ANUVASANA BASTI OR SNEHA BASTI - THERAPEUTIC OIL ENEMA

CONTENTS:

• Definition

• Indications

• Contraindications

• Anuvasanopaga Dravya

• Classification

• Dose

• Common Anuvasana Basti

• Combination of Anuvasana Basti and Niruha Basti

• Preparation of Anuvasana Basti

• Procedure of administration

• Anuvasana Basti Vyapad

I. DEFINITION:

अनुवासन्नपि न द्विष्यवत्यनुसं वा दीयत इत्यनुवासन: ॥ (Su.Chi. 35/18)

The Basti in which the main ingredient is a sneha dravya, and that can be retained for 24 hrs without causing any complicatios in the body is known as Anuvasana Basti. This Basti can be administered daily.

II. INDICATIONS:

• Person with excessive dryness in the body
• very high appetite
• vata predominant disorders
• vata disorders afeecting the groins, buttocks, udavarta.
• person indicated for Niruha Basti.
• can be adminitered by healthy person to enhance digestion and strenght.

III. CONTRAINDICATIONS: 

• diarrhoea
• coryza
• recent fever
• hard bowel
• intestinal worm
• pittaj and kaphaja abhishyandi
• acute poisoning
• empty stomach
• indigestion
• anorexia
• debiliated
• elephantiasis
• spleen disorders
• kaphaja udara roga
• anaemia
• piles
• polyuria
• lymphadenitis
• jaundice
• kushta (chronic skin disorders)
• obesity
• all conditions contraindicated for Niruha Bast

IV. ANUVASANOPAGA DRAVYA: 

• Rasna
• Suradaru
• Bilwa
• Madana
• Shatapushpa
• Vruschira
• Punarnava
• Shvadamstra
• Agnimantha
• Shyonaka

V.CLASSIFICATION: 

Anuvasana Basti is classified on the basis of Matra (dose) into three types:

• Sneha (Uttam) – 6 pala (300 ml)

• Anuvasana (Madhyam) – 3 pala (150 ml)

• Matra (Avara) – 1 1/2 pala (75 ml)

VI. DOSE: 

The dose of Anuvasana Basti is calculated according to the dose of Niruha Basti perscribed for that age.

Sneha Basti:
1/4th of the Niruha Basti prescribed for that particular age.
Example: For an 18 year old patient, the dose prescribed for Niruha Basti is 12 Prasrita. So the dose of Sneha Basti should be 3 Prasrita (300 ml)

Anuvasana Basti:
Half of Sneha Basti prescribed for that particula age.
Example: For an 18 year old patient, the dose of Sneha Basti is 3 Prasrita. So the dose of Anuvasana Basti should be 1 1/2 Prasrita or 3 Pala (150 ml).

Matra Basti:
Half of Anuvasana Basti prescribed for that particular age.
Example: For an 18 year old, the dose of Anuvasana Basti is 3 pala. So the dose of Matra Basti should be 1 1/2 pala (75 ml).

Matra Basti can be administered in any season and is relatively harmless. There are no restrictions or diet regimens that need to be followed during this Basti. It can be taken by a healthy person too as it promotes better bowel movements, increases strenght and cures any vitiation of vata.

VII. COMMOM ANUVASANA BASTI:

Sneha Dravya	Disease
Kalyanaka Ghruta	Manovyadhi, Arthabakshaya, kushta
Panchatikta Ghruta	Snshishools, Kushta
Varunadi Ghruta	Sthoulya, Mutrakruccha, Udararoga
Sukumara Ghruta	Vitsanga, Anaha
Shatavaryadi Ghruta	Mutrakruccha, Mutra Dosha
Ksheerbaladi Taila	Vata and Pitta Shamana, infertility
Sahacharadi Taila	Neurological disorders, varicose veins
Mahanarayana Taila	Vata-Pittahara, osteoporosis
Dhanvantari Taila	Vata-Kaphahara, Apana Vishesha
Pippalyadi Taila	Non bleeding piles, Atisaar, Pravahika
Balaguluchyadi Taila	Vatarakta
Lakshadi Taila & PTG	Osteoporosis
Murivenna	Anal Fissures

VIII. COMBINATION OF ANUVASANA AND NIRUHA BASTI:

The combination of Anuvasana and Niruha Basti gives excellent results for any given disease because excessive Anuvasana Bast causes Agnimandhya, and excessive Niruha Basti causes vata vitiation.

Hence, when these Bastis are given in combination, they counter each other’s complications and give the desired results.

IX. PREPARATION OF ANUVASANA BASTI:

Take processed oil in a container and do  proper murchana to reduce the samata of the oil.
Then add prakshepa dravyas like Saindhava and Shatahva to the oil to ensure proper and better return of the medicine.
The quantity of shatawa churna and saindhava is
Uttama – 6 Masha
Madhyam – 4 Masha
Avara – 2 Masha

X. PROCEDURE OF ADMINISTRATION:

(a) Poorva 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.

4. Time of administration:

Anuvasana Basti should be adminstered during the day in cold seasons, and during the night in other seasons.

5. Preparation of the patient / Atura Siddhata:

• The pt. should be prepared by giving proper abhyanga, preferably over the abdominal area. Full body Abhyanga can be done as well.
• Abhyanga should be followed by Nadi Sweda or Bashpa Sweda.
• After Swedan, the pt. should be made to take bath with warm water.
• Then advise the pt. to take light food in less quantity (less than 1/4th of the ususal quantity).
• The food taken should be light, not too oily, not too dry, cooked properly. Mamsaras (vata predominance), yusha kapha predominance) and dugdha ( pitta predominance) should be given.
• Chakramana adi:
• The pt. after eating, should walk about 100 steps.
• Then after the elimination of faeces and urine, should lie on a comfortable bed in left lateral position.

(b) Pradhana 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 is 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 faeces, 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.
• A small quantity of the medicine should be left inside the putaka to avoid the entrance of air into the guda.

6.  Position after the administration of the basti:

• The buttocks of the patient should be patted with palms 3-4 times and then asked to relax in supine position.
• The bed should be raised in a head-low position, and  the soles of the pt, are rubbed gently.
• The pt. should remain in this position for 100 Vak (time taken to count upto 100). This will allow the Veerya of the Basti to spread throughout the body.

(c) Paschaat karma:

1. Pratyagamana Kaala:

• The maximum time of retention is 3 yama (12 hours) from the time of administration. If Sneha returns before 12 hours, then another Anuvasana Basti should be given.
• If Bast does not come out after 12 hours, it ca be awaited for about 12 hours more.
• If after 24 hours too the Basti has not returned, then it should be removed by force with the help of Phala Varti (rectal suppository) and Teekshana Basti.
• If the Basti stays inside even after 24 hours without causing any complications, which can be seen in some Rooksha patients,then it should be ignored.

2. Warm water and Diet:

• The pt. is advised to drink warm water as it helps in digestion of remaining Sneha Dravya. It also helps in breaking down the Shleshma/ morbid kapha and regulation of peristaltic movements by mobilizing the vata in downward direction.
• If the Basti has not returned, the pt. is given warm water processed with coriander seeds and ginger.
• After the Basti has returned, on the next day afternoon, the pt. is advised to take easily digestible light food.
• And  in the evening, cooked yusha and mamsa rasa should be given.

3. Observation of Samyak Yoga Lakshana:

• The oil and faeces come out seperately, without sticking with each other.
• Clarity of senses and sense organs, intellect and Raktadi Dhatus.
• Feeling of lightness in the body.
• Increase in strenght.
• Regulation of excretory urges
• Proper and sound sleep.

4. Observation of Ayoga Lakshan:

• Sensation of pain in lower parts of the body, abdomen, arms, back and sides (parshva)
• Dryness and roughness in the body.
• Retention of flatus, faeces, and urine.

5. Observation of Atiyoga Lakshana:

• Nausea
• Stupor
• Fatigue
• Exhaustion
• Fainting
• Gripping pain

6. Observation of Vyapads:

• There are 6 possible vyapads of Anuvasana Basti.
• They should be checked and treated.

7. Pariharya Vishaya and Kala:

• Mamsarasa is pathya for Vata disorders
• Ksheera is pathya for Pitta disorders.
• Yusha is pathya for Kapha disorders.

XI. ANUVASANA BASTI VYAPADS:

1. Vatavruta Sneha:

Nidaan: Sheeta and alpa basti in pt. with Vataadhika avasths.

Lakshana: Jwara, angamarda, adhmaan, stambha, urupeedana, sheeta, parshvaruk.
Chikitsa:

• Rasnadi Teekshna Basti
• Rasnadi siddha taila Anuvasana Basti.

2. Pittavruta Sneha:

Nidaan: Atiushna Basti in pt. with Pittadhika avastha.
Lakshana: Daha, trushna, jwara, tamaka, moha, raga.
Chikitsa:

• Swadu tikta dravya Basti.

3. Kaphavruta Sneha:

Nidaan: Mrudu Basti in pt. with Kaphadhika avastha.
Lakshana: Sheeta jwara, aruchi, gourava, tandra, glani. alasya, praseka.
Chikitsa:

• Suranada Mutra yukta Teekshna Basti.

4. Annavruta Sneha:

Nidaan: Guru Basti given right after Atibhojana.
Lakshana: Chardi, aruchi, daha, glani, angamarda, nidra, amalinga, murcha, shula.
Chikitsa:

• Pachana with Katu and Kavanachurna and Kwath.
• Mrudu Virechana.

5. Purishavruta Sneha:

Nidaan: Alpabala Basti in pt. having Mala Snachaya.
Lakshana: Mala- Mutra avarodha, pakwashaya gourava, hrutgraha, adhmana, shawaasa.
Chikitsa:

• Abhyanga
• Swedana
• Phala Varti
• Shyamabilwadi siddha Niruha Basti, followed by Anuvasana Basti.
• Udavarta chikitsa.

6. Abhukta Pranita:

Nidaan: Atipeedana Basti given to pt. on empty stomach and empty bowel. 

Lakshana: Medicine may reach throat, and may come out of the upper orifices like mouth, nose, eyes, etc. Other lakshana include stiffness in the body, feeling of coating over the sense organs (indriya upalepa), smell of sneha in the mouth, kasa, shawasa, aruchi.
Chikitsa:

• Trivruttadi Niruha Basti.
• Chitrakadi vati
• Dashamoolarishta
• Hemagarbha Rasa
• Virechana
• Chardighna chikitsa
• Throat is gently pressed with the palms or with the help of a clean cloth.