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{{Infobox

{{Infobox

|title = Bastrisutriyam Siddhi

|title = Bastrisutriyam Siddhi

}}

}}

=== Introduction ===

=== Introduction ===

The previous chapter ([[Panchakarmiya Siddhi]]) dealt with the indications and contra-indications of [[Panchakarma]] and its applications. Now one of the content of [[Kalpana Siddhi]], ''basti kalpana'' is elaborated in the present chapter. ''Basti chikitsa'' is regarded as the prime treatment modality within [[Panchakarma]]. It not only has curative action, but also has preventive and promotive actions. Basti therapy is considered as ''chikitsardha'' (half of major treatments) among all therapy and some physicians even recognize it as a complete therapy because ''basti'' has a wide therapeutic area. It not only cures ''vatika'' disorders but also ''samsarga'' and ''sannipata'' condition of ''dosha, kaphaja'' and ''pittaja'' disorder, ''shakhagata'' (diseases of limbs) and ''koshthagata rogas'' (diseases of GIT) by making various permutations and combinations of different types of medicaments. Considering this rationale the third chapter is devoted for ''basti karma'' and given first place in the [[Siddhi Sthana]] among the [[Panchakarma]].  

The previous chapter ([[Panchakarmiya Siddhi]]) dealt with the indications and contra-indications of [[Panchakarma]] and its applications. Now one of the content of [[Kalpana Siddhi]], ''basti kalpana'' is elaborated in the present chapter. ''Basti chikitsa'' is regarded as the prime treatment modality within [[Panchakarma]]. It not only has curative action, but also has preventive and promotive actions. ''Basti'' therapy is considered as ''chikitsardha'' (half of major treatments) among all therapy and some physicians even recognize it as a complete therapy because ''basti'' has a wide therapeutic area. It not only cures ''vatika'' disorders but also ''samsarga'' and ''sannipata'' condition of ''dosha, kaphaja'' and ''pittaja'' disorder, ''shakhagata'' (diseases of limbs) and ''koshthagata rogas'' (diseases of GIT) by making various permutations and combinations of different types of medicaments. Considering this rationale the third chapter is devoted for ''basti karma'' and given first place in the [[Siddhi Sthana]] among the [[Panchakarma]].  

''Basti'' is not merely termed as ‘enema’; rather it is a highly complex, sophisticated, and systemic therapy having a wide range of therapeutic actions and indications. It is considered as prime treatment modality for ''vata dosha''. Contrary to this, enema is simply used for evacuation of colon and in few instances to rehydrate for therapeutic purpose.

''Basti'' is not merely termed as ‘enema’; rather it is a highly complex, sophisticated, and systemic therapy having a wide range of therapeutic actions and indications. It is considered as prime treatment modality for ''vata dosha''. Contrary to this, enema is simply used for evacuation of colon and in few instances to rehydrate for therapeutic purpose.

Thus ends the chapter [[Bastisutriyam Siddhi]]

Thus ends the chapter [[Bastisutriyam Siddhi]]

=== ''Tattva Vimarsha'' ===

=== ''Tattva Vimarsha'' / Fundamental Principles===

*Careful examination of ''dosha'' (vitiating factors), ''aushadha'' (potency of drugs), ''desha'' (place of living and body of patient), ''kala'' (season and time of administration), ''satmya'' (accustom), ''agni'' (factor responsible for process of digestion and metabolism), ''sattva'' (mind), ''oka'' (accustom due to continuous use), ''vaya'' (age) and ''bala'' (strength) is essential for success of ''basti'' therapy (enema). [Verse 6]

*Careful examination of ''dosha'' (vitiating factors), ''aushadha'' (potency of drugs), ''desha'' (place of living and body of patient), ''kala'' (season and time of administration), ''satmya'' (accustom), ''agni'' (factor responsible for process of digestion and metabolism), ''sattva'' (mind), ''oka'' (accustom due to continuous use), ''vaya'' (age) and ''bala'' (strength) is essential for success of ''basti'' therapy (enema). [Verse 6]

*The dose of ''basti'' differs according to age of patient. The minimum dose for patient of one year is half ''prasrita'' (approximately 40 ml) and maximum dose from age 18 years to 70 years is twelve ''prasrita'' (approximately 960 ml).

*The dose of ''basti'' differs according to age of patient. The minimum dose for patient of one year is half ''prasrita'' (approximately 40 ml) and maximum dose from age 18 years to 70 years is twelve ''prasrita'' (approximately 960 ml).

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

=== ''Vidhi Vimarsha'' / Applied Inferences===

==== Factors to be considered before ''basti'' administration  ====

==== Factors to be considered before ''basti'' administration  ====

The mouth of the ''netra'' is plugged with a ''varti'' to prevent foreign matter to enter into it when not in use.

The mouth of the ''netra'' is plugged with a ''varti'' to prevent foreign matter to enter into it when not in use.

One of the ''karnika'' fixed at level of 1/4th ''angula'' from the ''agrabhaga'' (anterior or rectal end) to limit the entry of ''netra'' beyond the ''guda vali''. The other 2 ''karnika'' placed at the ''mula bhaga'' (posterior or ''putaka'' end) will help in tying the ''basti putaka''.<ref>Chakrapanidutta, Commentator.  Charaka samhita, Siddhi Sthana, 3/8-10, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

One of the ''karnika'' fixed at level of 1/4th ''angula'' from the ''agrabhaga'' (anterior or rectal end) to limit the entry of ''netra'' beyond the ''guda vali''. The other 2 ''karnika'' placed at the ''mula bhaga'' (posterior or ''putaka'' end) will help in tying the ''basti putaka''.<ref>Chakrapanidutta, Commentator.  Charak samhita, Siddhi Sthana, 3/8-10, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

''Vriņa basti netra''- 8 ''angula'' & ''mudgavahi srota'' at ''agrabhāga''.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 35/11, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

''Vriņa basti netra''- 8 ''angula'' & ''mudgavahi srota'' at ''agrabhāga''.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 35/11, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

''Shukla paksha'' of a lunar month is auspicious for initiating all good activities. Planning of ''basti'' according to ''paksha'' may not be practical in diseased. It may be ideally adopted in healthy.

''Shukla paksha'' of a lunar month is auspicious for initiating all good activities. Planning of ''basti'' according to ''paksha'' may not be practical in diseased. It may be ideally adopted in healthy.

''Harita'' has described ''krishna paksha'' of lunar month is suitable for the ''basti prayoga'' because, all the diseases treated during this period get cured forever (radical cure) and the Gods appear during the ''shukla paksha'' where as demons as well as diseases appear during the ''krishna paksha''. Therefore, according to Harita, diseases should be treated during ''krishna paksha''.)<ref>Chakrapanidutta, Commentator.  Charaka samhita, Siddhi Sthana, 3/12-13, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref> (Verse 12 -13)

''Harita'' has described ''krishna paksha'' of lunar month is suitable for the ''basti prayoga'' because, all the diseases treated during this period get cured forever (radical cure) and the Gods appear during the ''shukla paksha'' where as demons as well as diseases appear during the ''krishna paksha''. Therefore, according to Harita, diseases should be treated during ''krishna paksha''.)<ref>Chakrapanidutta, Commentator.  Charak samhita, Siddhi Sthana, 3/12-13, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref> (Verse 12 -13)

==== Precautions during administration of enema ====

==== Precautions during administration of enema ====

The ''basti dravya'' should be administered in one squeeze or compress. If there is interruption, and the ''putaka'' is compressed again to push the remaining ''basti dravya'' into rectum, then there is possibility of entry of air into the ''pakvashaya'' which is not desirable.<ref>Chakrapanidutta, Commentator.  Charaka samhita, Siddhi Sthana, 3/13-20, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref> (Verse 13-19)

The ''basti dravya'' should be administered in one squeeze or compress. If there is interruption, and the ''putaka'' is compressed again to push the remaining ''basti dravya'' into rectum, then there is possibility of entry of air into the ''pakvashaya'' which is not desirable.<ref>Chakrapanidutta, Commentator.  Charak samhita, Siddhi Sthana, 3/13-20, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref> (Verse 13-19)

===== ''Kalka'' =====

===== ''Kalka'' =====

|}

|}

This is most commonly used ''kalka'' in the ''niruha'' described by Charaka. Whenever there is no mention of ''kalka dravya'', then it should be used. It is having ''vata-kaphahara, vatanulomana, malanulomana, deepana, pachana, srotoshodhana'' properties.

This is most commonly used ''kalka'' in the ''niruha'' described by Charak. Whenever there is no mention of ''kalka dravya'', then it should be used. It is having ''vata-kaphahara, vatanulomana, malanulomana, deepana, pachana, srotoshodhana'' properties.

According to the condition, ''hinguvachadi, shaddharana, vaishvanara churna'' can also be used.

According to the condition, ''hinguvachadi, shaddharana, vaishvanara churna'' can also be used.

===== Dose of ''kalka'' =====

===== Dose of ''kalka'' =====

*Charaka has not mentioned the dose of ''kalka''

*Charak has not mentioned the dose of ''kalka''

*Sushruta mentions it as one ''prasrita''

*Sushruta mentions it as one ''prasrita''

*According to Vriddha Vagbhata, 1/8th of 12 ''prasrita''=1.5 ''prasrita''  

*According to Vriddha Vagbhata, 1/8th of 12 ''prasrita''=1.5 ''prasrita''  

The patient, before the ''basti pranidana'' (administration), is required to lie down on his left side on a bed which has uniform level or which is low in the head side. These two alternatives are described for the comfort of the patient. This can be explained in a different way also. If the patient has a bulky buttock, then the head side of the cot should be uniform. If he has thin buttock, then the head side of bed should be lowered to facilitate the uniform distribution of ''basti dravya'' in the body.

The patient, before the ''basti pranidana'' (administration), is required to lie down on his left side on a bed which has uniform level or which is low in the head side. These two alternatives are described for the comfort of the patient. This can be explained in a different way also. If the patient has a bulky buttock, then the head side of the cot should be uniform. If he has thin buttock, then the head side of bed should be lowered to facilitate the uniform distribution of ''basti dravya'' in the body.

When the patient lies on his left side, both the grahaņi and guda remain in normal position. ''Basti'' administered in this position gets absorbed properly and distributed easily. In this position, the sphincters remain relaxed. Therefore, the enema fluid enters into rectum easily without any obstruction and impregnates the ''grahani'' to produce the desired therapeutic effect.<ref>Chakrapanidutta, Commentator.  Charaka samhita, Siddhi Sthana, 3/24-25, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

When the patient lies on his left side, both the grahaņi and guda remain in normal position. ''Basti'' administered in this position gets absorbed properly and distributed easily. In this position, the sphincters remain relaxed. Therefore, the enema fluid enters into rectum easily without any obstruction and impregnates the ''grahani'' to produce the desired therapeutic effect.<ref>Chakrapanidutta, Commentator.  Charak samhita, Siddhi Sthana, 3/24-25, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

''Basti'' drug reaches first to the ''pakvashaya'' and then to the ''grahani''. ''Pakvashaya'' is the site of ''pureeshadhara kala'' and ''grahani'' is the site of ''pittadhara kala''. So basti directly acts on ''pureeshadhara kala'' and ''pittadhara kala''.  

''Basti'' drug reaches first to the ''pakvashaya'' and then to the ''grahani''. ''Pakvashaya'' is the site of ''pureeshadhara kala'' and ''grahani'' is the site of ''pittadhara kala''. So basti directly acts on ''pureeshadhara kala'' and ''pittadhara kala''.  

''Basti'' is given to eliminate the aggravated ''vata'' from ''pakvashaya''. But as specific effect, this ''basti'' is also capable of eliminating the aggravated ''dosha'' even from the locations of ''pitta'' and ''kapha''. Thus, in general ''basti'' eliminates the ''vata'' from ''pakvashaya''. But by the application of special methods, this ''basti'' becomes capable of eliminating the ''dosha'' from other parts.

''Basti'' is given to eliminate the aggravated ''vata'' from ''pakvashaya''. But as specific effect, this ''basti'' is also capable of eliminating the aggravated ''dosha'' even from the locations of ''pitta'' and ''kapha''. Thus, in general ''basti'' eliminates the ''vata'' from ''pakvashaya''. But by the application of special methods, this ''basti'' becomes capable of eliminating the ''dosha'' from other parts.

''Basti'' is, no doubt, not the most effective therapy for aggravated ''pitta'' and ''kapha''. But it is very effective only when these two ''dosha'' are associated with aggravated ''vata''.<ref>Chakrapanidutta, Commentator.  Charaka samhita, Siddhi Sthana, 3/26, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

''Basti'' is, no doubt, not the most effective therapy for aggravated ''pitta'' and ''kapha''. But it is very effective only when these two ''dosha'' are associated with aggravated ''vata''.<ref>Chakrapanidutta, Commentator.  Charak samhita, Siddhi Sthana, 3/26, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

==== Diet ====

==== Diet ====

The patient is instructed to take the thin meat soup etc. after ''niruha basti'' to protect his ''agni'' which is slightly reduced due to therapy. ''Peyadi krama'' is not necessary after ''niruha''.  

The patient is instructed to take the thin meat soup etc. after ''niruha basti'' to protect his ''agni'' which is slightly reduced due to therapy. ''Peyadi krama'' is not necessary after ''niruha''.  

   

   

''Niruha basti'' does not cause ''agnimandya, bala kshaya, prana kshaya'' like ''virechana'', so ''peyadi krama'' is not needed. Bhoja stated that the ''virechana'' causes ''agnimandya'' by ''adhisthana samplavat'' whereas ''basti'' does not decrease the ''agni'' instead kindles it.<ref>Chakrapanidutta, Commentator.  Charaka samhita, Siddhi Sthana, 1/20-21, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

''Niruha basti'' does not cause ''agnimandya, bala kshaya, prana kshaya'' like ''virechana'', so ''peyadi krama'' is not needed. Bhoja stated that the ''virechana'' causes ''agnimandya'' by ''adhisthana samplavat'' whereas ''basti'' does not decrease the ''agni'' instead kindles it.<ref>Chakrapanidutta, Commentator.  Charak samhita, Siddhi Sthana, 1/20-21, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

==== Ratio of combination ====

==== Ratio of combination ====

In the exact quantity of these ingredients are told as follows - ''saindhava''-1 ''tola'', ''madhu''-2 ''prasrita'', ''sneha''-3 ''prasrita'', ''kalka''-1 ''prasrita'', kashaya-4 ''prasrita'' and ''avapa''-2 ''prasrita''. Thus, the total quantity becomes 12 ''prasrita'' ½ which is rounded to 12 prasruta. This kalpanā is meant for vāta  roga.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/37-39, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

In the exact quantity of these ingredients are told as follows - ''saindhava''-1 ''tola'', ''madhu''-2 ''prasrita'', ''sneha''-3 ''prasrita'', ''kalka''-1 ''prasrita'', kashaya-4 ''prasrita'' and ''avapa''-2 ''prasrita''. Thus, the total quantity becomes 12 ''prasrita'' ½ which is rounded to 12 prasruta. This kalpanā is meant for vāta  roga.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/37-39, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

Charaka recommended five ''prasrita'' of ''kashaya'' to be added. Sushruta recommended four ''prasrita''.This change in the quantity of ''kashaya'' is not acceptable.<ref>Chakrapanidutta, Commentator.  Charaka samhita, Siddhi Sthana, 30/31, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

Charak recommended five ''prasrita'' of ''kashaya'' to be added. Sushruta recommended four ''prasrita''.This change in the quantity of ''kashaya'' is not acceptable.<ref>Chakrapanidutta, Commentator.  Charak samhita, Siddhi Sthana, 30/31, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

''Basti kalpana'' according to ''dosha'':<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/29-32, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

''Basti kalpana'' according to ''dosha'':<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/29-32, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

{|class = "wikitable"

{|class = "wikitable"

|-

|-

!scope = "col"|Kalpanā

!scope = "col"|''Kalpana''

!scope = "col"|Qty in Pala for Vāta

!scope = "col"|Qty in ''Pala'' for ''Vata''

!scope = "col"|Qty in Pala for Pitta

!scope = "col"|Qty in ''Pala'' for ''Pitta''

!scope = "col"|Qty in Pala for Kapha

!scope = "col"|Qty in ''Pala'' for ''Kapha''

|-

|-

|Madhu

|''Madhu''

|3

|3

|4

|4

|6

|6

|-

|-

|Sneha

|''Sneha''

|6

|6

|4

|4

|3

|3

|-

|-

|Kalka

|''Kalka''

|2

|2

|2

|2

|2

|2

|-

|-

|Kashāya

|''Kashaya''

|10

|10

|10

|10

|10

|10

|-

|-

|Āvāpa

|''Avapa''

|3

|3

|4

|4

After ''anuvasana, yusha, ksheera'' and ''mamsa rasa, yusha, ksheera'' and ''mamsa rasa'' should be given along with ''anna'' in ''kapha, pitta'' and ''vata'' respectively. ''Peya'' should not be given as it causes ''abhishyandana'' of ''koshtha'' because of ''sneha'' in ''koshtha''.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 37/57, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

After ''anuvasana, yusha, ksheera'' and ''mamsa rasa, yusha, ksheera'' and ''mamsa rasa'' should be given along with ''anna'' in ''kapha, pitta'' and ''vata'' respectively. ''Peya'' should not be given as it causes ''abhishyandana'' of ''koshtha'' because of ''sneha'' in ''koshtha''.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 37/57, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

==== Dvipanchalamudi basti ====

==== ''Dvipanchalamudi basti'' ====

This ''basti'' is also highlighted in Ashtanga Hridaya which is detailed below for a practical understanding.

This ''basti'' is also highlighted in Ashtanga Hridaya which is detailed below for a practical understanding.

Dvipanchalamudi (A.H.Ka.4/4):

''Dvipanchalamudi'' (A.H.Ka.4/4):

Dravya Dose (classics) Practicing Dose  

 

Madhu 2 Prasruta 200ml

Saindhava 1 Karsha 12gm

Sneha-trisneha(sukumāra ghrita +sahacarādi taila + vasā) 4 Prasruta 150ml+150ml

!scope = "col"|''Dravya''

Kalka- putoyavānādi* 1 Prasruta 30gm

!scope = "col"|Dose (classics)

Kvātha dravya-laghupancamūla, bruhatpancamūla 5 Prasruta 400ml

!scope = "col"|Practicing Dose  

Āvāpa dravya-amla rasa, ajamāmsa 1 Pala 50gm  

Guņa- Sarva vātavyādhihara

|''Madhu''

|2 ''Prasrita''

|200ml

|''Saindhava''

|1 ''Karsha''

|12gm

|''Sneha-trisneha''(''sukumara ghrita +sahacharadi taila + vasa'')

|4 ''Prasrita''

|150ml+150ml

|''Kalka- putoyavanadi''*

|1 ''Prasrita''

|30gm

|''Kvatha dravya-laghupanchamula, brihatpanchamula''

|5 ''Prasrita''

|400ml

|''Avapa dravya-amla rasa, ajamamsa''

|1 ''Pala''

|50gm  

 

''Guņa- Sarva vātavyādhihara''

==== ''Niruha basti'' ====

==== ''Niruha basti'' ====

''Vaidya'' Kasture referring to the Sushruta’s view told that, one should not administer more than four ''basti'' in a day; otherwise it causes ''pakvashaya kshobha'' (irritation of colon).   

''Vaidya'' Kasture referring to the Sushruta’s view told that, one should not administer more than four ''basti'' in a day; otherwise it causes ''pakvashaya kshobha'' (irritation of colon).   

   

   

So the above discussion may be concluded that the second, third or fourth ''basti'' can be given after assessing the ''doshadi'' factors<ref>Charaka, Charaka samhita, Siddhi Sthana, 3/6, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref> in following conditions-

So the above discussion may be concluded that the second, third or fourth ''basti'' can be given after assessing the ''doshadi'' factors<ref>Charak, Charak samhita, Siddhi Sthana, 3/6, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref> in following conditions-

*After the self returning of first ''basti'' without any stimulation.

*After the self returning of first ''basti'' without any stimulation.

*If ''sunirudha lakshana'' are not observed  

*If ''sunirudha lakshana'' are not observed