Enema therapy also has a long history in Tibetan medicine. In Rgyud bzhi, it mentions a mild enema therapy (by applying mild cathartic for enema) and drastic enema therapy (by applying drastic cathartics).
Indications of enema include abdominal distension, dyspepsia, watery diarrhea menorrhagea, predominant cold in the large or small intestine and waist, weakness,and all rlung disorders. Use of drastic enema is indicated for constipation, exuberant heat in the lower body, anuria, worms and old epidemics.
Contra-indications: for mild enema, it includes edema, loss of appetite,intoxication, obesity, dyspepsia, cold badkan disorders; for drastic enema, includes proctoptosis, watery diarrhea, ini’tial stage of fever, decadent stomach fire, emission.
Drugs applied for enema include: Radix Vladimiria, Fructus Piper longi,Folium Cupressus, Sallucidum and Fructus Terminalia chebula, ground into powder and dissolved into any of the following enema solutions.(1) Fat mutton solution, yak milk, melted butter, used for rlung disorders; (2) cooked soup made of fish, frog or tadpole, plus ox milk and butter, for mixed rlung and mkhris pa diseases; (3) cooked soup made of animals from the stream beach, plus goat mutton, and its butter, for compound rlung-badkan disorders.
Procedures: put the medicinal solution and enema solution together in the enema equipment which is made of a sheep’s stomach or urinary bladder, with an eight-finger breadth catheter connected to its outlet orifice. The catheter has a smaller and smooth end and can be inserted into the anal canal for a length of 3-4 finger breadths. Press the bladder to push the contents into the anal canal. The patient must hold the solution in situ for a while and then defecate, Generally, enema is administered at dusk and the patient can defecate after dinner.
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