In Panchakarma – Basti is considered by physicians to be the half of entire therapeutics. Panchakarma is An Internal Bio-cleansing -Detoxification therapy. Literally means fivefold therapeutic action, is a collective expression for the cleansing of one’s physical constitution. The fivefold therapies comprise of Vaman, Virechan, Basti, Raktmokshana, Nasya.

Ayurveda states only two types of therapies i.e. Samshamana (dosha pacifying) and Samshodhana (cleansing). In Ayurveda, Basti procedure is prescribed as a route of drug administration. Basti is the best treatment for vata disorders.

Vata is responsible for all diseases as besides its own hazards it moves other vitiated dosha also. Basti has dual nature of action i.e. cleansing with dosha pacification. It acts mainly on vata hence basti can be considered as a single remedy for all the diseases; however, its formulation needs to vary as per disease and route through the rectal, urethral, or vaginal route.

Depending upon the combination of the herbs in Decoction-Oil-Ghee-Milk form is administered through the rectal route, can produce various results in the body.

In a nutshell, the basti therapy is stated as the best procedure, easily administered, well accepted by the patients, as well as very effective. Basti when administered properly with the proper selection of the medicine removes all the other morbid matter, doshas, and appropriately eliminates them with ease after oleating the body. Basti improves health & longevity. More than anything basti is said to maintain health and also enhances the life span of an individual. Hence this treatment is highly recommended.

Basti is described as the best line of treatment to cure the imbalances of the vata dosha. Simultaneously it is also true that this procedure is equally effective in rectifying the abnormal accumulation of the pitta as well as Kapha dosha. As the vata dosha has a predominant role in the pathogenesis of any disease; and this vata dosha alone is capable of mobilizing pathological accumulation of the dosha from the periphery into the abdomen, from where it is eliminated outside of the body. Thus the basti treatment gains much importance in the practice of Ayurveda.

The procedure followed Practically for medicated Basti is as follows:-

The patient is subjected to Abhyanga before the Swedana procedure. Whole-body abhyanga or application of oil followed by massaging stomach, abdomen, groin, and buttocks. Swedana (steam fomentation) is ideal either in the form of Bashpa swedana or any other form of swedana may be performed at oil applied region. Immediately following abhyanga and swedana procedures basti is administered.

The patient is made to lie down on the table in the left lateral position, with his left leg placed straight and the right leg is flexed at the hip and knee and is drawn up to the chest. The body is draped and the buttock and the anal region are exposed. This is the ideal position for the administration of the basti, with help of basti yantra basti is administered

Medicated Basti is given when the food taken on an earlier day is digested and the patient is not too hungry. Unctuous type of Basti is given after meal. After unctuous Basti his buttocks have clapped, palms and soles are massaged, patient’s bed is lifted thrice from his feet so that the Basti can retain for a longer duration.

Dos and don’ts in Basti Panchakarma:-

• Specific diet and behavioral restrictions should be followed after the basti karma. For all purposes, the Patient is asked to use boiled and warm water. A light diet in the form of milk, yusha (gram soup), mamsa rasa (meat soup) is advisable.
• Further, the Patient is advised to avoid the following activities
• During the basti procedure body should be protected from any type of exertion as it may adversely affect the mechanism involved in trans-membrane movement of matter or inhibit the receptor stimulation activity.
• Intake of untimely and unwholesome food leads to indigestion that may alter the digestion of Sneha during oleation or even can suppress digestive power so that therapy like basti may not affect with proper potency and problems like fever or cold due to ama (i.e. indigested food) may arise hampering the treatments.
• Daytime sleep in itself causes pitta-Kapha vitiation; anger, sun exposure, etc. causes pitta vitiation. As in shodhana, utklesha i.e. exciting the dosha is always the first step in cleansing, hence excess dosha vitiation along with already excited dosha may cause diseases symptoms aggravation.
• The things that need to be avoided during Panchakarma include excessive sitting, standing, speaking and riding, sexual intercourse, suppression of natural urges, cooling regimens, exposure to sun, grief, anger, and intake of untimely and unwholesome food.
• However, after following all measures correct treatment is given but in low or excess doses, in inappropriate time, or in the wrong manner then it fails to cure diseases.

 

Mode of action of Basti:-
Medicated Basti, when given properly, passes through the rectum and reaches the colon, where the maximum possible limit is up to the cecum since the ileocecal valve prevents further movement. Proper evacuation of Basti is also an important phenomenon as Basti retaining for a longer duration may cause abdominal discomfort, loss of osmotic balance, etc. and early removal of Basti may not produce desired clinical effect.

Vata is responsible for the separation and combination of stool, urine, pitta, etc. including other excreta and tissue elements. When it gets highly aggravated there is no remedy other than basti for its alleviation. Therefore, basti is considered by physicians to be the half of entire therapeutics. Some physicians even consider it as a whole of the therapeutics.

Selection of type of Basti:-
Niruha (evacuative Basti with decoction) is generally given for purification purposes in case of diseases with obstructive vata pathology. The administration of basti predominantly consisting of herbal decoction is known as Niruha basti. The composition of the medicine administered in the form of basti includes herbal decoction, medicated oil, honey, rock salt, and herbal powder. Among these different ingredients, the concentration of the herbal decoction is relatively more in comparison to other ingredients.

Anuvasana (unctuous Basti) is generally given for nourishment purposes in case of diseases with degenerative vata pathology.

Disease-specific medicine is to be given through the Basti because when medicated Basti is given it brings about multiple actions at a time that includes evacuation which is a local action, affects certain receptors which need a specific molecule that acts as a stimulant over gut receptors for secretion of particular chemical messenger for disease attenuation besides cleansing. Dosha pacification is also evident due to the action of absorbed active principles from drug-specific to the disease.

Types of Basti Course Duration:-
According to Adhishthana-bheda:-

Pakvashay gata Basti, Garbhashaya- gata Basti, Mutrashaya- gata Basti, Vrana- gata Basti

According to Dravya-bheda:-

Asthapana Basti, Anuvasana Basti, Matra Basti

According to Karma-bheda:-

Depending upon the therapeutic utility, basti is classified as shodhana basti, lekhana basti, snehana basti, brimhana basti, utkleshana basti, doshahara basti, shamana basti, karshana basti, Rasayana basti, and vajikarana basti.

According to Sankhya-bheda:-

In spite of all the above types of basti, depending upon the number of basti administered in the form of a course; it is further categorized into three types. Advised as an ideal treatment schedule in the form of yoga, Kala, and karma basti as per disease severity.

Karma Basti-
The course of karma basti includes 30 administrations of the basti treatment. And this course is the combination of both Niruha as well as Anuvasana basti

Kala Basti-
Kala basti refers to 16 days course of the combination of niruha basti as well as Anuvasana basti.

Yoga Basti-
Administering the combination of niruha and anuvasana basti regularly for 8 days is known by the name Yoga basti.

Beneficial Effects of Basti:-
Aging is a process that causes aggravation of vata due to loss of the body’s vital elements gradually and aggravated vata also fastens the aging. Thus being the best treatment for vata, basti proves to be an anti-aging therapy. Moreover, it has a cleansing spectrum in the lower part of the gut. This portion is surrounded by vital organs like the liver, spleen, pancreas, kidneys. Thus, the effect of cleansing is more marked for these organs, along with giving them strength. The liver and kidney play an important role in detoxification thus maintaining body homeostasis that is helpful to avoid aging.

Basti is considered as a harmless treatment mainly because in this treatment unlike that of purgation the fluid is supplied from outside for the cleansing process and the amount of evacuation is also very less as compared to purgation. It acts in the colon and rectum which has a dominant function of excretion rather than absorption of nutrients. Thus, Basti hardly alters the process of digestion; on the contrary, it supports the body’s natural process of excretion.

Vata is responsible for the movement of pitta and Kapha. Hence it plays the main role in the production of all diseases. Thus, being a remedy for vata, basti is said to cure all diseases.

Evacuating type of Basti cleanses the gut thus facilitating the absorption of fats. Oil is considered to be the best for vata on virtue of its properties. The example given by Acharya is as a tree gets destroyed by cutting its roots, similarly the diseases are eradicated by the administration of niruha basti.

Basti directly oleates the colon and after absorption affects the whole body by properties like unctuousness, heaviness, and warmth. As the site of production of vata is treated, no new vata formation occurs in the body

Even proper function of Agni (digestive strength) is dependent upon normal activity of vata as it has a vital function of igniting the digestive fire. Other functions like mental harmony, strength, vitality, complexion, etc. are taken care of by unctuous Basti as pacification of vata affects positively on the mind, improves the production of new body elements, and gives health to the skin as it is also a site of residence for vata.

Basti promotes complexion and strength in persons of whom all the channels of the body are cleansed by niruha Basti. There is no therapy better than the administration of oil (unctuous Basti) which is specifically useful for the patients afflicted with diseases caused by vata.

The colonic and rectal absorption of fats given through unctuous Basti and also specifies the superiority of the rectal route over the oral consumption of fats. This may be because of the fact that vata is nothing but an increase in some properties like dryness, lightness, cold, movement, etc. in the body and these properties are introduced in the human gut in the last part of digestion that occurs in the colon.

The oil by its unctuousness, heaviness, and warm properties counteracts the dryness, lightness, and coldness properties of vata respectively.

Administration of oil instantaneously improves complexion and digestive strength. Just as a tree irrigated with water at the root changes old blue leaves into beautiful with tender leaves and during the course of time grow to produce flowers and fruits, similarly a person changes by the administration of unctuous type of medicated Basti.

In patients suffering from neurological disorders (vata-vyadhi), the efficacy of Sneha basti is clinically proved beyond doubt.

Body strength and all Kapha dominant body elements like semen are inversely related with vata. Thus, if vitiated vata is evacuated, the strength, sturdiness are enhanced bringing a new essence to body elements.

Basti is indicated in a plethora of diseases pertaining to different systems, as this basti is capable of eliminating all three doshas. Basti route of drug administration and hence may be prescribed in any illness by changing the contents of the basti drug.