya, the foremost among the sages described the successful administration of Panchakarma (five purificatory therapies) for the wellbeing of the people in the form of answer to the twelve queries (described in verse nos. 3-5) [60 2/4- 61]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते सिद्धिस्थाने कल्पनासिद्धिर्नाम प्रथमोऽध्यायः||१||
ityagniveśakṛte tantre carakapratisaṃskṛte’prāpte dṛḍhabalasampūrite siddhisthāne kalpanāsiddhirnāma prathamo’dhyāyaḥ||1||
Thus, ends the first chapter of the siddhi section called “Kalpana- Sidhhi successful administration of therapeutic measures)” in the text of Agnivesha which was redacted by Charaka, and because of its non-availability, supplemented by Drdhabala.