Piccha basti is a classical therapeutic enema with decoction (niruha basti). It is indicated explicitly in colorectal disorders like dysentery, bleeding, colitis. It is also helpful in the management of specific complications of niruha basti. This formulation has styptic (sangrahi), healing (ropana), and hemostatic (shonitasthapana) properties.
1 Department of Panchakarma, All India Institute of Ayurveda, Goa, India |
2 Rheumatologist, Orlando, Florida, U.S.A.
3 Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
|Publisher||Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India|
|Date of publication:||December 16, 2022|
Etymology and derivation
|1.||In the management of bleeding piles (raktarsha)||Cha. Sa. Chikitsa Sthana 14/ 224|
|2.||In management of diarrhoea (atisara)||Cha. Sa. Chikitsa Sthana 19/ 63|
|3.||In management of dysentery (pravahika)||Cha. Sa. Chikitsa Sthana 19/ 94, |
Su. Sa. Chikitsa Sthana 37/ 41-42
|4.||In the management of obstructed Vata and kapha in the gastrointestinal tract (mahasrotas),
excessive evacuation of kapha (mucus) with colic pain
|Cha. Sa. Chikitsa Sthana 19/ 117|
|5.||In management of parisrava (rectal oozing),
a basti complication
|Cha. Sa. Siddhi Sthana 7/ 60|
|6.||Use of fresh blood in piccha basti||Su. Sa. Chikitsa Sthana 38/ 85-86, |
Sharangdhara Samhita 6/23
Classical formulations of piccha basti
1. Piccha basti formulation 1
Following ingredients are used as homogenous mixture for piccha basti:
- Two prastha (1536 ml) processed milk decoction (kshira Kashaya) made from Yavasa (Alhagi camelorum Fisch.), Kusha (Imperata cylindrical Beauv.), Kasha (Saccharum spontaneum Linn.), flowers of Semul (Bombax ceiba L), and adventitious roots of Nyagrodha (Ficus bengalensis Linn.), Udumbara (Ficus racemosa Linn.), and Ashwattha (Ficus religiosa Linn.) 2 pala i.e. 96 gm each)
- Paste of the resin from Shalmali (mocharasa, Bombax ceiba L), Manjishtha (Rubia cordifolia L.), Chandana (Santalum album L.), Utpala (Nymphaea stellata Willd), seeds of Kutaja (Holorrhena antidysenterica Wall.), Priyangu (Callicarpa macrophylla Vahl.) and Padmakeshar (Nelumbo nucifera Gaertn.)
- Ghee, honey, and sugar. [Cha.Sa. Chikitsa Sthana 14/ 225-229]
2. Piccha basti formulation 2
- One pala (48 gm) paste of green stalks of Shalmali (Bombax ceiba L) prepared by putapaka method mixed with one prastha (768 gm) of boiled milk
- Oil, ghee
- Paste of madhuka (Glycyrrhiza glabra Linn.)
3. Piccha basti formulation 3
Dose of piccha basti
Total 1536 ml (32 pala) [Dalhana]
Total 576 ml (12 pala) [Sharangadhara]*
*However, this particular dose seems specific for the piccha basti having fresh blood as an ingredient. [Su. Sa. Chikitsa Sthana 38/ 85-86]
Practical application of piccha basti
The widely used formulation of piccha basti and its dose is as below:
- Honey -200 ml
- Saindhava- 12 gm
- Goghrita/ Jatyadi Ghrita/ Nalpamaradi Keram (based on condition)- 100 ml
- The paste of the resin from Shalmali (mocharas, Bombax ceiba L) & madhuka (Glycyrrhiza glabra Linn.)- 30 gm
- Shalmali and Mustadi siddha kshira (milk)- 200 ml
Mode of action of piccha basti
Properties of commonly used drugs in piccha basti
Tannins and gallic acids present in mocharasa acts as astringents which precipitate proteins that are helpful in restoring the damaged epithelial mucosal lining of the ulcerated mucosa. A gum resin rich in starch contents, mocharasa forms a mucilaginous layer that protects the inflamed and damaged intestinal mucosa.
Nyagrodha (Ficus bengalensis Linn.), Udumbara (Ficus racemosa Linn.), and Ashwattha (Ficus religiosa Linn.) are used in piccha basti formulation. These are contents of panchavalkala with wound healing properties. It also possesses antimicrobial and anticancer properties. Manjishtha (Rubia cordifolia L.), chandana (Santalum album L.), utpala (Nymphaea stellata Willd), madhuka (Glycyrrhiza glabra Linn.) used in piccha basti are cold in nature and pacify pitta dosha, which is vital for the reduction of inflammation. Badara (Ziziphus mauritiana Lamk), nagabala (Sida Veronicaefolia), shleshmataka (Cordia dichotoma G.Forsk.) are also helpful for pacifying pitta dosha and checking to bleed. Rakta basti (enema with fresh blood) is beneficial formulation that significantly improves hemoglobin level. The use of rakta in basti formulation may be useful to overcome the anemia caused by blood loss through the colonic bleeding. Due to antibacterial and healing properties, pichha basti can be well deployed in fissure in ano. Piccha basti probably removes the accumulated secretions in the fissure bed, promotes healing and reduces secondary infection too.
Honey and ghee together relieve the wound's warmth showing anti-inflammatory actions. Ghrita is a well-known remedy for vitiated pitta. Research has proven the wound-healing potential of honey and its inhibitory effect on most strains of pathogenic bacteria. Also, the increase in resistant bacterial species has stressed using natural antibacterial agents.
Indications of piccha basti
- Ulcerative colitis
- Irritable bowel syndrome
- Crohn’s disease
- Chronic diarrhoea
- Colorectal cancer
- Bleeding piles
- Celiac disease
- Drug induced colitis
- Enteropathic arthritis
- Fissure in ano
Following research works have been done to study effect of piccha basti as treatment modality.
- Sharma P, Kajaria D. Efficacy of Piccha Basti and immune enhancer medicines in the management of ulcerative colitis. Indian Journal of Ayurveda integrative Medicine 2022; 3:41-6
- Daberao, M. Role Of Piccha Basti In The Management Of Celiac Disease W.S.R To Grahani: A Review. IJ-RIM 2020, 4.
- Sankal, Gurdipsingh and Behera (2018): Clinical Study on role of Piccna Basti in management of chronic colitis. Journal of Ayurveda Physicians and Surgeons July 2018 Volume 5(3) : 77
- Dabas R, Gupta S, Kar AC. Picchabasti and Nilotpaladi yoga in the management of Ulcerative colitis. J AyuCaRe 2017;1(2): 10-15
- Lovekrishna Pal Singh Rathore and Lakshman Singh, World Journal of Pharmaceutical Research, 2021, 10(13): 1290-1296
- Bhausaheb A. Patange, Clinical Efficacy Of Piccha Basti Inparikartika (Fissure-In-Ano), Aayushi International Interdisciplinary Research Journal (AIIRJ), 2019, 6(12): 38-43
- Dr. Aparna K., & Dr. Ananta S Desai. (2020). Ayurvedic management of Enteropathic arthritis : A Case Study. Journal of Ayurveda and Integrated Medical Sciences, 5(05), 501-504.
- Pankaj Kumar, Sumit Kumar, Ragini Kumari, & Vijay Bahadur Singh. (2022). Ayurvedic Management of Ulcerative Colitis: A Case Study. International Journal of Ayurveda and Pharma Research, 10(6), 45-48.
- Jha Shailesh Arunkumar, Pallavi A. Hegde, & M. M. Salimath. (2022). Lateral Fissure-In-Ano - A Case Study. Journal of Ayurveda and Integrated Medical Sciences, 6(6), 291 - 295.
- Varsakiya JN, Goyal M, Kathad D, Kumari R. Efficacy of Ayurveda modalities in the management Raktaja pravahika (ulcerative colitis): A case report. J Ayurveda Case Rep 2021;4:115-20
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- ↑ https://www.wisdomlib.org/definition/picchila cited on 27.09.22
- ↑ Dalhana on Sushrut Samhita Chikitsasthana 38/ 85-86, https://niimh.nic.in/ebooks/esushruta/?mod=read, cited on 1.10.2022
- ↑ L. Mahadevan, Ayurvedic clinical practice, Dr. Y Mahadeva iyyar’s Sri Sarada Ayurvedic hospital, 1st edition, 2010; 1: 55
- ↑ Sharma P, Kajaria D. Efficacy of Piccha Basti and immune enhancer medicines in the management of ulcerative colitis. Indian Journal of Ayurveda integrative Medicine 2022; 3:41-6
- ↑ Spiller R. Role of motility in chronic diarrhoea. Neurogastroenterol Motil. 2006 Dec;18(12):1045-55
- ↑ https://www.easyayurveda.com/2012/10/03/shalmali-silk-cotton-tree-ayurveda-use-formulations-home-remedies/ cited on 1.10.2022
- ↑ Sarita Karole*, Dr. Greindra Gautam, Dr. Shailsh Gupta, Pharmacognostic And Pharmacological Profile Of Bombax Ceiba, Asian Journal of Pharmaceutical Education and Research, 2017, 6(3): 16-27
- ↑ Jagtap AG, Niphadkar PV, Phadke AS. Protective effect of aqueous extract of Bombax malabaricum DC on experimental models of inflammatory bowel disease in rats and mice. Indian J Exp Biol 2011;49:343-51
- ↑ Dhurve, V., & Dudhamal, T. (2020, September 29). Wound healing potential of three forms of Panchavalkala in post-operative fistula wounds- Case Series. International Journal of AYUSH Case Reports, 4(3), 189-197.
- ↑ Aphale S, Pandita S, Raina P, Mishra J N, Kaul-Ghanekar R. Phytochemical standardization of panchavalkala: An ayurvedic formulation and evaluation of its anticancer activity in cervical cancer cell lines. Phcog Mag 2018;14:554-60
- ↑ https://www.iafaforallergy.com/herbs-a-to-z/badara-ziziphus-jujuba/ cited on 25.09.2022
- ↑ https://www.easyayurveda.com/2012/10/03/nagabala-full-ayurvedic-details-usage-health-benefits-formulation/#properties cited on 25.09.2022
- ↑ https://www.easyayurveda.com/2016/12/21/lasoda-cordia-dichotoma-shleshmataka/ cited on 25.09.2022
- ↑ Abhijit Dinkarrao Shekhar, Role of Raktabasti In Pandu (Mycrocytic Hypocromic Anemia), World Journal Of Pharmaceutical And Medical Research, 2017,3(5), 146-151
- ↑ Charde MS, Fulzele SV, Satturwar PM, et al. Wound healing and anti-inflammatory potential of madhu-ghrita. Indian J Pharm Sci. 2006;68:26–31.
- ↑ Subrahmanyam M. Topical application of honey for burn wound treatment – an overview. Ann Burns Fire Disasters. 2007;20:137–140.
- ↑ Cooper RA, Molan PC, Harding KG (1999) Antibacterial activity of honey against strains of Staphylococcus aureus from infected wounds. J Roy Soc Med 283–285