Basti: Medicated Enema Therapy
Vata’s predominant site is the colon. Ayurvedic basti involves the introduction into the rectum of herbal substances like oil and decoction etc in a liquid medium. Basti, is the most effective treatment of vata disorders, although many enemas over a prescribed period of time are usually required. This is one of the five pradhana karma of panchakarma.
Mode of action:
Vata is a very active principle in pathogenesis. If we can control vata through the use of basti, we have gone a long way in going to the root cause of the vast majority of diseases.
Vata is the main etiological factor in the manifestation of diseases. It is the motive force behind the elimination and retention of feces, urine, bile and other excreta. Vata is mainly located in the large intestine, but bone tissue (asthi dhatu) is also a site for vata. Hence the medication administered rectally effects asthi dhatu. The mucus membrane of the colon is related to the outer covering of the bones (peritoneum), which nourishes the bones. Therefore, any medication given rectally goes into the deeper tissues, like bones, and corrects vata disorders.
There are Eight main types of basti, according to traditional texts, each with their own indications and contra-indications as listed below.
1. Anuvasana (oil enema) is used in pure vata disorders and when a person is having excess hunger or dryness related to vata imbalances.
2. Niruha-Asthapana (decoction enema) is used, among other conditions, for evacuation of vata, nervous diseases, gastro-intestinal vata conditions, gout, certain fever conditions, unconsciousness, certain urinary conditions, appetite, pain, hyperacidity and heart diseases.
3. Uttara Basti (through the urethra with men or vagina with women) is used for selected semen and ovulation disorders and for some problems involving painful urination or bladder infections. This is not to be used for someone with diabetes.
4. Matra Basti (daily oil enema) is used by someone emaciated by overwork or too much exercise, too much heavy lifting, walking too long a distance, too much sexual activity or someone with chronic vata disorders. It does not need to be accompanied by any strict dietary restriction or daily routine and can be administered, in the appropriate cases, in all seasons. It gives strength, promotes weight and helps elimination of waste products.
5. Karma Basti (schedule of 30 bastis),
6. Kala Basti (schedule of 15 bastis; 10 oil + 5 decoction)
7. Yoga Basti (schedule of 8 bastis; 5 oil + 3 decoction).
In karma, kala and yoga bastis, it is better to give both types of basti in combination and not oil and decoction separately. The conditions under which these are recommended are too detailed to be able to list in this article. In general, the indications and contra-indications that apply to basti also apply here.
8. Bruhana Basti (nutritional enema) is used for providing deep nutrition in select conditions. Traditionally, highly nutritive substances have been used, such as warm milk, meat broth, bone marrow soup and herbs like shatavari or ashwagandha.
It relieves constipation, distension, chronic fever, cold, sexual disorders, kidney stones, heart pain, backache, sciatica and other pains in the joints. Many other vata disorders such as arthritis, rheumatism, gout, muscle spasms and headaches may also be treated with basti
General Indications for Basti:
2) low back ache
3) Inflammatory disorders like Gout, rheumatism
4) Neurological disorders like sciatica
5) Nervous disorders like vata headache
8) sexual weakness, infertility
9) Muscular atrophy
General Contra-Indications for Basti (include but are not limited to the following):
Enema therapy should not be used if the patient is suffering from diarrhoea, bleeding of the rectum, chronic indigestion, breathlessness, diabetes, fever, emaciation, severe anaemia, pulmonary tuberculosis, old age or for children below the age of seven years.
For oil enemas: diabetes, obesity, indigestion, low agni, enlarged liver or spleen, unconsciousness, tuberculosis and cough. for decoction enemas: debility, hiccough, haemorrhoids, inflammation of anus, piles, diarrhoea, pregnancy, ascites, obesity, diabetes and some conditions involving painful or difficult breathing. for nutritional enemas: diabetes, lymphatic obstruction, ascites. for urethra or vaginal enemas: diabetes