🔘 BASTI KARMA

BASTI (MEDICATED ENEMA)

बस्तिभिर्दीयते यस्मात् तस्मात् बस्तिरिति स्मृतः

Bastikarma is  the  procedure by  which  the  medicines  in  suspension  form  are administered through rectum or genitourinary tract using Bastiyantra. It is the most important procedure  among  Panchakarma  procedures and the  most  appropriate remedial  measure  for Vatadosha.

👉🏻Medicines- usual ingredients:

Medicated oils for Abhyanga

Swedana Karma materials

Medicated oils for Basti

Kwatha (Decoction) & Kalka (Paste) made from prescribed medicines –

Madhu (Honey)

Saindhava (Rock-salt)

👉🏻Man Power:

Ayurvedic Physician : 1

Masseur : 1

👉🏻Types of Basti (Classified into many ways):

According to the nature of medicine used, two types of enemas are: Astapana/Kashaya/ Niruha Basti  - Decoction based enema

Anuvasana/ Sneha Basti  - Oil based enema

👉🏻Matra (dose) of Basti dravyas:

It depends upon age, sex, strength (bala) of the patient and state of Doshas / disease. 

👉🏻Apparatus for Basti:

Basti yantra is composed of a Bastiputaka (animal bladder/polythene bag) and Bastinetra or nozzle made up of metals like gold, silver, copper, etc. (Charak Siddhi 3/7). The length of Bastinetra may be 6 to12 fingers according to age of the patient (Sushrut chikista 35/8)

👉🏻NIRUHA BASTI/ KASHAYA BASTI (DECOCTION ENEMA):

Decoction enema is given before meals (i.e. 8-9 AM) and usually consists of

Medicated oil/ghee : 240ml

Madhu (Honey) : 180ml

Decoction made from prescribed drugs : 480ml

Shatahwa kalka :   30gm

Rock-salt :   15gm

👉🏻Preparation of Basti dravya

Powdered rock-salt  is added to  honey and stirred in  a clean vessel with a pestle.  Oil is added  to  this  mixture  little  by  little  and  again  stirred.  Then  paste  of  Shatahwa  followed  by decoction  is to  be  added  little  by  little  quantity  and mixed  properly to  make  homogenous emulsion, and heated gently in a water bath (slightly above body temperature).  This mixture is poured into a Bastiputaka (polythene bag/ animal  bladder) and  fixed with Basti Netra (tied by using thread).

👉🏻Procedure:

Having  undergone  Abhyanga and  Swedana,  the  patient is  advised to  lie down  in left lateral position.  Apply  little  quantity  of  oil  on patient’s anus and  nozzle of  Basti yantra.  The nozzle is gently  inserted into the anal  canal up to a specific  length and Bastiputaka containing mixture is pressed with a uniform pressure. The pressure is continued till only small quantity of fluid  remains  in  the bag (to  avoid  air  insertion).    Then  the  nozzle  is  removed gently  and  the patient is allowed to lie down on supine position till he feels urge to excrete. The Basti dravya along  with faeces normally comes out within  10 minutes when  a full dose of Niruha Basti is given. The  maximum  time specified for  retention  of Bastidravya is 48 minutes.   After evacuation of the bowel, the patient may take hot water bath and semi solid diet.  Usually Niruha Bastis are not  to be given alone. Wherever required, Niruha Basti must be  given  alternatively  with  Snehabasti. Arrangement  of  SnehaBastis in  the  beginning,  Niruha Bastis and SnehaBastis alternatively later followed by SnehaBastis in the last is done in three specific patterns according to total number of bastis, the severity of disease and condition of the patient etc. 

👉🏻These are known as:   

    Karmabasti - 30 in number (12 Niruha, 18 Anuvasana)

Kalabasti     - 16 in number (6 Niruha, 10 Anuvasana)

Yogabasti   -8 in number (3 Niruha, 5 Anuvasana).

👉🏻Commonly used basti Yogas:

Madhutailika basti

Bala guduchyadi basti

Patolanimbadi basti

Vaitarana  basti

👉🏻Indications:

 Neurological disorders  - Hemiplegia, Paraplegia, Sciatica, parkinson’s                                                         disease etc.

Rheumotological disorders - Gout, Rheumatoid Arthritis, Lumbago, Osteo                                                    Arthritis,  Myalgia etc.

Digestive disorders

Chronic Fever

Secondary Amenorrhea, etc.

👉🏻Contraindications:

Urakshata (Chest Injuries)

Krisha (Emaciated body)

Amatisara (Diarrhoea with mucus)

Chhardi (Vomiting)

Kasa (Cough)

Swasa (Asthma)

Madhumeha (Diabetes)

Arsha  (Piles)  

Shoona Payu (Inflammed Anus)

Kritahara (Immediately after taking food)

Udakodara (Ascitis)

Garbhini (Pregnant woman) 

👉🏻SNEHA BASTI (OIL ENEMA):

Administration of medicated oil through anal /genitourinary route is called Sneha basti.The  dosage  through  anal  route  may  vary  from  100 ml  to  250 ml according  to  the  Doshika predominance, disease  condition  /  patient’s  condition  etc. The  usual  time  of  administration  is after noon immediately after lunch.

👉🏻Procedure:

After Abhyanga and  Swedana, the patient is advised to lie down in left lateral position. The bastidravya (Sneha)  is administered in similar manner as Niruha basti. As it is a retention enema, the contents should be allowed to retain inside for a minimum period of three hours and all efforts are to be done for the same. It is not harmful even though it is retained for one day.

👉🏻Indications: 

Neurological & Arthritic conditions - Katishoola (backaches), Gridhrasi (Sciatica) and other Vata vyadhis

Jeerna Jwara (chronic fevers)

👉🏻Contraindications:

Arsha (Piles)

Bhagandara (Fistula)

Raktapitta (bleeding disorders)

Navajwara (Acute fever)

Pushpita (menstrual period)

Pandu (Anemia)

Kamla (Jaundice)

Prameha (Diabetes)

Peenasa (Sinusitis)

Sthoola (Obese)

Krimi Koshtha (Worm infestation)

Galganda (Thyroid disorders)

Shlipada (Filariasis)     

  👉🏻MATRA BASTI:

Matra basti is the method of administration of medicated oil in small dose, which can be given daily and is totally harm less. It is a type of Sneha basti and indications are similar  to  Snehabasti.  It  can  be  indicated irrespective  of  age  and  no  precautionary measures are required. The usual dosage is 60 ml.

👉🏻Indications:

Vyayama (excess physical and mental exertion)

Madyapana (Alcoholism)

Dourbhalya (Debility)

Vataroga (Neurological disorders)

Bala, Vriddha (Children & Elderly persons) etc.

👉🏻Complications during Basti Cikitsa:

The complications of Vasti are dealt in detail in texts (Caraka Samhita Siddhi Sthana)There are:

Doshas (defects) of Netra (nozzle) – 8 types

Doshas of basti  - 8 types

Doshas of bastidata (technician) – 10 types

Snehabasti vyapat – 6 types

These may result into various symptoms related with:

-Local anal injury

-GIT symptoms like pain abdomen, vomiting etc.

-Generalized symptoms like murchha, angamarda etc.       Management is done accordingly.