2,062
edits
Changes
no edit summary
<big>''' Abstract </big>'''
<big>''' Abstract </big>'''
<div style="text-align:justify;">
<div style="text-align:justify;">
[[Bastivyapat Siddhi]] talks about various complications that may arise while administering ''niruha basti''. Complications of ''basti'' may arise either due to improper composition of ''basti'', faulty administration or specific clinical situation. There are twelve complications enlisted under ''niruha basti''. The twelve complications are: ''ayoga'' (insufficient or no effect), ''atiyoga'' (excess effect), ''klama'' (fatigue without exertion), ''adhmana'' (abdominal distension), ''hikka'' (hiccups), ''hritprapti'' (reaching the pericordium), ''urdhvata'' (''basti'' reaching oesophagus), ''pravahika'' (dysentery), ''shiroarti'' (headache), ''angarti'' (bodyache), ''parikartika'' (fissure-in-ano) and ''parisrava'' (discharge through anus). In this seventh chapter etiology, clinical features and management of these twelve ''vyapats'' (complications) are described in detail.
[[Bastivyapat Siddhi]] talks about various complications that may arise while administering ''niruha [[basti]]''. Complications of ''[[basti]]'' may arise either due to improper composition of ''[[basti]]'', faulty administration or specific clinical situation. There are twelve complications enlisted under ''niruha [[basti]]''. The twelve complications are: ''ayoga'' (insufficient or no effect), ''atiyoga'' (excess effect), ''klama'' (fatigue without exertion), ''adhmana'' (abdominal distension), ''hikka'' (hiccups), ''hritprapti'' (reaching the pericordium), ''urdhvata'' (''basti'' reaching oesophagus), ''pravahika'' (dysentery), ''shiroarti'' (headache), ''angarti'' (bodyache), ''parikartika'' (fissure-in-ano) and ''parisrava'' (discharge through anus). In this seventh chapter etiology, clinical features and management of these twelve ''vyapats'' (complications) are described in detail.
'''Keywords''': ''Basti vyapat, ayoga, atiyoga, mithyayoga, klama, adhamana, hikka, hritprapti, urdhvata, pravahika, siroarti, angaarti, parikartika, parisrava'', complications of ''basti''.
'''Keywords''': ''Basti vyapat, ayoga, atiyoga, mithyayoga, klama, adhamana, hikka, hritprapti, urdhvata, pravahika, siroarti, angaarti, parikartika, parisrava'', complications of ''basti''.
== Introduction ==
== Introduction ==
<div style="text-align:justify;">
<div style="text-align:justify;">
Improper administration of ''basti'' (trans-rectal drug administration in the form of enema) can cause various complications. Therefore, the clinician using ''basti'' as a treatment principle should have thorough knowledge to prevent, diagnose and manage them properly. Explanation of the complications of faulty therapeutic procedures are decribed in fourth ([[Snehavyapat Siddhi]] ''adhyaya''), fifth ([[Netrabastivyapat Siddhi]] ''adhyaya'') and sixth ([[Vamana Virechana Vyapat Siddhi]] ''adhyaya'') chapters earlier in this section. The complications arising due to unctuous enema are detailed in 4th chapter.
Improper administration of ''[[basti]]'' (trans-rectal drug administration in the form of enema) can cause various complications. Therefore, the clinician using ''[[basti]]'' as a treatment principle should have thorough knowledge to prevent, diagnose and manage them properly. Explanation of the complications of faulty therapeutic procedures are decribed in fourth ([[Snehavyapat Siddhi]] ''adhyaya''), fifth ([[Netrabastivyapat Siddhi]] ''adhyaya'') and sixth ([[Vamana Virechana Vyapat Siddhi]] ''adhyaya'') chapters earlier in this section. The complications arising due to unctuous enema are detailed in 4th chapter.
In the present chapter, twelve possible complications of ''niruha basti'' (enema with decoction) are described. The complications occur through ''ayoga'' (insufficient dose), ''atiyoga'' (excess dose) and ''mithyayoga'' (improper dose) which are described along with their etiology, signs and symptoms and their management.
In the present chapter, twelve possible complications of ''niruha [[basti]]'' (enema with decoction) are described. The complications occur through ''ayoga'' (insufficient dose), ''atiyoga'' (excess dose) and ''mithyayoga'' (improper dose) which are described along with their etiology, signs and symptoms and their management.
== Sanskrit text, Transliteration and English Translation ==
== Sanskrit text, Transliteration and English Translation ==
</div></div>
</div></div>
There are twelve complications of ''basti'' administration viz. ''ayoga, atiyoga, klama, adhamana, hikka, hritprapti, urdhvata, pravahika, siroarti, angaarti, parikartika, parisrava''. ''Atiyoga, ayoga'' and ''mithyayoga'' are the mechanisims of manifestations of these complications. The clinical manifestation and the management of each condition will be explained to you: [5-6]
There are twelve complications of ''[[basti]]' administration viz. ''ayoga, atiyoga, klama, adhamana, hikka, hritprapti, urdhvata, pravahika, siroarti, angaarti, parikartika, parisrava''. ''Atiyoga, ayoga'' and ''mithyayoga'' are the mechanisims of manifestations of these complications. The clinical manifestation and the management of each condition will be explained to you: [5-6]
=== Complication of ''ayoga'' (insufficience effect) ===
=== Complication of ''ayoga'' (insufficience effect) ===
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''basti'' complication-''ayoga'' ====
==== Etiology, clinical manifestation and management of ''[[basti]]'' complication-''ayoga'' ====
When ''basti'' having following mentioned qualities administered in patients with conditions mentioned below (any one or in combinations) result in ''ayoga'' type of ''basti'' complication (insufficient effect or no effect). ''Basti dravya'' of less potency cannot eliminate ''doshas'' and the remnant vitiated ''doshas'' lead to ''ayoga''.
When ''[[basti]]'' having following mentioned qualities administered in patients with conditions mentioned below (any one or in combinations) result in ''ayoga'' type of ''[[basti]]'' complication (insufficient effect or no effect). ''[[Basti]] dravya'' of less potency cannot eliminate ''[[dosha]]s'' and the remnant vitiated ''[[dosha]]s'' lead to ''ayoga''.
==== Condition of patient which can cause ''ayoga'' type of ''basti'' complication ====
==== Condition of patient which can cause ''ayoga'' type of ''[[basti]]'' complication ====
*''Guru kostha'' (hard bowel)
*''Guru kostha'' (hard bowel)
*''Vata'' predominance
*''Vata'' predominance
==== Qualities of ''basti'' which can cause ''ayoga'' type of ''basti''complication ====
==== Qualities of ''[[basti]]'' which can cause ''ayoga'' type of ''[[basti]]''complication ====
*Processed out of ''sheetaguna'' (cold potency) drugs
*Processed out of ''sheetaguna'' (cold potency) drugs
*''Phala varti'' (anal suppository)
*''Phala varti'' (anal suppository)
*''Virechana'' (subject to suitability and season)
*''Virechana'' (subject to suitability and season)
*Administration of ''basti'' prepared as mentioned below relieves ''vibaddha'' (obstruction) caused due to the ''ayoga'' of ''basti''.
*Administration of ''[[basti]]'' prepared as mentioned below relieves ''vibaddha'' (obstruction) caused due to the ''ayoga'' of ''[[basti]]''.
==== Preparation of ''basti'' ====
==== Preparation of ''[[basti]]'' ====
''Kashaya'' (decoction) of ''dravya - bilva mula'' (roots of Aegle marmelos Corr.), ''trivrit'' (Operculina turpethum (Linn.) silva manso.), ''daru''- (''Devadaru'') (Cedrus deodara ( Roxb.) Loud), ''kola'' (Zyzyphus jujuba Lam.), ''kulattha'' (Vigna unquiculata (Linn.) Walp.);
''Kashaya'' (decoction) of ''dravya - bilva mula'' (roots of Aegle marmelos Corr.), ''trivrit'' (Operculina turpethum (Linn.) silva manso.), ''daru''- (''Devadaru'') (Cedrus deodara ( Roxb.) Loud), ''kola'' (Zyzyphus jujuba Lam.), ''kulattha'' (Vigna unquiculata (Linn.) Walp.);
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''basti'' complication-''atiyoga'' ====
==== Etiology, clinical manifestation and management of ''[[basti]]'' complication-''atiyoga'' ====
''Atiyoga'' complication will occur when ''basti'' prepared out of drugs possessing ''ushna'' (hot potency) and ''teekshna'' (sharply acting/penetrating) property administered in patients of ''mridukostha'' (soft bowel) who had undergone ''sneha'' and ''sweda''.
''Atiyoga'' complication will occur when ''[[basti]]'' prepared out of drugs possessing ''ushna'' (hot potency) and ''teekshna'' (sharply acting/penetrating) property administered in patients of ''mridukostha'' (soft bowel) who had undergone ''sneha'' and ''sweda''.
Signs, symptoms and the management is similar to that mentioned for ''shodhana-atiyoga'':
Signs, symptoms and the management is similar to that mentioned for ''shodhana-atiyoga'':
*''Visrava'' (Flow/Oozing) of ''vit'' (stools), ''pitta, kapha, drava dhatu''
*''Visrava'' (Flow/Oozing) of ''vit'' (stools), ''[[pitta]], [[kapha]], drava [[dhatu]]''
*''Bala kshaya'' (loss/ decrease in strength)
*''Bala kshaya'' (loss/ decrease in strength)
*''Swara kshaya'' (low voice)
*''Swara kshaya'' (low voice)
==== Management ====
==== Management ====
''Basti'' prepared as mentioned below is to be administered along with ''ghrita'' (ghee) which relieves burning caused by ''atiyoga''.
''[[Basti]]'' prepared as mentioned below is to be administered along with ''ghrita'' (ghee) which relieves burning caused by ''atiyoga''.
==== ''Basti'' preparation ====
==== ''[[Basti]]'' preparation ====
''Kalka'' made of ''prisniparni'' (Uraria picta Desv)., ''sthira –shaliparni'' –(Desmodium gangeticum DC.), ''padma -kamala'' – (Nelumbo nucifera Gaertn), ''kashmarya - gambhari'' –(Gmelina arborea Roxb), ''madhuka –yastimadhu'' (Glycyrrhiza glabra Linn), ''bala'' (Sida cordifolia Linn.), ''draksha'' (Vitis vinifera Linn.), ''madhuka'' (Madhuca indica J.F.Gmel) add this ''kalka'' to ''ksheera'' (milk), ''tandulodaka'' (washed rice water), ''draksha prasada'' (i.e. ''sheeta kashaya''), ''pakvalostra prasada'' (supernatant water taken after heated earthen pot pieces were dipped in a vessel containing water), ''yastimadhu prasada'' (i.e.''sheeta kashaya'').[12-14]
''Kalka'' made of ''prisniparni'' (Uraria picta Desv)., ''sthira –shaliparni'' –(Desmodium gangeticum DC.), ''padma -kamala'' – (Nelumbo nucifera Gaertn), ''kashmarya - gambhari'' –(Gmelina arborea Roxb), ''madhuka –yastimadhu'' (Glycyrrhiza glabra Linn), ''bala'' (Sida cordifolia Linn.), ''draksha'' (Vitis vinifera Linn.), ''madhuka'' (Madhuca indica J.F.Gmel) add this ''kalka'' to ''ksheera'' (milk), ''tandulodaka'' (washed rice water), ''draksha prasada'' (i.e. ''sheeta kashaya''), ''pakvalostra prasada'' (supernatant water taken after heated earthen pot pieces were dipped in a vessel containing water), ''yastimadhu prasada'' (i.e.''sheeta kashaya'').[12-14]
</div></div>
</div></div>
Etiology clinical manifestation and management of ''basti'' complication - ''klama'' (fatigue): In ''amashesha'' (remnant of ''ama''- undigested material) condition, ''mridu'' type of ''niruha basti'' (transrectal administration of non-unctuous formulation) is administered, ''doshas'' (''pitta, kapha'' along with ''ama'') gets vitiated and leads to obstruction of ''marga'' (''srotas''), resulting in ''vata'' aggravation and ''agni'' impairement.
Etiology clinical manifestation and management of ''[[basti]]'' complication - ''klama'' (fatigue): In ''amashesha'' (remnant of ''ama''- undigested material) condition, ''mridu'' type of ''niruha [[basti]]'' (transrectal administration of non-unctuous formulation) is administered, ''[[dosha]]s'' (''[[pitta]], [[kapha]]'' along with ''ama'') gets vitiated and leads to obstruction of ''marga'' (''srotas''), resulting in ''[[vata]]'' aggravation and ''[[agni]]'' impairement.
==== Signs and symptoms seen in ''basti'' complication - ''klama'' ====
==== Signs and symptoms seen in ''[[basti]]'' complication - ''klama'' ====
*''Klama'' (fatigue)
*''Klama'' (fatigue)
*Powders of ''vacha'' (Acorus calamus Linn.), ''nagara'' (Zingiber officinale Roscoe.), ''shati'' (Hedychium spicatum, ela (Elettaria cardamomum Matan.) have to be mixed with either of ''dadhimanda'' or ''prasanna'' or ''aristha'' or ''asava'', to be given as a ''peya'' (drink).
*Powders of ''vacha'' (Acorus calamus Linn.), ''nagara'' (Zingiber officinale Roscoe.), ''shati'' (Hedychium spicatum, ela (Elettaria cardamomum Matan.) have to be mixed with either of ''dadhimanda'' or ''prasanna'' or ''aristha'' or ''asava'', to be given as a ''peya'' (drink).
*''Devadaru'' (Cedrus deodara Roxb.Loud), ''trikatu'' i.e. ''shunthi-maricha-pippali'' (Zingiber officinale Roscoe, Piper nigrum Linn., Piper longum Linn.), ''pathya'' - ''haritaki'' (Terminalia chebula Retz.), ''palasha'' (Butea frondosa Koen.ex.Roxb.), ''chitraka'' (Plumbago zeylalanica Linn.), ''shati'' (Hedychium spicatum Ham ex.Smith) and ''kushtha'' (Saussurea lappa C.B.Clarke) have to be made a paste with ''gomutra'' (cow’s urine) and administered orally for ''deepana''.
*''Devadaru'' (Cedrus deodara Roxb.Loud), ''trikatu'' i.e. ''shunthi-maricha-pippali'' (Zingiber officinale Roscoe, Piper nigrum Linn., Piper longum Linn.), ''pathya'' - ''haritaki'' (Terminalia chebula Retz.), ''palasha'' (Butea frondosa Koen.ex.Roxb.), ''chitraka'' (Plumbago zeylalanica Linn.), ''shati'' (Hedychium spicatum Ham ex.Smith) and ''kushtha'' (Saussurea lappa C.B.Clarke) have to be made a paste with ''gomutra'' (cow’s urine) and administered orally for ''[[deepana]]''.
*Administer ''kshara'' (kshara preparations mentioned in [[Grahani Chikitsa]] ) orally for ''deepana''.
*Administer ''kshara'' (kshara preparations mentioned in [[Grahani Chikitsa]] ) orally for ''[[deepana]]''.
*Administer ''basti'' prepared out of ''dashamula'' (''dashamulaniruhabasti'' ) and ''gomutra''.
*Administer ''[[basti]]'' prepared out of ''dashamula'' (''dashamulaniruhabasti'' ) and ''gomutra''.
**''Dashamula'' viz.
**''Dashamula'' viz.
#''Bilva''- (Aegle marmelos Carr.)
#''Bilva''- (Aegle marmelos Carr.)
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''basti'' complication - ''adhmana'' (distension of abdomen) ====
==== Etiology, clinical manifestation and management of ''[[basti]]'' complication - ''adhmana'' (distension of abdomen) ====
When ''basti'' compounded with drugs of less potency administered in patients having ''mahadosha, krurakostha, rukshasharira,'' the ''basti dravya'' undergo ''avarana'' by ''dosha'' leading to ''margavarodha'' thus obstructs ''vata''. The ''vata'' undergo ''vimarga-gamana'' results in ''adhmana'' (bloating of abdomen) along with following signs and symptoms:
When ''[[basti]]'' compounded with drugs of less potency administered in patients having ''mahadosha, krurakostha, rukshasharira,'' the ''[[basti]] dravya'' undergo ''avarana'' by ''[[dosha]]'' leading to ''margavarodha'' thus obstructs ''[[vata]]''. The ''[[vata]]'' undergo ''vimarga-gamana'' results in ''adhmana'' (bloating of abdomen) along with following signs and symptoms:
*''Marmapida'' (pain in vital parts) due to ''adhmana''
*''Marmapida'' (pain in vital parts) due to ''adhmana''
*''Vidaha'' (burning sensation) in ''guru koshtha''
*''Vidaha'' (burning sensation) in ''guru koshtha''
Suppositories may also be prepared by adding ''lavana, grihadhuma, siddharthaka'' (''sarshapa''- Brassica campestris Var.sarson Prain.).
Suppositories may also be prepared by adding ''lavana, grihadhuma, siddharthaka'' (''sarshapa''- Brassica campestris Var.sarson Prain.).
Patients may also be administered ''niruhabasti'' prepared with ''bilva'' (Aegle marmelos Carr.) etc. added with ''pilu'' (Salvadora persica Linn.), ''sarshapa'' (Brassica campestris Var.sarson Prain.) and ''gomutra'' (cow’s urine).
Patients may also be administered ''niruha [[basti]]'' prepared with ''bilva'' (Aegle marmelos Carr.) etc. added with ''pilu'' (Salvadora persica Linn.), ''sarshapa'' (Brassica campestris Var.sarson Prain.) and ''gomutra'' (cow’s urine).
Similarly ''anuvasanabasti'' (transrectal administration of unctuous formulations) may be administered with ''taila'' prepared with drugs of ''sarala'' (Pinus longifolia Roxb.), and ''amaradaru'' (''Devadaru'' – Cedrus deodara Roxb.Loud.).[21-26]
Similarly ''anuvasana [[basti]]'' (transrectal administration of unctuous formulations) may be administered with ''taila'' prepared with drugs of ''sarala'' (Pinus longifolia Roxb.), and ''amaradaru'' (''Devadaru'' – Cedrus deodara Roxb.Loud.).[21-26]
=== Complication of ''hikka'' (hiccups) ===
=== Complication of ''hikka'' (hiccups) ===
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''basti vyapat - hikka'' ====
==== Etiology, clinical manifestation and management of ''[[basti]] vyapat - hikka'' ====
''Hikka'' is resulted due to excessive elimination of ''doshas'' by ''basti. Doshas'' are eliminated in excess when ''basti'' having qualities of excessive ''tikshna'' (sharply acting/penetrating) qualities administered in a patient of ''mridu kostha'' and ''abala'' (persons of poor strength).
''Hikka'' is resulted due to excessive elimination of ''[[dosha]]s'' by ''[[basti]]. [[Dosha]]s'' are eliminated in excess when ''[[basti]]'' having qualities of excessive ''tikshna'' (sharply acting/penetrating) qualities administered in a patient of ''mridu kostha'' and ''abala'' (persons of poor strength).
In such cases ''hikkaghna'' (hic-cough suppressant therapy ) and ''brimhana'' (nourishment) therapies are advised.
In such cases ''hikkaghna'' (hic-cough suppressant therapy ) and ''[[brimhana]]'' (nourishment) therapies are advised.
*Administer ''anuvasana basti'' (unctuous enema) with ''taila'' (oil) prepared out of ''bala'' (Sida cordifolia Linn.), ''sthiradi'' (''Sthira/Shaliparni'' (Desmodium gangeticum DC.), ''prisnipari'' (Uraria picta Desv.). ''brihati'' (Solanum indicum Linn), ''kantakari'' (Solanum xanthocarpum Schrad & Wendl.) and ''gokshura'' (Tribulus terrestris Linn.) - ''laghu panchamula'' drugs ; ''kashmarya'' -(''gambhari'' -Gmelina arborea Linn.)), ''triphala'' i.e ''haritaki'' (Terminalia chebula Retz.), ''bibhitaki'' (Terminalia belerica Roxb.), amalaki (Emblica officinalis Gaertn.), guda (Jaggery), saindhava (rock salt), prasanna, amla aranala (sour fermented preparation).
*Administer ''anuvasana [[basti]]'' (unctuous enema) with ''taila'' (oil) prepared out of ''bala'' (Sida cordifolia Linn.), ''sthiradi'' (''Sthira/Shaliparni'' (Desmodium gangeticum DC.), ''prisnipari'' (Uraria picta Desv.). ''brihati'' (Solanum indicum Linn), ''kantakari'' (Solanum xanthocarpum Schrad & Wendl.) and ''gokshura'' (Tribulus terrestris Linn.) - ''laghu panchamula'' drugs ; ''kashmarya'' -(''gambhari'' -Gmelina arborea Linn.)), ''triphala'' i.e ''haritaki'' (Terminalia chebula Retz.), ''bibhitaki'' (Terminalia belerica Roxb.), amalaki (Emblica officinalis Gaertn.), guda (Jaggery), saindhava (rock salt), prasanna, amla aranala (sour fermented preparation).
*Administer mixture of ''krishna'' (''pippali'') (Piper longum Linn.) and ''saindhava lavana'', in the dose of one ''aksha/karsha'' (12 g) with hot water.
*Administer mixture of ''krishna'' (''pippali'') (Piper longum Linn.) and ''saindhava lavana'', in the dose of one ''aksha/karsha'' (12 g) with hot water.
*''Dhuma, avaleha, mamsarasa, ksheera, sveda'' and ''anna'' which are ''vatahara'' should be administered. [27-29]
*''Dhuma, avaleha, mamsarasa, ksheera, sveda'' and ''anna'' which are ''[[vata]]hara'' should be administered. [27-29]
=== Complication due to ''basti'' afflicting the heart ===
=== Complication due to ''[[basti]]'' afflicting the heart ===
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''basti'' complication - ''hritprapti'' ====
==== Etiology, clinical manifestation and management of ''[[basti]]'' complication - ''hritprapti'' ====
When ''basti'' administered under following conditions leads to ''hritprapti'' (affliction of heart) and cause ''hridghatta'':
When ''[[basti]]'' administered under following conditions leads to ''hritprapti'' (affliction of heart) and cause ''hridghatta'':
*''Basti'' prepared with ''ati-tikshna dravya'' (strongly medicated with sharp acting medicines)
*''[[Basti]]'' prepared with ''ati-tikshna dravya'' (strongly medicated with sharp acting medicines)
*Administered along with air bubbles
*Administered along with air bubbles
*Administered without maintaining proper pressure (not properly compressed)
*Administered without maintaining proper pressure (not properly compressed)
==== Management ====
==== Management ====
*In case of ''hritprapti, niruhabasti'' is to be administered with decoction prepared out of ''kasha'' (Saccharum spontaneum Linn.), ''kusha'' (Eragrostis cynosuroides Beaur.), ''utkata'' (Phragmites kirka Trin.), ''amla skandha'' (sour category) drugs , ''lavana skandha'' drugs(salt category) , ''karira'' (Capparis aphylla Rotz.), ''badaraphala'' (Zizyphus jujuba Lam.).
*In case of ''hritprapti, niruha [[basti]]'' is to be administered with decoction prepared out of ''kasha'' (Saccharum spontaneum Linn.), ''kusha'' (Eragrostis cynosuroides Beaur.), ''utkata'' (Phragmites kirka Trin.), ''amla skandha'' (sour category) drugs , ''lavana skandha'' drugs(salt category) , ''karira'' (Capparis aphylla Rotz.), ''badaraphala'' (Zizyphus jujuba Lam.).
*''Anuvasanabasti'' may also be administered with medicines having ''vatahara'' property (like ''dashamula'' etc). [30-31]
*''Anuvasana [[basti]]'' may also be administered with medicines having ''[[vata]]hara'' property (like ''dashamula'' etc). [30-31]
=== Complications due to ''basti'' reaching oesophagus ===
=== Complications due to ''[[basti]]'' reaching oesophagus ===
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''basti'' complication - ''urdhvagamana'' ====
==== Etiology, clinical manifestation and management of ''[[basti]]'' complication - ''urdhvagamana'' ====
''Basti dravya'' will be expelled from ''mukha'' (orally), after administration of ''basti'',
''[[Basti]] dravya'' will be expelled from ''mukha'' (orally), after administration of ''[[basti]]'',
*If the person suppresses the urge of ''vata'' (flatus), ''mutra'' (urine) and ''purisha'' (stool) or
*If the person suppresses the urge of ''[[vata]]'' (flatus), ''mutra'' (urine) and ''purisha'' (stool) or
*If administered with more pressure.
*If administered with more pressure.
*Raise the patient holding his hair only, into air and shake.
*Raise the patient holding his hair only, into air and shake.
*Frighten him by ox, donkey, horse, elephant, lion, servants of king, snakes, ''ulka'' (fiery meteor), or by other threatening things.
*Frighten him by ox, donkey, horse, elephant, lion, servants of king, snakes, ''ulka'' (fiery meteor), or by other threatening things.
*These cause ''adhopravartana'' of ''basti'' (normal intestinal movement will be restored).
*These cause ''adhopravartana'' of ''[[basti]]'' (normal intestinal movement will be restored).
*Press the throat (''kantha'') with either cloth or hand, taking care to prevent any death.
*Press the throat (''kantha'') with either cloth or hand, taking care to prevent any death.
*This obstruction of throat leads to obstructing ''prana'' and ''udana vata'', thus leading ''apana vata'' to take its normal path, reaches ''basti'' and eliminates the ''dosha''.
*This obstruction of throat leads to obstructing ''prana'' and ''udana vata'', thus leading ''apana vata'' to take its normal path, reaches ''basti'' and eliminates the ''[[dosha]]''.
*Then administer drink made with one ''aksha'' (''karsha''=12g) of ''kramuka'' (Areca catechu Linn.) paste along with ''amla'' (sour) ''dravya''.
*Then administer drink made with one ''aksha'' (''karsha''=12g) of ''kramuka'' (Areca catechu Linn.) paste along with ''amla'' (sour) ''dravya''.
*Due to ''ushna'' (hot), ''teekshna'' (sharply acting), ''sara'' (moving) qualities, ''basti'' does ''anulomana'' (normalize peristaltic movements).
*Due to ''ushna'' (hot), ''teekshna'' (sharply acting), ''sara'' (moving) qualities, ''[[basti]]'' does ''anulomana'' (normalize peristaltic movements).
*If ''bastidravya'' stabilises in ''pakvashaya'' (large instestine), after ''swedana, niruha basti'' has to be administered prepared with ''dashamula'' (''bilva, agnimantha, shyonaka, patala, gambhari, brihati, kantakari, shaliparni, prishniparni'' and ''gokshura'') or ''yava'' (Hordeum vulgare Linn.), ''kola'' (Zizyphus jujube Ram.), ''kulattha'' (Dolichos biflorus Linn.), with ''gomutra'' (cow urine).
*If ''[[basti]] dravya'' stabilises in ''pakvashaya'' (large instestine), after ''swedana, niruha [[basti]]'' has to be administered prepared with ''dashamula'' (''bilva, agnimantha, shyonaka, patala, gambhari, brihati, kantakari, shaliparni, prishniparni'' and ''gokshura'') or ''yava'' (Hordeum vulgare Linn.), ''kola'' (Zizyphus jujube Ram.), ''kulattha'' (Dolichos biflorus Linn.), with ''gomutra'' (cow urine).
*If ''bastidravya'' is in ''ura-pradesha'' (chest region), administer ''niruha basti'' prepared of ''bilvadipanchamula'' decoction (roots of ''bilva'' (Aegle marmelos Carr.), ''agnimantha'' (Premna integrifolia Linn), ''shyonaka'' (Oroxylum indicum Vent.), ''patala'' (Stereospermum suaveolens DC.) and ''gambhari'' (Gmelina arborea Linn.).
*If ''[[basti]] dravya'' is in ''ura-pradesha'' (chest region), administer ''niruha [[basti]]'' prepared of ''bilvadipanchamula'' decoction (roots of ''bilva'' (Aegle marmelos Carr.), ''agnimantha'' (Premna integrifolia Linn), ''shyonaka'' (Oroxylum indicum Vent.), ''patala'' (Stereospermum suaveolens DC.) and ''gambhari'' (Gmelina arborea Linn.).
*If ''basti dravya'' stay in head, administer ''navana'' (nasal administration), ''dhuma'' (smoke therapy) and external application of ''sarshapa'' (Brassica campestris Var. ''sarson'' prain) paste on head. [32-39]
*If ''[[basti]] dravya'' stay in head, administer ''navana'' (nasal administration), ''dhuma'' (smoke therapy) and external application of ''sarshapa'' (Brassica campestris Var. ''sarson'' prain) paste on head. [32-39]
=== Complication of ''pravahika'' (dysentery) due to ''basti'' ===
=== Complication of ''pravahika'' (dysentery) due to ''[[basti]]'' ===
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''pravahika'', a ''basti'' complication ====
==== Etiology, clinical manifestation and management of ''pravahika'', a ''[[basti]]'' complication ====
''Pravahika'' occurs when patient of ''mahadosha'' (excessively vitiated ''dosha'') having undergone ''sneha'' (oleation) and ''sweda'' (sudation), administered with ''niruha basti'', prepared of drugs with ''mridu'' quality and in lower dose. In such conditions ''dosha'' undergo ''utklesha'' (exciting) and ''doshas'' are expelled in ''alpamatra'' (little quantity) thus result in ''pravahika'' (dysentery).
''Pravahika'' occurs when patient of ''maha[[dosha]]'' (excessively vitiated ''[[dosha]]'') having undergone ''[[snehana]]'' (oleation) and ''[[swedana]]'' (sudation), administered with ''niruha [[basti]]'', prepared of drugs with ''mridu'' quality and in lower dose. In such conditions ''[[dosha]]'' undergo ''utklesha'' (exciting) and ''[[dosha]]s'' are expelled in ''alpamatra'' (little quantity) thus result in ''pravahika'' (dysentery).
Following other signs and symptoms are also seen:
Following other signs and symptoms are also seen:
*''Shopha'' (swelling/inflammation) of ''basti/mutrashaya'' (bladder) & ''payu'' (anorectal region)
*''Shopha'' (swelling/inflammation) of ''basti/mutrashaya'' (bladder) & ''payu'' (anorectal region)
*''Sadana'' (exhaustion) of ''jangha'' (calf region) and ''uru'' (thighs).
*''Sadana'' (exhaustion) of ''jangha'' (calf region) and ''uru'' (thighs).
*Increased frequency of bowels due to obstructed ''vata''
*Increased frequency of bowels due to obstructed ''[[vata]]''
==== Management ====
==== Management ====
*''Abhyanga'' ( oil massage)
*''Abhyanga'' ( oil massage)
*''Svedana'' (sudation)
*''[[Swedana]]'' (sudation)
*''Niruha basti'' ( non-unctous enema with decoction)
*''Niruha [[basti]]'' ( non-unctous enema with decoction)
*''Shodhana dravya'' (''trivrit'' etc. as mentioned in[ Cha. Sa. [[Kalpa Sthana]] 1] and
*''Shodhana dravya'' (''trivrit'' etc. as mentioned in[ Cha. Sa. [[Kalpa Sthana]] 1] and
*''Anulomana'' drugs (like ''ksheera'' (milk), ''ikshurasa'' (Saccharum officinarum Linn.)
*''Anulomana'' drugs (like ''ksheera'' (milk), ''ikshurasa'' (Saccharum officinarum Linn.)
*''Langhana'' (fasting)
*''[[Langhana]]'' (fasting)
*Patient is to be advised to adopt ''vritti'' (specific diet regimen) i.e. ''peyadi krama'' /''samsarjanakarma'' (post ''virechana'' management as per [Cha.Sa.[[Sutra Sthana]] 15/16]. [40-42]
*Patient is to be advised to adopt ''vritti'' (specific diet regimen) i.e. ''peyadi krama'' /''samsarjanakarma'' (post ''[[virechana]]'' management as per [Cha.Sa.[[Sutra Sthana]] 15/16]. [40-42]
=== Complication of ''shiro-arti'' (headache) ===
=== Complication of ''shiro-arti'' (headache) ===
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''shiro-arti basti'' complication ====
==== Etiology, clinical manifestation and management of ''shiro-arti [[basti]]'' complication ====
''Shiro-arti'' complication occurs when ''basti'' having qualities of ''tanu'' (not thick), ''mridu'' (mild), ''sheeta''(cold) quality and in less dose administered to patients of ''durbala'' (weak), ''krura koshtha''(hard bowel) and ''tivra dosha'' (severely vitiated ''dosha'').
''Shiro-arti'' complication occurs when ''[[basti]]'' having qualities of ''tanu'' (not thick), ''mridu'' (mild), ''sheeta''(cold) quality and in less dose administered to patients of ''durbala'' (weak), ''krura koshtha''(hard bowel) and ''tivra [[dosha]]'' (severely vitiated ''[[dosha]]'').
''Avarita dosha'' (covered/ obstructed ''dosha'') will further vitiate the agitated ''vata'' by ''niruha basti''. Vitiated ''vata'' will run in all directions in the body, especially upward and affect the head.
''Avarita [[dosha]]'' (covered/ obstructed ''[[dosha]]'') will further vitiate the agitated ''[[vata]]'' by ''niruha [[basti]]''. Vitiated ''[[vata]]'' will run in all directions in the body, especially upward and affect the head.
==== Signs & symptoms ====
==== Signs & symptoms ====
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''angarti basti'' complication ====
==== Etiology, clinical manifestation and management of ''angarti [[basti]]'' complication ====
''Angarti'' (body ache) occurs when ''doshas'' are eliminated in excess.
''Angarti'' (body ache) occurs when ''doshas'' are eliminated in excess.
When ''basti'' having ''guru'' (heavy to digest) & ''tikshna'' (Sharply acting) properties is administered in patient who have not undergone proper ''purvakarma'' (''sneha'' & ''sveda''), the ''doshas'' are eliminated in excess and thus ''angarti'' is resulted.
When ''[[basti]]'' having ''guru'' (heavy to digest) & ''tikshna'' (Sharply acting) properties is administered in patient who have not undergone proper ''purvakarma'' (''[[snehana]]'' & ''[[swedana]]''), the ''[[dosha]]s'' are eliminated in excess and thus ''angarti'' is resulted.
Due to excessive elimination there will be ''stabdha'' (dullness of abdomen) & ''avrita koshthata'' (intestinal obstruction/ intussusception) and the ''vata'' gets affected.
Due to excessive elimination there will be ''stabdha'' (dullness of abdomen) & ''avrita koshthata'' (intestinal obstruction/ intussusception) and the ''[[vata]]'' gets affected.
Pain over body parts is produced due to upward movement of ''vata''.
Pain over body parts is produced due to upward movement of ''[[vata]]''.
Signs & Symptoms:
Signs & Symptoms:
*''Abhyanga'' with ''lavanataila'' followed by sprinkling of hot water all over body.
*''Abhyanga'' with ''lavanataila'' followed by sprinkling of hot water all over body.
*''Prastara sweda'' through ''eranda patra kwatha'' (decoction of leaves of Ricinus communis Linn.).
*''Prastara sweda'' through ''eranda patra kwatha'' (decoction of leaves of Ricinus communis Linn.).
*''Yava'' (Hordeum vulgare Linn), ''kulattha'' (Dolichos biflorus Linn.), ''kola'' (Zizyphus jujube Lam.) and both types of ''panchamula'' i.e. ''Dashamula'' (as described in ''shloka'' no.37) added with two ''adhakha'' (12 kg. 228 g.) 13 of water and reduced to one-fourth. To this decoction add ''bilva'' (Aegle marmelos Carr.) ''taila'' and ''lavana''. This is to be given as ''niruha basti'' when it is warm. Patient is to be given assurance as well as ''avagahasveda'' (sudation therapy through tub-bath). When once the patient taken food ''anuvasana basti'' is to be given with ''bilwa-taila'' (Aegle marmelos Carr.) or ''yastimadhu'' (Glycyrrhizaglabra Linn.) ''taila''. [47-53]
*''Yava'' (Hordeum vulgare Linn), ''kulattha'' (Dolichos biflorus Linn.), ''kola'' (Zizyphus jujube Lam.) and both types of ''panchamula'' i.e. ''Dashamula'' (as described in ''shloka'' no.37) added with two ''adhakha'' (12 kg. 228 g.) 13 of water and reduced to one-fourth. To this decoction add ''bilva'' (Aegle marmelos Carr.) ''taila'' and ''lavana''. This is to be given as ''niruha [[basti]]'' when it is warm. Patient is to be given assurance as well as ''avagahasveda'' (sudation therapy through tub-bath). When once the patient taken food ''anuvasana [[basti]]'' is to be given with ''bilwa-taila'' (Aegle marmelos Carr.) or ''yastimadhu'' (Glycyrrhizaglabra Linn.) ''taila''. [47-53]
=== Complication of ''parikartika'' (fissure in ano) ===
=== Complication of ''parikartika'' (fissure in ano) ===
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''parikartika basti'' complication ====
==== Etiology, clinical manifestation and management of ''parikartika [[basti]]'' complication ====
''Parikartika'' (anal pain due to proctitis) manifested when the patients of ''mridu koshtha, alpa dosha'' are administered with ''niruha basti'' of qualities -''ruksha, tikshna'' or in higher dose.
''Parikartika'' (anal pain due to proctitis) manifested when the patients of ''mridu koshtha, alpa [[dosha]]'' are administered with ''niruha [[basti]]'' of qualities -''ruksha, tikshna'' or in higher dose.
==== Clinical manifestations ====
==== Clinical manifestations ====
*''Toda'' (pricking type of pain) over low-back, groins and urinary bladder.
*''Toda'' (pricking type of pain) over low-back, groins and urinary bladder.
*''Rija'' (pain) over lower umbilical region
*''Ruja'' (pain) over lower umbilical region
*''Lekhana'' effect of ''basti'' may result in constipation and bowel evacuation in little quantities
*''Lekhana'' effect of ''[[basti]]'' may result in constipation and bowel evacuation in little quantities
==== Management ====
==== Management ====
*''Basti'' prepared out of milk processed with drugs having ''madhura'' & ''sita'' properties for example ''ikshurasa'' (sugar cane juice); and by adding paste of ''yastimadhu'' (Glycyrrhiza glabra Linn.) & ''tila'' (Sesamum indicum Linn.) is to be administered.
*''[[Basti]]'' prepared out of milk processed with drugs having ''madhura'' & ''sita'' properties for example ''ikshurasa'' (sugar cane juice); and by adding paste of ''yastimadhu'' (Glycyrrhiza glabra Linn.) & ''tila'' (Sesamum indicum Linn.) is to be administered.
*Patient is to be kept on milk diet.
*Patient is to be kept on milk diet.
*Administer ''basti'' prepared with milk by adding ''sarjarasa'' (Vateria indica Linn.), ''yastimadhu'' (Glycyrrhiza glabra Linn.), ''jingini'' (Lannea grandis Engi.), ''kardama'' (Nelumbium speciosum Willd.), ''anjana'' (Extract of Berberis asiatica - Roxb. ex DC). The patient is to be kept on ''mridubhojana'' (soft diet) with ''amla rasa'' ( little sour in taste). [54-57]
*Administer ''[[basti]]'' prepared with milk by adding ''sarjarasa'' (Vateria indica Linn.), ''yastimadhu'' (Glycyrrhiza glabra Linn.), ''jingini'' (Lannea grandis Engi.), ''kardama'' (Nelumbium speciosum Willd.), ''anjana'' (Extract of Berberis asiatica - Roxb. ex DC). The patient is to be kept on ''mridubhojana'' (soft diet) with ''amla rasa'' ( little sour in taste). [54-57]
=== Complication of ''paristrava'' (oozing through anus) ===
=== Complication of ''paristrava'' (oozing through anus) ===
</div></div>
</div></div>
==== Etiology, clinical manifestation and management of ''parisrava'' (rectal oozing), a ''basti'' complication ====
==== Etiology, clinical manifestation and management of ''parisrava'' (rectal oozing), a ''[[basti]]'' complication ====
In a patient of ''pitta roga'' (pitta dominant disorders), if ''basti'' having any of the qualities of ''amla'' (sour), ''ushna'' (hot potency), ''tikshna'' (sharply acting), ''lavana''(salt) is administered, the ''basti dravya'' causes ''lekhana'' (irritates and injures) of ''payu'' (anus) resulting in injury and even ''vidaha'' (burning sensation). This leads to ''rakta'' (blood) and ''pitta'' oozes in different colors. Frequent/forced excretion will be followed by ''moha'' (unconsciousness) and ''asakrit'' (feeling of continuous defecation).
In a patient of ''[[pitta]] roga'' ([[pitta]] dominant disorders), if ''[[basti]]'' having any of the qualities of ''amla'' (sour), ''ushna'' (hot potency), ''tikshna'' (sharply acting), ''lavana''(salt) is administered, the ''[[basti]] dravya'' causes ''lekhana'' (irritates and injures) of ''payu'' (anus) resulting in injury and even ''vidaha'' (burning sensation). This leads to ''[[rakta]]'' (blood) and ''[[pitta]]'' oozes in different colors. Frequent/forced excretion will be followed by ''moha'' (unconsciousness) and ''asakrit'' (feeling of continuous defecation).
==== Management ====
==== Management ====
*''Basti'' made with –paste of ''ardra shalmali vrinta'' (leaf stalk/petioles of Bombax malabaricum DC) and goat milk, then heat it. Along with ''ghee basti'' is to be given when it is cold.
*''[[Basti]]'' made with –paste of ''ardra shalmali vrinta'' (leaf stalk/petioles of Bombax malabaricum DC) and goat milk, then heat it. Along with ''ghee [[basti]]'' is to be given when it is cold.
*Or administer ''basti'' prepared as a ''kalpa'' (like the above mentioned ''Shalmalivrintaksheerasamksarakalpa''), with tender leaves of ''vata'' (Ficus bengalensis Linn.) etc., ''Yava'' (Hordeum vulgare Linn.), ''tila'' (Sesamum indicum Linn.), ''sauvarchala, upodika'' (Bacellaalba), ''karbudara'' (Bauhinia variegate Linn.).
*Or administer ''[[basti]]'' prepared as a ''kalpa'' (like the above mentioned ''Shalmalivrintaksheerasamksarakalpa''), with tender leaves of ''vata'' (Ficus bengalensis Linn.) etc., ''Yava'' (Hordeum vulgare Linn.), ''tila'' (Sesamum indicum Linn.), ''sauvarchala, upodika'' (Bacellaalba), ''karbudara'' (Bauhinia variegate Linn.).
*''Sheka'' (sprinkling) or ''pradeha'' (application of paste) on anal region is also indicated with the drugs of ''madhura rasa'' (sweet taste) and ''shita guna'' (cold property).
*''Sheka'' (sprinkling) or ''pradeha'' (application of paste) on anal region is also indicated with the drugs of ''madhura rasa'' (sweet taste) and ''shita [[guna]]'' (cold property).
*Therapies indicated in ''raktapitta'' and ''atisara'' are also beneficial.[58-62]
*Therapies indicated in ''raktapitta'' and ''atisara'' are also beneficial.[58-62]
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
</div></div>
</div></div>
The ''tikshnata'' (strong sharp action) of ''bastidravya'' may be increased by adding ''gomutra'' (cow urine), ''pilu'' (Salvadora persica Linn.), ''agni'' (Chitraka-Plumbago zeylanica Linn.), ''lavana'' (salt), ''kshara'' (alkali), ''sarshapa'' (Brassica campestris Var.sarson Prain) and to improve ''mridutva'' of ''bastidravya, ksheera'' (milk) etc. is to be added.[63]
The ''tikshnata'' (strong sharp action) of ''[[basti]] dravya'' may be increased by adding ''gomutra'' (cow urine), ''pilu'' (Salvadora persica Linn.), ''agni'' (Chitraka-Plumbago zeylanica Linn.), ''lavana'' (salt), ''kshara'' (alkali), ''sarshapa'' (Brassica campestris Var.sarson Prain) and to improve ''mridutva'' of ''[[basti]] dravya, ksheera'' (milk) etc. is to be added.[63]
=== Overall cleansing effect of ''basti'' ===
=== Overall cleansing effect of ''[[basti]]'' ===
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
</div></div>
</div></div>
As sun located high in the sky dries up moisture of earth, in the same fashion ''basti'' situated in the ''pakvashaya'' due to its potency draws the ''doshas'' present entire in the body (head to toe).[64]
As sun located high in the sky dries up moisture of earth, in the same fashion ''[[basti]]'' situated in the ''pakvashaya'' due to its potency draws the ''[[dosha]]s'' present entire in the body (head to toe).[64]
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
</div></div>
</div></div>
''Purvakarma'' in the form of ''sneha'' and ''sweda'' commonly dissolves the ''doshas'' as well as body nutrients. However ''basti dravya'' eliminates only ''doshas'' as a piece of cloth soaked in a mixture of ''kusumbha'' (Carthamus tinctorius Linn.) (dye) and water get only dye.
''Purvakarma'' in the form of ''sneha'' and ''sweda'' commonly dissolves the ''[[dosha]]s'' as well as body nutrients. However ''[[basti]] dravya'' eliminates only ''[[dosha]]s'' as a piece of cloth soaked in a mixture of ''kusumbha'' (Carthamus tinctorius Linn.) (dye) and water get only dye.
''Niruha basti'' will eliminate the liquefied ''malas'' (''doshas'') from body like the cloth which will remove (attains) the color of ''kusumbha'' (Carthamus tinctorius Linn.) mixed water. [65]
''Niruha [[basti]]'' will eliminate the liquefied ''[[mala]]s'' (''[[dosha]]s'') from body like the cloth which will remove (attains) the color of ''kusumbha'' (Carthamus tinctorius Linn.) mixed water. [65]
=== Summary ===
=== Summary ===
</div></div>
</div></div>
To summarize, complications of ''basti'' along with their causes, signs, symptoms and management are described. If a physician administers ''basti'' with proper knowledge and understanding of all these will never commit a mistake.[66]
To summarize, complications of ''[[basti]]'' along with their causes, signs, symptoms and management are described. If a physician administers ''[[basti]]'' with proper knowledge and understanding of all these will never commit a mistake.[66]
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
</div></div>
</div></div>
In this way seventh chapter namely successful treatment of complications of ''basti'' of [[Siddhi Sthana]] of [[Charaka Samhita]] written by Agnivesha, edited by Charaka and redacted by Dridhabala is completed.[7]
In this way seventh chapter namely successful treatment of complications of ''[[basti]]'' of [[Siddhi Sthana]] of [[Charaka Samhita]] written by Agnivesha, edited by Charaka and redacted by Dridhabala is completed.[7]
== Tattva Vimarsha (Fundamental Principles) ==
== Tattva Vimarsha (Fundamental Principles) ==
*''Basti'' therapy has local and systemic effects on the body. ''Basti'' drugs can enter into systemic circulation.
*''[[Basti]]'' therapy has local and systemic effects on the body. ''[[Basti]]'' drugs can enter into systemic circulation.
*Properties of ingredients in ''basti'' formulation, its composition shall be considered in order to assess pharmaceutical properties of ''basti''.
*Properties of ingredients in ''[[basti]]'' formulation, its composition shall be considered in order to assess pharmaceutical properties of ''[[basti]]''.
*Examination of ''koshtha'' (bowel habit), ''agni'' (digestive power), ''prakriti'' (constitution) and ''dosha'' dominance of disease are important assessment factors for deciding appropriate ''basti'' formulation in the condition.
*Examination of ''koshtha'' (bowel habit), ''agni'' (digestive power), ''[[prakriti]]'' (constitution) and ''[[dosha]]'' dominance of disease are important assessment factors for deciding appropriate ''[[basti]]'' formulation in the condition.
*The above factors and skill of administration are important to have desired effect and avoid complications.
*The above factors and skill of administration are important to have desired effect and avoid complications.
== Vidhi Vimarsha (Applied Inferences ) ==
== Vidhi Vimarsha (Applied Inferences ) ==
There is debate in [[Ayurveda]] community on action of ''basti'' i.e. whether ''basti'' have local action or systemic action. The example coated by Charaka: "as sun located high in the sky dries up moisture of earth, in the same fashion ''basti'' situated in the ''pakvashaya'' due to its potency draws the ''doshas'' present in the entire body, similarly, ''basti'' acts locally as well as systemically". To exert systemic effect the active ingredients of ''basti'' need to be absorbed. In general osmosis, pH difference, active absorption, facilitated diffusion, electrochemical gradient, micelles facilitated transportation etc. are the methods of intestinal absorption. Hence composition of ''basti'' need to be compounded in such a way so that the active ingredients of ''basti'' are absorbed by following any one of the principles as explained earlier. Further ''basti dravya'' also need to address intestinal motility related issues.
There is debate in [[Ayurveda]] community on action of ''[[basti]]'' i.e. whether ''[[basti]]'' have local action or systemic action. The example coated by Charaka: "as sun located high in the sky dries up moisture of earth, in the same fashion ''[[basti]]'' situated in the ''pakvashaya'' due to its potency draws the ''[[dosha]]s'' present in the entire body, similarly, ''[[basti]]'' acts locally as well as systemically". To exert systemic effect the active ingredients of ''[[basti]]'' need to be absorbed. In general osmosis, pH difference, active absorption, facilitated diffusion, electrochemical gradient, micelles facilitated transportation etc. are the methods of intestinal absorption. Hence composition of ''[[basti]]'' need to be compounded in such a way so that the active ingredients of ''[[basti]]'' are absorbed by following any one of the principles as explained earlier. Further ''[[basti]] dravya'' also need to address intestinal motility related issues.
When we analyze the method of ''niruha basti'' preparation i.e ''kashaya, kalka, sneha, saindhavalavana'' etc. clearly indicates that ''basti kalpana'' is made very carefully to maintain desired pH, osmotic pressure, micelle formation etc.
When we analyze the method of ''niruha [[basti]]'' preparation i.e ''kashaya, kalka, sneha, saindhavalavana'' etc. clearly indicates that ''[[basti]] kalpana'' is made very carefully to maintain desired pH, osmotic pressure, micelle formation etc.
In spite of taking care of ''yogya'' (suitable), ''ayogya''(unsuitable) for ''basti'' and other aspects of ''basti dosha'' still there are chances of complications. All the factors leading to ''basti'' complications may be explained broadly under the headings of:
In spite of taking care of ''yogya'' (suitable), ''ayogya''(unsuitable) for ''[[basti]]'' and other aspects of ''[[basti]] dosha'' still there are chances of complications. All the factors leading to ''[[basti]]'' complications may be explained broadly under the headings of:
*Factors related to basti composition, consistency & dose
*Factors related to [[basti]] composition, consistency & dose
*Factors related to basti administration
*Factors related to [[basti]] administration
*Factors related to patients’ clinical condition
*Factors related to patients’ clinical condition
The signs and symptoms described for various basti complications are broadly categorised under
The signs and symptoms described for various [[basti]] complications are broadly categorised under
*Intestinal motility related
*Intestinal motility related
*Water and electrolyte balance related
*Water and electrolyte balance related
*Local anal inflammatory conditions
*Local anal inflammatory conditions
Complications of ''basti'' may result either due to errors in compounding it or consistency ''basti'', dose or temperature of ''basti dravya'' at the time of administration. However, these complications may result depending on body response to the above-mentioned factors. The responses may be explained under three headings viz. excessive response (''atiyoga''), poor/low/no response (''ayoga'') and faulty response (''mithyayoga''). [5-6]
Complications of ''[[basti]]'' may result either due to errors in compounding it or consistency ''[[basti]]'', dose or temperature of ''[[basti]] dravya'' at the time of administration. However, these complications may result depending on body response to the above-mentioned factors. The responses may be explained under three headings viz. excessive response (''atiyoga''), poor/low/no response (''ayoga'') and faulty response (''mithyayoga''). [5-6]
=== Etiology, clinical manifestation and management of ''basti'' complication-''ayoga'' ===
=== Etiology, clinical manifestation and management of ''[[basti]]'' complication-''ayoga'' ===
''Ayoga'' (poor/low/no response) complication of ''basti'' may result either due to quality of ''dravya'' or due to patient condition or combination of both.
''Ayoga'' (poor/low/no response) complication of ''[[basti]]'' may result either due to quality of ''dravya'' or due to patient condition or combination of both.
==== Poor response due to quality of ''bastidravya'' ====
==== Poor response due to quality of ''[[basti]] dravya'' ====
''Sheetaguna'' causes ''sthambhana. Sthambhana'' means stationary or movement less. In this context decreased intestinal motility is to be considered. Decreased intestinal motility may result in abdominal distension.
''Sheeta [[guna]]'' causes ''[[sthambhana]]. [[Sthambhana]]'' means stationary or movement less. In this context decreased intestinal motility is to be considered. Decreased intestinal motility may result in abdominal distension.
*Sufficient quantity of ''lavana'' (salt – rock salt) is required to maintain optimum osmotic pressure so that ionic exchange takes place. If optimum osmolality is not attained the active ingredients which are supposed to be absorbed through osmotic pressure are not absorbed and thus desired efficacy may not be achieved.
*Sufficient quantity of ''lavana'' (salt – rock salt) is required to maintain optimum osmotic pressure so that ionic exchange takes place. If optimum osmolality is not attained the active ingredients which are supposed to be absorbed through osmotic pressure are not absorbed and thus desired efficacy may not be achieved.
*Sufficient quantity of ''sneha'' (unctuous part - oil/ghee) is also important. Lipids in the form of ''sneha'' facilitate lipid mediated transportation. Insufficient quantity of ''sneha'' minimizes the lipid mediated transportation and thus desired efficacy is not achieved. Further salt present in ''basti'' helps in micelle (smallest particle of lipid) formation of lipids and facilitates absorption of lipids.
*Sufficient quantity of ''sneha'' (unctuous part - oil/ghee) is also important. Lipids in the form of ''sneha'' facilitate lipid mediated transportation. Insufficient quantity of ''sneha'' minimizes the lipid mediated transportation and thus desired efficacy is not achieved. Further salt present in ''[[basti]]'' helps in micelle (smallest particle of lipid) formation of lipids and facilitates absorption of lipids.
==== Poor response due to patient condition ====
==== Poor response due to patient condition ====
*''Guru koshtha'' (hard bowel) is the condition where in the digestion process is delayed mostly due to sluggish intestinal motility. In such cases ''basti'' predominant of ''sheetaguna'' further worsen the problem as ''sheeta'' does ''stambhana''.
*''Guru koshtha'' (hard bowel) is the condition where in the digestion process is delayed mostly due to sluggish intestinal motility. In such cases ''[[basti]]'' predominant of ''sheeta [[guna]]'' further worsen the problem as ''sheeta'' does ''[[stambhana]]''.
*''Vata'' predominance in general or ''ruksha'' in particular both require ''lavana'' or ''sneha'' to counteract. If ''bastidravya'' is compounded with insufficient quantity of ''lavana'' and ''sneha'', there will be further aggravation of ''vata'' or ''ruksha'' of ''vatadosha''. In this case it should be understood that, there is already negative ionic gradient (both osmotic / lipid mediated) and hence sufficient quantity of ''lavana/sneha'' are required to convert it into positive ionic gradient so that active ingredients are transported through osmotic pressure or lipid mediated ionic transportation.
*''[[Vata]]'' predominance in general or ''ruksha'' in particular both require ''lavana'' or ''sneha'' to counteract. If ''[[basti]] dravya'' is compounded with insufficient quantity of ''lavana'' and ''sneha'', there will be further aggravation of ''[[vata]]'' or ''ruksha'' of ''[[vata dosha]]''. In this case it should be understood that, there is already negative ionic gradient (both osmotic / lipid mediated) and hence sufficient quantity of ''lavana/sneha'' are required to convert it into positive ionic gradient so that active ingredients are transported through osmotic pressure or lipid mediated ionic transportation.
The management is mainly aimed at inducing/increasing intestinal peristaltic movements. ''Dipana-pachana'' drugs stimulates gastro-intestinal tract secretions and increases intestinal motility. Anal suppository, ''virechana'' and ''basti'' also induces/increases intestinal motility. [7-11]
The management is mainly aimed at inducing/increasing intestinal peristaltic movements. ''[[Dipana]]-[[pachana]]'' drugs stimulates gastro-intestinal tract secretions and increases intestinal motility. Anal suppository, ''[[virechana]]'' and ''[[basti]]'' also induces/increases intestinal motility. [7-11]
=== Etiology, clinical manifestation and management of ''basti'' complication-''atiyoga'' ===
=== Etiology, clinical manifestation and management of ''[[basti]]'' complication-''atiyoga'' ===
''
''
Atiyoga'' (excessive response) complication of basti is seen when patients of ''mridukostha'' (sensitive GI tract) had undergone ''sneha'' and ''sveda'' which further sensitize the GI tract when administered with ''basti'', prepared out of ''ushna'' and ''tikshna'' (high potent/irritant drugs), leads to hyper stimulation of intestinal tract, excessive elimination of bodily fluids, thus results in electrolyte imbalance and dehydration. The signs and symptoms mentioned are related to dehydration and electrolyte imbalance.
Atiyoga'' (excessive response) complication of [[basti]] is seen when patients of ''mridukostha'' (sensitive GI tract) had undergone ''sneha'' and ''sveda'' which further sensitize the GI tract when administered with ''[[basti]]'', prepared out of ''ushna'' and ''tikshna'' (high potent/irritant drugs), leads to hyper stimulation of intestinal tract, excessive elimination of bodily fluids, thus results in electrolyte imbalance and dehydration. The signs and symptoms mentioned are related to dehydration and electrolyte imbalance.
The drugs and other mediums used for management of ''atiyoga'' are rich in ''drava guna'', also having characteristics like ''balya'' (promotive of strength) ''brimhana'' (promotes growth) and ''jeevaniya'' (promotes life). These can help to make up for the loss of body fluids and other vital body elements that may be lost due to ''atiyoga'' of ''basti''. [12-14]
The drugs and other mediums used for management of ''atiyoga'' are rich in ''drava [[guna]]'', also having characteristics like ''balya'' (promotive of strength) ''[[brimhana]]'' (promotes growth) and ''jeevaniya'' (promotes life). These can help to make up for the loss of body fluids and other vital body elements that may be lost due to ''atiyoga'' of ''[[basti]]''. [12-14]
==== Management ====
==== Management ====
''Amashesha'' indicates incomplete digestion process. In such conditions ''mridu basti'' further suppress digestion. In case of indigestion we need to stimulate secretion of digestive juices and hence the management is to use measures which hasten the digestive process.
''Amashesha'' indicates incomplete digestion process. In such conditions ''mridu [[basti]]'' further suppress digestion. In case of indigestion we need to stimulate secretion of digestive juices and hence the management is to use measures which hasten the digestive process.
Management with ''pachana'' in conditions precipitated with presence of ''ama'' is very logical. ''Ama'' primarily accounts for ''agnimandya'' (lowers the digestive power) and action of ''pachana'' as told by Arundatta <ref>Arunadatta, Vagbhata. Sutra Sthana, Cha.8 Matrasheetiyam Adhyaya verse 21-22. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.</ref> is removing causes of obstruction that come in the way of function of ''agni'', and ''ama'' is one of them, signifying role of ''pachana''.
Management with ''[[pachana]]'' in conditions precipitated with presence of ''ama'' is very logical. ''Ama'' primarily accounts for ''agnimandya'' (lowers the digestive power) and action of ''[[pachana]]'' as told by Arundatta <ref>Arunadatta, Vagbhata. Sutra Sthana, Cha.8 Matrasheetiyam Adhyaya verse 21-22. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.</ref> is removing causes of obstruction that come in the way of function of ''agni'', and ''ama'' is one of them, signifying role of ''[[pachana]]''.
''Basti'' given in this ''avastha'' (condition) should be ''vyakta lavana'' (salt in profound quantity). Basic characteristics of ''lavana'' as told by Vagbhata <ref>Vagbhata. Sutra Sthana, Cha.6 Annaswarupavijnaniya Adhyaya verse 144. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.</ref>, are ''vishyandi'' (means one which helps to liquify and release the ''doshas'' from obstruction if any), ''sukshma'' (which can reach easily at cellular level), ''srishtamala'' (which accounts for easy elimination of ''mutra'' (urine) ''purisha'' (stool) etc. ''ama'' in present context), and ''mridu'' (soft) in nature.
''[[Basti]]'' given in this ''avastha'' (condition) should be ''vyakta lavana'' (salt in profound quantity). Basic characteristics of ''lavana'' as told by Vagbhata <ref>Vagbhata. Sutra Sthana, Cha.6 Annaswarupavijnaniya Adhyaya verse 144. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.</ref>, are ''vishyandi'' (means one which helps to liquify and release the ''[[dosha]]s'' from obstruction if any), ''sukshma'' (which can reach easily at cellular level), ''srishtamala'' (which accounts for easy elimination of ''[[mutra]]'' (urine) ''[[purisha]]'' (stool) etc. ''ama'' in present context), and ''mridu'' (soft) in nature.
These characteristics of ''lavana'' helps in releasing the obstruction caused by ''pitta kapha dosha'' along with ''ama''.[15-20]
These characteristics of ''lavana'' helps in releasing the obstruction caused by ''[[pitta]] [[kapha]] [[dosha]]'' along with ''ama''.[15-20]
As already discussed, the ''basti'' should contain enough ''tikshanata'' to induce enough peristalsis as well as to stimulate secretion of digestive enzymes. In case of ''krura kostha'' naturally there will be alternate phases of ''samavastha'' and ''vishamagni''. Hence in ''krurakostha, mahadoshavastha'' drugs with less potency are administered which further decrease peristaltic movements thus leading to abdominal distension.
As already discussed, the ''[[basti]]'' should contain enough ''tikshanata'' to induce enough peristalsis as well as to stimulate secretion of digestive enzymes. In case of ''krura kostha'' naturally there will be alternate phases of ''samavastha'' and ''vishamagni''. Hence in ''krurakostha, mahadoshavastha'' drugs with less potency are administered which further decrease peristaltic movements thus leading to abdominal distension.
Due to doshas obstructing the path of ''vayu'' by covering it, resultant ''vata prakopa'' causes ''vimargagamana'' of ''vayu'' (''vayu'' changing its normal path) leading to ''adhmana'' (flatulance) which creates ''marmapida'' (pain in vital parts) making ''koshtha'' (abdomen) ''guru'' i.e. ''krura'' (which leads to constipating habits) or ''malapurna'' (due to inaction of ''vayu mala'' gets accumulated [Cha. Sa. [[Siddhi Sthana]] 7/7-11,Chakrapani]. [21-26]
Due to [[dosha]]s obstructing the path of ''vayu'' by covering it, resultant ''[[vata]] prakopa'' causes ''vimargagamana'' of ''vayu'' (''vayu'' changing its normal path) leading to ''adhmana'' (flatulance) which creates ''marmapida'' (pain in vital parts) making ''koshtha'' (abdomen) ''guru'' i.e. ''krura'' (which leads to constipating habits) or ''malapurna'' (due to inaction of ''vayu mala'' gets accumulated [Cha. Sa. [[Siddhi Sthana]] 7/7-11,Chakrapani]. [21-26]
Due to excess elimination of ''doshas'' from strong ''basti'' given to weak patient, ''vata prakopa'' takes place leading to upward movement of vitiated ''vata'', as a result of which ''hikka'', which originates from ''amashaya'' (stomach) is observed.
Due to excess elimination of ''[[dosha]]s'' from strong ''[[basti]]'' given to weak patient, ''[[vata]] prakopa'' takes place leading to upward movement of vitiated ''[[vata]]'', as a result of which ''hikka'', which originates from ''amashaya'' (stomach) is observed.
Line of treatment of ''hikka'' along with ''brimhana'' is applied. ''Brimhana'' counters ''vata'' and at the same time will also increase ''dhatu'' which is in a debilitated state in this case.[27-29]
Line of treatment of ''hikka'' along with ''[[brimhana]]'' is applied. ''[[Brimhana]]'' counters ''[[vata]]'' and at the same time will also increase ''[[dhatu]]'' which is in a debilitated state in this case.[27-29]
Considering aetiology, signs & symptoms and management, ''hritghattana'' may be understood as epigastric discomfort. The air present in the ''basti'' may cause obstruction. The management is also aimed to stimulate gastrointestinal secretions, and intestinal motility to relieve colic.
Considering aetiology, signs & symptoms and management, ''hritghattana'' may be understood as epigastric discomfort. The air present in the ''basti'' may cause obstruction. The management is also aimed to stimulate gastrointestinal secretions, and intestinal motility to relieve colic.
In the management ''amla'' and ''lavana rasa'' is prefered over other ''rasa'', because of its ''anulomana'' (downward direction) action. Furthermore ''amla rasa'' is known for its specific function related to ''vata'', as ''moodhavatanulomana'' (brings about ''vata'' doing abnormal movement to its normal movement). In this ''vyapat'' as ''hridaya'' is involved ''amla'' which is best among ''hridya'' articles [Cha. Sa.[[Sutra Sthana]] 25/40] is a natural choice. [30-31]
In the management ''amla'' and ''lavana rasa'' is prefered over other ''rasa'', because of its ''anulomana'' (downward direction) action. Furthermore ''amla rasa'' is known for its specific function related to ''[[vata]]'', as ''moodhavatanulomana'' (brings about ''[[vata]]'' doing abnormal movement to its normal movement). In this ''vyapat'' as ''hridaya'' is involved ''amla'' which is best among ''hridya'' articles [Cha. Sa.[[Sutra Sthana]] 25/40] is a natural choice. [30-31]
The management is done by ''shodhaniya'' and ''anulomika basti''. ''Anulomika basti'' is to be given by ''ksheera'' (milk) ''ikshurasa'' (sugarcane juice). Here milk, ''ikshurasa'' etc is ''brimhana'', which acts as ''vatashamana'', at the same time it induces ''shodhana'' due to its ''sara guna''. This can be understood by opinion of Arundatta <ref>Arunadatta, Vagbhata. Sutra Sthana, Cha.14 Dvividhopakramaneeyam Adhyaya verse 7. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.</ref>where he says that in case of ''vata'' and ''vata-pitta, brimhana'' like milk etc. acts as ''shodhana''.[40-42]
The management is done by ''shodhaniya'' and ''anulomika [[basti]]''. ''Anulomika [[basti]]'' is to be given by ''ksheera'' (milk) ''ikshurasa'' (sugarcane juice). Here milk, ''ikshurasa'' etc is ''[[brimhana]]'', which acts as ''[[vata]]shamana'', at the same time it induces ''shodhana'' due to its ''sara [[guna]]''. This can be understood by opinion of Arundatta <ref>Arunadatta, Vagbhata. Sutra Sthana, Cha.14 Dvividhopakramaneeyam Adhyaya verse 7. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.</ref>where he says that in case of ''[[vata]]'' and ''[[vata]]-[[pitta]], [[brimhana]]'' like milk etc. acts as ''shodhana''.[40-42]
The treatment goes in a very methodical way with application of oil with salt for countering ''vata'' vitiation, followed by ''nasya'' in form of powders blown in to nostrils and ''dhoom'' medicated fumes made to inhale, acts for elimination of ''doshas'' that are present in the head. This is followed by food which is ''tikshna'' in property and ''anulomika'' which helps to regulate ''vata'' in its normal direction, followed by ''anuvasana basti''. This takes care of agitated ''vata'' having taken the course of head to go out through anus which is its normal root of elimination.[43-46]
The treatment goes in a very methodical way with application of oil with salt for countering ''[[vata]]'' vitiation, followed by ''[[nasya]]'' in form of powders blown in to nostrils and ''dhoom'' medicated fumes made to inhale, acts for elimination of ''[[dosha]]s'' that are present in the head. This is followed by food which is ''tikshna'' in property and ''anulomika'' which helps to regulate ''[[vata]]'' in its normal direction, followed by ''anuvasana [[basti]]''. This takes care of agitated ''[[vata]]'' having taken the course of head to go out through anus which is its normal root of elimination.[43-46]
To manage ''angarti'' (bodyache) types of ''swedana'' selected are ''sarvadehika'' (applicable to whole body) like ''prastara'', ''seka''. To counter ''vata'' these are preceded with application of oil with salt. Which takes care of vitiation of ''vata'' all over the body.[ 47-53]
To manage ''angarti'' (bodyache) types of ''[[swedana]]'' selected are ''sarvadehika'' (applicable to whole body) like ''prastara'', ''seka''. To counter ''[[vata]]'' these are preceded with application of oil with salt. Which takes care of vitiation of ''[[vata]]'' all over the body.[ 47-53]
The management given aims at soothening and softening the bowels and to also promote healing. Milk, sugarcane juice helps in countering dryness of the large intestine due to their ''snigdha guna''. Diet rich in ''mridu guna'' and ''amla rasa'' further helps in keeping softness of the bowel intact as well as maintaining normal actin of ''vata''. [54-57]
The management given aims at soothening and softening the bowels and to also promote healing. Milk, sugarcane juice helps in countering dryness of the large intestine due to their ''snigdha [[guna]]''. Diet rich in ''mridu [[guna]]'' and ''amla rasa'' further helps in keeping softness of the bowel intact as well as maintaining normal actin of ''[[vata]]''. [54-57]
''Basti'' dominating with ''amla lavana rasa'' and ''ushna tikshna'' properties in a patient suffering from disease of ''pitta dosha'' leads to further vitiation of ''pitta'', this in turn vitiates ''rakta'' which is seat of ''pitta dosha'', starts coming out through anus. The best remedy for this is piccha basti which has medicines acting for stopping the blood flow and also promotes healing. [58-62]
''[[Basti]]'' dominating with ''amla lavana rasa'' and ''ushna tikshna'' properties in a patient suffering from disease of ''[[pitta]] [[dosha]]'' leads to further vitiation of ''[[pitta]]'', this in turn vitiates ''[[rakta]]'' which is seat of ''[[pitta]] [[dosha]]'', starts coming out through anus. The best remedy for this is piccha [[basti]] which has medicines acting for stopping the blood flow and also promotes healing. [58-62]
=== Related Links ===
=== Related Links ===