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|title=VAITARANA BASTI
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|titlemode=append
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|keywords=Vaitaranabasti, VAITARANA BASTI, Charak samhita, carakasamhitaonline, Vaitarana enema, Ingredients of Vaitarana basti, Procedure of Vaitarana basti, pradhana karma, pashchat karma, Patil Rajkala P., Basisht G., Deole Y.S.
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|description=Vaitaranabasti is a therapeutic enema. It is effective in diseases like amavata, katishoola (lumbago), gridhasi (sciatica), klaibya (sexual dysfunction), vishamajwara(fever) etc.
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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<div style='text-align:justify;'>
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Vaitaranabasti is a therapeutic [[Basti|enema]]. It is effective in [[Vyadhi|diseases]] like [[Amavata|amavata]], katishoola (lumbago), gridhasi (sciatica), klaibya (sexual dysfunction), vishamajwara(fever) etc. The description is available in [[Ayurveda|ayurveda]] texts likeChakradutta, Vrandhamadhava, Vangasenasamhita. In current scenario, it is used in [[Amavata|amavata]] patients as a safe, innocuous & custodian therapy for the patient. It is also useful in amadosha predominant conditions like anaha (abdominal distension), [[Shvayathu Chikitsa|shotha (swelling)]], shula (pain). It has vata-kapha pacifying properties and helps in removing [[Avarana|avarana]] of [[Vata dosha|vata]] by [[Kapha|kapha]]. The present chapter describes advantages and practical aspects of vaitaranabasti.
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</div>
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{{Infobox
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|title =  Contributors
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|label1 = Section/Chapter/topic
 +
|data1 = Concepts/[[Prakriti]]/[[Manas prakriti]] 
 +
|label2 = Authors
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|data2 = Patil Rajkala P.<sup>1</sup>, Gupta Rishanki<sup>2</sup>
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|label3 = Reviewer
 +
|data3 = Basisht G.<sup>3</sup>,
 +
|label4 = Editor
 +
|data4 = Deole Y.S.<sup>4</sup>
 +
|label5 = Affiliations
 +
|data5 = <sup>1</sup>Department of Panchakarma, Faculty of Ayurveda, I.M.S., B.H.U., Varanasi, India
 +
<sup>2</sup>Department of Rog Nidana, Faculty of Ayurveda, I.M.S., B.H.U., Varanasi, India
 +
<sup>3</sup>Rheumatologist, Orlando, Florida, U.S.A.
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<sup>4</sup>Department ofKayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
 +
|label6 = Correspondence emails
 +
|data6 = rajkalapatil@bhu.ac.in,
 +
carakasamhita@gmail.com
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|label7 = Publisher
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|data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India
 +
|label8 = Date of publication:
 +
|data8 = November 18, 2022
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|label9 = DOI
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|data9 = In process
 +
}}
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 +
== Etymology and derivation ==
 +
<div style='text-align:justify;'>
 +
According to [https://en.wikipedia.org/wiki/Padma_Purana Padma Purana], Vaitarana means ‘Vai’ (meaning truly) to ‘tarana’ (means saving). Vaitarana is called so because the [[Basti|enema]] is said to prevent many [[Vyadhi|diseases]]. It means to donate, go across, to leave which helps to expel the [[Dosha|dosha]]. Vaitarana is the name of river, which can bring back the dead to live. It is meant to cross a river, transporting (a departed spirit) over the river that flows between earth and the lower regions [Monier-Williams Sanskrit-English Dictionary, 1899]. Hence, this [[Basti|basti]] is so powerful that it can bring back life of a person, who is about to die.
 +
The first reference regarding vaitaranibasti is probably found in the Siddhayogaor Vrindamadhava ; narrated as separate section as this formulation does not satisfy inclusion in description of niruhabasti. The critical edition of Vrindha Madhava by Dr.Premavati Tiwari and Dr. AshaKumari reports a variant reading where gudais replaced by Hingu.<ref>Vrindha. Vrindha madhava/sidhayogah Part 2. First edition. ByDr. Premvati Tiwari & Dr. Asha Kumari.Varanasi; ChaukambhaSanskrit Sansthan; 2006.p.938.</ref>
 +
</div>
 +
The basic difference in niruha and vaitaranabasti as follow-
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{| class="wikitable"
 +
|-
 +
! NIRUHA BASTI (purification enema)
 +
! VAITARANA BASTI (Vaitarana enema)
 +
|-
 +
| Contents- Makshika (honey), [[Lavana|Lavana]] (salt), Sneha(oil), Kalka(paste), &Kwatha(decoction)<ref>Vagbhata. Ashtanga Hridaya. With Commentaries SarvangaSundari of Arunadatta and Ayurvedarasayana of Hemadri.Varanasi; Chaukambha Sanskrit Sansthan; 2012. p.269. [A.H.SU19/45].</ref>.
 +
| Contents- Saindhava (rock salt), Guda (jaggery), Chincha (tamrind), Taila (oil), &Drava Dravya (liquids).
 +
|-
 +
| Makshika(honey)
 +
| Instead of Makshika(honey) ;Guda(jaggery) is there.
 +
|-
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| here kalka(paste) mainly of satapushpa (dill seed) or madhanaphala (emetic nut).
 +
| chincha(tamrind) act as kalka (paste).
 +
|-
 +
| sneha(oil)
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| here rukshnasneha(oil processed with herbs of hot potency and dry property that will not increase kapha) used like bhrityasaindhavaditaila (special medicated oil).
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|-
 +
| Generally used kwatha (decoction) like dashmoola (group of ten herbs).
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| Here Gomutra(cow urine) used instead of any kwatha (decoction).
 +
|-
 +
|}
 +
 
 +
{| class="wikitable"
 +
|+ style="caption-side:left; text-align: left;" | Ingredients described in different texts :
 +
! Contents
 +
! Chakradutta
 +
! Vrindhamadhava
 +
! Vangasena
 +
! Weight in grams/ml
 +
|-
 +
| Saindhava (rock salt)
 +
| 1 karsha
 +
| 1 karsha
 +
| 1 karsha
 +
| 10gms
 +
|-
 +
| Guda (jaggery)
 +
| 1 shukti(1/2 pala)
 +
| 1 shukti(1/2 pala)
 +
| 1/2 pala
 +
| 25gms
 +
|-
 +
| Amlika (tamrind)
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| 1 pala
 +
| 1 pala
 +
| 1 pala
 +
| 50gms
 +
|-
 +
| Gomutra (cow urine)
 +
| 1 kudava(4pala)
 +
| 1 kudava(4 pala)
 +
| Ishattaila
 +
| 200ml
 +
|-
 +
| Godugdha (cow milk)
 +
| Not mentioned
 +
| Not mentioned
 +
| 1 kudava
 +
| -
 +
|-
 +
| Taila(–ilataila- sesame oil)
 +
| Quantity not mentioned
 +
| Oil  insmall quantity
 +
| Oil  in small quantity
 +
| 10-25ML
 +
|-
 +
|}
 +
 
 +
{| class="wikitable"
 +
|+ style="caption-side: left; text-align: left;" | Pharmacological properties of ingredients<ref>Anonymous. The Ayurvedic Pharmacopoeia of India, Part-1, Vol-6.  PgNo.206/207/224/225 part1 vol-3 PgNo.16/17.</ref>
 +
! Sr.No
 +
! Contents
 +
! Botanical /English name
 +
! [[Rasa|Rasa (Taste)]]
 +
! Virya (Potency)
 +
! [[Vipaka|Vipaka]] (metabolic properties- after digestion)
 +
! [[Guna|Guna]]
 +
! Properties
 +
! Chemical constituent
 +
|-
 +
| style="text-align:center;" | 1.
 +
| Amlika
 +
| Tamarindus indica (fam. Fabaceae)/ Tamarind
 +
| Amla
 +
| Ushna
 +
| Amla
 +
| Guru, Ruksha, Sara.
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| Kaphavatanut, Dipana, Bastisuddhikara,
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| Tamarindica, saponin, sugar, inorganic acid.
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|-
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| style="text-align:center;" | 2.
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| ErandTaila
 +
| Ricinus Communis/ Castor Oil
 +
| Madhura,Katu, Kashaya (Sweet, pungent, Astringent)
 +
| Ushna (Hot)
 +
| Madhura (Sweet)
 +
| Snigdha, Guru, Sukshma, Vyavayi, Vishada,Sara,Vikasi.
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| Shool, Shothain kati, Vrsya, Amavatahara, VataKaphahara and Adhobhagadoshahara (disorders of lower parts of the body)
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| -
 +
|-
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| style="text-align:center;" | 3.
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| Saindhava
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| Rock salt
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| Madhura
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| Shita
 +
| -
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| Laghu
 +
| Srotosodhak
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| NACL
 +
|-
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| style="text-align:center;" | 4.
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| Gomutra
 +
| Cow’s urine
 +
| Katu
 +
| Ushna
 +
| -
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| Laghu, Tikshna
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| Vatanulomana, Srotosodhak
 +
| Urea,Uric acid
 +
|-
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| style="text-align:center;" | 5.
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| Guda
 +
| Saccharin offcinarum (fam.poaceae)/ Jaggery
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| Madhura
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| Ushna, Natishita
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| Madhura
 +
| Snigdha, Ishatksariya.
 +
| Vata-Pitta<br/>Nashaka.<br/>Saktasochana,<br/>Vrsya,<br/>Vataghna-Natipittajit-<br/>-Kaphavrddhikara,<br/>Krmivrddhikara, Balya, Medovrddhikara
 +
| sugar
 +
|-
 +
|}
 +
 
 +
== Indications ==
 +
* Shoola (pain),
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* Anaha (gaseous distention),
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* [[Amavata|Amavata]] (diseases due to Ama and Vata)
 +
* Shopha of kati, uru, prushta(inflammation of upper or lower back)
 +
* Urusthambha (specific diseaseof lower limb)
 +
* Gridhrasi (sciatica)
 +
* Janusamkocham (stiffness in Knee)
 +
* Vishamajwara(fever)
 +
* Klaibya(impotency)
 +
 
 +
== Method of preparation ==
 +
=== A) Materials Required to Formulate Basti. ===
 +
* Basti putak (enema can)
 +
* Basti netra (nozzle)
 +
* Gloves
 +
* Cotton cloth
 +
* Mortal &pastel
 +
 
 +
=== B)Ingredients of basti ===
 +
* Guda (jaggery)
 +
* Saindhavlavana(rock Salt)
 +
* Gomutraarka(cow urine)
 +
* Chincha (tamarind)
 +
* Erandtaila (castor oil)
 +
 
 +
=== C)Procedure to formulate & give basti. ===
 +
'''Pre-procedure:'''
 +
<br/>a) Preparation of patient
 +
<br/>b) Preparation of basti.
 +
<div style='text-align:justify;'>
 +
'''a) Preparation of patient:''' After the evacuation of bladder and bowels, local massage and fomentation on pelvic region shall be done.
 +
<br/>'''b) Preparation of basti:''' Vaitaranabasti is prepared as per the classical method used for the preparation of niruhabasti. Jaggery (guda) is mixed uniformly with a small amount of lukewarm water. Saindhava is added to the above. Tilataila is added till the mixture become homogenous. Chinchakalka is prepared with warm water and added to the above mixture carefully. Gomutra is added slowly and mixing is continued so as to have uniform bastidravya. Finally, after filtering, bastidravyais made lukewarm by keeping it into hot water bath.
 +
</div>
 +
 
 +
<div style='text-align:justify;'><br/>
 +
'''Main procedure (pradhana karma):'''
 +
Patient is advised to lie down in the left lateral position on the basti table with straight body and left hand kept below head. His right leg is folded at knee joint and made to rest flat over the straight left leg. Then lukewarm (sukhoshna) unctuous material (sneha) is applied to the anal region and on the basti instrument (Netra). It is inserted slowly up to 1/4 part of the bastinetra. Lukewarm bastishould be administered slowly. </div>
 +
 
 +
<div style='text-align:justify;'><br/>
 +
'''Post procedure (pashchat karma):'''
 +
The basti instrument is removed from anus. Then gentle tapping on thigh & buttocks is done. Then the patient is asked to change posture to left lateral. If patient gets natural urge within 10 to 30 minutes, he will be advised to evacuate bowels.Clinical features of proper [[Basti|basti]] [[Karma|karma]] are observed. </div>
 +
 
 +
'''Basti retention time (pratyagamana):'''Onemuhurta (48 minutes). <br/><br/>
 +
'''Clinical features after administration:'''<br/>
 +
'''Proper dose'''<br/>
 +
* Prashasta vidamutra (proper amount of defecation, urination & evacuation of flatus)
 +
* Agni vriddhi(improves digestion)
 +
* Ruchi (increased desire to take food),
 +
* Ashayalaghvani (lightness in body)
 +
* Rogaupshanti (resolution of disease state)
 +
* Balavraddhi(increased physical strength).
 +
 
 +
'''Less dose'''
 +
* Shiro hridaya, gudabasti, medhravedana(pain in head, heart, anal region, urinary bladder, penis)
 +
* Shopha (swelling)
 +
* Pratishyaya(rhinitis)
 +
* Parikartika(fissure)
 +
* Hrillasa (nausea)
 +
* Maruta mutra sanga(retention of flatus & urine)
 +
* [[Shwasa|Shwasa]] (dyspnea).
 +
 
 +
'''Excess dose'''
 +
* Kapha pitta kshaya (reduction of [[Kapha|kapha]] & [[Pitta|pitta]])
 +
* Anil prakopa (increment of [[Vata dosha|vata]])
 +
* Angamarda (body pain)
 +
* Klama (fatigue)
 +
* Vepana (trembling)
 +
* Nidra-balaabhava(absence of sleep & strength)
 +
* Tamapravesha(blackouts)
 +
* [[Hikka Shwasa Chikitsa|Hikka(hiccup)]]
 +
* [[Unmada Chikitsa|Unmada (insanity)]]
 +
* Adhmana(bloating)
 +
* Parikartika(fissure)
 +
* Stambha(stiffness)
 +
* [[Kamala|Kamala(jaundice)]]
 +
 
 +
=== D)Time of administration ===
 +
Vaitaranabastican be given after meal also.
 +
 
 +
== Mode of action of basti ==
 +
<div style='text-align:justify;'>
 +
Basti introduced into the rectum (pakwashaya)acts upon the whole [[Sharira|body]] and on every system of the [[Sharira|body]]. It draws out impurities from head to toe by its potency just as the sun evaporates water from the earth by its heat. [Cha.Sa.Siddhi Sthana 7/64]
 +
As the cloth absorbs the dye from water mixed with kusumba(safflower) plant, in the same way Basti eliminates the [[Mala|mala]] from the [[Sharira|body]] which have undergone liquefaction due to snehana and svedana. [A. Hru. Sutra Sthana 19]
 +
 
 +
The bastidravya churns and collects the accumulated [[Dosha|dosha]] and stool (shakrut) from umbilical, hypogastric and pelvic region (nabhi, kati, parshwa and kukshi pradesha), causes oleation (snehana) to the [[Sharira|body]] and expels out the [[Dosha|dosha]].[Cha. Sa. Siddhi Sthana1/40]
 +
</div>
 +
 
 +
=== Mode of action ofvaitaranabasti: ===
 +
Note: The pharmacological properties of ingredients after their rectal administration are not yet studied. The properties of ingredients after oral administration are studied and presented here for reference.
 +
 
 +
'''Saindhava lavana (rock salt):''' Saindhava lavanais the purest form of rock salt, considered the best among all varieties of salt and advisable for daily consumption. It possesses 85% NaCl and 15% trace materials, whereas anothersaltcontains 97% NaCl. It is salty and slightly sweet in taste; madhuravipaka (sweet post digestive effect), sheetaveerya (cold potency), light to digest and unctuous in nature. In bastitherapy, rock salt is added to prepare an emulsion. It helps to dissolve and expel [[Dosha|dosha]] from the intestines.<ref>Sarker A, Ghosh A, Sarker K, Basu DJ, Sen DJ. Halite; the Rock Salt: enormous health benefits. World Journal of Pharmaceutical Research.2016;5(12):407-16.</ref><br/>The role of subtle (sukshma), unctuous (snigdha) and sharp (tikshna) properties are as below:
 +
<dl>
 +
<dd>- By virtue of subtle (suskhmaguna), bastidravyareaches up to the molecular level. It helps to pass the drug molecule in systemic circulation through the mucosa.</dd>
 +
<dd>- Sharp (tikshnaguna) breaks down the morbid mala & [[Dosha|dosha]] bondings (sanghata), hence helpful for the elimination of waste due to its irritant property.</dd>
 +
<dd>- Unctuous (snigdhaguna) is capable of liquefying the [[Dosha|dosha]] and breaking it into minute particles.</dd>
 +
</dl>
 +
<div style='text-align:justify;'>
 +
'''Chincha / Tamarind (Tamarindus indica L.) :'''<br/>
 +
Oral administration of chinchahasvata-kapha pacifying, dry (ruksha) and hot (ushna) properties. These are useful in management of amavata. Tamarind is rich in tartaric acid which is a potent antioxidant and is a good source of iron and thiamine. The ripe fruit of tamarind is madhura-amla (sweet-sour) in taste. It is heavy to digest (guru),dry (ruksha),and hot in potency (ushnaveerya) with sour (amla) post digestive effect (vipaka).
 +
 
 +
Ripe fruit pacifies [[Vata dosha|vata]] and [[Pitta|pitta]]. It has appetizing, digestive, thirst suppressing liver stimulant, anti-inflammatory, diuretic, anti-toxic, bladder purifing, anti-fatigue actions. It is useful for fever, constipation, loss of appetite, wound, sunstroke, rheumatism, inflammation, and diabetes. Its fruit is laxative. Leaves are useful to destroy parasitic intestinal worms. It is used as a food and has culinary uses. It is made into a refreshing and cooling beverage particularly used in fever. It possesses antioxidant, antiinflammatory, anti-microbial, anti-fungal, anti-viral,hepato-protective, anti-nematodal, molluscicidal, antidiabetic, anti-cytotoxic activities.<ref>Caluwe ED, Halamova K, Damme PV. Tamarind (Tamarindus indica L.): A Review of Traditional Uses, Phytochemistry and Pharmacology. In: Juliani H, et al. African Natural Plant Products: New Discoveries and Challenges in Chemistry andQuality. Washington, DC: ACS Symposium Series, American Chemical Society; 2010. p. 85-110.</ref><ref>Pandey G. DravyagunaVijnan, Part-1. Varanasi: Krishna DasAcademy; 1998. p.119-128.</ref>
 +
 
 +
Tamarind fruit has anti spasmolytic activity by blocking calcium channel has a laxative effect due to the presence of malic acid, tartaric acid and potassium and it prevents cardiovascular diseases and obesity due to the content of polyphenol and flavanoids in it.<ref>Kuru P. Tamarindus indica and its health-related effects. Asian Pacific Journal of Tropical Biomedicine. 2104; 4(9):676-681.</ref>
 +
</div>
 +
<div style='text-align:justify;'>
 +
'''Jaggery:''' In vaitarana basti, jaggary is used instead of honey(madhu). Saindhavaalong with jaggary makes a homogenous mixture, to form a solution having properties to permeable the water easily. The retention of the irritative substances may be favored by making its solution as nearly isotonic as possible by using colloidal fluids as a combination of this bastidravya, it also helps in carrying the drug into the micro-cellular level.It also contains polyphenols, a phenolic compound withantioxidant and cytoprotective activities. Jaggery is a very useful substance for oedema patient, when it is consumed along with ardraka, abhaya, sunthi, or pippali. It is also good for the patients with dysuria, constipation, cardiac problems, asthma, allergies, chronic fever, piles, throat and lung infections, malabsorption syndrome (grahani) and kaphavataja roga. <ref>Srivastav P. Verma AK, Walia R, Rehena P, Singh AK. Europeanjournal of Pharmaceutical and Medical Research. 2016.3 (3):198-202.</ref><ref>Nadkarni KM, Nadkarni AK. Indian Materia Medica. 3rd edition. Bombay; Popular Prakashan; 1976.</ref>
 +
</div>
 +
<div style='text-align:justify;'>
 +
'''Gomutra (cow urine):''' In vaitaranabasti, cow urine is main ingredient. Its pungent taste (katu rasa), pungent post digestive effect (katuvipaka), hot potency (ushnavirya), light to digest (laghu), dry (ruksha) and sharp (tikshna) properties pacify kapha and vata. It stimulates agni (agnideepana-pachana), purifies body channels (srotovishodhana),pacifies vata (vatanulomana) and relieves ama. It is the best and useful among all urines (mutra).<ref>Vagbhata. Ashtanga Hridaya. With Commentaries SarvangaSundari of Arunadatta and Ayurvedarasayana of Hemadri.Varanasi; Chaukambha Sanskrit Sansthan; 2012. p.83[A.h.Sus.5/82].</ref> It is useful in obesity, certain cardiac and renal diseases,indigestion, stomachache, diarrhea, oedema, jaundice,anemia, hemorrhoids and skin diseases including vitiligo. It acts as bio-enhancer and has antifungal, antimicrobial, germicidal, bactericidal, anthelmintic, antioxidant and antineoplastic action. It is useful in hypersensitivity reactions and in numerous other diseases including increasing the life span of a person. It has immune enhancer properties. It augments B and Tblastogenesis and IgA, IgG, and IgM titer in experimental animals. It exhibits antimicrobial and germicidal activity due to the presence of urea, creatinine, and Arum hydroxide (wwarnakshara) in it.Its anti-cancerous activity is due to the presence of uric acid and Allantoin in it. It shows wound healing activity due to the presence of allantoin, immunomodulation due to presence of Arum hydroxide. It prevents cardiovascular diseases due to the presence of kallikrein, urokinase, hippuric acid and ammonia in it. It attributes anti-obesity properties due to the content of copper. It exhibits anti-toxic activity by virtue of Arum hydroxide present in it.<ref>Randhwa GL, Sharma R. Chemotherapeutic potential of cow urine: A review. Journal of Intercultural Ethnopharmacology. 2015;4(2):180-6.</ref>
 +
</div>
 +
<div style='text-align:justify;'>
 +
'''Tilataila(Sesame oil):''' In vaitaranbasti, sesame oil is mixed with the solution of jaggary and saindhavato form uniform mixture.
 +
</div>
 +
 
 +
=== Probable mode of action ===
 +
<div style='text-align:justify;'>
 +
It may act through vascular route(myo-enteric venous plexus),nervous route(specifically act on apana&samanavata,hence ENS involved).
 +
[[File:Nervous system.jpg|center]]
 +
There may be possible correlation -
 +
* It modulates endocrine functions [[File:Endocrine.jpg]] (myoentericplexus—ANS—Brain—Pituitary—Adrenal ovarian/testicular axis).
 +
* It maycauses pressure variation of intestinal mucosa, which may induce difference in intestinal intra- cellular and extra -cellular fluid.
 +
* It acts by a curious bio feedback mechanism yet to be identified.
 +
Basti dravya reaches up to micro & macro levels due to its virya(potency). It helps first to disrupt the pathogenic process &carries  the morbid matter towards the colon (pakwashaya) for elimination. Thus, it acts as a curative as well as purification measure.
 +
</div>
 +
 
 +
== practical application ==
 +
The practical applied aspect of vaitaranibastiis described as follows:
 +
<div style='text-align:justify;'>
 +
'''A) Pre-requisites for formulation of basti:''' The following points should be in consideration to have good results;-
 +
<dl>
 +
<dd>- Tamarind paste (Chinchakalka):The tamarind paste is prepared after removing fiber and seeds from it. Actual weight of this paste is measured. Tamarind (chicha) should be soaked in water(room temperature) overnight, then fibrous & seed part extracted & remaining portion should be filtered with the help of fine cotton cloth. In case of instant preparation, the tamarind can be used after soaking it in hot water for fifteen minutes. Tamarind (chincha) should be old (purana), blackish in texture; should not having whitish coated texture. </dd>
 +
<dd>- Jaggery: It should be use in melted form(semiliquid preparation). Jaggery should be added with 3-4ml hot water, mixed gently & then should be filtered out.It should not be grinned or rigorously stirred in any possible way. </dd>
 +
<dd>- Cow urine: It should not have any turbidity in appearance or strong pungent smell.  Foaming is observed when it is mixed with other contents. It ensures the fresh and qualitative aspect of cow urine.  In absence of fresh cow urine, its extract (gomutraarka) is used after diluting it in 1:2 or 1:3 ratio with lukewarm water.</dd>
 +
</dl> </div>
 +
<div style='text-align:justify;'>
 +
'''B) Administration of basti to the patient:'''
 +
<dl>
 +
<dd>- Vaitaranabasti should be administered at evening or in morning hours of day because during that time of a day [[Pitta|pitta]] predominance is at its lower range or should say tikshnaguna effect is at its lowest peak </dd>
 +
<dd>- Per rectal examination should be done before administration to check any anorectal disease like pile mass, sentinel tag, inflammation, fissure etc.Vaitaranabastiis contraindicated in such conditions. </dd>
 +
</dl> </div>
 +
<div style='text-align:justify;'>
 +
'''C) Clinical indications and contraindications of vaitaranabasti:'''
 +
The classical references of indications include shoola,anaha,amavata. 
 +
Following table shows clinical conditions in which vaitaranabasti can be useful as well as contraindications.
 +
{| class="wikitable"
 +
! Classical References
 +
! Current clinical correlations
 +
|-
 +
| Shoola (pain)
 +
| Vatashonita -Kaphaanubandha,<br/>amavastha of Sandhivata.<br/>Rhematoid Arthritis, Osteoarthritis, Gout Arthritis, Ankylosing Spondylitis, Systemic Lupus Erythematous, Avascular Necrosis.
 +
|-
 +
| Anaha (flatulence)
 +
| Vaitaranabastiis contraindicated in flatulence originated due to any space occupying lesion, Ileitis, Colitis, Pancreatitis, Hepatitis, Chronic Liver Disease, High Grade Fever, Crohn’s Disease, Ulcerative Colitis.
 +
|-
 +
| [[Amavata|Amavata]]
 +
| Rheumatoid Arthritis,Osteoarthritis,Gout Arthritis,Ankylosing Spondylitis, Systemic Lupus Erythematous,Intervertebral Disc Prolapse,GreevagataVata,JanugataVata,Katigraha,Katishoola,Frozen Shoulder.
 +
|-
 +
|}
 +
 
 +
Other contraindications:
 +
* Anal diseases
 +
* Skin diseases       
 +
* Blood disorders
 +
* Pitta prakriti
 +
</div>
 +
 
 +
== Current research works ==
 +
<div style='text-align:justify;'>
 +
* It is noticed that relief in sign and symptoms were found in patients when treated with vaitaranabasti and VatariGuggulu. Thus, it can be said that vaitaranabastiworks as a curative as well as purifying measure. Proper diet restrictions as per [[Prakriti|prakriti]] of a patient must be followed. This will provide a better and healthy [[Ayu|life]] to [[Amavata|Amavata]] patients.<ref>Virmani M, Kaushik AK, Virmani G. A Clinical Study Of Vaitarana Vasti andVatariGuggulu In Aamvata (Rheumatoid Arthritis). PARIPEX Indian journal of Research 2017;6(11):114-5.</ref>
 +
* The study reveals that a patient has got significant result infunctional score and swelling. Patients had got very significant result in morning stiffness, pain, tenderness & grip. Since [[Amavata|amavata]] is an autoimmune disease patients may require second course of the same pattern.<ref>Wadhava RS, Ghore JK. Efficacy of VaitaranaVasti and SimhanadGuggulu in Amavata. International journal of Applied Ayurveda Research 2015;II(II):230-5.</ref>
 +
* It is noticed that relief in signs and symptoms of [[Amavata|amavata]] was found in both groups. Comparatively, Valukasweda with Vaitarana [[Basti|Basti]] group showed better results.<ref>Pooja BA, Bhatted SK, Bhojani M. Role of ValukaSweda and Vaitarana Basti in the management of Amavata (Rheumatoid Arthritis). Int J Res Ayurveda Pharm. 2013;4(5):712-4.</ref>
 +
* The clinical assessment of results proves the efficacy of vaitaranabasti with moderate improvement in symptoms.<ref>Mishra SC. A piloting study on GodugdhayuktaVaitarana Basti in Vataj Gridhrasi (Sciatica). Intenational Journal of Ayurveda and Pharmaceutical Chemistry 2014;I(1). Available from: http://ijapc.com/vol1/4.pdf</ref>
 +
* Vaitaranabasti can be used in the disease in which niruhabasti is indicated and which are caused due to [[Ama|Ama]]; vaitaranabastihave significant result in Sandhigatavata(Upastambhita).<ref>Chaudhari T, Karande L, Gahukar D. Evaluation of the effect of Vaitarana Basti in Sandhigata Vata (Upastambhit) w.s.r to inflammatory arthritis. AYUSHDHARA 2016;3(5):853-6.</ref>
 +
* Vaitaranabasti is an effective treatment in the management of Amavata& it shows long lasting result. vaitaranabastican be administered without priorsnehapana, swedanaor virechana.<ref>Wanole RM, Chothe DS. Vaitarana Basti in – Amavata A pilot study. Europian Journal of Pharmaceutical and Medical Research 2016;3(11):379-82.</ref>
 +
* Vaitaranabastiand virechanakarma is an effective treatment in the management of [[Amavata|amavata]]. Proper line of treatment gives better result in [[Ayurveda|Ayurveda]].<ref>Medi S, Wange D. Efficacy of Vaitaran Basti and Virechana Karma along with Shaman Chikitsa in the management of Amavata (Rheumatoid Arthritis) –Case Study. World Journal of Pharmaceutical Research 2017;6(14):478-87.</ref>
 +
* In this single center, randomized, open clinical study total 30 patients diagnosed with amavata were selected. In one group AlambushadiGhana Vati(each500 mg) two tablets thrice a day was given and in second group Alambushadi Ghana vati with Vaitaranabastion alternate day (15 days) was administered. The result shows that excellent relief in 20% patients, significant relief in 60% patients, moderate relief in 13.33% patients, whereas mild relief in 6.66% patients. Research study concluded that comparing the effect of two therapies(Alambushadighanavatialong with vaitaranabasti) provided better relief than (Alambushadi Ghana Vvti alone) in most of the signs and symptoms of the disease at significant level.<ref>Sasane P, Saroj UR, Joshi RK. Clinical evaluation of efficacy of Alambushadi Ghana Vati and Vaitarana Basti in the management of Amavata with special reference to rheumatoid arthritis.Ayu 2016;37(2):105-12.</ref>
 +
* Vaitaranabastiis one of the most effective and economical bastiwhich can be administered in a wide range of diseases.<ref>Aswani PS, Ratha KK, Dighe DP, Rao MM, Remya V. VaitaranaVasti - A Conceptual Study. Research Journal of Pharmacology and Pharmacodynamics.2018;10(1):45-50. doi: 10.5958/2321-5836.2018.00008.3 .</ref>
 +
* The majority of the content drugs of vaitaranabastiare having laghu, ruksha, ushnaand tikshna properties which pacifies vatakapha dosha. Vaitaranabastishows significant effect in ama, shula and shotha avastha.<ref>Mukherjee A, Dwivedi OP, Dr. Jain J, Khuje SMR. Efficacy of Vaitarana Basti with respective to Ayurveda, Journal of Drug Delivery and Therapeutics. 2018;8(6-s):246-50 doi:http://dx.doi.org/10.22270/jddt.v8i6-s.2122.</ref>
 +
* Pharmacognostic studies shows that authentic drugs were used for preparation of the formulation and the physiochemical analysis indicates that the formulation meets all the qualitative standards. Current literature review indicates that characterization parameters of vaitaranabastiare not reported anywhere so the parameters discussed here may be used as identification tools for the quality assessment of vaitarana basti.<ref>Pravin Kumar KS, Thakar AB, Harisha CR, Shukla VJ. Pharmacognostical And Preliminary Physicochemical Evaluation OfVaitarana Basti. 2020;7(3):343-6. </ref>
 +
</div>
 +
Vaitaranabasti is primarily depicted in the following texts:<br/>
 +
'''B.''' Chakrapanidutta. Chakradutta with BhavarthaSandipaniHindiVyakhya. Varanasi; Chaukambha Sanskrit Sansthan; 1961. <br/>
 +
'''C.''' Vangasena-Vangasena Samhita, Vol.2. Second edition. By Nirmal Saxena. Varanasi: Chaukambha Sanskrit Sansthan; 2001.<br/>
 +
'''D.''' Vrndhamadhav-Sidhayogah, Part 2. First edition. By Dr. Premvati Tiwari & Dr. Asha Kumari. Varanasi: Chaukambha Sanskrit Sansthan; 2006.
 +
 
 +
== References ==
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