Rectal route of administration of medicine, predominantly containing kwath. The main ingredients of this basti are honey, saindhava lavan, medicated sneha, kalka, and large quantities of decoction/ kashaya.
Since this Basti expels morbid doshas, it is called Niruha Basti.
Since this Basti also increases lifespan, it is called Asthapan Basti

II. ASTHAPANOPAGA:

Trivrutta
Bilwa
Pippali
Kushta
Sarshapa
Vacha
Vatsakaphala
Shatapushpa
Madhuka
Madanphala

III. INDICATIONS:

Vata and its disorders
Sarvanga, ekanga and kukshi roga
udavarta
adhmana
parvabheda
anga supti
krimi koshta
shuddhaatisara
pleeha, gulma, hridroga, bhagandara, unmada, jwara, bradhna
abhitapa
sphik, janu, jangha, uru, gulpha, parshni, yoni, bahu, anguli, stana, danta, nakha, parvasthi shula
alpalpa, sashabda, ugragandhottana
amenorrhea and other menstrual disorders
spleen disorders
benign tumors of abdomen (gulma)
Ano- rectal diseases
wasting and stiffness of buttock, thigh, knee, calf, ankle, heel, feet, vagina, arm, finger, nipple, teeth, nails, bones and joints.
cardiac disorders
tremors, convulsions, and major psychosis.

IV. CONTRAINDICATIONS:

urakshata (ulcer in lungs)
emaciated and dehydrated due to shodhana
debilitated and unconscious
just after meals or drinking large quantities of water.
just after internal snehana
after excessive snehana
inflicted with anger, fear, and intoxication.
hungry and thirsty
impaired digestion
excessive salivation
nausea
perforation of intestine
diabetes mellitus
gastroenteritis
kushtha
miscarriage
dyspnoea
cough and hiccup

V: DOSE OF NIRUHA BASTI:

There is an easy formula for deciding the dose of Niruha Basti. Half of the age in Prasrita.
Example: For a 2 year child – 1 Prasrita. For 4 year child - 2 Prasrita. For 12 year child – 6 Prasrita.
After the age of 12, there should be an increment of 1 Prasrita per year.
Example: For 13 year – 7 Prasrita. For 14 year – 8 Prasrita.

VI. COMPOSITION OF NIRUHA BASTI:

Makshika, lavana, sneha, kalka and kwath are added in this order. This order is to be followed strictly, or else it will not form a homogeneous mixture.

Common kwath in Niruha Basti:

Coarse powder of-
Bala – 1 pala
Guduchi – 1pala
Triphala – 1 pala
Rasna – 1 pala
Dashamoola – 1 pala
Mix the above powder well and add 8 fruits of Madanphala.
Then add 2.4 kg of goat’s meat.
Then by adding water, bring it to a boil and reduce the mixture to 1/4th of the initial quantity.
Filter the decoction and use it for giving basti.

Erandamula Kwath: If the above mentioned ingredients are not available, use Erandamula Kwath instead.

Common Kalka:

Acharya Charaka has mentioned Putoyavanyadi kalka.
Take each of these eight drugs in 1 tola quntity:

Yavani
Madanphala
Bilva
Kushta
Vacha
Shatahva
Musta
Pippali

Common Sneha:

Only pakva (cooked) or murchita (boiled) sneha is preferred, because ama sneha may cause mucus secretion from the rectum.
Medicated oil or ghee are the most commonly used sneha.
The amount of sneha added is dependent on the vitiated doshas.
Vata – 1/4th of the total quantity of basti dravya.
Pitta/healthy – 1/6th of the total quantity of basti dravya.
Kapha – 1/8th of the total quantity of basti dravya.

Common Madhu:

Acharya Sushruta mentions 200 gm (2 Prasrita) of honey in 12 Prasrita basti dravya.
In Ashtanga Hrudayam it has been mentioned to add 50 gm (1 Pala) of guda (jaggery).

Common Saindhava:

Saindhava should comprise only 1% of the total quantity of basti dravya.
Example: In 12 Prasrita (1200ml) of basti dravya, 1 karsha (12 gm) Saindhava is added.

Common Prakshepa Dravya:

To the basti, apart from the above ingredients, some other liquids are also added to make it relatively milder or stronger.
Example: Dugdha is added to make it mrudu. Gomutra is added to make it teekshna.
The general matra is 2 Prasrita in 12 Prasrita of basti dravya.

VII. PREPARATION:

Take 12 gm of Saindhava and 200 gm Madhu in a Khalva Yantra and triturate them till they are well combined.
Then, keep churning and add Sneha little by little.
After the Sneha has been added completely, add the kalka and mix and pound the mixture well.
When the mixture is well combined, add the Prakshepa dravyas and give a good mix to the mixture.
Filter the mixture and add the Kashaya in 5 Prasrita quantity and give a final mix to the homogeneous mixture.
The Basti Dravya is ready to be administered.

VIII. PROCEDURE / BASTI PRANIDHANA VIDHI:

(a) Purva Karma:

1. Selection of Patient:

It should be made sure that the patient selected is fit for Basti. He should not have any conditions that are contraindicated for Basti Chikitsa.

2. Examination of the patient:

Examination of factors like Dosha, Aushadha, Desha, Kala, Satmya, Agni, Satva, Vaya, and Bala, etc. should be done. Only then it is possible to get the desired results.

3. Preparation of Basti:

Preparation of Basti should be done according to the rules mentioned by the Acharyas in the classics.

4. Selection of an auspicious day:

Basti can be carried out on any auspicious day of Shukla Paksha (between new moon and full moon).
It should not be carried out on a cloudy day.
In cases of emergency, the treatment can be carried out on any day.
Mostly, Niruha is carried out 7 days after the Virechana Karma.

5. Preparation of patient/ Atura Siddhata:

Pt. should be made to pass the urine, feces, and flatus properly.
Then on an empty stomach, pt. should be prepared for Snehan and Swedan.
Generally, for Basti, Abhyanga is done on the abdominal region, followed by Tapa Sweda.
Full body Abhyanga and Bashpa Sweda can also be given prior to giving Basti.
Niruha Basti is always given on an empty stomach, preferably during afternoon.

(b) Pradhan Karma:

1. Bed for Basti:

Should not be too high or too low.
Should allow slight lowering of the head portion of the bed.

2. Assembling the apparatus:

The Basti Netra and Basti Putaka should be tied properly as mentioned in the Ayurvedic texts.
The Basti Dravya should be filled properly in the Basti Putaka that does not contain any air and there is no leakage.

3. Position of the patient:

The patient is made to lie down comfortably on his left lateral side, in a way that his left arm flexes to form a pillow under his head.
The left leg should be stretched straight, and the right leg should be folded at the knee joint.
The anal region faces the doctor or the nurse in this position and it is easy to administer the Basti.
This position is also helpful because the Grahani and Guda are on the left side of the body, and in this position, the medicine will reach these organs properly as the folds and valves of the rectum are straightened out.
This position also allows easy flow of medicine due to gravity.

4. Introduction of the Basti Netra:

Lubricate the anal orifice and the enema nozzle with a sterile cotton pad dipped in medicated ghee or oil like Jatyadi taila.
After removing air bubble, with a steady hand, 1/4th of the enema nozzle is introduced in the anus slowly, carefully following the curve of the spinal column.

5. Basti Peedana:

Ask the patient to relax and take deep breaths while compressing the basti putaka slowly and firmly. It takes 30 matra kala for squeezing out the contents of the putaka.
Once all the contents of the basti putaka are introduced in the anal canal, withdraw the nozzle gradually from the anus.
Midway through the process if the patient feels an urge to pass flatus or feces, the enema nozzle should be pulled out, the patient should be allowed to pass the urge and then the administration of the remaining medicine should be done.

6. Position after the administration of the Basti:

After the administration, the patient is made to lie in a supine slight head low position.
This is necessary for the virya of the Basti to spread all over the body.
When the urge for defecation is felt, patient should sit in Utkataka position (squatting position).

(c) Paschaat Karma:

1. Basti Pratyagamana:

Niruha Basti is supposed to come out within 1 Muhurta (48 hours) of administration.
If there is a delay in the evacuation, sneha virechan or teekhsna basti is administered to the patient.
If no complications encountered, second, third or fourth Niruha Basti can be administered in the consequent days, till samyak lakshanas are seen.

2. Observation of Samyak Lakshana:

Prasruta Vit	Evacuation of bowel without discomfort
Prasruta Mutra	Evacuation of urine without discomfort
Ruchi in Ahara	Interest in food
Agni Vruddhi	Increase in Agni and appetite
Ashaya Lagahva	Lightness in the body
Rogopashamana	Recovery from the disease
Prakriti Sthita	Restoration of normal health
Bala	Increase in strength

3. Oservation of Ayoga Lakshana:

Ruk	Pain in head, cardiac region, anal region, urinary bladder and genital organs.
Shopha	Swelling
Pratishayaya	Rhinitis
Parikartika	Cutting pain in the anal region
Hrillasa	Nausea
Marutha Sanga	Obstruction of flatus
Mutra Sanha	Retention of urine
Swasa	Difficulty in breathing

4. Observation of Atiyoga Lakshana:

Anga Supti	Numbness all over the body
Angamarda	Pain all over the body
Klama	Exhaustion
Kampa	Shivering
Nidranasha	Loss of sleep
Daurbalya	Weakness
Tama Pravesh	Darkness in front of eyes
Unmada	Irrelevant behaviour
Hikka	Hiccups

5. Observation of Vyapads:

There are 12 possible vyapads of Niruha Basti.
They should be checked and treated.

6. Bath:

After proper evacuation, the patient can take bath with warm water or as per dosha awastha.

7. Diet:

Diet is prescribed according to the disease and condition of patient.
It should comprise of soup of pulses, milk, meat soup and shali variety of rice.
After digestion of this food, on the same day, the patient is given Anuvasan Basti to provide him strength.

8. Parihaar Vishaya and kala:

The following things should be avoided for double the days taken for Niruha Basti.

Atyasana	Excessive sitting
Atisthana	Standing for long time
Vachamsi	Excessive standing
Yana	Travelling
Divaswapa	Sleeping during daytime
Maithuna	Sexual intercourse
Vegavrordha	Suppression of natural urges
Shitopachaara	Indulgence in cold things
Atapa	Basking under sunlight
Shoka	Worrying
Rosha	Anger
Akala bhojana	Untimely/ irregular meals
Ahita bhojana	Unwholesome food.

XI. NIRUHA BASTI VYAPADS:

1. Ayoga:

Nidaan: Sheeta, alpa lavana, sneha yukta basti in pt. with krura koshtha and vata vruddhi.
Lakshana: Heaviness, obstruction in mala, mutra, vata, pain in nabhi, burning sensation, oedema, itching.
Chikitsa:

Ushna pramatya prayoga (atisaar chikitsa)
swedana
phala varti prayoga
virechsn
suradi dravya yukta gomutra basti.

2. Atiyoga:

Nidaan: Ati teekshna and ushna basti in pt. having mrudu koshtha.
Lakshana: Chest pain, insomnia, excessive thirst, giddiness, vata aggravation, burning sensation, altered state of consciousness.
Chikitsa: Prushnaparnyadi basti along with ghruta.

3. Klama:

Nidaan: Mrudu Niruha Basti in person having ama shesha (leftover ama in the body).
Lakshana: Aggravation of pitta and kapha, hrutashula, moha, vishtana, gourava.
Chikitsa:

Agnideepanartha kwath
Prasnna, asava, arishtha prayoga.
Gomutra basti.
Swedana and virukshana measures.

4. Adhmana (flatulence):

Nidaan: Alpa virya basti in pt. with mahadosha and krurakoshta.
Lakshana: Adhmana, marmapeeda, vidaha, heaviness, hrudaya avarodha.
Chikitsa:

Shyamaphaladi siddha taila anuvasana basti.
Guda varti.
Dashmoola and gomutra siddha Niruha Basti.

5. Hikka:

Nidaan: Teekshna basti in durbala pt. with mrudu koshtha.
Lakshana: Hikka.
Chikitsa:

Bruhana chikitsa
Bala stiradi varga siddha taila anuvasana basti.
Vatanashak dhooma
Leha
Mamsarasa
Ksheera
Sweda

6. Hrutaprapti:

Nidaan: Ati teekshna and savata basti given to pt. without samyak prapeedana.
Lakshana: Pressure over hrudaya pradesh.
Chikitsa:

Amla, lavana, skanda, karira, badar phala siddha Niruha Basti.
Vataghna dravya siddha anuvasana basti.

7. Udavarta:

Nidaan: Vegaavrodh of vata, mutra, purisha after Niruha Basti.
Lakshana: Basti dravya may come out from mouth, murcha, medicine reaches the urdhwa bhaga of shareera.
Chikitsa:

If murcha is present, sheeta ambu sechana should be done over face, then mardana over parshwa and udara.
Hair should be pulled upwards.
Should be feared by telling names of Gaja etc.
Throat should be covered by hand or cloth and slight pressure should be applied to make apana vayu move downwards.
Give kramuka jala to drink.
If basti is stuck in Pakwashaya, give bilwadi dwipanchamula basti.
If medicine reaches shiras, navana, dhuma, lepa of sharshapa should be done.

8. Pravahika:

Nidaan: Mrudu and alpa matra basti in pt. with mahadosh.
Lakshana: Swelling in paya, guda pradesh, sadana in jangha and ura pradesh, difficulty in passing stools.
Chikitsa:

Swedana
Abhyanga
Shodhana and anulomak drugs basti.

9. Shiroruk:

Nidaan: Tanu, mrudu, sheeta and alpa matra basti in dubala pt. with mahadosha and krura koshta.
Lakshana: Stiffness in greeva and manya, deafness, tinnitus, coryza, agitation of eyes.
Chikitsa:

Lavana taila abhyanga
Pradhmana nasya and dhumapana.
Shirovirechana
Teekshna and vatanulomak dravya siddha anuvasana.

10. Angarti:

Nidaan: Guru, teekshna and atimatra basti given to pt. without samyak snehan and swedana.
Lakshana: Pain all over the body, pricking and throbbing pain, cramps, numbness, and yawning.
Chikitsa:

Lavana tail abhyanga
Ushna jala sinchana
Yava, kola, kulattha panchamula siddha Niruha basti.

11. Paristrava:

Nidaan: Amla, ushna, teekshna and lavana basti administered to pt. with pittaj vyadhi.
Lakshana: Bleeding of various colours, murcha.
Chikitsa:

Piccha basti with shamali pushpa, etc.
Madhuragana sadhita sheetala kwatha sechana on guda.
Raktapitta chikitsa.

12. Parikartika:

Nidaan: Ruksha, teekshna atimatra basti in pt. with alpa dosha and mrudu koshtha.
Lakshana: Pricking pain in lumbar, groin and bladder, pain below umbilicus, constipation.
Chikitsa:

Madhura sheeta dravya basti
Ksheera basti with sarjarasa, etc.
Madhura and amla rasa pradhaan diet.

NIRUHA BASTI OR ASTHAPANA BASTI

CONTENTS:

I. DEFINITION:

स दोष निर्हरणात् शरीर नीरोहणाद् वा निरूह : ॥ (Su.Chi. 35/18)