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The Ultimate Guide to Basti Treatment in Ayurveda: Everything You Need to Know

Basti is one of the Shodhana therapy or Panchakarma. It is mainly indicated in Vataja disorders. Basti is defined as the administration of medicine through the anal canal that reaches the entire body and brings the toxins to expel from the body. The other way to define Basti, is the usage of Basti instrument to administer the medicine.

It is quoted that Basti is ‘Chikitsaardha’- that means Basti treatment is half of the treatment. Varsha rutu is the ideal season for Basti therapy as Vata dosha is aggravated. The treatment of Basti is compared with watering of roots of the plants. The way when the roots of the plants are watered and the rest parts of the plant get nourished, in a similar way, Basti administered through the anal canal nourishes the entire body.    

Classification of Basti Treatment

Basti can be broadly classified into the following:

  1. Adhishthana Bheda (According to the site of administration)
  2. Dravya Bheda (According to drugs used in Basti karma)
  3. Karmukata Bheda (According to the therapeutic action)
  4. Sankhya Bheda (According to the number)
  5. Anusangika Bheda (According to the nomenclature)
  6. According to potency
  7. According to intensity

According to the site of administration, Basti is classified as:

  1. Pakwashayagata
  2. Uttara Basti

Pakwashayagata Basti – The Basti is administered through the anal canal into the colon.

Uttara Basti – In females, Uttara Basti can be Mutrashayagata Basti and Garbhashayagata Basti. Mutrashayagata Basti is administered through the urethra to reach the urinary bladder and Garbhashayagata Basti is administered through the vagina to reach the uterus. In males, it is only Mutrashayagata Basti, in which the enema is given through the penis to reach the urinary bladder.

According to the drugs used in Basti karma, it is classified as:

  1. Snaihika Basti
  2. Niruha Basti

Snaihika Basti – Here, the Sneha (oil/ghee/Vasa/Majja) is used to administer the Basti. The enema is administered through the anal route to reach the colon. This form of Basti can be administered after taking the food and can be retained for one day. Based on the dosage of Sneha used it is further divided into three types:

  1. Snaihika Basti – The amount or quantity of Sneha used is six pala (240 ml).
  2. Anuvasana Basti – The quantity of Sneha used is three pala (120 ml).
  3. Matra Basti – The quantity used is the minimum dosage and is 1 ½ pala (60 ml).

Niruha Basti – This is also known as Kashaya Basti or Asthapana Basti. The main ingredient used is the Kwatha (decoction). The other ingredients are honey, Saindhava lavana (rock salt), Sneha (medicated oil or ghee), and Kalka (paste of the medicines.

  1. This is further categorized based on the dosage: Dwadasha Prasritaki Basti, Ekadasha Prasritaki Basti, Nava Prasritaki Basti, Pancha Prasritaki Basti, Chatuha Prasritaki Basti, Ekaika Prasritaki Basti, Padaheena Prasritaki Basti.

According to the therapeutic action, it is classified as:

Brimhana, Lekhana, Snehana, Sangrahi, Shukravruddhikara, Balavranakara, Krimighna, Doshahara, Shodhana, Shamana Basti.

According to the number, Basti is classified as:

  1. Karma Basti – The total number of Basti administered is 30. Among them 12 are Niruha Basti and 18 are Anuvasana Basti.
  2. Kala Basti – The total number of Basti administered is 16. Among them 6 are Niruha Basti and 10 are Anuvasana Basti.
  3. Yoga Basti – The total number of Basti administered is 8. Among them 3 are Niruha Basti and 5 are Anuvasana Basti.
  4. Chaturbhadrika Basti – A total number of 12 Basti is administered. First 4 days continuously 4 Sneha Basti are given followed by 4 Niruha Basti and then again 4 Sneha Basti are administered.

According to the nomenclature, Basti is classified as:

Yapana Basti – This type of Basti can be administered at any time and promotes the longevity of an individual hence called Yapana Basti.

Siddha Basti – This type of Basti is indicated in a specific disease.

According to the potency, it is classified as Ushna Basti, Sheeta Basti, Laghu Basti, Snigdha Basti, and Ruksha Basti.

According to the intensity of the Basti, it is classified as Teekshna Basti, Madhyama Basti, Mrudu Basti.

Indications and Contra-indications Basti Treatment

Indications of Basti Treatment

Contra-indications of Basti Treatment

  • Hikka (hiccough)
  • Kasa (cough)
  • Shwasa (dyspnea)
  • Unmada (schizophrenia)
  • Adhmana (distension of abdomen)
  • Kshataksheena (emaciated)
  • Weak
  • Old aged people
  • Children
  • Pregnancy
  • Bhagandara (fistula-in-ano)
  • Arshas (piles)
  • Female who is menstruating
  • Who are highly intolerant
  • Who indulges in excess weight-lifting
  • Who have not undergone Snehana (oleation) and Swedana (fomentation)

Time of administration of Basti treatment

  • Varsha rutu or the rainy season is the ideal period to administer Basti treatment (enema therapy). During the rainy season, Vata dosha is aggravated, and thus, Basti eliminates the vitiated Vata dosha and the associated diseases.
  • Basti treatment can also be administered to healthy individuals during Varsha rutu. It keeps the person healthy by cleansing and activating all the upper body systems and the channels in a normal state.
  • Apart from this, Basti treatment can be given based on the condition of the patient and the intensity of the dosha which is to be decided by the physician.

Basti treatment

The administration of Basti treatment is divided into three stages: Purva karma, Pradhana karma, and Paschat karma.

Purva karma: The pre-requisites and the pre-arrangements before carrying out Basti treatment.

  • Basti Dravya (medicine should be prepared) in the case of Niruha Basti in which Madhu (honey), Saindhava Lavana (rock salt), Sneha (medicated ghee or oil), Kalka (medicinal paste), Kwatha (medicated decoction)are added in chronology and stirred well to form a homogeneous mixture.
  • For Anuvasana Basti, medicated oil or ghee in the prescribed quantity is kept ready.
  • Basti equipment that contains Basti Netra (nozzle)and Basti Putaka (bag) are to be checked for any damage or defects.
  • The screening of the patients is done based on indications and contra-indications for Basti treatment.
  • The Agni (digestion strength), Prakriti (constitution of the individual), psychological state of the person, external environmental factors, etc. are assessed and then decide the therapy.
  • Deepana-Pachana (appetizers and digestives) are given to the patient to stimulate digestion and digest any undigested food in the gastrointestinal tract. This will prepare the person to achieve the benefits of Basti.
  • The patient is asked to come on an empty stomach for Niruha Basti and to take food for Anuvasana Basti.
  • Abhyanga (oil massage) followed by Bashpa Swedana (fomentation) are given to the patient.

Pradhana karma

  • The patient is asked to lie on a table in a left lateral position with the right leg semi-flexed and the left leg completely straightened.
  • The Basti medicine is poured into the Basti bag, and the nozzle and the anal region is smeared with oil or ghee.
  • The nozzle is introduced in the anal region with the help of the index finger of the left hand gently. The insertion should not be too fast nor too slow.
  • It should be introduced 2-4 fingers away from the anus into the rectum.
  • Keep it in the same position and allow the medicine to enter.
  • The medicine should neither be too hot nor too cold.
  • The nozzle is taken out immediately but not to cause any injury.
  •  The pressure should be appropriate while administering the medicine.
  • Retain some medicine to prevent the air entry.
  • Basti is administered on an empty stomach in Niruha Basti and Anuvasana Basti, after food.

Paschat karma

  • After the administration of medicine, gentle strokes are given on the soles and buttocks of the patient.
  • The patient is made to lie in the supine position and the foot end of the table is raised.
  • A mild massage over the soles and abdomen is done.
  • If there is an urge for defecation, the patient is allowed to pass the stools.
  • In Niruha Basti, Basti medicine must be retained till one muhurta (48 minutes) but if the medicine is passed out immediately then two to three more Niruha Basti are given.
  • And if there is increased Vata dosha, Sneha Basti is given.
  • Anuvasana Basti can be retained even for one day.

Ayoga, Samyak yoga and, Atiyoga symptoms of Niruha Basti and Anuvasana Basti

Ayoga (impoper or inadequate) symptoms of Anuvasana Basti

Ruja (pain in the lower body, arms, and back regions.), Rukshata (dryness of the body), Kharata (roughness of the body), Graha (retention of urine, faeces, flatus).

Ayoga (impoper or inadequate) symptoms of Niruha Basti

Shiro- Hridaya-Basti-Linga Ruja (pain in the head, cardiac region, urinary bladder, penile region), Shopha (edema), Parikartika (anal fissure), Hrillasa (nausea), Vata-Mutra Sanga (retention of flatus and urine), Shwasakrichchrata (difficulty in breathing), Alpa vega (incomplete urge), Jadyata (stiffness in the body).

Atiyoga (impoper or excess dosage administration) symptoms of Anuvasana Basti

Parikartika (anal fissure), Sammoha (semi-consciousness), Klama (fatigue), etc.

Atiyoga (impoper or excess dosage administration) symptoms of Niruha Basti

Angasupti (numbness of the body), Angamarda (bodyache), Nidranasha (loss of sleep), Dourbalya (weakness), Hikka (hiccough).

Samyak yoga (proper administration) symptoms of Anuvasana Basti

Elimination of Sneha with Vata, Mala (faeces)and at proper time, Laghuta (feeling of lightness of the body), Buddhi (enhanced intellect) and Indriyaprasadanam (increased functioning of sense organs), Balavardhana (increased strength), Swapnanivrutti (initiation of good sleep).

Samyak yoga (proper administration) symptoms of Niruha Basti

Parisrishta Vit-Mootra (easy elimination of feces and urine), elimination of Mala, Pitta, Kapha and Vayu in the order, Balavardhanam (increased strength), Agnivruddhi (increased appetite), Laghavam (feeling of lightness in the body).

Conclusion

Basti is one of the Shodhana therapy indicated in Vata dosha. This is said to be Chikitsa Ardha. The classical texts of Ayurveda gives great significance to Basti treatment. Basti Dravya do the elimination of dosha and mitigate the aggravated dosha. It restores the normal health from the diseased conditions and maintain the health of a healthy individual. It acts as a rejuvenation therapy.

References
  1. AN AYURVEDIC APPROACH ON BASTI: A REVIEW, International Journal of Research in Ayurveda and Pharmacy, 2020, Volume 11, Issue 3, p. 128-142.
  2. AN IN-DEPTH REVIEW OF AYURVEDIC BASTI KARMA (MEDICATED ENEMA), International Journal of Research in AYUSH and Pharmaceutical Sciences, 2020 (February), Volume 4, Issue 2, p. 388-391.
  3. A CRITICAL REVIEW ON BASTI KARMA, World Journal of Pharmaceutical and Medical Research, 2020, Volume 6, Issue 8, p.131-133.
  4. https://www.researchgate.net/publication/361076902_Matra_Basti-Mode_of_Action-A_Conceptual_Study

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