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Asthapana basti (view source)

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Asthapana basti or niruha basti (therapeutic decoction enema) is a prime treatment for disorders due to vitiation of vata dosha. It can expel out the increased dosha. [Cha.Sa. Siddhi Sthana 1/27]<ref name="ref1">Charak. Charak Samhita. Edited by Jadavaji Trikamji Aacharya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> Niruha basti (therapeutic decoction enema) can pacify vata at its root i.e. colon. Thus, it protects the whole body from diseases due to vata dosha. Both asthapana (therapeutic decoction enema) and virechana (therapeutic purgation) remove the doshas from the body through the colon. Asthapana basti (therapeutic decoction enema) has the advantage of eliminating dosha without causing difficulties like belching, pain in the heart region and koshtha (gut). [Cha.Sa. Siddhi Sthana 10/07]<ref name="ref1"/> Niruha (therapeutic decoction enema) can be administered in weak persons, where virechana is contraindicated. (therapeutic purgation) [Cha.Sa. Chikitsa Sthana 28/86]<ref name="ref1"/> Virechana (therapeutic purgation) is contraindicated in children and old people, whereas asthapana (therapeutic decoction enema) can be used for lifetime. [Cha.Sa. Siddhi Sthana 10/07]<ref name="ref1"/> This chapter focuses on the concept and practices of asthapana basti (therapeutic decoction enema).

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Asthapana basti or niruha basti (therapeutic decoction enema) is a prime treatment for disorders due to vitiation of [[Vata dosha|vata dosha]]. It can expel out the increased [[Dosha|dosha]]. [Cha.Sa. Siddhi Sthana 1/27]<ref name="ref1">Charak. Charak Samhita. Edited by Jadavaji Trikamji Aacharya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> Niruha basti (therapeutic decoction enema) can pacify [[Vata dosha|vata]] at its root i.e. colon. Thus, it protects the whole [[Sharira|body]] from diseases due to [[Vata dosha|vata dosha]]. Both asthapana (therapeutic decoction enema) and virechana (therapeutic purgation) remove the [[Dosha|doshas]] from the [[Sharira|body]] through the colon. Asthapana basti (therapeutic decoction enema) has the advantage of eliminating [[Dosha|dosha]] without causing difficulties like belching, pain in the heart region and koshtha (gut). [Cha.Sa. Siddhi Sthana 10/07]<ref name="ref1"/> Niruha (therapeutic decoction enema) can be administered in weak persons, where virechana is contraindicated. (therapeutic purgation) [Cha.Sa. Chikitsa Sthana 28/86]<ref name="ref1"/> Virechana (therapeutic purgation) is contraindicated in children and old people, whereas asthapana (therapeutic decoction enema) can be used for lifetime. [Cha.Sa. Siddhi Sthana 10/07]<ref name="ref1"/> This chapter focuses on the concept and practices of asthapana basti (therapeutic decoction enema).

{{Infobox

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== Etymology and derivation ==

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Asthapana: The word asthapana is derived from aan, stha with lyut suffix in Sanskrit. This means to stay in one place (for longer time). Asthapana prevents the aging process by fixing the malfunctioning dosha.<ref name="ref2">www.wisdomlib.org. Asthapana, Āsthāpana: 7 definitions [Internet]. 2021 [cited 2023 July 31st]. Available from https://www.wisdomlib.org/definition/asthapana.</ref> Niruha: The word niruha is derived from nir (निर्) (privative)+ uha (ऊहा) (reasoning)+ karane (करणे घञ्). Thus, the word niruha stands for the treatment whose effect is beyond reasoning (or effective without any doubt). Synonyms: Asthapana basti, niruha basti, kashaya basti

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Asthapana: The word asthapana is derived from aan, stha with lyut suffix in Sanskrit. This means to stay in one place (for longer time). Asthapana prevents the aging process by fixing the malfunctioning [[Dosha|dosha]].<ref name="ref2">www.wisdomlib.org. Asthapana, Āsthāpana: 7 definitions [Internet]. 2021 [cited 2023 July 31st]. Available from https://www.wisdomlib.org/definition/asthapana.</ref> Niruha: The word niruha is derived from nir (निर्) (privative)+ uha (ऊहा) (reasoning)+ karane (करणे घञ्). Thus, the word niruha stands for the treatment whose effect is beyond reasoning (or effective without any doubt). Synonyms: Asthapana basti, niruha basti, kashaya basti

== Types of asthapana basti ==

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<li style="font-weight:bold">Teekshna asthapana basti (strong potency): The basti with strong potency is indicated in diseases of prolonged duration, challenging to cure, and having maximum strength. It can be administered in persons having superior mental strength (pravara sattva). The basti will get sharpness (teekshnatvam), when it gets added with cow’s urine (gomutra), pilu (Salvadora persica Linn), Chitraka (Plumbago zeylanica), salt (lavana) and alkali (kshara).</li></ol>

<li style="font-weight:bold">Based on effect (karma): </li>

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<ol type="a"><li style="font-weight:bold">Utkleshana basti: This type of basti is intended to aggravate dosha in dormant state (leena avastha). After initial aggravation, the basti expelles the dosha to create equilibrium. Eranda beeja (seed of Ricinus communis), madhuka (Madhuka longifolia), pippali (Piper longum), saindhava (rock salt) and hapusha phala (Juniperus communis Linn.) as kalka are the ingredients of utkleshana basti. [Su.Sa. Chikitsa Sthana 35/93]<ref name="ref3" /></li>

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<ol type="a"><li style="font-weight:bold">Utkleshana basti: This type of basti is intended to aggravate [[Dosha|dosha]] in dormant state (leena avastha). After initial aggravation, the basti expelles the [[Dosha|dosha]] to create equilibrium. Eranda beeja (seed of Ricinus communis), madhuka (Madhuka longifolia), pippali (Piper longum), saindhava (rock salt) and hapusha phala (Juniperus communis Linn.) as kalka are the ingredients of utkleshana basti. [Su.Sa. Chikitsa Sthana 35/93]<ref name="ref3" /></li>

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<li style="font-weight:bold">Doshahara basti : This pacifies dosha by removing them.The ingredients of doshahara basti are satahva (Anethum sowa), madhuka (Madhuca longifolia), kutaja beeja (Holarrhena antidysenterica), madanaphala (Randia dumetorum) along with kanjika (fermented rice gruel) and gomutra (cow’s urine). [Su.Sa. Chikitsa Sthana 35/94]<ref name="ref3" />.</li>

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<li style="font-weight:bold">Doshahara basti : This pacifies [[Dosha|dosha]] by removing them.The ingredients of doshahara basti are satahva (Anethum sowa), madhuka (Madhuca longifolia), kutaja beeja (Holarrhena antidysenterica), madanaphala (Randia dumetorum) along with kanjika (fermented rice gruel) and gomutra (cow’s urine). [Su.Sa. Chikitsa Sthana 35/94]<ref name="ref3" />.</li>

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<li style="font-weight:bold">Dosha shamana basti: This pacifies dosha with mild potency.Priyangu (Callicarpa macrophylla), Madhuka (Madhuca longifolia), Musta (Cyperus rotundus), Rasanjana (semisolid extract obtained from decotion of Berberis aristata with milk) along with cow’s milk (goksheera) are the ingredients. [Su.Sa. Chikitsa Sthana 35/95]<ref name="ref3" /></li></ol>

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<li style="font-weight:bold">[[Dosha|Dosha]] shamana basti: This pacifies [[Dosha|dosha]] with mild potency.Priyangu (Callicarpa macrophylla), Madhuka (Madhuca longifolia), Musta (Cyperus rotundus), Rasanjana (semisolid extract obtained from decotion of Berberis aristata with milk) along with cow’s milk (goksheera) are the ingredients. [Su.Sa. Chikitsa Sthana 35/95]<ref name="ref3" /></li></ol>

<li style="font-weight:bold">Yapana basti (enema for sustaining life) Yapana bastis can be administered in all seasons. There are 12 types of yapana bastis mentioned and they are indicated in different stages of all diseases. They serve the action of niruha basti (therapeutic decoction enema) and sneha basti (therapeutic unctuous enema). Mustadi yapana basti. shaliparnyadi yapana basti, sthiradi yapana basti are examples of yapana basti. [Cha.Sa. Siddhi Sthana 12/16-17]<ref name="ref1" /></li>

<li style="font-weight:bold">Piccha basti (enema for healing) Piccha basti is a kind of asthapana basti prepared using slimy (picchila) dravyas. It is indicated in conditions like diarrhea (atisara), where there is bleeding from rectum. [Cha.Sa. Chikitsa Sthana 19/93]<ref name="ref1" /></li>

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<li style="font-weight:bold">Ksheera basti (enema with medicated milk) The type of asthapana basti where medicated milk (shrita ksheera) is used instead of decoction is known as ksheera basti. It is also a kind of mridu basti (basti with mild potency). It is indicated mainly in diseases like vatarakta (rheumatism due to vitiated vata and rakta), sandhigata vata (degenerative joint disorder), visarpa (erysipelas), vatavyadhi (disorders due to vata) etc.</li>

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<li style="font-weight:bold">Ksheera basti (enema with medicated milk) The type of asthapana basti where medicated milk (shrita ksheera) is used instead of decoction is known as ksheera basti. It is also a kind of mridu basti (basti with mild potency). It is indicated mainly in diseases like vatarakta (rheumatism due to vitiated [[Vata dosha|vata]] and rakta), sandhigata vata (degenerative joint disorder), visarpa (erysipelas), vatavyadhi (disorders due to [[Vata dosha|vata]]) etc.</li>

<li style="font-weight:bold">Rakta basti (enema with animal blood) Rakta basti contains the blood of freshly killed animals which is indicated mainly in atisara(diarrhea) where the patient is debilitated by losing blood through the rectum. It is indicated in raktatisara (ulcerative colitis with blood in stools) and jeevadana vyapat of virechana (therapeutic purgation) and basti (therapeutic enema). [Cha.Sa. Siddhi Sthana 6/82]<ref name="ref1" /></li>

<li style="font-weight:bold">Doshaghna basti</li>

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<ol type="a"><li style="font-weight:bold">Vataghna basti In diseases having the aggravation vata dosha, the basti processed with the decoction prepared out of drugs having the property to pacify vata (vataghna aushadha). Trividha sneha (combination of three snehas viz ghee, plant oil and muscle fat.), amla dravyas (drugs having sour taste) and saindhava (rock salt) is used. [Su.Sa. Chikitsa Sthana 38/77]<ref name="ref3" /></li>

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<ol type="a"><li style="font-weight:bold">Vataghna basti In diseases having the aggravation [[Vata dosha|vata dosha]], the basti processed with the decoction prepared out of drugs having the property to pacify [[Vata dosha|vata]] (vataghna aushadha). Trividha sneha (combination of three snehas viz ghee, plant oil and muscle fat.), amla dravyas (drugs having sour taste) and saindhava (rock salt) is used. [Su.Sa. Chikitsa Sthana 38/77]<ref name="ref3" /></li>

<li style="font-weight:bold">Pittaghna basti In diseases associated with pitta dosha, basti (therapeutic enema) processed with the decoction of nyagrodhadi gana combined with kakolyadi gana as kalka (paste) along with ghee and sugar is advised. [Su.Sa. Chikitsa Sthana 38/78]<ref name="ref3" /></li>

<li style="font-weight:bold">Kaphaghna basti In diseases having an association of kapha dosha, basti (therapeutic enema) processed with the decoction of aragvadhadi gana combined with pippalyadi gana as kalka (medicinal paste) along with honey, cow’s urine (gomutra) is to be used. [Su.Sa. Chikitsa Sthana 38/79]<ref name="ref3" /></li>

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== Importance in the management of diseases ==

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<ul style="text-align:justify;"><li>Basti (therapeutic enema) therapy (asthapana and anuvasana) is the most important among the therapies for treating vata dosha disorders. It enters the intestine (pakvashaya) after the administration cuts the root of aggravation of vata and thereby it pacifies vata all over the body. Its effect is like cutting the root of a tree (disease) will destroy the whole tree (disease). [Cha.Sa. Sutra Sthana 20/13]<ref name="ref1" /></li>

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<ul style="text-align:justify;"><li>Basti (therapeutic enema) therapy (asthapana and anuvasana) is the most important among the therapies for treating [[Vata dosha|vata dosha]] disorders. It enters the intestine (pakvashaya) after the administration cuts the root of aggravation of [[Vata dosha|vata]] and thereby it pacifies [[Vata dosha|vata]] all over the [[Sharira|body]]. Its effect is like cutting the root of a tree (disease) will destroy the whole tree (disease). [Cha.Sa. Sutra Sthana 20/13]<ref name="ref1" /></li>

<li>Basti (therapeutic enema), in general, is helpful in the prevention of aging, and it produces health, strength, proper digestion, intelligence, voice, and complexion.</li>

<li>It is recommended for both children and old age as it effectively cures diseases without causing complications.</li>

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<li>It removes the vit (stool), shleshma, pitta and vata dosha from the body.</li>

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<li>It removes the vit (stool), shleshma, pitta and [[Vata dosha|vata dosha]] from the [[Sharira|body]].</li>

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<li>It provides compactness to the body and strength to shukra dhatu (the 6th basic structural element of the body).</li>

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<li>It provides compactness to the [[Sharira|body]] and strength to shukra dhatu (the 6th basic structural element of the [[Sharira|body]]).</li>

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<li>It removes doshas from the body’s channels and thus pacifies all diseases. [Cha.Sa. Siddhi Sthana 1/27]<ref name="ref1" /></li>

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<li>It removes [[Dosha|doshas]] from the [[Sharira|body’s]] channels and thus pacifies all diseases. [Cha.Sa. Siddhi Sthana 1/27]<ref name="ref1" /></li>

<li>Administration of niruha basti (therapeutic decoction enema) before anuvasana basti (therapeutic unctuous enema) clears the channels.. It helps properly transport unctuous substance (sneha) like the pipe which carries water when the impurities causing obstruction are removed. [Su.Sa. Chikitsa Sthana 38/84]<ref name="ref3" /></li>

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<li>Basti (asthapana and anuvasana) is important as it is the prime treatment for vata. Vata is the reason for the diseases originating in peripheral tissues (shakha), visceral organs (koshtha), vital points of the body (marma), upper part of the body (urdhva), entire body (sarvavayava) and individual parts of the body (anga). The same vata is responsible for separating and combining stool, urine, pitta, etc. at their sites. As basti is supreme in managing vata, it is said to be half of the entire therapeutics. [Cha.Sa. Siddhi Sthana 1/38-40]<ref name="ref1" /></li></ul>

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<li>Basti (asthapana and anuvasana) is important as it is the prime treatment for [[Vata dosha|vata]]. [[Vata dosha|Vata]] is the reason for the diseases originating in peripheral tissues (shakha), visceral organs (koshtha), vital points of the body (marma), upper part of the body (urdhva), entire body (sarvavayava) and individual parts of the body (anga). The same [[Vata dosha|vata]] is responsible for separating and combining stool, urine, pitta, etc. at their sites. As basti is supreme in managing [[Vata dosha|vata]], it is said to be half of the entire therapeutics. [Cha.Sa. Siddhi Sthana 1/38-40]<ref name="ref1" /></li></ul>

== Indications of asthapana basti ==

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<ul style="text-align:justify;"><li>Sarvanga roga – The diseases are affecting the whole body.</li>

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<ul style="text-align:justify;"><li>Sarvanga roga – The diseases are affecting the whole [[Sharira|body]].</li>

<li>Ekanga roga – The diseases are affecting the organs. </li>

<li>Kukshiroga – Diseases affecting the abdomen and pelvis</li>

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<li>Balavarnamamsaretaskshaya – depletion of strength, complexion, muscle, and sperms</li>

<li>Atisara – Diarrhea without the involvement of metabolic dysfunction (ama)</li>

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<li>Udavarta - Upward movement of vata due to retention of stool and urine</li>

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<li>Udavarta - Upward movement of [[Vata dosha|vata]] due to retention of stool and urine</li>

<li>Parvabheda – Pain in joints</li>

<li>Pleeha - Splenomegaly</li>

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<li>Sphikjanujangha shula – Pain on flanks, knee, and calf</li>

<li>Akshepaka - convulsions</li>

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<li>Gourava – Heaviness of body</li>

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<li>Gourava – Heaviness of [[Sharira|body]]</li>

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<li>Ati laghava – Excessive lightness of body</li>

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<li>Ati laghava – Excessive lightness of [[Sharira|body]]</li>

<li>Uru gulpha parshnishula – Pain over thigh, ankle, and heel</li>

<li>Rajakshaya – loss of menstrual blood with burning</li>

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<li>Ashmari – Renal calculi</li>

<li>Khuda – A disesase which is affecting the skin and muscle over the joints of legs and hands first and later spreads to deeper sites</li>

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<li>Vatavyadhi – Diseases originates from vitiated vata</li>

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<li>Vatavyadhi – Diseases originates from vitiated [[Vata dosha|vata]]</li>

<li>Alpalpodhana – Voidance of stool frequently in less quantity</li>

<li>Sashabdodhana – Voidance of stool with sound</li>

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<li>Decoction (kashaya): 384 ml (4 prasruta) to 480 ml (5 prasruta) *[Su.Sa. Chikitsa Sthana 38/37-39]<ref name="ref3" /></li>

<li>Additives (avapadravya): 192 ml (2 prasruta) [Cha.Sa.Siddhi Sthana 3/30]<ref name="ref1" /></li></ol>

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The proportion of sneha (unctuous substance) and honey is based on dosha association.

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The proportion of sneha (unctuous substance) and honey is based on [[Dosha|dosha]] association.

{| class="wikitable"

|+ '''Table 1. Ingredients’ proportion in basti formulation based on dosha association'''

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<li style="font-weight: bold;">Post therapeutic procedure (paschat karma)</li>

<ul><li>After the proper elimination of enema, the patient should have undergone bath with lukewarm water and take boiled rice with thin meat soup.</li>

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<li>The patient should be given anuvasana basti (therapeutic unctuous enema) with the oil (taila) having 1/4th quantity of that of asthapana (therapeutic decoction enema) processed with drugs having the property to pacify vata and having sour taste, for the nourishment of the body after the digestion of the above-mentioned diet in the evening.

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<li>The patient should be given anuvasana basti (therapeutic unctuous enema) with the oil (taila) having 1/4th quantity of that of asthapana (therapeutic decoction enema) processed with drugs having the property to pacify [[Vata dosha|vata]] and having sour taste, for the nourishment of the [[Sharira|body]] after the digestion of the above-mentioned diet in the evening.

[Cha.Sa. Siddhi Sthana 3/27-30]<ref name="ref1"/></li></ul></ol>

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!'''Diet'''

|-

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|Vata

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|[[Vata dosha|Vata]]

|meat soup (mamsarasa)

|-

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!'''number'''

|-

−

|Vata

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|[[Vata dosha|Vata]]

|Meat soup (mamsa rasa)

|Unctuous (snigdha), Hot in potency (ushna)

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<li>Hikka - hiccups</li>

<li>Hrudprapti – reaching cardiac region</li>

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<li>Urdhvavata – upward dislocation of vata</li>

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<li>Urdhvavata – upward dislocation of [[Vata dosha|vata]]</li>

<li>Pravahika - dysentery</li>

<li>Shiro arti – headache</li>

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* having less quantity of salt, unctuous substance fluid part (drava dravya)

* thick in nature

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* In patients having heaviness due to chronic constipation, vata dominance and dry koshtha (Viscera).

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* In patients having heaviness due to chronic constipation, [[Vata dosha|vata]] dominance and dry koshtha (Viscera).

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* Increased abdominal heaviness,

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|Adhmana

|

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* Administration of enema having less potency in patients having great aggravation of doshas, dryness and constipation

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* Administration of enema having less potency in patients having great aggravation of [[Dosha|doshas]], dryness and constipation

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* Abdominal distension

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* The medications of hiccup and drugs having nourishment property

* Therapeutic unctuous enema with balasthiradi thaila

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* Intake of black salt (krishna lavana) with hot water medicated smoking, linctus, milk, sudations, and food processed with vata pacifying drugs

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* Intake of black salt (krishna lavana) with hot water medicated smoking, linctus, milk, sudations, and food processed with [[Vata dosha|vata]] pacifying drugs

|-

|Hrudprapti

|

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* Administration of enema which is having extremely high potency or by pushing the vata to the rectum by its complete drainage

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* Administration of enema which is having extremely high potency or by pushing the [[Vata dosha|vata]] to the rectum by its complete drainage

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* Shaking the heart

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* Kasadi basti

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* Therapeutic unctuous enema processed with drugs pacifying vata

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* Therapeutic unctuous enema processed with drugs pacifying [[Vata dosha|vata]]

|-

|Urdhvata

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|Pravahika

|

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* Administration of soft potency drug or less quantity drug in greatly aggravated doshas.

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* Administration of soft potency drug or less quantity drug in greatly aggravated [[Dosha|doshas]].

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* Dysentery

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|Shiro arti

|

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* Enema having soft potency and less quantity in weak, constipated, and severely aggravated dosha.

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* Enema having soft potency and less quantity in weak, constipated, and severely aggravated [[Dosha|dosha]].

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* Deafness

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* Administering enema which has the properties like heaviness and sharp potency in more than required quantity in patients who haven’t undergone snehana and swedana (sudation therapy)

|

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* Pain all over the body resembling wrapping, pricking, breaking, and quivering.

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* Pain all over the [[Sharira|body]] resembling wrapping, pricking, breaking, and quivering.

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* Massage with sesame oil (taila) processed with salt.

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|Parikartika

|

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* Administering dry, sharp potent and excess quantity of enema in delicate bowels and minimally increased doshas

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* Administering dry, sharp potent and excess quantity of enema in delicate bowels and minimally increased [[Dosha|doshas]]

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* Sharp cutting pain in anus

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== Contemporary approach ==

The oral route is considered as the most convenient route for drug administration. However, oral medications are not possible in some clinical and pharmaceutical perspective in several circumstances. Rectal route may be used as a clinical alternative in these circumstances which yields both systemic and local actions. The hepatic first-pass metabolism effect can be reduced by rectal administration by partially bypassing the liver following systemic absorption. Rectal formulations are mainly used in the systemic conditions such as pain, fever, nausea, vomiting, migraines, allergies, and sedation.<ref name="ref7">Susan Hua. Physiological and Pharmaceutical Considerations for Rectal Drug Formulations. Front Pharmacol. 2019; 10: 1196. doi: 10.3389/fphar.2019.01196. PMCID: PMC6805701, PMID: 31680970.</ref>

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Boofing or rectal administration medication and other fluids are administered through rectum. There they are absorbed by capillaries of rectum and thus enter the circulatory system and distribute them to whole body.<ref name="ref8">www.en.wikipedia.org.Rectal administration. [Internet].2023 [cited 2023 July 31]. Available from https://en.wikipedia.org/wiki/Rectal_administration#:~:text=Rectal%20administration%2C%20colloquially%20known%20as,body's%20organs%20and%20bodily%20systems.</ref> One of the studies also showed that basti medicine reaches up to ileo-caecal junction.<ref name="ref9">Juneja Yashwant M, Thakar A. B. Standardization of procedure of administration of Basti w.s.r to Kshinashukra (oligozoospermia), MD Dissertation, IPGT& RA. Jamnagar: Gujarat Ayurved University; 2010</ref>

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Boofing or rectal administration medication and other fluids are administered through rectum. There they are absorbed by capillaries of rectum and thus enter the circulatory system and distribute them to whole [[Sharira|body]].<ref name="ref8">www.en.wikipedia.org.Rectal administration. [Internet].2023 [cited 2023 July 31]. Available from https://en.wikipedia.org/wiki/Rectal_administration#:~:text=Rectal%20administration%2C%20colloquially%20known%20as,body's%20organs%20and%20bodily%20systems.</ref> One of the studies also showed that basti medicine reaches up to ileo-caecal junction.<ref name="ref9">Juneja Yashwant M, Thakar A. B. Standardization of procedure of administration of Basti w.s.r to Kshinashukra (oligozoospermia), MD Dissertation, IPGT& RA. Jamnagar: Gujarat Ayurved University; 2010</ref>

As compared with oral administration, rectal administration is faster in action and higher in bioavailability. Vomiting can be prevented by rectal administration thus it prevents the loss of drug. The two third of rectum’s venous drainage is in the middle and inferior rectal vein which drains directly to systemic circulation and only one third of it goes to the hepatic portal system. Thus, two third of rectal administered drug bypasses the metabolic phase. It can be administered at home which doesn’t require inpatient setup as in intravenous administration. Many of the oral drugs can be modified for rectal administration by crushing and suspending them in water.

There are many digestive tract problems where the rectal route can be selected for drug administration such as bowel obstruction, dysphagia etc. In palliative care and long-term care, it is the cheap and safe alternative to intravenous or subcutaneous delivery of medications.<ref name="ref10">www.en.wikipedia.org.Rectal administration.[Internet] 2023 [cited 2023 July 31].Available from https://en.wikipedia.org/wiki/Rectal_administration#:~:text=Rectal%20administration%2C%20colloquially%20known%20as,body's%20organs%20and%20bodily%20systems.</ref>

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<li>Castile soap – It causes irritation of colon’s lining and increases the urgency to defecate.</li>

<li>Glycerol – It is a bowel mucosa irritant which induces peristalsis via hyperosmotic effect.</li>

−

<li>Equal parts of milk and molasses – They are heated together slightly above the body temperature. It can retain the water portion of enema in the intestine.</li>

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<li>Equal parts of milk and molasses – They are heated together slightly above the [[Sharira|body]] temperature. It can retain the water portion of enema in the intestine.</li>

<li>Mineral oils – These can act as lubricants and stool softener.<ref name="ref11">www.en.wikipedia.org.Enema.[Internet] 2023 .[Internet] 2023 [cited 2023 July 31].Available from https://en.wikipedia.org/wiki/Enema#Large_volume_enemas</ref></li></ul>

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<li>Kala basti has shown better improvement in amavata (rheumatoid arthritis) when compared with virechana.<ref name="ref18">Gohil Jalpa H (2009): A comparative clinical study of Virechana karma and kala basti in management of Amavata. Department of Panchakarma, IPGT&RA Jamnagar</ref></li>

<li>Administration of Erandamuladi yapana basti in comparison with Erandabija ksheera paka in patients of katigraha have shown better improvement in signs and symptoms of basti group.<ref name="ref19"/>Damayanthie Fernando (2011): Assessment of Clinical Efficacy of ErandamuladiYapana Basti and ErandaBijaKshiraPaka in the management of Kati Graha w.s.r. to Lumbar Spondylosis. Department of Panchakarma, IPGT&RA Jamnagar</li>

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<li>Clinically in patients treated with lekhana basti there was a decrease in s. cholesterol, s.low density lipoprotein and s. apolipoprotein B. There was a significant reduction in BMI, weight, body fat storage etc. It was effective to a lesser extent on lipid profile than triphala guggulu.<ref name="ref20">Shital G Bhagiya (2015): A Comparative Clinical Study of Lekhana Basti and Shamana Sneha (Triphaladi Taila) In the Management of Sthaulya W.S.R. To Obesity.Department Of panchakarma, GAAC, Ahmedabad.</ref></li>

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<li>Clinically in patients treated with lekhana basti there was a decrease in s. cholesterol, s.low density lipoprotein and s. apolipoprotein B. There was a significant reduction in BMI, weight, [[Sharira|body]] fat storage etc. It was effective to a lesser extent on lipid profile than triphala guggulu.<ref name="ref20">Shital G Bhagiya (2015): A Comparative Clinical Study of Lekhana Basti and Shamana Sneha (Triphaladi Taila) In the Management of Sthaulya W.S.R. To Obesity.Department Of panchakarma, GAAC, Ahmedabad.</ref></li>

<li>A comparative study between the effect of rectal administration and oral administration of the same group of drugs (guduchi bhadramustadi) have proved the higher efficacy of rectal administration for the management of sthoulya.<ref name="ref21">Hemal Kumar V Dodiya (2013): A comparative clinical study on the effect of Guduchi-Bhadramustadi yoga administered orally and by basti in the management of sthaulya w.s.r to obesity. Department of Panchakarma, IPGT&RA Jamnagar</ref></li>

<li>In a comparative study,vaitararana basti has shown marked improvement in 45% of patients of ghridrasi. Whereas siravyadha has shown marked improvement in 55% of patients. Vaitarana basti was found more effective than siravedha in stambha (stiffness), spandana (twitching), suptata (numbness), sakthikshephanigraha (SLR) and gaurava(heaviness).<ref name="ref22">Paikrao Sumedh Narayanrao (2014): A clinical study on siravedha and vaitarana basti in the management of gridhrasi with special reference to sciatica. Department of Panchakarma, IPGT&RA Jamnagar</ref></li>

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