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==([[Siddhi Sthana]] Chapter 4, Chapter on Management of complications of unctuous enema therapy)==

==[[Siddhi Sthana]] Chapter 4, Snehavyapat Siddhi (Chapter on Management of complications of unctuous enema therapy)==

=== Abstract ===

=== Abstract ===

iti ha smAha bhagavAnAtreyaH||2||  

iti ha smAha bhagavAnAtreyaH||2||  

Now onwards we will describe chapter [[Snehavyapat Siddhi]] (chapter on complications of Unctuous enema and their successful management). [1]

Now onwards we will describe chapter [[Snehavyapat Siddhi]] (chapter on complications of Unctuous enema and their successful management).  

 

Thus said Lord Atreya. [1-2]

Thus said Lord Atreya. [2]

==== Various formulations ====

==== Various formulations ====

=== ''Vidhi Vimarsha'' ===

=== ''Vidhi Vimarsha'' ===

==== Effect of ''Snehabasti'': [verse 23-24] ====

==== 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.

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]

==== Impediment by ''vata'': [verse 26-30] ====

==== 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''.

''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'': [verse 31] ====

==== 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.

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'': [verse 32-33] ====

==== 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.

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: [verse 34-35] ====

==== 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.

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: [verse 36-37] ====

==== 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> :

*Anal sphincter spasm leading to a functional obstruction

*Anal sphincter spasm leading to a functional obstruction

*Dysfunctional innervations of colonic, anal sphincter, or pelvic floor muscles. These abnormalities can lead to lack of synchronization among the colon, anal sphincter, and pelvic floor.

*Dysfunctional innervations of colonic, anal sphincter, or pelvic floor muscles. These abnormalities can lead to lack of synchronization among the colon, anal sphincter, and pelvic floor.

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.

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: [verse 38-40] ====

==== 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>.

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: [verse 43-45] ====

==== 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>

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'': [verse 46-47] ====

==== 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''.

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]

==== Advice regarding ''basti'' administration: [verse 48-49] ====

==== 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. 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. 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.

*''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]

==== ''Matra basti'': [verse 52-54] ====

==== ''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( 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):

*2 ''pala'' = 8 ''tola'' = (80ml) = ''uttama matra''

*2 ''pala'' = 8 ''tola'' = (80ml) = ''uttama 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.

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'' ====

==== Practically employed methods regarding schedule of ''snehabasti'' ====