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{{#seo:
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|title=Snehavyapat Siddhi
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|titlemode=append
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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), Ayurveda, charak samhita, Indian system of medicine.
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|description=Siddhi Sthana Chapter 4. Complications of unctuous enema and their successful management
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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|image_alt=charak samhita
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|type=article
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}}
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'''<big>[[Siddhi Sthana]] Chapter 4. Complications of unctuous enema and their successful management </big>'''
 
{{Infobox
 
{{Infobox
 
|title = Snehavyapat Siddhi
 
|title = Snehavyapat Siddhi
Line 9: Line 20:
 
|label5 = Other Sections
 
|label5 = Other Sections
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]
−
 
+
|label6 = Translator and commentator
−
|header3 =  
+
|data6 = Thakar A. B., Auti S.
−
 
+
|label7 = Reviewer
 +
|data7  = Mangalasseri P., Auti S.
 +
|label8 = Editors
 +
|data8  = Thakar A. B., Mangalasseri P., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
 +
|label9 = Year of publication
 +
|data9 =  2020
 +
|label10 = Publisher
 +
|data10 =  [[Charak Samhita Research, Training and Skill Development Centre]]
 +
|label11 = DOI
 +
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s08.005 10.47468/CSNE.2020.e01.s08.005]
 
}}
 
}}
  
−
==[[Siddhi Sthana]] Chapter 4, Chapter on Management of complications of unctuous enema therapy==
+
<big>''' Abstract </big>'''
−
 
+
<p style="text-align:justify;">The fourth chapter of [[Siddhi Sthana]], [[Snehavyapat Siddhi]], deals with various formulations of ''sneha basti'' (unctuous enema) and management of complications caused due to its improper administration. ''Sneha basti'' formulations, their clinical applications, reasons for ''sneha basti'' occlusion, symptoms of impediment, ailments caused by administration of ''[[basti]]'' on empty stomach, their treatments and ''matra basti'', etc. have been explained in detail in this chapter. Vitiated ''[[dosha]]s'' , excess food, and stools are responsible for obstructions and empty stomach administration leads to improper movement of ''sneha basti''. Liquid, hot, light, wholesome food and warm water use have been suggested for avoidance of these complications.
−
=== Abstract ===
+
<br/>
−
 
+
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.
−
The fourth chapter of [[Siddhi Sthana]], [[Snehavyapat Siddhi]], deals with various formulations of ''sneha basti'' (unctuous enema) and management of complications caused due to its improper administration. ''Sneha basti'' formulations, their clinical applications, reasons for ''sneha basti'' occlusion, symptoms of impediment, ailments caused by administration of ''basti'' on empty stomach, their treatments and ''matra basti'', etc. have been explained in detail in this chapter. Vitiated ''doshas'' , excess food, and stools are responsible for obstructions and empty stomach administration leads to improper movement of ''sneha basti''. Liquid, hot, light, wholesome food and warm water use have been suggested for avoidance of these complications.
+
<br/>
−
 
+
'''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,
−
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.
+
</p>
−
 
 
−
'''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'').
 
  
−
=== Introduction ===
 
  
−
Charaka has explained schedule, importance and symptoms of proper and improper ''basti'' administration, indications- contraindications, elaborated ''basti'' procedure and ''niruha basti'' formulations in earlier three chapters. Thus, in this sequence acharya has described fourth chapter to put forward some ''sneha basti'' formulations. Purpose of [[Siddhi Sthana]] is to give excellence in therapeutics thus the complications arising due to some improper methods need to be tackled. Vitiated ''dosha,'' fecal matter, indigestion are some factors that occlude the ''basti'' and empty stomach administration leads to improper movement of fats. Moreover, due to busy work schedule, improper dietary habits and debilitating disorders most of the patients are unsuitable for ''anuvasana'' or ''sneha basti''. In such individuals if ''vata'' vitiation is evident and needs ''basti'' therapy, then use of ''sneha basti'' (unctuous enema) in lowest dose i.e. ''matra basti'' can be employed without any complications.
+
== Introduction ==
 +
<div style="text-align:justify;">
 +
The schedule, importance and symptoms of proper and improper ''[[basti]]'' administration, indications- contraindications, elaborated ''[[basti]]'' procedure and ''niruha basti'' formulations are explained in earlier three chapters. Thus, in this sequence the present chapter is described to put forward some ''sneha basti'' (unctuous enema) formulations. In order to fulfill the purpose of [[Siddhi Sthana]] to give excellence in therapeutics, the complications arising due to some improper methods need to be tackled. Vitiated ''[[dosha]],'' fecal matter, indigestion are some factors that occlude the ''[[basti]]'' and empty stomach administration leads to improper movement of fats. Moreover, due to busy work schedule, improper dietary habits and debilitating disorders most of the patients are unsuitable for ''anuvasana'' or ''sneha basti''. In such individuals if ''[[vata]]'' vitiation is evident and needs ''[[basti]]'' therapy, then use of ''sneha basti'' (unctuous enema) in lowest dose i.e. ''matra basti'' can be employed without any complications.
  
−
===Sanskrit text, Transliteration and English Translation===
+
== Sanskrit text, Transliteration and English Translation ==
 +
<div class="mw-collapsible mw-collapsed">
  
 
अथातः स्नेहव्यापत्सिद्धिं  व्याख्यास्यामः||१||  
 
अथातः स्नेहव्यापत्सिद्धिं  व्याख्यास्यामः||१||  
  
 
इति ह स्माह भगवानात्रेयः||२||  
 
इति ह स्माह भगवानात्रेयः||२||  
 +
<div class="mw-collapsible-content">
 +
 +
athātaḥ snēhavyāpatsiddhiṁ  vyākhyāsyāmaḥ||1||
  
−
athātaḥ snēhavyāpatsiddhiṁ  vyākhyāsyāmaḥ||1|
 
−
|
 
 
iti ha smāha bhagavānātrēyaḥ||2||  
 
iti ha smāha bhagavānātrēyaḥ||2||  
  
Line 41: Line 62:
  
 
iti ha smAha bhagavAnAtreyaH||2||  
 
iti ha smAha bhagavAnAtreyaH||2||  
 +
</div></div>
  
−
Now onwards we will describe chapter [[Snehavyapat Siddhi]] (chapter on complications of Unctuous enema and their successful management).  
+
Now we shall expound the chapter "Snehavyapat Siddhi" (Complications of Unctuous enema and their successful management).  
 
Thus said Lord Atreya. [1-2]
 
Thus said Lord Atreya. [1-2]
  
−
==== Various formulations ====
+
=== Various formulations ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
स्नेहबस्तीन्निबोधेमान् वातपित्तकफापहान्|  
 
स्नेहबस्तीन्निबोधेमान् वातपित्तकफापहान्|  
  
 
मिथ्याप्रणिहितानां च व्यापदः सचिकित्सिताः||३||  
 
मिथ्याप्रणिहितानां च व्यापदः सचिकित्सिताः||३||  
 +
<div class="mw-collapsible-content">
  
 
snēhabastīnnibōdhēmān vātapittakaphāpahān|  
 
snēhabastīnnibōdhēmān vātapittakaphāpahān|  
Line 58: Line 82:
  
 
mithyApraNihitAnAM ca vyApadaH sacikitsitAH||3||
 
mithyApraNihitAnAM ca vyApadaH sacikitsitAH||3||
 +
</div></div>
  
−
Unctuous enema formulations for attenuation of ''vata, pitta'' and ''kapha'', possible complications arising from improper administration  and their treatments will be discussed. [3]
+
Unctuous enema formulations for attenuation of ''[[vata]], [[pitta]]'' and ''[[kapha]]'', possible complications arising from improper administration  and their treatments will be discussed. [3]
  
−
==== Unctuous enema for ''vata'' disorders ====
+
=== Unctuous enema for ''[[vata]]'' disorders ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
दशमूलं बलां रास्नामश्वगन्धां पुनर्नवाम्|  
 
दशमूलं बलां रास्नामश्वगन्धां पुनर्नवाम्|  
Line 76: Line 102:
  
 
अनुवासनमेतद्धि सर्ववातविकारनुत्|  
 
अनुवासनमेतद्धि सर्ववातविकारनुत्|  
 +
<div class="mw-collapsible-content">
  
 
daśamūlaṁ balāṁ rāsnāmaśvagandhāṁ punarnavām|  
 
daśamūlaṁ balāṁ rāsnāmaśvagandhāṁ punarnavām|  
Line 104: Line 131:
  
 
anuvAsanametaddhi sarvavAtavikAranut|   
 
anuvAsanametaddhi sarvavAtavikAranut|   
 +
</div></div>
  
 
{| class="wikitable" style="width: 100pt;"|
 
{| class="wikitable" style="width: 100pt;"|
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|-
 
|-
 
|rowspan="27"| Drugs for Decoction
 
|rowspan="27"| Drugs for Decoction
−
| ''Bilva''
+
| ''Bilva'', ''Shyonaka'', ''Gambhari'',''Patala'',''Ganikarika'',
−
| 1 ''Pala''
+
''Shaliparni'',''Prishniparni'',''Brihati'',''Kantakarika'',''Gokshura'',
−
|-
+
''Bala'',''Ashwagandha'',''Punarnava'',''Guduchi'',''Rasna'',
−
| ''Shyonaka''
+
''Eranda'',''Bhutika'',''Bharangi'',''Vasa'',''Rohisha'',''Shatavari'',''Kakanasa''
−
| 1 ''Pala''
+
| 1 ''Pala'' each
−
|-
 
−
| ''Gambhari''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Patala''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Ganikarika''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Shaliparni''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Prishniparni''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Brihati''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Kantakarika''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Gokshura''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Bala''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Rasna''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Ashwagandha''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Punarnava''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Guduchi''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Eranda''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Bhutika''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Bharangi''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Vasa''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Rohisha''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Shatavari''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Kakanasa''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Yava''
 
−
| 2 ''Pala''
 
−
|-
 
−
| ''Masha''
 
−
| 2 ''Pala''
 
−
|-
 
−
| ''Atasi''
 
−
| 2 ''Pala''
 
−
|-
 
−
| ''Kola''
 
−
| 2 ''Pala''
 
 
|-
 
|-
−
| ''Kulattha''
+
| ''Yava'',''Masha'',''Atasi'',''Kola'',''Kulattha''
−
| 2 ''Pala''
+
| 2 ''Pala'' each
 
|-
 
|-
 
| Water
 
| Water
−
|
 
 
| 4 ''Drona''
 
| 4 ''Drona''
 
|-
 
|-
 
| Sesame Oil
 
| Sesame Oil
−
|
 
 
| 1 ''Adhaka''
 
| 1 ''Adhaka''
 
|-
 
|-
 
| Milk
 
| Milk
−
|
 
 
| 1 ''Adhaka''
 
| 1 ''Adhaka''
 
|-
 
|-
−
| rowspan="10"|''Kalka''
+
|''Kalka'' of ''Jivaka'',''Rishabhaka'',''Meda'',''Mahameda'',''Kakoli'',
−
| ''Jivaka''
+
''Kshirakakoli'',''Mudgaparni'',''Mashaparni'',''Jivanti'',''Madhuka''
−
| 1 ''Pala''
+
| 1 ''Pala'' each
−
|-
 
−
| ''Rishabhaka''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Meda''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Mahameda''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Kakoli''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Kshirakakoli''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Mudgaparni''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Mashaparni''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Jivanti''
 
−
| 1 ''Pala''
 
−
|-
 
−
| ''Madhuka''
 
−
| 1 ''Pala''
 
 
|}
 
|}
  
−
The decoction of above mentioned drugs should be prepared using four ''drona'' (approx. 49 liters) of water, boiling till 1 ''drona'' ( approx. 12.2 liters) of liquid remains. To this decoction paste of above mentioned herbs, 1 ''adhaka'' (approx. 3.07 liters) sesame oil and milk should be added. The oil prepared with this method can be used successfully in all ''vata'' disorders in ''anuvasana'' form. [4-7]
+
The decoction of above mentioned drugs should be prepared using four ''drona'' (approx. 49 liters) of water, boiling till 1 ''drona'' ( approx. 12.2 liters) of liquid remains. To this decoction paste of above mentioned herbs, 1 ''adhaka'' (approx. 3.07 liters) sesame oil and milk should be added. The oil prepared with this method can be used successfully in all ''[[vata]]'' disorders in ''anuvasana'' form. [4-7]
 +
<div class="mw-collapsible mw-collapsed">
  
 
आनूपानां वसा तद्वज्जीवनीयोपसाधिता||७||  
 
आनूपानां वसा तद्वज्जीवनीयोपसाधिता||७||  
 +
<div class="mw-collapsible-content">
  
 
ānūpānāṁ vasā tadvajjīvanīyōpasādhitā||7||  
 
ānūpānāṁ vasā tadvajjīvanīyōpasādhitā||7||  
  
 
AnUpAnAM vasA tadvajjIvanIyopasAdhitA||7||
 
AnUpAnAM vasA tadvajjIvanIyopasAdhitA||7||
 +
</div></div>
  
−
''Anuvasana basti'' prepared from ''vasa'' i.e. muscle fat of animals inhabiting marshy land, boiled with drugs of ''jivaniya gana'' i.e. ''jivaka, rishabhaka, meda, mahameda, kakoli, kshirakakoli, mudgaparni, mashaparni, jivanti, madhuka'' cures ''vata'' disorders. [7]
+
''Anuvasana basti'' prepared from ''vasa'' i.e. muscle fat of animals inhabiting marshy land, boiled with drugs of ''jivaniya gana'' i.e. ''jivaka, rishabhaka, meda, mahameda, kakoli, kshirakakoli, mudgaparni, mashaparni, jivanti, madhuka'' cures ''[[vata]]'' disorders. [7]
 +
<div class="mw-collapsible mw-collapsed">
  
 
शताह्वायवबिल्वाम्लैः सिद्धं तैलं समीरणे|  
 
शताह्वायवबिल्वाम्लैः सिद्धं तैलं समीरणे|  
  
 
सैन्धवेनाग्नितप्तेन तप्तं चानिलनुद्धृतम्||८||  
 
सैन्धवेनाग्नितप्तेन तप्तं चानिलनुद्धृतम्||८||  
 +
<div class="mw-collapsible-content">
  
 
śatāhvāyavabilvāmlaiḥ siddhaṁ tailaṁ samīraṇē|  
 
śatāhvāyavabilvāmlaiḥ siddhaṁ tailaṁ samīraṇē|  
Line 258: Line 189:
  
 
saindhavenAgnitaptena taptaM cAnilanuddhRutam||8||  
 
saindhavenAgnitaptena taptaM cAnilanuddhRutam||8||  
 +
</div></div>
  
−
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]
+
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]
  
−
==== Unctuous enema for ''pitta'' disorders ====
+
=== Unctuous enema for ''[[pitta]]'' disorders ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
जीवन्तीं मदनं मेदां श्रावणीं मधुकं बलाम्|  
 
जीवन्तीं मदनं मेदां श्रावणीं मधुकं बलाम्|  
Line 278: Line 211:
  
 
तैलपादं  घृतं सिद्धं पित्तघ्नमनुवासनम्||१२||
 
तैलपादं  घृतं सिद्धं पित्तघ्नमनुवासनम्||१२||
 +
<div class="mw-collapsible-content">
  
 
jīvantīṁ madanaṁ mēdāṁ śrāvaṇīṁ madhukaṁ balām|  
 
jīvantīṁ madanaṁ mēdāṁ śrāvaṇīṁ madhukaṁ balām|  
Line 310: Line 244:
  
 
tailapAdaM  ghRutaM siddhaM pittaghnamanuvAsanam||12||  
 
tailapAdaM  ghRutaM siddhaM pittaghnamanuvAsanam||12||  
 +
</div></div>
  
 
{| class="wikitable"
 
{| class="wikitable"
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|}
 
|}
  
−
Cow ghee and oil should be taken one part and cooked with milk four times along with above mentioned pastes of herbs (all together one fourth of ''sneha''). This formulation of ''anuvasana basti'' is nourishing, alleviates ''vata'' and ''pitta'', increases strength, semen and ''agni'' (digestive power). Also it cures diseases of urinary, seminal and menstrual origin.
+
Cow ghee and oil should be taken one part and cooked with milk four times along with above mentioned pastes of herbs (all together one fourth of ''sneha''). This formulation of ''anuvasana basti'' is nourishing, alleviates ''[[vata]]'' and ''[[pitta]]'', increases strength, semen and ''agni'' (digestive power). Also it cures diseases of urinary, seminal and menstrual origin.
  
 
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]
 
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]
  
−
==== Unctuous enema for ''kapha'' disorders ====
+
=== Unctuous enema for ''kapha'' disorders ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
सैन्धवं मदनं कुष्ठं शताह्वां निचुलं वचाम्  |  
 
सैन्धवं मदनं कुष्ठं शताह्वां निचुलं वचाम्  |  
Line 375: Line 311:
  
 
तैलं कफहरैर्वाऽपि कफघ्नं कल्पयेद्भिषक्||१७||
 
तैलं कफहरैर्वाऽपि कफघ्नं कल्पयेद्भिषक्||१७||
 +
<div class="mw-collapsible-content">
  
 
saindhavaṁ madanaṁ kuṣṭhaṁ śatāhvāṁ niculaṁ vacām  |  
 
saindhavaṁ madanaṁ kuṣṭhaṁ śatāhvāṁ niculaṁ vacām  |  
Line 415: Line 352:
  
 
tailaM kaphaharairvA~api kaphaghnaM kalpayedbhiShak||17||
 
tailaM kaphaharairvA~api kaphaghnaM kalpayedbhiShak||17||
 +
</div></div>
  
 
{| class="wikitable"
 
{| class="wikitable"
Line 461: Line 399:
 
|}
 
|}
  
−
''Anuvasana basti'' prepared with above mentioned ingredients cures ''kaphaja'' disorders, ''bradhna'' (inguinal enlargements), ''udavarta''(reverse movement of ''vata''), ''gulma''(abdominal lumps), ''arsha'' (haemorrhoids), ''pliha'' (spenic disorders), ''meha'' (urinary disorders), ''adhyavata'' (disease due to ''vata'' occluded by excess ''meda''), ''anaha''(distension of abdomen), ''ashmari'' (calculus).[13-17]
+
''Anuvasana basti'' prepared with above mentioned ingredients cures ''kaphaja'' disorders, ''bradhna'' (inguinal enlargements), ''udavarta''(reverse movement of ''[[vata]]''), ''gulma''(abdominal lumps), ''arsha'' (haemorrhoids), ''pliha'' (spenic disorders), ''meha'' (urinary disorders), ''adhyavata'' (disease due to ''[[vata]]'' occluded by excess ''[[meda]]''), ''anaha''(distension of abdomen), ''ashmari'' (calculus).[13-17]
 +
<div class="mw-collapsible mw-collapsed">
  
 
विडङ्गैरण्डरजनीपटोलत्रिफलामृताः|  
 
विडङ्गैरण्डरजनीपटोलत्रिफलामृताः|  
Line 482: Line 421:
  
 
प्रयुक्तं प्रणुदत्याशु पानाभ्यङ्गानुवासनैः||२२||  
 
प्रयुक्तं प्रणुदत्याशु पानाभ्यङ्गानुवासनैः||२२||  
 +
<div class="mw-collapsible-content">
  
 
viḍaṅgairaṇḍarajanīpaṭōlatriphalāmr̥tāḥ|  
 
viḍaṅgairaṇḍarajanīpaṭōlatriphalāmr̥tāḥ|  
Line 522: Line 462:
  
 
prayuktaM praNudatyAshu pAnAbhya~ggAnuvAsanaiH||22||  
 
prayuktaM praNudatyAshu pAnAbhya~ggAnuvAsanaiH||22||  
 +
</div></div>
  
 
{| class="wikitable"
 
{| class="wikitable"
Line 589: Line 530:
 
|}
 
|}
 
   
 
   
−
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]
+
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]
  
−
==== Effects of ''sneha basti'' ====
+
=== Effects of ''sneha basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
व्याधिव्यायामकर्माध्वक्षीणाबलनिरोजसाम्|  
 
व्याधिव्यायामकर्माध्वक्षीणाबलनिरोजसाम्|  
Line 600: Line 542:
  
 
जनयेदप्रजानां च प्रजां स्त्रीणां तथा नृणाम्||२४||  
 
जनयेदप्रजानां च प्रजां स्त्रीणां तथा नृणाम्||२४||  
 +
<div class="mw-collapsible-content">
  
 
vyādhivyāyāmakarmādhvakṣīṇābalanirōjasām|  
 
vyādhivyāyāmakarmādhvakṣīṇābalanirōjasām|  
Line 616: Line 559:
  
 
janayedaprajAnAM ca prajAM strINAM tathA nRuNAm||24||  
 
janayedaprajAnAM ca prajAM strINAM tathA nRuNAm||24||  
 +
</div></div>
  
−
''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]
+
''Sneha basti'' gives strength to those who are emaciated due to disease, excessive exercise, labor, excess walking, loss of ''[[ojas]]'' (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]
  
−
==== Six complications of ''sneha basti'' (unctuous enema) ====
+
=== Six complications of ''sneha basti'' (unctuous enema) ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
वातपित्तकफात्यन्नपुरीषैरावृतस्य च|  
 
वातपित्तकफात्यन्नपुरीषैरावृतस्य च|  
  
 
अभुक्ते च प्रणीतस्य स्नेहबस्तेः षडापदः||२५||  
 
अभुक्ते च प्रणीतस्य स्नेहबस्तेः षडापदः||२५||  
 +
<div class="mw-collapsible-content">
  
 
vātapittakaphātyannapurīṣairāvr̥tasya ca|  
 
vātapittakaphātyannapurīṣairāvr̥tasya ca|  
Line 632: Line 578:
  
 
abhukte ca praNItasya snehabasteH ShaDApadaH||25||  
 
abhukte ca praNItasya snehabasteH ShaDApadaH||25||  
 +
</div></div>
  
 
''Sneha Basti'' causes following six complications:
 
''Sneha Basti'' causes following six complications:
−
*Occlusion of enema fluid by ''vata''
+
*Occlusion of enema fluid by ''[[vata]]''
−
*Occlusion of enema fluid by ''pitta''
+
*Occlusion of enema fluid by ''[[pitta]]''
−
*Occlusion of enema fluid by ''kaph''a
+
*Occlusion of enema fluid by ''[[kapha]]''
 
*Occlusion of enema fluid by food
 
*Occlusion of enema fluid by food
 
*Occlusion of enema fluid by feces
 
*Occlusion of enema fluid by feces
 
*Administration of enema in empty stomach. [25]
 
*Administration of enema in empty stomach. [25]
  
−
==== Factors responsible for complication of ''sneha basti'' ====
+
=== Factors responsible for complication of ''sneha basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
शीतोऽल्पो वाऽधिके वाते पित्तेऽत्युष्णः कफे मृदुः|  
 
शीतोऽल्पो वाऽधिके वाते पित्तेऽत्युष्णः कफे मृदुः|  
Line 650: Line 598:
  
 
अभुक्तेऽनावृतत्वाच्च यात्यूर्ध्वं तस्य लक्षणम्||२७||  
 
अभुक्तेऽनावृतत्वाच्च यात्यूर्ध्वं तस्य लक्षणम्||२७||  
 +
<div class="mw-collapsible-content">
  
 
śītō'lpō vā'dhikē vātē pittē'tyuṣṇaḥ kaphē mr̥duḥ|  
 
śītō'lpō vā'dhikē vātē pittē'tyuṣṇaḥ kaphē mr̥duḥ|  
Line 666: Line 615:
  
 
abhukte~anAvRutatvAcca yAtyUrdhvaM tasya lakShaNam||27||  
 
abhukte~anAvRutatvAcca yAtyUrdhvaM tasya lakShaNam||27||  
 +
</div></div>
  
−
*If ''basti'' preparation is too cold or less than therapeutic dose and given in ''vata'' dominant patient,
+
*If ''[[basti]]'' preparation is too cold or less than therapeutic dose and given in ''[[vata]]'' dominant patient,
−
*If hot ''basti'' is given in ''pitta'' dominant patient,
+
*If hot ''[[basti]]'' is given in ''[[pitta]]'' dominant patient,
−
*If mild ''basti'' is given in ''kapha'' dominant patient,
+
*If mild ''[[basti]]'' is given in ''[[kapha]]'' dominant patient,
−
*If ''basti'' prepared with ''guru'' (those digests relatively late) drugs is given in patient who has overeaten.
+
*If ''[[basti]]'' prepared with ''guru'' (those digests relatively late) drugs is given in patient who has overeaten.
−
*If ''basti'' of mild nature is given in patient having stool accumulation,
+
*If ''[[basti]]'' of mild nature is given in patient having stool accumulation,
  
−
Then ''basti'' becomes occluded and does not reach its destination as it gets covered with ''dosha''. Similarly, if ''basti'' is given in patient with empty stomach then it goes upwards as all the channels are uncovered.  
+
Then ''[[basti]]'' becomes occluded and does not reach its destination as it gets covered with ''[[dosha]]''. Similarly, if ''[[basti]]'' is given in patient with empty stomach then it goes upwards as all the channels are uncovered.  
  
 
Hereafter, the signs of different complications will be discussed. [26-28]
 
Hereafter, the signs of different complications will be discussed. [26-28]
  
−
==== Symptoms of impediment by ''vata'' and its management ====
+
=== Symptoms of impediment by ''[[vata]]'' and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
अङ्गमर्दज्वराध्मानशीतस्तम्भोरुपीडनैः  |  
 
अङ्गमर्दज्वराध्मानशीतस्तम्भोरुपीडनैः  |  
Line 690: Line 641:
  
 
ताभ्यामेव च तैलाभ्यां सायं भुक्तेऽनुवासयेत्||३०||  
 
ताभ्यामेव च तैलाभ्यां सायं भुक्तेऽनुवासयेत्||३०||  
 +
<div class="mw-collapsible-content">
  
 
aṅgamardajvarādhmānaśītastambhōrupīḍanaiḥ  |  
 
aṅgamardajvarādhmānaśītastambhōrupīḍanaiḥ  |  
Line 714: Line 666:
  
 
tAbhyAmeva ca tailAbhyAM sAyaM bhukte~anuvAsayet||30||  
 
tAbhyAmeva ca tailAbhyAM sAyaM bhukte~anuvAsayet||30||  
 +
</div></div>
  
−
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''.
+
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]]''.
  
−
===== Treatment of ''vata'' impediment =====
+
==== 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]
+
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]
  
−
==== Symptoms of impediment by ''pitta'' and its management ====
+
=== Symptoms of impediment by ''[[pitta]]'' and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
दाहरागतृषामोहतमकज्वरदूषणैः|  
 
दाहरागतृषामोहतमकज्वरदूषणैः|  
  
 
विद्यात् पित्तावृतं स्वादुतिक्तैस्तं बस्तिभिर्हरेत्||३१||
 
विद्यात् पित्तावृतं स्वादुतिक्तैस्तं बस्तिभिर्हरेत्||३१||
 +
<div class="mw-collapsible-content">
  
 
dāharāgatr̥ṣāmōhatamakajvaradūṣaṇaiḥ|  
 
dāharāgatr̥ṣāmōhatamakajvaradūṣaṇaiḥ|  
Line 734: Line 689:
  
 
vidyAt pittAvRutaM svAdutiktaistaM bastibhirharet||31||  
 
vidyAt pittAvRutaM svAdutiktaistaM bastibhirharet||31||  
 +
</div></div>
  
−
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]
+
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]
  
−
==== Symptoms of impediment by ''kapha'' and its management ====
+
=== Symptoms of impediment by ''[[kapha]]'' and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
तन्द्राशीतज्वरालस्यप्रसेकारुचिगौरवैः|  
 
तन्द्राशीतज्वरालस्यप्रसेकारुचिगौरवैः|  
Line 746: Line 703:
  
 
फलतैलयुतैः साम्लैर्बस्तिभिस्तं विनिर्हरेत्||३३||  
 
फलतैलयुतैः साम्लैर्बस्तिभिस्तं विनिर्हरेत्||३३||  
 +
<div class="mw-collapsible-content">
  
 
tandrāśītajvarālasyaprasēkārucigauravaiḥ|  
 
tandrāśītajvarālasyaprasēkārucigauravaiḥ|  
Line 762: Line 720:
  
 
phalatailayutaiH sAmlairbastibhistaM vinirharet||33||  
 
phalatailayutaiH sAmlairbastibhistaM vinirharet||33||  
 +
</div></div>
  
−
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]
+
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]
  
−
==== Symptoms and treatment of impediment due to excess intake of food ====
+
=== Symptoms and treatment of impediment due to excess intake of food ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
छर्दिमूर्च्छारुचिग्लानिशूलनिद्राङ्गमर्दनैः  |  
 
छर्दिमूर्च्छारुचिग्लानिशूलनिद्राङ्गमर्दनैः  |  
Line 774: Line 734:
  
 
विरेको मृदुरत्रामविहिता च क्रिया हिता||३५||  
 
विरेको मृदुरत्रामविहिता च क्रिया हिता||३५||  
 +
<div class="mw-collapsible-content">
  
 
chardimūrcchāruciglāniśūlanidrāṅgamardanaiḥ  |  
 
chardimūrcchāruciglāniśūlanidrāṅgamardanaiḥ  |  
Line 790: Line 751:
  
 
vireko mRuduratrAmavihitA ca kriyA hitA||35||  
 
vireko mRuduratrAmavihitA ca kriyA hitA||35||  
 +
</div></div>
  
−
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]
+
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]
  
−
==== Symptoms and treatment of impediment by stool ====
+
=== Symptoms and treatment of impediment by stool ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
विण्मूत्रानिलसङ्गार्तिगुरुत्वाध्मानहृद्ग्रहैः|  
 
विण्मूत्रानिलसङ्गार्तिगुरुत्वाध्मानहृद्ग्रहैः|  
Line 802: Line 765:
  
 
निर्हरेद्विधिना सम्यगुदावर्तहरेण च||३७||  
 
निर्हरेद्विधिना सम्यगुदावर्तहरेण च||३७||  
 +
<div class="mw-collapsible-content">
  
 
viṇmūtrānilasaṅgārtigurutvādhmānahr̥dgrahaiḥ|  
 
viṇmūtrānilasaṅgārtigurutvādhmānahr̥dgrahaiḥ|  
Line 818: Line 782:
  
 
nirharedvidhinA samyagudAvartahareNa ca||37||
 
nirharedvidhinA samyagudAvartahareNa ca||37||
 +
</div></div>
  
−
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]
+
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]
  
−
==== Ailments caused by administration of ''basti'' on empty stomach and their treatments ====
+
=== Ailments caused by administration of ''[[basti]]'' on empty stomach and their treatments ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
अभुक्ते शून्यपायौ वा वेगात् स्नेहोऽतिपीडितः|  
 
अभुक्ते शून्यपायौ वा वेगात् स्नेहोऽतिपीडितः|  
Line 834: Line 800:
  
 
छर्दिघ्नीभिः क्रियाभिश्च तस्य कार्यं निवर्तनम्||४०||  
 
छर्दिघ्नीभिः क्रियाभिश्च तस्य कार्यं निवर्तनम्||४०||  
 +
<div class="mw-collapsible-content">
  
 
abhuktē śūnyapāyau vā vēgāt snēhō'tipīḍitaḥ|  
 
abhuktē śūnyapāyau vā vēgāt snēhō'tipīḍitaḥ|  
Line 858: Line 825:
  
 
chardighnIbhiH kriyAbhishca tasya kAryaM nivartanam||40||
 
chardighnIbhiH kriyAbhishca tasya kAryaM nivartanam||40||
 +
</div></div>
  
 
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.
 
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.
  
−
In this condition oil cooked with cow’s urine, ''shyama-trivrita, yava, kola'' and ''kulattha'' should be used for giving ''niruha'' and ''anuvasana''. If the enema fluid starts coming out of throat, then the patient should be given ''stambhana'' therapies, pressure should be applied over his throat and should be given purgatives and antiemetic therapies. [38-40]
+
In this condition oil cooked with cow’s urine, ''shyama-trivrita, yava, kola'' and ''kulattha'' should be used for giving ''niruha'' and ''anuvasana''. If the enema fluid starts coming out of throat, then the patient should be given ''[[stambhana]]'' therapies, pressure should be applied over his throat and should be given purgatives and antiemetic therapies. [38-40]
 +
<div class="mw-collapsible mw-collapsed">
  
 
यस्य नोपद्रवं कुर्यात् स्नेहबस्तिरनिःसृतः|  
 
यस्य नोपद्रवं कुर्यात् स्नेहबस्तिरनिःसृतः|  
  
 
सर्वेऽल्पो वाऽऽवृतो रौक्ष्यादुपेक्ष्यः स विजानता||४१||  
 
सर्वेऽल्पो वाऽऽवृतो रौक्ष्यादुपेक्ष्यः स विजानता||४१||  
 +
<div class="mw-collapsible-content">
  
 
yasya nōpadravaṁ kuryāt snēhabastiraniḥsr̥taḥ|  
 
yasya nōpadravaṁ kuryāt snēhabastiraniḥsr̥taḥ|  
Line 874: Line 844:
  
 
sarve~alpo vA~a~avRuto raukShyAdupekShyaH sa vijAnatA||41||
 
sarve~alpo vA~a~avRuto raukShyAdupekShyaH sa vijAnatA||41||
 +
</div></div>
  
 
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]
 
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]
  
−
==== Diet after ''anuvasana basti'' ====
+
=== Diet after ''anuvasana basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
युक्तस्नेहं द्रवोष्णं च लघुपथ्योपसेवनम्|  
 
युक्तस्नेहं द्रवोष्णं च लघुपथ्योपसेवनम्|  
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तस्मादुष्णोदकं देयं वातश्लेष्मोपशान्तये||४५||  
 
तस्मादुष्णोदकं देयं वातश्लेष्मोपशान्तये||४५||  
 +
<div class="mw-collapsible-content">
  
 
yuktasnēhaṁ dravōṣṇaṁ ca laghupathyōpasēvanam|  
 
yuktasnēhaṁ dravōṣṇaṁ ca laghupathyōpasēvanam|  
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tasmAduShNodakaM deyaM vAtashleShmopashAntaye||45||  
 
tasmAduShNodakaM deyaM vAtashleShmopashAntaye||45||  
 +
</div></div>
  
 
After proper ''anuvasana basti'', patient should be given liquid, hot, light, wholesome food. After intake of this food in appropriate quantity the patient may given ''anuvasana basti'' on every third day.
 
After proper ''anuvasana basti'', patient should be given liquid, hot, light, wholesome food. After intake of this food in appropriate quantity the patient may given ''anuvasana basti'' on every third day.
  
−
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]
+
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]
  
−
==== Frequency of ''anuvasana basti'' ====
+
=== Frequency of ''anuvasana basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
रूक्षनित्यस्तु दीप्ताग्निर्व्यायामी  मारुतामयी|  
 
रूक्षनित्यस्तु दीप्ताग्निर्व्यायामी  मारुतामयी|  
Line 940: Line 915:
  
 
अतोऽन्येषां त्र्यहात्प्रायः स्नेहं पचति पावकः||४७||  
 
अतोऽन्येषां त्र्यहात्प्रायः स्नेहं पचति पावकः||४७||  
 +
<div class="mw-collapsible-content">
  
 
rūkṣanityastu dīptāgnirvyāyāmī  mārutāmayī|  
 
rūkṣanityastu dīptāgnirvyāyāmī  mārutāmayī|  
Line 956: Line 932:
  
 
ato~anyeShAM tryahAtprAyaH snehaM pacati pAvakaH||47||  
 
ato~anyeShAM tryahAtprAyaH snehaM pacati pAvakaH||47||  
 +
</div></div>
  
−
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]
+
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]
  
−
==== Instructions before ''basti'' administration ====
+
=== Instructions before ''[[basti]]'' administration ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
न त्वामं प्रणयेत् स्नेहं स ह्यभिष्यन्दयेद्गुदम्|  
 
न त्वामं प्रणयेत् स्नेहं स ह्यभिष्यन्दयेद्गुदम्|  
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उभयस्मात्  समं गच्छन् वातमग्निं च दूषयेत्||४९||  
 
उभयस्मात्  समं गच्छन् वातमग्निं च दूषयेत्||४९||  
 +
<div class="mw-collapsible-content">
  
 
na tvāmaṁ praṇayēt snēhaṁ sa hyabhiṣyandayēdgudam|  
 
na tvāmaṁ praṇayēt snēhaṁ sa hyabhiṣyandayēdgudam|  
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ubhayasmAt samaM gacchan vAtamagniM ca dUShayet||49||
 
ubhayasmAt samaM gacchan vAtamagniM ca dUShayet||49||
 +
</div></div>
  
−
Advice regarding ''basti'' administration:
+
Advice regarding ''[[basti]]'' administration:
 
*Plain/ unprocessed fat should not be used for ''anuvasana basti'' as it produces ''abhishyanda'' (stuffiness) in the rectum.  
 
*Plain/ unprocessed fat should not be used for ''anuvasana basti'' as it produces ''abhishyanda'' (stuffiness) in the rectum.  
−
*Some portion of fat should be allowed to remain in ''basti'' because in attempt to give complete ''basti'', some portion of ''vata'' also goes inside.
+
*Some portion of fat should be allowed to remain in ''[[basti]]'' because in attempt to give complete ''[[basti]]'', some portion of ''[[vata]]'' also goes inside.
−
*Use of fats orally and through ''basti'' simultaneously should be avoided as it vitiates ''vata'' and ''agni''. [48-49]
+
*Use of fats orally and through ''[[basti]]'' simultaneously should be avoided as it vitiates ''[[vata]]'' and ''agni''. [48-49]
  
−
==== Importance of alternate administration of ''sneha'' and ''niruha basti'' ====
+
=== Importance of alternate administration of ''sneha'' and ''niruha basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
स्नेहबस्तिं निरूहं वा नैकमेवातिशीलयेत्|  
 
स्नेहबस्तिं निरूहं वा नैकमेवातिशीलयेत्|  
Line 999: Line 980:
  
 
स्नेहशोधनयुक्त्यैवं बस्तिकर्म त्रिदोषनुत्||५१||  
 
स्नेहशोधनयुक्त्यैवं बस्तिकर्म त्रिदोषनुत्||५१||  
 +
<div class="mw-collapsible-content">
  
 
snēhabastiṁ nirūhaṁ vā naikamēvātiśīlayēt|  
 
snēhabastiṁ nirūhaṁ vā naikamēvātiśīlayēt|  
Line 1,015: Line 997:
  
 
snehashodhanayuktyaivaM bastikarma tridoShanut||51||  
 
snehashodhanayuktyaivaM bastikarma tridoShanut||51||  
 +
</div></div>
  
−
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]
+
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 ''[[dosha]]s''. [50-51]
  
−
==== ''Matra basti'' ====
+
=== ''Matra basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
कर्मव्यायामभाराध्वया(पा)नस्त्रीकर्षितेषु च|  
 
कर्मव्यायामभाराध्वया(पा)नस्त्रीकर्षितेषु च|  
Line 1,031: Line 1,015:
  
 
स्नेहमात्राविधानं हि बृंहणं वातरोगनुत्||५४||  
 
स्नेहमात्राविधानं हि बृंहणं वातरोगनुत्||५४||  
 +
<div class="mw-collapsible-content">
  
 
karmavyāyāmabhārādhvayā(pā)nastrīkarṣitēṣu ca|  
 
karmavyāyāmabhārādhvayā(pā)nastrīkarṣitēṣu ca|  
Line 1,055: Line 1,040:
  
 
snehamAtrAvidhAnaM hi bRuMhaNaM vAtaroganut||54||  
 
snehamAtrAvidhAnaM hi bRuMhaNaM vAtaroganut||54||  
 +
</div></div>
  
−
''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]
+
''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]
  
−
==== Summary ====
+
=== Summary ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
तत्र श्लोकौ-  
 
तत्र श्लोकौ-  
Line 1,069: Line 1,056:
  
 
स्नेहबस्तिविधिश्चोक्तो मात्राबस्तिविधिस्तथा||५६||  
 
स्नेहबस्तिविधिश्चोक्तो मात्राबस्तिविधिस्तथा||५६||  
 +
<div class="mw-collapsible-content">
  
 
tatra ślōkau-  
 
tatra ślōkau-  
Line 1,089: Line 1,077:
  
 
snehabastividhishcokto mAtrAbastividhistathA||56||
 
snehabastividhishcokto mAtrAbastividhistathA||56||
 +
</div></div>
  
 
To sum up here-
 
To sum up here-
  
−
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]
+
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 ''matra basti'' are the topics dealt with. [55-56]
  
−
=== ''Tattva Vimarsha'' ===
+
== 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.
+
*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.
−
*''Snehabasti'' has ''vata'' pacifying, regenerating, anti-aging, ''shukra'' and ''oja'' enhancing effect.
+
*''Snehabasti'' has ''[[vata]]'' pacifying, regenerating, anti-aging, ''[[shukra]]'' and ''[[ojas]]'' enhancing effect.
−
*Impediment of ''sneha basti'' can occur by occlusion due to vitiated ''vata, pitta, kapha,'' excess food and stool. These conditions should be recognized and appropriately treated. ''Sneha basti'' should not be given on empty stomach.
+
*Impediment of ''sneha basti'' can occur by occlusion due to vitiated ''[[vata]], [[pitta]], [[kapha]],'' excess food and stool. These conditions should be recognized and appropriately treated. ''Sneha basti'' should not be given on empty stomach.
 
*Wholesome diet and lifestyle is important to be followed after ''sneha basti'' to achieve maximum efficacy.   
 
*Wholesome diet and lifestyle is important to be followed after ''sneha basti'' to achieve maximum efficacy.   
−
*''Matra basti'' is low dose ''basti'', can be given to patients with ''vata'' dominant disorders who are weak and ambulatory. It can be given in all seasons, and doesn’t produce any complications. The dose of ''matra basti'' is similar to low dose of ''sneha''.
+
*''Matra basti'' is low dose ''[[basti]]'', can be given to patients with ''[[vata]]'' dominant disorders who are weak and ambulatory. It can be given in all seasons, and doesn’t produce any complications. The dose of ''matra basti'' is similar to low dose of ''sneha''.
  
−
=== ''Vidhi Vimarsha'' ===
+
== Vidhi Vimarsha (Applied Inferences ) ==
  
−
==== Effect of ''Snehabasti''  ====
+
=== 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]
+
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 ''[[ojas]]'' 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]
  
−
==== Impediment by ''vata''  ====
+
=== 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]
+
''[[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]
  
−
==== Impediment by ''pitta''  ====
+
=== 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]
+
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]
  
−
==== Impediment by ''kapha''  ====
+
=== 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]
+
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]
  
−
==== Impediment by food in excess quantity  ====
+
=== 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]
+
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]
  
−
==== Impediment by stools  ====
+
=== 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> :
+
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> :
 
*Abnormal colon contractions
 
*Abnormal colon contractions
 
*Anal sphincter spasm leading to a functional obstruction
 
*Anal sphincter spasm leading to a functional obstruction
Line 1,132: Line 1,121:
 
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]
 
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]
  
−
==== Ailments caused by administration of ''basti'' on empty stomach  ====
+
=== Ailments caused by administration of ''[[basti]]'' on empty stomach  ===
  
−
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]
+
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]
  
−
==== Importance of warm water in ''snehabasti'' course ====
+
In clinical practice, this condition is extremely rare.  
  
−
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]
+
=== Importance of warm water in ''snehabasti'' course ===
  
−
==== Frequency of ''anuvasana basti'' ====
+
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]
  
−
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]
+
=== Frequency of ''anuvasana basti'' ===
  
−
==== Advice regarding ''basti'' administration  ====
+
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 [A.Hr. Sutra Sthana. 1/11] that in turn gives dryness to the colonic mucosa which attains proper oleation when comes in contact with ''[[basti]]''.[verse 46-47]
 +
 
 +
=== 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>
 
*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>
 
*Fat digestion depends upon lipase enzyme, bile salts etc<ref> http://courses.washington.edu/conj/bess/fats/fats.html</ref>. Consuming fats from oral as well as from ''basti'' may dilute these enzymatic actions and also the process of emulsification<ref>http://www.bio.davidson.edu/people/midorcas/animalphysiology/websites/2005/castle/page3.htm</ref>  is hampered thus most of the part of fats remain undigested which may in turn reduce digestive strength.
 
*Fat digestion depends upon lipase enzyme, bile salts etc<ref> http://courses.washington.edu/conj/bess/fats/fats.html</ref>. Consuming fats from oral as well as from ''basti'' may dilute these enzymatic actions and also the process of emulsification<ref>http://www.bio.davidson.edu/people/midorcas/animalphysiology/websites/2005/castle/page3.htm</ref>  is hampered thus most of the part of fats remain undigested which may in turn reduce digestive strength.
−
*''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]
+
*''Utklesha, agnimandya'' and ''[[vata]] prakopa''- Continuous use of ''snehabasti'' may cause ''utklesha'' as ''snehabasti'' is also an alternative way of oleation therapy [Cha. Sa. [[Sutra Sthana]] 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 ''[[dhatu]]s'' 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]
  
−
==== ''Matra basti''  ====
+
=== ''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):
+
''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<ref> Vagbhata. Sutra Sthana Cha 28, Bastividhi, Verse 8, In:Dr. Shivprasad Sharma,Editor,Ashtanga-Sangraha, 2nd edition, Varanasi: Chaukhamba Sanskrit Series Office, Varanasi (India),2008 Page No.-9</ref>. 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''<ref>Sushruta. Chikitsa Sthana, Cha.37 Anuvasanottarabasti Chikitsitam Adhyaya verse 80. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>. 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, <ref>Kashyapa. Kashyapa Samhita. Khila Sthana Chap 8, Verse 104-105, Edited by P. V. Tewari. Reprint. Varanasi: Chaukhambha vishvabharati;2008. pp.--</ref>
 
*1''prakuncha'' = 4 ''tola'' = (40ml) =''kaniyasi matra''
 
*1''prakuncha'' = 4 ''tola'' = (40ml) =''kaniyasi matra''
 
*1½ ''pala'' = 6 ''tola'' = (60 ml) = ''madhyama matra''
 
*1½ ''pala'' = 6 ''tola'' = (60 ml) = ''madhyama matra''
Line 1,159: Line 1,150:
 
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]
 
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]
  
−
==== Practically employed methods regarding schedule of ''snehabasti'' ====
+
=== 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''.
 
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''.
Line 1,165: Line 1,156:
 
=== Scope for further research ===
 
=== Scope for further research ===
  
−
*''Matrabasti'' needs to be explored for its possible use as an alternative to ''snehapana'' and also standardization of dosage needs to be done to get specific health benefit like ''shamana, brimhana'' etc.
+
*''Matrabasti'' needs to be explored for its possible use as an alternative to ''snehapana'' and also standardization of dosage needs to be done to get specific health benefit like ''shamana, [[brimhana]]'' etc.
−
*''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.
+
*''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.
−
 
+
* Clinical studies are needed to compare the effect of sneha basti (unctuous enema) with sneha pana (oral administration).The duration of administration, dosage, long term effect needs more exploration.
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=== Glossary ===
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</div>
  
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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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<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
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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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== References ==
 
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Latest revision as of 10:45, 23 February 2024

Cite.png

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

Snehavyapat Siddhi
Section/Chapter Siddhi Sthana Chapter 4
Preceding Chapter Bastisutriyam Siddhi
Succeeding Chapter Netrabastivyapat Siddhi
Other Sections Sutra Sthana, Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana
Translator and commentator Thakar A. B., Auti S.
Reviewer Mangalasseri P., Auti S.
Editors Thakar A. B., Mangalasseri P., Deole Y.S., Basisht G.
Year of publication 2020
Publisher Charak Samhita Research, Training and Skill Development Centre
DOI 10.47468/CSNE.2020.e01.s08.005

Abstract

The fourth chapter of Siddhi Sthana, Snehavyapat Siddhi, deals with various formulations of sneha basti (unctuous enema) and management of complications caused due to its improper administration. Sneha basti formulations, their clinical applications, reasons for sneha basti occlusion, symptoms of impediment, ailments caused by administration of basti on empty stomach, their treatments and matra basti, etc. have been explained in detail in this chapter. Vitiated doshas , excess food, and stools are responsible for obstructions and empty stomach administration leads to improper movement of sneha basti. Liquid, hot, light, wholesome food and warm water use have been suggested for avoidance of these complications.
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.
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,


Introduction

The schedule, importance and symptoms of proper and improper basti administration, indications- contraindications, elaborated basti procedure and niruha basti formulations are explained in earlier three chapters. Thus, in this sequence the present chapter is described to put forward some sneha basti (unctuous enema) formulations. In order to fulfill the purpose of Siddhi Sthana to give excellence in therapeutics, the complications arising due to some improper methods need to be tackled. Vitiated dosha, fecal matter, indigestion are some factors that occlude the basti and empty stomach administration leads to improper movement of fats. Moreover, due to busy work schedule, improper dietary habits and debilitating disorders most of the patients are unsuitable for anuvasana or sneha basti. In such individuals if vata vitiation is evident and needs basti therapy, then use of sneha basti (unctuous enema) in lowest dose i.e. matra basti can be employed without any complications.

Sanskrit text, Transliteration and English Translation

अथातः स्नेहव्यापत्सिद्धिं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ snēhavyāpatsiddhiṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH snehavyApatsiddhiM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter "Snehavyapat Siddhi" (Complications of Unctuous enema and their successful management). Thus said Lord Atreya. [1-2]

Various formulations

स्नेहबस्तीन्निबोधेमान् वातपित्तकफापहान्|

मिथ्याप्रणिहितानां च व्यापदः सचिकित्सिताः||३||

snēhabastīnnibōdhēmān vātapittakaphāpahān|

mithyāpraṇihitānāṁ ca vyāpadaḥ sacikitsitāḥ||3||

snehabastInnibodhemAn vAtapittakaphApahAn|

mithyApraNihitAnAM ca vyApadaH sacikitsitAH||3||

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

Unctuous enema for vata disorders

दशमूलं बलां रास्नामश्वगन्धां पुनर्नवाम्|

गुडूच्येरण्डभूतीकभार्गीवृषकरोहिषम्||४||

शतावरीं सहचरं काकनासां पलांशिकम् |

यवमाषातसीकोलकुलत्थान् प्रसृतोन्मितान्||५||

चतुर्द्रोणेऽम्भसः पक्त्वा द्रोणशेषेण तेन च|

तैलाढकं समक्षीरं जीवनीयैः पलोन्मितैः||६||

अनुवासनमेतद्धि सर्ववातविकारनुत्|

daśamūlaṁ balāṁ rāsnāmaśvagandhāṁ punarnavām|

guḍūcyēraṇḍabhūtīkabhārgīvr̥ṣakarōhiṣam||4||

śatāvarīṁ sahacaraṁ kākanāsāṁ palāṁśikam |

yavamāṣātasīkōlakulatthān prasr̥tōnmitān||5||

caturdrōṇē'mbhasaḥ paktvā drōṇaśēṣēṇa tēna ca|

tailāḍhakaṁ samakṣīraṁ jīvanīyaiḥ palōnmitaiḥ||6||

anuvāsanamētaddhi sarvavātavikāranut|

dashamUlaM balAM rAsnAmashvagandhAM punarnavAm|

guDUcyeraNDabhUtIkabhArgIvRuShakarohiSham||4||

shatAvarIM sahacaraM kAkanAsAM PalaMshikam |

yavamAShAtasIkolakulatthAn prasRutonmitAn||5||

caturdroNe~ambhasaH paktvA droNasheSheNa tena ca|

tailADhakaM samakShIraM jIvanIyaiH palonmitaiH||6||

anuvAsanametaddhi sarvavAtavikAranut|

Content Quantity
Drugs for Decoction Bilva, Shyonaka, Gambhari,Patala,Ganikarika,

Shaliparni,Prishniparni,Brihati,Kantakarika,Gokshura, Bala,Ashwagandha,Punarnava,Guduchi,Rasna, Eranda,Bhutika,Bharangi,Vasa,Rohisha,Shatavari,Kakanasa

1 Pala each
Yava,Masha,Atasi,Kola,Kulattha 2 Pala each
Water 4 Drona
Sesame Oil 1 Adhaka
Milk 1 Adhaka
Kalka of Jivaka,Rishabhaka,Meda,Mahameda,Kakoli,

Kshirakakoli,Mudgaparni,Mashaparni,Jivanti,Madhuka

1 Pala each

The decoction of above mentioned drugs should be prepared using four drona (approx. 49 liters) of water, boiling till 1 drona ( approx. 12.2 liters) of liquid remains. To this decoction paste of above mentioned herbs, 1 adhaka (approx. 3.07 liters) sesame oil and milk should be added. The oil prepared with this method can be used successfully in all vata disorders in anuvasana form. [4-7]

आनूपानां वसा तद्वज्जीवनीयोपसाधिता||७||

ānūpānāṁ vasā tadvajjīvanīyōpasādhitā||7||

AnUpAnAM vasA tadvajjIvanIyopasAdhitA||7||

Anuvasana basti prepared from vasa i.e. muscle fat of animals inhabiting marshy land, boiled with drugs of jivaniya gana i.e. jivaka, rishabhaka, meda, mahameda, kakoli, kshirakakoli, mudgaparni, mashaparni, jivanti, madhuka cures vata disorders. [7]

शताह्वायवबिल्वाम्लैः सिद्धं तैलं समीरणे|

सैन्धवेनाग्नितप्तेन तप्तं चानिलनुद्धृतम्||८||

śatāhvāyavabilvāmlaiḥ siddhaṁ tailaṁ samīraṇē|

saindhavēnāgnitaptēna taptaṁ cānilanuddhr̥tam||8||

shatAhvAyavabilvAmlaiH siddhaM tailaM samIraNe|

saindhavenAgnitaptena taptaM cAnilanuddhRutam||8||

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]

Unctuous enema for pitta disorders

जीवन्तीं मदनं मेदां श्रावणीं मधुकं बलाम्|

शताह्वर्षभकौ कृष्णां काकनासां शतावरीम्||९||

स्वगुप्तां क्षीरकाकोलीं कर्कटाख्यां शटीं वचाम्|

पिष्ट्वा तैलं घृतं क्षीरे साधयेत्तच्चतुर्गुणे||१०||

बृंहणं वातपित्तघ्नं बलशुक्राग्निवर्धनम्|

मूत्ररेतोरजोदोषान् हरेत्तदनुवासनम्||११||

लाभतश्चन्दनाद्यैश्च पिष्टैः क्षीरचतुर्गुणम्|

तैलपादं घृतं सिद्धं पित्तघ्नमनुवासनम्||१२||

jīvantīṁ madanaṁ mēdāṁ śrāvaṇīṁ madhukaṁ balām|

śatāhvarṣabhakau kr̥ṣṇāṁ kākanāsāṁ śatāvarīm||9||

svaguptāṁ kṣīrakākōlīṁ karkaṭākhyāṁ śaṭīṁ vacām|

piṣṭvā tailaṁ ghr̥taṁ kṣīrē sādhayēttaccaturguṇē||10||

br̥ṁhaṇaṁ vātapittaghnaṁ balaśukrāgnivardhanam|

mūtrarētōrajōdōṣān harēttadanuvāsanam||11||

lābhataścandanādyaiśca piṣṭaiḥ kṣīracaturguṇam|

tailapādaṁ ghr̥taṁ siddhaṁ pittaghnamanuvāsanam||12||

jIvantIM madanaM medAM shrAvaNIM madhukaM balAm|

shatAhvarShabhakau kRuShNAM kAkanAsAM shatAvarIm||9||

svaguptAM kShIrakAkolIM karkaTAkhyAM shaTIM vacAm|

piShTvA tailaM ghRutaM kShIre sAdhayettaccaturguNe||10||

bRuMhaNaM vAtapittaghnaM balashukrAgnivardhanam|

mUtraretorajodoShAn harettadanuvAsanam||11||

lAbhatashcandanAdyaishca piShTaiH kShIracaturguNam|

tailapAdaM ghRutaM siddhaM pittaghnamanuvAsanam||12||

Content
Cow ghee
Sesame oil
Milk
Kalka Jeevanti Krishna Kshirakakoli
Madanaphala kakanasa Krishna
Meda Shatavari Shati
Shravani Swagupta Vacha
Madhuka Shatahva
Bala Rishabhaka

Cow ghee and oil should be taken one part and cooked with milk four times along with above mentioned pastes of herbs (all together one fourth of sneha). This formulation of anuvasana basti is nourishing, alleviates vata and pitta, increases strength, semen and agni (digestive power). Also it cures diseases of urinary, seminal and menstrual origin.

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]

Unctuous enema for kapha disorders

सैन्धवं मदनं कुष्ठं शताह्वां निचुलं वचाम् |

ह्रीवेरं मधुकं भार्गीं देवदारु सकट्फलम्||१३||

नागरं पुष्करं मेदां चविकां चित्रकं शटीम्|

विडङ्गातिविषे श्यामां हरेणुं नीलिनीं स्थिराम्||१४||

बिल्वाजमोदे कृष्णां च दन्तीं रास्नां च पेषयेत्|

साध्यमेरण्डजं तैलं तैलं वा कफरोगनुत्||१५||

व्रध्नोदावर्तगुल्मार्शःप्लीहमेहाढ्यमारुतान्|

आनाहमश्मरीं चैव हन्यात्तदनुवासनात्||१६||

मदनैर्वाऽम्लसंयुक्तैर्बिल्वाद्येन गणेन वा|

तैलं कफहरैर्वाऽपि कफघ्नं कल्पयेद्भिषक्||१७||

saindhavaṁ madanaṁ kuṣṭhaṁ śatāhvāṁ niculaṁ vacām |

hrīvēraṁ madhukaṁ bhārgīṁ dēvadāru sakaṭphalam||13||

nāgaraṁ puṣkaraṁ mēdāṁ cavikāṁ citrakaṁ śaṭīm|

viḍaṅgātiviṣē śyāmāṁ harēṇuṁ nīlinīṁ sthirām||14||

bilvājamōdē kr̥ṣṇāṁ ca dantīṁ rāsnāṁ ca pēṣayēt|

sādhyamēraṇḍajaṁ tailaṁ tailaṁ vā kapharōganut||15||

vradhnōdāvartagulmārśaḥplīhamēhāḍhyamārutān|

ānāhamaśmarīṁ caiva hanyāttadanuvāsanāt||16||

madanairvā'mlasaṁyuktairbilvādyēna gaṇēna vā|

tailaṁ kaphaharairvā'pi kaphaghnaṁ kalpayēdbhiṣak||17||

saindhavaM madanaM kuShThaM shatAhvAM niculaM vacAm |

hrIveraM madhukaM bhArgIM devadAru sakaTphalam||13||

nAgaraM puShkaraM medAM cavikAM citrakaM shaTIm|

viDa~ggAtiviShe shyAmAM hareNuM nIlinIM sthirAm||14||

bilvAjamode kRuShNAM ca dantIM rAsnAM ca peShayet|

sAdhyameraNDajaM tailaM tailaM vA kapharoganut||15||

vradhnodAvartagulmArshaHplIhamehADhyamArutAn|

AnAhamashmarIM caiva hanyAttadanuvAsanAt||16||

madanairvA~amlasaMyuktairbilvAdyena gaNena vA|

tailaM kaphaharairvA~api kaphaghnaM kalpayedbhiShak||17||

Content
Castor oil/Sesame oil
Kalka Saindhava Hlibera Pushkara Ativisha Ajamoda
Madanaphala Madhuka Meda Shyama Krishna
Kushtha Barangi Chavika Harenu Danti
Shatahva Devadaru Chitraka Nilini Rasna
Nichula Katphala Shati Sthira
Vacha Nagara Vidanga Bilva

Anuvasana basti prepared with above mentioned ingredients cures kaphaja disorders, bradhna (inguinal enlargements), udavarta(reverse movement of vata), gulma(abdominal lumps), arsha (haemorrhoids), pliha (spenic disorders), meha (urinary disorders), adhyavata (disease due to vata occluded by excess meda), anaha(distension of abdomen), ashmari (calculus).[13-17]

विडङ्गैरण्डरजनीपटोलत्रिफलामृताः|

जातीप्रवालनिर्गुण्डीदशमूलाखुपर्णिकाः||१८||

निम्बपाठासहचरशम्पाककरवीरकाः|

एषां क्वाथेन विपचेत्तैलमेभिश्च कल्कितैः||१९||

फलबिल्वत्रिवृत्कृष्णारास्नाभूनिम्बदारुभिः|

सप्तपर्णवचोशीरदार्वीकुष्ठकलिङ्गकैः||२०||

लतागौरीशताह्वाग्निशटीचोरकपौष्करैः |

तत् कुष्ठानि क्रिमीन् मेहानर्शांसि ग्रहणीगदम्||२१||

क्लीबतां विषमाग्नित्वं मलं दोषत्रयं तथा|

प्रयुक्तं प्रणुदत्याशु पानाभ्यङ्गानुवासनैः||२२||

viḍaṅgairaṇḍarajanīpaṭōlatriphalāmr̥tāḥ|

jātīpravālanirguṇḍīdaśamūlākhuparṇikāḥ||18||

nimbapāṭhāsahacaraśampākakaravīrakāḥ|

ēṣāṁ kvāthēna vipacēttailamēbhiśca kalkitaiḥ||19||

phalabilvatrivr̥tkr̥ṣṇārāsnābhūnimbadārubhiḥ|

saptaparṇavacōśīradārvīkuṣṭhakaliṅgakaiḥ||20||

latāgaurīśatāhvāgniśaṭīcōrakapauṣkaraiḥ |

tat kuṣṭhāni krimīn mēhānarśāṁsi grahaṇīgadam||21||

klībatāṁ viṣamāgnitvaṁ malaṁ dōṣatrayaṁ tathā|

prayuktaṁ praṇudatyāśu pānābhyaṅgānuvāsanaiḥ||22||

viDa~ggairaNDarajanIpaTolatriphalAmRutAH|

jAtIpravAlanirguNDIdashamUlAkhuparNikAH||18||

nimbapAThAsahacarashampAkakaravIrakAH|

eShAM kvAthena vipacettailamebhishca kalkitaiH||19||

phalabilvatrivRutkRuShNArAsnAbhUnimbadArubhiH|

saptaparNavacoshIradArvIkuShThakali~ggakaiH||20||

latAgaurIshatAhvAgnishaTIcorakapauShkaraiH |

tat kuShThAni krimIn mehAnarshAMsi grahaNIgadam||21||

klIbatAM viShamAgnitvaM malaM doShatrayaM tathA|

prayuktaM praNudatyAshu pAnAbhya~ggAnuvAsanaiH||22||

Content
Castor oil/Sesame oil
Kashaya Vidanga Jati Patala Sahachara
Eranda Nirgundi Brihati Shampaka
Rajani Ganikarika Kantakari Karavira
Patola Shaliparni Gokshura Gambhari
Haritaki Prishniparni Akhuparni Amrita
Bibhitaki Bilva Nimba
Amalaki Shyonaka Patha
Kalka Madanaphala Patha
Bilva Ushira
Trivrit Darvi
Krishna Kushtha
Rasna Kalinga
Bhunimba Saptaparna
Devadaru

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]

Effects of sneha basti

व्याधिव्यायामकर्माध्वक्षीणाबलनिरोजसाम्|

क्षीणशुक्रस्य चातीव स्नेहवस्तिर्बलप्रदः||२३||

पादजङ्घोरुपृष्ठांसकटीनां स्थिरतां पराम्|

जनयेदप्रजानां च प्रजां स्त्रीणां तथा नृणाम्||२४||

vyādhivyāyāmakarmādhvakṣīṇābalanirōjasām|

kṣīṇaśukrasya cātīva snēhavastirbalapradaḥ||23||

pādajaṅghōrupr̥ṣṭhāṁsakaṭīnāṁ sthiratāṁ parām|

janayēdaprajānāṁ ca prajāṁ strīṇāṁ tathā nr̥ṇām||24||

vyAdhivyAyAmakarmAdhvakShINAbalanirojasAm|

kShINashukrasya cAtIva snehavastirbalapradaH||23||

pAdaja~gghorupRuShThAMsakaTInAM sthiratAM parAm|

janayedaprajAnAM ca prajAM strINAM tathA nRuNAm||24||

Sneha basti gives strength to those who are emaciated due to disease, excessive exercise, labor, excess walking, loss of ojas (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]

Six complications of sneha basti (unctuous enema)

वातपित्तकफात्यन्नपुरीषैरावृतस्य च|

अभुक्ते च प्रणीतस्य स्नेहबस्तेः षडापदः||२५||

vātapittakaphātyannapurīṣairāvr̥tasya ca|

abhuktē ca praṇītasya snēhabastēḥ ṣaḍāpadaḥ||25||

vAtapittakaphAtyannapurIShairAvRutasya ca|

abhukte ca praNItasya snehabasteH ShaDApadaH||25||

Sneha Basti causes following six complications:

  • Occlusion of enema fluid by vata
  • Occlusion of enema fluid by pitta
  • Occlusion of enema fluid by kapha
  • Occlusion of enema fluid by food
  • Occlusion of enema fluid by feces
  • Administration of enema in empty stomach. [25]

Factors responsible for complication of sneha basti

शीतोऽल्पो वाऽधिके वाते पित्तेऽत्युष्णः कफे मृदुः|

अतिभुक्ते गुरुर्वर्चःसञ्चयेऽल्पबलस्तथा||२६||

दत्तस्तैरावृतः स्नेहो न यात्यभिभवादपि |

अभुक्तेऽनावृतत्वाच्च यात्यूर्ध्वं तस्य लक्षणम्||२७||

śītō'lpō vā'dhikē vātē pittē'tyuṣṇaḥ kaphē mr̥duḥ|

atibhuktē gururvarcaḥsañcayē'lpabalastathā||26||

dattastairāvr̥taḥ snēhō na yātyabhibhavādapi |

abhuktē'nāvr̥tatvācca yātyūrdhvaṁ tasya lakṣaṇam||27||

shIto~alpo vA~adhike vAte pitte~atyuShNaH kaphe mRuduH|

atibhukte gururvarcaHsa~jcaye~alpabalastathA||26||

dattastairAvRutaH sneho na yAtyabhibhavAdapi |

abhukte~anAvRutatvAcca yAtyUrdhvaM tasya lakShaNam||27||

  • If basti preparation is too cold or less than therapeutic dose and given in vata dominant patient,
  • If hot basti is given in pitta dominant patient,
  • If mild basti is given in kapha dominant patient,
  • If basti prepared with guru (those digests relatively late) drugs is given in patient who has overeaten.
  • If basti of mild nature is given in patient having stool accumulation,

Then basti becomes occluded and does not reach its destination as it gets covered with dosha. Similarly, if basti is given in patient with empty stomach then it goes upwards as all the channels are uncovered.

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

Symptoms of impediment by vata and its management

अङ्गमर्दज्वराध्मानशीतस्तम्भोरुपीडनैः |

पार्श्वरुग्वेष्टनैर्विद्यात् स्नेहं वातावृतं भिषक्||२८||

स्निग्धाम्ललवणोष्णैस्तं रास्नापीतद्रुतैलिकैः |

सौवीरकसुराकोलकुलत्थयवसाधितैः||२९||

निरूहैर्निर्हरेत् सम्यक् समूत्रैः पाञ्चमूलिकैः|

ताभ्यामेव च तैलाभ्यां सायं भुक्तेऽनुवासयेत्||३०||

aṅgamardajvarādhmānaśītastambhōrupīḍanaiḥ |

pārśvarugvēṣṭanairvidyāt snēhaṁ vātāvr̥taṁ bhiṣak||28||

snigdhāmlalavaṇōṣṇaistaṁ rāsnāpītadrutailikaiḥ |

sauvīrakasurākōlakulatthayavasādhitaiḥ||29||

nirūhairnirharēt samyak samūtraiḥ pāñcamūlikaiḥ|

tābhyāmēva ca tailābhyāṁ sāyaṁ bhuktē'nuvāsayēt||30||

a~ggamardajvarAdhmAnashItastambhorupIDanaiH |

pArshvarugveShTanairvidyAt snehaM vAtAvRutaM bhiShak||28||

snigdhAmlalavaNoShNaistaM rAsnApItadrutailikaiH |

sauvIrakasurAkolakulatthayavasAdhitaiH||29||

nirUhairnirharet samyak samUtraiH pA~jcamUlikaiH|

tAbhyAmeva ca tailAbhyAM sAyaM bhukte~anuvAsayet||30||

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.

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]

Symptoms of impediment by pitta and its management

दाहरागतृषामोहतमकज्वरदूषणैः|

विद्यात् पित्तावृतं स्वादुतिक्तैस्तं बस्तिभिर्हरेत्||३१||

dāharāgatr̥ṣāmōhatamakajvaradūṣaṇaiḥ|

vidyāt pittāvr̥taṁ svādutiktaistaṁ bastibhirharēt||31||

dAharAgatRuShAmohatamakajvaradUShaNaiH|

vidyAt pittAvRutaM svAdutiktaistaM bastibhirharet||31||

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]

Symptoms of impediment by kapha and its management

तन्द्राशीतज्वरालस्यप्रसेकारुचिगौरवैः|

सम्मूर्च्छाग्लानिभिर्विद्याच्छ्लेष्मणा स्नेहमावृतम्||३२||

कषायकटुतीक्ष्णोष्णैः सुरामूत्रोपसाधितैः|

फलतैलयुतैः साम्लैर्बस्तिभिस्तं विनिर्हरेत्||३३||

tandrāśītajvarālasyaprasēkārucigauravaiḥ|

sammūrcchāglānibhirvidyācchlēṣmaṇā snēhamāvr̥tam||32||

kaṣāyakaṭutīkṣṇōṣṇaiḥ surāmūtrōpasādhitaiḥ|

phalatailayutaiḥ sāmlairbastibhistaṁ vinirharēt||33||

tandrAshItajvarAlasyaprasekArucigauravaiH|

sammUrcchAglAnibhirvidyAcchleShmaNA snehamAvRutam||32||

kaShAyakaTutIkShNoShNaiH surAmUtropasAdhitaiH|

phalatailayutaiH sAmlairbastibhistaM vinirharet||33||

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]

Symptoms and treatment of impediment due to excess intake of food

छर्दिमूर्च्छारुचिग्लानिशूलनिद्राङ्गमर्दनैः |

आमलिङ्गैः सदाहैस्तं विद्यादत्यशनावृतम्||३४||

कटूनां लवणानां च क्वाथैश्चूर्णैश्च पाचनम्|

विरेको मृदुरत्रामविहिता च क्रिया हिता||३५||

chardimūrcchāruciglāniśūlanidrāṅgamardanaiḥ |

āmaliṅgaiḥ sadāhaistaṁ vidyādatyaśanāvr̥tam||34||

kaṭūnāṁ lavaṇānāṁ ca kvāthaiścūrṇaiśca pācanam|

virēkō mr̥duratrāmavihitā ca kriyā hitā||35||

chardimUrcchAruciglAnishUlanidrA~ggamardanaiH |

Amali~ggaiH sadAhaistaM vidyAdatyashanAvRutam||34||

kaTUnAM lavaNAnAM ca kvAthaishcUrNaishca pAcanam|

vireko mRuduratrAmavihitA ca kriyA hitA||35||

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]

Symptoms and treatment of impediment by stool

विण्मूत्रानिलसङ्गार्तिगुरुत्वाध्मानहृद्ग्रहैः|

स्नेहं विडावृतं ज्ञात्वा स्नेहस्वेदैः सवर्तिभिः||३६||

श्यामाबिल्वादिसिद्धैश्च निरूहैः सानुवासनैः|

निर्हरेद्विधिना सम्यगुदावर्तहरेण च||३७||

viṇmūtrānilasaṅgārtigurutvādhmānahr̥dgrahaiḥ|

snēhaṁ viḍāvr̥taṁ jñātvā snēhasvēdaiḥ savartibhiḥ||36||

śyāmābilvādisiddhaiśca nirūhaiḥ sānuvāsanaiḥ|

nirharēdvidhinā samyagudāvartaharēṇa ca||37||

viNmUtrAnilasa~ggArtigurutvAdhmAnahRudgrahaiH|

snehaM viDAvRutaM j~jAtvA snehasvedaiH savartibhiH||36||

shyAmAbilvAdisiddhaishca nirUhaiH sAnuvAsanaiH|

nirharedvidhinA samyagudAvartahareNa ca||37||

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]

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

अभुक्ते शून्यपायौ वा वेगात् स्नेहोऽतिपीडितः|

धावत्यूर्ध्वं ततः कण्ठादूर्ध्वेभ्यः खेभ्य एत्यपि||३८||

मूत्रश्यामात्रिवृत्सिद्धो यवकोलकुलत्थवान्|

तत्सिद्धतैल इष्टोऽत्र निरूहः सानुवासनः||३९||

कण्ठादागच्छतः स्तम्भकण्ठग्रहविरेचनैः|

छर्दिघ्नीभिः क्रियाभिश्च तस्य कार्यं निवर्तनम्||४०||

abhuktē śūnyapāyau vā vēgāt snēhō'tipīḍitaḥ|

dhāvatyūrdhvaṁ tataḥ kaṇṭhādūrdhvēbhyaḥ khēbhya ētyapi||38||

mūtraśyāmātrivr̥tsiddhō yavakōlakulatthavān|

tatsiddhataila iṣṭō'tra nirūhaḥ sānuvāsanaḥ||39||

kaṇṭhādāgacchataḥ stambhakaṇṭhagrahavirēcanaiḥ|

chardighnībhiḥ kriyābhiśca tasya kāryaṁ nivartanam||40||

abhukte shUnyapAyau vA vegAt sneho~atipIDitaH|

dhAvatyUrdhvaM tataH kaNThAdUrdhvebhyaH khebhya etyapi||38||

mUtrashyAmAtrivRutsiddho yavakolakulatthavAn|

tatsiddhataila iShTo~atra nirUhaH sAnuvAsanaH||39||

kaNThAdAgacchataH stambhakaNThagrahavirecanaiH|

chardighnIbhiH kriyAbhishca tasya kAryaM nivartanam||40||

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.

In this condition oil cooked with cow’s urine, shyama-trivrita, yava, kola and kulattha should be used for giving niruha and anuvasana. If the enema fluid starts coming out of throat, then the patient should be given stambhana therapies, pressure should be applied over his throat and should be given purgatives and antiemetic therapies. [38-40]

यस्य नोपद्रवं कुर्यात् स्नेहबस्तिरनिःसृतः|

सर्वेऽल्पो वाऽऽवृतो रौक्ष्यादुपेक्ष्यः स विजानता||४१||

yasya nōpadravaṁ kuryāt snēhabastiraniḥsr̥taḥ|

sarvē'lpō vāvr̥tō raukṣyādupēkṣyaḥ sa vijānatā||41||

yasya nopadravaM kuryAt snehabastiraniHsRutaH|

sarve~alpo vA~a~avRuto raukShyAdupekShyaH sa vijAnatA||41||

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]

Diet after anuvasana basti

युक्तस्नेहं द्रवोष्णं च लघुपथ्योपसेवनम्|

भुक्तवान् मात्रया भोज्यमनुवास्यस्त्र्यहात्त्र्यहात्||४२||

धान्यनागरसिद्धं हि तोयं दद्याद्विचक्षणः|

व्युषिताय निशां कल्यमुष्णं वा केवलं जलम्||४३||

स्नेहाजीर्णं जरयति श्लेष्माणं तद्भिनत्ति च|

मारुतस्यानुलोम्यं च कुर्यादुष्णोदकं नृणाम्||४४||

वमने च विरेके च निरूहे सानुवासने|

तस्मादुष्णोदकं देयं वातश्लेष्मोपशान्तये||४५||

yuktasnēhaṁ dravōṣṇaṁ ca laghupathyōpasēvanam|

bhuktavān mātrayā bhōjyamanuvāsyastryahāttryahāt||42||

dhānyanāgarasiddhaṁ hi tōyaṁ dadyādvicakṣaṇaḥ|

vyuṣitāya niśāṁ kalyamuṣṇaṁ vā kēvalaṁ jalam||43||

snēhājīrṇaṁ jarayati ślēṣmāṇaṁ tadbhinatti ca|

mārutasyānulōmyaṁ ca kuryāduṣṇōdakaṁ nr̥ṇām||44||

vamanē ca virēkē ca nirūhē sānuvāsanē|

tasmāduṣṇōdakaṁ dēyaṁ vātaślēṣmōpaśāntayē||45||

yuktasnehaM dravoShNaM ca laghupathyopasevanam|

bhuktavAn mAtrayA bhojyamanuvAsyastryahAttryahAt||42||

dhAnyanAgarasiddhaM hi toyaM dadyAdvicakShaNaH|

vyuShitAya nishAM kalyamuShNaM vA kevalaM jalam||43||

snehajIrNaM jarayati shleShmANaM tadbhinatti ca|

mArutasyAnulomyaM ca kuryAduShNodakaM nRuNAm||44||

vamane ca vireke ca nirUhe sAnuvAsane|

tasmAduShNodakaM deyaM vAtashleShmopashAntaye||45||

After proper anuvasana basti, patient should be given liquid, hot, light, wholesome food. After intake of this food in appropriate quantity the patient may given anuvasana basti on every third day.

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]

Frequency of anuvasana basti

रूक्षनित्यस्तु दीप्ताग्निर्व्यायामी मारुतामयी|

वङ्क्षणश्रोण्युदावृत्तवाताश्चार्हा दिने दिने||४६||

एषां चाशु जरां स्नेहो यात्यम्बु सिकतास्विव|

अतोऽन्येषां त्र्यहात्प्रायः स्नेहं पचति पावकः||४७||

rūkṣanityastu dīptāgnirvyāyāmī mārutāmayī|

vaṅkṣaṇaśrōṇyudāvr̥ttavātāścārhā dinē dinē||46||

ēṣāṁ cāśu jarāṁ snēhō yātyambu sikatāsviva|

atō'nyēṣāṁ tryahātprāyaḥ snēhaṁ pacati pāvakaḥ||47||

rUkShanityastu dIptAgnirvyAyAmI mArutAmayI|

va~gkShaNashroNyudAvRuttavAtAshcArhA dine dine||46||

eShAM cAshu jarAM sneho yAtyambu sikatAsviva|

ato~anyeShAM tryahAtprAyaH snehaM pacati pAvakaH||47||

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]

Instructions before basti administration

न त्वामं प्रणयेत् स्नेहं स ह्यभिष्यन्दयेद्गुदम्|

सावशेषं च कुर्वीत वायुः शेषे हि तिष्ठति||४८||

न चैव गुदकण्ठाभ्यां दद्यात् स्नेहमनन्तरम्|

उभयस्मात् समं गच्छन् वातमग्निं च दूषयेत्||४९||

na tvāmaṁ praṇayēt snēhaṁ sa hyabhiṣyandayēdgudam|

sāvaśēṣaṁ ca kurvīta vāyuḥ śēṣē hi tiṣṭhati||48||

na caiva gudakaṇṭhābhyāṁ dadyāt snēhamanantaram|

ubhayasmāt samaṁ gacchan vātamagniṁ ca dūṣayēt||49||

na tvAmaM praNayet snehaM sa hyabhiShyandayedgudam|

sAvasheShaM ca kurvIta vAyuH sheShe hi tiShThati||48||

na caiva gudakaNThAbhyAM dadyAt snehamanantaram|

ubhayasmAt samaM gacchan vAtamagniM ca dUShayet||49||

Advice regarding basti administration:

  • Plain/ unprocessed fat should not be used for anuvasana basti as it produces abhishyanda (stuffiness) in the rectum.
  • Some portion of fat should be allowed to remain in basti because in attempt to give complete basti, some portion of vata also goes inside.
  • Use of fats orally and through basti simultaneously should be avoided as it vitiates vata and agni. [48-49]

Importance of alternate administration of sneha and niruha basti

स्नेहबस्तिं निरूहं वा नैकमेवातिशीलयेत्|

उत्क्लेशाग्निवधौ स्नेहान्निरूहात् पवनाद्भयम्||५०||

तस्मान्निरूढः संस्नेह्यो निरूह्यश्चानुवासितः|

स्नेहशोधनयुक्त्यैवं बस्तिकर्म त्रिदोषनुत्||५१||

snēhabastiṁ nirūhaṁ vā naikamēvātiśīlayēt|

utklēśāgnivadhau snēhānnirūhāt pavanādbhayam||50||

tasmānnirūḍhaḥ saṁsnēhyō nirūhyaścānuvāsitaḥ|

snēhaśōdhanayuktyaivaṁ bastikarma tridōṣanut||51||

snehabastiM nirUhaM vA naikamevAtishIlayet|

utkleshAgnivadhau snehannirUhAt pavanAdbhayam||50||

tasmAnnirUDhaH saMsnehyo nirUhyashcAnuvAsitaH|

snehashodhanayuktyaivaM bastikarma tridoShanut||51||

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]

Matra basti

कर्मव्यायामभाराध्वया(पा)नस्त्रीकर्षितेषु च|

दुर्बले वातभग्ने च मात्राबस्तिः सदा मतः||५२||

यथेष्टाहारचेष्टस्य सर्वकालं निरत्ययः|

ह्रस्वायाः स्नेहमात्राया मात्राबस्तिः समो भवेत्||५३||

बल्यं सुखोपचर्यं च सुखं सृष्टपुरीषकृत्|

स्नेहमात्राविधानं हि बृंहणं वातरोगनुत्||५४||

karmavyāyāmabhārādhvayā(pā)nastrīkarṣitēṣu ca|

durbalē vātabhagnē ca mātrābastiḥ sadā mataḥ||52||

yathēṣṭāhāracēṣṭasya sarvakālaṁ niratyayaḥ|

hrasvāyāḥ snēhamātrāyā mātrābastiḥ samō bhavēt||53||

balyaṁ sukhōpacaryaṁ ca sukhaṁ sr̥ṣṭapurīṣakr̥t|

snēhamātrāvidhānaṁ hi br̥ṁhaṇaṁ vātarōganut||54||

karmavyAyAmabhArAdhvayA(pA)nastrIkarShiteShu ca|

durbale vAtabhagne ca mAtrAbastiH sadA mataH||52||

yatheShTAhAraceShTasya sarvakAlaM niratyayaH|

hrasvAyAH snehamAtrAyA mAtrAbastiH samo bhavet||53||

balyaM sukhopacaryaM ca sukhaM sRuShTapurIShakRut|

snehamAtrAvidhAnaM hi bRuMhaNaM vAtaroganut||54||

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]

Summary

तत्र श्लोकौ-

वातादीनां शमायोक्ताः प्रवराः स्नेहबस्तयः|

तेषां चाज्ञप्रयुक्तानां व्यापदः सचिकित्सिताः||५५||

प्राग्भोज्यं स्नेहबस्तेर्यद् ध्रुवं येऽर्हास्त्र्यहाच्च ये

स्नेहबस्तिविधिश्चोक्तो मात्राबस्तिविधिस्तथा||५६||

tatra ślōkau-

vātādīnāṁ śamāyōktāḥ pravarāḥ snēhabastayaḥ|

tēṣāṁ cājñaprayuktānāṁ vyāpadaḥ sacikitsitāḥ||55||

prāgbhōjyaṁ snēhabastēryad dhruvaṁ yē'rhāstryahācca yē

snēhabastividhiścōktō mātrābastividhistathā||56||

tatra shlokau-

vAtAdInAM shamAyoktAH pravarAH snehabastayaH|

teShAM cAj~japrayuktAnAM vyApadaH sacikitsitAH||55||

prAgbhojyaM snehabasteryad dhruvaM ye~arhAstryahAcca ye

snehabastividhishcokto mAtrAbastividhistathA||56||

To sum up here-

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 matra basti are the topics dealt with. [55-56]

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.
  • Snehabasti has vata pacifying, regenerating, anti-aging, shukra and ojas enhancing effect.
  • Impediment of sneha basti can occur by occlusion due to vitiated vata, pitta, kapha, excess food and stool. These conditions should be recognized and appropriately treated. Sneha basti should not be given on empty stomach.
  • Wholesome diet and lifestyle is important to be followed after sneha basti to achieve maximum efficacy.
  • Matra basti is low dose basti, can be given to patients with vata dominant disorders who are weak and ambulatory. It can be given in all seasons, and doesn’t produce any complications. The dose of matra basti is similar to low dose of sneha.

Vidhi Vimarsha (Applied Inferences )

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.[1][2] 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.[3] 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 ojas 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]

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 [4] which may be the possible reason for this occlusion. Hence the symptoms also resemble that of intestinal motility disorders [5] 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[6], 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]

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]

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]

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]

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[7] :

  • Abnormal colon contractions
  • Anal sphincter spasm leading to a functional obstruction
  • Dysfunctional innervations of colonic, anal sphincter, or pelvic floor muscles. These abnormalities can lead to lack of synchronization among the colon, anal sphincter, and pelvic floor.

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]

Ailments caused by administration of basti on empty stomach

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[8]. 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[9]. [verse 38-40]

In clinical practice, this condition is extremely rare.

Importance of warm water in snehabasti course

Drinking warm water accelerates the gastric emptying[10], clears the bowel and hence prevents indigestion or constipation during basti course. It also has inhibitory effect on mucus production[11] 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.[12] [verse 43-45]

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 [A.Hr. Sutra Sthana. 1/11] that in turn gives dryness to the colonic mucosa which attains proper oleation when comes in contact with basti.[verse 46-47]

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[13] 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[14]. Short chain fatty acids are easily absorbed from colon whereas long chain fatty acids are rarely absorbed. [15]
  • Fat digestion depends upon lipase enzyme, bile salts etc[16]. Consuming fats from oral as well as from basti may dilute these enzymatic actions and also the process of emulsification[17] is hampered thus most of the part of fats remain undigested which may in turn reduce digestive strength.
  • Utklesha, agnimandya and vata prakopa- Continuous use of snehabasti may cause utklesha as snehabasti is also an alternative way of oleation therapy [Cha. Sa. Sutra Sthana 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]

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[18]. 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[19]. 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, [20]

  • 1prakuncha = 4 tola = (40ml) =kaniyasi matra
  • 1½ pala = 6 tola = (60 ml) = madhyama matra
  • 2 pala = 8 tola = (80ml) = uttama matra

The capacity to hold fecal matter, also termed as rectal compliance ranges between 60ml to 500ml[21]. 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]

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.

Scope for further research

  • Matrabasti needs to be explored for its possible use as an alternative to snehapana and also standardization of dosage needs to be done to get specific health benefit like shamana, brimhana etc.
  • 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.
  • Clinical studies are needed to compare the effect of sneha basti (unctuous enema) with sneha pana (oral administration).The duration of administration, dosage, long term effect needs more exploration.

Send us your suggestions and feedback on this page.

References

  1. ↑ 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
  2. ↑ 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
  3. ↑ 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.
  4. ↑ 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
  5. ↑ https://emedicine.medscape.com/article/179937-overview
  6. ↑ Bujanda L, The effects of alcohol consumption upon the gastrointestinal tract, American Journal of Gastroenterology. 2000 Dec;95(12):3374-82.
  7. ↑ http://www.cpmc.org/services/gi/services/lowergut.html
  8. ↑ 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
  9. ↑ 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
  10. ↑ 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
  11. ↑ http://www.top10homeremedies.com/home-remedies/home-remedies-phlegm.html
  12. ↑ http://www.stylecraze.com/articles/benefits-of-hot-water-for-skin-hair-and-health/
  13. ↑ 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
  14. ↑ 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
  15. ↑ 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.
  16. ↑ http://courses.washington.edu/conj/bess/fats/fats.html
  17. ↑ http://www.bio.davidson.edu/people/midorcas/animalphysiology/websites/2005/castle/page3.htm
  18. ↑ Vagbhata. Sutra Sthana Cha 28, Bastividhi, Verse 8, In:Dr. Shivprasad Sharma,Editor,Ashtanga-Sangraha, 2nd edition, Varanasi: Chaukhamba Sanskrit Series Office, Varanasi (India),2008 Page No.-9
  19. ↑ Sushruta. Chikitsa Sthana, Cha.37 Anuvasanottarabasti Chikitsitam Adhyaya verse 80. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.
  20. ↑ Kashyapa. Kashyapa Samhita. Khila Sthana Chap 8, Verse 104-105, Edited by P. V. Tewari. Reprint. Varanasi: Chaukhambha vishvabharati;2008. pp.--
  21. ↑ 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
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