For both male and female Uttarabasti

द्वित्रास्थापनशुद्धेभ्यो विदध्याद्बस्तिमुत्तरम्||          (A. H. Su. 19/70)

Uttarabasti should be administered to those who have purified by 2-3 Nirūha Basti. In usual practice Nirūha Basti given in the morning and Uttara Basti in the afternoon.

अथातुरमुपस्निग्धं स्विन्नं प्रशिथिलाशयम् ||
यवागूं सघृतक्षीरां पीतवन्तं यथाबलम् |                              (Su. Chi. 37/8)

The patient should be given mild oleation and sudation in the lower abdomen, thighs and groins. The patient is asked to void urine and faeces and given yavāgū added with ghee and milk as much as he can drink by his strength

For male Uttarabasti

• Uttarabasti Yantra – For the administration of male Uttarabasti, urinary rubber catheter no.8 or 11 is used as Basti Netra and 50cc disposable syringe may be used as Basti Puṭaka.
• Table
• Hole towel
• Medicine
• Tray
• Sponge holding forceps
• Xylocaine jelly
• Gauze pieces
• Cleaning agents like normal saline, betadine

For female Uttarabasti

• Uttarabasti Yantra – For the urethral administration of Uttarabasti, urinary rubber catheter no.8 or 11 is used as Basti Netra and 50cc disposable syringe may be used as Basti Puṭaka. For intra uterine administration of Uttarabasti, IV or IUI canula and infant feeding tube is used as Basti Netra and 10 cc disposable syringe may be used as Basti Puṭaka.
• Lithotomy table
• Hole towel
• Medicine
• Kelley’s pad
• Tray
• Cuscus speculum
• Sponge holding forceps
• Xylocaine jelly
• Tampon
• Gauze pieces
• Cleaning agents like normal saline, betadine

Preparation of the medicine

• The Basti Dravya for Uttarabasti is of two type, Sneha and Kvātha.
• Take the required quantity of medicine in a pre-cleaned container
• Autoclave the medicine along with all the required materials
• Medicine should be filled in the Basti Puṭaka.

For male

स्नेहप्रमाणंपरमंप्रकुञ्चश्चात्रकीर्तितः |

पञ्चविंशादधोमात्रांविदध्याद्बुद्धिकल्पिताम् ||                 (Su. Chi. 37/102)

The maximum dose of Sneha to be given for persons below 25 years of age is 1 Prakuñcaie, 1 Pala. Above that age, the quantity should be decided by the intelligence of the physician.

तस्यबस्तिर्मृदुलघुर्मात्राशुक्तिर्विकल्प्यवा|                               (A. H. Su. 19/72)

The UttarabastiDravya shall be Mṛdu, Laghu and its quantity is 1 Śukti or parts of it.

तेनाजबस्तियुक्तेनस्नेहस्यार्धपलंनयेत्|

यथावयोविशेषेणस्नेहमात्रांविकल्प्यवा||                                  (Cha. Si. 9/52)

The Basti Netra should be tied to a goat’s bladder containing half Pala of the unctuous recipe which is to be administered. The exact dose in which this unctuous recipe is to be administered should be determined on the basis of the age of the patient.

For female

गर्भाशयविशुद्ध्यर्थंस्नेहेनद्विगुणेनतु|

क्वाथप्रमाणंप्रसृतं,स्त्रियाद्विप्रसृतंभवेत्||

कन्येतरस्याः,कन्यायास्तद्वद्बस्तिप्रमाणकम्|                    (Su. Chi. 37/116-117)

The quantity of oil should be double (2 Prasṛta) for cleansing the uterus. The quantity of decoction for urethral enema in males should be 1 Prasṛta; for females 2 Prasṛta for women who are not virgins; for virgins it should be the same as of men (1 Prasṛta).

प्रकुञ्चोमध्यमामात्रा. बालानांशुक्तिरेवतु||                              (A. H. Su. 19/80)

The medium quantity of Basti Dravya is 1 Prakuñca and for children, it is 1 Śukti only.

स्नेहस्यप्रसृतंचात्रस्वाङ्गुलीमूलसम्मितम्|
देयंप्रमाणंपरममर्वाग्बुद्धिविकल्पितम् ||              (Su. Chi. 37/106)

The maximum quantity of oil to beused for women is 1 Prasṛta which can be measured by cupping the palm of that female in which the level of Snehareaches up to base line of the fingers, as determined by intelligence of the physician.

1. Pūrvakarma
2. Pradhānakarma
3. Paścātkarma

PŪRVAKARMA

• Preparation of the patient

द्वित्रास्थापनशुद्धेभ्यो विदध्याद्बस्तिमुत्तरम्||          (A. H. Su. 19/70)

Uttarabasti should be administered to those who have purified by 2-3 Nirūha Basti. In usual practice Nirūha Basti given in the morning and Uttarabasti in the afternoon.

अथातुरमुपस्निग्धं स्विन्नं प्रशिथिलाशयम् ||
यवागूं सघृतक्षीरां पीतवन्तं यथाबलम् |                              (Su. Chi. 37/8)

The patient should be given mild oleation and sudation in the lower abdomen, thighs and groins. The patient is asked to void urine and faeces and given yavāgū added with ghee and milk as much as he can drink by his strength.

(b) Time of Administration

तेनपूर्वाह्णेचोत्तरबस्तिप्रणिधानम्| [i]             (Su. Chi. 37/109, Dalhana commentary)

Uttarabasti should be administered in the morning time.

(c) Position of the Patient

ऋजोःसुखोपविष्टस्यपीठेजानुसमेमृदौ| [ii]                 (A. H. Su. 19/74)

सृष्टविण्मूत्रवेगस्यपीठेजानुसमेमृदौ||५३||[iii]             (Cha. Si. 9/53)

The patient who has voided the stool as well as the urine should be made to sit straight and comfortably over a knee-high and soft seat.

PRADHĀNA KARMA

हृष्टेमेढ्रेस्थितेचर्जौशनैःस्रोतोविशुद्धये ||
सूक्ष्मांशलाकांप्रणयेत्तयाशुद्धेऽनुसेवनि |
आमेहनान्तंनेत्रंचनिष्कम्पंगुदवत्ततः ||
पीडितेऽन्तर्गतेस्नेहेस्नेहबस्तिक्रमोहितः| [iv]              (A. H. Su. 19/74-76)

His penis should be made erect. Then the thin probe should be slowly inserted into urethra to clear the channels. After thus clearing the passage, the Basti Netra should be inserted along the line of suture to the entire length of the urethral passage without shaking. The enema bag pressed just as described for rectal enema for pushing the oil into the urinary bladder. This is the ideal method of administration of male Uttarabasti.

शलाकयाऽन्विष्यगतिंयद्यप्रतिहताव्रजेत् ||
ततःशेफःप्रमाणेनपुष्पनेत्रंप्रवेशयेत् |
गुदवन्मूत्रमार्गेणप्रणयेदनुसेवनीम् ||
हिंस्यादतिगतंबस्तिमूनेस्नेहोनगच्छति |
सुखंप्रपीड्यनिष्कम्पंनिष्कर्षेन्नेत्रमेवच || [v]              (Cha. Si. 9/54-56)

In the erected phallus of the patient, the passage of urethra should be determined with the help of a ghee smeared probe. If the probe passes  through the urethra without any difficulty then the Netra should be inserted up to the length of phallus following the direction of perineal suture in the manner prescribed for the insertion of Netra in the Guda.

If the Netra is inserted beyond the prescribed limit, then it will cause injury to the bladder. If it is inserted less than that limit, then the unctuous recipe will not enter the bladder.

Gentle pressure should be applied over the Basti Puṭaka without shaking it. Thereafter the netra should be withdrawn.

PAŚCĀT KARMA

प्रत्यागतेद्वितीयंचतृतीयंचप्रदापयेत्| [vi]                              (Cha. Si. 9/57)

ततःप्रत्यागतस्नेहमपराह्णेविचक्षणः |
भोजयेत्पयसामात्रांयूषेणाथरसेनवा ||[vii]                 (Su. Chi. 37/113)

बस्तीननेनविधिनादद्यात्त्रींश्चतुरोऽपिवा||७६||
अनुवासनवच्छेषंसर्वमेवास्यचिन्तयेत् |[viii]                           (A. H. Su. 19/76)

After the medicine has come out, 2 – 4 Bastis should be administered in this manner .In the evening, after the oil has come out, the wise physician should ask the patient to take food in limited quantity along with milk, soup of pulses or soup of meat.

After the withdrawal of given drug, follow the postoperative regimen as that of Sneha Basti. Management of the complications is also similar to that of Sneha Basti.

MaleUttarabastiin practice

• Autoclave the medicine and all the instruments used for Uttarabasti.
• Patient is made to lie down in supine position by exposing the genital area.
• Wash the genitals and surrounding area with normal saline by using sponge holding forceps and gauze. Then retract the prepuce and wash the glans penis and apply betadine.
• The physician should spread the surgical towel over the patient, exposing the penis.
• The autoclaved medicine is filled in to the syringe
• After lubricating the catheter with xylocaine jelly, gently introduce it in to the urethra, then slowly to the bladder.
• Ensure that the catheter has entered the bladder. Then the fix the syringe to the catheter and slowly inject the medicine to the bladder.
• Remove the catheter after the injection is completed and take rest for 5-10 minutes.

[i] Vaidya Yadavji Trikamji,Suśruta Samhita, with Nibandha śangraha commentary of Sree Dalhana ācharya and Nyayachandrika Panchaka of Sri gayadasa ācharya , edition -2014, Varanasi, Chikitsa Sthānan, Chapter-37, śloka109, p -538

[ii]Āchārya Vāgbhata, Aṣtanga Hridaya elaborated by Vāgbhata with joined commentaries of Āyurveda Rasayana by Hemadri and SarvangaSundari by Arunadatta, Haridasasiva Paradakara, edition- 2010, Varanasi, Chaukamba Sutrasthāna chapter 19, śloka 74,p-283

[iii]  Vaidya Yadavaji Trikamji ācharya, Charaka Samhita with āyurveda deepika commentary of Chakrapānidatta revised by Charaka and Dhridhabala,reprint -2011, New delhi, Chaukambha surbhārti prakashan, Siddhisthāna, Chapter-9, Sloka-53, p-720

[iv]Āchārya Vāgbhata, Aṣtanga Hridaya elaborated by Vāgbhata with joined commentaries of Āyurveda Rasayana by Hemadri and SarvangaSundari by Arunadatta, Haridasasiva Paradakara, edition- 2010, Varanasi, Chaukamba Sutrasthāna chapter 19, śloka 74-76,p-283-284

[v] Vaidya Yadavaji Trikamji ācharya, Charaka Samhita with āyurveda deepika commentary of Chakrapānidatta revised by Charaka and Dhridhabala,reprint -2011, New delhi, Chaukambha surbhārti prakashan, Siddhisthāna,, Chapter-9, Sloka-54-56, p-720

[vi]Vaidya Yadavaji Trikamji ācharya, Charaka Samhita with āyurveda deepika commentary of Chakrapānidatta revised by Charaka and Dhridhabala,reprint -2011, New delhi, Chaukambha surbhārti prakashan, Siddhisthāna,, Chapter-9, Sloka-57 p-721

[vii] Vaidya Yadavji Trikamji,Suśruta Samhita, with Nibandha śangraha commentary of Sree Dalhana ācharya and Nyayachandrika Panchaka of Sri gayadasa ācharya , edition -2014, Varanasi, Chikitsa Sthānan, Chapter-37, śloka-113, p-538

[viii]Āchārya Vāgbhata, Aṣtanga Hridaya elaborated by Vāgbhata with joined commentaries of Āyurveda Rasayana by Hemadri and SarvangaSundari by Arunadatta, Haridasasiva Paradakara, edition- 2010, Varanasi, Chaukamba Sutrasthāna chapter 19, śloka 76,p-284