The commentary says that after the chapter on worms, beginning udāvarta is fitting because bitter, pungent and astringent substances used in worm treatment cause udāvarta. Udāvarta means the disease in which vāta, stool, urine and the like turn (āvarta) upward (ut); others say udāvarta is stool that has been rounded by vāyu, according to common usage.
Key terms
udāvarta
Upward-turning (reverse movement) of vāta with obstruction of stool, urine or wind.
pratiṣedha
Treatment or prevention.
Adhikarana ೨ (೩) · Śloka ೩
ಅಧಶ್ಚೋರ್ಧ್ವಂ ಚ ಭಾವಾನಾಂ ಪ್ರವೃತ್ತಾನಾಂ ಸ್ವಭಾವತಃ |
ನ ವೇಗಾನ್ ಧಾರಯೇತ್ ಪ್ರಾಜ್ಞೋ ವಾತಾದೀನಾಂ ಜಿಜೀವಿಷುಃ ||೩||
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अधश्चोर्ध्वं च भावानां प्रवृत्तानां स्वभावतः |
न वेगान् धारयेत् प्राज्ञो वातादीनां जिजीविषुः ||३||
Meaning of the śloka
The wise person who wishes to live should not hold back the urges of downward- and upward-moving things, of vāta and the others, that arise naturally.
The commentary says that since holding back urges is invariably a cause of udāvarta, the prohibition is stated. Downward things are urine and the like; upward things are belching and the like. 'Arising naturally' means arising by their own nature from their own seat, which implies that urges that have not arisen should not be forced. Some read 'prāptān' for 'prājñaḥ' and explain that urges that are 'arrived' should not be held back, quoting another tantra listing greed, envy, hatred and pride as urges to be held back; the commentary rejects this reading because those are already implied. It prefers 'arrived' as 'turned toward emerging'. Others say vāta urges should not be held back but urges of rashness and the like should.
Key terms
vegadhāraṇa (vegān dhārayet)
Holding back a natural urge.
adhobhāva / ūrdhvabhāva (adhaḥ, ūrdhvaṃ bhāvāḥ)
Downward and upward things: urine, stool, wind, belching and the like.
When wind, stool, urine, yawning, tears, sneezing, belching, vomiting and semen (indriya) are obstructed when they have arisen, udāvarta is said to occur.
The commentary gives the causes through the derivation. Aśru is tears; kṣava is sneezing; 'indriya' here means semen, as later 'shukrāśmarī (semen stone)' is mentioned, and the word indriya is seen elsewhere for semen; a quoted line says 'speech, hearing and mind, and semen, are called indriya'. 'Obstructed' means blocked; 'arisen' means gone upward.
Key terms
vātaviṇmūtra
Wind, stool and urine.
indriya (śukra) (indriya)
Here semen, per the commentary.
Adhikarana ೪ (೫) · Śloka ೫
ಕ್ಷುತ್ತೃಷ್ಣಾಶ್ವಾಸನಿದ್ರಾಣಾಮುದಾವರ್ತೋ ವಿಧಾರಣಾತ್ |೫|
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क्षुत्तृष्णाश्वासनिद्राणामुदावर्तो विधारणात् |५|
Meaning of the śloka
Udāvarta also occurs from suppressing hunger, thirst, breathlessness and sleep.
The commentary says that udāvarta also arises from holding back other urges. The separate mention of hunger and the rest from wind, stool and urine shows that wind and the like are close causes while hunger and the rest are remote causes; or it points to a cause later stated as arising from food ('vāyu in the abdomen with dry, astringent, pungent and bitter foods'). Some read a different verse: 'from wind, stool, urine, yawning, tears, sneezing, belching, vomiting and semen, and of hunger, thirst, breathlessness and sleep, udāvarta arises from restraint', meaning by holding back. An objection: udāvarta from blocking downward urges by aggravation of apāna is understandable, but how does it arise from holding back tears or yawning? Answer: when the vāyu, after holding back those urges, lodges in the abdomen, it leads to aggravation of apāna and so to udāvarta.
Key terms
kṣut
Hunger.
tṛṣṇā
Thirst.
vidhāraṇa
Holding back.
Adhikarana ೫ (೫) · Śloka ೫
ತಸ್ಯಾಭಿಧಾಸ್ಯೇ ವ್ಯಾಸೇನ ಲಕ್ಷಣಂ ಚ ಚಿಕಿತ್ಸಿತಮ್ ||೫||
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तस्याभिधास्ये व्यासेन लक्षणं च चिकित्सितम् ||५||
Meaning of the śloka
I shall describe in detail its signs and its treatment.
The commentary says that after the thirteen kinds from holding back vāta and the others, another cause is given: another kind, different from the ones arising from suppression, is stated, from food.
The obstructed apāna in its own path causes distension, colicky pain, oppression of the heart, headache, breathlessness, severe hiccup, cough, running nose, throat spasm, and a terrible spread of kapha and pitta; it may destroy stool (dry it up) or throw stool out through the mouth.
The commentary gives the signs of vātaja udāvarta. Hṛdayoparodha is oppression of the heart; balāsapittaprasara is spread of kapha and pitta. 'Blocked in its own path' means at the anus. 'Destroy stool' means it causes dryness of stool; it may also throw it out through the mouth. By 'and' (galagraha) other signs like worms are included, as in similar tantras. Obstruction of apāna also aggravates prāṇa and the others, so headache and cough are fitting.
आटोपशूलौ परिकर्तनं च सङ्गः पुरीषस्य तथोर्ध्ववातः ||८||
पुरीषमास्यादपि वा निरेति पुरीषवेगेऽभिहते नरस्य |९|
Meaning of the śloka
Abdominal distension, colic, cutting pain, retention of stool and upward-moving wind; and stool comes out even through the mouth in one whose stool-urge is obstructed.
The commentary gives the signs of purīṣaja udāvarta. Āṭopa is fullness of the abdomen; parikartana is cutting-like pain in the anus, penis, bladder and the like; ūrdhvavāta is repeated belching. 'From the mouth' means stool emerges through the mouth. By 'and', calf twisting and the like are included.
In one whose urine-urge is blocked, he passes urine with difficulty, little by little; severe pains occur in the penis, anus, groin, bladder, testes, navel region or head, and there is a bound bladder (ānaddhabasti); the pains are like being torn in body.
The commentary gives the signs of mūtra udāvarta. Vaṅkṣaṇa is the junction of abdomen and thigh; muṣka are the testes; mūrdhan is the head; ānaddhabasti is a bladder distended with urine. Some read 'ānaddhabaste' (of the bound bladder) with pains in the head, which the commentary rejects by agreement with similar tantras. 'Torn body' means as if the body were split.
From suppressing a yawn, disorders of the neck and throat (stiffness) and of the head arise, of vāta nature; and severe disorders arise of the ears, mouth, nose and eyes.
The commentary gives the signs of jṛmbha (yawn) udāvarta. 'Stiffness' attaches to both neck and throat; galastambha is throat spasm; head disorders are such as sūryāvarta; 'of vāta nature' includes tremor, numbness and the like; by 'ca', distaste for food, giddiness and similar are included.
The commentary gives the signs of tear udāvarta. Netrodaka is tears; 'arrived' means about to come out; pīnasa here is pratiśyāya (nasal catarrh), by agreement with similar tantras. By 'and', catarrh and the like are included.
From obstruction of sneezing there arise severe disorders of the head, eyes, nose and ears; a feeling of fullness and pricking pain in the throat and mouth, a murmuring sound, or non-movement of vāyu.
The commentary gives the signs of sneeze udāvarta. 'Obstruction' means holding back a sneeze; the throat and mouth seem full of wind, with great pain in them; kūja is indistinct speech; 'non-movement of vāyu' is obstructed breathing. Some read 'of the throat' with fullness and pain in the throat only. By 'and', neck stiffness and the like are included.
The commentary gives the signs of belch udāvarta. 'Terrible' means more troublesome; some read 'of a person' for 'terrible'. Disorders of vāta origin are tremor, hiccup, heart obstruction and the like.
The commentary gives the signs of vomit udāvarta. 'Kuṣṭha' here also includes conditions like urticaria (śītapitta). The disease is of that doṣa which, among vāta and the others, has spoiled the food, so it is a kuṣṭha in which that doṣa is dominant. By 'ca', distaste for food and the like are included.
मूत्राशये पायुनि मुष्कयोश्च शोफो रुजो मूत्रविनिग्रहश्च |
शुक्राश्मरी तत्स्रवणं भवेद्वा ते ते विकारा विहते तु शुक्रे ||१५||
Meaning of the śloka
Swelling and pain in the bladder, anus and testes, obstruction of urine; semen stone (śukrāśmarī) or leakage of semen: these and other disorders arise when the semen is obstructed.
The commentary gives the signs of semen-suppression udāvarta. Mūtrāśaya is the bladder; pāyu is the anus; śopha is swelling; obstruction of urine is its non-passage. 'Leakage of that' means leakage of semen, by agreement with similar tantras. 'Those and those disorders' are heart pain, body ache and others of semen-holding-back type described in similar tantras.
Key terms
śukrodāvarta (śukravegavighāta)
Disorders from suppressing the semen urge.
śukrāśmarī
A stone-like concretion of semen.
Adhikarana ೧೭ (೧೬) · Śloka ೧೬
ತನ್ದ್ರಾಙ್ಗಮರ್ದಾರುಚಿವಿಭ್ರಮಾಃ ಸ್ಯುಃ ಕ್ಷುಧೋಽಭಿಘಾತಾತ್ ಕೃಶತಾ ಚ ದೃಷ್ಟೇಃ |೧೬|
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तन्द्राङ्गमर्दारुचिविभ्रमाः स्युः क्षुधोऽभिघातात् कृशता च दृष्टेः |१६|
Meaning of the śloka
From suppressing hunger there are drowsiness, body ache, distaste for food, giddiness and thinness, and dimness of the sight...
The commentary gives the signs of hunger udāvarta. Tandrā is a disordered sleep; aṅgamarda is a pain like wringing of limbs (or cracking per others); vibhrama is spinning as if on a wheel. Krśatā of the sight is weakness of vision; by 'and', weakness and other signs from similar tantras are included.
Key terms
kṣudhodāvarta (kṣudho 'bhighāta)
Disorders from suppressing hunger.
tandrā
Drowsiness.
Adhikarana ೧೮ (೧೬) · Śloka ೧೬
ಕಣ್ಠಾಸ್ಯಶೋಷಃ ಶ್ರವಣಾವರೋಧಸ್ತೃಷ್ಣಾಭಿಘಾತದ್ಧೃದಯೇ ವ್ಯಥಾ ಚ ||೧೬||
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कण्ठास्यशोषः श्रवणावरोधस्तृष्णाभिघातद्धृदये व्यथा च ||१६||
Meaning of the śloka
... and, from suppressing thirst, dryness of the throat and mouth, obstruction of hearing, and pain in the heart.
The commentary gives the signs of thirst udāvarta. Obstruction of hearing is deafness; by 'and', exhaustion, sweat and the like are included from similar tantras.
The commentary gives the signs of breath-suppression udāvarta. 'Tired' means fatigued by fast travelling and the like. It indicates that in an untired person, holding the breath does not cause distress. Moha is bewilderment.
The commentary gives the person to be abandoned. Parikliṣṭa means greatly depleted, without action; others take it as one who has suffered distress on all sides. Abhidruta means afflicted; utsṛjet means abandon.
सर्वेष्वेतेषु विधिवदुदावर्तेषु कृत्स्नशः |
वायोः क्रिया विधातव्याः स्वमार्गप्रतिपत्तये ||१९||
सामान्यतः पृथक्त्वेन क्रियां भूयो निबोध मे |२०|
Meaning of the śloka
In all these udāvartas, the measures for vāyu should be performed by rule, completely, to restore it to its own path. Hear again the specific treatments separately, apart from the general.
The commentary says that, since vāyu is present in all udāvartas, a general vāta-relieving treatment is stated: measures such as oleation and sweating, to bring vāyu into its own course. Some read 'in nine' for 'in all', meaning vāta-type and the other nine; the commentary rejects this because vāyu is present even in the four kinds arising from hunger and the like.
Key terms
svamārgapratipatti
Restoring vāyu to its own path.
vidhivat
By rule.
Adhikarana ೨೩ (೨೦) · Śloka ೨೦
ಆಸ್ಥಾಪನಂ ಮಾರುತಜೇ ಸ್ನಿಗ್ಧಸ್ವಿನ್ನೇ ವಿಶಿಷ್ಯತೇ ||೨೦||
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आस्थापनं मारुतजे स्निग्धस्विन्ने विशिष्यते ||२०||
Meaning of the śloka
In vātaja (udāvarta), an āsthāpana (decoction enema) is best, given to the oleated and sweated patient.
The commentary says āsthāpana is nirūha, prepared with downward-moving vāta-relieving drugs; 'the patient' is supplied; 'is best' means specially done.
Key terms
āsthāpana
Decoction enema.
ānulomika
Downward-moving (carminative-type).
Adhikarana ೨೪ (೨೧) · Śloka ೨೧
ಪುರೀಷಜೇ ತು ಕರ್ತವ್ಯೋ ವಿಧಿರಾನಾಹಿಕೋ ಭವೇತ್ |೨೧|
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पुरीषजे तु कर्तव्यो विधिरानाहिको भवेत् |२१|
Meaning of the śloka
In the stool-born (udāvarta), the regimen for ānāha (distension with obstruction) should be done.
The commentary says the ānāha regimen is that of fruit-suppositories and the like stated in the vāta-disease chapter, or as will be stated in visūcikā. 'But' includes any other measure for easing stool.
When the urge to urinate is obstructed, he may drink madirā rich in sauvarcala; or elā with madya; or milk; or the juice of āmalaka fruits with water for three days; or the juice of horse dung or of donkey dung; or honey (madya) with meat as accompaniment; or sīdhu made from jaggery. Bhadradāru, ghana, mūrvā, haridrā and madhuka in kola measure, drunk with celestial water (rain water); or juice of duḥsparśā, or a decoction of kuṅkuma; or ervāru seeds in water, slightly salted; or milk cooked with the pañcamūlī; or grape juice.
The commentary says madirā is madya; 'but' allows other measures such as ghee nasal drops. Elā with madya, milk; āmalaka juice with water; 'with meat as accompaniment' means madya (of grapes) with meat, as another tantra says; gauḍika sīdhu is jaggery liquor. Bhadradāru is devadāru; ghana is mustā; mūrvā is corasnāyu; madhuka is yaṣṭīmadhu; kola measure is half a karṣa; duḥsparśā is durālabhā; ervāru is summer cucumber; the pañcamūlī is the small pañcamūla, as another tantra says.
He should give also the yogas stated before that break stones; and do the full regimen of mūtrakṛcchra without remainder. I shall again tell the yogas that pacify obstruction of urine.
The commentary extends to this urinary udāvarta the treatment of stone (aśmarī), painful urination (mūtrakṛcchra) and urinary obstruction (mūtrāghāta). 'Stated before' means those described in the stone chapter beginning 'kuśa, kāśa, śara'. 'I shall tell' is joined with 'he should do'.
Key terms
aśmarī
Urinary stone.
mūtrakṛcchra
Painful, difficult urination.
mūtrāghāta
Obstruction of urine.
Adhikarana ೨೭ (೨೮) · Śloka ೨೮
ಸ್ನೈಹೈಃ ಸ್ವೇದೈರುದಾವರ್ತಂ ಜೃಮ್ಭಾಜಂ ಸಮುಪಾಚರೇತ್ |೨೮|
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स्नैहैः स्वेदैरुदावर्तं जृम्भाजं समुपाचरेत् |२८|
Meaning of the śloka
Udāvarta from yawning should be treated with oleation and sweating.
By sharp collyrium and avapīḍa, by sniffing sharp scents, or by use of wicks, he should bring on a stuck sneeze. (A bracketed line adds: by blowing sharp drugs, or by looking at the sun's rays.)
The commentary gives treatment of sneeze udāvarta. 'Sharp' attaches to collyrium and avapīḍa; avapīḍa is a kind of nasya; sniffing is of powders such as pepper; the wicks are for smoking. By omitted ādi, looking at the sun's rays is included, as another tantra says: 'one should bring on a stuck sneeze by sharp smoke, collyrium, sniffing, nasal drops and looking at the sun'. Some read the phrase 'sharp collyrium and avapīḍa' as belonging only to the tear udāvarta, not the sneeze, as unsuitable and conflicting with another tantra.
The commentary says 'in sequence' means with the order stated in the treatments of smoke, nasya and gargling. It asks whether only sneha-smoke or other things are given, and answers with 'surā rich in sauvarcala, with citron juice'.
Vomit-suppression udāvarta should be overcome by oleation and the like, according to the doṣa, properly; and an anointing with kṣāra and salt should be given here.
The commentary says this concerns udāvarta from suppressing vomiting; 'and the like' includes emesis. Anointing is with slight yavakṣāra and rock salt; although another tantra prescribes oil anointing, here ghee anointing is used by the tradition of elders. By 'ca', exercise, fasting and the like are included. Some read 'vamyāghāta'.
Milk with four times water, cooked with bladder-cleansing additions and boiled until only the milk remains, drunk as much as he likes: dear women should delight a man with semen-suppression udāvarta.
The commentary says the additions that cleanse the bladder are ash gourd, tṛṇapañcamūla and the like, at one-eighth the milk. 'As he likes' means at will. Women's delighting the man is stated to produce excess pleasure in one with semen-suppression udāvarta; 'dear' means agreeable to the mind. By an omitted conjunction, the cock and other things from another tantra are included.
Key terms
śukrodāvartin
A man with udāvarta from suppressing semen.
bastiśuddhikara
Bladder-cleansing (additions).
Adhikarana ೩೩ (೩೪) · Śloka ೩೪
ಕ್ಷುದ್ವಿಘಾತೇ ಹಿತಂ ಸ್ನಿಗ್ಧಮುಷ್ಣಮಲ್ಪಂ ಚ ಭೋಜನಮ್ |೩೪|
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क्षुद्विघाते हितं स्निग्धमुष्णमल्पं च भोजनम् |३४|
Meaning of the śloka
In hunger-suppression, unctuous, warm and scanty food is beneficial.
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ಕ್ಷುದ್ವಿಘಾತೇ ಹಿತಮಿತ್ಯಾದಿ| ಚಕಾರಾತ್ ಲಘ್ವಪಿ|೩೪|-
Meaning of the commentary
The commentary says that by 'and', light food too is included.
The commentary says mantha is barley flour with ghee and cool water; the gruel is a thin peyā. By 'also', immersing in cool water, drinking and the like are included.
Key terms
mantha
Flour-based drink.
tṛṣṇāghāta
Suppression of thirst.
Adhikarana ೩೫ (೩೫) · Śloka ೩೫
ಭೋಜ್ಯೋ ರಸೇನ ವಿಶ್ರಾನ್ತಃ ಶ್ರಮಶ್ವಾಸಾತುರೋ ನರಃ |೩೫|
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भोज्यो रसेन विश्रान्तः श्रमश्वासातुरो नरः |३५|
Meaning of the śloka
One who is tired and breathless from holding back breath should be fed with meat juice, after rest.
The commentary says milk means cow's milk, not buffalo's, by the principle of the primary preparation and by agreement with similar tantras; another tantra says 'in loss of sleep let a man drink milk from the cow's udder'. Pleasant stories are agreeable tales he should listen to; another reading is 'fond of pleasant stories'. 'Sleep' means go to sleep.
In disorders such as distension and the like, one should make effort according to each; and whatever remedy is appropriate in any of them, that should be applied there.
The commentary says that after the treatment of udāvarta, the treatment of its complications is stated. Distension and the rest are conditions arising from suppressing urges; 'and the rest' includes pain, cutting pain and retention of stool. 'According to each' means the medicine stated in the vāta-disease and other chapters for each of these. Any other suitable treatment is also to be applied to each.
Vāyu going into the abdomen, aggravated at once by dry, astringent, pungent and bitter foods, produces udāvarta. It turns upward the channels that carry wind, urine, stool, blood, kapha and fat, and makes the stool overly hard. Then he is tormented by pain in the heart and bladder, oppressed by heaviness and distaste, passes wind, urine and stool with difficulty, and gets breathlessness, cough, running nose, burning, fainting, vomiting, fever, thirst, hiccup, headache, and disturbances of mind and hearing, and many other vāta-caused disorders.
The commentary says this is the other kind of udāvarta mentioned earlier as arising from unwholesome food. The vāyu that goes into the abdomen here is apāna. 'Turns up' means reverses the channels, making the downward-flowing channels flow upward; 'makes stool very hard' means makes it hard like the stool of camels and the like. Vibhrama is a special trouble. 'Many others' includes distension and reverse distension.
He should be anointed with oil and salt, oleated and sweated, and given a decoction enema (nirūha); after the stool has been loosened according to the doṣa, and after he has eaten, an anuvāsana should be given.
The commentary gives the treatment. 'Whose stool is broken' means whose stool has been broken up by the nirūha. Some take the anuvāsana as to relieve the complications of excess nirūha; the commentary rejects this by agreement with a similar tantra: 'in udāvarta from unwholesome causes, after a good nirūha, the physician should soon give an anuvāsana according to the doṣa to one who has eaten'. Some read 'bhinnavarcāṃsi' and explain it as the stool-easing foods eaten.
Key terms
nirūha
Decoction enema.
anuvāsana
Oil enema.
Adhikarana ೪೦ (೪೨) · Śloka ೪೩
ನ ಚೇಚ್ಛಾನ್ತಿಂ ವ್ರಜತ್ಯೇವಮುದಾವರ್ತಃ ಸುದಾರುಣಃ ||೪೨||
ಅಥೈನಂ ಬಹುಶಃ ಸ್ವಿನ್ನಂ ಯುಞ್ಜ್ಯಾತ್ ಸ್ನೇಹವಿರೇಚನೈಃ |೪೩|
The commentary says that when nirūha and anuvāsana fail, this treatment is stated: 'thus' means by the method stated; 'sweated' means oleated and sweated; snehavirecana is purgation with castor oil and similar.
He may drink trivṛt, pīlu and yavānī with sour, digestive drugs; or hiṅgu, kuṣṭha, vacā, svarjī and viḍaṅga, each double the one before. These two yogas destroy udāvarta and vātaja colic.
The commentary gives two yogas for udāvarta from unwholesome causes. Pīlu is the jujube-like fruit loved by camels. 'Sour, digestive' means with kāñjika and citraka and similar; the first yoga is trivṛt and the rest; the second is hiṅgu and the rest. Svarjī is svarjikākṣāra; 'double the one before' means each drug from the second onward is twice the previous. This 'doubling' is not applied to the first yoga, as another tantra shows. Some read 'yavāgū' for 'yavānī' and 'sour drinks' for 'sour digestive drugs'.
Devadāru, agnika, kuṣṭha, dry ginger, pathyā, palaṅkaṣā and pauṣkara roots, cooked in half an āḍhaka of water, reduced to a quarter, when drunk, removes udāvarta.
The commentary says agnika is ajamodā; pathyā is harītakī; palaṅkaṣā is guggulu. Half an āḍhaka is thirty-two palas; a quarter remaining is eight palas, from the usage of the elders and another tantra, which is quoted: 'having cooked kuṣṭha, palaṅkaṣā, pathyā, dry ginger, dāru, agni and puṣkara in thirty-two palas of water reduced to a quarter, let him drink'. Although a rule says a decoction is 'a handful', when the measure is not stated the rule is used, not when it is stated. Some take half an āḍhaka as sixty-four palas and give sixteen palas; others prefer sipping a large decoction in steps, both rejected by agreement with similar tantras.
Dry and fresh radish, varṣābhū, pañcamūla and ārevata fruit are cooked in water, and ghṛta is cooked with that; when drunk, it destroys udāvarta completely.
The commentary gives a drinking ghṛta. 'Dry' and 'fresh' qualify the radish; varṣābhū is punarnavā; pañcamūla is bilva and the rest; ārevata fruit is girimālaka fruit. 'Cooked' means a decoction is made; the ghṛta is cooked with that decoction.
Ikṣvāku root, madana, viśalyā, ativiṣā, vacā, kuṣṭha, kiṇva and agnika in equal parts, as before, may be drunk; or devadāru, agni, triphalā and bṛhatī, with (cow's) urine.
The commentary says ikṣvāku is bitter gourd; viśalyā is kāṣṭhapāṭalā, or indravāruṇī per others; kiṇva is a ferment; agnika is ajamodā; 'as before' means with warm water; the urine is cow's urine; agni is citraka.
The commentary says a prastha is sixteen palas of the equal-part mixture of kaṇṭakārī fruit and barley; an āḍhaka of water is sixty-four palas; the elders' usage does not adopt double water here; half a prastha remaining is eight palas. That such a large decoction can be drunk is not to be doubted, as it is said 'the sages alone know the results of combinations'. Those who want water in greater measure as in the earlier devadāru drink take kaṇṭakārī fruits also as a prastha. Some read 'a prastha of barley and two palas of kaṇṭakārī'.
The commentary says madana is madanaphala and its seeds are taken, by agreement with Vaitaraṇa (quoted: 'seeds of madana and alābu with kaṇṭakārī and pippalī'); nidigdhikā is kaṇṭakārī. The powder is blown by mouth through a tube (nāḍī) and sent into the anus.
Powder of nikumbha, kampillaka, śyāmā, ikṣvāku and agnika, with kṛtavedhana, māgadhī and salts, cooked in cow's urine; suppositories made of them and inserted along the anus give quick comfort. These two yogas are held as equal to nectar.
The commentary explains: nikumbha is the dantī tree; kampilla is rocanikā; śyāmā is red-rooted trivṛt; ikṣvāku is bitter gourd; agnika is ajamodā; kṛtavedhana is a kind of koṣātakī; māgadhī is pippalī; the salts are saindhava and the like. 'Along the anus' means of a size fit for entering the anus. 'Comfortable' means bringing comfort. The two yogas are the powder-blowing and the suppository. 'Like nectar' means because they are of the life-giving kind. The suppository method: the powder of nikumbha and the rest is cooked in cow's urine, and when thick and cooled, made into suppositories.
इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातेन्त्रे उदावर्तप्रतिषेधो नाम (सप्तदशोऽध्यायः, आदितः) पञ्चपञ्चाशत्तमोऽध्यायः ||५५||
Meaning of the śloka
Thus ends the fifty-fifth chapter (the seventeenth from the beginning of this section), named Udāvartapratiṣedha, in the Kāyacikitsā-tantra within the Uttaratantra of the Suśruta Saṃhitā.
Thus ends the fifty-fifth chapter, named Udāvartapratiṣedha, in the Uttaratantra, in the Suśruta commentary called Nibandhasaṅgraha composed by Śrī Ḍalhaṇa.