Changes

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

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

==== Verse 6 ====

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

Ten fold examination is advised before the administration of ''basti''. These examinations are slightly different from the ''dashavisha pariksha'' explained in the [[Vimana Sthana]].  

Ten fold examination is advised before the administration of ''basti''. These examinations are slightly different from the ''dashavisha pariksha'' explained in the [[Vimana Sthana]].  

''Basti'' should be administered after considering ''kala'' (''teekshna'' in ''sheeta kala, mridu'' in ''ushna kala''), ''bala, dosha'' (''teekshnadi basti'' in ''uttamadi bala'' of ''dosha''), ''roga'' (''teekshna, madhyama, mridu basti'' in ''uttamadi bala'' of ''dosha'', ''teekshna'' in ''kapha vata, mridu'' in ''raktapitta'', and ''madhyama'' in ''kaphapitta'')<ref>Dalhana,  Commentator. Sushruta Samhita, Chikitsa Samhita, 38/71, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

''Basti'' should be administered after considering ''kala'' (''teekshna'' in ''sheeta kala, mridu'' in ''ushna kala''), ''bala, dosha'' (''teekshnadi basti'' in ''uttamadi bala'' of ''dosha''), ''roga'' (''teekshna, madhyama, mridu basti'' in ''uttamadi bala'' of ''dosha'', ''teekshna'' in ''kapha vata, mridu'' in ''raktapitta'', and ''madhyama'' in ''kaphapitta'')<ref>Dalhana,  Commentator. Sushruta Samhita, Chikitsa Samhita, 38/71, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref> (Verse 6)

==== Verse 7-9 ====

==== Age wise differentiation ====

While describing the age of the patient as 6, 20 and 12, the sequence changed to emphasize the fact that before 6th year and after 20th year of age there should be no variation in the size of ''netra'' (nozzle). After the 6th year, the size of the ''netra'' should be increased 1/3rd ''angula'' every year. Thus for the 12th year of age, the size of the ''netra'' becomes 8 ''angula''. After 12th year of age, the size should be increased ½ ''angula'' every year. Thus for a patient of 20 year age the size of ''netra'' becomes 12 ''angula''.

While describing the age of the patient as 6, 20 and 12, the sequence changed to emphasize the fact that before 6th year and after 20th year of age there should be no variation in the size of ''netra'' (nozzle). After the 6th year, the size of the ''netra'' should be increased 1/3rd ''angula'' every year. Thus for the 12th year of age, the size of the ''netra'' becomes 8 ''angula''. After 12th year of age, the size should be increased ½ ''angula'' every year. Thus for a patient of 20 year age the size of ''netra'' becomes 12 ''angula''.

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>

'''Table showing measurements of Basti Netra<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 35/7-11, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>'''

'''Table showing measurements of Basti Netra<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 35/7-11, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>''' (Verse 7-9)

==== Verse 10-11 ====

==== ''basti yantra'' (instrument used for administration of enema) ====

In present practice enema can or pot are used for administering the ''niruha basti'' as it is having following advantages over the classical ''basti yantra''.

In present practice enema can or pot are used for administering the ''niruha basti'' as it is having following advantages over the classical ''basti yantra''.

*Easy & simple to administer

*Easy & simple to administer

*Sterile and disposable and hence no chances of infection

*Sterile and disposable and hence no chances of infection

In olden days due to non availability of rubber, the use of metallic nozzle as ''basti netra'' was seen. Texts have have given freedom for the changes if better options are available. Some conservative Ayurvedic practitioners believe that ''basti'' given by ''basti netra'' provides better result than the methods that are used in current practice. Vaidya H.S.Kasture has disapproved this fact by saying that among the 17 lakh ''basti'' given using the enema pot and enema catheter by him (till 2005) he has observed same efficacy as that of classical ''basti yantra'' except for a very few complications due to the enema pot and catheter (lecture given at national seminar held in 2005 at Jamnagar). In a research work carried out by Juneja.Y et.al. (Jamnagar, 2008)<ref>Juneja.Y et.al. Standardization of procedure  of administration of Basti w.s.r. to Kshinashukra (oligozoospermia), Gujrat Ayured University, Jamnagar, 2008</ref> have concluded work that ''basti'' administered by classical ''yantra'' and enema pot - rubber catheter provided same effect. Considering all these it can be concluded that the use of enema pot and catheter is simple, economical, safe, and free from complications.

In olden days due to non availability of rubber, the use of metallic nozzle as ''basti netra'' was seen. Texts have have given freedom for the changes if better options are available. Some conservative Ayurvedic practitioners believe that ''basti'' given by ''basti netra'' provides better result than the methods that are used in current practice. Vaidya H.S.Kasture has disapproved this fact by saying that among the 17 lakh ''basti'' given using the enema pot and enema catheter by him (till 2005) he has observed same efficacy as that of classical ''basti yantra'' except for a very few complications due to the enema pot and catheter (lecture given at national seminar held in 2005 at Jamnagar). In a research work carried out by Juneja.Y et.al. (Jamnagar, 2008)<ref>Juneja.Y et.al. Standardization of procedure  of administration of Basti w.s.r. to Kshinashukra (oligozoospermia), Gujrat Ayured University, Jamnagar, 2008</ref> have concluded work that ''basti'' administered by classical ''yantra'' and enema pot - rubber catheter provided same effect. Considering all these it can be concluded that the use of enema pot and catheter is simple, economical, safe, and free from complications.(verse 10-11)

==== Verse 12 -13 ====

==== Time of administration ====

''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>

''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)

==== Verse 13-19 ====

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

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 ''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.  Charaka samhita, Siddhi Sthana, 3/13-20, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

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

Putoyavānyādi kalka:

Putoyavānyādi kalka:

Name of drug Botanical Name Parts used

Name of drug Botanical Name Parts used

*Prevents ''ayoga'' (insufficient action), ''adhmana'' (flatulence) etc. ''upadrava''

*Prevents ''ayoga'' (insufficient action), ''adhmana'' (flatulence) etc. ''upadrava''

==== Verse 24 ====

==== Rationale for mixing sequence of ''basti'' ====

 

Rationale for mixing sequence of ''basti'':

*''Madhu''- ''mangalakaraka'' auspicious  

*''Madhu''- ''mangalakaraka'' auspicious  

*Mūtra- increases the action & potency basti.<ref>Kashyapa, Kashyapa Samhita, Siddhisthana, chapter 1, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

*Mūtra- increases the action & potency basti.<ref>Kashyapa, Kashyapa Samhita, Siddhisthana, chapter 1, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

==== Verse 24-25 ====

==== Suitable position for administration ====

 

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 grahaņi 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 grahaņi 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>

It is thought that an enema introduced would never ascend so high as the stomach. There is a referance from the Best and Taylor that “materials introduced by enema, in some instances pass through the walls into the ilium, such incompetence may permit the enema fluid to reach the duodenum.” Also the possibility of materials from even the lower bowel, reaching the mouth is strongly suggested by the fact that lycopodium sporce, introduced into the colon by enema, has been recovered some hours later from washing of the stomach.<ref>Best and Taylor, Physiological Basis of Medicine</ref>

It is thought that an enema introduced would never ascend so high as the stomach. There is a referance from the Best and Taylor that “materials introduced by enema, in some instances pass through the walls into the ilium, such incompetence may permit the enema fluid to reach the duodenum.” Also the possibility of materials from even the lower bowel, reaching the mouth is strongly suggested by the fact that lycopodium sporce, introduced into the colon by enema, has been recovered some hours later from washing of the stomach.<ref>Best and Taylor, Physiological Basis of Medicine</ref>

==== Verse 26 ====

==== ''Dosha'' specific dose ====

For ''vata prakopa'', one ''basti'', for ''pitta prakopa'' one ''basti'' and for ''kapha prakopa'' one ''basti'' should be given. It is not that three ''basti prayoga'' for ''tridosha prakopa'', the first ''basti'' eliminates the ''vata'', second ''pitta'' and third, ''kapha''. The author himself will explain the need of giving one ''basti'' for ''vayu,'' two for ''pitta'' and three for ''kapha'' in verse no. 69. Thus, the one ''basti'' eliminates the aggravated ''vata'' from its location, two of them (given on after the other) eliminate the ''pitta'' from its location and three of them (given on after the other) eliminate ''kapha'' from its location.

For ''vata prakopa'', one ''basti'', for ''pitta prakopa'' one ''basti'' and for ''kapha prakopa'' one ''basti'' should be given. It is not that three ''basti prayoga'' for ''tridosha prakopa'', the first ''basti'' eliminates the ''vata'', second ''pitta'' and third, ''kapha''. The author himself will explain the need of giving one ''basti'' for ''vayu,'' two for ''pitta'' and three for ''kapha'' in verse no. 69. Thus, the one ''basti'' eliminates the aggravated ''vata'' from its location, two of them (given on after the other) eliminate the ''pitta'' from its location and three of them (given on after the other) eliminate ''kapha'' from its location.

''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.  Charaka samhita, Siddhi Sthana, 3/26, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

==== Verse 27-29 ====

==== 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.  Charaka samhita, Siddhi Sthana, 1/20-21, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

==== Verse 30-31 ====

==== Ratio of combination ====

The above-mentioned ratio of decoction and ''sneha'' should be adopted even if the ''niruha basti'' is administered in minimum quantity. Apart from the decoction and ''sneha'', the ''niruha kalpana'' also contains ''madhu, kalka,'' and ''saindhava'' etc. The quantity of these ingredients is variable according to the ''dosha, prakriti'' etc. of the patient. However, the quantity of the ingredients should be such that it should make the kalpana equal to 12 ''prasrita'' in total.  

The above-mentioned ratio of decoction and ''sneha'' should be adopted even if the ''niruha basti'' is administered in minimum quantity. Apart from the decoction and ''sneha'', the ''niruha kalpana'' also contains ''madhu, kalka,'' and ''saindhava'' etc. The quantity of these ingredients is variable according to the ''dosha, prakriti'' etc. of the patient. However, the quantity of the ingredients should be such that it should make the kalpana equal to 12 ''prasrita'' in total.  

Total 24 Pala or 12 Prasruta 24 pal 24 Pala

Total 24 Pala or 12 Prasruta 24 pal 24 Pala

==== Verse 34 ====

==== Procedures after''basti'' ====

   

   

After the manifestation of ''samyak nirudha'' symptoms, the patient should be advised to take bathe (in hot water) and to take meat-soup (''rasa''), milk and pulse-soup (''yusha'') in diseases due to the action of the deranged ''vata, pitta'' and ''kapha'' respectively. The essence (''rasa'') of the meat of any ''jangala'' animal may, however, be prescribed in all cases under the circumstances, since it would produce no harm. Only a quarter, a half or three-quarter part of the usual diet should be prescribed according to the digestive capacity of the patient, and the nature and intensity of the ''dosha'' involved in each case.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/11-13, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

After the manifestation of ''samyak nirudha'' symptoms, the patient should be advised to take bathe (in hot water) and to take meat-soup (''rasa''), milk and pulse-soup (''yusha'') in diseases due to the action of the deranged ''vata, pitta'' and ''kapha'' respectively. The essence (''rasa'') of the meat of any ''jangala'' animal may, however, be prescribed in all cases under the circumstances, since it would produce no harm. Only a quarter, a half or three-quarter part of the usual diet should be prescribed according to the digestive capacity of the patient, and the nature and intensity of the ''dosha'' involved in each case.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/11-13, 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>

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>

==== Verse 35 ====

==== 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.

Guņa- Sarva vātavyādhihara

Guņa- Sarva vātavyādhihara

==== Verse 39 ====

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

In the same method, the skilled physician should administer second, third or fourth ''niruha basti'' or till ''samyak nirudha'' and then stop.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 37/6-7, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref> Dalhaņa while commenting has justified that, in ''krura koshtha'' if improperly administered or if ''sunirudha lakshana'' not observed and ''dosha'' to be eliminated are present, in such condition fourth ''basti'' should be used judiciously.<ref>Dalhana,  Commentator. Sushruta Samhita, Sutrasthana, 38/3-6, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

In the same method given in verses, the skilled physician should administer second, third or fourth ''niruha basti'' or till ''samyak nirudha'' and then stop.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 37/6-7, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref> Dalhaņa while commenting has justified that, in ''krura koshtha'' if improperly administered or if ''sunirudha lakshana'' not observed and ''dosha'' to be eliminated are present, in such condition fourth ''basti'' should be used judiciously.<ref>Dalhana,  Commentator. Sushruta Samhita, Sutrasthana, 38/3-6, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

Some other considered fourth ''basti'' is advocated for ''rakta''. Some other considered that the fourth ''basti'' with ''madhura'' and ''sheeta dravya'' for ''daha nirvapana''.<ref>Dalhana,  Commentator. Sushruta Samhita, Sutrasthana, 38/7, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

Some other considered fourth ''basti'' is advocated for ''rakta''. Some other considered that the fourth ''basti'' with ''madhura'' and ''sheeta dravya'' for ''daha nirvapana''.<ref>Dalhana,  Commentator. Sushruta Samhita, Sutrasthana, 38/7, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>