BASTI CHIKITSA - ARDHA CHIKITSA, BASTI YANTRA AND CLASSIFICATION

Content:

• Introduction
• Etymology
• Definition
• Importance as Ardha Chikitsa and utility
• Basti yantra
• Classification
  

Introduction:

Basti chikitsa is known as the prime treatment modality among the panchakarma therapies. It is not just a soap water of glycerine enema administered through the anal route, it has curative, preventive and promotive aspects. Acharya Charaka considered it as the prime treatment regimen for various disorders, mainly vata disorders.

Etymology:

The word basti/vasti is derived from root vas to which tich pratyay is added. it is a pulling/ masculine word.
Basti is also considered as the bladder. In olden days, the bladder of animals like buffalo, sheep, ox, etc. were used as an instrument for administration of drugs via anal route.

Definition:

वस्तिना दीयते इति वस्तिः।(अ.हृ.सू.१९/१, अरुणदत्त)

बस्तिभिः दीयते यस्मात् तस्मात् वस्तिः इति स्मृतः।(शा.उ.ख.५/१)

That (medicine) which is administered using Vasti (urinary bladder) or Bastis (urinary bladders) is called as Vasti or Basti.

The procedure in which an animal’s bladder is used to administer medicines is known as Basti.

Importance and utility:

When Basti is introduced in the Pakwashaya, it acts upon the whole body, from head to toe and draws out, or pulls out the impurities from each organ and every system of the body by means of its potency; just like the sun which evaporates the water from the earth by its heat.
Basti is considered as Ardha Chikitsa, due to its importance and efficacy is treating various disorders in the body, and all the vata predominant vyadhis. Some Acharyas have gone as far as calling it Poorna Chikitsa (complete treatment).
Acharya Charaka says, the root cause for the disease in shakhas, koshthas, marma pradesh, urdhwanga (head and neck), sarva avayava is Vata dosha. Vata is responsible for the dislodgement of mala, mutra, pitta and kapha. It can therefore be said that in any malfunction of the body, there is involvement of vitiated vata dosha. And Basti is the main line of treatment for vata dosha. None of the other chikitsa is as effective as basti in case of vata dosha vitiation. Therefore, Acharya Charaka calls Basti as Ardha Chikitsa or even Poorna Chikitsa.
Acharya Sushruta says that Basti is efficient in treating the vitiated vata, pitta and kapha doshas, and even the derangement of rakta dhatu. It is also effective in dwidoshaj or tridoshaj vyadhis.
The functions of Basti can be varied by varying the combination of drugs, and hence desired results can be obtained from Basti chikitsa. Functions like shodhan, shamana, sangrahan, bruhana, langhana, treatment of shukra dosha, increment of strenght and lifespan can be brought about by Basti chikitsa.

Utility:

• Strotoshuddhi: purification of all systems.
• Shaman karma: Curative action.
• Sarvavaysthapan vikaran upyogita: can be administered at any age and at any stage of disorder. Can be given to normal persons as well.

1. Promotive aspects:

• Vayasthapan: Sustains age.
• Provides better life.
• Improves strenght.
• Improves digestive power.
• Improves voice and complexion.
• performs all functions.
• provides firmness and compactness to body.
• lightness in viscera because of removal of morbid matters from all over the body.
• Restores normalcy.
• Increases taste perception.

2. Curative aspects:

• relieves stiffness.
• relieves sankocha in anga.
• effective in paralytic conditions.
• effective in dislocation and paralytic conditions.
• effective in aggravated vata.
• relieves pain.
• effective in GIT disorders.
• efective in the diseases of vital parts, upper extremities and localised or general parts of the body.

3. Rejuvenative aspects:

• Increases quantity and quality of shukra.
• Effective to restore the normal functions of blood and other dhatus.
• Aphrodisiac.

4. Effects on Mental Functions:

• Improves intellectual power.
• Nourishes buddhi, indriya and manas.
• Induces sound sleep.
• Causes cheerfulness.

Basti Yantra:

Ancient: 

It has two parts-
1. Basti putaka (container)
2. Basti netra (nozzle)

1. Basti Putaka: This instrument holds the Basti medicine liquids.

Materials used:

Mutrashaya of old ox, buffalo, deer, pig, goat. If bladder is not available, skin of a bird Plave or Ankhapada is used, or a very thick cloth can be used too.
Before the bladders are used, they are dipped in kashaya (herbal decoctions) and taila (herbal oils) for many days. This helps in sterilizing, de-contaminating and disinfecting the urinary baldder. It also helps in maintaining the elasticity and flexibility of the basti putaka or the bladder.

Basti putaka dosha:

1. Visham (irregular) - doesn’t enter correctyly in the route.
2. Mamsal (fleshy) - Raw smell of putaka.
3. Cchidral (having many holes) - spillig out of medicines.
4. Sthoola (thick) - Difficulty in holding.
5. Jaalik (presence of veins or small holes) - leaking of medicines.
6. Vaatal (presence of air) - medicines become frothy.
7. Atisnigdha (slimy) - may slip out of hand.
8. Atiklinna ( excessively wet) - becomes difficult to hold and may slip out.

Bastiputaka guna:

Druda (firm)
Tanu (thin)
Nasta sira (free of veins)
Durgandha rahita (devoid of bad odour)
Rakta varna (red or pink in colour)
Mrudu (flexible and elastic)

2. Basti Netra: This is a hollow tube like instrument that is tied at the end of the putaka.

Materials used:

Gold, silver, trapu, copper, brass, bronze, bones, wood, bamboo, tooth, horns, beads.

Karnikas:

Basti netra should have 3 karnikas/ calyx/ rings. These rings help in tying the Putaka and guiding the administrator to limit the netr’s entry into the anal canal to some extent.

Age	Distance of Karnika from Agrabhaga
1 year	1.5 Angula
8 years	2 Angula
16 years	3.5 Angula
25-70 years	3 Angula

* 1 Angula = 1.763 cm.

Vrana Basti Netra:

The vrana basti yantra is 8 angula in lenght and has a hole through which a green gram can pass.

Basti Netra Dosha:

1. Atihrasva (too short) – Doesn’t reach Pakwashaya.
2. Atideergha (too long) – Goes behind the Pakwashaya.
3. Tanu (very thin) – Causes irritation.
4. Sthoola (very thick) – Imparts pressure.
5. Jeerna (very old) – May cause abrasion.
6. Shithila bandhan (loose binding) – Spilling of medicines.
7. Parshva chhidra (perforated or holes on the sides) – Pain in guda pradesh.
8. Vakra (curved or irregular in shape) – Medicines may deviate their route.

Length of Basti Netra:

Acharya Charaka has mentioned the following lengths according to the age.

Basti Netra Pramana (lenght)	Age (in years)
5 Angulas	Below 1
6 Angulas	1-6
6 1/3 Angulas	7
6 2/3 Angulas	8
7 Angulas	9
7 1/3 Angulas	10
7 2/3 Angulas	11
8 Angulas	12
8 1/2 Angulas	13
9 Angulas	14
9 1/2 Angulas	15
10 Angulas	16
10 1/2 Angulas	17
11 Angulas	18
11 1/2 Angulas	19 - 20
12 Angulas	Above 25

Modern Equipments:

• Enema can
• Modified plastic/rubber can
• Enema syringe
• Rubber catheter

Classification of Basti:

I. Adhishtana Bheda: Based on site of administration.

1. Pakvashayagata:

• Aministration of basti through anal canal.
• Includes both Niruha and Anuvasan.

2. Mutrashayagata:

• Administration of basti through the urethra into the urinary bladder.

3. Grbhashayagata:

• Administration of basti through the vagina, into the uterus.
• Both mutrashayagata and garbhashayagat bastis are known as uttar basti.

4. Vrana Basti:

• Mentioned by Acharya Sushruta.
• Administration of basti into the the vrana (wounds) for shodhana and ropana purposes.

II. Dravya Bheda: Based on type of liquid medicine.

1. Niruha Basti / Asthapana Basti: Here, kashaya is the chief ingredient, along with madhu, saindhava, kalka and sneha.
2. Madhu tailik / Yapana/ Siddha Basti: It is a variant of Niruha Basti, but here apart from the other ingredients, Madhu and Taila are the chief components og the basti dravya.
3. Sneha Basti: Administration of sneha dravya through the anal canal. 1/4 dose of Niruha Basti according to the age is the dose of Sneha Basti.
Has 3 sub types

• Sneha basti:  dose: 6 pala (288ml)
• Anuvasana basti: dose: half of sneha basti i.e., 3 pala (144ml)
• Matra basti: dose: half of Anuvasana Basti i.e., 1 pala (72ml)

III. Sankhya Bheda: Based on the number of bastis given.

1. Karma Basti: 30 bastis are given, out of which 18 are Anuvasana and 12 are Niruha.

Day	Basti
1	A
2	N
3	A
4	N
5	A
6	N
7	A
8	N
9	A
10	N
11	A
12	N
13	A
14	N
15	A
16	N
17	A
18	N
19	A
20	N
21	A
22	N
23	A
24	N
25	A
26	N
27	A
28	A
29	A
30	A

2. Kala Basti: 16 Bastis are given (10 Anuvasana and 6 Niruha), although Acharya Charaka opines that the number of kala basti should be half of that of karma basti.

Day	Basti
1	A
2	N
3	A
4	N
5	A
6	N
7	A
8	N
9	A
10	N
11	A
12	N
13	A
14	A
15	A
16	A

3. Yoga Basti: 8 Bastis are given, out of which 5 are Anuvasana and 3 are Niruha.

Day	Basti
1	A
2	N
3	A
4	N
5	A
6	N
7	A
8	A

IV. Karma Bheda: Based on function:

A. According to Acharya Sushruta:


1. Shodhana Basti: This basti is mainly opted when there is a need for expelling out the aggravated doshas and excreta out of the body.
2. Lekhana Basti: Lekhana basically means scraping. This basti used for scraping out the excessive fat that is causing morbidity. This is mainly effective in diseases like obesity, hyperlipidaemia, and other metabolic diseases that lead to weight gain.
Ingredients:
Makshik – 4 pala
Saindhava lavana – 1 aksha
Triphalakashaya – 8 pala
Gomutra – 3 pala
Kshara – 3 karsha
Katu taila – 6 pala
Ushakadi prativapa – 2 pala
3. Snehana Basti: Snehana basti is basically that Basti which imparts oiliness or unctuousness to the body. Sneha or fat like ghee, oil, butter, etc are the main ingredient of this basti.
4. Bruhana Basti: Bruhana basically means enhancing bulk in the body. This basti is given in wasting disorders where the tissues of the body have wasted away due to lack of nourishment and excessive vitiation of vata dosha. This basti helps in enhancing the quality and quantity of the body tissues.

B. According to Acharya Vagbhata:

1. Utkleshana Basti: Utklesahana means to provoke. This Basti provokes the morbid doshas furthermore and causes them to increase in quantity by liquifying them. Such provocation and liquefaction of the morbid doshas makes it easier to flush them out of the body.
2. Doshahara Basti: This basti helps in the haran of doshas that is, in expelling out the doshas. It can also be called as Shodhana type of Niruha Basti.
3. Shaman Basti: Shaman refers to pacifying. This Basti helps in pacifying the doshas.

C. According to Acharya Charaka:

1. Vataghna Basti: That which destroys the vitiated vata.
2. Bala – varna krit Basti: Enhances strenght, immunity, and complexion.
3. Snehaniya Basti: Provides lubrication and unctuousness to the body.
4. Krimighna Basti: This Basti helps in expelling out the krimi or micro-organisms from the body. The main ingredients are Tila tail, vidang & pippali kalka and kashaya of vidanga, haritaki, vibhitaki, amalaki, shigru, madanphala, musta and danti.

D. According to Acharya Sharangadhara:

1. Utkleshana Basti
2. Doshahara Basti
3. Shodhana Basti
4. Lekhana Basti
5. Bruhana Basti
6. Picchila Basti: Pichhila means sticky or slimy. This basti brings about picchilatva in the body. It is indicated in Crohn’s disease, ulcerative colitis, bleedin from lower orifices, chronic diarrhoea and dysentry.
7. Deepana Basti: This basti helps in increasing the digestive fire. Helpful in conditions like indigestion, presence of ama in the body, etc.

E. On the basis of chief action:

1. Utkleshana Basti
2. Shodhana Basti
3. Shamana Basti
4. Lekhana Basti
5. Bruhana Basti
6. Sangrahi Basti: This basti helps in the accumulation and liquefaction of morbid doshas and malas.
7. Vajikaran Basti: This basti helps in increasing the strenght and vigour of the all the indriyas and is aphrodisiac.
8. Chakshushya Basti: This basti helps in enhancing the efficiency of eyes.
9. Balavarnakara Basti:  This helps in enhancing the strength, immunity and complexion.
10. Piccha Basti: This basti acts as grahi ( bowel binding). Therefore, it is indicated in conditions like pittaj atisaar, jwara, gulma, shotha, jeernatisaar, grahani, gudabhramsa, raktasrava, diarrhoea, dysentry, and other duodenal disorders.

V. Anushangika bheda: Based on specific names given to Basti.

1. Yapana/ Madhutailika Basti: The main ingredients of this basti are Madhu and Taila in equal proportions. It is also known as Yukta-ratha Basti.
Indications: Krimi, kushtha, udavarta, gulma, arsha, bradhna(inguinal swelling), pleeha and prameha.
Benefits: It can be given at anytime, even while travelling. Acts as deepan, bruhana, balavarnakara, nirupadrava, vrushya, rasayan.
2. Siddha Basti: The basti that is specially planned to eradicate particular diseases is known as Siddha Basti. These bastis effectively conquer the diseases and gets rid of them.
3. Prasruta Yougika Basti: This type of basti is administered in the dose of 1 prasruta, or 8 tola.
4. Dwadasha Prasrutiki Basti: This type of basti is administered in the dose of 12 prasruta, or 96 tola. This is the highest dose of Basti.
5. Padaheena Basti: This type of basti is taken in the dose that is 1/4th of the Dwadasha Prasrutiki Basti, that is, 9 prasruta.
6. Teekshna Basti: As the name suggests, this basti is teekshna. Ingredients like kshara, mutra, and ushna-teekshna drugs are used to prepare the basti dravya. It is mostly used when the previous basti doesn’t come out properly.
7. Mrudu Basti: As the name suggests, this basti is mild or mrudu in nature. It is mainly indicated in old aged people and kids or in patients that cannot handle strong basti. The main ingredients and madhura skanda aushadhas, milk, meat soup, ghee etc.
8. Piccha Basti
9. Rakta Basti: The main ingredient of this basti is blood. This basti is indicated in bleeding disorders where there is excessive loss of blood.