Basti in Panchakarma (पंचकर्मसु बस्तिः )

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Basti is the samskrit term which indicates urinary bladder or humans and animals. 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. Basti as a type of panchakarma suggests a procedure wherein the medicated oils or decoctions or combination of multiple medicated ingredients and their administration per rectally. In this article a brief account on the panchakarma procedure basti has been given.

Introduction

Basti is one of the five procedures of panchakarma in Ayurveda. Classically, it is advocated in the diseases of vata. It is mainly of two types viz. asthapana and anuvasana. According to the classical texts basti administration is done with the help of animal bladder (bastiputaka) and specially prepared metal/wooden nozzle/catheter (bastinetra), the whole assembly is called as bastiyantra. 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.

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.

Etymology

Etymology: According to Vachaspathyam the word “Basti” is derived from the root “Vas” by adding “Tich” Pratyaya and it belongs to masculine gender. Basti denotes a Karma wherein the drugs administered through the anal canal stays for certain time in the body (NIVASE) that produces the coating of the Sneha in the body (SNEHAACHADANA), and draws the waste substances from all over the body into the colon (GANDHA YACHANE), and eliminates them out of the body by producing the movement in the colon resulting into pleasant (beneficial) effect (SURBHIKARNE).

Basti denotes an organ which is a receptacle or reservior of urine i.e. “Urine bladder”. As it is basically a receptacle having soft and elastic nature, it was used as an instrument for drug administration with a constant pressure.

Types

The type of basti where decoction is the major part is called as asthapana basti or niruha basti and the basti in, which major part is oil or other sneha (oleaginous substance) is called as anuvasana.

Niruha basti,

Anuvasana basti and

Uttar basti

Basti Karma is broadly divided in two types according to the consistency of the drugs Sneha Basti(Anuvasan) and Niruha Basti (Aasthaapana) . In Sneha Basti/ Anuvasan Basti i.e. in this type medicated Oil/ Ghee, lipids are used, word Anuvasan indicates “To stay”, the administrated medicines stay inside for a longer duration, but still do not cause any untoward problem. 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 (Su.Chi 35/38).

Common indications of basti

Basti have been categorised into various types according to type of ingredients action of Basti & number of Basti. Medicines/ ingredients used in Basti Karma are selected as per the condition of disease & condition of the patient. Basti is commonly used alone or along with Ayurveda medication, in all Vata Vyadhi (neurological disorders) & is also indicated in various diseases as Anaha (Distended Abdomen), Malavrodh (Constipation), Rajokshay (Amenorrhea), Adhman (Abdominal spasmodic Pain), Vatrakta (Gout), Pleeha (splenomegaly) Parshva graham (Slipped Disc), Prishta graham (Spondylosis), Akshepak (Paralysis) etc. It is also used for increasing weight in emaciated peoples (by Brihan Basti), & for reduce weight in obese (by Lekhan Basti). It can also be used in children as well but with utmost care under physician’s supervision.

How basti is absorbed in body

  Lipid soluble drugs are absorbed by passive diffusion and some of the active ingredients are absorbed through active transport. The bioavailability of the drug i.e the part of the drug which is able to produce an active effect on the body, will be higher when given as Basti. As per Ayurvedic classics Basti works as plant watered at its root & then root circulate it in all branches (su.ch.35/24-25). It has also been described as Ardha Chikitsa (Ch.si.1/39). i.e. half treatment for management of diseases.

Mode of Action of Basti

Ayurveda is having its unique approach of explaining the complex subjects by giving the similes which are commonly seen in day to day life to understand the subject easily. Similes were used, because the objective parameters were not developed to an extent as they are today. Similies were used to explain complex mechanisms in the physiology, pathology (Symptomatology) and in the therapeutic measures. The same is true in the case of Basti also. A) Eliminative or purificative action of the Basti Acharya Charaka explained in Siddhi Sthana (7/64) that the Basti administered to the Pakvashaya draws the Dosha/Mala from all over the body from the foot to the head by virtue of its Virya, just as the sun situated in the sky draws the moisture from the earth by virtue of its heat. Why only the waste substance (Mala) is eliminated. This is explained by another simile in Charaka Siddhi (7/65). i.e. As the cloth sucks up the pigment only from the water dyed with flower, similarly Basti eliminates only the Mala (waste substances) from the body. B) Systemic action of the Basti Acharaya Sushruta explained in Chikitsa Sthana (36/25) that the Virya of the drugs administered through the Basti into the Pakvasaya reaches the whole body through the channels (Srotas), as the active principles in the water when poured at the root of the tree reaches the whole plant.

Basti - A Supreme Line Of Treatment

It is the Best threapy to regulate the Vata Dosha which is the chief governing force behind all the physiological and pathological processes both in the body and the mind. (Cha. Su.12/8, 17/118, 25/40,

Cha.Si. 1/38- 39, 10/17, 18).

It performs both the Upakramas viz. Langhana and Brumhana and can provide the benefit of whole of the Panchakarma by virtue of its specific type and different drugs utilised in it. (Cha.Si.11/16, 3/6 ).

It acts as both Samsodhana and Samsamana (Su. Ci. 35/3,4) It provides immediate strength; hence it is a supreme line of treatment, particularly in children and aged persons (Cha.Si 11/36).

It can be used in almost all the diseases by using specific drugs indicated in that disease condition (Ca. Si. 10/4, Su. Ci. 38/111)

There is no treatment equivalent to Basti in the protection of the Marmasthi and Sandhi in the management of their affliction, which are considered as vital parts in the body (Cha. Si. 9/7).

It eliminates the Doshas/Mala accumulated in the whole body; in turn alleviates the disease (Cha. Si. 1/28).