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Basti (बस्तिः) is the samskrit term which means urinary bladder. Ayurveda considers basti as one of the 3 chief vital organs of humans. When the term basti is used in reference to Panchakarma procedures of Ayurveda, it refers to the procedure of giving medicated enema. In this panchakarma procedure, medicated oils or decoctions or combination of multiple medicated ingredients is done and the fluid is administered per rectally. In this article a brief account on the panchakarma procedure basti has been given.  

Basti (बस्तिः) is the samskrit term which means urinary bladder. Ayurveda considers basti as one of the 3 chief vital organs of humans. When the term basti is used in reference to Panchakarma procedures of Ayurveda, it refers to the procedure of giving medicated enema. In this panchakarma procedure, medicated oils or decoctions or combination of multiple medicated ingredients is done and the fluid is administered per rectally. In this article a brief account on the panchakarma procedure basti has been given.  

== Introduction ==

== परिचयः॥ Introduction ==

Ayurveda has categorized the [[Chikitsa (चिकित्सा)|chikitsa]] (treatment) into 2 main types. Pacification of aggravated doshas with the help of medicines means Shamanam (शमनम्) while eliminating the excessively aggravated doshas out of the body through Panchakarma procedures is called as shodhanam (शोधनम्). Basti, the prime treatment in shodhana is considered as one of the most important treatments for many diseases according to Ayurvedic classical literature. It is the best treatment modality for all types of vata diseases. The route of administration of basti ensures the entry of medicines directly into the pakwashaya (part of large intestine) which is believed to be the chief site of Vata dosha in body. Thus the basti directly acts on the site of vata and facilitates easy control or pacification of vitiated  vata. Thus classically it is advocated in the diseases of vata. According to the classical texts basti administration is done with the help of animal urinary bladder and specially prepared metal/wooden nozzle/catheter, the whole assembly is called as basti-yantra i.e. Tool for basti. As basti is basically a receptacle having soft and elastic nature, it was used as an instrument for drug administration with a constant pressure.

Ayurveda has categorized the [[Chikitsa (चिकित्सा)|chikitsa]] (treatment) into 2 main types. Pacification of aggravated doshas with the help of medicines means Shamanam (शमनम्) while eliminating the excessively aggravated doshas out of the body through Panchakarma procedures is called as shodhanam (शोधनम्). Basti, the prime treatment in shodhana is considered as one of the most important treatments for many diseases according to Ayurvedic classical literature. It is the best treatment modality for all types of vata diseases. The route of administration of basti ensures the entry of medicines directly into the pakwashaya (part of large intestine) which is believed to be the chief site of Vata dosha in body. Thus the basti directly acts on the site of vata and facilitates easy control or pacification of vitiated  vata. Thus classically it is advocated in the diseases of vata. According to the classical texts basti administration is done with the help of animal urinary bladder and specially prepared metal/wooden nozzle/catheter, the whole assembly is called as basti-yantra i.e. Tool for basti. As basti is basically a receptacle having soft and elastic nature, it was used as an instrument for drug administration with a constant pressure.

== Etymology ==

== निरुक्तिः॥ Etymology ==

According to Vachaspathyam the word “Basti” is derived from the root “Vas” by adding “Tich” Pratyaya and it belongs to masculine gender.   

According to Vachaspathyam the word “Basti” is derived from the root “Vas” by adding “Tich” Pratyaya and it belongs to masculine gender.   

If the function of basti in the body is observed, it is understood that, bladder is that organ which collects waste liquid from all over the body up to certain capacity and then throws it all at one time not continuously. Thus basti has capacity to store and then expel out in a particular fashion which makes it suitable organ for giving basti. In the basti procedures, multiple ingredients are mixed in a specific manner, stored for little time and then the resultant mixture is administered.   

If the function of basti in the body is observed, it is understood that, bladder is that organ which collects waste liquid from all over the body up to certain capacity and then throws it all at one time not continuously. Thus basti has capacity to store and then expel out in a particular fashion which makes it suitable organ for giving basti. In the basti procedures, multiple ingredients are mixed in a specific manner, stored for little time and then the resultant mixture is administered.   

== Types ==

== बस्तिभेदाः॥ Types ==

Basti is categorized into 3 main types by Acharya Vagbhata.<ref>Ashtanga Hrudayam (Sutrasthanam Adhyaya 19 Sutra 1-2)</ref> In Ashtanga hrudayam, 3 types of basti have been mentioned as below,

Basti is categorized into 3 main types by Acharya Vagbhata.<ref>Ashtanga Hrudayam (Sutrasthanam Adhyaya 19 Sutra 1-2)</ref> In Ashtanga hrudayam, 3 types of basti have been mentioned as below,

# Niruha basti : The type of basti where decoction is the major part is called as asthapana basti or niruha basti. In Niruha Basti/ Aasthaapana Basti, decoction of medicinal plants is the main content wherein other ingredients like honey, salt, lipids & other drugs are incorporated to form a colloid or a suspension. Word Niruha, indicates “To eliminate” or eliminate morbid Doshas or Disease from body, & its synonym word “Asthapan” indicates “establish life span & age.<ref>Sushruta Samhita (Chikitsasthanam Adhyaya 35 Sutra 38)</ref>.

# Niruha basti (निरुहबस्तिः) : The type of basti where decoction is the major part is called as asthapana basti or niruha basti. In Niruha Basti/ Aasthaapana Basti, decoction of medicinal plants is the main content wherein other ingredients like honey, salt, lipids & other drugs are incorporated to form a colloid or a suspension. Word Niruha, indicates “To eliminate” or eliminate morbid Doshas or Disease from body, & its synonym word “Asthapan” indicates “establish life span & age.<ref>Sushruta Samhita (Chikitsasthanam Adhyaya 35 Sutra 38)</ref>.

# Anuvasana basti : Basti in which major part of plain or medicated oil is used is called as ''anuvasana''. The word Anuvasan indicates “To stay”, the administrated medicines stay inside for a longer duration, but still do not cause any untoward problem  

# Anuvasana basti (अनुवासनबस्तिः) : Basti in which major part of plain or medicated oil is used is called as ''anuvasana''. The word Anuvasan indicates “To stay”, the administrated medicines stay inside for a longer duration, but still do not cause any untoward problem

# Uttar basti :  The basti administered through different route (Uttara:next) i.e. through urethral opening in males and vaginal orifice in females is called as uttara basti. In this type of basti also chiefly oil or ghee is used as a drug.

# Uttar basti (उत्तरबस्तिः) :  The basti administered through different route (Uttara:next) i.e. through urethral opening in males and vaginal orifice in females is called as uttara basti. In this type of basti also chiefly oil or ghee is used as a drug.

Other common basti types include following bastis,

Other common basti types include following bastis,

# Yapana basti: Basti indicated for strengthening, longevity, maintenance of health etc. Milk, broth, ghee, oil etc are common ingredients.

# Yapana basti (यापनबस्तिः): Basti indicated for strengthening, longevity, maintenance of health etc. Milk, broth, ghee, oil etc are common ingredients.

# Ksheera basti: Milk is the major ingredient. ALong with milk, ghee, oil, honey can be used.

# Ksheera basti (क्षीरबस्तिः): Milk is the major ingredient. ALong with milk, ghee, oil, honey can be used.

# Matra basti: Type of anuvasana basti wherein medicated or plain oil is administered like anuvasana basti but the quantity of the oil is very less as compared to it.  

# Matra basti (मात्रा बस्तिः): Type of anuvasana basti wherein medicated or plain oil is administered like anuvasana basti but the quantity of the oil is very less as compared to it.

== What factors are considered before planning Basti for a patient? ==

== बस्तिप्रयोगपूर्वा समीक्षा ॥ What factors are considered before planning Basti for a patient? ==

Your [[Vaidya (वैद्यः)|Vaidya]] will examine you thoroughly and make assessment on the basis of Ayurveda's parameters. Usually Dashavidha pariksha (10 fold assessment) is done and only then it will be decided whether the patient needs basti therapy and all other details of basti treatment e.g. type, total period, ingredients, dose, do's and dont's etc. Acharya charaka has briefly listed the basic parameters a vaidya will consider before planning basti. Those are as follows,

Your [[Vaidya (वैद्यः)|Vaidya]] will examine you thoroughly and make assessment on the basis of Ayurveda's parameters. Usually Dashavidha pariksha (10 fold assessment) is done and only then it will be decided whether the patient needs basti therapy and all other details of basti treatment e.g. type, total period, ingredients, dose, do's and dont's etc. Acharya charaka has briefly listed the basic parameters a vaidya will consider before planning basti. Those are as follows,

When all these factors are considered, one can attain maximum benefits, desired outcomes and prevent adverse effects of basti therapy.  

When all these factors are considered, one can attain maximum benefits, desired outcomes and prevent adverse effects of basti therapy.  

== Common indications of basti ==

== बस्ति अर्हता ॥ Common indications of basti ==

Basti is the chief treatment for aggravated or vitiated vata dosha. Although it chiefly acts on vata, it does help to balance vitiated pitta and kapha dosha as well due to appropriately selected ingredients in basti preparation. Therefore basti is called as a supreme line of treatment.  

Basti is the chief treatment for aggravated or vitiated vata dosha. Although it chiefly acts on vata, it does help to balance vitiated pitta and kapha dosha as well due to appropriately selected ingredients in basti preparation. Therefore basti is called as a supreme line of treatment.  

Ayurveda scholars have also described the states specifically suitable for different types of bastis. The indications for 2 different types of basti are listed below.

Ayurveda scholars have also described the states specifically suitable for different types of bastis. The indications for 2 different types of basti are listed below.

=== Indications for niruha basti ===

=== निरुहबस्ति अर्हता ॥ Indications for niruha basti ===

There are certain conditions in which specifically niruha basti is recommended.<ref name=":2">Charaka Samhita (Siddhisthanam Adhyaya 2 Sutra 16-19)</ref> These are follows,

There are certain conditions in which specifically niruha basti is recommended.<ref name=":2">Charaka Samhita (Siddhisthanam Adhyaya 2 Sutra 16-19)</ref> These are follows,

# Various vata related diseases

# Various vata related diseases

=== Indications for Anuvasana basti ===

=== अनुवासनबस्ति अर्हता॥ Indications for Anuvasana basti ===

The diseases wherein niruha basti is recommended are also fit for Anuvasana type of basti. However, those who have excessive dryness in the body, strong agni and when the diseases are caused due to vata alone i.e not associated with ama require anuvasana type of basti chiefly. <ref name=":2" />  

The diseases wherein niruha basti is recommended are also fit for Anuvasana type of basti. However, those who have excessive dryness in the body, strong agni and when the diseases are caused due to vata alone i.e not associated with ama require anuvasana type of basti chiefly. <ref name=":2" />  

Niruha basti shows more of cleansing and purifying action whereas anuvasana type of basti is nourishing type. Thus basti is chosen depending upon the desired action. When both the types of basti are used in succession or alternatively, cleansing and tonic both the actions are performed at a time. One type of basti works better when paired with the other type also. Therefore many a times niruha and anuvasana bastis are administered in alternate manner or one after the other.  

Niruha basti shows more of cleansing and purifying action whereas anuvasana type of basti is nourishing type. Thus basti is chosen depending upon the desired action. When both the types of basti are used in succession or alternatively, cleansing and tonic both the actions are performed at a time. One type of basti works better when paired with the other type also. Therefore many a times niruha and anuvasana bastis are administered in alternate manner or one after the other.  

== Unfit for basti or contraindications ==

== बस्तिअनर्हता॥ Unfit for basti or contraindications ==

Basti is a type of Panchakarma which is known as detoxification or cleansing therapy. Since such therapies include administration of strong medicines and immediate elimination of body wastes through different routes of body, it needs careful observation. Therefore it is also extremely important to screen patients for their fitness before undergoing these procedures. Ayurveda scholars have listed certain conditions when the basti should not be given because then it might lead to serious adverse effects. These are called as contraindications for basti and are listed below.  

Basti is a type of Panchakarma which is known as detoxification or cleansing therapy. Since such therapies include administration of strong medicines and immediate elimination of body wastes through different routes of body, it needs careful observation. Therefore it is also extremely important to screen patients for their fitness before undergoing these procedures. Ayurveda scholars have listed certain conditions when the basti should not be given because then it might lead to serious adverse effects. These are called as contraindications for basti and are listed below.  

=== Unfit for Niruha basti ===

=== निरुहबस्तिअनर्हता॥ Unfit for Niruha basti ===

The person should not receive niruha basti if he/she is having following conditions,<ref name=":3">Charaka Samhita (Siddhisthanam Adhyaya 2 Sutram 15-17)</ref>

The person should not receive niruha basti if he/she is having following conditions,<ref name=":3">Charaka Samhita (Siddhisthanam Adhyaya 2 Sutram 15-17)</ref>

* Many other illnesses where administering large amount of decoction or suspension of multiple liquids might aggravate the already existing disease like intestinal perforation, obstruction etc.

* Many other illnesses where administering large amount of decoction or suspension of multiple liquids might aggravate the already existing disease like intestinal perforation, obstruction etc.

=== Unfit for Anuvasana Basti ===

=== अनुवासनबस्तिअनर्हता॥ Unfit for Anuvasana Basti ===

All those conditions where niruha basti is contraindicated, anuvasana basti is also contraindicated. In addition to that, certain other specific conditions where anuvasana basti is contraindicated are listed below,<ref name=":3" />

All those conditions where niruha basti is contraindicated, anuvasana basti is also contraindicated. In addition to that, certain other specific conditions where anuvasana basti is contraindicated are listed below,<ref name=":3" />

* other medical conditions where purification or cleansing is recommended and not nourishing e.g worm infestation

* other medical conditions where purification or cleansing is recommended and not nourishing e.g worm infestation

== How basti is given in today's times (Niruha basti or anuvasana basti) ==

== सांप्रतकाले बस्तिदानम्॥ How basti is given in today's times (Niruha basti or anuvasana basti) ==

Basti is known as the procedure there is rectal administration of medicated liquids. Thus technically it is somewhat similar to the enema procedure. However the instruments or tools used to administer basti have been described in depth in Ayurveda literature.  Dimensions of catheter tube, quantity of total fluid to be administered have been described as per age and basti type. As described earlier the basti obtains its name from the fact that urinary bladders of animals (thoroughly cleaned and processed) were used as the bags to hold the fluid and push it through catheter inside the rectum.  Nowadays, except in some of the Vaidya traditions in Kerala, basti administration is often done using enema-can or douche-set. In the aforesaid classical procedure active pressure is expected to be given on the bastiputaka whereas, in conventionally used enema-can only passive or gravitational force plays a role. It can also be used in children as well but with utmost care under physician’s supervision. The procedure of administering basti has been described in brief here.  

Basti is known as the procedure there is rectal administration of medicated liquids. Thus technically it is somewhat similar to the enema procedure. However the instruments or tools used to administer basti have been described in depth in Ayurveda literature.  Dimensions of catheter tube, quantity of total fluid to be administered have been described as per age and basti type. As described earlier the basti obtains its name from the fact that urinary bladders of animals (thoroughly cleaned and processed) were used as the bags to hold the fluid and push it through catheter inside the rectum.  Nowadays, except in some of the Vaidya traditions in Kerala, basti administration is often done using enema-can or douche-set. In the aforesaid classical procedure active pressure is expected to be given on the bastiputaka whereas, in conventionally used enema-can only passive or gravitational force plays a role. It can also be used in children as well but with utmost care under physician’s supervision. The procedure of administering basti has been described in brief here.