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Snehavyapat Siddhi (view source)

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|titlemode=append

|keywords=Impediments of sneha basti (unctuous enema), oleation therapy, abhuktapraneeta (empty stomach administration), annavrita (occluded due to food), kaphavrita ( occluded due to kapha), pittavrita (occluded due to pitta), pureeshavrita (occluded due to feces), snehabastivyapad, vatavrita (occluded due to vata)

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|description=Siddhi Sthana Chapter 4. ~~Management of complications~~ of unctuous enema ~~therapy~~

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|description=Siddhi Sthana Chapter 4. Complications of unctuous enema and their successful management

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'''<big>[[Siddhi Sthana]] Chapter 4. ~~Management of complications~~ of unctuous enema ~~therapy~~</big>'''

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'''<big>[[Siddhi Sthana]] Chapter 4. Complications of unctuous enema and their successful management </big>'''

<big>''' Abstract </big>'''

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Continuous excess use of both ''anuvasana'' and ''niruha'' is to be avoided as they cause ''utklesha- agnimandya'' (aggravation of ''kapha-pitta dosha'', decrease in digestion and metabolic process) and ''vata prakopa'' (vitiation of ''vata'') respectively. ''Matra basti'', that is similar to lowest dose of oleation, can be used in any season with no dietary restrictions.

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'''Keywords''': Impediments of ''sneha basti'' (unctuous enema), oleation therapy, ''abhuktapraneeta'' (empty stomach administration), ''annavrita'' (occluded due to food), ''kaphavrita'' ( occluded due to ''kapha''), ''pittavrita'' (occluded due to ''pitta''), ''pureeshavrita'' (occluded due to feces), ''snehabastivyapad, vatavrita'' (occluded due to ''vata'').

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'''Keywords''': Impediments of ''sneha basti'' (unctuous enema), oleation therapy, ''abhuktapraneeta'' (empty stomach administration), ''annavrita'' (occluded due to food), ''kaphavrita'' ( occluded due to ''kapha''), ''pittavrita'' (occluded due to ''pitta''), ''pureeshavrita'' (occluded due to feces), ''snehabastivyapad, vatavrita'' (occluded due to ''vata''), anuvasana basti, matra basti,

{{Infobox

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</div></div>

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Now ~~onwards~~ we ~~will describe~~ chapter [[Snehavyapat Siddhi]] (~~chapter on complications~~ of Unctuous enema and their successful management).

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Now we shall expound the chapter "Snehavyapat Siddhi" (Complications of Unctuous enema and their successful management).

Thus said Lord Atreya. [1-2]

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==== Various formulations ====

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=== Various formulations ===

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Unctuous enema formulations for attenuation of ''vata, pitta'' and ''kapha'', possible complications arising from improper administration and their treatments will be discussed. [3]

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==== Unctuous enema for ''vata'' disorders ====

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=== Unctuous enema for ''vata'' disorders ===

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Oil cooked with ''shatahva, yava, bilva'' and sour liquids is also useful for ''anuvasana'' in ''vata'' disorders. ''Anuvasana'' of warm ghee prepared by immersing hot rock salt relieves diseases caused by ''vata''. [8]

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==== Unctuous enema for ''pitta'' disorders ====

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=== Unctuous enema for ''pitta'' disorders ===

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Cow ghee should be taken one part, sesame oil one fourth of ghee and contents of ''chandanadi taila'' mentioned in [[Jwara Chikitsa]] ([[Chikitsa Sthana]], chapter 3) should be taken in one fourth quantity of total ''sneha'' and cooked with milk four times of ''sneha''. [9-12]

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==== Unctuous enema for ''kapha'' disorders ====

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=== Unctuous enema for ''kapha'' disorders ===

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Using this oil in ''snehapana,'' massage and ''basti'' cures ''kushtha'' (skin diseases), ''krimi'' (parasite infestations), ''meha'' (urinary disorders), ''arsha'' (haemorrhoids), ''grahani'' (gastrointestinal diseases), ''klibata'' (impotency), irregular appetite, ''mala'' (morbid matters) and diseases caused by all the three ''dosha''.[18-22]

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==== Effects of ''sneha basti'' ====

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=== Effects of ''sneha basti'' ===

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''Sneha basti'' gives strength to those who are emaciated due to disease, excessive exercise, labor, excess walking, loss of ''oja'' (vital essence) and semen. It gives great strength to feet, calves, thighs, back, shoulders and lumbar region. It is useful to procreate off springs for sterile men and women. [23-24]

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==== Six complications of ''sneha basti'' (unctuous enema) ====

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=== Six complications of ''sneha basti'' (unctuous enema) ===

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*Administration of enema in empty stomach. [25]

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==== Factors responsible for complication of ''sneha basti'' ====

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=== Factors responsible for complication of ''sneha basti'' ===

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Hereafter, the signs of different complications will be discussed. [26-28]

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==== Symptoms of impediment by ''vata'' and its management ====

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=== Symptoms of impediment by ''vata'' and its management ===

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Malaise, fever, ''adhmana'' (flatulence), ''sheeta'' (feeling of cold), ''stambha'' (stiffness), ''uru-pidana'' (pain in the thighs) and ''parshva-veshtana'' (cramps in the sides of chest) are symptoms from which a physician should come to know that ''basti'' is occluded due to ''vata''.

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===== Treatment of ''vata'' impediment =====

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==== Treatment of ''vata'' impediment ====

When ''anuvasana'' is occluded due to ''vata'' patient should be given ''niruha'' prepared with ''kalka'' (paste) of unctuous, sour, saline and hot ingredients; cow urine, decoction of ''brihatpanchamula, sauviraka'' (vinegar), ''sura'' (alcohol), ''kola, kulattha, yava'' along with ''rasna taila'' and ''pitadru taila''. In evening ''anuvasana'' of same oils (i.e. ''rasna'' and ''pitadru'' oil) should be given. [28-30]

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==== Symptoms of impediment by ''pitta'' and its management ====

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=== Symptoms of impediment by ''pitta'' and its management ===

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Burning sensation, redness, excess thirst, unconsciousness, ''tamaka'' (entering into darkness) and fever are symptoms from which a physician should come to know that ''basti'' is occluded due to ''pitta''. This occlusion can be removed by administration of enema containing sweet and bitter ingredients. [31]

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==== Symptoms of impediment by ''kapha'' and its management ====

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=== Symptoms of impediment by ''kapha'' and its management ===

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Drowsiness, cold, fever, lethargy, salivation, anorexia, heaviness, fainting and depression are symptoms from which a physician should come to know that ''basti'' is occluded due to ''kapha''. This occlusion can be removed by administration of enema prepared from alcohol and cows urine by adding ''madanaphala taila'' along with astringent, pungent, ''tikshna'', hot and sour ingredients. [32-33]

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==== Symptoms and treatment of impediment due to excess intake of food ====

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=== Symptoms and treatment of impediment due to excess intake of food ===

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Vomiting, fainting, anorexia, depression, colic pain, excess sleep, malaise, signs of ''ama'' and burning sensation are symptoms from which a physician should come to know that ''basti'' is occluded due to intake of food in excess. This occlusion can be removed by ''pachana'' (therapy to improve digestion) with pungent and saline decoctions or powders, mild purgation and therapies prescribed for correction of ''ama''. [34-35]

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==== Symptoms and treatment of impediment by stool ====

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=== Symptoms and treatment of impediment by stool ===

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Obstruction to the passage of stool, urine and flatus, pain, heaviness, flatulence and cardiac spasm are symptoms from which a physician should come to know that basti is occluded due to stool. This occlusion can be removed by oleation, fomentation and ''phala-varti'' (medicated suppository) therapies. ''niruha basti'' prepared with ''shyama, bilva'' etc. followed by ''anuvasana'' should be given appropriately. ''udavarta'' (reverse movement of ''vata'') treatment principles should be followed. [36-37]

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==== Ailments caused by administration of ''basti'' on empty stomach and their treatments ====

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=== Ailments caused by administration of ''basti'' on empty stomach and their treatments ===

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If due to impediments ''sneha basti'' is not removed completely or partially, but if no complications are observed then an expert physician can ignore the condition. [41]

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==== Diet after ''anuvasana basti'' ====

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=== Diet after ''anuvasana basti'' ===

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In the next morning after the night the expert physician should give water boiled with ''dhanyaka'' and ''nagara'' (''shunthi'') or simple warm water. This warm water helps the patient in the digestion of undigested fat and disintegrates ''kapha''. Therefore, after emesis, purgation, ''niruha'' and ''anuvasana'' therapies warm water is to be given to the patients for alleviation of ''vata'' and ''kapha''. [42-45]

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==== Frequency of ''anuvasana basti'' ====

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=== Frequency of ''anuvasana basti'' ===

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Persons who are habituated to take dry food, having strong digestive capacity, those indulged in physical exertion, sufferers of ''vata'' disorders, whose pelvic and hip regions are afflicted with ''vata'' and who are suffering from ''udavarta'' should be given ''anuvasana'' every day. As the water falling on sand gets absorbed immediately, similarly the fat given to these patients gets immediately digested. In case of others the ''agni'' generally digests ''sneha'' in three days. [46-47]

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==== Instructions before ''basti'' administration ====

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=== Instructions before ''basti'' administration ===

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*Use of fats orally and through ''basti'' simultaneously should be avoided as it vitiates ''vata'' and ''agni''. [48-49]

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==== Importance of alternate administration of ''sneha'' and ''niruha basti'' ====

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=== Importance of alternate administration of ''sneha'' and ''niruha basti'' ===

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Either ''niruha'' or ''anuvasana'' should not be given continuously in excess as, continuous ''anuvasana'' causes ''utklesha'' (excitement of ''dosha'') and suppression of digestive power. Continuous excess ''niruha'' causes ''vata'' aggravation. Thus, after ''niruha basti'' the patient should be given ''anuvasana'' and after ''anuvasana basti, niruha'' should be administered. Thus, by giving ''anuvasana'' and ''niruha'' appropriately, ''basti'' therapy cures diseases caused by all the three ''doshas''. [50-51]

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==== ''Matra basti'' ====

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=== ''Matra basti'' ===

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''Matra basti'' is always useful for persons emaciated by excess activities, exercise, weight lifting, long way faring, riding vehicles or indulging in sexual intercourse and for person who are weak and afflicted with ''vatika'' disorders. While taking ''matra basti'', the person can take food and do the activities as per his liking and can be administered in any season. The dose of ''matra basti'' is equal to the minimum dose of oleation therapy. ''Matra basti'' promotes strength and can be administered easily. It helps in easy voiding of stool. It causes nourishment and cures diseases caused by aggravated ''vata''. [52-54]

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==== Summary ====

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=== Summary ===

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Foremost ''basti'' preparations for ''vata'' and other ''dosha'' vitiation, complications arising from improper administration with their treatments, diet before administration, whom to give ''basti'' every day and for whom it is indicated on every third day, method of administration of ''anuvasana'' and ''matrabasti'' are the topics dealt with. [55-56]

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=== Tattva Vimarsha (Fundamental Principles) ===

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== Tattva Vimarsha (Fundamental Principles) ==

*Bioavailability of drugs and fats is more by ''basti'' as compared to oral route as degradation from metabolic enzymes is minimal and larger amount can be given by rectal route.

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== Vidhi Vimarsha (Applied Inferences ) ==

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==== Effect of ''Snehabasti'' ====

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=== Effect of ''Snehabasti'' ===

Charaka has given due importance to the nourishment properties of ''snehabasti''. Probable reason may be, drugs administered low in the rectum are delivered systemically by the inferior and middle rectal veins before passing through the liver.<ref>Van Hoogdalem EJ, de Boer AG, Breimer DD (1991) Pharmacokinetics of rectal drug administration: Part II: clinical applications of peripherally acting drugs, and conclusions. Clinical Pharmacokinetics. 21:110–128</ref><ref>Khalil SN, Florence FB, Van den Nieuwenhuyzen MC, Wu AH, Stanley TH (1990) Rectal methohexital: concentration and length of the rectal catheters. Anesth Analg. 70:645–649</ref> Thus the bioavailability increases as compared to oral route as degradation from metabolic enzymes is minimal. Hence energy providing capacity is more for ''snehabasti'' compared to oral fat consumption. Moreover, palatability is not an issue in ''basti'' hence larger doses for nourishment are possible to be used. Some fatty acids like omega-3-fatty acid, omega-9-fatty acid, alpha-linolenic acids, cervonic acid etc. are useful for normal intellectual capacity and brain functioning and also prevents ageing.<ref>Bourre JM. Roles of unsaturated fatty acids (especially omega-3 fatty acids) in the brain at various ages and during ageing. Journal of Nutrition Healthand Aging. 2004;8(3):163-74.</ref> ''Sneha'' itself and ''basti karma'' both remove ''vata'' hence age related degeneration due to increased ''vata'' can be hampered with the use of ''snehabasti'' which can be termed as ''oja'' enhancing effect. Higher intake of omega-3 fats is positively related to sperm morphology hence ''sneha basti'' can also be beneficial for semen’s qualitative improvement. [verse 23-24]

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==== Impediment by ''vata'' ====

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=== Impediment by ''vata'' ===

''Vata'' has ''ruksha'' (dry) property on virtue of which it may hamper smooth movement of ''snehabasti'' while ''pratyagamana'' (removal of ''basti''). Hydrogen sulphide produced by bacterial flora has inhibitory effect on intestinal motility <ref>Gallego D, Clave´ P, Donovan J, et al. The gaseous mediator, hydrogen sulphide, inhibits in vitro motor patterns in the human, rat and mouse colon and jejunum. Neurogastroenterol Motil 2008; 20:1306–1316</ref> which may be the possible reason for this occlusion. Hence the symptoms also resemble that of intestinal motility disorders <ref>https://emedicine.medscape.com/article/179937-overview</ref> and the treatment is targeted on improving the intestinal motility by use of certain drugs having ''tikshna'' properties and thus proves to be ''shodhana'' (helps evacuation) in nature. Salt has purgative action due to shifting of osmotic gradient, alcohol in low doses is responsible for enhanced gastric emptying<ref>Bujanda L, The effects of alcohol consumption upon the gastrointestinal tract, American Journal of Gastroenterology. 2000 Dec;95(12):3374-82.</ref>, vinegar, cow urine are the acidic preparations that may help in stimulating colonic mucosa that helps in evacuation of occluded enema. Thus, these drugs are commonly employed in treatment of impediment by ''vata''. [verse 26-30]

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==== Impediment by ''pitta'' ====

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=== Impediment by ''pitta'' ===

The normal site of ''pitta'' production in GI tract is ''pachyamanashaya'' which can be considered as a part of small intestine up to the level of caecum. However, impediment of ''snehabasti'' by ''pitta'' is probably a condition wherein ''vimarga-gamana'' (movement of ''pitta'' in improper direction) of ''pitta'' occurs which can be correlated with inflammation of colon due to any reason. If hot ''basti'' is given in already existing inflammation then it may lead to increase in symptoms. Thus, treatment is targeted to cure this acute inflammation. Hence sweet and bitter drugs are employed as they have ''pitta'' alleviating properties.[verse 31]

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==== Impediment by ''kapha'' ====

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=== Impediment by ''kapha'' ===

The normal site of ''kapha'' production in gastro-instestinal tract is ''amashaya'' which can be considered as stomach and an initial part of small intestine. ''Kapha'' has a role in moistening the gastric contents and facilitates its smooth passage in GI tract. Hence impediment by ''kapha'' can be well correlated with excess mucus activity which is secreted in stomach and carried to the intestine and colon by food or even secreted by colonic mucosa up to some extent. ''Sneha'' has ''snigdha'' (unctuous) properties which add to mucus activity hence leading to ''agnimandya'' that may produce the symptoms as described. Hence treatment is also planned to remove ''kleda'' (moisture) in order to reduce excess mucus activity.[verse 32-33]

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==== Impediment by food in excess quantity ====

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=== Impediment by food in excess quantity ===

Digestion of food starts from stomach and almost completed in small intestine. However, role of colon is very limited in digestion and confines to absorption of water, some minerals and produces vitamins by colonic bacterial flora. Thus, impediment by food suggests presence of undigested food that reaches colon. ''Ama'' is a product or is itself is undigested material of food. Thus, the symptoms of impediment by food resembles that of ''ama'' disorders. Undigested food material affects gastric motility hence ''pachana'' is the remedy that helps in digestion. Thus, in case of impediment by food ''pachana'' is preferred as it makes possible ''ama'' degradation into easily absorbable nutrients. If this ''pachana'' is not possible then mild purgation is also advised to remove out the undigested material.[verse 34-35]

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==== Impediment by stools ====

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=== Impediment by stools ===

Impediment by stools refers to the state of constipation or excess accumulation of stool in colon that obstructs the ''basti'' while evacuation. Constipation in general has following ill effects<ref>http://www.cpmc.org/services/gi/services/lowergut.html</ref> :

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All these effects reduce colonic motility and are similar to those symptoms of impediment by stool. Thus, treatment is targeted to resolve constipation and hence ''phalavarti'' and ''udavarta'' treatment principles are employed. [verse 36-37]

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==== Ailments caused by administration of ''basti'' on empty stomach ====

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=== Ailments caused by administration of ''basti'' on empty stomach ===

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When ''anuvasana'' is given on empty stomach or on emptied bowel or if the enema fluid is injected with great force then it goes up speedily and comes out from the throat or through the orifices in the upper part of the body which seems practically difficult phenomena but some evidences suggest that possibility cannot be ruled out. Materials introduced by enema, may in some instances pass through the valve into the ileum. Such incompetence may permit the enema fluid to reach the duodenum. Further, the possibility of material from even lower bowel reaching the mouth is strongly suggested by the fact that lycopodium spores, introduced into the colon by enema, have been recovered some hours later from washings of the stomach, alimentary canal movements<ref>Best C H, Taylor N B. ‘The Physiological Basis of Medical Practice-‘Alimentary Canal ~~Movemnets’~~.Seventh edition. Baltimore (U.S.A.): The Williams & Wilkins Company; 1961. pp. 715–691</ref>. Thus when alimentary tract is empty and clear the ''sneha'' due to its easy penetration capacity may reach up to mouth. The treatment suggested i.e. pressure application over throat results in sudden sympathetic activation leading to adrenaline production. As a result of this, the smooth muscles of the digestive tract are inhibited, so peristalsis stops, sphincter of the bladder also contracts and the bladder wall relaxes. This may lead to involuntary bowel movement<ref>Jurriaan Plesman, Anxiety and the Autonomic Nervous System, available from http://www.hypoglycemia.asn.au/2011/anxiety-and-the-autonomic-nervous-system/ cited on 23-04-2014</ref>. [verse 38-40]

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When ''anuvasana'' is given on empty stomach or on emptied bowel or if the enema fluid is injected with great force then it goes up speedily and comes out from the throat or through the orifices in the upper part of the body which seems practically difficult phenomena but some evidences suggest that possibility cannot be ruled out. Materials introduced by enema, may in some instances pass through the valve into the ileum. Such incompetence may permit the enema fluid to reach the duodenum. Further, the possibility of material from even lower bowel reaching the mouth is strongly suggested by the fact that lycopodium spores, introduced into the colon by enema, have been recovered some hours later from washings of the stomach, alimentary canal movements<ref>Best C H, Taylor N B. ‘The Physiological Basis of Medical Practice-‘Alimentary Canal Movements’.Seventh edition. Baltimore (U.S.A.): The Williams & Wilkins Company; 1961. pp. 715–691</ref>. Thus when alimentary tract is empty and clear the ''sneha'' due to its easy penetration capacity may reach up to mouth. The treatment suggested i.e. pressure application over throat results in sudden sympathetic activation leading to adrenaline production. As a result of this, the smooth muscles of the digestive tract are inhibited, so peristalsis stops, sphincter of the bladder also contracts and the bladder wall relaxes. This may lead to involuntary bowel movement<ref>Jurriaan Plesman, Anxiety and the Autonomic Nervous System, available from http://www.hypoglycemia.asn.au/2011/anxiety-and-the-autonomic-nervous-system/ cited on 23-04-2014</ref>. [verse 38-40]

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==== Importance of warm water in ''snehabasti'' course ====

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In clinical practice, this condition is extremely rare.

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=== Importance of warm water in ''snehabasti'' course ===

Drinking warm water accelerates the gastric emptying<ref>http://www.emptyingthebowel.com/index.php?option=com_content&view=article&id=98:how-to-manipulate-gut-motility&catid=44:manipulating-the-process-of-defecation&Itemid=119 </ref>, clears the bowel and hence prevents indigestion or constipation during ''basti'' course. It also has inhibitory effect on mucus production<ref>http://www.top10homeremedies.com/home-remedies/home-remedies-phlegm.html</ref> thus preventing from ''kapha'' vitiation. When hot water is consumed, the body temperature goes up and sweating starts, which can flush the toxic materials out of internal system and cleanse it properly.<ref>http://www.stylecraze.com/articles/benefits-of-hot-water-for-skin-hair-and-health/ </ref> [verse 43-45]

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==== Frequency of ''anuvasana basti'' ====

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=== Frequency of ''anuvasana basti'' ===

In ''vata'' dominant individuals ''anuvasana'' is indicated daily. ''Pakvashaya'' i.e. colon is the site of production of ''vata''. Hence to cure any ''vata'' disorder the production of ''vata'' has to be hampered which is achieved by giving ''snehabasti''. In ''vata'' dominance in ''koshtha, snehabasti'' is readily absorbed because ''vata'' has ''ruksha'' (dry) property (AH. Su. 1/11) that in turn gives dryness to the colonic mucosa which attains proper oleation when comes in contact with ''basti''.[verse 46-47]

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==== Advice regarding ''basti'' administration ====

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=== Advice regarding ''basti'' administration ===

*Unprocessed ''snehabasti'' is to be avoided in general as it causes ''abhishyanda''. This may be explained by the fact that uncooked fats contain more free radicals<ref>Prabhu, H.R. Lipid peroxidation in culinary oils subjected to thermal stress. Indian J Clin Biochem (2000) 15: 1. https://doi.org/10.1007/BF02873539 </ref> and long chain fatty acids. Whereas due to cooking the free radicals are removed and long chain fatty acids may get converted into short chain fatty acids. Free radicals have a number of ill effects and they may increase preexisting inflammation<ref>Li XY1, Gilmour PS, Donaldson K, MacNee W, Free radical activity and pro-inflammatory effects of particulate air pollution (PM10) in vivo and in vitro, Thorax, 1996 Dec;51(12):1216-22</ref>. Short chain fatty acids are easily absorbed from colon whereas long chain fatty acids are rarely absorbed. <ref>Ruppin H, Bar-Meir S, Soergel KH, Wood CM, Schmitt MG Jr, Absorption of short-chain fatty acids by the colon, Gastroenterology. 1980 Jun;78(6):1500-7.</ref>

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*''Utklesha, agnimandya'' and ''vataprakopa''- Continuous use of ''snehabasti'' may cause ''utklesha'' as ''snehabasti'' is also an alternative way of oleation therapy (Ch. Su. 13/24). If continued still further, then ''ama'' formation occurs as indigested ''sneha'' and ''utklishtha'' (eager to be removed) ''dosha'' are not removed from the body by any ''shodhana'' procedure like ''virechana'' or ''niruha''. ''Niruha'' on the contrary causes removal of vitiated ''dosha'', next comes ''dhatu'' and when ''dhatus'' are removed from body then ''vata'' vitiation occurs. This can be correlated to the fact that if continuous ''niruha'' are given, it causes inflammation of mucosal lining or may further damage the colonic mucosa leading to leakage of nutrients from mucosa and negatively affecting nutritional activity of colonic bacterial flora.[verse 48-49]

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==== ''Matra basti'' ====

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=== ''Matra basti'' ===

''Matrabasti'' is a low dose form of snehabasti which is equal to lowest dose of oleation therapy. According to Vagbhata, the dose of ''matra basti'' is equal to the dose of ''hrasva snehapana''. The ''matra'' which gets digested in two ''yama'' i.e. 6 hours, is called as ''hrasva matra'' but the dose required to get digested in two ''yama'' is not mentioned( A.S.Su 28/8). According to Sushruta, the dose of ''matra basti'' is ¼ of the dose of ''anuvasana basti'' and the dose of ''anuvasana basti'' is ¼ of ''niruha basti'' i.e. 24 ''pala''. Hence, the dose of ''anuvasana basti'' is 6 ''Pala'' and dose of ''matra basti'' is 1½ ''Pala'' i.e. 6 ''tola''(Su. Chi. 37/80). On the basis of above reference it can be said that the dose of ''matra basti'' is 1½ ''pala'' of ''sneha'' i.e. 6 ''tola'' equal to 60-70 ml. According to Kashyapa the dose of ''matrabasti'' is, (Ka. Khi. 8/104-5):

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The capacity to hold fecal matter, also termed as rectal compliance ranges between 60ml to 500ml<ref>Felt-Bersma RJ1, Sloots CE, Poen AC, Cuesta MA, Meuwissen SG. Rectal compliance as a routine measurement: extreme volumes have direct clinical impact and normal volumes exclude rectum as a problem, Disease of Colon & Rectum. 2000 Dec;43(12):1732-8</ref>. This may be the probable reason to use a dose in quantity lower than 60ml in order to retain the ''sneha'' for longer duration in rectum so that the volume of absorption increases. Hence though given in lower doses ''matrabasti'' can give similar results as that of other ''snehabasti'' in respect of oleation and nutritive activity.[verse 52-54]

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==== Practically employed methods regarding schedule of ''snehabasti'' ====

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=== Practically employed methods regarding schedule of ''snehabasti'' ===

Charaka has advocated to give continuously anuvasana maximum for 3 days, However ''matrabasti'' can be given continuously for longer durations. Generally, ''niruha'' and ''anuvasana'' are given alternately to avoid any complications. The maximum dose of ''snehabasti'' is 1/4th of maximum dose of ''niruha'' (Approx. 240 ml) and is to be given on the same day in evening after ''niruha''. But practically such large doses are not used and up to 120 ml of ''snehabasti'' (classically ''anuvasana'') is given on the next day of administration of ''niruha''.

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*''Yamaka'' (combination of different type of fats) ''sneha'', needs to be tested clinically in large sample size as it is considered that combination of ''sneha'' gives ''rasayana'' effect.

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~~=== Glossary ===~~

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== References ==

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~~#Snēhabastī ( स्नेहबस्ति): Oiliness, unctousness, lubricity, moisture, oil medicated unctous enema having quantity four times less to that of decoction enema.~~

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#Mātrābasti ( मात्राबस्ति): A form of unctous enema, The medicated enema given in such a dose which will show no complications even if the post-therapy regimen are not followed.

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#anuvāsana (अनुवासनं): A form of medicated unctous enema which can be given every day and which doesn’t harm the body even if retained inside. The dose of the anuvasana basti is half to that of sneha basti.

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#Nirūhaḥ (निरूह): The medicated enema having more quantity of the decoction prepared out of various drugs and possessing very potent action by which it expels the dosha out of the body (niruha) and there by gives relief from the dieases, prolons life and stabilizes the body tissues (asthaapana ).

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#Pañchakarma (पञ्चकर्म): Internal Bio-cleansing therapy / detoxification therapy. Literally means fivefold therapeutic action, is a collective expression for the cleansing of one’s physical constitution. The five fold therapies comprises of emesis, catharsis, decoction enema, unctuous enema and errhine therapy.

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~~#Oja (ओज): immunity or the general strength of body or the bodily essence~~

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#Āma (आम): 1. Raw, uncooked, unbaked, immature, unripe 2. May be associated with food or other physiological entities to mean incomplete transformation or metabolism causing a harmful effect on health

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~~#Udāvarta (उदावर्त): Abnormal condition characterized by retention of faeces, urine and flatus, associated with pain and leading to or caused by anti peristaltic movements in the body~~

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~~#Stambha (स्तम्भ): One of the six folds of the therapeutic measure or action of drug action causing contraction of tissues, arrest of secretion, or control of bleeding.~~

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~~#Abhiṣyanda (अभिष्यन्द): stuffiness or obstruction in srotas produced by food having slimy & heavy nature; e.g. Curd~~

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#Utklēśa (उत्क्लेश): An abnormal condition either made therapeutically or manifested on its own wherein there is quantitatively increase in the dosha as a result they move upwards in the body and this movement of the dosha is experienced by patient as a discomfort in and around cardiac region.

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=== References ===

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