The chapter opens by announcing the treatment of complications arising from vamana and virecana. It says that these therapies may fail in fifteen ways because of factors connected with the physician and patient. Vamana may move downward and virecana upward; thirteen further complications are common to both: medicine remaining incompletely expelled, medicine becoming digested, insufficient removal of dosas, vata pain, inadequate action, excessive action, discharge of living tissue or blood, abdominal distension, cutting pain, continued discharge, straining dysentery-like evacuation, involvement of the heart, obstruction, and rigidity of the limbs.
The commentary says that naming the physician and patient also implicitly includes the medicine and attendant, so each may contribute to a complication. It supplies the omitted word 'complication' after the downward movement of vamana and the upward movement of virecana. The remaining thirteen complications are shared equally by vamana and virecana. The total of fifteen is stated, despite the list itself, to exclude different counts given in other treatises.
Key terms
vamana
Therapeutic emesis in the classical regimen.
virecana
Therapeutic purgation in the classical regimen.
vyāpat
A complication or failed course of treatment.
jīvādāna
A dangerous complication named in the list, traditionally associated with discharge of vital material or blood.
hṛdayopasaraṇa
A complication described as approaching or involving the heart.
Vamana may move downward in a person distressed by hunger, one with very sharp agni or a soft kostha, or one who is difficult to make vomit when the medicine remains in the body; the text attributes this to similarity of qualities. The intended result is then not obtained and the dosa becomes stirred up. The passage historically directs renewed, stronger vamana after oleation.
The commentary distinguishes the proposed causes. In a hungry person the medicine passes downward immediately; in one with sharp agni it is digested; in one with soft kostha it descends because of bowel softness; and in a person difficult to make vomit, retained medicine becomes digested and moves downward because of qualities such as fluidity. Although dosa is a general term, the commentator understands kapha here because it is the target of vamana. Fomentation is taken as implied together with oleation.
Key terms
adhogati
Downward movement of a medicine intended for vamana.
tīkṣṇāgni
Very sharp digestive activity in the classical classification.
mṛdukoṣṭha
A soft or readily responsive bowel constitution.
doṣotkleśa
Stirring up or aggravation of dosa; interpreted here as kapha.
अपरिशुद्धामाशयस्योत्क्लिष्टश्लेष्मणः सशेषान्नस्य वाऽहृद्यमतिप्रभूतं वा विरेचनं पीतमूर्ध्वं गच्छति, तत्रेप्सितानवाप्तिर्दोषोक्लेशश्च ; तत्राशुद्धामाशयमुल्बणश्लेष्माणमाशु वामयित्वा भूयस्तीक्ष्णतरैर्विरेचयेत्, आमान्वये त्वामवत् संविधानम्, अहृद्येऽतिप्रभूते च हृद्यं प्रमाणयुक्तं च; अत ऊर्ध्वमुत्तिष्ठत्यौषधे न तृतीयं पाययेत्, ततस्त्वेनं मधुघृतफाणितयुक्तैर्लेहैर्विरेचयेत् ||५||
Meaning of the śloka
Virecana may move upward when the stomach has not been cleared, slesma is stirred up, food remains, or the medicine is disagreeable or excessive. The intended result is not obtained and the dosa becomes disturbed. The text then gives different historical responses according to the proposed cause: clearing prominent slesma before repeating virecana, managing ama as such, choosing an agreeable and measured medicine, and, after two upward expulsions, avoiding a third administration and instead using a lickable preparation containing honey, ghee, and phanita.
The commentary identifies this as the upward-movement complication of virecana and understands dosa here as pitta. For association with ama, it explains the management as measures such as lightening and digestion-promoting treatment. It supplies 'purgative medicine' after the direction not to give a third dose, and says the final lickable preparation is the means proposed for producing virecana.
Key terms
ūrdhvagati
Upward expulsion of medicine intended to act as virecana.
āma
An incompletely processed state in the classical account.
utkliṣṭa śleṣman
Stirred-up or prominent slesma described as obstructing the intended action.
phāṇita
A concentrated sweet preparation named as an ingredient in the historical formulation.
दोषविग्रथितमल्पमौषधमवस्थितमूर्ध्वभागिक्रमधोभागिकं वा न स्रंसयति दोषान्, तत्र तृष्णा पार्श्वशूलं छर्दिर्मूर्च्छा पर्वभेदो हृल्लासोऽरतिरुद्गाराविशुद्धिश्च भवति; तमुष्णाभिरद्भिराशु वामयेदूर्ध्वभागिके, अधोभागिकेऽपि च सावशेषौषधमतिप्रधावितदोषमतिबलमसम्यग्विरिक्तलक्षणमप्येवं वामयेत् ||६||
Meaning of the śloka
A small amount of medicine entangled with the dosas may remain and fail to dislodge them, whether intended for the upper or lower route. The resulting signs are thirst, flank pain, vomiting, fainting, pain at the joints, nausea, restlessness, and unclean belching. The passage historically directs emesis when an emetic remains, and also in a very strong person when residual purgative medicine is associated with rapidly moving dosas and signs of incomplete purgation.
The commentary presents residual medicine as a complication shared by both therapies. It glosses doṣavigrathita as mixed with dosa and 'does not release' as does not dislodge it. It explains parvabheda as a splitting sensation at the joints, hṛllāsa as retching, and arati as mental inability to remain settled. For retained emetic medicine accompanied by the listed symptoms, it gives the stated response. In the purgative context, it restricts that response to a person of exceptional strength whose dosas have moved excessively, even if signs of incomplete purgation are present.
Key terms
sāvaśeṣauṣadha
Medicine remaining incompletely expelled or active after the intended therapy.
doṣavigrathita
Intermingled or entangled with dosa, according to the commentary.
parvabheda
A splitting or breaking-like pain at the joints.
hṛllāsa
Nausea or retching in the commentator's explanation.
क्रूरकोष्ठस्यातितीक्ष्णाग्नेरल्पमौषधमल्पगुणं वा भक्तवत् पाकमुपैति, तत्र समुदीर्णा दोषा यथाकालमनिर्ह्रीयमाणा व्याधिविभ्रमं बलविभ्रंशं चापादयन्ति, तमनल्पममन्दमौषधं च पाययेत् ||७||
Meaning of the śloka
In a person with a hard kostha or very sharp agni, medicine that is too little or weak may be digested like food. The aroused dosas, not removed at the proper time, are said to cause disturbance of disease and loss of strength. The text historically directs giving medicine that is neither small in amount nor mild.
The commentary identifies this as the complication in which the medicine has been digested. It glosses samudīrṇa as aggravated, vyādhivibhrama as disturbance of the kostha and related systems, and balavibhraṃśa by reference to signs such as loosening of joints described elsewhere. It interprets the final phrase as directing a plentiful and sharp medicine.
Key terms
jīrṇauṣadha
Medicine digested without producing its intended eliminative action.
krūrakoṣṭha
A hard or difficult-to-purge bowel constitution in the classical classification.
vyādhivibhrama
A disturbance or worsening of disease, glossed as agitation of the kostha and related systems.
अस्निग्धस्विन्नेनाल्पगुणं वा भेषजमुपयुक्तमल्पान् दोषान् हन्ति; तत्र वमने दोषशेषो गौरवमुत्क्लेशं हृदयाविशुद्धिं व्याधिवृद्धिं च करोति, तत्र तं यथायोगं पाययित्वा वामयेद्दृढतरं; विरेचने तु गुदपरिकर्तनमाध्मानं शिरोगौरवमनिःसरणं वा वायोर्व्याधिवृद्धिं च करोति; तमुपपाद्य भूयः स्नेहस्वेदाभ्यां विरेचयेद्दृढतरं, दृढं बहुप्रचलितदोषं वा तृतीये दिवसेऽल्पगुणं चेति ||८||
Meaning of the śloka
When a person has not been oleated and fomented, or when a weak medicine is used, only a small amount of dosa is removed. After vamana, the residue may cause heaviness, agitation, a sense that the heart region is uncleared, and worsening disease. After virecana, it may cause cutting pain at the anus, distension, heaviness of the head, failure of vata to pass, and worsening disease. The passage then gives historical directions for stronger repeat elimination after preparation and, in specified robust cases, on the third day.
The commentary identifies insufficient removal of dosa as the complication. It interprets alpaguṇa as having very slight potency and takes 'that' to mean the remaining dosa. Yathāyoga means without exceeding the proper course, with oleation and related preparation first; omitted words are supplied to mean giving the patient an emetic, with enough force to act strongly. The phrase about remaining dosa also carries into the virecana section. Gudaparikartana is explained as cutting-like pain all around the anus. One interpretation places repeat treatment for a strong-bodied person with abundant, mobilized dosas on the third day after prior oleation and fomentation; others count the third day specifically from the day of vamana or virecana. These timing interpretations remain distinct.
Key terms
hīnadoṣāpahṛta
A complication in which too little dosa has been removed.
gudaparikartana
Cutting-like pain around the anus.
ādhmāna
Abdominal distension.
aniḥsaraṇa vāyu
Failure of vata or flatus to pass in the classical description.
A dry medicine taken by a person who has not been oleated or fomented, or by one who has not observed brahmacarya, may aggravate vayu. The aggravated vayu is said to produce pain in the flanks, back, pelvis, neck, and vital regions, together with fainting, vertigo, intoxication-like impairment, and loss of consciousness; this is called vata pain. The passage then gives a historical sequence of oil application, sweating with grains, and an oil enema prepared with yastimadhu.
The commentary identifies this as the vātashūla complication. It glosses śroṇi as the waist or pelvic region and understands marma here as the heart. Bhrama is compared to the sensation of being spun on a wheel, while mada is compared to intoxication after eating areca nut. Dhānyasveda is explained as fomentation using grains such as māṣa and śamī. Because enemas are restricted in fainting and vertigo, the commentator says the yaṣṭīmadhu oil enema should be understood as cool; this qualification and its reasoning should be preserved as the commentator's view.
Key terms
vātashūla
Pain attributed to aggravated vayu in this complication.
When a person has not been properly prepared with sneha and sveda, a medicine that is too small in quantity or too weak may move neither upward nor downward. It agitates the doṣas without removing them and causes loss of strength, abdominal distension, constriction around the heart, thirst, fainting, and burning; this is called ayoga, inadequate action. The passage then describes distinct signs after inadequate vamana or virecana and sets out historical corrective measures. It also discusses what was advised when elimination began only slightly or not at all, and identifies suppression of urges through shame, fear, or greed as a reason some people were considered difficult to purge.
The commentary defines ayoga technically as complete failure of vamana or virecana to proceed, rather than merely removal of too little doṣa. Loss of strength and distension are common signs of either failure; nausea, salivation, scant stool, and heaviness below the navel help distinguish the two forms after attempted correction. It explains the text's successive historical responses to difficult vomiting, difficult purgation, slight action, and complete non-action. A second medicine is said to depend on whether the first has been digested, the abundance of doṣa, the remaining part of the day, and the person's strength. When no doṣa has moved, the commentary reads the interval as ten nights with dietary and oleation preparation before another attempt. It explains the social groups named in the source through habitual suppression of urges: women through shame, persons near a king through fear, and merchants and learned ritual specialists through greed. These statements reflect the commentator's historical assumptions and should not be generalized.
Key terms
ayoga
Complete inadequate action or non-action of the intended eliminative procedure in this passage.
sneha-sveda
Oleation and fomentation described as preparation in the classical regimen.
durvānta
A state in which the intended vomiting has occurred inadequately.
durvirecya
A person described as difficult to purge within the text's classification.
An excessive dose, an excessively sharp medicine, or too much medicine given to a person already oleated and fomented, especially one with very soft koṣṭha, may cause atiyoga, excessive action. Excessive vamana is said to produce excessive flow of pitta, marked loss of strength, and strong aggravation of vāta. Excessive virecana first produces excessive kapha-like discharge and later blood-stained discharge, again with severe weakness and vāta aggravation. The passage lists historical measures intended to counter these states and restore strength.
The commentary glosses balavisraṃsa as collapse or loss of bodily power. It explains yathāsvam as selecting the appropriate preparation, sometimes made from parched grain or flour with sugar and sometimes with honey. Kṣīrasarpis is clarified as ghee derived from milk. The listed interventions are assigned separate purposes within the traditional reasoning: a rice-water and honey emetic was intended to check downward-moving śleṣman; picchā-basti to restrain excessive blood and pitta discharge; milk-ghee anuvasana to restrain vāta; priyaṅgvādi with rice-water, in a stated traditional measure, to promote retention; and milk or meat broth to recover strength. Gayi preserves a different reading in which milk and meat broth belong among the constituents of the picchā-basti; that textual variant must remain distinct.
Key terms
atiyoga
Excessive action of vamana or virecana and its complications.
balavisraṃsa
A severe collapse or loss of strength, as glossed by the commentary.
picchā-basti
A retaining or mucilaginous enema named in the historical response.
kṣīrasarpis
Ghee derived from milk, according to the commentary.
In the most advanced excessive vamana, the person may spit or vomit blood and develop protrusion or retraction of the tongue, abnormal turning of the eyes, locking of the jaw, thirst, hiccup, fever, and loss of consciousness. In excessive virecana, the discharge is described as first watery and patterned, then like water used to wash meat, and later as jīvaśoṇita; prolapse of the rectum, tremor, and complications like those of excessive vamana may follow. The passage records historical responses to bleeding, tongue displacement, eye and jaw abnormalities, prolapse, tremor, and loss of consciousness. It also gives traditional tests intended to distinguish jīvaśoṇita from raktapitta.
The commentary calls this severe complication jīvādāna and presents it as difficult to treat. It explains tongue displacement as either outward protrusion or inward retraction, eye change as upward turning, jaw closure as loss of movement, and tremor as shaking. It distinguishes the manifestations after excessive vamana from those after excessive virecana: bleeding is common to both, but rectal prolapse replaces tongue protrusion in the latter; Gayi also says eye turning, jaw locking, hiccup, and belching do not occur there. Jejjata instead reads the text as extending the other advanced-vamana complications, apart from tongue protrusion, to excessive virecana. Their disagreement must remain unresolved. The commentary explains the traditional blood descriptions and assigns historical measures to particular signs. It reports a cloth test and a feeding test involving a dog as attempted distinctions between jīvaśoṇita and raktapitta, then notes that a further passage about treatment is absent from its received text.
Key terms
jīvādāna
The name given to the gravest bleeding complication of excessive elimination.
jīvaśoṇita
Blood regarded by the text as vital or pure bodily blood.
gudaniḥsaraṇa
Prolapse or outward displacement of the rectal region described after excessive purgation.
When medicine that is insufficiently warm or unctuous is taken while food remains undigested, by a person described as having abundant doṣa, dryness, and a vāta-predominant koṣṭha, it may produce ādhmāna. The stated features are retention of flatus, urine, and stool; a tense, distended abdomen; pain or breaking discomfort in the flanks; pricking pain in the rectal and bladder regions; and loss of appetite. The passage then names historical warming, suppository, dīpana, and basti measures.
After jīvādāna, the commentary introduces ādhmāna as a complication shared by both forms of śuddhi. It locates the distension caused by vamana in the āmāśaya and that caused by virecana in the pakvāśaya. Its brief treatment gloss adds fomentation, measures intended to restore the movement of urine and related functions, fasting or lightening, and dīpana within the historical framework.
Key terms
ādhmāna
Tense abdominal distension with obstructed bodily discharges in this complication.
anila-mūtra-purīṣa-saṅga
Retention or obstruction of flatus, urine, and stool.
āmāśaya
The upper digestive region where the commentary locates distension associated with vamana.
pakvāśaya
The lower intestinal region where the commentary locates distension associated with virecana.
In an emaciated or weakened person, one with very soft koṣṭha, weak agni, or dryness, a medicine that is excessively sharp, hot, salty, or drying may disturb pitta and vāta and cause parikartikā. The passage describes burning, cutting pain around the rectum, navel, genital region, bladder, and head, together with retention of vāta, obstructed flatus, and loss of appetite. It then records historical picchā-basti and unctuous measures.
The commentary defines kṣāma as a person whose body and strength are depleted. It explains parikartikā as a sensation of cutting all around the bladder and related regions. Within the traditional differentiation, ghee-derived treatment is assigned to a pitta-predominant form and oil to a vāta-predominant form. For the corresponding complication after vamana, it places burning and cutting pain in the throat and chest and records cooling applications and milk-and-sugar food as the historical response.
Key terms
parikartikā
A complication characterized by severe cutting pain and burning in the regions named by the source.
kṣāma
Emaciated or depleted in bodily strength, as glossed by the commentary.
atimṛdu koṣṭha
An extremely responsive or soft bowel constitution in the classical classification.
picchā-basti
A retaining or mucilaginous enema named as a historical measure.
In a person with krūra koṣṭha and very abundant doṣa, a mild medicine may agitate the doṣas without removing them completely, after which they cause parisrāva. The stated features are weakness, abdominal obstruction or distension, loss of appetite, bodily exhaustion, and painful discharge of pitta and śleṣman. The passage then records a historical herbal basti and renewed oleation and elimination after the complication has subsided.
The commentary identifies this complication as parisrāva and gives botanical equivalents for three ingredients: ajakarṇa as aśvakarṇa, dhava as indravṛkṣa, and tiniśa as syandana. It interprets upaśāntadoṣa here as the subsiding of parisrāva and then describes renewed oleation followed by sharp elimination. For the vamana form it describes upward kapha discharge and, after settling it with additional food, a further mild, small vamana after oleation and fomentation. Gayi offers another interpretation: the phrase refers to a person whose agitated doṣas have been calmed through śamana and pācana, after which either basti or śodhana may be used. These readings should remain separate.
Key terms
parisrāva
A painful continuing discharge described as a complication of incomplete elimination.
krūra koṣṭha
A bowel constitution considered difficult to purge in the classical framework.
śamana
Pacification, used in Gayi's alternative explanation.
pācana
A processing or digestive measure paired with śamana in Gayi's reading.
अतिरूक्षेऽतिस्निग्धे वा भेषजमवचारितमप्राप्तं वातवर्च उदीरयति वेगाघातेन वा, तदा प्रवाहिका भवति; तत्र सवातं सदाहं सशूलं गुरु पिच्छिलं श्वेतं कृष्णं सरक्तं वा भृशं प्रवाहमाणः कफमुपविशति; तां परिस्रावविधानेनोपचरेत् ||१८||
Meaning of the śloka
When medicine is administered to a person who is excessively dry or excessively unctuous, it may prematurely set vāta and stool in motion, or their urge may be obstructed. The text says that pravāhikā then develops: the person strains repeatedly and passes kapha that may be accompanied by vāta, burning and pain, and may be heavy, slimy, white, black, or blood-stained. It directs that this be managed according to the method stated for parisrāva.
The commentary identifies this as the thirteenth complication, called pravāhikā. In an excessively dry person, the medicine produces an urge before the intended therapeutic action has properly arisen; in an excessively unctuous person, pravāhikā is attributed to obstruction of the urge. It explains upaviśati here as repeated diarrhoeal evacuation. It then distinguishes the historical management by cause: the form arising from excessive dryness is related to the method for krūra koṣṭha, whereas the form arising from excessive unctuousness is related to the digestive and associated measures described for parisrāva in a person with mṛdu koṣṭha and abundant doṣa.
Key terms
pravAhikA (pravāhikā)
A complication characterized here by repeated straining and passage of mucus, sometimes with pain, burning, or blood.
atirUkSha (atirūkṣa)
An excessively dry state of the person in the passage's causal account.
atisnigdha
An excessively unctuous state of the person in the passage's causal account.
vegAghAta (vegāghāta)
Obstruction or suppression of an arising bodily urge.
parisrAva (parisrāva)
A previously described complication whose management framework is referenced here.
If a person ignorantly suppresses an already active upward or downward medicinal urge, the doṣas are said to move toward the heart. Affliction of this principal marma produces extreme distress: tooth-clenching, protruding or upturned eyes, biting of the tongue, faintness, and loss of consciousness. The text criticizes those who abandon such a person and then lists historical measures involving anointing and fomentation, medicated oil, sharp cleansing of the head, induced vomiting, and basti selected according to the predominance of doṣa.
The commentary calls this the fourteenth complication, hṛdayopasaraṇa. It explains the affliction of the principal marma as distress of the heart, pratāmyati as becoming faint or confused, and acetā as loss of consciousness. Those who leave the patient because they assume death is imminent are described as foolish or incompetent practitioners. In interpreting the historical regimen, it distinguishes fainting attributed to pitta from that attributed to kapha and explains that both evacuative and unctuous forms of basti are included. These distinctions are the commentator's account and do not establish a safe modern treatment.
Key terms
hRudayopasaraNa (hṛdayopasaraṇa)
The named complication in which doṣas are described as approaching or afflicting the heart.
pradhAnamarma (pradhānamarma)
A principal vital site, identified by the commentary here with the heart.
pratAmyati (pratāmyati)
Becomes faint or confused, according to the commentary.
acetA (acetā)
Without consciousness or awareness.
basti
A class of rectally administered therapies mentioned in the historical regimen.
If, while doṣas are moving upward or downward, a person is exposed to a cold room, cold water, wind, or something similar, the doṣas are said to contract within the channels and become dense. Their movement is obstructed, producing retention of flatus, urine, and stool, with distension, burning, fever, and severe pain. The text then gives historical measures according to whether the obstruction concerns the upper route, lower route, or both, and directs that diet and complications be addressed according to the doṣa.
The commentary names this fifteenth complication vibandha and explains that the obstruction prevents the progress of vamana or virecana. The phrase prāptakālā kriyā is understood as treatment appropriate to the stage reached. For obstruction during virecana, it describes a historical purgative combination and a doṣa-based dietary sequence. If both routes are affected, each particular complication is to be addressed in its own way. The commentary also preserves Gayi's different interpretation: he reads the condition as involving doṣas that have not begun to move or have not been dislodged, rather than doṣas already in motion.
Key terms
vibandha
Obstruction of the intended upward or downward therapeutic movement.
vAtamUtrashakRudgraha (vātamūtraśakṛdgraha)
Retention of flatus, urine, and stool described as part of the complication.
srotas
Channels within which the doṣas are said to contract and become obstructed.
prAptakAlA kriyA (prāptakālā kriyā)
An intervention considered appropriate to the stage reached, as explained by the commentary.
ubhayatobhAga (ubhayatobhāga)
Involvement of both the upward and downward routes.
या तु विरेचने गुदपरिकर्तिका तद्वमने कण्ठक्षणनं, यदधः परिस्रवणं स ऊर्ध्वभागे श्लेष्मप्रसेकः, या त्वधः प्रवाहिका सा तूर्ध्वं शुष्कोद्गारा इति ||२१||
Meaning of the śloka
The text pairs certain complications of the downward and upward therapies. The anal cutting pain associated with virecana corresponds in vamana to injury or excoriation of the throat; downward parisrāva corresponds in the upper route to excessive salivary or mucous flow; and downward pravāhikā corresponds upward to dry eructations.
The commentary says that the purpose of the passage is to show the differences that occur in only some of the otherwise corresponding complications. It adds no further explanation of the individual terms.
Key terms
gudaparikartikA (gudaparikartikā)
Cutting pain or injury in the anal region associated here with virecana.
kaNThakShaNana (kaṇṭhakṣaṇana)
Injury, abrasion, or cutting pain of the throat associated here with vamana.
shleShmapraseka (śleṣmapraseka)
Excess flow of saliva or mucus in the upper-route comparison.
pravAhikA (pravāhikā)
A lower-route complication marked in the preceding passage by repeated straining and mucous discharge.
shuShkodgAra (śuṣkodgāra)
Dry eructation, presented as the upper-route counterpart of pravāhikā.
भवति चात्र- यास्त्वेता व्यापदः प्रोक्ता दश पञ्च च तत्त्वतः |
एता विरेकातियोगदुर्योगायोगजाः स्मृताः ||२२||
Meaning of the śloka
The fifteen complications described in detail are understood to arise from excessive application, improper application, or inadequate application of vireka, a term used here for eliminative therapy.
The commentary presents this verse as a summary and explains that vireka here includes both virecana and vamana because both evacuate doṣa and waste. It then preserves Jejjaṭa's alternative reading with vipāka and his classification: two complications from excessive application; several from improper application, subdivided according to practitioner, patient, or both; and five from inadequate application. A further view, based on other treatises, classifies ten complications under inadequate application and three under excessive application, while counting ayoga and atiyoga themselves as causes, yielding fifteen in all. These schemes are alternative enumerations and should not be collapsed into a single list.
Key terms
vyApad (vyāpad)
A complication or adverse outcome of the therapies discussed.
atiyoga
Excessive application or overuse.
duryoga
Improper, faulty, or wrongly applied use.
ayoga
Inadequate or deficient application; the commentary notes a slight or insufficient use.
vireka
Eliminative therapy, interpreted by the commentary here as encompassing both vamana and virecana.
vipAka (vipāka)
In Jejjaṭa's alternative reading, therapies or applications whose outcome is adverse or irregular.
इति सुश्रुतसंहितायां चिकित्सास्थाने वमनविरेचनव्यापच्चिकित्सितं नाम चतुस्त्रिंशोऽध्यायः ||३४||
Meaning of the śloka
Thus ends the thirty-fourth chapter of the Cikitsāsthāna in the Suśruta Saṃhitā, entitled Vamanavirecanavyāpaccikitsita, the treatment of complications arising from emesis and purgation.
The colophon states that the thirty-fourth chapter of the Cikitsāsthāna is complete in Dalhaṇa's commentary on the Suśruta Saṃhitā entitled Nibandhasaṅgraha. The supplied text contains the variant spelling Dalhaṇa/Dalhlaṇa, which should be checked against the edition.