Anuvaasana Basti

Prakaara Paribhaashaa:

• The medicated enema which can be administered daily and which does not harm the body if retained inside the body is termed as AnuvaasanaBasti.
• The medicated enema administered with medicine in the form of oil.
• The dose of AnuvaasanaBasti is half that of Sneha Basti.

Description:Kaala/Vaya/Ahoratra/Ritu/Bhukta

• During cold season Anuvaasana Basti should be administered during day time.
• During S`harada, Greeshma and Varshaa Ritu, Anuvaasana Basti should be administered during evening time.
• If Anuvaasana Bastiis to be administered after Nirooha Basti, then it should be administered on the same evening of administration of Nirooha Basti.
• If Anuvaasana Bastiis to be administered after Virechana it should be administered on 7^th day or 9^th day after Virechana.
• The course of Karma Basti, Kaala Basti and Yoga Basti should begin and end with Anuvaasana Basti.

Poorvakarma (Prerequisites):

Patient preparation:

• Abhyanga (Oil massage) Whole body massage particularly over S`hron`ee, Uru, Kat`ee, Sphik and Pakvaas`haya (lower back, thighs, buttocks and abdomen)
• Application of local fomentation by Taapa Sveda or Avagaaha Sveda or Parisheka Sveda over above mentioned regions.
• The patient should be given meal having items with following properties before administration of Basti
• The meal should not be too oily.
• The meal should not be too dry.
• The meal should be properly cooked.
• The food items should be according to the disease or Dosha Praadhaanya. I.e. Maamsarasafor Vaata Praadhaanya, Ksheera for Pitta Praadhaanya etc.
• The quantity of food should be half that of regular quantity.
• Chankraman`a (walking)should be advised to the patient after meal.
• Patient should be advised to pass urine and evacuate bowels before administering Basti. This helps in retention of oil in the colon for a longer period.

Pradhaanakarma:

• Basti Pran`idhaana The Bastiput`aka should be attached to the Bastinetra tightly.The Bastiput`aka should be filled with lukewarm prescribed medicine. The quantity of medicine should be such that there should be space to tie the Bastiput`aka easily.
• Yantran`aa (position of the patient) The patient is asked to lie down on his left side. He should keep his left hand below his head. His left leg should be stretched and right leg should be flexed at the knee and hip joint and should be in front of the abdomen, this relaxes the abdominal wall and the intestinal coils are in their natural position.
• The anal opening and Basti Netra Mukha are lubricated with ghee or oil.
• Now days rubber flatus tube is attached to Basti Netra and inserted, instead of directly inserting Basti Netra.
• The flatus tube or the Basti Netra is inserted slowly and steadily in the direction parallel to the vertebral column. If flatus tube is used then the Basti Netrais connected to the tube. In that case a little more oil than indicated is taken to counter the loss in the flatus tube and Basti Netra.
• Then the Bastiput`aka should be held in left hand below and right hand above.
• The patient is advised to inhale slowly and deeply.
• Then the physician should squeeze the Bastiput`aka evenly and administer the medicine inside the Pakvaas`haya (rectum) steadily with a moderate speed with a steady hand.
• The physician should not administer all the medicine. He should keep some amount inside the Bastiput`aka to prevent entry of Vaata inside the rectum.
• Then the physician should immediately remove the tube or Netra gently in one stroke.
• The patient is advised to lie in supine position for a period of 100 Maatraa. The hands and legs of the patient should be in a stretched out position.
• Then the patient is given a slightly head low position by rising the legs side of the bed 6 inches.
• Mild massage should be applied over sole of the patient.
• MriduAbhyanga (soft massage) and Mridu Taad`ana (beating) should be applied over buttocks of patient. (These methods help to retain the Basti for a longer time inside the body.)
• Exertion and speech should be avoided immediately after administration of Basti.
• There are three types of Anuvaasana Basti depending upon the dose

1. Sneha Basti The Basti should be administered in amount of ¼th of the dose of Nirooha Basti at that age.
2. Anuvaasana Basti –The Basti should be administered in amount of 1/2 of the dose of Sneha Basti at that age.
3. Maatraa Basti – The Basti should be administered in amount of 1/2 of the dose of Anuvaasana Basti at that age.

Pas`hchaatkarma:

• Basti Pratyaagama The Basti should come out within 3 Yaama (9 hours) up to Ahoraatra (12 hours). If the Basti comesout before 12 hours Anuvaasana Bastishould be administered again. If the Basti doesnt come out even after 24 hours and there are no signs of Basti Vyaapad then no medication should be administered. Sneha Basti or Phalavarti should be administered only if there are signs of Basti Vyaapad (complications).
• After Basti Pratyaagama meal should be consumed on the next day afternoon and evening. After this administration of another Anuvaasana Basti can be done in the evening.
• If Nirooha Basti is indicated it should be administered on the next day on empty stomach.
• If the Basti doesnt come out and signs of Basti Vyaapad are not present then the patient should be advised rest. Then next morning Dhaanya, Naagara Siddha Jala or only hot watershould be consumed which digests the remaining oil and does Kapha Chhedana and Vaataanulomana (eliminates Kapha Doshaand facilitates movement of Vaata Dosha along its channels).

Chikitsaa Karma (Benefits):

• Vayasthaapana (stabilizes age)
• Ayuvardhaka (lengthens the life span)
• Agnivardhaka (improves Agnifunction)
• Medhya (improves intellect and memory)
• Svarya (improves voice)
• Varn`ya (improves skin colour)
• Sarvavyaadhihara (indicated in almost all diseases)
• Vit`, S`hleshma, Pitta, Anila and Mootra S`hodhaka (cleanses faecal matter, Kapha, Pitta, Vaata Dosha and urine sequentially)
• S`hareera Daard`hyakara (enhances stability and firmness of body)
• S`hukra Vardhaka (increases the semen)
• Balya (improves physical strength and power)
• Doshachaya Nirasana (alleviates the accumulated Dosha)
• Vaata Niyamana (controls Vaata Dosha activity in the body)
• S`hamana (palliates by improving Agni)
• S`hodhana (cleanses the vitiated Dosha)
• Lekhana (depletes Maamsa Dhaatu and Meda Dhaatu, causesweight reduction)
• Vaajeekaran`a (improves sexual function)
• S`hareera Upachaya (helps gain weight and improves build)

Samyak Yoga (Signs of adequate administration of Basti):

• Kinchitkaalam Sthito Yas`hcha Sapureesho Nivartate (comes out with little amount of stool after staying in for sometime)
• Vaataanulomana (facilitates Vaata Dosha movement along its channels)
• Agni Deepana (improvement in digestive capacity)
• Snigdha Asamhata Varcha (oily, ill formed stool)
• Snehodvega (revulsion for unctuousness)
• Klama (fatigue without physical exertion)
• AngaMaardava (softness and suppleness of body)
• Snigdha Anga (unctuous skin and body)
• Laaghava (lightness of body)
• Vimalendriya (acuity of sense organs)

• The Basti comes out with stools and Vaata without any pain or difficulty.

Atiyoga (signs of excessive administration of Basti):

• Paan`d`utva (paleness, anaemic look)
• Gudadaaha (anal / rectal burning sensation)
• Aruchi (tastelessness)
• Chhardi (vomiting)
• Moorchchhaa(fainting)
• Trishn`aa (thirst)
• Pravaahikaa (straining for defecation / colitis)
• S`hushkodgaara (dry eructation)
• Bhrama (vertigo / giddiness)
• S`hvaasa (breathlessness)
• Kaasa (cough)
• Ghraan`a Sraava (nasal discharge)
• Vaktra Sraava (excessive salivation)
• Guda Sraava (discharge from rectum)

Heenayoga (Signs of inadequacy):

• Vaata Pratilomana (reversal of Vaata)
• Mandaagni (diminishes digestive capacity)
• Rooksha Anga (dryness of body skin)

Vyapad (complications):

• Vaataavrita Sneha (oil is prevented from coming back due to excess Vaata in the colon)
• Pittavrita Sneha (oil is prevented from coming back due to excess Pitta in the colon)
• Kaphaavrita Sneha (oil is prevented from coming back due to excess Kapha in the colon)
• Annaavrita Sneha (oil is prevented from coming back due to excess ingested foodin the colon)
• Pureeshaavrita Sneha (oil is prevented from coming back due to excess accumulated faecal materialin the colon)
• Abhukta Pran`eeta Sneha Vyaapad
• Basti Netra Vyaapad:

1. Ati Hrasva Netra (Short applicator)
2. Ati Deergha Netra (Very long applicator)
3. Tanu Netra (thin applicator)
4. Sthoola Netra (thick applicator)
5. Jeern`a Netra (old applicator)
6. S`hithila Bandhana (loosely tied knot between the applicator and thePut`aka)
7. Paars`hva Chhidra (applicator with a hole in the side)
8. Vakra Netra (bent crooked applicator)

• Basti Put`aka Vyaapad (complications due to enema pot):

1. VishamaBasti
2. Maamsala Basti
3. Chhinna Basti
4. Sthoola Basti
5. Jaalika Basti
6. Vaatala Basti
7. Snigdha Basti
8. Klinna Basti

• Bastipranetri Vyaapad (complications due to the administering physician or the attendant):

1. Savaata Basti (inadequately filled pot)
2. Druta Pran`eeta Basti (fast administration)
3. Tiryag Pran`idhaana (improper administration)
4. Ullupta Basti (administration with jerks and not uniformly)
5. Sakampa Basti (administration with shaky hands)
6. Atipran`ita Basti (excessive medication)
7. Atibaahya Datta basti (administration before the applicator is in the place)
8. Atimanda Datta Basti (very slow administration)
9. Ativega Datta Basti (very fast administration)

• S`hayana Vidhi Pramaadajanya Vyaapad (wrong positioning of the patient leads to following
• Klama (fatigue without physical work)
• Adhmaana (distension)
• Hikkaa (hiccough)
• Hritpraapti (medication causing discomfort in the chest)
• Urdhvapraapti
• Pravaahikaa (straining while defecation)
• S`hirorti (headache)
• Angaarti (body ache)
• Parikartikaa (cutting sensation in anus)
• Parisrava

Other Description:

• According to Sus`hruta eighteen Anuvaasana Basti should be administered along with Nirooha Basti in between.
• According to Charaka one or three Anuvaasana Basti for Kaphaja Vikaara, five or seven Anuvaasana Basti for Pittaja Vikaara and nine or eleven Anuvaasana Basti for Vaataja Vikaara should be administered.
• Anuvaasana Basti should never be administered on empty stomach.
• Now a days syringe and catheter is used for administering Anuvaasana Basti.
• If more than one Basti are to be administered then Anuvaasana and Nirooha Bastishould be administered alternately and never administration of only one type of Basti should be done.
• Followingpatients are indicated for daily administration of Anuvaasana Basti Patients consuming Rooha (dry) food items daily, patients having Deepta Agnipatients who are used to do physical exercises daily, patients suffering from Vaatavyaadhi, Udaavarta, patients suffering from Vankshan`agata andS`hron`igata Vaata.
• Snehapaana (consuming unctuous drugs orally) should be avoided during administration of Anuvaasana Basti.
• Aamtailashould never be used as Basti medication (Raw oil should never be used).
• If Sraavi Ars`ha is associated with Udaavarta then Anuvaasana Basti of Teekshn`a Dravya should be administered.