Yapana basti

The word ‘yapana’ means to sustain or to maintain. The therapeutic enema (basti) intended for sustaining life is termed as ‘Yapana basti’. It is indicated in chronic and critical conditions like urolithiasis (ashmari), insanity (unmada), obstinate urinary diseases (prameha), abdominal distension (adhmana), vatarakta.[Cha.Sa. Siddhi Sthana 12/16] It is used for providing instant nourishment and strength. In current practices, yapana basti is mainly used in disease of shukra and asthi dhatu like infertility and lumbar spondylosis etc.. The present chapter deals with specific indications of yapana basti and its utility in current practices.

Contributors

Section/Chapter/topic	Concepts/Basti/Yapana basti
Authors	Kulkarni Gajanan1 Deole Y.S.2 Bhatt Hemisha2
Reviewer & Editor	Basisht G.3
Affiliations	1 Consultant, Ayurveda Clinic, Pune, India 2 Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India 3 Rheumatologist, Orlando, Florida, U.S.A.
Correspondence emails	ayurgk@yahoo.co.in, dryogeshdeole@gmail.com, carakasamhita@gmail.com
Publisher	Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of publication:	August 25, 2023
DOI	10.47468/CSNE.2023.e01.s09.146

Etymology and derivation

The word ‘Yapana’ is derived from combination of ya + nich + lyut. ‘Yapya’ means to be expelled or to be discharged. [Monnier-Williams Sanskrit-English Dictionary, 1899]

Synonyms

Following words are synonymous to yapana.

• Dharanam – to maintain [Su. Sa. Nidana Sthana 1/12]
• Poshanam – to nourish [Su. Sa. Nidana Sthana 14/30]
• Rog-shamanam – to pacify disease [Su. Sa. Chikitsa Sthana 6/13]
• Yatrakara- supporting journey of life [Cha. Sa. Sutra Sthana 18/39]
• The basti which promotes longevity of life is ‘yapana basti’ [Chakrapani on Cha. Sa. Siddhi Sthana 12/17]
• Pranadharana- sustain viatality [Arundatta A.Hr. Kalpa Sthana 14/29]

Difference in Yapana and Anuvasana basti

Table no.1: Difference in Yapana basti, Anuvasana Basti and Niruha Basti

Yapan basti	Anuvasana basti	Niruha basti
Mild (mrudu) in nature	It can be mild (mrudu) or sharp (tikshna) based on ingredients	Sharp (Tikshna) in nature
It leads to purification (shodhana) and nourishment (brimhana) at same time.	It mainly leads to nourishment (brimhana).	Mainly for purification (shodhan) purpose.
Mamsa, asthi and majjagat dhatu related diseases are treated by giving yapana basti	Vata vyadhi and depletion related disorders (apatarpanottha roga) can be treated by giving anuvasana basti	Vata vyadhi and over nutrition related disorders (santarpanottha roga) are treated by giving niruha basti
Can be administered in healthy individual	Can be administered in healthy individual by less dose	Mostly can’t be given in healthy person
Single yapana basti is given	Combination with niruha gives more results	Always combine with anuvasana
Basti retention time is more than niruha	Basti retention time is 3 hours	Retention time is 48 minutes

Ingredient described in different context:

Charak Samhita(12)	Sushrut Samhita(1)	Ashtang hruday(2)
Jaggery (guda)	Mustadi Rajyapan basti (su.chi.38/103)	Honey (Madhu)
Ghee (ghrita)	Medicinal decoction (mustadi kwath)	Oil (Tail)
Oil (taila), medicated paste (kalka)	Milk (ksheera)	Meat soup(mamsa rasa)
Honey (kshaudra)	Meat soup(mamsa rasa)	Ghee (ajya)
Medicated milk (siddha ksheera)	Medicated paste (kalka)	Medicated paste (ghana kalka)
Meat soup (mamsa rasa)		Musle fat (Vasa)(prasut)
Amlakanji (sour fermented liquid)

Pharmacological property of different ingredients of yapana basti:

Sr no	Contents	Sanskrit name	Rasa (taste)	Veerya (potency)	Vipaka (post digestion effect)	Guna (properties)	Chemical constituents
1	Milk	Kshira	Madhura (sweet)	Sheeta (cold)	Madhura (sweet)	Snigdha (unctuous) Sara (moving)	Lactose Lipid Lieolinic acid Palmitic acid
2	Honey	Madhu	Madhur Kashay	Sheeta	Madhura	Sheeta, Laghu, Shukshma, Vishada, Ropana,	Glucose Lactose Vanallic acid Pinobanksin Galangin
3	Meat soup	Mamsa rasa	Madhura		Madhura	Guru	75% of water, 25% of solids. Solids: 20% of proteins, 5% of organic substances
4	Ghee	Ghruta	Madhura	Sheet	Madhura	Alpa Abhishyandikari	Leonalic acid, Beutenolic acid, Lanosterol,
5	Rock salt	Saindhav	Lavan	sheet	madhur	Laghu Snigdha Sukshma	Nacl
6	Oil	Taila	As per its source	Ushna	As per its source	Tikshna, Vyavayi, Sukshma	Lipid Folic acid, nicotinic acid, planteose, pentosan
7	Jaggery	Guda	Madhura	Ushna	Madhur	Laghu, Unabhishyandi	Sucrose Fat Protein Ash
8	Fermented alcohol based formulation	Amla kanji	Amla	ushna	Amla	Laghu, Tikshna	Fermented chemicals

Indications

Yapana basti is indicated for purification (shodhana), nourishment (brimhana) with proper functioning of vayu (vata anulomana). These are mridu basti. [Cha. Sa. Siddhi Sthana 12/29], hence these are indicated in diseases due to vata pitta vitiation and depletion of shukra and mamsa dhatu (ksheena).
It is indicated in following conditions:

1. Vishama jvara [Cha. Sa. Chikitsa Sthana 3/302]
   Visham jwara is a condition where both strength (bala) of dosha and dhatu are diminished. Hence these types of fevers come intermittently.
2. Halimaka [Cha. Sa. Chikitsa Sthana 16/136]
   Halimaka is state where vata and pitta are excessively increased and have excessive bala – shukra kshaya, redering the patient in very critical condition.
3. Avrutta vata [Cha. Sa. Chikitsa Sthana 28/240]
   Long standing conditions of avrutta vayu inevitabely lead to emaciation of dhatu (shosha). Here yapan is used to increase dhatu as well as to achieve sroto shodhana and vata anulomana.
4. Jara sambhavaja klaibya [Cha. Sa. Chikitsa Sthana 30/203]
   Jara is a condition where rasa dhatu is unable to nourish all other dhatus
5. Pain in lower half of body
   It eradicates pain from rectum, thighs, knee joints, scrotum and bladder. (Payu janu uru vrushan basti shulnut) [Aas. Hru. Kalpa Sthana 4/29]

Sushruta Samhita advise yapan basti in following condition: [Su.Sa. Chikitsa Sthana 38/111]

1. Vatrakta
2. Meha
3. Shopha
4. Arsha
5. Gulma
6. Mutrakruchhha
7. Chakshushya
8. Visarp
9. Jwara
10. Raktapitta
11. Balya
12. Sanjeevan
13. Shoolanashak
14. Vrushya

Method of preparation

1. Material required in making basti
• Basti putak (enema bag)
• Basti netra (nozzle)
• Gloves
• Cotton cloth
• Mortal & pastel
2. Ingredients of basti
1. In case of yapana basti, medicated milk (sidhdha ksheera) is used in place of kashaya (decoction)
2. Honey, mamsa rasa, ghee are other major ingredients used in yapana basti.
3. Procedure to formulate & administration of basti:

Pre-procedure:

1. Preparation of patient
2. Preparation of basti.

1. Preparation of patient:
   After the evacuation of bladder and bowels, local massage and fomentation on pelvic region shall be done.
2. Preparation of basti:
   First of all, the dravyas soaked in warm water for overnight then next morning milk and water should be added with the measurement 1:8:16 and kept for boiling upto ashtamansh shoshit (..).
   This siddha ksheera is kept nearby. Then take morter and pestle and add lavan and triturate it properly then add makshik followed by sneh (ghrut/tail/vasa) followed by kalka (various aushadhi) and then sidhdh ksheera. Make homogenous mixture of it by continuous stirring of morter within pestle. The proportion of dravyas are as per classical list.

Main procedure (pradhana karma) and post procedure (pashchat karma):

The procedure for administration of yapana basti and post therapeutic protocol are same as like therapeutic enema (basti).
Some clinical research suggests that average retention time of yapan basti is 92 minutes.(Gajanan Kulkarni)

Adverse effect and it’s management:

The improper administration of yapana basti can lead to following adverse effects like oedema, loss of digestive power, anemia, pain, hemorrhoids, proctalgia/fissure in ano, fever, diarrhea.
In such cases, patients are treated with medicinal formulations like arishta, kshira, sidhu. All the treatment planned should be aimed at increasing the power of digestion. [Cha.Sa. Siddhi Sthana 2/31]
Sometime due to its mild nature (mrudutva), the yapana basti does not get eliminated out of body. Then immediately another asthapana basti with cow urine (gomutra) and other sharply acting agents (tikshna dravyas) should be administered.

Time of administration

Yapana basti can be given at all times and after meal also.

Practical application and rationale behind using of yapana basti

Among all these diseases which are mentined above, there is obvious loss of one or more components (dhatu) of the body. Moreover, all these dieases are chronic in nature.
The following phenomena appear in this type of diseases due to the damage to body components that has already taken place (dhatukshaya) and prolonged presence of the disease in the body.

1. Vata dosha rages very strongly (vayurdhatukshayatkopo). This overpowered vayu carries pitta and kapha dosha to different parts of body [Cha. Sa. Chikitsa Sthana 28/60] and gets obstructed by them. Once it gets obstructed there, vayu starts absorbing and emaciating the dhatu present there. [Cha.Sa. Chikitsa Sthana 28/61]
   This extension in the pathology of original disease gives rise to more depletion of dhatu (dhatu kshaya) and causing new symptoms or disease.
   It means that the original disease becomes more serious. If we look at these diseases like halimaka, vishama jvara etc., these all are fatal in nature, because such type of extended pathophysiology.
2. Prolonged disease condition with extension of dosha in all over body involves all other systems in body in disease process. This makes the original disease multisystemic disorder, and this can cause critical condition of the patient.
3. From the discussion, so far it is clear that the following things happen in all of the above mentioned diseases :
1. Great loss of body components in a progressive way
2. Very strong dominance of vata in pathogenesis due to dhatukshaya and avarana as well.
3. Multi system involvement
4. A huge fall in strength of body. (balaadhishthanam aarogyam) [Cha.Sa. Chikitsa Sthana 3]

Now considering the treatment of these conditions, there needs to be a treatment that has, nourishment (brimhana), strengthening power (balya), pacifying vayu (vata shamana), anulomana and clearing the channels (srotoshodhan) property.
Yapan basti hits all these criteria to treat these ailments surely.
This clearing of channels (srotoshodhana), provides lubrication (snehana), vata anulomana, nourishment (brimhana) and strengthening power (balya). Yapan basti becomes a radical therapy there.

Things to be avoided during yapan basti therapy

Vyayama – exercise
Maithuna – sexual activities
Madya – alcoholic beverages
Madhu – honey
Shishira ambu –Intake of cold water
Rath kshobha – travelling

Current researches

Effect of yapana basti in shukragata vata

In a clinical study, the effect of yapana basti and akarakarabhadi yoga was assessed in cases of shukragata vata. The patients treated with protocol of yapana basti and akarkarbhadi yoga showed considerable improvement (55.35%) in premature ejaculation.

Effect of yapana basti in shukra dushti

In a clinical study, the effect of yapana basti was assessed in case of shukra dushti. The patient treated with protocol of yapana basti and vajikarana yoga showed considerable improvement in semen volume (32%), sperm viability(14.6%) and sperm count(42.58%).

Effect of yapana basti in pakshaghata

In clinical study, the effect of yapana basti was assessed in case of pakshaghata. The patient treated with protocol of yapan basti and karm basti showed considerable improvement in speech (100%), facial expression (44.44%), and drooping wrist (21.42%).

Effect of yapana basti in kampavata

In a clinical study, the effect of yapana basti was assessed in case of kampavata. The patient treated with protocol of yapan basti showed considerable improvement in kampa (tremors) (41.17%), stambha (stiffness) (46.15%), in gati vikriti (movements) (60%), in vak vikriti (abnormal speech)(50%) and smriti (memory)(33.33%).

Effect of yapana basti in katigraha

In a clinical study, the effect of yapana basti was assessed to study its efficacy in katigraha (lumbago with stiffness). The patient treated with protocol of erandmuladi yapana basti and erandabeeja kshirapaka showed considerable improvement in katigraha (lumbago with stiffness) (70%), kati shula (pain in waist) (70.97%), sparsha asahatwa (tenderness) (91.11%).

Effect of yapana basti in cervical spondylosis

In a clinical study, the effect of yapana basti was assessed in case of cervical spondylosis. The patient treated with protocol of bruhatyadi yapan basti and patrapinda sweda showed considerable improvement in spine, like flexion (81.82%), extension (67.74%), lateral rotation (82.93%), numbness (91.30%), tingling sensation (80.95%).

Effect of yapana basti in vandhyatva (infertility)

In a clinical study, the effect of yapana basti was assessed in cases of vandhyatva. The patient treated with protocol of brihtyadi yapana basti and shivalingi beej churna showed considerable improvement in effect on ovulation (80%) and follicular size.

These preliminary studies show positive effects of yapana basti in various conditions. More focused research can be helpful in understanding effect of yapana basti in chronic and critical conditions.

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