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Line 1: − '''<big>[[Siddhi Sthana]] Chapter 4. Management of complications of unctuous enema therapy</big>'''+ + + + + + + + + + Line 11:
Line 20: − + − + − + + + + + + + + + + − === Abstract ===+ − + − + − + − + + − === Introduction === − + + + − ===Sanskrit text, Transliteration and English Translation===+ + + + + − athātaḥ snēhavyāpatsiddhiṁ vyākhyāsyāmaḥ||1| − | Line 41:
Line 63: + − + − ==== Various formulations ====+ + + Line 58:
Line 83: + − + − ==== Unctuous enema for ''vata'' disorders ====+ + Line 76:
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Line 190: + − + − ==== Unctuous enema for ''pitta'' disorders ====+ + Line 176:
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Line 286: − + − ==== Unctuous enema for ''kapha'' disorders ====+ + Line 273:
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Line 531: − + − ==== Effects of ''sneha basti'' ====+ + Line 498:
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Line 560: + − + − ==== Six complications of ''sneha basti'' (unctuous enema) ====+ + + Line 530:
Line 579: + − + − + − + − ==== Factors responsible for complication of ''sneha basti'' ====+ + Line 548:
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Line 616: + − + − + − + − + − + − + − ==== Symptoms of impediment by ''vata'' and its management ====+ + Line 588:
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Line 667: + − + − ===== Treatment of ''vata'' impediment =====+ − + − ==== Symptoms of impediment by ''pitta'' and its management ====+ + + Line 632:
Line 690: + − + − ==== Symptoms of impediment by ''kapha'' and its management ====+ + Line 644:
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Line 721: + − + − ==== Symptoms and treatment of impediment due to excess intake of food ====+ + Line 672:
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Line 752: + − + − ==== Symptoms and treatment of impediment by stool ====+ + Line 700:
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Line 783: + − + − ==== Ailments caused by administration of ''basti'' on empty stomach and their treatments ====+ + Line 732:
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Line 845: + − ==== Diet after ''anuvasana basti'' ====+ + Line 792:
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Line 900: + − + − ==== Frequency of ''anuvasana basti'' ====+ + Line 838:
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Line 933: + − + − ==== Instructions before ''basti'' administration ====+ + Line 866:
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Line 964: + − + − + − + − ==== Importance of alternate administration of ''sneha'' and ''niruha basti'' ====+ + Line 897:
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Line 998: + − + − ==== ''Matra basti'' ====+ + Line 929:
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Line 1,041: + − + − ==== Summary ====+ + Line 967:
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Line 1,078: + − + − + − + − + − + − + − + − ==== Effect of ''Snehabasti'' ====+ − + − ==== Impediment by ''vata'' ====+ − + − ==== Impediment by ''pitta'' ====+ − + − ==== Impediment by ''kapha'' ====+ − + − ==== Impediment by food in excess quantity ====+ − + − ==== Impediment by stools ====+ − + Line 1,030:
Line 1,122: − ==== Ailments caused by administration of ''basti'' on empty stomach ====+ + + − When ''anuvasana'' is given on empty stomach or on emptied bowel or if the enema fluid is injected with great force then it goes up speedily and comes out from the throat or through the orifices in the upper part of the body which seems practically difficult phenomena but some evidences suggest that possibility cannot be ruled out. Materials introduced by enema, may in some instances pass through the valve into the ileum. Such incompetence may permit the enema fluid to reach the duodenum. Further, the possibility of material from even lower bowel reaching the mouth is strongly suggested by the fact that lycopodium spores, introduced into the colon by enema, have been recovered some hours later from washings of the stomach, alimentary canal movements<ref>Best C H, Taylor N B. ‘The Physiological Basis of Medical Practice-‘Alimentary Canal Movemnets’.Seventh edition. Baltimore (U.S.A.): The Williams & Wilkins Company; 1961. pp. 715–691</ref>. Thus when alimentary tract is empty and clear the ''sneha'' due to its easy penetration capacity may reach up to mouth. The treatment suggested i.e. pressure application over throat results in sudden sympathetic activation leading to adrenaline production. As a result of this, the smooth muscles of the digestive tract are inhibited, so peristalsis stops, sphincter of the bladder also contracts and the bladder wall relaxes. This may lead to involuntary bowel movement<ref>Jurriaan Plesman, Anxiety and the Autonomic Nervous System, available from http://www.hypoglycemia.asn.au/2011/anxiety-and-the-autonomic-nervous-system/ cited on 23-04-2014</ref>. [verse 38-40]+ − ==== Importance of warm water in ''snehabasti'' course ====+ − + − ==== Frequency of ''anuvasana basti'' ====+ − + − ==== Advice regarding ''basti'' administration ====+ − + − ==== ''Matra basti'' ====+ − + Line 1,057:
Line 1,151: − ==== Practically employed methods regarding schedule of ''snehabasti'' ====+ Line 1,063:
Line 1,157: − + − + − + − === Glossary ===+ − #Snēhabastī ( स्नेहबस्ति): Oiliness, unctousness, lubricity, moisture, oil medicated unctous enema having quantity four times less to that of decoction enema.+ − #Mātrābasti ( मात्राबस्ति): A form of unctous enema, The medicated enema given in such a dose which will show no complications even if the post-therapy regimen are not followed. − #anuvāsana (अनुवासनं): A form of medicated unctous enema which can be given every day and which doesn’t harm the body even if retained inside. The dose of the anuvasana basti is half to that of sneha basti. − #Nirūhaḥ (निरूह): The medicated enema having more quantity of the decoction prepared out of various drugs and possessing very potent action by which it expels the dosha out of the body (niruha) and there by gives relief from the dieases, prolons life and stabilizes the body tissues (asthaapana ). − #Pañchakarma (पञ्चकर्म): Internal Bio-cleansing therapy / detoxification therapy. Literally means fivefold therapeutic action, is a collective expression for the cleansing of one’s physical constitution. The five fold therapies comprises of emesis, catharsis, decoction enema, unctuous enema and errhine therapy. − #Oja (ओज): immunity or the general strength of body or the bodily essence − #Āma (आम): 1. Raw, uncooked, unbaked, immature, unripe 2. May be associated with food or other physiological entities to mean incomplete transformation or metabolism causing a harmful effect on health − #Udāvarta (उदावर्त): Abnormal condition characterized by retention of faeces, urine and flatus, associated with pain and leading to or caused by anti peristaltic movements in the body − #Stambha (स्तम्भ): One of the six folds of the therapeutic measure or action of drug action causing contraction of tissues, arrest of secretion, or control of bleeding. − #Abhiṣyanda (अभिष्यन्द): stuffiness or obstruction in srotas produced by food having slimy & heavy nature; e.g. Curd − #Utklēśa (उत्क्लेश): An abnormal condition either made therapeutically or manifested on its own wherein there is quantitatively increase in the dosha as a result they move upwards in the body and this movement of the dosha is experienced by patient as a discomfort in and around cardiac region. − === References ===+
→Scope for further research
{{#seo:
|title=Snehavyapat Siddhi
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|keywords=Impediments of sneha basti (unctuous enema), oleation therapy, abhuktapraneeta (empty stomach administration), annavrita (occluded due to food), kaphavrita ( occluded due to kapha), pittavrita (occluded due to pitta), pureeshavrita (occluded due to feces), snehabastivyapad, vatavrita (occluded due to vata), Ayurveda, charak samhita, Indian system of medicine.
|description=Siddhi Sthana Chapter 4. Complications of unctuous enema and their successful management
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'''<big>[[Siddhi Sthana]] Chapter 4. Complications of unctuous enema and their successful management </big>'''
{{Infobox
{{Infobox
|title = Snehavyapat Siddhi
|title = Snehavyapat Siddhi
|label5 = Other Sections
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]
|label6 = Translator and commentator
|header3 =
|data6 = Thakar A. B.,Auti S.
|label7 = Reviewer
|data7 = Mangalasseri P., Auti S.
|label8 = Editors
|data8 = Thakar A. B., Mangalasseri P., Deole Y.S., Basisht G.
|label9 = Year of publication
|data9 = 2020
|label10 = Publisher
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]
|label11 = DOI
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s08.005 10.47468/CSNE.2020.e01.s08.005]
}}
}}
<big>''' Abstract </big>'''
<div style="text-align:justify;">
The fourth chapter of [[Siddhi Sthana]], [[Snehavyapat Siddhi]], deals with various formulations of ''sneha basti'' (unctuous enema) and management of complications caused due to its improper administration. ''Sneha basti'' formulations, their clinical applications, reasons for ''sneha basti'' occlusion, symptoms of impediment, ailments caused by administration of ''basti'' on empty stomach, their treatments and ''matra basti'', etc. have been explained in detail in this chapter. Vitiated ''doshas'' , excess food, and stools are responsible for obstructions and empty stomach administration leads to improper movement of ''sneha basti''. Liquid, hot, light, wholesome food and warm water use have been suggested for avoidance of these complications.
The fourth chapter of [[Siddhi Sthana]], [[Snehavyapat Siddhi]], deals with various formulations of ''sneha basti'' (unctuous enema) and management of complications caused due to its improper administration. ''Sneha basti'' formulations, their clinical applications, reasons for ''sneha basti'' occlusion, symptoms of impediment, ailments caused by administration of ''[[basti]]'' on empty stomach, their treatments and ''matra basti'', etc. have been explained in detail in this chapter. Vitiated ''[[dosha]]s'' , excess food, and stools are responsible for obstructions and empty stomach administration leads to improper movement of ''sneha basti''. Liquid, hot, light, wholesome food and warm water use have been suggested for avoidance of these complications.
Continuous excess use of both ''anuvasana'' and ''niruha'' is to be avoided as they cause ''utklesha- agnimandya'' (aggravation of ''kapha-pitta dosha'', decrease in digestion and metabolic process) and ''vata prakopa'' (vitiation of ''vata'') respectively. ''Matra basti'', that is similar to lowest dose of oleation, can be used in any season with no dietary restrictions.
Continuous excess use of both ''anuvasana'' and ''niruha'' is to be avoided as they cause ''utklesha- agnimandya'' (aggravation of ''[[kapha]]-[[pitta]] [[dosha]]'', decrease in digestion and metabolic process) and ''[[vata]] prakopa'' (vitiation of ''[[vata]]'') respectively. ''Matra basti'', that is similar to lowest dose of oleation, can be used in any season with no dietary restrictions.
'''Keywords''': Impediments of ''sneha basti'' (unctuous enema), oleation therapy, ''abhuktapraneeta'' (empty stomach administration), ''annavrita'' (occluded due to food), ''kaphavrita'' ( occluded due to ''kapha''), ''pittavrita'' (occluded due to ''pitta''), ''pureeshavrita'' (occluded due to feces), ''snehabastivyapad, vatavrita'' (occluded due to ''vata'').
'''Keywords''': Impediments of ''sneha basti'' (unctuous enema), oleation therapy, ''abhuktapraneeta'' (empty stomach administration), ''annavrita'' (occluded due to food), ''kaphavrita'' ( occluded due to ''[[kapha]]''), ''pittavrita'' (occluded due to ''[[pitta]]''), ''pureeshavrita'' (occluded due to feces), ''snehabastivyapad, vatavrita'' (occluded due to ''[[vata]]''), anuvasana basti, matra basti,
</div>
The schedule, importance and symptoms of proper and improper ''basti'' administration, indications- contraindications, elaborated ''basti'' procedure and ''niruha basti'' formulations are explained in earlier three chapters. Thus, in this sequence the present chapter is described to put forward some ''sneha basti'' (unctuous enema) formulations. In order to fulfill the purpose of [[Siddhi Sthana]] to give excellence in therapeutics, the complications arising due to some improper methods need to be tackled. Vitiated ''dosha,'' fecal matter, indigestion are some factors that occlude the ''basti'' and empty stomach administration leads to improper movement of fats. Moreover, due to busy work schedule, improper dietary habits and debilitating disorders most of the patients are unsuitable for ''anuvasana'' or ''sneha basti''. In such individuals if ''vata'' vitiation is evident and needs ''basti'' therapy, then use of ''sneha basti'' (unctuous enema) in lowest dose i.e. ''matra basti'' can be employed without any complications.
== Introduction ==
<div style="text-align:justify;">
The schedule, importance and symptoms of proper and improper ''[[basti]]'' administration, indications- contraindications, elaborated ''[[basti]]'' procedure and ''niruha basti'' formulations are explained in earlier three chapters. Thus, in this sequence the present chapter is described to put forward some ''sneha basti'' (unctuous enema) formulations. In order to fulfill the purpose of [[Siddhi Sthana]] to give excellence in therapeutics, the complications arising due to some improper methods need to be tackled. Vitiated ''[[dosha]],'' fecal matter, indigestion are some factors that occlude the ''[[basti]]'' and empty stomach administration leads to improper movement of fats. Moreover, due to busy work schedule, improper dietary habits and debilitating disorders most of the patients are unsuitable for ''anuvasana'' or ''sneha basti''. In such individuals if ''[[vata]]'' vitiation is evident and needs ''[[basti]]'' therapy, then use of ''sneha basti'' (unctuous enema) in lowest dose i.e. ''matra basti'' can be employed without any complications.
== Sanskrit text, Transliteration and English Translation ==
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अथातः स्नेहव्यापत्सिद्धिं व्याख्यास्यामः||१||
अथातः स्नेहव्यापत्सिद्धिं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
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athātaḥ snēhavyāpatsiddhiṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||
iti ha smāha bhagavānātrēyaḥ||2||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
</div></div>
Now onwards we will describe chapter [[Snehavyapat Siddhi]] (chapter on complications of Unctuous enema and their successful management).
Now we shall expound the chapter "Snehavyapat Siddhi" (Complications of Unctuous enema and their successful management).
Thus said Lord Atreya. [1-2]
Thus said Lord Atreya. [1-2]
=== Various formulations ===
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स्नेहबस्तीन्निबोधेमान् वातपित्तकफापहान्|
स्नेहबस्तीन्निबोधेमान् वातपित्तकफापहान्|
मिथ्याप्रणिहितानां च व्यापदः सचिकित्सिताः||३||
मिथ्याप्रणिहितानां च व्यापदः सचिकित्सिताः||३||
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snēhabastīnnibōdhēmān vātapittakaphāpahān|
snēhabastīnnibōdhēmān vātapittakaphāpahān|
mithyApraNihitAnAM ca vyApadaH sacikitsitAH||3||
mithyApraNihitAnAM ca vyApadaH sacikitsitAH||3||
</div></div>
Unctuous enema formulations for attenuation of ''vata, pitta'' and ''kapha'', possible complications arising from improper administration and their treatments will be discussed. [3]
Unctuous enema formulations for attenuation of ''[[vata]], [[pitta]]'' and ''[[kapha]]'', possible complications arising from improper administration and their treatments will be discussed. [3]
=== Unctuous enema for ''[[vata]]'' disorders ===
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दशमूलं बलां रास्नामश्वगन्धां पुनर्नवाम्|
दशमूलं बलां रास्नामश्वगन्धां पुनर्नवाम्|
अनुवासनमेतद्धि सर्ववातविकारनुत्|
अनुवासनमेतद्धि सर्ववातविकारनुत्|
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daśamūlaṁ balāṁ rāsnāmaśvagandhāṁ punarnavām|
daśamūlaṁ balāṁ rāsnāmaśvagandhāṁ punarnavām|
anuvAsanametaddhi sarvavAtavikAranut|
anuvAsanametaddhi sarvavAtavikAranut|
</div></div>
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The decoction of above mentioned drugs should be prepared using four ''drona'' (approx. 49 liters) of water, boiling till 1 ''drona'' ( approx. 12.2 liters) of liquid remains. To this decoction paste of above mentioned herbs, 1 ''adhaka'' (approx. 3.07 liters) sesame oil and milk should be added. The oil prepared with this method can be used successfully in all ''vata'' disorders in ''anuvasana'' form. [4-7]
The decoction of above mentioned drugs should be prepared using four ''drona'' (approx. 49 liters) of water, boiling till 1 ''drona'' ( approx. 12.2 liters) of liquid remains. To this decoction paste of above mentioned herbs, 1 ''adhaka'' (approx. 3.07 liters) sesame oil and milk should be added. The oil prepared with this method can be used successfully in all ''[[vata]]'' disorders in ''anuvasana'' form. [4-7]
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आनूपानां वसा तद्वज्जीवनीयोपसाधिता||७||
आनूपानां वसा तद्वज्जीवनीयोपसाधिता||७||
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ānūpānāṁ vasā tadvajjīvanīyōpasādhitā||7||
ānūpānāṁ vasā tadvajjīvanīyōpasādhitā||7||
AnUpAnAM vasA tadvajjIvanIyopasAdhitA||7||
AnUpAnAM vasA tadvajjIvanIyopasAdhitA||7||
</div></div>
''Anuvasana basti'' prepared from ''vasa'' i.e. muscle fat of animals inhabiting marshy land, boiled with drugs of ''jivaniya gana'' i.e. ''jivaka, rishabhaka, meda, mahameda, kakoli, kshirakakoli, mudgaparni, mashaparni, jivanti, madhuka'' cures ''vata'' disorders. [7]
''Anuvasana basti'' prepared from ''vasa'' i.e. muscle fat of animals inhabiting marshy land, boiled with drugs of ''jivaniya gana'' i.e. ''jivaka, rishabhaka, meda, mahameda, kakoli, kshirakakoli, mudgaparni, mashaparni, jivanti, madhuka'' cures ''[[vata]]'' disorders. [7]
<div class="mw-collapsible mw-collapsed">
शताह्वायवबिल्वाम्लैः सिद्धं तैलं समीरणे|
शताह्वायवबिल्वाम्लैः सिद्धं तैलं समीरणे|
सैन्धवेनाग्नितप्तेन तप्तं चानिलनुद्धृतम्||८||
सैन्धवेनाग्नितप्तेन तप्तं चानिलनुद्धृतम्||८||
<div class="mw-collapsible-content">
śatāhvāyavabilvāmlaiḥ siddhaṁ tailaṁ samīraṇē|
śatāhvāyavabilvāmlaiḥ siddhaṁ tailaṁ samīraṇē|
saindhavenAgnitaptena taptaM cAnilanuddhRutam||8||
saindhavenAgnitaptena taptaM cAnilanuddhRutam||8||
</div></div>
Oil cooked with ''shatahva, yava, bilva'' and sour liquids is also useful for ''anuvasana'' in ''vata'' disorders. ''Anuvasana'' of warm ghee prepared by immersing hot rock salt relieves diseases caused by ''vata''. [8]
Oil cooked with ''shatahva, yava, bilva'' and sour liquids is also useful for ''anuvasana'' in ''[[vata]]'' disorders. ''Anuvasana'' of warm ghee prepared by immersing hot rock salt relieves diseases caused by ''[[vata]]''. [8]
=== Unctuous enema for ''[[pitta]]'' disorders ===
<div class="mw-collapsible mw-collapsed">
जीवन्तीं मदनं मेदां श्रावणीं मधुकं बलाम्|
जीवन्तीं मदनं मेदां श्रावणीं मधुकं बलाम्|
तैलपादं घृतं सिद्धं पित्तघ्नमनुवासनम्||१२||
तैलपादं घृतं सिद्धं पित्तघ्नमनुवासनम्||१२||
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jīvantīṁ madanaṁ mēdāṁ śrāvaṇīṁ madhukaṁ balām|
jīvantīṁ madanaṁ mēdāṁ śrāvaṇīṁ madhukaṁ balām|
tailapAdaM ghRutaM siddhaM pittaghnamanuvAsanam||12||
tailapAdaM ghRutaM siddhaM pittaghnamanuvAsanam||12||
</div></div>
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Cow ghee and oil should be taken one part and cooked with milk four times along with above mentioned pastes of herbs (all together one fourth of ''sneha''). This formulation of ''anuvasana basti'' is nourishing, alleviates ''vata'' and ''pitta'', increases strength, semen and ''agni'' (digestive power). Also it cures diseases of urinary, seminal and menstrual origin.
Cow ghee and oil should be taken one part and cooked with milk four times along with above mentioned pastes of herbs (all together one fourth of ''sneha''). This formulation of ''anuvasana basti'' is nourishing, alleviates ''[[vata]]'' and ''[[pitta]]'', increases strength, semen and ''agni'' (digestive power). Also it cures diseases of urinary, seminal and menstrual origin.
Cow ghee should be taken one part, sesame oil one fourth of ghee and contents of ''chandanadi taila'' mentioned in [[Jwara Chikitsa]] ([[Chikitsa Sthana]], chapter 3) should be taken in one fourth quantity of total ''sneha'' and cooked with milk four times of ''sneha''. [9-12]
Cow ghee should be taken one part, sesame oil one fourth of ghee and contents of ''chandanadi taila'' mentioned in [[Jwara Chikitsa]] ([[Chikitsa Sthana]], chapter 3) should be taken in one fourth quantity of total ''sneha'' and cooked with milk four times of ''sneha''. [9-12]
=== Unctuous enema for ''kapha'' disorders ===
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सैन्धवं मदनं कुष्ठं शताह्वां निचुलं वचाम् |
सैन्धवं मदनं कुष्ठं शताह्वां निचुलं वचाम् |
तैलं कफहरैर्वाऽपि कफघ्नं कल्पयेद्भिषक्||१७||
तैलं कफहरैर्वाऽपि कफघ्नं कल्पयेद्भिषक्||१७||
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saindhavaṁ madanaṁ kuṣṭhaṁ śatāhvāṁ niculaṁ vacām |
saindhavaṁ madanaṁ kuṣṭhaṁ śatāhvāṁ niculaṁ vacām |
tailaM kaphaharairvA~api kaphaghnaM kalpayedbhiShak||17||
tailaM kaphaharairvA~api kaphaghnaM kalpayedbhiShak||17||
</div></div>
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''Anuvasana basti'' prepared with above mentioned ingredients cures ''kaphaja'' disorders, ''bradhna'' (inguinal enlargements), ''udavarta''(reverse movement of ''vata''), ''gulma''(abdominal lumps), ''arsha'' (haemorrhoids), ''pliha'' (spenic disorders), ''meha'' (urinary disorders), ''adhyavata'' (disease due to ''vata'' occluded by excess ''meda''), ''anaha''(distension of abdomen), ''ashmari'' (calculus).[13-17]
''Anuvasana basti'' prepared with above mentioned ingredients cures ''kaphaja'' disorders, ''bradhna'' (inguinal enlargements), ''udavarta''(reverse movement of ''[[vata]]''), ''gulma''(abdominal lumps), ''arsha'' (haemorrhoids), ''pliha'' (spenic disorders), ''meha'' (urinary disorders), ''adhyavata'' (disease due to ''[[vata]]'' occluded by excess ''[[meda]]''), ''anaha''(distension of abdomen), ''ashmari'' (calculus).[13-17]
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विडङ्गैरण्डरजनीपटोलत्रिफलामृताः|
विडङ्गैरण्डरजनीपटोलत्रिफलामृताः|
प्रयुक्तं प्रणुदत्याशु पानाभ्यङ्गानुवासनैः||२२||
प्रयुक्तं प्रणुदत्याशु पानाभ्यङ्गानुवासनैः||२२||
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viḍaṅgairaṇḍarajanīpaṭōlatriphalāmr̥tāḥ|
viḍaṅgairaṇḍarajanīpaṭōlatriphalāmr̥tāḥ|
prayuktaM praNudatyAshu pAnAbhya~ggAnuvAsanaiH||22||
prayuktaM praNudatyAshu pAnAbhya~ggAnuvAsanaiH||22||
</div></div>
{| class="wikitable"
{| class="wikitable"
|}
|}
Using this oil in ''snehapana,'' massage and ''basti'' cures ''kushtha'' (skin diseases), ''krimi'' (parasite infestations), ''meha'' (urinary disorders), ''arsha'' (haemorrhoids), ''grahani'' (gastrointestinal diseases), ''klibata'' (impotency), irregular appetite, ''mala'' (morbid matters) and diseases caused by all the three ''dosha''.[18-22]
Using this oil in ''snehapana,'' massage and ''[[basti]]'' cures ''kushtha'' (skin diseases), ''krimi'' (parasite infestations), ''meha'' (urinary disorders), ''arsha'' (haemorrhoids), ''grahani'' (gastrointestinal diseases), ''klibata'' (impotency), irregular appetite, ''mala'' (morbid matters) and diseases caused by all the three ''[[dosha]]''.[18-22]
=== Effects of ''sneha basti'' ===
<div class="mw-collapsible mw-collapsed">
व्याधिव्यायामकर्माध्वक्षीणाबलनिरोजसाम्|
व्याधिव्यायामकर्माध्वक्षीणाबलनिरोजसाम्|
जनयेदप्रजानां च प्रजां स्त्रीणां तथा नृणाम्||२४||
जनयेदप्रजानां च प्रजां स्त्रीणां तथा नृणाम्||२४||
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vyādhivyāyāmakarmādhvakṣīṇābalanirōjasām|
vyādhivyāyāmakarmādhvakṣīṇābalanirōjasām|
janayedaprajAnAM ca prajAM strINAM tathA nRuNAm||24||
janayedaprajAnAM ca prajAM strINAM tathA nRuNAm||24||
</div></div>
''Sneha basti'' gives strength to those who are emaciated due to disease, excessive exercise, labor, excess walking, loss of ''oja'' (vital essence) and semen. It gives great strength to feet, calves, thighs, back, shoulders and lumbar region. It is useful to procreate off springs for sterile men and women. [23-24]
''Sneha basti'' gives strength to those who are emaciated due to disease, excessive exercise, labor, excess walking, loss of ''[[ojas]]'' (vital essence) and semen. It gives great strength to feet, calves, thighs, back, shoulders and lumbar region. It is useful to procreate off springs for sterile men and women. [23-24]
=== Six complications of ''sneha basti'' (unctuous enema) ===
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वातपित्तकफात्यन्नपुरीषैरावृतस्य च|
वातपित्तकफात्यन्नपुरीषैरावृतस्य च|
अभुक्ते च प्रणीतस्य स्नेहबस्तेः षडापदः||२५||
अभुक्ते च प्रणीतस्य स्नेहबस्तेः षडापदः||२५||
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vātapittakaphātyannapurīṣairāvr̥tasya ca|
vātapittakaphātyannapurīṣairāvr̥tasya ca|
abhukte ca praNItasya snehabasteH ShaDApadaH||25||
abhukte ca praNItasya snehabasteH ShaDApadaH||25||
</div></div>
''Sneha Basti'' causes following six complications:
''Sneha Basti'' causes following six complications:
*Occlusion of enema fluid by ''vata''
*Occlusion of enema fluid by ''[[vata]]''
*Occlusion of enema fluid by ''pitta''
*Occlusion of enema fluid by ''[[pitta]]''
*Occlusion of enema fluid by ''kaph''a
*Occlusion of enema fluid by ''[[kapha]]''
*Occlusion of enema fluid by food
*Occlusion of enema fluid by food
*Occlusion of enema fluid by feces
*Occlusion of enema fluid by feces
*Administration of enema in empty stomach. [25]
*Administration of enema in empty stomach. [25]
=== Factors responsible for complication of ''sneha basti'' ===
<div class="mw-collapsible mw-collapsed">
शीतोऽल्पो वाऽधिके वाते पित्तेऽत्युष्णः कफे मृदुः|
शीतोऽल्पो वाऽधिके वाते पित्तेऽत्युष्णः कफे मृदुः|
अभुक्तेऽनावृतत्वाच्च यात्यूर्ध्वं तस्य लक्षणम्||२७||
अभुक्तेऽनावृतत्वाच्च यात्यूर्ध्वं तस्य लक्षणम्||२७||
<div class="mw-collapsible-content">
śītō'lpō vā'dhikē vātē pittē'tyuṣṇaḥ kaphē mr̥duḥ|
śītō'lpō vā'dhikē vātē pittē'tyuṣṇaḥ kaphē mr̥duḥ|
abhukte~anAvRutatvAcca yAtyUrdhvaM tasya lakShaNam||27||
abhukte~anAvRutatvAcca yAtyUrdhvaM tasya lakShaNam||27||
</div></div>
*If ''basti'' preparation is too cold or less than therapeutic dose and given in ''vata'' dominant patient,
*If ''[[basti]]'' preparation is too cold or less than therapeutic dose and given in ''[[vata]]'' dominant patient,
*If hot ''basti'' is given in ''pitta'' dominant patient,
*If hot ''[[basti]]'' is given in ''[[pitta]]'' dominant patient,
*If mild ''basti'' is given in ''kapha'' dominant patient,
*If mild ''[[basti]]'' is given in ''[[kapha]]'' dominant patient,
*If ''basti'' prepared with ''guru'' (those digests relatively late) drugs is given in patient who has overeaten.
*If ''[[basti]]'' prepared with ''guru'' (those digests relatively late) drugs is given in patient who has overeaten.
*If ''basti'' of mild nature is given in patient having stool accumulation,
*If ''[[basti]]'' of mild nature is given in patient having stool accumulation,
Then ''basti'' becomes occluded and does not reach its destination as it gets covered with ''dosha''. Similarly, if ''basti'' is given in patient with empty stomach then it goes upwards as all the channels are uncovered.
Then ''[[basti]]'' becomes occluded and does not reach its destination as it gets covered with ''[[dosha]]''. Similarly, if ''[[basti]]'' is given in patient with empty stomach then it goes upwards as all the channels are uncovered.
Hereafter, the signs of different complications will be discussed. [26-28]
Hereafter, the signs of different complications will be discussed. [26-28]
=== Symptoms of impediment by ''[[vata]]'' and its management ===
<div class="mw-collapsible mw-collapsed">
अङ्गमर्दज्वराध्मानशीतस्तम्भोरुपीडनैः |
अङ्गमर्दज्वराध्मानशीतस्तम्भोरुपीडनैः |
ताभ्यामेव च तैलाभ्यां सायं भुक्तेऽनुवासयेत्||३०||
ताभ्यामेव च तैलाभ्यां सायं भुक्तेऽनुवासयेत्||३०||
<div class="mw-collapsible-content">
aṅgamardajvarādhmānaśītastambhōrupīḍanaiḥ |
aṅgamardajvarādhmānaśītastambhōrupīḍanaiḥ |
tAbhyAmeva ca tailAbhyAM sAyaM bhukte~anuvAsayet||30||
tAbhyAmeva ca tailAbhyAM sAyaM bhukte~anuvAsayet||30||
</div></div>
Malaise, fever, ''adhmana'' (flatulence), ''sheeta'' (feeling of cold), ''stambha'' (stiffness), ''uru-pidana'' (pain in the thighs) and ''parshva-veshtana'' (cramps in the sides of chest) are symptoms from which a physician should come to know that ''basti'' is occluded due to ''vata''.
Malaise, fever, ''adhmana'' (flatulence), ''sheeta'' (feeling of cold), ''stambha'' (stiffness), ''uru-pidana'' (pain in the thighs) and ''parshva-veshtana'' (cramps in the sides of chest) are symptoms from which a physician should come to know that ''[[basti]]'' is occluded due to ''[[vata]]''.
==== Treatment of ''[[vata]]'' impediment ====
When ''anuvasana'' is occluded due to ''vata'' patient should be given ''niruha'' prepared with ''kalka'' (paste) of unctuous, sour, saline and hot ingredients; cow urine, decoction of ''brihatpanchamula, sauviraka'' (vinegar), ''sura'' (alcohol), ''kola, kulattha, yava'' along with ''rasna taila'' and ''pitadru taila''. In evening ''anuvasana'' of same oils (i.e. ''rasna'' and ''pitadru'' oil) should be given. [28-30]
When ''anuvasana'' is occluded due to ''[[vata]]'' patient should be given ''niruha'' prepared with ''kalka'' (paste) of unctuous, sour, saline and hot ingredients; cow urine, decoction of ''brihatpanchamula, sauviraka'' (vinegar), ''sura'' (alcohol), ''kola, kulattha, yava'' along with ''rasna taila'' and ''pitadru taila''. In evening ''anuvasana'' of same oils (i.e. ''rasna'' and ''pitadru'' oil) should be given. [28-30]
=== Symptoms of impediment by ''[[pitta]]'' and its management ===
<div class="mw-collapsible mw-collapsed">
दाहरागतृषामोहतमकज्वरदूषणैः|
दाहरागतृषामोहतमकज्वरदूषणैः|
विद्यात् पित्तावृतं स्वादुतिक्तैस्तं बस्तिभिर्हरेत्||३१||
विद्यात् पित्तावृतं स्वादुतिक्तैस्तं बस्तिभिर्हरेत्||३१||
<div class="mw-collapsible-content">
dāharāgatr̥ṣāmōhatamakajvaradūṣaṇaiḥ|
dāharāgatr̥ṣāmōhatamakajvaradūṣaṇaiḥ|
vidyAt pittAvRutaM svAdutiktaistaM bastibhirharet||31||
vidyAt pittAvRutaM svAdutiktaistaM bastibhirharet||31||
</div></div>
Burning sensation, redness, excess thirst, unconsciousness, ''tamaka'' (entering into darkness) and fever are symptoms from which a physician should come to know that ''basti'' is occluded due to ''pitta''. This occlusion can be removed by administration of enema containing sweet and bitter ingredients. [31]
Burning sensation, redness, excess thirst, unconsciousness, ''tamaka'' (entering into darkness) and fever are symptoms from which a physician should come to know that ''[[basti]]'' is occluded due to ''[[pitta]]''. This occlusion can be removed by administration of enema containing sweet and bitter ingredients. [31]
=== Symptoms of impediment by ''[[kapha]]'' and its management ===
<div class="mw-collapsible mw-collapsed">
तन्द्राशीतज्वरालस्यप्रसेकारुचिगौरवैः|
तन्द्राशीतज्वरालस्यप्रसेकारुचिगौरवैः|
फलतैलयुतैः साम्लैर्बस्तिभिस्तं विनिर्हरेत्||३३||
फलतैलयुतैः साम्लैर्बस्तिभिस्तं विनिर्हरेत्||३३||
<div class="mw-collapsible-content">
tandrāśītajvarālasyaprasēkārucigauravaiḥ|
tandrāśītajvarālasyaprasēkārucigauravaiḥ|
phalatailayutaiH sAmlairbastibhistaM vinirharet||33||
phalatailayutaiH sAmlairbastibhistaM vinirharet||33||
</div></div>
Drowsiness, cold, fever, lethargy, salivation, anorexia, heaviness, fainting and depression are symptoms from which a physician should come to know that ''basti'' is occluded due to ''kapha''. This occlusion can be removed by administration of enema prepared from alcohol and cows urine by adding ''madanaphala taila'' along with astringent, pungent, ''tikshna'', hot and sour ingredients. [32-33]
Drowsiness, cold, fever, lethargy, salivation, anorexia, heaviness, fainting and depression are symptoms from which a physician should come to know that ''[[basti]]'' is occluded due to ''[[kapha]]''. This occlusion can be removed by administration of enema prepared from alcohol and cows urine by adding ''madanaphala taila'' along with astringent, pungent, ''tikshna'', hot and sour ingredients. [32-33]
=== Symptoms and treatment of impediment due to excess intake of food ===
<div class="mw-collapsible mw-collapsed">
छर्दिमूर्च्छारुचिग्लानिशूलनिद्राङ्गमर्दनैः |
छर्दिमूर्च्छारुचिग्लानिशूलनिद्राङ्गमर्दनैः |
विरेको मृदुरत्रामविहिता च क्रिया हिता||३५||
विरेको मृदुरत्रामविहिता च क्रिया हिता||३५||
<div class="mw-collapsible-content">
chardimūrcchāruciglāniśūlanidrāṅgamardanaiḥ |
chardimūrcchāruciglāniśūlanidrāṅgamardanaiḥ |
vireko mRuduratrAmavihitA ca kriyA hitA||35||
vireko mRuduratrAmavihitA ca kriyA hitA||35||
</div></div>
Vomiting, fainting, anorexia, depression, colic pain, excess sleep, malaise, signs of ''ama'' and burning sensation are symptoms from which a physician should come to know that ''basti'' is occluded due to intake of food in excess. This occlusion can be removed by ''pachana'' (therapy to improve digestion) with pungent and saline decoctions or powders, mild purgation and therapies prescribed for correction of ''ama''. [34-35]
Vomiting, fainting, anorexia, depression, colic pain, excess sleep, malaise, signs of ''ama'' and burning sensation are symptoms from which a physician should come to know that ''[[basti]]'' is occluded due to intake of food in excess. This occlusion can be removed by ''[[pachana]]'' (therapy to improve digestion) with pungent and saline decoctions or powders, mild purgation and therapies prescribed for correction of ''ama''. [34-35]
=== Symptoms and treatment of impediment by stool ===
<div class="mw-collapsible mw-collapsed">
विण्मूत्रानिलसङ्गार्तिगुरुत्वाध्मानहृद्ग्रहैः|
विण्मूत्रानिलसङ्गार्तिगुरुत्वाध्मानहृद्ग्रहैः|
निर्हरेद्विधिना सम्यगुदावर्तहरेण च||३७||
निर्हरेद्विधिना सम्यगुदावर्तहरेण च||३७||
<div class="mw-collapsible-content">
viṇmūtrānilasaṅgārtigurutvādhmānahr̥dgrahaiḥ|
viṇmūtrānilasaṅgārtigurutvādhmānahr̥dgrahaiḥ|
nirharedvidhinA samyagudAvartahareNa ca||37||
nirharedvidhinA samyagudAvartahareNa ca||37||
</div></div>
Obstruction to the passage of stool, urine and flatus, pain, heaviness, flatulence and cardiac spasm are symptoms from which a physician should come to know that basti is occluded due to stool. This occlusion can be removed by oleation, fomentation and ''phala-varti'' (medicated suppository) therapies. ''niruha basti'' prepared with ''shyama, bilva'' etc. followed by ''anuvasana'' should be given appropriately. ''udavarta'' (reverse movement of ''vata'') treatment principles should be followed. [36-37]
Obstruction to the passage of stool, urine and flatus, pain, heaviness, flatulence and cardiac spasm are symptoms from which a physician should come to know that [[basti]] is occluded due to stool. This occlusion can be removed by oleation, fomentation and ''phala-varti'' (medicated suppository) therapies. ''niruha basti'' prepared with ''shyama, bilva'' etc. followed by ''anuvasana'' should be given appropriately. ''udavarta'' (reverse movement of ''[[vata]]'') treatment principles should be followed. [36-37]
=== Ailments caused by administration of ''[[basti]]'' on empty stomach and their treatments ===
<div class="mw-collapsible mw-collapsed">
अभुक्ते शून्यपायौ वा वेगात् स्नेहोऽतिपीडितः|
अभुक्ते शून्यपायौ वा वेगात् स्नेहोऽतिपीडितः|
छर्दिघ्नीभिः क्रियाभिश्च तस्य कार्यं निवर्तनम्||४०||
छर्दिघ्नीभिः क्रियाभिश्च तस्य कार्यं निवर्तनम्||४०||
<div class="mw-collapsible-content">
abhuktē śūnyapāyau vā vēgāt snēhō'tipīḍitaḥ|
abhuktē śūnyapāyau vā vēgāt snēhō'tipīḍitaḥ|
chardighnIbhiH kriyAbhishca tasya kAryaM nivartanam||40||
chardighnIbhiH kriyAbhishca tasya kAryaM nivartanam||40||
</div></div>
When ''anuvasana'' is given on empty stomach or on emptied bowel or if the enema fluid is injected with great force then it goes up speedily and comes out from the throat or through the orifices in the upper part of the body.
When ''anuvasana'' is given on empty stomach or on emptied bowel or if the enema fluid is injected with great force then it goes up speedily and comes out from the throat or through the orifices in the upper part of the body.
In this condition oil cooked with cow’s urine, ''shyama-trivrita, yava, kola'' and ''kulattha'' should be used for giving ''niruha'' and ''anuvasana''. If the enema fluid starts coming out of throat, then the patient should be given ''stambhana'' therapies, pressure should be applied over his throat and should be given purgatives and antiemetic therapies. [38-40]
In this condition oil cooked with cow’s urine, ''shyama-trivrita, yava, kola'' and ''kulattha'' should be used for giving ''niruha'' and ''anuvasana''. If the enema fluid starts coming out of throat, then the patient should be given ''[[stambhana]]'' therapies, pressure should be applied over his throat and should be given purgatives and antiemetic therapies. [38-40]
<div class="mw-collapsible mw-collapsed">
यस्य नोपद्रवं कुर्यात् स्नेहबस्तिरनिःसृतः|
यस्य नोपद्रवं कुर्यात् स्नेहबस्तिरनिःसृतः|
सर्वेऽल्पो वाऽऽवृतो रौक्ष्यादुपेक्ष्यः स विजानता||४१||
सर्वेऽल्पो वाऽऽवृतो रौक्ष्यादुपेक्ष्यः स विजानता||४१||
<div class="mw-collapsible-content">
yasya nōpadravaṁ kuryāt snēhabastiraniḥsr̥taḥ|
yasya nōpadravaṁ kuryāt snēhabastiraniḥsr̥taḥ|
sarve~alpo vA~a~avRuto raukShyAdupekShyaH sa vijAnatA||41||
sarve~alpo vA~a~avRuto raukShyAdupekShyaH sa vijAnatA||41||
</div></div>
If due to impediments ''sneha basti'' is not removed completely or partially, but if no complications are observed then an expert physician can ignore the condition. [41]
If due to impediments ''sneha basti'' is not removed completely or partially, but if no complications are observed then an expert physician can ignore the condition. [41]
=== Diet after ''anuvasana basti'' ===
<div class="mw-collapsible mw-collapsed">
युक्तस्नेहं द्रवोष्णं च लघुपथ्योपसेवनम्|
युक्तस्नेहं द्रवोष्णं च लघुपथ्योपसेवनम्|
तस्मादुष्णोदकं देयं वातश्लेष्मोपशान्तये||४५||
तस्मादुष्णोदकं देयं वातश्लेष्मोपशान्तये||४५||
<div class="mw-collapsible-content">
yuktasnēhaṁ dravōṣṇaṁ ca laghupathyōpasēvanam|
yuktasnēhaṁ dravōṣṇaṁ ca laghupathyōpasēvanam|
tasmAduShNodakaM deyaM vAtashleShmopashAntaye||45||
tasmAduShNodakaM deyaM vAtashleShmopashAntaye||45||
</div></div>
After proper ''anuvasana basti'', patient should be given liquid, hot, light, wholesome food. After intake of this food in appropriate quantity the patient may given ''anuvasana basti'' on every third day.
After proper ''anuvasana basti'', patient should be given liquid, hot, light, wholesome food. After intake of this food in appropriate quantity the patient may given ''anuvasana basti'' on every third day.
In the next morning after the night the expert physician should give water boiled with ''dhanyaka'' and ''nagara'' (''shunthi'') or simple warm water. This warm water helps the patient in the digestion of undigested fat and disintegrates ''kapha''. Therefore, after emesis, purgation, ''niruha'' and ''anuvasana'' therapies warm water is to be given to the patients for alleviation of ''vata'' and ''kapha''. [42-45]
In the next morning after the night the expert physician should give water boiled with ''dhanyaka'' and ''nagara'' (''shunthi'') or simple warm water. This warm water helps the patient in the digestion of undigested fat and disintegrates ''[[kapha]]''. Therefore, after emesis, purgation, ''niruha'' and ''anuvasana'' therapies warm water is to be given to the patients for alleviation of ''[[vata]]'' and ''[[kapha]]''. [42-45]
=== Frequency of ''anuvasana basti'' ===
<div class="mw-collapsible mw-collapsed">
रूक्षनित्यस्तु दीप्ताग्निर्व्यायामी मारुतामयी|
रूक्षनित्यस्तु दीप्ताग्निर्व्यायामी मारुतामयी|
अतोऽन्येषां त्र्यहात्प्रायः स्नेहं पचति पावकः||४७||
अतोऽन्येषां त्र्यहात्प्रायः स्नेहं पचति पावकः||४७||
<div class="mw-collapsible-content">
rūkṣanityastu dīptāgnirvyāyāmī mārutāmayī|
rūkṣanityastu dīptāgnirvyāyāmī mārutāmayī|
ato~anyeShAM tryahAtprAyaH snehaM pacati pAvakaH||47||
ato~anyeShAM tryahAtprAyaH snehaM pacati pAvakaH||47||
</div></div>
Persons who are habituated to take dry food, having strong digestive capacity, those indulged in physical exertion, sufferers of ''vata'' disorders, whose pelvic and hip regions are afflicted with ''vata'' and who are suffering from ''udavarta'' should be given ''anuvasana'' every day. As the water falling on sand gets absorbed immediately, similarly the fat given to these patients gets immediately digested. In case of others the ''agni'' generally digests ''sneha'' in three days. [46-47]
Persons who are habituated to take dry food, having strong digestive capacity, those indulged in physical exertion, sufferers of ''[[vata]]'' disorders, whose pelvic and hip regions are afflicted with ''[[vata]]'' and who are suffering from ''udavarta'' should be given ''anuvasana'' every day. As the water falling on sand gets absorbed immediately, similarly the fat given to these patients gets immediately digested. In case of others the ''agni'' generally digests ''sneha'' in three days. [46-47]
=== Instructions before ''[[basti]]'' administration ===
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न त्वामं प्रणयेत् स्नेहं स ह्यभिष्यन्दयेद्गुदम्|
न त्वामं प्रणयेत् स्नेहं स ह्यभिष्यन्दयेद्गुदम्|
उभयस्मात् समं गच्छन् वातमग्निं च दूषयेत्||४९||
उभयस्मात् समं गच्छन् वातमग्निं च दूषयेत्||४९||
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na tvāmaṁ praṇayēt snēhaṁ sa hyabhiṣyandayēdgudam|
na tvāmaṁ praṇayēt snēhaṁ sa hyabhiṣyandayēdgudam|
ubhayasmAt samaM gacchan vAtamagniM ca dUShayet||49||
ubhayasmAt samaM gacchan vAtamagniM ca dUShayet||49||
</div></div>
Advice regarding ''basti'' administration:
Advice regarding ''[[basti]]'' administration:
*Plain/ unprocessed fat should not be used for ''anuvasana basti'' as it produces ''abhishyanda'' (stuffiness) in the rectum.
*Plain/ unprocessed fat should not be used for ''anuvasana basti'' as it produces ''abhishyanda'' (stuffiness) in the rectum.
*Some portion of fat should be allowed to remain in ''basti'' because in attempt to give complete ''basti'', some portion of ''vata'' also goes inside.
*Some portion of fat should be allowed to remain in ''[[basti]]'' because in attempt to give complete ''[[basti]]'', some portion of ''[[vata]]'' also goes inside.
*Use of fats orally and through ''basti'' simultaneously should be avoided as it vitiates ''vata'' and ''agni''. [48-49]
*Use of fats orally and through ''[[basti]]'' simultaneously should be avoided as it vitiates ''[[vata]]'' and ''agni''. [48-49]
=== Importance of alternate administration of ''sneha'' and ''niruha basti'' ===
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स्नेहबस्तिं निरूहं वा नैकमेवातिशीलयेत्|
स्नेहबस्तिं निरूहं वा नैकमेवातिशीलयेत्|
स्नेहशोधनयुक्त्यैवं बस्तिकर्म त्रिदोषनुत्||५१||
स्नेहशोधनयुक्त्यैवं बस्तिकर्म त्रिदोषनुत्||५१||
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snēhabastiṁ nirūhaṁ vā naikamēvātiśīlayēt|
snēhabastiṁ nirūhaṁ vā naikamēvātiśīlayēt|
snehashodhanayuktyaivaM bastikarma tridoShanut||51||
snehashodhanayuktyaivaM bastikarma tridoShanut||51||
</div></div>
Either ''niruha'' or ''anuvasana'' should not be given continuously in excess as, continuous ''anuvasana'' causes ''utklesha'' (excitement of ''dosha'') and suppression of digestive power. Continuous excess ''niruha'' causes ''vata'' aggravation. Thus, after ''niruha basti'' the patient should be given ''anuvasana'' and after ''anuvasana basti, niruha'' should be administered. Thus, by giving ''anuvasana'' and ''niruha'' appropriately, ''basti'' therapy cures diseases caused by all the three ''doshas''. [50-51]
Either ''niruha'' or ''anuvasana'' should not be given continuously in excess as, continuous ''anuvasana'' causes ''utklesha'' (excitement of ''[[dosha]]'') and suppression of digestive power. Continuous excess ''niruha'' causes ''[[vata]]'' aggravation. Thus, after ''niruha basti'' the patient should be given ''anuvasana'' and after ''anuvasana basti, niruha'' should be administered. Thus, by giving ''anuvasana'' and ''niruha'' appropriately, ''[[basti]]'' therapy cures diseases caused by all the three ''[[dosha]]s''. [50-51]
=== ''Matra basti'' ===
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कर्मव्यायामभाराध्वया(पा)नस्त्रीकर्षितेषु च|
कर्मव्यायामभाराध्वया(पा)नस्त्रीकर्षितेषु च|
स्नेहमात्राविधानं हि बृंहणं वातरोगनुत्||५४||
स्नेहमात्राविधानं हि बृंहणं वातरोगनुत्||५४||
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karmavyāyāmabhārādhvayā(pā)nastrīkarṣitēṣu ca|
karmavyāyāmabhārādhvayā(pā)nastrīkarṣitēṣu ca|
snehamAtrAvidhAnaM hi bRuMhaNaM vAtaroganut||54||
snehamAtrAvidhAnaM hi bRuMhaNaM vAtaroganut||54||
</div></div>
''Matra basti'' is always useful for persons emaciated by excess activities, exercise, weight lifting, long way faring, riding vehicles or indulging in sexual intercourse and for person who are weak and afflicted with ''vatika'' disorders. While taking ''matra basti'', the person can take food and do the activities as per his liking and can be administered in any season. The dose of ''matra basti'' is equal to the minimum dose of oleation therapy. ''Matra basti'' promotes strength and can be administered easily. It helps in easy voiding of stool. It causes nourishment and cures diseases caused by aggravated ''vata''. [52-54]
''Matra basti'' is always useful for persons emaciated by excess activities, exercise, weight lifting, long way faring, riding vehicles or indulging in sexual intercourse and for person who are weak and afflicted with ''vatika'' disorders. While taking ''matra basti'', the person can take food and do the activities as per his liking and can be administered in any season. The dose of ''matra basti'' is equal to the minimum dose of oleation therapy. ''Matra basti'' promotes strength and can be administered easily. It helps in easy voiding of stool. It causes nourishment and cures diseases caused by aggravated ''[[vata]]''. [52-54]
=== Summary ===
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तत्र श्लोकौ-
तत्र श्लोकौ-
स्नेहबस्तिविधिश्चोक्तो मात्राबस्तिविधिस्तथा||५६||
स्नेहबस्तिविधिश्चोक्तो मात्राबस्तिविधिस्तथा||५६||
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tatra ślōkau-
tatra ślōkau-
snehabastividhishcokto mAtrAbastividhistathA||56||
snehabastividhishcokto mAtrAbastividhistathA||56||
</div></div>
To sum up here-
To sum up here-
Foremost ''basti'' preparations for ''vata'' and other ''dosha'' vitiation, complications arising from improper administration with their treatments, diet before administration, whom to give ''basti'' every day and for whom it is indicated on every third day, method of administration of ''anuvasana'' and ''matrabasti'' are the topics dealt with. [55-56]
Foremost ''[[basti]]'' preparations for ''[[vata]]'' and other ''[[dosha]]'' vitiation, complications arising from improper administration with their treatments, diet before administration, whom to give ''[[basti]]'' every day and for whom it is indicated on every third day, method of administration of ''anuvasana'' and ''matra basti'' are the topics dealt with. [55-56]
=== ''Tattva Vimarsha'' ===
== Tattva Vimarsha (Fundamental Principles) ==
*Bioavailability of drugs and fats is more by ''basti'' as compared to oral route as degradation from metabolic enzymes is minimal and larger amount can be given by rectal route.
*Bioavailability of drugs and fats is more by ''[[basti]]'' as compared to oral route as degradation from metabolic enzymes is minimal and larger amount can be given by rectal route.
*''Snehabasti'' has ''vata'' pacifying, regenerating, anti-aging, ''shukra'' and ''oja'' enhancing effect.
*''Snehabasti'' has ''[[vata]]'' pacifying, regenerating, anti-aging, ''[[shukra]]'' and ''[[ojas]]'' enhancing effect.
*Impediment of ''sneha basti'' can occur by occlusion due to vitiated ''vata, pitta, kapha,'' excess food and stool. These conditions should be recognized and appropriately treated. ''Sneha basti'' should not be given on empty stomach.
*Impediment of ''sneha basti'' can occur by occlusion due to vitiated ''[[vata]], [[pitta]], [[kapha]],'' excess food and stool. These conditions should be recognized and appropriately treated. ''Sneha basti'' should not be given on empty stomach.
*Wholesome diet and lifestyle is important to be followed after ''sneha basti'' to achieve maximum efficacy.
*Wholesome diet and lifestyle is important to be followed after ''sneha basti'' to achieve maximum efficacy.
*''Matra basti'' is low dose ''basti'', can be given to patients with ''vata'' dominant disorders who are weak and ambulatory. It can be given in all seasons, and doesn’t produce any complications. The dose of ''matra basti'' is similar to low dose of ''sneha''.
*''Matra basti'' is low dose ''[[basti]]'', can be given to patients with ''[[vata]]'' dominant disorders who are weak and ambulatory. It can be given in all seasons, and doesn’t produce any complications. The dose of ''matra basti'' is similar to low dose of ''sneha''.
=== ''Vidhi Vimarsha'' ===
== Vidhi Vimarsha (Applied Inferences ) ==
=== Effect of ''Snehabasti'' ===
Charaka has given due importance to the nourishment properties of ''snehabasti''. Probable reason may be, drugs administered low in the rectum are delivered systemically by the inferior and middle rectal veins before passing through the liver.<ref>Van Hoogdalem EJ, de Boer AG, Breimer DD (1991) Pharmacokinetics of rectal drug administration: Part II: clinical applications of peripherally acting drugs, and conclusions. Clinical Pharmacokinetics. 21:110–128</ref><ref>Khalil SN, Florence FB, Van den Nieuwenhuyzen MC, Wu AH, Stanley TH (1990) Rectal methohexital: concentration and length of the rectal catheters. Anesth Analg. 70:645–649</ref> Thus the bioavailability increases as compared to oral route as degradation from metabolic enzymes is minimal. Hence energy providing capacity is more for ''snehabasti'' compared to oral fat consumption. Moreover, palatability is not an issue in ''basti'' hence larger doses for nourishment are possible to be used. Some fatty acids like omega-3-fatty acid, omega-9-fatty acid, alpha-linolenic acids, cervonic acid etc. are useful for normal intellectual capacity and brain functioning and also prevents ageing.<ref>Bourre JM. Roles of unsaturated fatty acids (especially omega-3 fatty acids) in the brain at various ages and during ageing. Journal of Nutrition Healthand Aging. 2004;8(3):163-74.</ref> ''Sneha'' itself and ''basti karma'' both remove ''vata'' hence age related degeneration due to increased ''vata'' can be hampered with the use of ''snehabasti'' which can be termed as ''oja'' enhancing effect. Higher intake of omega-3 fats is positively related to sperm morphology hence ''sneha basti'' can also be beneficial for semen’s qualitative improvement. [verse 23-24]
Charaka has given due importance to the nourishment properties of ''snehabasti''. Probable reason may be, drugs administered low in the rectum are delivered systemically by the inferior and middle rectal veins before passing through the liver.<ref>Van Hoogdalem EJ, de Boer AG, Breimer DD (1991) Pharmacokinetics of rectal drug administration: Part II: clinical applications of peripherally acting drugs, and conclusions. Clinical Pharmacokinetics. 21:110–128</ref><ref>Khalil SN, Florence FB, Van den Nieuwenhuyzen MC, Wu AH, Stanley TH (1990) Rectal methohexital: concentration and length of the rectal catheters. Anesth Analg. 70:645–649</ref> Thus the bioavailability increases as compared to oral route as degradation from metabolic enzymes is minimal. Hence energy providing capacity is more for ''snehabasti'' compared to oral fat consumption. Moreover, palatability is not an issue in ''[[basti]]'' hence larger doses for nourishment are possible to be used. Some fatty acids like omega-3-fatty acid, omega-9-fatty acid, alpha-linolenic acids, cervonic acid etc. are useful for normal intellectual capacity and brain functioning and also prevents ageing.<ref>Bourre JM. Roles of unsaturated fatty acids (especially omega-3 fatty acids) in the brain at various ages and during ageing. Journal of Nutrition Healthand Aging. 2004;8(3):163-74.</ref> ''Sneha'' itself and ''[[basti]] karma'' both remove ''[[vata]]'' hence age related degeneration due to increased ''[[vata]]'' can be hampered with the use of ''snehabasti'' which can be termed as ''[[ojas]]'' enhancing effect. Higher intake of omega-3 fats is positively related to sperm morphology hence ''sneha basti'' can also be beneficial for semen’s qualitative improvement. [verse 23-24]
=== Impediment by ''[[vata]]'' ===
''Vata'' has ''ruksha'' (dry) property on virtue of which it may hamper smooth movement of ''snehabasti'' while ''pratyagamana'' (removal of ''basti''). Hydrogen sulphide produced by bacterial flora has inhibitory effect on intestinal motility <ref>Gallego D, Clave´ P, Donovan J, et al. The gaseous mediator, hydrogen sulphide, inhibits in vitro motor patterns in the human, rat and mouse colon and jejunum. Neurogastroenterol Motil 2008; 20:1306–1316</ref> which may be the possible reason for this occlusion. Hence the symptoms also resemble that of intestinal motility disorders <ref>https://emedicine.medscape.com/article/179937-overview</ref> and the treatment is targeted on improving the intestinal motility by use of certain drugs having ''tikshna'' properties and thus proves to be ''shodhana'' (helps evacuation) in nature. Salt has purgative action due to shifting of osmotic gradient, alcohol in low doses is responsible for enhanced gastric emptying<ref>Bujanda L, The effects of alcohol consumption upon the gastrointestinal tract, American Journal of Gastroenterology. 2000 Dec;95(12):3374-82.</ref>, vinegar, cow urine are the acidic preparations that may help in stimulating colonic mucosa that helps in evacuation of occluded enema. Thus, these drugs are commonly employed in treatment of impediment by ''vata''. [verse 26-30]
''[[Vata]]'' has ''ruksha'' (dry) property on virtue of which it may hamper smooth movement of ''snehabasti'' while ''pratyagamana'' (removal of ''[[basti]]''). Hydrogen sulphide produced by bacterial flora has inhibitory effect on intestinal motility <ref>Gallego D, Clave´ P, Donovan J, et al. The gaseous mediator, hydrogen sulphide, inhibits in vitro motor patterns in the human, rat and mouse colon and jejunum. Neurogastroenterol Motil 2008; 20:1306–1316</ref> which may be the possible reason for this occlusion. Hence the symptoms also resemble that of intestinal motility disorders <ref>https://emedicine.medscape.com/article/179937-overview</ref> and the treatment is targeted on improving the intestinal motility by use of certain drugs having ''tikshna'' properties and thus proves to be ''[[shodhana]]'' (helps evacuation) in nature. Salt has purgative action due to shifting of osmotic gradient, alcohol in low doses is responsible for enhanced gastric emptying<ref>Bujanda L, The effects of alcohol consumption upon the gastrointestinal tract, American Journal of Gastroenterology. 2000 Dec;95(12):3374-82.</ref>, vinegar, cow urine are the acidic preparations that may help in stimulating colonic mucosa that helps in evacuation of occluded enema. Thus, these drugs are commonly employed in treatment of impediment by ''[[vata]]''. [verse 26-30]
=== Impediment by ''[[pitta]]'' ===
The normal site of ''pitta'' production in GI tract is ''pachyamanashaya'' which can be considered as a part of small intestine up to the level of caecum. However, impediment of ''snehabasti'' by ''pitta'' is probably a condition wherein ''vimarga-gamana'' (movement of ''pitta'' in improper direction) of ''pitta'' occurs which can be correlated with inflammation of colon due to any reason. If hot ''basti'' is given in already existing inflammation then it may lead to increase in symptoms. Thus, treatment is targeted to cure this acute inflammation. Hence sweet and bitter drugs are employed as they have ''pitta'' alleviating properties.[verse 31]
The normal site of ''[[pitta]]'' production in GI tract is ''pachyamanashaya'' which can be considered as a part of small intestine up to the level of caecum. However, impediment of ''snehabasti'' by ''pitta'' is probably a condition wherein ''vimarga-gamana'' (movement of ''[[pitta]]'' in improper direction) of ''[[pitta]]'' occurs which can be correlated with inflammation of colon due to any reason. If hot ''[[basti]]'' is given in already existing inflammation then it may lead to increase in symptoms. Thus, treatment is targeted to cure this acute inflammation. Hence sweet and bitter drugs are employed as they have ''[[pitta]]'' alleviating properties.[verse 31]
=== Impediment by ''[[kapha]]'' ===
The normal site of ''kapha'' production in gastro-instestinal tract is ''amashaya'' which can be considered as stomach and an initial part of small intestine. ''Kapha'' has a role in moistening the gastric contents and facilitates its smooth passage in GI tract. Hence impediment by ''kapha'' can be well correlated with excess mucus activity which is secreted in stomach and carried to the intestine and colon by food or even secreted by colonic mucosa up to some extent. ''Sneha'' has ''snigdha'' (unctuous) properties which add to mucus activity hence leading to ''agnimandya'' that may produce the symptoms as described. Hence treatment is also planned to remove ''kleda'' (moisture) in order to reduce excess mucus activity.[verse 32-33]
The normal site of ''[[kapha]]'' production in gastro-instestinal tract is ''amashaya'' which can be considered as stomach and an initial part of small intestine. ''[[Kapha]]'' has a role in moistening the gastric contents and facilitates its smooth passage in GI tract. Hence impediment by ''[[kapha]]'' can be well correlated with excess mucus activity which is secreted in stomach and carried to the intestine and colon by food or even secreted by colonic mucosa up to some extent. ''Sneha'' has ''snigdha'' (unctuous) properties which add to mucus activity hence leading to ''agnimandya'' that may produce the symptoms as described. Hence treatment is also planned to remove ''kleda'' (moisture) in order to reduce excess mucus activity.[verse 32-33]
=== Impediment by food in excess quantity ===
Digestion of food starts from stomach and almost completed in small intestine. However, role of colon is very limited in digestion and confines to absorption of water, some minerals and produces vitamins by colonic bacterial flora. Thus, impediment by food suggests presence of undigested food that reaches colon. ''Ama'' is a product or is itself is undigested material of food. Thus, the symptoms of impediment by food resembles that of ''ama'' disorders. Undigested food material affects gastric motility hence ''pachana'' is the remedy that helps in digestion. Thus, in case of impediment by food ''pachana'' is preferred as it makes possible ''ama'' degradation into easily absorbable nutrients. If this ''pachana'' is not possible then mild purgation is also advised to remove out the undigested material.[verse 34-35]
Digestion of food starts from stomach and almost completed in small intestine. However, role of colon is very limited in digestion and confines to absorption of water, some minerals and produces vitamins by colonic bacterial flora. Thus, impediment by food suggests presence of undigested food that reaches colon. ''Ama'' is a product or is itself is undigested material of food. Thus, the symptoms of impediment by food resembles that of ''ama'' disorders. Undigested food material affects gastric motility hence ''[[pachana]]'' is the remedy that helps in digestion. Thus, in case of impediment by food ''[[pachana]]'' is preferred as it makes possible ''ama'' degradation into easily absorbable nutrients. If this ''[[pachana]]'' is not possible then mild purgation is also advised to remove out the undigested material.[verse 34-35]
=== Impediment by stools ===
Impediment by stools refers to the state of constipation or excess accumulation of stool in colon that obstructs the ''basti'' while evacuation. Constipation in general has following ill effects<ref>http://www.cpmc.org/services/gi/services/lowergut.html</ref> :
Impediment by stools refers to the state of constipation or excess accumulation of stool in colon that obstructs the ''[[basti]]'' while evacuation. Constipation in general has following ill effects<ref>http://www.cpmc.org/services/gi/services/lowergut.html</ref> :
*Abnormal colon contractions
*Abnormal colon contractions
*Anal sphincter spasm leading to a functional obstruction
*Anal sphincter spasm leading to a functional obstruction
All these effects reduce colonic motility and are similar to those symptoms of impediment by stool. Thus, treatment is targeted to resolve constipation and hence ''phalavarti'' and ''udavarta'' treatment principles are employed. [verse 36-37]
All these effects reduce colonic motility and are similar to those symptoms of impediment by stool. Thus, treatment is targeted to resolve constipation and hence ''phalavarti'' and ''udavarta'' treatment principles are employed. [verse 36-37]
=== Ailments caused by administration of ''[[basti]]'' on empty stomach ===
When ''anuvasana'' is given on empty stomach or on emptied bowel or if the enema fluid is injected with great force then it goes up speedily and comes out from the throat or through the orifices in the upper part of the body which seems practically difficult phenomena but some evidences suggest that possibility cannot be ruled out. Materials introduced by enema, may in some instances pass through the valve into the ileum. Such incompetence may permit the enema fluid to reach the duodenum. Further, the possibility of material from even lower bowel reaching the mouth is strongly suggested by the fact that lycopodium spores, introduced into the colon by enema, have been recovered some hours later from washings of the stomach, alimentary canal movements<ref>Best C H, Taylor N B. ‘The Physiological Basis of Medical Practice-‘Alimentary Canal Movements’.Seventh edition. Baltimore (U.S.A.): The Williams & Wilkins Company; 1961. pp. 715–691</ref>. Thus when alimentary tract is empty and clear the ''sneha'' due to its easy penetration capacity may reach up to mouth. The treatment suggested i.e. pressure application over throat results in sudden sympathetic activation leading to adrenaline production. As a result of this, the smooth muscles of the digestive tract are inhibited, so peristalsis stops, sphincter of the bladder also contracts and the bladder wall relaxes. This may lead to involuntary bowel movement<ref>Jurriaan Plesman, Anxiety and the Autonomic Nervous System, available from http://www.hypoglycemia.asn.au/2011/anxiety-and-the-autonomic-nervous-system/ cited on 23-04-2014</ref>. [verse 38-40]
In clinical practice, this condition is extremely rare.
=== Importance of warm water in ''snehabasti'' course ===
Drinking warm water accelerates the gastric emptying<ref>http://www.emptyingthebowel.com/index.php?option=com_content&view=article&id=98:how-to-manipulate-gut-motility&catid=44:manipulating-the-process-of-defecation&Itemid=119 </ref>, clears the bowel and hence prevents indigestion or constipation during ''basti'' course. It also has inhibitory effect on mucus production<ref>http://www.top10homeremedies.com/home-remedies/home-remedies-phlegm.html</ref> thus preventing from ''kapha'' vitiation. When hot water is consumed, the body temperature goes up and sweating starts, which can flush the toxic materials out of internal system and cleanse it properly.<ref>http://www.stylecraze.com/articles/benefits-of-hot-water-for-skin-hair-and-health/ </ref> [verse 43-45]
Drinking warm water accelerates the gastric emptying<ref>http://www.emptyingthebowel.com/index.php?option=com_content&view=article&id=98:how-to-manipulate-gut-motility&catid=44:manipulating-the-process-of-defecation&Itemid=119 </ref>, clears the bowel and hence prevents indigestion or constipation during ''[[basti]]'' course. It also has inhibitory effect on mucus production<ref>http://www.top10homeremedies.com/home-remedies/home-remedies-phlegm.html</ref> thus preventing from ''[[kapha]]'' vitiation. When hot water is consumed, the body temperature goes up and sweating starts, which can flush the toxic materials out of internal system and cleanse it properly.<ref>http://www.stylecraze.com/articles/benefits-of-hot-water-for-skin-hair-and-health/ </ref> [verse 43-45]
=== Frequency of ''anuvasana basti'' ===
In ''vata'' dominant individuals ''anuvasana'' is indicated daily. ''Pakvashaya'' i.e. colon is the site of production of ''vata''. Hence to cure any ''vata'' disorder the production of ''vata'' has to be hampered which is achieved by giving ''snehabasti''. In ''vata'' dominance in ''koshtha, snehabasti'' is readily absorbed because ''vata'' has ''ruksha'' (dry) property (AH. Su. 1/11) that in turn gives dryness to the colonic mucosa which attains proper oleation when comes in contact with ''basti''.[verse 46-47]
In ''[[vata]]'' dominant individuals ''anuvasana'' is indicated daily. ''Pakvashaya'' i.e. colon is the site of production of ''[[vata]]''. Hence to cure any ''[[vata]]'' disorder the production of ''[[vata]]'' has to be hampered which is achieved by giving ''snehabasti''. In ''[[vata]]'' dominance in ''koshtha, snehabasti'' is readily absorbed because ''[[vata]]'' has ''ruksha'' (dry) property [A.Hr. Sutra Sthana. 1/11] that in turn gives dryness to the colonic mucosa which attains proper oleation when comes in contact with ''[[basti]]''.[verse 46-47]
=== Advice regarding ''[[basti]]'' administration ===
*Unprocessed ''snehabasti'' is to be avoided in general as it causes ''abhishyanda''. This may be explained by the fact that uncooked fats contain more free radicals<ref>Prabhu, H.R. Lipid peroxidation in culinary oils subjected to thermal stress. Indian J Clin Biochem (2000) 15: 1. https://doi.org/10.1007/BF02873539 </ref> and long chain fatty acids. Whereas due to cooking the free radicals are removed and long chain fatty acids may get converted into short chain fatty acids. Free radicals have a number of ill effects and they may increase preexisting inflammation<ref>Li XY1, Gilmour PS, Donaldson K, MacNee W, Free radical activity and pro-inflammatory effects of particulate air pollution (PM10) in vivo and in vitro, Thorax, 1996 Dec;51(12):1216-22</ref>. Short chain fatty acids are easily absorbed from colon whereas long chain fatty acids are rarely absorbed. <ref>Ruppin H, Bar-Meir S, Soergel KH, Wood CM, Schmitt MG Jr, Absorption of short-chain fatty acids by the colon, Gastroenterology. 1980 Jun;78(6):1500-7.</ref>
*Unprocessed ''snehabasti'' is to be avoided in general as it causes ''abhishyanda''. This may be explained by the fact that uncooked fats contain more free radicals<ref>Prabhu, H.R. Lipid peroxidation in culinary oils subjected to thermal stress. Indian J Clin Biochem (2000) 15: 1. https://doi.org/10.1007/BF02873539 </ref> and long chain fatty acids. Whereas due to cooking the free radicals are removed and long chain fatty acids may get converted into short chain fatty acids. Free radicals have a number of ill effects and they may increase preexisting inflammation<ref>Li XY1, Gilmour PS, Donaldson K, MacNee W, Free radical activity and pro-inflammatory effects of particulate air pollution (PM10) in vivo and in vitro, Thorax, 1996 Dec;51(12):1216-22</ref>. Short chain fatty acids are easily absorbed from colon whereas long chain fatty acids are rarely absorbed. <ref>Ruppin H, Bar-Meir S, Soergel KH, Wood CM, Schmitt MG Jr, Absorption of short-chain fatty acids by the colon, Gastroenterology. 1980 Jun;78(6):1500-7.</ref>
*Fat digestion depends upon lipase enzyme, bile salts etc<ref> http://courses.washington.edu/conj/bess/fats/fats.html</ref>. Consuming fats from oral as well as from ''basti'' may dilute these enzymatic actions and also the process of emulsification<ref>http://www.bio.davidson.edu/people/midorcas/animalphysiology/websites/2005/castle/page3.htm</ref> is hampered thus most of the part of fats remain undigested which may in turn reduce digestive strength.
*Fat digestion depends upon lipase enzyme, bile salts etc<ref> http://courses.washington.edu/conj/bess/fats/fats.html</ref>. Consuming fats from oral as well as from ''basti'' may dilute these enzymatic actions and also the process of emulsification<ref>http://www.bio.davidson.edu/people/midorcas/animalphysiology/websites/2005/castle/page3.htm</ref> is hampered thus most of the part of fats remain undigested which may in turn reduce digestive strength.
*''Utklesha, agnimandya'' and ''vataprakopa''- Continuous use of ''snehabasti'' may cause ''utklesha'' as ''snehabasti'' is also an alternative way of oleation therapy (Ch. Su. 13/24). If continued still further, then ''ama'' formation occurs as indigested ''sneha'' and ''utklishtha'' (eager to be removed) ''dosha'' are not removed from the body by any ''shodhana'' procedure like ''virechana'' or ''niruha''. ''Niruha'' on the contrary causes removal of vitiated ''dosha'', next comes ''dhatu'' and when ''dhatus'' are removed from body then ''vata'' vitiation occurs. This can be correlated to the fact that if continuous ''niruha'' are given, it causes inflammation of mucosal lining or may further damage the colonic mucosa leading to leakage of nutrients from mucosa and negatively affecting nutritional activity of colonic bacterial flora.[verse 48-49]
*''Utklesha, agnimandya'' and ''[[vata]] prakopa''- Continuous use of ''snehabasti'' may cause ''utklesha'' as ''snehabasti'' is also an alternative way of oleation therapy [Cha. Sa. [[Sutra Sthana]] 13/24]. If continued still further, then ''ama'' formation occurs as indigested ''sneha'' and ''utklishtha'' (eager to be removed) ''[[dosha]]'' are not removed from the body by any ''[[shodhana]]'' procedure like ''[[virechana]]'' or ''niruha''. ''Niruha'' on the contrary causes removal of vitiated ''[[dosha]]'', next comes ''[[dhatu]]'' and when ''[[dhatu]]s'' are removed from body then ''[[vata]]'' vitiation occurs. This can be correlated to the fact that if continuous ''niruha'' are given, it causes inflammation of mucosal lining or may further damage the colonic mucosa leading to leakage of nutrients from mucosa and negatively affecting nutritional activity of colonic bacterial flora.[verse 48-49]
=== ''Matra basti'' ===
''Matrabasti'' is a low dose form of snehabasti which is equal to lowest dose of oleation therapy. According to Vagbhata, the dose of ''matra basti'' is equal to the dose of ''hrasva snehapana''. The ''matra'' which gets digested in two ''yama'' i.e. 6 hours, is called as ''hrasva matra'' but the dose required to get digested in two ''yama'' is not mentioned( A.S.Su 28/8). According to Sushruta, the dose of ''matra basti'' is ¼ of the dose of ''anuvasana basti'' and the dose of ''anuvasana basti'' is ¼ of ''niruha basti'' i.e. 24 ''pala''. Hence, the dose of ''anuvasana basti'' is 6 ''Pala'' and dose of ''matra basti'' is 1½ ''Pala'' i.e. 6 ''tola''(Su. Chi. 37/80). On the basis of above reference it can be said that the dose of ''matra basti'' is 1½ ''pala'' of ''sneha'' i.e. 6 ''tola'' equal to 60-70 ml. According to Kashyapa the dose of ''matrabasti'' is, (Ka. Khi. 8/104-5):
''Matrabasti'' is a low dose form of snehabasti which is equal to lowest dose of oleation therapy. According to Vagbhata, the dose of ''matra basti'' is equal to the dose of ''hrasva snehapana''. The ''matra'' which gets digested in two ''yama'' i.e. 6 hours, is called as ''hrasva matra'' but the dose required to get digested in two ''yama'' is not mentioned<ref> Vagbhata. Sutra Sthana Cha 28, Bastividhi, Verse 8, In:Dr. Shivprasad Sharma,Editor,Ashtanga-Sangraha, 2nd edition, Varanasi: Chaukhamba Sanskrit Series Office, Varanasi (India),2008 Page No.-9</ref>. According to Sushruta, the dose of ''matra basti'' is ¼ of the dose of ''anuvasana basti'' and the dose of ''anuvasana basti'' is ¼ of ''niruha basti'' i.e. 24 ''pala''. Hence, the dose of ''anuvasana basti'' is 6 ''Pala'' and dose of ''matra basti'' is 1½ ''Pala'' i.e. 6 ''tola''<ref>Sushruta. Chikitsa Sthana, Cha.37 Anuvasanottarabasti Chikitsitam Adhyaya verse 80. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>. On the basis of above reference it can be said that the dose of ''matra basti'' is 1½ ''pala'' of ''sneha'' i.e. 6 ''tola'' equal to 60-70 ml. According to Kashyapa the dose of ''matrabasti'' is, <ref>Kashyapa. Kashyapa Samhita. Khila Sthana Chap 8, Verse 104-105, Edited by P. V. Tewari. Reprint. Varanasi: Chaukhambha vishvabharati;2008. pp.--</ref>
*1''prakuncha'' = 4 ''tola'' = (40ml) =''kaniyasi matra''
*1''prakuncha'' = 4 ''tola'' = (40ml) =''kaniyasi matra''
*1½ ''pala'' = 6 ''tola'' = (60 ml) = ''madhyama matra''
*1½ ''pala'' = 6 ''tola'' = (60 ml) = ''madhyama matra''
The capacity to hold fecal matter, also termed as rectal compliance ranges between 60ml to 500ml<ref>Felt-Bersma RJ1, Sloots CE, Poen AC, Cuesta MA, Meuwissen SG. Rectal compliance as a routine measurement: extreme volumes have direct clinical impact and normal volumes exclude rectum as a problem, Disease of Colon & Rectum. 2000 Dec;43(12):1732-8</ref>. This may be the probable reason to use a dose in quantity lower than 60ml in order to retain the ''sneha'' for longer duration in rectum so that the volume of absorption increases. Hence though given in lower doses ''matrabasti'' can give similar results as that of other ''snehabasti'' in respect of oleation and nutritive activity.[verse 52-54]
The capacity to hold fecal matter, also termed as rectal compliance ranges between 60ml to 500ml<ref>Felt-Bersma RJ1, Sloots CE, Poen AC, Cuesta MA, Meuwissen SG. Rectal compliance as a routine measurement: extreme volumes have direct clinical impact and normal volumes exclude rectum as a problem, Disease of Colon & Rectum. 2000 Dec;43(12):1732-8</ref>. This may be the probable reason to use a dose in quantity lower than 60ml in order to retain the ''sneha'' for longer duration in rectum so that the volume of absorption increases. Hence though given in lower doses ''matrabasti'' can give similar results as that of other ''snehabasti'' in respect of oleation and nutritive activity.[verse 52-54]
=== Practically employed methods regarding schedule of ''snehabasti'' ===
Charaka has advocated to give continuously anuvasana maximum for 3 days, However ''matrabasti'' can be given continuously for longer durations. Generally, ''niruha'' and ''anuvasana'' are given alternately to avoid any complications. The maximum dose of ''snehabasti'' is 1/4th of maximum dose of ''niruha'' (Approx. 240 ml) and is to be given on the same day in evening after ''niruha''. But practically such large doses are not used and up to 120 ml of ''snehabasti'' (classically ''anuvasana'') is given on the next day of administration of ''niruha''.
Charaka has advocated to give continuously anuvasana maximum for 3 days, However ''matrabasti'' can be given continuously for longer durations. Generally, ''niruha'' and ''anuvasana'' are given alternately to avoid any complications. The maximum dose of ''snehabasti'' is 1/4th of maximum dose of ''niruha'' (Approx. 240 ml) and is to be given on the same day in evening after ''niruha''. But practically such large doses are not used and up to 120 ml of ''snehabasti'' (classically ''anuvasana'') is given on the next day of administration of ''niruha''.
=== Scope for further research ===
=== Scope for further research ===
*''Matrabasti'' needs to be explored for its possible use as an alternative to ''snehapana'' and also standardization of dosage needs to be done to get specific health benefit like ''shamana, brimhana'' etc.
*''Matrabasti'' needs to be explored for its possible use as an alternative to ''snehapana'' and also standardization of dosage needs to be done to get specific health benefit like ''shamana, [[brimhana]]'' etc.
*''Yamaka'' (combination of different type of fats) ''sneha'', needs to be tested clinically in large sample size as it is considered that combination of ''sneha'' gives ''rasayana'' effect.
*''Yamaka'' (combination of different type of fats) ''sneha'', needs to be tested clinically in large sample size as it is considered that combination of ''sneha'' gives ''[[rasayana]]'' effect.
* Clinical studies are needed to compare the effect of sneha basti (unctuous enema) with sneha pana (oral administration).The duration of administration, dosage, long term effect needs more exploration.
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