19 Basti Vidhi Adhyaya enema therapy

19 Basti Vidhi Adhyaya enema therapy

Basti treatment

वातोल्बणेषु दोषेषु वाते वा वस्तिरिष्यते
उपक्रमाणां सर्वेषां सो अग्रणीस्त्रिविधस्तु सः 
निरूहो अन्वासनं बस्तिरुत्तरः


Basti is described for diseases with 

• imbalanced Doshas having predominance of Vata or
• for diseases with Vata imbalance alone,

• It is the best among all treatments.

It is of three kinds- viz-

1. Niruha  also known as Asthapana Basti  

• Decoction enema  decoction mixed with salt, honey, ghee etc is administered.

2. Anuvasana  also known as snehabasti  

• ghee, oil, fat etc are administered. 
• Herbal oils such as Narayana Taila, 
• Herbal ghritas are more commonly used for this purpose.

3. Uttarabasti  administered through urethral route. 

Notes- 

Basti  means urinary bladder. In ancient times urinary bladder of animals like buffalo etc were used as a bag to hold the enema material like decoctions, oil etc.

Persons suitable for decoction enema -Asthapya / Asthapana Arha

तेन साधयेत् 
गुल्मानाहखुडप्लीहशुद्धातीसारशूलिनः
जीर्णज्वरप्रतिश्यायशुक्रानिलमलग्रहान्
वर्ध्माश्मरीरजोनाशान् दारुणांश्चानिलामयान्


Patients suffering from

• 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 abdomen
• Jeernajwara -  Chronic fever
• Pratishyaya  rhinitis
• Shukra, Anila, Mala Graha –  obstruction of semen, flatus and constipation,
• Vardhma – enlargement of the scrotum,
• Ashmari  Urinary calculi,
• Rajonasha – Amenorrhoea and
• grevious diseases of vata origin. 

Unsuitable for Niruha – Asthapana Anarha – Anasthapyah


अनास्थाप्यास्त्वतिस्निग्धः क्षतोरस्को भृशं कृशः 
आमातिसारी वमिमान् संशुद्धो दत्तनावनः 
श्वासकासप्रसेकार्शोहिध्माध्मानाल्पवह्न्यः 
शूनपायुः कृताहारो बद्धच्छिद्रोदकोदरी
कुष्ठी च मधुमेही च मासान् सप्त च गर्भिणी

• Atisnigdha  who have had excess of oleation therapy;
• Urakshata -  Chest injury
• Krusha – highly emaciated,
• -Ama Atisara – diarrhoea, dysentery due to Ama or diarrhea of recent onset,
• Vami – vomiting,
• Samshuddha – who have undergone purification therapies (Panchakarma),
• Datta Navana – who have been administered nasal medication
• Shvasa  COPD, Asthma, Dyspnoea
• Kasa – cough, cold
• Praseka  excessive salivation
• Arsha – Hemorrhoids
• Hidhma – Hiccups
• Adhmana  Adbominal 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 in the seventh month. 

Patients suitable for Anuvasana Basti  Anuvasana Arha – Anuvasya


आस्थाप्या एव च अनुवास्या विशेषादतिवह्न्यः 
रूक्षाः केवलवातार्ताः


Person suitable for Asthapana are suitable for oil enema (Anuvasana).

•  Especially those who have strong digestion power,
•  who are dry not undergone Snehana therapy and
•  those suffering from diseases of vata. 

 Patients not suitable for Anuvasana – Nanuvasyah  Anuvasana Anarha

नानुवास्यास्त एव च 
ये अनास्थाप्यास्तथा पाण्डुकामलामेहपीनसाः
निरन्नप्लीहविड्भेदिगुरुकोष्ठकफोदराः
अभिष्यन्दिभृशस्थूलकृमिकोष्ठाढ्यमारुताः
पीते विषे गरे अपच्यां श्लीपदी गलगण्डवान्


Persons unsuitable for oil enema are all those unsuitable for decoction enema, 
those suffering from

• Pandu – anemia,
• Kamala – Jaundice,
• Meha – diabetes, urinary tract disorders
• Peenasa – rhinitis
• Niranna  on empty stomach-
• Pleeha  Disease of the spleen, Splenomegaly
• Vid bhedi – diarrohea
• 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 have consumed poison, 
• those suffering from artificial poison, goiter, filariasis and scrofula. 

 Basti netra  enema nozzle-

तथोस्तु नेत्रं हेमादिधातुदार्वास्थिवेणुजम्
गोपुच्छाकारमच्छिद्रंश्लक्ष्णर्जु गुलिकामूखम्

Enema nozzle -

• should be made from metals like gold, silver, wood, bone or bamboo;-
• Gopuchhakara – resembling the tail of the cow in shape
• Achidra – without holes (except at the ends)
•  smooth, 
• straight and-
•  with Gulikamukha – tip shaped like a pill. 

ऊने अब्दे पञ्च, पूर्णे अस्मिन्नासप्तभ्यो अङ्गुलानि षट्
सप्तमे सप्त, तान्यष्टौ द्वादशे, षोडशे नव
द्वादशैव परं विंशाद्धीक्ष्य वर्षान्तरेषु च 
वयोबलशरीराणि प्रमाणमभिवर्द्धयेत्
-
For children less than 1year of age, 

• nozzle should be five angula- fingers breadth of Patients own finger in length;

1 – 7years of age,

•  it should be 6 angula;

7 year 

• it should be 7 Angula,

12 years  - 8 Angula
16 years  - 9 Angula
20 years and onwards - it should be 12 Angulas only.

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


स्वाङ्गुष्ठेन समं मूले स्थौल्येनाग्रे कनिष्ठया 
पूर्णे अब्दे अङ्गुलभादाय तदर्द्धार्द्धप्रवर्द्धितम्
त्रयङ्गुलं परमं छिद्रं मूले अग्रे वहते तु यत्
मुद्गं माषं कलायं च क्लिन्नं कर्कन्धुकं क्रमात्

Its orifice at its root should be 

• 1 Angula in diameter for children of one year of age.

Diameter of the orifice 

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

• At its tip, the orifice should allow free movement of 

1. soaked Mudga (green gram), 
2. Masha (black gram), 
3. Kalaya (round pea) 
4. and seed of Karkandhu Jujube respectively. 

मूलच्छिद्रप्रमाणेन प्रान्ते घटिककर्णिकम्
वर्त्या अग्रे पिहितं, मूले यथास्वं ह्यङ्गुलान्तरम्
कर्णिकाद्वितयं नेत्रे कुर्यात् 

• Near the office at its root, 

1. a Karnika- ear-like ridge of this same size of the orifice should be constructed  at the time of preparing the nozzle, 
2. another second Karnika- ridge 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:-

तत्र च योजयेत्
अजाविमहिषादीनां बस्तिं सुमृदितं दृढम्
कषायरक्तं निश्च्छिद्रग्रन्थिगन्धसिरं तनुम्
ग्रथितं साधु सूत्रेण सुखसंस्थाप्यभेषजम्
बस्त्यभावे अङ्कपादं वा न्यसेद्वासो अथवा घनम्

• Urinary bladder of goat, sheep, buffalo or other animals was used as enema bag. 
• The bladder should be sturdy, well beaten, made red by tanning with astringent substances.
• The bladder should be devoid of holes, hard spots.
• It should not be torn.

• To such a bladder, big end of the nozzle is adjusted and tied with threads.

• If the bladder is not available, 

• skin of thigh and legs of animals or thick cloth may be utilized for making the bag. 

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

निरूहमात्रा प्रथमे प्रकुञ्चो वत्सरे परम्
प्रकुञ्चवृद्धिः प्रत्यब्धं यावत्षट्प्रस्रुतास्ततः 
प्रसृतं वर्द्धयेदूर्ध्वं द्वादशाष्टादशस्य तु
आसप्ततेरिदं मानं, दशैव प्रसृताः परम् 

For a child upto 1 year age, 

• the decoction enema quantity is 1 prakuncha = 1 Pala = 48g.

• For each succeeding year it should be increased by 1 pala till it becomes six Prasruta- 12 pala =576g;
• So for a 12 year old, the quantity is 12 Pala.

• Further on it should be in increased by one Prasruta (2 Palas= 96 g). 
• Each year till it becomes twelve Prasta- 24 Palas=1152g.

• At the 18 years, it is 24 Pala.
• 18 – 70 years – 24 Pala.
• After 70 years, 10 Prasruta = 20 Pala = 960 grams / ml

 Anuvasana Matra- quantity for oil enema:-

यथायथं निरूहस्य पादो मात्रा अनुवासने 

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

 Anuvasana Vidhi - procedure of fat Enema:-

आस्थाप्यं स्नेहितं स्विन्नं शुद्धं लब्धबलं पुनः
अन्वासनार्हे विज्ञाय पूर्वमेवानुवासयेत्
शीते वसन्ते च दिवा रात्रौ केचित्ततो अन्यदा
अभ्यक्तस्नातमुचितात्पादहीनं हितं लघु
अस्निग्धरूक्षमशितं सानुपानं द्रवादि च 
कृतचङ्क्रमणं मुक्तविण्मूत्रं शयने सुखे 
नात्युच्छ्रिते न चोच्छीर्षे संविष्टं वामपार्श्वतः 
सङ्कोच्य दक्षिणं सक्थि प्रसार्य च ततो अपरम्


The person suitable for decoction enema 

• should be administered Snehana (oleation) and sweating therapy followed by purification therapy- emesis or purgation.

• After he regains strength, determining that he is fit for oil enema, he should be given an oil enema first. The following procedure is adopted.

• During cold season (Hemanta and Shishira Rutus) and Vasanta (spring) it should be given during day in other seasons during night.
• He should be given oil massage and bath, 
• then accustomed food, less by one fourth of the usual quantity; satiable, light- easily digestible neither with more of fats nor very dry,
•  followed by an after-drink of appropriate liquid.

• Next he should walk for some time, 
• eliminate faeces and urine and
•  lie on a comfortable cot, neither too high nor too low,
• on his left side, 
• folding his right thigh, and extending the left thigh. 

अथास्य नेत्रं प्रणयेत्स्निग्धे स्निग्धमुखं गुदे
उच्छ्वास्य बस्तेर्वदने बद्धे हस्तमकम्पयन्
पृष्ठवंशं प्रति ततो नातिद्रुतविलम्बितम्
नातिवेगं न वा मन्दं सकृदेव प्रपीडयेत्
सावशेषं च कुर्वीत वायुः शेषे हि तिष्ठति 

• Next, the enema nozzle which is Lubricated, 
• after the air inside the bag is expelled out, 
• confirming that it is well fastened to the nozzle,
•  it should be pressed without shaking the hands, in the direction of the vertebral column,

• neither too fast nor too slow, 
• neither with great force nor with low pressure 
• but in one attempt, 
• a little quantity  of liquid  material be allowed to remain in the bag. 

दत्ते तूत्तानदेहस्य पाणिना ताडयेत्स्फिजौ
तत्पार्ष्णिभ्यां तथा शय्यां पादतश्च त्रिरुत्क्षिपेतत्
ततः प्रसारिताङ्गस्य सोपधानस्य पार्ष्णिके 
आहन्यान्मुष्टिना अङ्गं च स्नेहेनाभ्यज्य मर्दयेत्
वेदनार्तमिति स्नेहो न हि शीघ्रं निवर्तते
योज्यः शीघ्रं निवृत्ते अन्यः स्नेहो अतिष्ठन्नकार्यकृत्
दीप्ताग्निं त्वागतस्नेहं सायाह्ने भोजयेल्लघु 

After the administration and removing the nozzle

•  the person should be placed with his face upwards, 
• his buttocks beaten gently by by the hands of the physician, 
• then by patients own heels;
• the foot of the cot should be lifted up thrice;

• Next he must lie extending the entire body, 
• with a pillow under his heels,
•  oil should be smeared all over the body 
• and all the parts of it beaten with fist or massaged, 
• concentrating on the painful areas of the body, 
• so that the fat  enema liquid inside the rectum does not come out soon.

• If it comes out soon, another oil enema should be administered immediately because fat which does not remain inside does not serve the purpose.

•  If the person has good digestive activity, and if the fat comes out after the stipulated time he can be given light food in the evening. 

निवृत्तिकालः परमस्त्रयो यामास्ततः परम्
अहोरात्रमुपेक्षेत, परतः फलवर्तिभिः 
तीक्ष्णैर्वा वस्तिभिः कुर्याध्यत्रं स्नेहनिवृत्तये 

• The maximum time for the fat to 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,  attempt should be made to remove it by force, with the help of rectal suppositories made from fruits or strong decoction enema. 

-
अतिरौक्ष्यादनागच्छन्न चेज्जाड्यादिदोषकृत्
उपेक्षेतैव हि ततोअध्युषितश्च निशां पिबेत्
प्रातर्नागधान्याम्भः कोष्णं, केवलमेव वा

• If it does not come out due to severe dryness inside and 
• does not produce any troubles like lassitude etc.

•  it should be neglected 
• and  allowed to remain inside for the night;

• Next morning he is made to drink warm water either processed with ginger and coriander or plain. 

अन्वासयेत्तृतीये अह्नि पञ्चमे वा पुनश्च तम्

•  Again he should be given fat enema on the third or fifth day, or till the fat gets well digested;

To whom fat enema can be given daily?


यथा वा स्नेहपक्तिः स्यादतो अत्युल्बणमारुतान्
व्यायामनित्यान् दीप्ताग्नीन् रूक्षांश्च प्रतिवासरम्

1. Those who have profound increased of vata, 
2. who do exercises- Physical activities daily, 
3. who have good digestive power 
4. and those who are very dry

•  can be given fat enema daily. 

इति स्नेहैस्त्रिचतुरैः स्निग्धे स्रोतोविशुद्धये 
निरूहं शोधनं युञ्ज्यादस्निग्धे स्नेहनं तनोः 

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

• purification decoction enema should be administered next, to clear the channels, 

• if not well lubricated, fat enema only should be continued. 

Niruha Basti Vidhi- Procedure of decoction enema:-


पञ्चमे अथ तृतीये वा दिवसे साधके शुभे 
मध्याह्ने किञ्चिदावृत्ते प्रयुक्ते बलिमङ्गले 
अभ्यक्तस्वेदितोत्सृष्टमलं नातिबुभुक्षितम्
अवेक्ष्य पुरुषं दोषभेषजादीनि चादरात्
बस्तिं प्रकल्पयेद्वैद्यस्तद्विद्यैर्बहुभिः सह

• On the fifth or third day- after fat enema, 
• at an Auspicious time, 
• some time after midday, 
• after performing Auspicious rites, 
• after oleation and Sweating, 
• after elimination of wastes- urine, faeces 
• after not taking a heavy meal  after a light meal .,
•  after carefully considering the nature of the person patient, the Dosas, Drugs etc, 

- the physician, accompanied by many experts of the enema therapy, should administer  decoction enema to the patient. 



 Niruhadraya Kalpana  preparation of enema decoction:-

क्वाथयेद्विंशतिपलं द्रव्यस्याष्टौ फलानि च 
ततः क्वाथाच्चतुर्थांशं स्नेहं वाते प्रकल्पयेत्
पित्ते स्वस्थे च षष्ठांशमष्टमांशं कफे अधिके 
सर्वत्र चाष्टमं भागं कल्काद्भवति वा यथा 
नात्यच्छसान्द्रता बस्तेः पलमात्रं गुडस्य च
मधुपट्वादिशेषं च युक्त्या

• 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 (15.360 liters) 
• and boiled down to 1/4th quantity; 
• Thus, 3.840 liters of decoction will be obtained.

To the decoction, is 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 (Paste) of some Drugs to be 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- Molasses/ jaggery and appropriate quantity of honey and salt also are also added.

सर्वं तदेकतः 
उष्णाम्बुकुम्भीबाष्पेण तप्तं खजसमाहतम्
प्रक्षिप्य बस्तौ प्रणयेत्पायौ नात्युष्णशीतलम्
नातिस्निग्धं न वा रूक्षं नातितीक्ष्णं न वा मृदु 
नातच्छसान्द्रं नोनातिमात्रं नापटु नाति च 
लवणं तद्वदम्लं च 

• All these are then mixed together, 
• churned well with a churner 
• and made warm by keeping its container either in hot water or by steam from a pot.

• It should then be 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 of salt nor with too less
• neither too much sour nor with too less 

- it is then pushed into the rectum. 


पठन्त्यन्ये तु तद्विदः 
मात्रां त्रिपलिकां कुर्यात्स्नेहमाक्षिकयोः पृथक्
कर्षाद्धं माणिमन्थस्य स्वस्थे कल्कपलद्वयम्
सर्वद्रवाणां शेषाणां पलानि दश कल्पयेत्


Some other experts of enema therapy say that

• the quantity of fats- oil, ghee and honey should be three pala (144 g) individually;

• Quantity of Manimantha (Saindhava salt) for healthy will be half a Karsha – 6 grams, 
• the Kalka- paste of drugs be two Pala 96 g 
• and of all the other liquids put together shall be 10Pala- 480  g. 

माक्षिकं लवणं स्नेहं कल्कं क्वाथमिति क्रमात्
आवपेत निरूहाणामेव संयोजने विधिः 


Honey, salt, fat, paste and decoction are to be mixed in successive order, one after the other;

• This shall be the method of mixing the materials for decoction enema. 

उत्तानो दत्तमात्रे तु निरूहे तन्मना भवेत् 
कृतोपधानः सञ्जातवेगश्चोत्कटकः सृजेत्
  
After receiving the enema, 

• the patient should lie with his face upward with a pillow  under his head, 
• mentally intent of the enema; 
• after getting the urge he should eliminate the faeces sitting on his heels. 

आगतौ परमः कालो मुहूर्तो मृत्येव परम्
तत्रानुलोमिकं स्नेहक्षारमूत्राम्लकल्पितम्
त्वरितं स्निग्धतीक्ष्णोष्णं बस्तिमण्यं प्रपीडयेत्
विद्धात्फलवर्तिं वा स्वेदनोत्रासनादि च 

• The maximum time for decoction enema material to come out is one Muhurta- 48 minutes, 
• after that period it may be fatal;

Hence another purgative enema prepared with

•  fats, 
• Alkalies, 
• Urine of animals like the cow and sour substances and 
• possessing unctuous, Penetrating and hot properties should be administered immediately; 
• or a rectal suppository prepared from fruits should be made use of;

Sweating therapy and frightening should also be resorted to, to induce defecation. 


स्वयमेव निवृत्ते तु द्वितीयो बस्तिरिष्यते 
तृतीये अपि चतुर्थो अपि यावद्वा सुनिरूढता


If the materials comes out on its own accord, then second, third or fourth enema can be given or as many as required till he developed symptoms of proper enema therapy. 



विरिक्तवच्च योगादीन्विद्यात्

The symptoms of bouts of decoction enema therapy are similar to those of purgation therapy. 



योगे तु भोजयेत्
कोष्णेन वारिणा स्नातं तनुधन्वरसौदनम्
विकारा ये निरूढस्य भवन्ति प्रचलैर्मलैः 
ते सुखोष्णाम्बुसिक्तस्य यान्ति भुक्तवतः शमम्

After the appearance of the decided symptoms, 

• the patient should take a bath with warm water, 
• and eat rice mass along with juice of animals of desert- like land. 

• The complications of decoction enema caused by the circulating Malas  Doshas will subside by warm water bath and food.

अथ वातार्दितं भूयः सद्य एवानुवासयेत्

If the patient becomes troubled by increased Vata 

• he should be given a fat enema immediately on the Same day. 

सम्यग्घीनातियोगाश्च तस्य स्युः स्नेहपीतवत् 

The symptoms of proper, inadequate and excess- decoction enema therapy are the same as those of Snehana (drinking of fat) therapy.

Signs of good Anuvasana basti Procedure –


किञ्चित् कालं स्थितो यश्च सपुरीषो निवर्तते 
स अनुलोमानिल: स्नेहस्तत्सिद्धं अनुवासनम् 

1. Enema material – fat coming out along with faeces after staying inside for a short time, 
2. followed by flatus moving down 

• are the symptoms of proper fat enema therapy .

एकं त्रीन् वा बलासे तु स्नेहबस्तीन् प्रकल्पयेत्
पञ्च वा सप्त वा पित्ते, नवैकादश वा अनिले
पुनस्ततो अप्ययुग्मांस्तु पुनरास्थापनं ततः

• 1 – 3 fat enema (Anuvasana) should be administered for the treatment of Kapha dominant diseases.
• 5 – 7 for Pitta,
• 9 – 11 for Vata.

• Again on uneven alternative days- third, Fifth, seventh etc. decoction enema should be given. 

Note – 

• Always, Niruha Basti = decoction enema is given in empty stomach.
• Anuvasana basti – fat enema is given soon after taking food, when the palms of the patient is still wet due to hand wash, after food intake. (Ardra Pani Avastha)

कफपित्तानिलेष्वन्नं यूषक्षीररसैः क्रमात्

Food should be given along with

• Anna Yusha (Soup prepared with rice, grains)  in case of Kapha disorder 
• Milk, in case of Pitta disorder and
• Meat juice / Meat soup in case of Vata disorder. 

वातघ्नौषधनिष्क्वाथत्रिवृतासैन्धवैर्युतः

बस्तिरेको अनिले स्निग्धः स्वाद्वम्लोष्णो रसान्वितः

In case of increased of Vata, 

• one enema consisting of decoction of drugs which mitigate Vata, 
• Trivrt, Saindhava Mixed with fats,
•  Liquids of sweet and sour taste, made warm and administered  will be ideal.

न्यग्रोधादिगणक्वाथपद्मकादिसितायुतौ
पित्ते स्वादुहिमौ साज्यक्षीरेक्षुरसमाक्षिकौ 

in case of increase of pitta

• one enema consisting of decoction of drugs of nyagrodhadi gana and padmakadi gana
• made sweet and cold
• and mixed with ghee, milk , sugarcane juice and honey will be ideal

आरग्वधादिनिष्क्वाथवत्सकादियुतास्त्रयः
रूक्षाः सक्षौद्रगोमूत्रास्तीक्ष्णोष्णकटुकाः कफे 

In case of increase of Kapha, 

• three  enemas consisting of decoction of drugs of Aragwadhadi gana and Vatsakadi gana 
• mixed with honey, cow urine, 
• possessing penetrating, hot and pungent properties is ideal. 

त्रयस्ते सन्निपाते अपि दोषान् घ्नन्ति यतः क्रमात्

In case of increase of all the Doshas together, 

• these three kinds of enema will bring down the Doshas for which another enema need to be given with drugs of all the above mentioned qualities. 

त्रिभ्यः परं बस्तिमतोनेच्छन्त्यन्ये चिकित्सकाः
न हि दोषश्चतुर्थो अस्ति पुनर्दीयेत यं प्रति

Other physicians do not desire any enema other than these three 

• because there is no fourth dosha for which another enema need to be given.

उत्क्लेशनं शुद्धिकरं दोषाणां शमनं क्रमात्
त्रिधैव कल्पयेद्बस्तिमित्यन्ये अपि प्रचक्षते

Yet others say that only three kinds of enema are to be prepared,

1. Utkleshana - that causing of the Doshas,
2. Shodhana - that causing purification, by expelling the Doshas and
3. Shamana – that causing mitigation  subsiding them inside the body. 

दोषौषधादिबलतः सर्वमेतत्प्रमाणयेत्

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


सम्यङ्ग्निरूढलिङ्गं तु नासंभाव्य निवर्तयेत्

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

 

Karma Basti – treatment with 30 enemas

प्राक्स्नेह एकः पञ्चान्ते द्वादशास्थापनानि च 
सान्वासनानि कर्मैवं बस्तयस्त्रिंशदीरिताः


A 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. 

• Here, each day, one enema is usually given. 
• Some expert doctors may give two enemas per day. 
• But one enema per day is the common standard

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

कालः पञ्चदशैको अत्र प्राक् स्नेहो अन्ते त्रयस्तथा 
षट् पञ्चबस्त्यन्तरिताः


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. 

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 - 

योगो अष्टौ बस्तयो अत्र तु
त्रयो निरूहाः स्नेहाश्च स्नेहावाद्यन्तयोरुभौ

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

स्नेहवस्तिं निरूहं वा नैकमेवादिशीतयेत्
उत्क्लेशाग्निवधौ स्नेहान्निरूहान्मरुतौ भयम्
तस्मान्निरूढः स्नेह्यः स्यान्निरूह्यश्चानुवासितः
स्नेहशोधनयुक्त्यैवं बस्तिकर्म त्रिदोषजित्

• Either fat enema or decoction enema alone should not be administered.

• More of fat enema may cause nausea and loss of digestion strength.

• More of decoction enema may cause fear of increase of Vata.

• Hence those 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 only when it is both lubricating and  purifying.

Matra Basti – Low dose fat enema –

ह्रस्वया स्नेहपानस्य मात्रया योजितः समः  
मात्राबस्तिः स्मृतः स्नेहः

• Fat enema consisting of fat quantity equivalent to the minimum quantity of fat used for Snehakarma is known as Matra Basti.

• In practice, a very low dose of medicated oil or ghee – 50 – 75 ml is administered as Matra Basti.

शीलनीयः सदा च सा
बालवृद्धाध्वभारस्त्रीव्यायामासक्तचिन्तकैः 
वातभग्नाबलाल्पाग्निनृपेश्वरसुखात्मभिः 
दोषघ्नो निष्परीहारो बल्यः स्रुष्टमलः सुखः

It should be used always for

1. Bala – children,
2. Vriddha – the aged,
3. Adhva, 
4. Bhara, 
5. Stri, 
6. Vyayama –
7.  who are habituated to long walking, 
8. carrying heavy weight, 
9. sexual activity and exercise
10. Chinta – who think too much,
11. who  are suffering from- diseases of vata, 
12. fractures, 
13. debility, 
14. poor digestive activity,
15.  for kings, 
16. wealthy persons 
17. and persons who live happily.

• It conquers the Doshas,
•  does not need strict regimen, 
• gives strength, 
• eliminates the wastes- faeces, urine etc. easily 
• and is comfortable. 

Uttarabasti- urethral and vaginal enema/ douche:-

बस्तौ रोगेषु नारीणां योनिगर्भाशयेषु च 
द्वित्रास्थापनशुद्धेभ्यो विदध्याद्बस्तिमुत्तरम्

In diseases of the urinary bladder and of vagina and uterus in women, 

• uttarabasti should be administered, 
• to those who have purified by two or three decoction enemas, per rectum. 

आतुराङ्गुलमानेन तन्नेत्रं द्वादशाङ्गुलम्

वृत्त गोपुच्छवन्मूलमध्ययोः कृतकर्णिकम्

सिद्धार्थकप्रवेशाग्रं श्लक्ष्णं हेमादिसम्भवम्

कुन्दाश्वमारसुमनः पुष्पवृन्तोपमं दृढम्

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

तस्य बस्तिर्मृदुलघुर्मात्रा शुक्तिर्विकल्प वा 

The enema liquid should be 

• mild in strength,
•  light- easily acting, 
• its quantity one Sukti- 24 g or lesser.

Uttarabasti Vidhi_ Procedure:-

अथ स्नाताशितस्यास्य स्नेहबस्तिविधानतः 
ऋजोः सुखोपविष्टस्य पीठे जानुसमे मृदौ
दृष्टे मेढ्रे स्थिते चर्ज्जौ शनैः स्रोतोविशुद्धये
सूक्ष्मां शलाकां प्रणयेत्तया शुद्धे अनुसेवनि
आमेहनान्तं नेत्रं च निष्कम्पं गुदवत्ततः 
पीडिते अन्तर्गते स्नेहे स्नेहबस्तिक्रमो हितः 

• Next the patient who has been given bath and food in accordance with the regimen prescribed for fat enema, 
• should be asked to sit erect on a soft seat or stool
• of the height of one’s knees, 
• his penis should be held straight- by the physician
• a thin probe should be slowly inserted  into the  urethra to clear the channel; 

• after thus 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 and 
• the enema bag pressed just as  described for rectal enema, 
• pushing the fat- oil, ghee etc. into the urinary bladder; this is the ideal method- for a urethral enema. 

बस्तिनमेन विधिना दद्यात्रींश्चतुरो अपि वा
अनुवासनवच्छेषं सर्वमेवास्य चिन्तयेत्

• In this manner three or four enemas should be given; 
• all other procedures- after care, food etc. are planned similar to that of fat enema therapy. 

स्त्रीणामार्तवकाले तु योनिर्गृह्यात्यपावृतेः
विदधीत तदा तस्मादनृतावपि चात्यये 
योनिविभ्रंशशूलेषु योनिव्यापचसृन्दरे


For women, -

• Vaginal/ Uterine enema- douche should be administered during the Menstrual period only for,-
•  it is only then that it- uterus is without its closure material; -
• in other words it is open and so can retain the enema material

• it can be  given even apart from the menstrual period, in emergency. 
• In diseases such as prolapsed and pain of the uterus or Vagina, in other diseases of uterus and vagina and in menorrhagia. 

नेत्रं दशाङ्गुलं मुद्गप्रवेशं चतुरङ्गुलम् 
अपत्यमार्गे योज्यं स्याद् ह्यङ्गुलं मूत्रवर्त्मनि 
मूत्रकृच्छ्रविकारेषु, बालानां त्वेकमङ्गुलम्

The nozzle- for this enema 

• should be ten Angulas in length, 
• permitting the entry of a grain of Mudga- green gram, 

• it should inspected to a length of four Angula in case of  vaginal passage 
• and to a length of two Angula in case of  urethral passage in diseases like Dysuria etc. 

• and in case of children it shall be one Angulas. 

प्रकुञ्चो मध्यमा मात्रा, बालानां शुक्तिरेवतु

• The medium quantity of enema is one prakunca  / Pala=48 g 
• and for children one Sukti- half Pala=24 g only 

उत्तानायाः शयनायाः सम्यक् सङ्कोच्य सक्थिनी 
उर्ध्वजान्वास्त्रिचतुरानहोरात्रेण योजयेत्
बस्तिंस्त्रिरात्रमेवं च स्नेहमात्रां विवर्द्धयन् 
त्रयहमेव च विश्रम्य प्रणिदध्यात्पुनस्त्रयहम्

The women, 

• who is lying on a cot 
• with her face upwards, 
• and legs folded at the knees and kept erect, 

• should be administered, the Vaginal/ Urethal enema, 
• three or four times in a day and night; 

• it should be continued for three days only increasing the quantity of fat enema liquid daily;

• After a gap three days it should be administered again for another three days. 

 Samanya Bastikala-  periods of administration of enema generally :-

पक्षाद्विरेको वमिते ततः पक्षात् निरुहणम् 
सद्यो निरुढश्च आन्वास्यः सत्परात्रात् विरेचितः 

• 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. 

Importance of Basti



यथा कुसुम्भादियुतात्तोयाद्रागं हरेत्पटः
तथा द्रवीकृताद्देहाद्बस्तिर्निर्हरते मलान्

• Just as the cloth absorbs the color from the water,mixed / boiled with Kusumbha etc,  [colouring materials], 
• similarly, the enema, absorbs the Doshas from the moistened body. 

Basti Chikitsa Sresthata- importance of enema therapy :-



शाखागताः कोष्ठगताश्च रोगा मर्मार्ध्वसर्वावयवाङ्गजाश्च
ये सन्ति तेषां न तु कश्चिदन्यो वायोः परं  जन्मनि हेतुरस्ति 
विट्श्लेष्मपित्तादिमलोचयानां विक्षेपसंहारकरः स यस्मात्
तस्यातिंवृद्धस्य शमाय नान्यद्वस्तेर्विना भेषजमस्ति किञ्चित्
तस्माश्चिकित्सार्द्ध इति प्रदिष्टः कृत्स्ना चिकित्सा अपि च बस्तिरेकैः 

• For all the diseases which are localized in  the  Shakha (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 faeces, Kapha, Pitta and other Malas – wastes;

• To balance the greatly increased Vata, there is no treatment more efficient other than enema therapy.

Hence it is described as half of the treatment (Ardha Chikitsa) – of all  diseases while some others  authorities say, that it is full treatment even.


तथा निजागन्तुविकारकारिरक्तौषधत्वेन शिरव्यधो अपि 

Similarly, Sira Vyadha – venesection treatment is considered to be effective in vitiated blood conditions. 

siravyadha is the treatment either half or full for the vitiated / increased blood which is the cause for internal and external diseases.