Vasti Vidhi– Enema

Basti means urinary bladder or enema. In ancient time’s urinary bladder of animals like buffalo were used as a bag to hold the enema material like decoctions, oil, etc. Vasti vidhi Adhyaya is the 19th chapter of Ashtanga Hrudaya Sutrasthana. Basti is useful for diseases with imbalanced Doshas, where Vata is dominant or diseases arise with Vata imbalance alone, it is the best treatment among all treatments.

TYPES

Niruha Vasti – it is also known as Asthapana Basti. A decoction is used in this therapy, where decoction mixed with salt, honey, ghee, etc., and then administered in the body.

Anuvasana Vasti – it is also known as Sneha Basti. In this therapy ghee, oil, fat, etc. administered to the body. 

Uttarabasti administered through the urethral route. 

Notes

Persons suitable for Niruhu Basti or Asthapana Basti

Gulma – Tumors of the abdomen

Anaha – bloating, fullness

Khuda – gout,

Pleeha – Disease of the spleen, Splenomegaly

Shuddha atisara – Diarrhoea unassociated with other diseases

Shula – pain in the abdomen

Jeernajwara – Chronic fever

Pratishyaya – rhinitis

Shukra – obstruction of semen, 

Mala Graha – constipation,

Vardhma – enlargement of the scrotum,

Ashmari Urinary calculi,

Rajonasha – Amenorrhoea

Unsuitable for Niruha or Asthapana Vasti

Atisnigdha – excess of Oleation therapy;

Urakshata – Chest injury

Krusha – highly emaciated,

Ama Atisara – diarrhea, dysentery due to Ama or diarrhea of recent onset,

Vami – vomiting,

Samshuddha – people who have undergone purification therapies (Panchakarma),

Datta Navana – nasal medication

Shvasa – COPD, Asthma, Dyspnoea

Kasa – cough, cold

Praseka excessive salivation

Arsha – Hemorrhoids

Hidhma – Hiccups

Adhmana – Abdominal bloating

Alpavahni- low digestion strength

Shunapayu – Swelling in the rectum

Kruta Ahara – Who have just taken food

Badhodara – intestinal obstruction

Chidra Udara – Intestinal rupture

Udakodara – Ascites

Kushta – skin diseases

Madhumeha diabetes

Pregnant woman 

Patients suitable for Anuvasana Vasti 

A person suitable for Asthapana is suitable for Anuvasana. 

Mainly those people who have strong digestion power, 

People with dry body or skin or not undergone Snehana therapy

People who suffer from Vata disease

Patients not suitable for Anuvasana Vasti

Persons who are not suitable for oil enema are those who are not suitable for decoction enema, 

Pandu – anemia,

Kamala – Jaundice,

Meha – diabetes, urinary tract disorders

Peenasa – rhinitis

Niranna – empty stomach

Pleeha – Disease of the spleen, Splenomegaly

Vid bhedi – diarrhea,

Guru koshta – hard bowels- constipated,

Kaphodara – Kapha type of Ascites

Abhishyandi a type of eye disorder

Bhrusha Sthula – profound obesity,

Krumi Koshta – Intestinal worm infestation

Adhyamaruta – gout

Who consumed poison

Suffering from artificial poison

Goiter, 

filariasis and scrofula.

Bastinetra enema nozzle-

It is made up of metals like gold, silver, bamboo, wood, or bone

Gopuchhakara – this type of nozzle resembles the tail of the cow in shape,

Achidra – this type of nozzle is without holes except at the ends,  smooth in touch and straight,

Gulikamukha – this type of nozzle is tip-shaped like a pill. 9

For children less than 1year of age, the nozzle should be of five angula- fingers breadth of Patients own

finger in length;

1 – 7years of age, the nozzle should be 6 angula;

The 7-year nozzle should be 7 Angula,

12 years nozzle should be 8 Angula

16 years nozzle should be 9 Angula

20 years and onwards nozzle should be 12 Angulas only.

These measurements may be slightly increased for other age groups based on age, strength, and body build.

Its orifice and its root should be 1 Angula in diameter for children of one year of age.

 Orifice diameter should be increased  ½ angula for different age groups and its maximum diameter is 3 Angula.

At the tip of the nozzle, the orifice should allow free movement of green gram, Masha (black

gram), and Kalaya (round pea).

Near the office, a Karnika ear-like ridge of this same size of the orifice should be

Made at the time of preparing the nozzle, another Karnika should be made

at a distance of two Angula- towards its tip, the orifice at the tip should be kept closed with a

plug of cloth.

Basti Putaka- Enema bag:-

The urinary bladder of sheep, buffalo goats, or other animals was used as an enema bag. The bladder should be bulky, well beaten, made by red tanning with astringent substances. The bladder should be avoided if it has holes and hard spots. It should not be torn. If the bladder is not available, then the skin of the animal thigh and legs is used or thick cloth may be used for making the bag.

Niruha Matra (quantity of medicine for decoction enema):-

For a child up to 1 year of age, the quantity of decoction enema is 1 prakuncha = 1 Pala = 48g.

For each upcoming year, it should be increased by 1 pala till it becomes six Prasruta = 12 pala =576g, so for a 12-year-old, the quantity of decoction is 12 Pala.

Further, it should be increased one Prasruta (2 Palas= 96 g). so it becomes twelve Prasta- 24 Palas=1152g at the age of 18 years, it is 24 Pala.

18 – 70 years – 24 Pala.

After 70 years, 10 Prasruta = 20 Pala = 960 grams.

Anuvasana Matra- quantity for oil enema:-

The quantity for oil enema should be one-fourth of the quantity of that of decoction enema, as prescribed for each age group. 20

Anuvasana Vidhi procedure of fat Enema:-

The person suitable for decoction should be administered Snehana and Sweden therapy followed by purification therapy – emesis.  After person regains strength, determining that he is suitable for oil enema or not, if suitable he should be given an oil enema first. 

The following procedure is adopted during procedure:

During cold season like Hemanta, Shishira and Vasanta ritus it should be given during day time in other seasons during night. Person should be given oil massage and bath, then eat habitual food, less by one fourth of the usual quantity, light- easily digestible food neither with more of fats or not very dry, followed by an appropriate liquid drink. Then he should walk for some time, eliminate faces and urine and lie down on a comfortable bed which neither too high nor too low, on his left side with bend his right thigh, and extending the left leg. Next, the enema nozzle which is lubricated with oil, expelled the air inside the bag and should be pressed without shaking the hands, in the direction of the vertebral column, it should neither be too fast nor too slow, neither given with great force nor with low force but given in in one attempt, a little quantity of liquid material will be allowed to remain inside the bag. 

After removing the nozzle patients buttocks beaten gently with hands. Next he lie with extending his entire body, with a pillow under his heels, oil should be smeared all over the body and all the parts massaged well concentrating on the painful areas of the body, so that the fat enema inside the rectum does not come out soon.

If enema comes out early then another oil enema should be administered soon because fat which does not remain inside does not fulfil the purpose. If the person has good digestive activity, and if the fat comes out after the specific time he can be given light food in the evening. 

The maximum time for the fat should come out is three Yama- nine hours, after that, it can be awaited

for one day and night, later on, after 24 hours after administration. If it does not come out due to severe dryness inside the body then it does not produce any discomfort like lassitude etc. it should be neglected and allowed to remain inside for the night, Next morning drink warm water either processed with ginger and coriander or plain. Again he should be given fat enema on the 3rd or 5th day, till the fat gets well digested through body.

To whom fat enema can be given daily?

People with profound increased of vata dosha, 

People who do Physical activities daily, 

People who have good digestive power 

People with very dry skin can be given fat enema daily.

After 3 – 4 fat enemas if the body is found to be well lubricated, purification decoction

Enema should be administered next to clear the channels obstruction, if not well lubricated, then fat enema should be continued.

Nirahadraya Kalpana preparation of enema decoction:-

20 Pala – (960 g) of Drugs- enumerated in the prescription and 8 Madana Phala fruits should be made into a decoction with the 16 parts of water and boiled till 1/4th quantity is remain and added a fat- oil, ghee etc in 1/4th quantity = 960 g, for treatment of Vata, 1/6th quantity = 640 g for the treatment of Pitta, 1/8th quantity = 480 g for healthy person and for the treatment of Kapha disorders.

The quantity of Kalka of some Drugs added to the decoction for all Doshas and the healthy person shall be 1/8th part of the decoction (480 g) neither too thin nor too thick after mixing.

Next one pala (48 g) of Guda/jaggery and appropriate quantity of honey and salt also are also added.

All these are mixed together, churned well and made warm by keeping in container either in hot water or by steam. It should then filled into the enema bag in that condition, which is neither too hot nor too cold, neither too fatty nor too dry, neither too strong nor mild, neither too thick nor too thin, neither too much nor too less in quantity, neither with too much salty nor with it is then pushed into the rectum.

Signs of good Anuvasana basti Procedure –

Enema material coming out along with faces after staying inside for a short time, followed by flatus moving down are the symptoms of proper anuvasana vasti.

1 – 3 Anuvasana should be administered for the treatment of Kapha dominant diseases.

5 – 7 for Pitta,

9 – 11 for Vata.

Again alternative days like 3rd, 5th, 7th day decoction enema should be given. 

Niruha Basti always given in empty stomach.

Anuvasana basti is given soon after taking food.

Food should be given along with Anna Yusha means soup prepared with rice and grains in case of Kapha disorder with milk in case of Pitta disorder and in vata disorders Meat soup are given

three kinds of enema are to be prepared,

Utkleshana – that causing of the Doshas,

Shodhana – that causing purification, by expelling the Doshas

Shamana – that subsiding dosha inside the body.

All these are to be justified on the basis of strength of the Doshas, drugs etc.

Administration of enemas should be continued till symptoms of proper enema are obtained.

Karma Basti – treatment with 30 enemas

It is the course of 30 enemas with one fat enema at the beginning and five at the end, with twelve decoction enema and twelve fat enema alternately in the middle is called as Karma basti. 63

Each day, one enema is usually given. 

F = Fat enema = Anuvasana = Snehabasti

D = Decoction enema = Niruha = Asthapana

1=F 2 = F 3 = D 4 = F 5 = D 6 = F 7 = D 8 = F 9 = D 10 = F

11 = D 12 = F 13 = D 14 = F 15 = D 16 = F 17 = D 18 = F 19 = D 20 = F

21= D 22 = F 23= D 24 = F 25 = D 26 = F 27 = F 28 = F 29 = F 30 = F

Kala Basti – 15 enema regimen

A course of 15 enemas, with one fat enema at the beginning and three at the end, with six decoction enemas and five fat enema alternately in the middle is known as Kala Basti. 64

1=F 2 = D 3 = F 4 = D 5 = F 6 = D 7 = F 8 = D 9 = F 10 = D

11 = F 12 = D 13 = F 14 = F 15 = F

Yogabasti – 8 day enema regimen –

A course of eight enemas, with one fat enema both at the beginning and at the end, with three decoction enema and three fat enema alternately in the middle is known as- yoga basti.

1=F 2 = D 3 = F 4 = D 5 = F 6 = D 7 = F 8 = F

Sneha Basti – Niruha Basti

Either fat enema or decoction enema alone should not be given alone. More of fat enema may cause nausea and loss of digestion. More of decoction enema may cause increase of Vata. Hence people who are given decoction enema should also be given fat enema and those who are given fat enema should also be given decoction enema. Enema therapy will balance the three Doshas.

Matra Basti (Low dose fat enema)

Fat enema consisting of high fat quantity in matra basti minimum quantity of fat used for Snehakarma. In general a very low dose of medicated oil or ghee 50 – 75 ml is administered as Matra Basti. It should be given for Bala, Vriddha, Adhva, Bhara, Stri, Vyayama and who are habituated to long walking, carrying heavy weight, sexual activity and exercise

Chinta – who think too much, suffering from vata disease, fractures, debility, poor digestive activity, kings, wealthy persons and persons who live happily. 

Uttarabasti- urethral and vaginal enema/ douche:-

Diseases of urinary bladder, vagina and uterus in women, uttarabasti should be administered or to those who have purified by two or three decoction enemas, per rectum.

The nozzle should be 12 Angula in length, in terms of patients own fingers and round- tubular resembling to cow’s tail at its end should have an orifice of mustard size, made up of gold, silver and metals, it should be smooth, resembling the stalk of flowers such as Kunda, Ashvamara and sumanas. 

The enema liquid should be mild in strength, easily acting, its quantity one Sukti- 24 g or lesser.

Uttarabasti Vidhi Procedure:-

patient who has been given bath and food in accordance with the regimen prescribed for

fat enema, one should be on his knees then his penis should be held straight by the physician and a thin

probe should be inserted slowly the by the physician and a thin probe should be slowly inserted

into the urethra to clear the channel, after clearing the passage, the enema nozzle should be

inserted along the line of the Suture, to the entire length of the Urethal passage till the cavity of

the urinary bladder is reached, without shaking the hand and the enema bag pressed just as described for rectal enema, pushing the oil, ghee etc. into the urinary bladder this is the ideal method- for a urethral enema. In this way 3 or 4 enemas should be given.

Samanya Bastikala (periods of administration of enema generally)

Purgation therapy should be resorted to after a fortnight after emesis therapy and decoction enema after a fortnight after purgation therapy,

Fat enema- therapy should be administered immediately after decoction enema but after seven days after purgation therapy.

Just as the cloth adsorbs the color from the water, boiled with Kusumbha etc, colouring materials, similarly, the enema, absorbs the Doshas from the moistened body.

Basti Chikitsa Sresthata- importance of enema therapy:-

For all the diseases which are localized in the extremities, Koshta (alimentary tract), Marma (vital organs), all the organs above the shoulders, there is no other cause, more important than Vata.

Vata is the one responsible for transportation and destruction of the increased faces, Kapha, Pitta and other Malas.