Basti Karma (Medicated Enema Therapy) - Panchakarma Therapy in Ayurveda

Abstract

The word basti is termed so because the urinary bladders of the animals are used to introduce the elimination drugs or unctuous drugs into the rectum of the body to generate some effect. The word basti has the following meaning to inhibit, to stay, to reside, to produce an aromatic drug effect, to live, to dwell or to abide. The word basti is a location where the mutra (urine) is collected. In modern medicine enema is given to eliminate the feces from the anal route but in Ayurveda it is given as a nourishing enema. It provides longevity and health to the person. So today we will read about basti karma (Enema therapy) in brief in this article.

Introduction

Basti is a procedure in which the medicated decoction or oil is introduced into the urinary (mutrashaya gata), vaginal (garbhashaya gata) and anal route (pakwashaya gata) with the help of basti yantra is known as basti. In Ayurveda chikitsa (treatment), the role of panchakarma and specially basti has a very important role in the treatment of various diseases. Its action is from head to toe. Basti is the best treatment for all the vata diseases.

Classification Of Basti

Adhishtan Bheda (Place Of Administration)

• Pakwashaya gata basti (Ano-rectal)
• Mutrashayagata basti (Urethro-vesical)
• Garbhashayagata basti (Uterine)
• Vranagata basti (Wound/abscess)

Dravya Bheda (Decoction Or Unctuous)

1. Niruha Basti

This basti is kwath pradhana (Mostly decoction) and it eliminates the doshas from the body hence is called as niruha basti. It enhances the age of the person hence it is also known as asthapan and other bastis like yapan basti, yuktarath basti, madhutailika basti, siddha basti are its synonyms.

2. Anuvasana Basti

In anuvasana basti sneha (Oil) is the main ingredient.

According to the dose of the sneha it is of three types:-

1. Sneha basti - 240 ml
2. Anuvasan basti - 120 ml
3. Matra basti - 60 ml

Sankhya Bheda

According to number the bastis have been divided as follows:-

Yog Basti - 8

1. Anuvasana basti
2. Niruha basti
3. Anuvasana basti
4. Niruha basti
5. Anuvasana basti
6. Niruha basti
7. Anuvasana basti
8. Anuvasana basti

Kala Basti - 16

In this total 16 bastis are given. Firstly given 1 anuvasana basti then systematically given 6 niruha and 6 anuvasana basti and lastly given again 3 anuvasana basti.

Karma Basti - 30

In this firstly given anuvasana basti and 12 niruha and 12 anusavana basti is given alternatively and lastly given again 5 anuvasana basti.

Indication For Basti Therapy

• Constipation
• Gout
• Sciatica
• Rheumatoid arthritis
• Diverticulosis
• Arthritis
• Headache
• Tinnitus
• Slipped disk
• Distension and gas
• Insomnia
• Nervous disorders
• Hernia

Contraindication For Basti Therapy

• Diarrhea
• Pregnancy
• Rectum bleeding (Except piccha basti)
• Menstruation
• Anus inflamed
• Extreme weakness and debility

Complication

• Fatigue
• Vomiting
• Pain in anus
• Headache
• Discharge from rectal
• Excessive expulsion
• Strenuous defecation
• Hiccups
• Bodyache
• Chest congestion
• Abdominal distension

Preparation Of Different Types Of Basti

1. Madhutailika Basti

The basti, which has honey and oil as the main ingredient is known as madhutailika basti. Acharya Sushruta says that madhutailika basti is one of the varieties of niruha basti and yapana, yuktaratha bastis are its synonyms. It can be given at any time and to anybody as such there are no precautions that should be followed to undergo this basti.

Indications

• Vata disorders
• Prameha (Diabetes)
• Arsha (Piles)
• Gulma (Tumor)
• Krimi Roga (Worm infestation)
• Skin diseases  
• Hernia
• Spleen disease

In healthy person this basti can be indicated to achieve the following benefits:-

• Deepana (Carminative)
• Brimhana (Nourishing)
• Balavarnakara (Strength and glowing)
• Rasayana (Rejuvenating)
• Vrishya (Aphrodisiac)

Material And Dose

• Madhu (Honey) - 20 ml
• Tila taila - 20 ml
• Saunf churna (Fennel powder) - 10 gram
• Saindhava lavana (Rock salt) - 10 gram        
• Madanaphala churna (Randia dumetorum) - 10 gram
• Eranda moola kwath (Ricinus communis) - 100 ml

Manufacturing Process

Take 50 gram eranda moola in 1 litre water and make decoction left 100 ml. Firstly take saindhava lavana in a kalvam and make fine powder add saunf, madanaphala churna, honey and mix properly while mixing oil should be poured slowly. Then lastly add decoction of errand moola slowly and mix properly.

2. Vaitarana Basti

The basti in which tamarind, jaggery, rock salt, cow milk and oil are used is known as vaitarana basti. It is also known as kshara basti. This basti is described in chakradatta.

Indications

• Rheumatism
• Flatulence
• Abdominal pains (Vataja and kaphaj)
• Sciatica

Materials And Dose

• Tamarind swarasa - 50 ml
• Jaggery - 20 ml
• Rock salt - 10 ml
• Cow milk - 500 ml
• Tila oil - 50 ml

Manufacturing Process

Take 50 gram tamarind and 20 gram jaggery into 50 ml water and boil it and after lukewarm  press hard and strain and mix into boiled 500 ml milk. Take rock salt in a kalwa make fine powder and add tila oil slowly and mix properly. Then mix the remaining dravya (Material).

3. Piccha Basti

It is a process in which the medicated milk is administered through the rectum into pakwashaya (Large intestine) by drip method.

Indication

• Grahani (Irritable bowel syndrome)
• Pravahika (Dysentery)
• Amoebiasis
• Bacillary dysentery

Material And Dose

• Mocharas - 80 gram
• Lodhra - 20 gram
• Kutaj - 10 gram
• Water for decoction - 800 ml
• Milk - 50 ml
• Ghee - 10 ml
• Saline bottle with saline set without needle

Manufacturing Process

Take mocharas, lodhra and kutaj into 800 ml of water and boil it and reduce it to 200 ml then mix cow milk and ghee and fill in the saline bottle and give it to the patient by drip method very slowly about 50 to 60 minutes.

4. Ksheer Basti

It is a procedure in which medicated milk is administered through the rectum into the large gut by drip method. This basti is safest and can be given to any age of person and can be given in dehydration instead of I.V. fluids.

Indication

• All types of pittaj diseases
• Dehydration condition
• Peptic ulcer and duodenal ulcers
• Amlapitta (Acid gastritis)
• Palpitations
• Hotness
• Anxiety
• Sleeplessness
• Restlessness

Material And Dose

• Shatavari siddha milk - 100 ml
• Ghee -20 ml
• Tila oil - 20 ml
• Madhu - 20 ml

Manufacturing Process

Take shatavari 500 gram mix into milk 100 ml and water 100 ml and boil it and reduce water and mix ghee, tila oil and madhu and prepare it.

5. Lekhan Basti

Lekhan basti is the combination of triphala decoction, cow urine, honey, and yavakshara. It has been described as a powerful fat reducing basti.

Indication

• Obesity (Sthoulya)

Material And Dose

• Triphala (Emblica officinalis, Terminalia chebula, Terminalia bellirica) decoction - 100 ml
• Cow urine - 50 ml
• Madhu - 20 ml
• Yavakshara - 10 gram

Manufacturing Process

Firstly prepare triphala decoction through the decoction process and add the remaining material and prepare it.

6. Uttar Basti

Administration of medicines through the orifice which is situated anteriorly to the anus is said to be uttar basti. In females, intrauterine administration of basti through the cervix and in males, the administration of basti into the intravesical through urethra is known as uttar basti.

Indication

• Infertility 
• Prolapse of the uterus
• Menstrual disorders
• Amenorrhoea
• Menorrhagia
• Disorders of vagina

Contraindication

• Bleeding per vagina during pregnancy.

Material And Dose

• Phala kalyanaka ghrita - 150 ml (For conceive baby)

Manufacturing Process

Syringe of 20 ml filled with ghrita and give basti slowly.

7. Shitta Pittahar Basti

Indication

• Vata pitta disorders

Material And Dose

• Gairik (Red ochre) - 10 gram
• Water - 25 ml

Manufacturing Process

Take 25 ml filtered water mix with gairik and fill in the 25 ml syringe and give the basti slowly.

8. Mutrakriccha Basti

Indication

• Dysuria and urine related problems

Material And Dose

• Gokshura kwath - 100 ml
• Pashanbhed - 10 gram
• Yastimadhu - 10 gram
• Mishri - 10 gram

Manufacturing Process

Make gokshura kwath through the decoction process then add the remaining material and give basti.

9. Chakshushya Basti

Indication

• Eye diseases

Material And Dose

• Madhu taishik yoga -170 gram
• Yastimadhu - 30 gram

Manufacturing Process

Mix madhu taishik yoga with 30 gram mulethi churna and prepare basti.

10. Krimighan Basti

Indication

• Worms infestation

Material And Dose

• Triphala kwath - 100 ml
• Vidanga churna - 10 gram
• Nagarmotha - 10 gram
• Shigu churna - 10 gram
• Madan phala churna - 10 gram

Manufacturing Process

By the decoction method, prepare triphala kwath and add the remaining material in it and prepare basti. Take this as lukewarm for the best results.

Basti Dana Viddhi (Method Of Administration Of Basti)

There is three steps for administration of the basti:-

1. Poorva karma
2. Pradhana karma
3. Paschat karma

1. Poorva Karma (Pre-Operative Procedure)

Before the administration of basti proper history should be taken. Proper examination of the patient should be done. Massage should be done to the whole body or buttocks after passing the natural urges. Sudation therapy should be given for 10 to 15 minutes. Patients should be given a light and fresh diet before basti dana. Ask the patient to lie down on the table on his left side with left leg straight and keep the right leg on it by flexing at hip and knee.

2. Pradhana Karma (Operative Procedure)

The material of basti is put in the basti yantra, which is impregnated with emulsion of basti medicine. Next, lubricate or oil the basti netra and administered through anal region by the left hand index finger. It is administered 2 to 4 fingers apart from the anal region to rectum. Stay in the same posture so that the basti material goes inside properly. Basti netra should pull out. In anuvasana, basti should be administered after the food while niruha, basti should be administered on an empty stomach.

3. Paschat Karma (Post-Operative Procedure)

Keep the patient lying on his back and light massage should be done on buttocks, and soles. If he gets an urge or vega for defecation, advise him to go for a motion. After passing motions and when the patient gets good appetite should be kept on hot and fresh khichadi.

Features Of Administration Of Niruha Basti

Symptoms Of Proper Administration Of Niruha Basti

• Proper elimination of feces, urine and air
• Enhance appetite
• Pacify of ailment
• Increase strength
• Revival of normalcy
• Lightness in viscera

Symptoms Of Improper Administration Of Niruha Basti

• Pain in heart, head, pelvis, anus and penis
• Cutting pain
• Swelling
• Nausea
• Dyspnea
• Retention of air and urine
• Coryza

Symptoms Of Excessive Administration Of Niruha Basti

• Exhaustion
• Numbness
• Trembling
• Fatigue
• Sleeplessness
• Unconsciousness
• Hiccup
• Insanity
• Bodyache

Features Of Administration Of Anuvasana Basti

Symptoms Of Proper Administration Of Anuvasana Basti

• Oil comes back un-adhered along with feces
• Clarity of dhatu (Tissues)
• Clarity in sense organs
• Lightness
• Elimination of natural urges
• Good sleep
• Strength

Symptoms Of Improper Administration Of Anuvasana Basti

• Pain in lower part, arm, abdomen, back and sides
• Coarseness and roughness in the body
• Retention of urine, feces and air

Symptoms Of Excessive Administration Of Anuvasana Basti

• Mental confusion
• Fainting
• Exhaustion
• Nausea
• Malaise
• Cutting pain

Why Anuvasana Basti Should Be Administered Immediately After Meals (Adrapanitala Avastha)

As soon as we take something through the mouth the pyloric sphincter will contract to facilitate proper digestion. According to the Ayurveda it can be described physiologically that the elevation of kapha dosha will take place in the prapaka (Digestion) stage. If we administered the anuvasana basti in a particular digestion stage it might increase the strength of basti action and also increase the brimhana (Nourishing) effect. Due to this reason Acharyas have suggested that anuvasana basti should be given immediately after taking meals.

Why Shodhana Basti Should Be Administered In Empty Stomach (Rikta Kostha)

After administration of shodhana basti within one muhurta (45 minutes) it should come out otherwise it may create so many complications and even cause death. Shodhana basti should be given in empty stomach due to the alimentary canal being a both side open ended hence the contents are not allowed to retain more time in the colons and it necessitates to evacuate as early as possible.

As we mentioned above, the preparation of different-different basti, in which they are made by various types of herbal powders that are mixed with other contents or ingredients. There are several herbs that are used in preparation of various basti are manufactured by Rajamruth Vaidyashala with no preservatives, additives are used. They contain pure, natural herbs whose efficacy is very high. There is a list of herbs which are used in preparation of basti in Rajamruth Vaidyashala:- Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), Vidanga (Embelia ribes), Lodhra (Symplocos racemosa), Kutaj (Holarrhena antidysenterica), Gokshura (Tribulus terrestris), and Eranda moola (Ricinus communis). These herbal powders are made naturally with no side effects and give effective results in the human body.

Conclusion

Basti is one of the most important therapy amongest all the treatments of Ayurveda. Basti can be introduced in almost all the diseases. Indication of basti is not only in vata diseases but also in pittaj, kaphaj and rakta vikaras (Diseases) and even in combination of two dosha (Samsarga) and combination of three dosha (Sannipata) diseases. Its properties are broad spectrum and multi-dimensional. It acts as aphrodisiac, anabolic, geriatric and it is indicated in emaciated persons because it enhances the quantity and quality of dhatu (Tissue).