Changes

Vāta eliminating mesures usually promotes quality of dhātus and upadhātus (structural components of the body). This eventually results in promotion of the body strength and the complexion. Word ‘bala’ also denotes the immune function; hence this may also be interpreted as promoting immune activity. In ancient time to mix a basti material, churning stick was used. In modern time an electric blender is an ideal alternative. With a blender the mixture is better homogenized than a manual churning stick.

Vāta eliminating mesures usually promotes quality of dhātus and upadhātus (structural components of the body). This eventually results in promotion of the body strength and the complexion. Word ‘bala’ also denotes the immune function; hence this may also be interpreted as promoting immune activity. In ancient time to mix a basti material, churning stick was used. In modern time an electric blender is an ideal alternative. With a blender the mixture is better homogenized than a manual churning stick.

Cakrapāṇi considered bilvādi group in his Āyurveda dīpikā commentary as daśamula.[ ]This group consists of roots of ten plants viz. bilva (Aegle marmelos Carr.), śyonāka (Oroxylum indicumVent.),gambhārī (Gmelina arborea Roxb.), pāṭalā (Stereospermum suaveolensDC.),agnimantha (Premna integrifolia Roxb.), śālaparṇī (Desmodium gangeticumDC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.).  While Gaṅgādhara in his Jalpakalpataru commentary mentions this as pañchamūla –the roots of a group of five plants viz. bilva,śyonāka, gambhārī, pāṭalā and agnimantha.[ ]Since next verse (5th) describes a recipe with pañchamūla, in this verse considering bilvādi as daśamula is more logical and practical. This basti consists a total of eight prasritas (one prasrita each of taila, prasannā, madhu and ghṛta and two prasritas each of bilvādi decoction and kulattha decoction). Therefore, Gaṅgādhara names this as aṣṭaprāsṛtika basti.[ ]

Cakrapāṇi considered bilvādi group in his Āyurveda dīpikā commentary as daśamula.[ ]This group consists of roots of ten plants viz. bilva (Aegle marmelos Carr.), śyonāka (Oroxylum indicumVent.),gambhārī (Gmelina arborea Roxb.), pāṭalā (Stereospermum suaveolensDC.),agnimantha (Premna integrifolia Roxb.), śālaparṇī (Desmodium gangeticumDC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.).  While Gaṅgādhara in his Jalpakalpataru commentary mentions this as pañchamūla –the roots of a group of five plants viz. bilva,śyonāka, gambhārī, pāṭalā and agnimantha.[ ]Since next verse (5th) describes a recipe with pañchamūla, in this verse considering bilvādi as daśamula is more logical and practical. This basti consists a total of eight prasritas (one prasrita each of taila, prasannā, madhu and ghṛta and two prasritas each of bilvādi decoction and kulattha decoction). Therefore, Gaṅgādhara names this as aṣṭaprāsṛtika basti.[ ]

The basti in verse six, consists of total nine prasritas i.e. pañchamūla decoction- five prasritas, sesame oil - two prasritas, honey- one prasrita, ghṛta- one prasrita. Therefore, Gaṅgādhara names this as navaprāsṛtika basti.[ ] (verses 4-6)

The basti in verse six, consists of total nine prasritas i.e. pañchamūla decoction- five prasritas, sesame oil - two prasritas, honey- one prasrita, ghṛta- one prasrita. Therefore, Gaṅgādhara names this as navaprāsṛtika basti.[ ] (verses 4-6)

Akṣa and karṣa are the units of same amount, which is equal to about twelve grams. Hence the amount of rock salt in this basti would be about 6 grams. Śukra is one of the seven dhātus (structural components). Śukra is not a single entity. It comprises male reprodudtive cells and substances including the androgenic hormones responsible for manhood in a man. This basti promotes quality and quantity of all these entities in the body.

Akṣa and karṣa are the units of same amount, which is equal to about twelve grams. Hence the amount of rock salt in this basti would be about 6 grams. Śukra is one of the seven dhātus (structural components). Śukra is not a single entity. It comprises male reprodudtive cells and substances including the androgenic hormones responsible for manhood in a man. This basti promotes quality and quantity of all these entities in the body.

The usual contents of a nirūha basti are salt, honey, oil, kalka and decoction (or a liquid). These are to be mixed by churning in the sequence as mentioned above. Here the mixing may be in this sequence- saindhava, honey, oil, ghṛta, hapuṣā (fruits of Juniperus communis Linn.)and milk.

The usual contents of a nirūha basti are salt, honey, oil, kalka and decoction (or a liquid). These are to be mixed by churning in the sequence as mentioned above. Here the mixing may be in this sequence- saindhava, honey, oil, ghṛta, hapuṣā (fruits of Juniperus communis Linn.)and milk.(verse 7)

(verse 7)

 

Basti is usually contraindicated in kuṣṭha [Ca. Si. 2/14][ ]. However, Suśrutasaṁhitā recommends nirūhabastis in this condition [Su.Ci.35/22].[ ] Practically nirūha basti, with bitter substances e.g. pañchatikta nirūha, is useful in kuṣṭha.

Basti is usually contraindicated in kuṣṭha [Ca. Si. 2/14][ ]. However, Suśrutasaṁhitā recommends nirūhabastis in this condition [Su.Ci.35/22].[ ] Practically nirūha basti, with bitter substances e.g. pañchatikta nirūha, is useful in kuṣṭha.

The quantity of kalka of sarṣapa is not mentioned in the above recipe. According to commentary of Cakrapāṇi on this verse, it may be decided. [ ] In the nirūha bastis with an amount of twelve prasritas, the amount of kalka is usually two palas (about100gms).  In present recipe, the amount is five prasritas and therefore the amount of kalka of sarṣapa would be about 40 gms. This principle is applicable in latter recipes also where the amount of kalka is not mentioned.  

The quantity of kalka of sarṣapa is not mentioned in the above recipe. According to commentary of Cakrapāṇi on this verse, it may be decided. [ ] In the nirūha bastis with an amount of twelve prasritas, the amount of kalka is usually two palas (about100gms).  In present recipe, the amount is five prasritas and therefore the amount of kalka of sarṣapa would be about 40 gms. This principle is applicable in latter recipes also where the amount of kalka is not mentioned.  

This basti contains viḍaṅga (Embelia ribes Burm.) which is the best among krimighna(anti-parasitic) [Ca.Su. 25/40] substances. Therefore, it has a krimināśana effect. (verse 9-10)

This basti contains viḍaṅga (Embelia ribes Burm.) which is the best among krimighna(anti-parasitic) [Ca.Su. 25/40] substances. Therefore, it has a krimināśana effect. (verse 9-10)

Gaṅgādhara in his Jalpakalpataru commentary considers payasyāas kṣīrakākolī, which is Fritillaria roylei Hook. Some scholars consider payasyāas vidārī, but in present recipe vidārīis already one ingredient therefore to consider it kṣīrakākolīis appropriate.

Gaṅgādhara in his Jalpakalpataru commentary considers payasyāas kṣīrakākolī, which is Fritillaria roylei Hook. Some scholars consider payasyāas vidārī, but in present recipe vidārīis already one ingredient therefore to consider it kṣīrakākolīis appropriate.

In the recipes of verse 11-12, the amount of paste is not mentioned. This may be calculated as stated in earlier verse 8th -9th. (verse 11-12)

In the recipes of verse 11-12, the amount of paste is not mentioned. This may be calculated as stated in earlier verse 8th -9th. (verse 11-12)

In above verses from 4 to 14, nine recipes of prasrita bastis are described. Here a special and practical instruction is given that even if salt is not mentioned in any of the recipes, rock salt is to be added and these bastis are always given with a moderate warm temperature.

In above verses from 4 to 14, nine recipes of prasrita bastis are described. Here a special and practical instruction is given that even if salt is not mentioned in any of the recipes, rock salt is to be added and these bastis are always given with a moderate warm temperature.

While preparing the bastis, rock salt is to be added. The amount is to be calculated according to the principle described in the 7th verse i.e. about 6 gms. After preparing the basti, to keep it warm until it is administered, a hot water bath may be used. (verse 13-14)

While preparing the bastis, rock salt is to be added. The amount is to be calculated according to the principle described in the 7th verse i.e. about 6 gms. After preparing the basti, to keep it warm until it is administered, a hot water bath may be used. (verse 13-14)

In the verse 15-16, two opposite possibilities are described.  It may be milder than normal or it may be stronger than a normal. A mild basti is unable not only to eliminate doṣas, but it itself is not ableto come out. This is ayoga or hīnayoga (insufficient action). In such a case a basti is to be repeated with a stronger recipe. Contrary to this, if a basti is stronger it may cause an atiyoga (action in excess) causing evacuation of colonic contents more than required and eventually loss of essential substances.

In the verse 15-16, two opposite possibilities are described.  It may be milder than normal or it may be stronger than a normal. A mild basti is unable not only to eliminate doṣas, but it itself is not ableto come out. This is ayoga or hīnayoga (insufficient action). In such a case a basti is to be repeated with a stronger recipe. Contrary to this, if a basti is stronger it may cause an atiyoga (action in excess) causing evacuation of colonic contents more than required and eventually loss of essential substances.

A soft acting basti is not able to eliminate the doṣhas and may get stagnated and cause disturbance. To eliminate it, a strong and sharp acting basti is recommended. If strong bastis have caused emaciation, dehydration or weakness, the bastis with madhura (sweet) substances are useful because madhura substances are nourishing in action. (verses 15-16)

A soft acting basti is not able to eliminate the doṣhas and may get stagnated and cause disturbance. To eliminate it, a strong and sharp acting basti is recommended. If strong bastis have caused emaciation, dehydration or weakness, the bastis with madhura (sweet) substances are useful because madhura substances are nourishing in action. (verses 15-16)

In vāta-related disorders, basti material with physically and pharmacologically hot property is preferred. It may cause pitta aggravation resulting in burning sensation and other such pitta-related symptoms. In such a condition, grape juice or decoction of raisins added with a kalka (paste) of trivṛt (Operculina turpethum Linn.) is given. In case of unavailability of kalka, its powder can be used. This cures the burning sensation and other pitta-related symptoms with its anti-pitta action and expulsion of stool, pitta and vāta. Yavāgu with sugar is given for nourishing purpose after this laxation. (verses 16-17)

In vāta-related disorders, basti material with physically and pharmacologically hot property is preferred. It may cause pitta aggravation resulting in burning sensation and other such pitta-related symptoms. In such a condition, grape juice or decoction of raisins added with a kalka (paste) of trivṛt (Operculina turpethum Linn.) is given. In case of unavailability of kalka, its powder can be used. This cures the burning sensation and other pitta-related symptoms with its anti-pitta action and expulsion of stool, pitta and vāta. Yavāgu with sugar is given for nourishing purpose after this laxation. (verses 16-17)

If the purgation is in excess, it may cause significant loss of stool along with essential substances (e.g.water and electrolytes). This requires immediate attention to prevent the harm due to depletion of essential body components.

If the purgation is in excess, it may cause significant loss of stool along with essential substances (e.g.water and electrolytes). This requires immediate attention to prevent the harm due to depletion of essential body components.

In such a condition it is to be corrected by eating māṣayūṣa (soup of black beans) and kulmāṣa (half cooked grains); and by taking honey or surā. Kulmāṣa is also interpreted as a sour gruel (prepared by the spontaneous fermentation of fruit-juices or boiled rice). However, according to Cakrapāṇi this is half cooked grain (barley etc.), which is popularly known as ghughunī.[ ],[ ]This is known as ghughari in Gujarat and western Madhyapradesh. This is more suitable interpretation. This is considered to be well nourishing food article. (verse 18)

In such a condition it is to be corrected by eating māṣayūṣa (soup of black beans) and kulmāṣa (half cooked grains); and by taking honey or surā. Kulmāṣa is also interpreted as a sour gruel (prepared by the spontaneous fermentation of fruit-juices or boiled rice). However, according to Cakrapāṇi this is half cooked grain (barley etc.), which is popularly known as ghughunī.[ ],[ ]This is known as ghughari in Gujarat and western Madhyapradesh. This is more suitable interpretation. This is considered to be well nourishing food article. (verse 18)

Faulty application of bastis may cause a complication in the form of atisāra. Atisāra is a clinical condition of colon characterized by excessive and frequent defecation with altered consistency of stool. In short it may be interpreted as diarrhea. In next verse different forms of atisāra and their management are described. In this verse the condition is characterized by sāma stool (stool containing āma- undigested material), which smells like a decomposing body (putrid smell) and is associated with abdominal pain. Āma is a substance produced due to weak agni resulting in incomplete transformation of substance. In the present context, due to weak jatharāgni the transformation of food in to digested absorbable substances is incomplete resulting in to production of some intermediate substances.[ ],[ ] These substances are known as āma. Because of its adherent quality it is supposed to be a pathogenic substance.In this condition a decoction of mustā, ativiṣā, kuṣṭha, nata, dāru and vacā is recommended. These medicines help in pāchana (termination) of āma.

Faulty application of bastis may cause a complication in the form of atisāra. Atisāra is a clinical condition of colon characterized by excessive and frequent defecation with altered consistency of stool. In short it may be interpreted as diarrhea. In next verse different forms of atisāra and their management are described. In this verse the condition is characterized by sāma stool (stool containing āma- undigested material), which smells like a decomposing body (putrid smell) and is associated with abdominal pain. Āma is a substance produced due to weak agni resulting in incomplete transformation of substance. In the present context, due to weak jatharāgni the transformation of food in to digested absorbable substances is incomplete resulting in to production of some intermediate substances.[ ],[ ] These substances are known as āma. Because of its adherent quality it is supposed to be a pathogenic substance.In this condition a decoction of mustā, ativiṣā, kuṣṭha, nata, dāru and vacā is recommended. These medicines help in pāchana (termination) of āma.

This chapter describes six types of atisāra based on the pathogens being excreted in excess. This verse explains the remedy for one of them in which patient passes stool with significant undigested material. This undigested material causes putrid smell after decomposition. Decomposition also produces some toxic substances, which cause abdominal pain and loss of appetite. The recipe described here is not useful in atisāra produced as complication of basti but also in āmātisāra of any origin. (verse 19)

This chapter describes six types of atisāra based on the pathogens being excreted in excess. This verse explains the remedy for one of them in which patient passes stool with significant undigested material. This undigested material causes putrid smell after decomposition. Decomposition also produces some toxic substances, which cause abdominal pain and loss of appetite. The recipe described here is not useful in atisāra produced as complication of basti but also in āmātisāra of any origin. (verse 19)

This verse number 20 describes other five types of atisāra. In this way, six types of atisāras those are depicted in above verses are as follow.

This verse number 20 describes other five types of atisāra. In this way, six types of atisāras those are depicted in above verses are as follow.

1.Atisāra (diarrhea) in which stool contains āma (undigested material)   

1.Atisāra (diarrhea) in which stool contains āma (undigested material)   

2. Atisāra (diarrhea) in which stool is pakva i.e.free from āma (undigested material)  

2. Atisāra (diarrhea) in which stool is pakva i.e.free from āma (undigested material)  

6. Atisāra (diarrhea) in which stool is pakva and containing kapha.

6. Atisāra (diarrhea) in which stool is pakva and containing kapha.

In this version of Charaka samhitā thirty six variants are cited, but another version ‘kēvalaiḥ saha ceṭ triṁśadvidyāt sōpadravānapi’ mentions only thirty.[ ]Gaṅgādhara also explains thirty forms in the following manner.[ ]

In this version of Charaka samhitā thirty six variants are cited, but another version ‘kēvalaiḥ saha ceṭ triṁśadvidyāt sōpadravānapi’ mentions only thirty.[ ]Gaṅgādhara also explains thirty forms in the following manner.[ ]

 The six basic forms of atisāra are:  

 

The six basic forms of atisāra are:  

o āmātisāra (diarrhea with undigested material)  

o āmātisāra (diarrhea with undigested material)  

o śakṛdatisāra (frequent stool only)  

o śakṛdatisāra (frequent stool only)  

o asṛk-pitta, asṛk-kapha, and

o asṛk-pitta, asṛk-kapha, and

o pitta-kapha.

o pitta-kapha.

 Nine upadrava as cited above.

 

Nine upadrava as cited above.

The upadravas in present version of chapter are ten. Gaṅgādhara has taken description of nine upadravas from another version.[ ]But upadravas cannot be counted among types of a disease. Hence the thirtysix variants would be in following manner.

The upadravas in present version of chapter are ten. Gaṅgādhara has taken description of nine upadravas from another version.[ ]But upadravas cannot be counted among types of a disease. Hence the thirtysix variants would be in following manner.

 The six basic forms of atisāra are as mentioned above.

The six basic forms of atisāra are as mentioned above.

 Due to saṁsarga (mutual combinations of two) atotal of thirtyvariants occur, viz. fifteen samsargas as mentioned above and other fifteen are as below:

Due to saṁsarga (mutual combinations of two) atotal of thirtyvariants occur, viz. fifteen samsargas as mentioned above and other fifteen are as below:

o śakṛd- āma, vāta-āma, asṛk-āma, pitta-āma, kapha-āma,

o śakṛd- āma, vāta-āma, asṛk-āma, pitta-āma, kapha-āma,

o vāta-śakṛd, asṛk-śakṛd, pitta-śakṛd, kapha-śakṛd,

o vāta-śakṛd, asṛk-śakṛd, pitta-śakṛd, kapha-śakṛd,

For vātaghna medicines to be used in vata associated atisara, Cakrapāṇi recommends daśhamula, while Gaṅgādhara considers bṛhat pañchamūla (see the commentary on 5th verse). For grāhī purpose the medicines of purīṣasaṁgrahaṇīya varga [Ca.Sū.4/8/31] are to be used.[ ]

For vātaghna medicines to be used in vata associated atisara, Cakrapāṇi recommends daśhamula, while Gaṅgādhara considers bṛhat pañchamūla (see the commentary on 5th verse). For grāhī purpose the medicines of purīṣasaṁgrahaṇīya varga [Ca.Sū.4/8/31] are to be used.[ ]

Next condition in which atisāra is associated with dominance of vāta, snēhabasti supplemented with sweet, sourand salty substances is recommended. Being opposite to the properties of vāta, the substances in this basti antagonizes the vāta principle. (verse 24)

Next condition in which atisāra is associated with dominance of vāta, snēhabasti supplemented with sweet, sourand salty substances is recommended. Being opposite to the properties of vāta, the substances in this basti antagonizes the vāta principle. (verse 24)

The basti used in pittātisārais useful in raktātisāra also. Applying this principle, this type of basti may be used in a disease entity known as ulcerative colitis. (verse 25)

The basti used in pittātisārais useful in raktātisāra also. Applying this principle, this type of basti may be used in a disease entity known as ulcerative colitis. (verse 25)

These verses number 26-27 describe management plan for the saṁsargaja atisāras (in which two morbid components are associated and have mutual vitiation). Cakrapāṇi in his commentary decides the main and secondary role of the involved components on the basis of vibhakti (noun case) of the words. 7thvibhakti signifies the main role while 3rd expresses secondary role of the factors.[ ]

These verses number 26-27 describe management plan for the saṁsargaja atisāras (in which two morbid components are associated and have mutual vitiation). Cakrapāṇi in his commentary decides the main and secondary role of the involved components on the basis of vibhakti (noun case) of the words. 7thvibhakti signifies the main role while 3rd expresses secondary role of the factors.[ ]

In the 26th verse the possible combination are-

In the 26th verse the possible combination are-

1.āma is associated with śakṛt i.e.stool (āma is primary and stool is secondary)

1.āma is associated with śakṛt i.e.stool (āma is primary and stool is secondary)

4.rakta is associated with āma (rakta is primary and āma is secondary)

4.rakta is associated with āma (rakta is primary and āma is secondary)

In these conditions in mentioned in 26th verse, a drink prepared with trikaṭu, sour and salty substances is recommended. While the conditions mentioned in 27th verse, are manageable with adrink, prepared with trikaṭu, sweetand bitter substances is useful. (verse 26-27)

In these conditions in mentioned in 26th verse, a drink prepared with trikaṭu, sour and salty substances is recommended. While the conditions mentioned in 27th verse, are manageable with adrink, prepared with trikaṭu, sweetand bitter substances is useful. (verse 26-27)

The description of saṁsargaja atisāras continues in these verses 28-29. In the 28th verse, the possible combination are-

The description of saṁsargaja atisāras continues in these verses 28-29. In the 28th verse, the possible combination are-

1.āma is associated with kapha (āma is primary and kapha is secondary)

1.āma is associated with kapha (āma is primary and kapha is secondary)

2.kapha is associated with āma (kapha is primary and āma is secondary)

2.kapha is associated with āma (kapha is primary and āma is secondary)

In 1st condition the recommended basti is with trikaṭu, astringent and bitter substances while in 2nd condition with trikaṭu, astringent and salty medicines.

In 1st condition the recommended basti is with trikaṭu, astringent and bitter substances while in 2nd condition with trikaṭu, astringent and salty medicines.

In a pāthabheda (another version) of 29th verse[ ], rakta is also included. With this inclusion the the possible combination are-

In a pāthabheda (another version) of 29th verse[ ], rakta is also included. With this inclusion the the possible combination are-

1. śakṛt (stool) is associated with vāta  (stool is primary and vāta is secondary)

1. śakṛt (stool) is associated with vāta  (stool is primary and vāta is secondary)

4. kapha is associated with pitta (kapha is primary and pitta is secondary)

4. kapha is associated with pitta (kapha is primary and pitta is secondary)

5. kapha is associated with rakta (kapha is primary and rakta issecondary)

5. kapha is associated with rakta (kapha is primary and rakta issecondary)

The conditions mentioned in 30th verse are managed by administration of basti prepared with astringent, sweet and bitter ingredients. While the pathologies in 31stverse, are manageable by a basti with trikaṭu, bitter and astringent ingredients. (verse 30-31)

The conditions mentioned in 30th verse are managed by administration of basti prepared with astringent, sweet and bitter ingredients. While the pathologies in 31stverse, are manageable by a basti with trikaṭu, bitter and astringent ingredients. (verse 30-31)

Rakta as main with kapha as secondary sweet,trikaṭu and bitter  

Rakta as main with kapha as secondary sweet,trikaṭu and bitter  

Vāta is main factor with kapha as secondary trikaṭu,sour and salty

Vāta is main factor with kapha as secondary trikaṭu,sour and salty

Pitta is main with vāta as secondary. sweet, sour and bitter

Pitta is main with vāta as secondary. sweet, sour and bitter(verse 32-33)

(verse 32-33)

 

There are six components involved in the pathogenesis of atisāra. In earlier verses the combinations of two components are described. The combinations of three, four or five are also possible. Gaṅgādhara in his Jalpakalpataru commentary mentions the possibility of combination of all six also.[ ] This appears logical, as when five may combine six together may also be possible.  

There are six components involved in the pathogenesis of atisāra. In earlier verses the combinations of two components are described. The combinations of three, four or five are also possible. Gaṅgādhara in his Jalpakalpataru commentary mentions the possibility of combination of all six also.[ ] This appears logical, as when five may combine six together may also be possible.  

According to Gaṅgādhara, the following combinations may happen viz. ten clinical forms due to combinations of three, six forms due to combinations of four, three forms due to combinations of five and one form with all six. In this way twenty forms are possible. These combinations are as below.

According to Gaṅgādhara, the following combinations may happen viz. ten clinical forms due to combinations of three, six forms due to combinations of four, three forms due to combinations of five and one form with all six. In this way twenty forms are possible. These combinations are as below.

Combinations of three Combinations of four Combinations of five Combination of six

Combinations of three Combinations of four Combinations of five Combination of six

āmaviḍvātaja

āmaviḍvātaja

āmaviḍvātāsṛkkaphaja

āmaviḍvātāsṛkkaphaja

viḍvātāsṛkpitta kaphaja

viḍvātāsṛkpitta kaphaja

āmaviḍvātāsṛkpittakaphaja

āmaviḍvātāsṛkpittakaphaja(verse 34)

If case of association of āma, bastis are contraindicated. This is a general rule. In such condition the āmapācana (preparation to terminate āma)is given. However, in nirāma condition (without association of āma), bastis are recommended. (verse 35)

If case of association of āma, bastis are contraindicated. This is a general rule. In such condition the āmapācana (preparation to terminate āma)is given. However, in nirāma condition (without association of āma), bastis are recommended. (verse 35)

In these verses 36-37, two new units of measurement are described i.e. pala and prastha. After calculating these amounts in modern units of metric system, pala is around 50 gms or 50 ml while prastha around 800 ml. Though, in previous verses the management of different types of atisāras, has been described. In coherence of the topic, more remedies for atisāra are described in present verses.

In these verses 36-37, two new units of measurement are described i.e. pala and prastha. After calculating these amounts in modern units of metric system, pala is around 50 gms or 50 ml while prastha around 800 ml. Though, in previous verses the management of different types of atisāras, has been described. In coherence of the topic, more remedies for atisāra are described in present verses.

This medicated ghṛta is processed with plants having staṁbhana action. Therefore, it is useful in all types of atisāra. Being a nourishing preparation, it is useful in compensating the loss of the essential body substances. A basti may also be given with this preparation and should be retained as much as possible. This type of basti may be useful in inflammatory bowel diseases. (verse 36-37)

This medicated ghṛta is processed with plants having staṁbhana action. Therefore, it is useful in all types of atisāra. Being a nourishing preparation, it is useful in compensating the loss of the essential body substances. A basti may also be given with this preparation and should be retained as much as possible. This type of basti may be useful in inflammatory bowel diseases. (verse 36-37)

The remedies for atisāra continue in these verses 38-39. These verses describe recipe of medicated gruels useful in management of this disease. First the decoction is prepared according to the recipe of ṣaḍaṅgapānīya.[ ],[ ]

The remedies for atisāra continue in these verses 38-39. These verses describe recipe of medicated gruels useful in management of this disease. First the decoction is prepared according to the recipe of ṣaḍaṅgapānīya.[ ],[ ]

For this purpose one part of the course powder of all plants is boiled with 64 parts of water. When water is reduced to half, this is to be taken to cook yavāgū. There are three varieties of yavāgū-maṇḍa, peyā and vilepī. These three are gradually thicker in consistency and may be chosen according to strength of a patient and his agni. (verse 38-39)

For this purpose one part of the course powder of all plants is boiled with 64 parts of water. When water is reduced to half, this is to be taken to cook yavāgū. There are three varieties of yavāgū-maṇḍa, peyā and vilepī. These three are gradually thicker in consistency and may be chosen according to strength of a patient and his agni. (verse 38-39)

Gaṅgādhara considers Sthirādi group of plantsas Svalpapañcamūlaconsists of śālaparṇī (Desmodium gangeticum DC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.). About balādi group there is no clarification by any commentator however the plants Sida cordifolia Linn., abutilon indicum Linn., Sida rhombifolia Linn. and Grewia hirsute Vahl. may be taken for this purpose. Ikṣvādi is considered by Cakrapāṇi as roots of Saccharum officinarum Linn., Desmostachya bipinnata Stapf., Saccharum spontaneum Linn. and roots of rice.

Gaṅgādhara considers Sthirādi group of plantsas Svalpapañcamūlaconsists of śālaparṇī (Desmodium gangeticum DC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.). About balādi group there is no clarification by any commentator however the plants Sida cordifolia Linn., abutilon indicum Linn., Sida rhombifolia Linn. and Grewia hirsute Vahl. may be taken for this purpose. Ikṣvādi is considered by Cakrapāṇi as roots of Saccharum officinarum Linn., Desmostachya bipinnata Stapf., Saccharum spontaneum Linn. and roots of rice.

There is another version of verse 42, which mentions last line as ‘sasarpirlavaṇā yojyā madhurā lavaṇāpi vā’ which means that this preparation can be used with ghṛta and rock salt in sweet or salty form.

There is another version of verse 42, which mentions last line as ‘sasarpirlavaṇā yojyā madhurā lavaṇāpi vā’ which means that this preparation can be used with ghṛta and rock salt in sweet or salty form.

Above verses give some more recipes for medicated yavāgūs those are helpful in management of atisāra. (verse 40-42)

Above verses give some more recipes for medicated yavāgūs those are helpful in management of atisāra. (verse 40-42)

In these verses some additional and useful remedies for management of various types of atisāra are given. It is to be recalled that in this chapter, authors have considered six factors responsible in pathogenesis and manifestation of atisāra viz. āma vāta, pitta, kapha, rakta and sakṛt (stool). The treatments are to be considered as per the factors involved. (verse 43-45)

In these verses some additional and useful remedies for management of various types of atisāra are given. It is to be recalled that in this chapter, authors have considered six factors responsible in pathogenesis and manifestation of atisāra viz. āma vāta, pitta, kapha, rakta and sakṛt (stool). The treatments are to be considered as per the factors involved. (verse 43-45)

The chapter describes various clinical forms of atisara according to the components involved in the pathogenesis. The therapeutics for these various forms of atisāra is described in a planned manner. Ayurvedic management is not merely medicaments but it recommends the food preparations those are helpful in restoring the normalcy of the body components of the patient. Thus the chapter is significantly useful for clinical practice of basti therapies and the treatment of disease atisāra, which includes several modern diseases such as ulcerative colitis, Crohn’s dieases and irritable bowel syndrome. (verse 46)

The chapter describes various clinical forms of atisara according to the components involved in the pathogenesis. The therapeutics for these various forms of atisāra is described in a planned manner. Ayurvedic management is not merely medicaments but it recommends the food preparations those are helpful in restoring the normalcy of the body components of the patient. Thus the chapter is significantly useful for clinical practice of basti therapies and the treatment of disease atisāra, which includes several modern diseases such as ulcerative colitis, Crohn’s dieases and irritable bowel syndrome. (verse 46)

The basti formulations mentioned in this chapter are used widely in today’s clinical practice. However, though atisara (diarrhea) is explained in detail as complication of improperly administered basti, in todays clinical practice, this complication is observed rarely.  

The basti formulations mentioned in this chapter are used widely in today’s clinical practice. However, though atisara (diarrhea) is explained in detail as complication of improperly administered basti, in todays clinical practice, this complication is observed rarely.

=== Glossary ===

=== Glossary ===