Asthapana basti

Asthapana basti or niruha basti (therapeutic decoction enema) is a prime treatment for disorders due to vitiation of vata dosha. It can expel out the increased dosha. [Cha.Sa. Siddhi Sthana 1/27] Niruha basti (therapeutic decoction enema) can pacify vata at its root i.e. colon. Thus, it protects the whole body from diseases due to vata dosha. Both asthapana (therapeutic decoction enema) and virechana (therapeutic purgation) remove the doshas from the body through the colon. Asthapana basti (therapeutic decoction enema) has the advantage of eliminating dosha without causing difficulties like belching, pain in the heart region and koshtha (gut). [Cha.Sa. Siddhi Sthana 10/07] Niruha (therapeutic decoction enema) can be administered in weak persons, where virechana is contraindicated. (therapeutic purgation) [Cha.Sa. Chikitsa Sthana 28/86] Virechana (therapeutic purgation) is contraindicated in children and old people, whereas asthapana (therapeutic decoction enema) can be used for lifetime. [Cha.Sa. Siddhi Sthana 10/07] This chapter focuses on the concept and practices of asthapana basti (therapeutic decoction enema).

Contributors

Section/Chapter/topic	Concepts/Basti/Asthapana basti
Authors	Adarsh P. M. 1, Deole Y.S. 2
Reviewer & Editor	Basisht G.3
Affiliations	1 Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, 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	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.s09.145

Etymology and derivation

Asthapana: The word asthapana is derived from aan, stha with lyut suffix in Sanskrit. This means to stay in one place (for longer time). Asthapana prevents the aging process by fixing the malfunctioning dosha.
Niruha: The word niruha is derived from nir (निर्) (privative)+ uha (ऊहा) (reasoning)+ karane (करणे घञ्). Thus, the word niruha stands for the treatment whose effect is beyond reasoning (or effective without any doubt).

Synonyms: Asthapana basti, niruha basti, kashaya basti

Types of asthapana basti

1. Based on veerya (potency):
1. Mridu asthapana basti (mild potency): The basti with mild potency is indicated in diseases of short duration, easy to cure, and having minimum strength.[Cha.Sa.Siddhi Sthana 10/15,16]. It is indicated in persons of inferior mental strength (avara sattva).[Su.Sa.Chikitsa Sthana 38/90]. It is indicated explicitly in old age and children.[Su.Sa.Chikitsa Sthana 35/10]The basti becomes mild (mridu), when milk (ksheera) etc. are added to it.[Cha.Sa.Siddhi Sthana 7/63]
   Prasrutika basti is an example of mridu basti (basti with mild potency), which is indicated for tender/delicate persons(sukumaras). There are chatur prasrutika, pancha prasrutika, shat prasrutika, sapta prasrutika and nava prasrutika bastis mentioned in prasruthayogika siddhi.
2. Teekshna asthapana basti (strong potency): The basti with strong potency is indicated in diseases of prolonged duration, challenging to cure, and having maximum strength. It can be administered in persons having superior mental strength (pravara sattva). The basti will get sharpness (teekshnatvam), when it gets added with cow’s urine (gomutra), pilu (Salvadora persica Linn), Chitraka (Plumbago zeylanica), salt (lavana) and alkali (kshara).
2. Based on effect (karma):
1. Utkleshana basti: This type of basti is intended to aggravate dosha in dormant state (leena avastha). After initial aggravation, the basti expelles the dosha to create equilibrium. Eranda beeja (seed of Ricinus communis), madhuka (Madhuka longifolia), pippali (Piper longum), saindhava (rock salt) and hapusha phala (Juniperus communis Linn.) as kalka are the ingredients of utkleshana basti. [Su.Sa. Chikitsa Sthana 35/93]
2. Doshahara basti : This pacifies dosha by removing them.The ingredients of doshahara basti are satahva (Anethum sowa), madhuka (Madhuca longifolia), kutaja beeja (Holarrhena antidysenterica), madanaphala (Randia dumetorum) along with kanjika (fermented rice gruel) and gomutra (cow’s urine). [Su.Sa. Chikitsa Sthana 35/94].
3. Dosha shamana basti: This pacifies dosha with mild potency.Priyangu (Callicarpa macrophylla), Madhuka (Madhuca longifolia), Musta (Cyperus rotundus), Rasanjana (semisolid extract obtained from decotion of Berberis aristata with milk) along with cow’s milk (goksheera) are the ingredients. [Su.Sa. Chikitsa Sthana 35/95]
3. Yapana basti (enema for sustaining life)
   Yapana bastis can be administered in all seasons. There are 12 types of yapana bastis mentioned and they are indicated in different stages of all diseases. They serve the action of niruha basti (therapeutic decoction enema) and sneha basti (therapeutic unctuous enema). Mustadi yapana basti. shaliparnyadi yapana basti, sthiradi yapana basti are examples of yapana basti. [Cha.Sa. Siddhi Sthana 12/16-17]
4. Piccha basti (enema for healing)
   Piccha basti is a kind of asthapana basti prepared using slimy (picchila) dravyas. It is indicated in conditions like diarrhea (atisara), where there is bleeding from rectum. [Cha.Sa. Chikitsa Sthana 19/93]
5. Ksheera basti (enema with medicated milk)
   The type of asthapana basti where medicated milk (shrita ksheera) is used instead of decoction is known as ksheera basti. It is also a kind of mridu basti (basti with mild potency). It is indicated mainly in diseases like vatarakta (rheumatism due to vitiated vata and rakta), sandhigata vata (degenerative joint disorder), visarpa (erysipelas), vatavyadhi (disorders due to vata) etc.
6. Rakta basti (enema with animal blood)
   Rakta basti contains the blood of freshly killed animals which is indicated mainly in atisara(diarrhea) where the patient is debilitated by losing blood through the rectum. It is indicated in raktatisara (ulcerative colitis with blood in stools) and jeevadana vyapat of virechana (therapeutic purgation) and basti (therapeutic enema). [Cha.Sa. Siddhi Sthana 6/82]
7. Doshaghna basti
1. Vataghna basti
   In diseases having the aggravation vata dosha, the basti processed with the decoction prepared out of drugs having the property to pacify vata (vataghna aushadha). Trividha sneha (combination of three snehas viz ghee, plant oil and muscle fat.), amla dravyas (drugs having sour taste) and saindhava (rock salt) is used. [Su.Sa. Chikitsa Sthana 38/77]
2. Pittaghna basti
   In diseases associated with pitta dosha, basti (therapeutic enema) processed with the decoction of nyagrodhadi gana combined with kakolyadi gana as kalka (paste) along with ghee and sugar is advised. [Su.Sa. Chikitsa Sthana 38/78]
3. Kaphaghna basti
   In diseases having an association of kapha dosha, basti (therapeutic enema) processed with the decoction of aragvadhadi gana combined with pippalyadi gana as kalka (medicinal paste) along with honey, cow’s urine (gomutra) is to be used. [Su.Sa. Chikitsa Sthana 38/79]
4. Rakta shamana basti
   In diseases having loss of blood (shonita pravrutti), the enema processed with the decoction prepared out of ksheeri vrikshas (group of trees starting from nyagrodha) combined with sugar cane juice), milk, ghee, and sugar is used. [Su.Sa. Chikitsa Sthana 38/80]
8. Shodhana basti
   The enema, which is processed with the decoction and medicinal paste of shodhana dravyas (group of drugs with purifying action), with rock salt and unctuous substance (sneha) is known as the shodhana basti. [Su.Sa. Chikitsa Sthana 38/81]
9. Lekhana basti:
   The enema is processed with the decoction of triphala, cow’s urine, honey, alkali (kshara) and combined with ushakadi gana as a medicinal paste (kalka), known as lekhana basti. [Su.Sa. Chikitsa Sthana 38/82]
10. Brimhana basti:
    The basti processed with the decoction of drugs having the nourishing property(brimhana) combined with the drugs having a sweet taste (madhura rasa) as a medicinal paste (kalka) along with ghee and meat soup (mamsarasa) is known as brimhana basti. [Su.Sa. Chikitsa Sthana 38/83]
11. Grahi basti
    The enema is processed with the drugs of priyangvadi gana combined with ambashtadi gana as medicinal paste and honey and ghee known as grahi basti. [Su.Sa. Chikitsa Sthana 38/87]
12. Madhutailika basti
    When honey (madhu) and oil (taila) are given equal importance in enema, then it is known as madhutailika basti. Yapana basti, yuktharadha basti and siddha basti are synonyms of madhutailika basti. It helps remove the doshas and bring up the strength and complexion of a patient. The peculiarity of this kind of enema is that there will be no restrictions on diet, beverages, travel, and sexual intercourse. The enema shows many benefits to the patient with no complications at all. [Su.Sa. Chikitsa Sthana 38/114]

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