NIRŪHABASTIVYĀPAT

नातियोगौ क्लमाध्माने हिक्का हृत्प्राप्तिरूर्ध्वता|
प्रवाहिका शिरोङ्गार्तिः परिकर्तः परिस्रवः||५||
द्वादश व्यापदो बस्तेरसम्यग्योगसम्भवाः|                                   (Cha. Si. 7/5)

AYOGA

Nidāna

गुरुकोष्ठेऽनिलप्राये रूक्षे वातोल्बणेऽपि वा|
शीतोऽल्पलवणस्नेहद्रवमात्रो घनोऽपि वा||७||                            (Cha. Si. 7/7)

Samprāpti

दोषं दुर्बलत्वादनिर्हरन् |                                    (Cha. Si. 7/8)

Basti cause Utkleśana of Doṣa, but does not help in their elimination because of its weak action as a result of the Nidānas.

Lakṣaṇa

करोति गुरुकोष्ठत्वं वातमूत्रशकृद्ग्रहम्||८||
नाभिबस्तिरुजं दाहं हृल्लेपं श्वयथुं गुदे|
कण्डूगण्डानि वैवर्ण्यमरुचिं वह्निमार्दवम्||९|                             (Cha. Si. 7/8-9)

• Guru Koṣṭha- Heaviness in Koṣṭha
• VātaMūtraŚakṛtGraha – Obstruction to Vāta, Mūtra, Purīṣa
• Nābhi Basti Ruja – Pain in Nābhi and Basti
• Dāha – Burning sensation
• Hṛllepa – Feeling of cold cloth covered over HṛdayaPradeśa
• GudaŚotha – Oedema in guda
• Ganda Kaṇḍū – Itching in abscesses
• Vaivarṇya – Discoloration of skin
• Aruci – Anorexia
• Agni Mārdava – loss of appetite

Cikitsā

तत्रोष्णायाः प्रमथ्यायाः पानं स्वेदाः पृथग्विधाः|
फलवर्त्योऽथवा कालं ज्ञात्वा शस्तं विरेचनम्||१०||
बिल्वमूलत्रिवृद्दारुयवकोलकुलत्थवान्|
सुरादिमूत्रवान्  बस्तिः सप्राक्पेष्यस्तमानयेत्||११||                     (Cha. Si. 7/10-11)

• UṣṇaPramathyaPāna
• Different types of Svedana
• Phalavarti
• A course of Virecana in appropriate time
• Basti prepared out of BilvaMūla, Trivṛt, Devadāru, Yava, Kola, KulatthaKvātha or SurasadiDravya or Gomūtra Basti

ATIYOGA

Nidāna

स्निग्धस्विन्नेऽतितीक्ष्णोष्णो मृदुकोष्ठेऽतियुज्यते|                         (Cha. Si. 7/12)

Administration of AtiTīkṣṇa and AtiUṣṇa Basti after doing Abhyaṅga and Svedana in MṛduKoṣṭha person leads to AtiyogaVyāpat.

Lakṣaṇa

तस्य लिङ्गं चिकित्सा च शोधनाभ्यां समा भवेत्||१२||                 (Cha. Si. 7/12)

Similar to VamanaVirecanaVyāpat(Caraka&Suśruta)

• Visrāva – oozing out of stool, Pitta, Kapha, Drava Dhātu
• BalaKṣaya – decrease in strength
• SvaraKṣaya – low voice
• KaṇṭhaŚoṣa – dryness of throat
• Bhrma – giddiness
• Tṛṣṇā – thirst

Cikitsā

Vamana VirecanaVyāpatCikitsā

• SthambhanaCikitsā – ŚītaPariṣeka and Avagāha, intake of Kaṣāya, Madhura, ŚītaAnnapāna and Auṣadha
• Raktapittaghna, Atisāraghna, DāhaJvaraharaCikitsā
• Mantha prepared of Anjana, Candana, Uśīra, Majjā, Rakta, Śarkarā and water along with LājaCūrṇa.
• Peya prepared of the Śunga of Vaṭa, Nyagrodha, Udumbara, Aśvatha, Kapitha mixed with honey
• Milk and food items prepared with VarcaSaṅgrāhika drugs
• Food along with JāṅgalaMāṃsarasa
• Picchā Basti
• Anuvāsana Basti with Madhura Auṣadha Siddha KṣīraSarpi

पृश्निपर्णीं स्थिरां पद्मं काश्मर्यं मधुकं बलाम्|||                            (Cha. Si. 7/12-14)

Pṛśniparṇyadi Basti with Ghṛta for Dāha

KLAMA

Nidāna

आमशेषे निरूहेण मृदुना  दोष ईरितः|                         (Cha. Si. 7/15)

Administration of MṛduNirūha Basti when there is residual Āma in the Koṣṭha produce Klama

Samprāpti

मार्गं रुणद्धि वातस्य हन्त्यग्निं मूर्च्छयत्यपि||१५               (Cha. Si. 7/15)

Nidāna leads to Kapha and Pitta Prakopa. This leads to obstruction to movement of Vāta causes fainting and suppression of power of digestion.

Lakṣaṇa

क्लमं विदाहं हृच्छूलं मोहवेष्टनगौरवम्|              (Cha. Si. 7/16)

• Klama – Fatigue
• Vidāha – Burning sensation
• Hṛtśūla – Pain in heart region
• Moha – Delusion
• Veṣṭana – Colic
• Gaurava – Heaviness of body

Cikitsā

कुर्यात् स्वेदैर्विरूक्षैस्तं पाचनैश्चाप्युपाचरेत्||१६||
पिप्पलीकत्तृणोशीरदारुमूर्वाशृतं जलम्|
पिबेत् सौवर्चलोन्मिश्रं दीपनं हृद्विशोधनम्||१७||
वचानागरशट्येला दधिमण्डेन मूर्च्छिताः|
पेयाः प्रसन्नया वा स्युररिष्टेनासवेन वा||१८||
दारु त्रिकटुकं पथ्यां पलाशं चित्रकं शटीम्|
पिष्ट्वा कुष्ठं च मूत्रेण पिबेत् क्षारांश्च दीपनान्||१९||
बस्तिमस्य विदध्याच्च समूत्रं दाशमूलिकम्|
समूत्रमथवा व्यक्तलवणं माधुतैलिकम्||२०||                                          (Cha. Si. 7/16-20)

• RūkṣaSveda along with Pācana
• For DīpanaPācana –

• Drink water boiled with Pippali, Kattṛna, Uśīra, Devadāru and Mūrvā by adding Sauvarcala salt which is Dīpana and HṛtŚodhaka
• Cūrṇa of Vacā, Nāgara, Śaṭi, Ela should be added with whey. This recipe should be taken along with Prasanna, Ariṣta or Āsava
• Kalka of Devadāru, Śuṇṭhī, Pippali, Maricā, Pathyā, Palāśa, Citraka, Śaṭi and Kuṣṭhā along with Gomūtra
• Kṣāra which are Dīpana
• DaśamūlaNirūhaBasti withGomūtra
• Mādhutailika Basti with Gomūtra , Lavana

ĀDHMĀNA

Nidāna

अल्पवीर्यो महादोषे रूक्षे क्रूराशये कृतः|                                               (Cha. Si. 7/21)

Administration of AlpaVīrya Basti to a person who has Mahā Doṣa, whose body is Rūkṣa and who has KrūraKoṣṭha.

Samprāpti

बस्तिर्दोषावृतो रुद्धमार्गो रुन्ध्यात् समीरणम्||२१||
स विमार्गोऽनिलः कुर्याद…………………………                             (Cha. Si. 7/22)

Basti will get Āvṛta by Doṣa leading to DoṣaPrakopa and VimārgaGamana of Vāta.

Lakṣaṇa

…………………………ध्मानं मर्मपीडनम्|
विदाहं गुरुकोष्ठस्य मुष्कवङ्क्षणवेदनाम्||२२||
रुणद्धि हृदयं शूलैरितश्चेतश्च धावति|                                          (Cha. Si. 7/22)

• Aādhmāna – Bloating of abdomen
• MarmaPīda – Pain in vital points
• Vidāha – Burning sensation
• Guru Koṣṭha – heaviness in abdomen
• MuṣkaVaṅkṣaṇaVedana – Pain over scrotum , groin
• HṛudayaAvarodha due to ŚūlaVṛddhi – Heaviness over chest, pain

Cikitsā

श्यामाफलादिभिः कुष्ठकृष्णालवणसर्षपैः||२३||
धूममाषवचाकिण्वक्षारचूर्णगुडैः कृताम्|
कराङ्गुष्ठनिभां वर्तिं यवमध्यां निधापयेत् ||२४||
अभ्यक्तस्विन्नगात्रस्य तैलाक्तां स्नेहिते गुदे|
अथवा लवणागारधूमसिद्धार्थकैः कृताम्||२५||
बिल्वादिना निरूहः स्यात् पीलुसर्षपमूत्रवान्|
सरलामरदारुभ्यां सिद्धं चैवानुवासनम्||२६||                                        (Cha. Si. 7/23-26)

• GudaVartiPrayoga

A Varti of the size of the thumb and shape of barley seed should be prepared of Syāmā, Trivṛt, CaturAṅgula, Tilvaka, Mahāvṛkṣa, Saptalā, Śaṅkhinī, Danti And Dravanti, Phala, Jīmūtaka, Ikṣvāku, Dhāmārgava, Kutaja And Kṛtavedhana, Kuṣṭha, Pippali, salt, Sarṣapa, powder of ĀgaraDhūma, Maṣa, Vacā, Kiṇva, Kṣāra and jaggery. Alternatively this Varti can be prepared by adding salt, kitchen soot and Siddhārthaka to Syāmādi and Phalādi drugs described above.

These Vartis may be smeared with oil and inserted into the lubricated anus of the patient who is previously given massage and fomentation therapies.

• DashamūlaNirūha basti withGomūtra
• Anuvāsana Basti – Oil cooked with Sarala and Devadāru

HIKKA

Nidāna

मृदुकोष्ठेऽबले बस्तिरतितीक्ष्णोऽतिनिर्हरन्|                               (Cha. Si. 7/27)

Administration of Tīkṣṇa Basti to a person who is Durbala and having MṛduKoṣṭha

Samprāpti

…………..ऽतिनिर्हरन्|                                                   (Cha. Si. 7/27)

AtiNirharaṇa of Doṣās leading to Hikkā.

Lakṣaṇa

कुर्याद्धिक्कां

Hikka

Cikitsā

हिक्काघ्नं बृंहणं च यत्||२७||
बलास्थिरादिकाश्मर्यत्रिफलागुडसैन्धवैः|
सप्रसन्नारनालाम्लैस्तैलं पक्त्वाऽनुवासयेत्||२८||
कृष्णालवणयोरक्षं पिबेदुष्णाम्बुना युतम्  |
धूमलेहरसक्षीरस्वेदाश्चान्नं च वातनुत्||२९||                                             (Cha. Si. 7/27-29)

• HikkāghnaCikitsā – Bṛṃhaṇa
• BalaSthirādiAnuvāsana Basti
• Cūrṇa – 1 Akṣa of Pippali and LavanaCūrṇa along with hot water.
• VātaNāśaka – Dhūma, Leha, Māṃsarasa, Kṣīra, Sveda, Anna.

HṚTPRĀPTI

Nidāna

अतितीक्ष्णः सवातो वा न वा सम्यक् प्रपीडितः|                                                 (Cha. Si. 7/30)

Lakṣaṇa

घट्टयेद्धृदयं 

Pressure over HṛdayaPradeśa.

Cikitsā

बस्तिस्तत्र काशकुशेत्कटैः||३०||
स्यात् साम्ललवणस्कन्धकरीरबदरीफलैः|
शृतैर्बस्तिर्हितः सिद्धं वातघ्नैश्चानुवासनम्||३१                                          (Cha. Si. 7/31)

• Nirūha Basti with Kaṣāya of Kāśa, Kuśa, Itkaṭa, Amla and LavanaSkandhaDravya, Karīra and fruit of Badari should be used for Nirūha.
• Anuvāsana basti usingVātaharaDravya (Daśamūladi)

ŪRDHVA GAMANANA

Nidāna

वातमूत्रपुरीषाणां दत्ते वेगान्निगृह्णतः|
अति वा पीडितो ………………………….                                                   (Cha. Si. 7/7)

• Supression of Vāta, Mūtra, Purīṣa Vega after administration of Basti
• Excessive pressure is applied over the Basti receptacle during administration

Lakṣaṇa

बस्तिर्मुखेनायाति वेगवान्||३२||
मूर्च्छाविकारं तस्यादौ दृष्ट्वा                                                       (Cha. Si. 7/32-33)

Basti Dravya come out through oral cavity

Cikitsā

शीताम्बुना मुखम्|
सिञ्चेत् पार्श्वोदरं चाधः प्रमृज्याद्वीजयेच्च तम्||३३||

केशेष्वालम्ब्यचाकाशेधुनुयात्त्रासयेच्चतम्|
गोखराश्वगजैःसिंहैराजप्रेष्यैस्तथोरगैः||३४||
उल्काभिरेवमन्यैश्चभीतस्याधःप्रवर्तते|
वस्त्रपाणिग्रहैः कण्ठं रुन्ध्यान्न म्रियते यथा||३५||
प्राणोदाननिरोधाद्धि प्रसिद्धतरमार्गवान्  |
अपानः पवनो बस्तिं तमाश्वेवापकर्षति||३६||

ततःक्रमुककल्काक्षंपाययेताम्लसंयुतम्|
औष्ण्यात्तैक्ष्यात्सरत्वाच्चबस्तिंसोऽस्यानुलोमयेत्||३७||
पक्वाशयस्थितेस्विन्नेनिरूहोदाशमूलिकः|
यवकोलकुलत्थैश्चविधेयोमूत्रसाधितः||३८||
बिल्वादिपञ्चमूलेनसिद्धोबस्तिरुरःस्थिते|
शिरःस्थे नावनं धूमः प्रच्छाद्यं सर्षपैः शिरः||३९                                       (Cha. Si. 7/33-39)

If  on account of this there is Mūrccha,

• Secana – Śītambu over face
• Mardana – Sides of chest and abdomen should be squeezed downward.
• Rogi should be fanned
• He should be pulled up to the midair by holding his hair and shaken
• Frightened by means of infuriated bull, ass, horse, elephant, lion, … fireworks and such other fearful objects. These procedures will help in the downward movement of previously administered Nirūha.
• The throat of patient should be squeezed with a cloth hand , taking care not to asphyxiate the patient which may otherwise leads to death. By this ApānaVāta will move down normally
• Kramuka Jala – 1 Akṣa Kalka of Kramuka added with sour juice for drinking – Uṣṇa, Tīkṣṇa, Sara Guna helps in Anulomana of Basti Dravya
• BilvādiDvipañcamūla Basti – If Basti Dravya gets strucked in Pakvāśaya
• Pañcamūla Basti – If Basti Dravya gets strucked in chest.
• Nāvana, Dhūma, SarṣapaLepa – If Basti Dravya gets strucked in Śiras

PRAVĀHIKA

Nidāna

स्निग्धस्विन्ने महादोषे बस्तिर्मृद्वल्पभेषजः|                                                                                                                   (Cha. Si. 7/40)

Administration of  Mṛdu and AlpaMātra Basti in a person after Samyak Sneha Sveda and who is having Mahā Doṣa.

Samprāpti

उत्क्लिश्याल्पं हरेद्दोषं जनयेच्च प्रवाहिकाम्||४०                                    (Cha. Si. 7/40)

Basti Dravya causes Utkleśana of Doṣa and eliminates only small amount of Doṣās leading to Pravāhika.

Lakṣaṇa

स बस्तिपायुशोफेन जङ्घोरुसदनेन वा|
निरुद्धमारुतो जन्तुरभीक्ष्णं सम्प्रवाहते||४१                                           (Cha. Si. 7/41)

Cikitsā

स्वेदाभ्यङ्गान्निरूहांश्च शोधनीयानुलोमिकान्|
विदध्याल्लङ्घयित्वा तु वृत्तिं कुर्याद्विरिक्तवत्||४२                                               (Cha. Si. 7/42)

• Svedana
• Abhyaṅga
• Nirūha Basti- using Śodhana and Anulomana drugs
• Follow Virecana regimen

ŚIRO ARTI

Nidāna

दुर्बले क्रूरकोष्ठे च तीव्रदोषे तनुर्मृदुः|
शीतोऽल्पश्चावृतो दोषैर्बस्तिस्तद्विहतोऽनिलः||४३                                   (Cha. Si. 7/43)

Administration of  Tanu, MṛduVīrya, Śītala Basti in AlpaMātra to a patient who is Durbala, who has KrūraKoṣṭha and who is afflicted with Mahā Doṣa.

Samprāpti

मार्गैर्गात्राणि सन्धावन्नूर्ध्वं मूर्ध्नि विहन्यते|                                                (Cha. Si. 7/44)

Basti Dravya gets occluded by Doṣās and stays in the Mūrdhā Pradeśa.

Lakṣaṇa

ग्रीवां मन्ये च गृह्णाति शिरः कण्ठं भिनत्ति च||४४||
बाधिर्यं कर्णनादं च पीनसं नेत्रविभ्रमम्|                                                 (Cha. Si. 7/44)

Cikitsā

कुर्यादभ्यञ्जनं तैललवणेन यथाविधि||४५||
युञ्ज्यात् प्रधमनैर्नस्यैर्धूमैरस्य  विरेचयेत्|
तीक्ष्णानुलोमिकेनाथ स्निग्धं भुक्तेऽनुवासयेत्  ||४६||                            (Cha. Si. 7/45-46)

• Abhyaṅga with LavanaTaila
• PradhamanaNasya
• Dhūmapana
• Tīkṣṇa and VātanulomikaDravyaSādhitaAnuvāsana Basti

AṄGA ARTI

Nidāna

स्नेहस्वेदैरनापाद्य  गुरुस्तीक्ष्णोऽतिमात्रया|
यस्य बस्तिः प्रयुज्येत                                                                             (Cha. Si. 7/47)

Administration of guru, Tīkṣṇa Basti in Atimātra to person who had not undergone Samyak Sneha Sveda.

Samprāpti

सोऽतिमात्रं प्रवर्तयेत्||४७||
स्रुतेषु तस्य दोषेषु निरूढस्यातिमात्रशः|
स्तब्धोदावृतकोष्ठस्य वायुः सम्प्रतिहन्यते||४८||                                      (Cha. Si. 7/48)

Nidāna leads to AtiPravartana of Doṣa. Because of AtiNirharaṇa of Doṣa, there is Stabdhata and Udāvarta in Amāśaya. There will be VātaAvarodha.

Lakṣaṇa

रुजत्यङ्गानि देहिनः|
गात्रवेष्टननिस्तोदभेदस्फुरणजृम्भणैः ||४९||                                                      (Cha. Si. 7/49)

Cikitsā

तं तैललवणाभ्यक्तं, सेचयेदुष्णवारिणा|
यवान्  कुलत्थान् कोलानि पञ्चमूले तथोभये|
यष्टीमधुकतैलेन बिल्वतैलेन वा भिषक्  ||५३||                                       (Cha. Si. 7/50-53)

• Abhyaṅga – with Taila added with Lavana
• Seka – Uṣṇa Jala and Eraṇḍa Patra Kaṣāya
• PrastaraSveda
• Nirūha Basti – Yava, Kola, Kulattha, both PañcamūlaKaṣāya, warm BilvaTaila and Lavana
• AvagāhaSveda
• Anuvāsana Basti – YaṣṭīmadhuTailaorBilvaTaila

PARIKARTIKA

Nidāna

मृदुकोष्ठाल्पदोषस्य रूक्षस्तीक्ष्णोऽतिमात्रवान्|                                                  (Cha. Si. 7/54)

Administration of  Rūkṣa and Tīkṣṇa Basti in Atimātra to a patient who has MṛduKoṣṭha and who has AlpaDoṣā

Samprāpti

बस्तिर्दोषान्निरस्याशु  जनयेत् परिकर्तिकाम्||५४||                                 (Cha. Si. 7/54)

Basti given in such condition will cause sudden Nirharaṇa of Doṣās and will leads to Parikartika.

Lakṣaṇa

त्रिकवङ्क्षणबस्तीनां तोदं नाभेरधो रुजम्|
विबन्धोऽल्पाल्पमुत्थानं   बस्तिनिर्लेखनाद्भवेत्||५५                               (Cha. Si. 7/55)

Cikitsā

स्वादुशीतौषधैस्तत्र पय इक्ष्वादिभिः शृतम्|

यष्ट्याह्वतिलकल्काभ्यांबस्तिःस्यात्क्षीरभोजिनः||५६||
ससर्जरसयष्ट्याह्वजिङ्गिनीकर्दमाञ्जनम्|
विनीयदुग्धेबस्तिःस्यात्व्यक्ताम्लमृदुभोजिनः||                            (Cha. Si. 7/56)

• Administration of Kṣīra Basti

• Prepared with Madhura, ŚītaAuṣadhaSidhaKṣīra and Yaṣṭīmadhu– Tila Kalka, keeping the patient on milk diet.
• Prepared by Kṣīra processed with Sarjarasa, Yaṣṭīmadhu, Jiṅginī, Kardama and anjana added with sour juice for the patient who is on soft diet.

PARISRĀVA

Nidāna

पित्तरोगेऽम्ल  उष्णो वा तीक्ष्णो वा लवणोऽथवा|                                                (Cha. Si. 7/57)

Administration of Amla, Uṣṇa, Tīkṣṇa and LavanaYukta Basti in person suffering from PittajaVyādhi.

Samprāpti

बस्तिर्लिखति पायुं तु क्षिणोति विदहत्यपि||५८                                       (Cha. Si. 7/58)

Basti causes scrapping and ulceration in GudaPradeśa and Dāha in Guda region.

Lakṣaṇa

स विदग्धः स्रवत्यस्रं पित्तं चानेकवर्णवत्|
सार्यते बहुवेगेन मोहं गच्छति चासकृत्||५९                                           (Cha. Si. 7/59)

• Ulceration and burning sensation
• Exudation of Rakta and Pitta, having various colours from the inflamed anus
• Frequent fainting

Cikitsā

गुदे सेकाः प्रदेहाश्च शीताः स्युर्मधुराश्च ये|
रक्तपित्तातिसारघ्नी क्रिया चात्र प्रशस्यते||६२                                         (Cha. Si. 7/62)

• Śīta Basti
• Seka, Lepa – using Madhura ŚītaDravyas
• RaktapittaCikitsā
• AtisāraCikitsā

COMMONLY   ENCOUNTERED   COMPLICATION

• Agnimāndya
• Adhmāna
• Atisāra
• Udara Śūla
• Burning sensation in abdomen
• Jvara
• Heaviness of body

Precautions to avoid complications

• Vital parameters like BP, PR should be checked before and after treatment
• Per rectal examination
• Proctoscopy examination to rule out piles, fissure,…
• Counselling of patient
• Explain the whole procedure to patient
• Doctor should wear gloves during procedure
• Sterilization of Netra, vessels to avoid infection
• Use proper quantity of ingredients
• Use good quality ingredients
• Advice the patient to maintain personal hygiene
• Temperature of Basti Dravya should be checked
• Ensure no air filled up in Basti Yantra
• Should not dip finger in Basti Dravya directly for checking temperature
• Lubricate nozzle and Guda
• Introduce nozzle parallel to vertebral column
• Avoid complete evacuation of Basti Dravya, should remain 25-30 ml
• Should advice to take bath and have food soon after excretion in case of Nirūha Basti
• Should monitor the patient to avoid complications like stroke

PRACTICALLY OBSERVED COMPLICATIONS AND MANAGEMENT