catustriṃśattamo+adhyāyaḥ/

Su.4.34.1 athāto vamanavirecanavyāpaccikitsitaṃ vyākhyāsyāmaḥ//

Su.4.34.2 yathovāca bhagavān dhanvantariḥ//

Su.4.34.3 vaidyāturanimittaṃ vamanaṃ virecanaṃ ca pañcadaśadhā vyāpadyate/ tatra vamanasyādho gatirūrdhvaṃ virecanasyeti pṛthak; sāmānyamubhayoḥ sāvaśeṣaudhatvaṃ, jīrṇauṣadhatvaṃ, hīnadoṣāpahṛtatvaṃ, vātaśūlam, ayogo, atiyogo, jīvādānam, ādhmānaṃ, parikartikā, parisrāvaḥ, pravāhikā, hṛdayopasaraṇaṃ, vibandha, aṅgapragraha iti//

Su.4.34.4 tatra bubhukṣāpīḍitasyātitīkṣṇāgnermṛdukoṣṭhasya cāvatiṣṭhamānaṃ durvamasya vā guṇasāmānyabhāvādvamanamadho gacchati, tatrepsitānavāptirdoṣotkleśaśca; tamāśu snehayitvā bhūyastīkṣṇatarairvāmayet//

Su.4.34.5 apariśuddhāmāśayasyotkliṣṭaśleṣmaṇaḥ saśeṣānnasya vā+ahṛdyamatiprabhūtaṃ vā virecanaṃ pītamūrdhvaṃ gacchati, tatrepsitānavāptirdoṣokleśaśca; tatrāśuddhāmāśayamulbaṇaśleṣmāṇamāśu vāmayitvā bhūyastīkṣṇatarairvirecayet, āmānvaye tvāmavat saṃvidhānam, ahṛdye+atiprabhūte ca hṛdyaṃ pramāṇayuktaṃ ca; ata ūrdhvamuttiṣṭhatyauṣadhe na tṛtīyaṃ pāyayet, tatastvenaṃ madhughṛtaphāṇitayuktairlehairvirecayet//

Su.4.34.6 doṣavigrathitamalpamauṣadhamavasthitamūrdhvabhāgikamadhobhāgikaṃ vā na sraṃsayati doṣān, tatra tṛṣṇā pārśvaśūlaṃ chardirmūrcchā parvabhedo hṛllāso+aratirudgārāviśuddhiśca bhavati; tamuṣṇābhiradbhirāśu vāmayedūrdhvabhāgike, adhobhāgike+api ca sāvaśeṣauṣadhamatipradhāvitadoṣamatibalamasamyagviriktalakṣaṇamapyevaṃ vāmayet//

Su.4.34.7 krūrakoṣṭhasyātitīkṣṇāgneralpamauṣadhamalpaguṇaṃ vā bhaktavat pākamupaiti, tatra samudīrṇā doṣā yathākālamanirhrīyamāṇā vyādhivibhramaṃ balavibhraṃśaṃ cāpādayanti, tamanalpamamandamauṣadhaṃ ca pāyayet//

Su.4.34.8 asnigdhasvinnenālpaguṇaṃ vā bheṣajamupayuktamalpān doṣān hanti; tatra vamane doṣaśeṣo gauravamutkleśaṃ hṛdayāviśuddhiṃ vyādhivṛddhiṃ ca karoti, tatra taṃ yathāyogaṃ pāyayitvā vāmayeddṛḍhataraṃ; virecane tu gudaparikartanamādhmānaṃ śirogauravamaniḥsaraṇaṃ vā vāyorvyādhivṛddhiṃ ca karoti; tamupapādya bhūyaḥ snehasvedābhyāṃ virecayeddṛḍhataraṃ, dṛḍhaṃ bahupracalitadoṣaṃ vā tṛtīye divase+alpaguṇaṃ ceti//

Su.4.34.9 asnigdhasvinnena rūkṣauṣadhamupayuktamabrahmacāriṇā vā vāyuṃ kopayati, tatra vāyuḥ prakupitaḥ pārśvapṛṣṭhaśroṇimanyāmarmaśūlaṃ mūrcchāṃ bhramaṃ madaṃ saṃjñānāśaṃ ca karoti, taṃ vātaśūlamityācakṣate; tamabhyajya dhāvyasvedena svedayitvā yaṣṭīmadhukavipakvena tailenānuvāsayet//

Su.4.34.10 snehasvedābhyāmavibhāvitaśarīreṇālpamauṣadhamalpaguṇaṃ vā pītamūrdhvamadho vā nābhyeti doṣāṃścotkleśya taiḥ saha balakṣayamāpādayati, tatrādhmānaṃ hṛdayagrahastṛṣṇā mūrcchā dāhaśca bhavati, tamayogamityācakṣate; tamāśu vāmayenmadanaphalalavaṇāmbubhirvirecayettīkṣṇataraiḥ kaṣāyaiśca/ durvāntasya tu samutkliṣṭādoṣā vyāpya śarīraṃ kaṇḍūśvayathukuṣṭhapiḍakājvarāṅgamardanistodanāni kurvanti, tatastānaśeṣānmadauṣadhenāpaharet/ asnigdhasvinnasya durviriktasyādhonābheḥ stabdhapūrṇodaratā śūlaṃ vātapurīṣasaṅgaḥ kaṇḍūmaṇḍalaprādurbhāvo vā bhavati, tamāsthāpya punaḥ saṃsrehya virecayettīkṣṇena/ nātipravartamāne tiṣṭhati vā duṣṭasaṃśodhane tatsantejanārthamuṣṇodakaṃ pāyayet, pāṇitāpaiśca pārśvodaramupasvedayet, tataḥ pravartante doṣāḥ/ anupravṛtte cālpadoṣe jīrṇauṣadhaṃ bahudoṣamahaḥśeṣaṃ daśarātrādūrdhvamupasaṃskṛtadehaṃ snehasvedābhyāṃ bhūyaḥ śodhayet/ durvirecyamāsthāpya punaḥ saṃsnehya virecayet/ hrībhayalobhairvegāghātaśīlāḥ prāyaśaḥ striyo rājasamīpasthā vaṇijaḥ śrotriyāśca bhavanti, tasmādete durvirecyāḥ, bahuvātatvāt; ata eva tānatisnigdhān svedopapannāñ śodhayet//

Su.4.34.11 sngidhasvinnasyātimātramatimṛdukoṣṭhasya vā+atitīkṣṇamadhikaṃ vā dattamauṣadhamatiyogaṃ kuryāt/ tatra vamanātiyoge pittātipravṛttirbalavisraṃso vātakopaśca balavān bhavati, taṃ ghṛtenābhyajyāvagāhya śītāsvapsu śarkarāmadhumiśrairlehairupacaredyathāsvaṃ; virecanātiyoge kaphasyātipravṛttiruttarakālaṃ ca saraktasya, tatrāpi balavisraṃso vātakopaśca balavān bhavati, tamatiśītāmbubhiḥ pariṣicyāvagāhya vā śītaistaṇḍulāmbubhirmadhumiśraiśchardayet, picchābastiṃ cāsmai dadyāt, kṣīrasarpiṣā cainamanuvāsayet, priyaṅgvādiṃ cāsmai taṇḍulāmbunā pātuṃ prayacchet, kṣīrarasayoścānyatareṇa bhojayet//

Su.4.34.12 tasiminneva vamanātiyoge pravṛddhe śoṇitaṃ ṣṭhīvati chardayati vā, tatra jihvāniḥsaraṇamapasaraṇamakṣṇorvyāvṛttirhanusaṃhananaṃ tṛṣṇā hikkā jvaro vaisaṃjñyamityaupadravā bhavanti; tamajāsṛkcandanośīrāñjanalājacūrṇaiḥ saśarkarodakairmanthaṃ pāyayet, phalarasairvā saghṛtakṣaudraśarkaraiḥ śuṅgābhirvā vaṭādīnāṃ peyāṃ siddhāṃ sakṣaudrāṃ varcogrāhibhirvā, payasā jāṅgalarasena vā bhojayet, atisrutaśoṇitavidhānenopacaret; jihvāmatisarpitāṃ kaṭukalavaṇacūrṇapraghṛṣṭāṃ tiladrākṣāpraliptāṃ vā+antaḥ pīḍayet, antaḥ praviṣṭāyāmamlamanye tasya purastāt khādayeyuḥ; vyāvṛtte cākṣiṇī ghṛtābhyakte pīḍayet, tṛṣṇādiṣu ca yathāsvaṃ pratikurvīta, visaṃjñe veṇuvīṇāgītasvanaṃ śrāvayet//

Su.4.34.13 virecanātiyoge ca sacandrakaṃ salilamadhaḥ sravati tato māṃsadhāvanaprakāśamuttarakālaṃ jīvaśoṇitaṃ ca, tato gudaniḥsaraṇaṃ vepathurvamanātiyogopadravāścāsya bhavanti; tamapi niḥsrutaśoṇitavidhānenopacaret, niḥsarpitagudasya gudamabhyajya parisvedyāntaḥ pīḍayet kṣudrarogacikitsitaṃ vā vīkṣeta, vepathau vātavyādhividhānaṃ kurvīta, jihvāniḥsaraṇādiṣūktaḥ pratīkāraḥ, atipravṛtte vā jīvaśoṇite kāśmarīphalabadarīdūrvośīraiḥ śṛtena payasā ghṛtamaṇḍāñjanayuktena suśītenāsthāpayet, nyagrodhādikaṣāyekṣurasaghṛtaśoṇitasaṃsṛṣṭaiścainaṃ bastibhirupācaret, śoṇitaṣṭhīvane raktapittaraktātīsārakriyāścāsya vidhadhyāt, nyagrodhādiṃ cāsya vidadhyāt pānabhojaneṣu//

Su.4.34.14 jīvaśoṇitaraktapittayośca jijñāsārthaṃ tasmin picuṃ plotaṃ vā kṣipet, yadyuṣṇodakaprakṣālitamapi vastraṃ rañjayati tajjīvaśoṇitamavagantavyaṃ; sabhaktaṃ ca śune dadyācchaktusaṃmiśraṃ vā, sa yadyupabhuñjīta tajjīvaśoṇitamavagantavyam; anyathā raktapittamiti//

Su.4.34.15 saśeṣānnena bahudoṣeṇa rūkṣeṇānilaprāyakoṣṭhenānuṣṇamasnigdhaṃ vā pītamauṣadhamādhmāpayati, tatrānilamūtrapurīṣasaṅgaḥ samunnaddhodaratā pārśvabhaṅgo gudabastinistodanaṃ bhaktāruciśca bhavati, taṃ cādhmānamityācakṣate; tamupasvedyānāhavartidīpanabastikriyābhirupacaret//

Su.4.34.16 kṣāmeṇātimṛdukoṣṭhena mandāgninā rūkṣeṇa vā+atitīkṣṇoṣṇātilavaṇamatirūkṣaṃ vā pītamauṣadhaṃ pittānilau pradūṣya parikartikāmāpādayati, tatra gudanābhimeḍhrebastiśiraḥsu sadāhaṃ parikartanamanilasaṅgo vāyuviṣṭambho bhaktāruciśca bhavati; tatra picchābastiryaṣṭīmadhukakṛṣṇatilakalkamadhughṛtayuktaḥ, śītāmbupariṣiktaṃ cainaṃ payasā bhuktavantaṃ ghṛtamaṇḍena yaṣṭīmadhukasiddhena tailena vā+anuvāsayet//

Su.4.34.17 krūrakoṣṭhasyātiprabhūtadopasya mṛdvauṣadhamavacāritaṃ samutkliśya doṣānna niḥśeṣānapaharati, tataste doṣāḥ parisrāvamāpādayanti, tatra daurbalyodaraviṣṭambhārucigātrasadanāni bhavanti, savedanau cāsya pittaśleṣmāṇau parisravataḥ, taṃ parisrāvamityācakṣate; tamajakarṇadhavatiniśapalāśabalākaṣāyairmadhusaṃyuktairāsthāpayet, upaśāntadoṣaṃ snigdhaṃ ca bhūyaḥ saṃśodhayet//

Su.4.34.18 atirūkṣe+atisnigdhe vā bheṣajamavacāritamaprāptaṃ vātavarca udīrayati vegāghātena vā, tadā pravāhikā bhavati; tatra savātaṃ sadāhaṃ saśūlaṃ guru picchilaṃ śvetaṃ kṛṣṇaṃ saraktaṃ vā bhṛśaṃ pravāhamāṇaḥ kaphamupaviśati; tāṃ parisrāvavidhānenopacaret//

Su.4.34.19 yastūrdhvamadho vā bheṣajavegaṃ pravṛttamajñatvādvinihanti tasyopasaraṇaṃ hṛdi kurvanti doṣāḥ, tatra pradhānamarmasantāpādvedanābhiratyarthaṃ pīḍyamāno dantān kiṭakiṭāyate udgatākṣo jihvāṃ svādati pratāmyatyacetāśca bhavati, taṃ parivarjayanti mūrkhāḥ; tamabhyajya dhānyasvedena svedayet, yaṣṭimadhukasiddhena ca tailenānuvāsayet, śirovirecanaṃ cāsmai tīkṣṇaṃ vidadhyāt, tato yaṣṭimadhukamiśreṇa taṇḍulāmbunā chardayet, yathādoṣocchrāyeṇa cainaṃ bastibhirupācaret//

Su.4.34.20 yastūrdhvamadho vā pravṛttadoṣaḥ śītāgāramudakamanilamanyadvā seveta, tasya doṣāḥ srotaḥsvavalīyamānā ghānībhāvamāpannā vātamūtraśakṛdgrahamāpādya vibadhyante, tasyāṭopo dāho jvaro vedanāśca tīvrā bhavanti; tamāśu vāmayitvā prāptakālāṃ kriyāṃ kurvīta; adhobhāge tvadhobhāgadoṣaharadravyaṃ saindhavāmlamūtrasaṃsṛṣṭaṃ virecanāya pāyayet, āsthāpanamanuvāsanaṃ ca yathādoṣaṃ vidadhyāt, yathādoṣamāhārakramaṃ ca; ubhayatobhāge tūpadravaviśeṣān yathāsvaṃ pratikurvīta//

Su.4.34.21 yā tu virecane gudaparikartikā tadvamane kaṇṭhakṣaṇanaṃ, yadadhaḥ parisravaṇaṃ sa ūrdhvabhāge śleṣmaprasekaḥ, yā tvadhāḥ pravāhikā sā tūrdhvaṃ śuṣkodgārā iti//

Su.4.34.22 bhavati cātra yāstvetā vyāpadaḥ proktā daśa pañca ca tattvataḥ/ etā virekātiyogaduryogāyogajāḥ smṛtāḥ//

iti suśrutasaṃhitāyāṃ cikitsāsthāne vamanavirecanavyāpaccikitsitaṃ nāma catustriṃśo+adhyāyaḥ //34//