Charaka Siddhisthana Chapter 3 - Basti Sutriya Siddhi

This article explains the third chapter of siddhisthana of Charaka samhita called 'Bastisutriya Siddhi Adhyaya'. In this chapter, indications, contra-indications and adverse effects of Basti are explained.

Prologue
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athato bastisutriyam siddhim vyakhyasyamah||1||
iti ha smaha bhagavanatreyah||2||

We shall now explore the chapter - Basti Sutriya Siddhi. Thus said Lord Atreya [1-2]

Dialogue
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krtaksanam sailavarasya ramye sthitam dhanesayatanasya parsve|maharsisanghairvrtamagnivesah punarvasum pranjaliranvaprcchat||3||
bastirnarebhyah kimapeksya dattah syat siddhiman kimmayamasya netram| kidrkpramanakrti kingunam ca kebhyasca kimyonigunasca bastih||4||
niruhakalpah pranidhanamatra snehasya ka va sayane vidhih kah| ke bastayah kesu hita itidam srutvottaram praha vaco maharsih||5||

When Punarvasu, after completing his daily rituals, was leisurely sitting in the beautiful valley of the Himalayas, being surrounded by a group of saints, close to the abode of Kubera (the god of wealth), Agnivesha with folded hands enquired about the following topics:

Which factors should be kept in mind for the successful administration of basti therapy? [to be explained in the verse no.6]
Which material is used to prepare the nozzle (basti netra) for giving enema? [explained in verse no. 7]
What is the size, shape and quantities of basti putaka? [explained in the verse nos. 8-2/4 10]
What is the source material to be used in the preparation of the basti for different persons, and what are its attributes? [explained in verse nos. 10 2/4 -2/4 12]
What are the recipes of niruha Basti? [explained in the verse nos. 12 2/4 - 2/4 31]
What is the Dosage of Niruha basti? [explained in the verse nos. 31 2/4- 2/4 33]
What is the Dosage of Anuvasana Basti? [explained in the chapter no. IV]
In which position, the patient should lie down during the administration of Basti? [explained in the verse nos. 33 2/4- 2/4 34]
What are the recipes of Basti, and for which type of patients these are useful? [explained in the verse nos. 35 2/4- 70]
After hearing these queries, the Great Sage replied as follows. [3-5]
Read: Basti Chikitsa: Benefits, Routes, Types, Indications, Equipment

Table of Contents

Factors for successful administration of Niruha Basti

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samiksya dosausadhadesakalasatmyagnisattvadivayobalani|
bastih prayukto niyatam gunaya syat sarvakarmani ca siddhimanti||6||

To achieve success in the administration and to obtain the desired therapeutic effects, Basti is administered keeping in view the factors like nature of the Doshas, Medicines, desha (habitat), kala (season), satmya (homologation), Agni (power of digestion and metabolism), Sattva (psychic condition), age and strength of the patient etc. [6]

Material for Basti Netra

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suvarnarupyatraputamraritikamsyasthisastradrumavenudantaih nalairvisanairmanibhisca taistairnetrani karyani su(tri)karnikani ||7||
The enema-nozzle is made of gold, silver, tin, copper, brass, bronze, bone, iron, wood, bamboo-reed, ivory, pipe, horn or gems. It is fitted with well-polished rings (karnika, which are three in number). [7]

Size, Shape of Bastinetra

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saddvadasastangulasammitani sadvimsatidvadasavarsajanam| syurmudgakarkandhusatinavahicchidrani vartya'pihitani caiva||8||
yathavayo'ngusthakanisthikabhyam mulagrayoh syuh parinahavanti| rjuni gopucchasamakrtini slaksnani ca syurgudikamukhani||9||
syat karnikaika'gracaturthabhage mulasrite bastinibandhane dve|10|

For the patients of the six, twenty and twelve years, the length of the nozzle is six, twelve and eight Angulas (one angula or finger's breadth = 3/4 th of an inch), respectively.
The calibre of the hole inside the nozzle is such as to allow the passage of a seed of Mudga (green Gram), Karkandhu (small variety of Jujube) and satina (pea) respectively. This hole is crooked with a Varti (elongated plug).
The circumference of the nozzle at the base and top is the same as that of the thumb and little finger respectively of the patient of that age (i.e., six, twenty and twelve years old).
It is straight and tapering like the tail of a cow. The mouth (opening at the top) of the nozzle is smooth and circular.
One ring (Karnika) is fixed at the level of one fourth from the top, and two other rings are fixed at the base in order to facilitate tying the mouth of the bladder (basti) around the nozzle. [8 - 2/4 10]

Source of Basti Putaka and its Attributes

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jaradgavo mahisaharinau va syacchaukaro bastirajasya va'pi||10|| drdhastanurnastasiro vigandhah kasayaraktah sumrduh susuddhah|
nrnam vayo viksya yathanurupam netresu yojyastu subaddhasutrah||11||

Enema- receptacle :
The enema- receptacle is prepared on the bladder of old ox, buffalo, deer, pig or goat. It is firm, thin, and free from vessels and without any foul odour. It is tanned with astringent drugs by which it becomes red in odour. It is very soft and very clean. Keeping in view the age of the patient, the Basti putaka of appropriate capacity is selected, and it is tied securely to the nozzle of appropriate size with the help of strings. [10 2/4- 11]

In case of non-availability of bladder
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basteralabhe plavajo galo va syadankapadah sughanah pato va|12|

If bladder is not available then the sac in the throat of a pelican (Plava) or a sac prepared of either the skin of a bat or a thick cloth is used as enema- receptacle. [2/4 12]

Auspicious Time for Administration of Basti

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asthapanarham purusam vidhijnah samiksya punye'hani suklapakse||12||
prasastanaksatramuhurtayoge jirnannamekagramupakrameta |13|

The physician well-versed in the method of administering Basti (medicated enema) should give therapy to a suitable patient (for whom Basti therapy is indicated) after he has digested his meal, and has concentration of the mind. It is given on an auspicious day in the Sukla-Paksa (bright fortnight of lunar month) having a propitious Naksatra (constellation), Muhurta (period of the day) and Yoga (Planatory conjunction). [12 2/4 - 2/4 13]

Method of Administering Basti

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balam guducim triphalam sarasnam dve pancamule ca palonmitani||13||
astau phalanyardhatulam ca mamsacchagat pacedapsu caturthasesam|
putam yavaniphalabilvakusthavacasatahvaghanapippalinam||14||
kalkairgudaksaudraghrtaih satailairyutam sukhosnaistu picupramanaih|
gudat palam dviprasrtam tu matram snehasya yuktya madhu saindhavam ca||15||
praksipya bastau mathitam khajena subaddhamucchvasya ca nirvalikam|
angusthamadhyena mukham pidhaya netragrasamsthamapaniya vartim||16||
tailaktagatram krtamutravitkam natiksudhartam sayane manusyam|
same'thavesannatasirsake va natyucchrite svastaranopapanne||17||
savyena parsvena sukham sayanam krtvarjudeham svabhujopadhanam|
sankocya savyetaradasya sakthi vamam prasarya pranayettatastam||18||
snigdhe gude netracaturthabhagam snigdham sanairrjvana prsthavamsam|
akampanavepanalaghavadin panyorgunamscapi vidarsayamstam ||19||
prapidya caikagrahanena dattam netram sanaireva tato'pakarset|20|

One Pala each of Bala, Guduchi, Haritaki, Vibhitaka, Amalaki, Rasna, Bilva, Syonaka, Gambhari, Patala, Ganikarika, Salaparni, Prsniparni, Brhati, Kantakari and Goksura, eight fruits of madana and half Tula (200 Tolas) of Goat meat should be added with water, and boiled till one fourth of water remains.

Then the decoction is collected by filtration. To this decoction, one Picu (12 g) each of the paste of Yavani, Madana phala, Bilva, Kustha, Vaca, Satahva, Ghana and Pippali, one Pala of Jaggery, two Prastas each of ghee and oil, and appropriate quantities of honey and rock salt should be added. The recipe should then be stirred with a stirrer (Khaja), and kept inside the basti (enema receptacle) should then be tied to the base of the nozzle, the air inside the bladder is taken out, and the bladder is made free from wrinkles.

Thereafter, Varti (elongated plug) at the mouth (of the nozzle) is removed, and the opening (in the mouth) is covered with the middle part of the thumb.
The patient whose body is anointed with oil, who has passed urine and stool, and who is not very hungry is made to sleep over a well spread, and not very high bed which is uniform in level or which is slightly low in level at the head- side.
The patient should sleep comfortably on his left side. He should keep his body straight, and use his flooded left hand as a pillow. He should then flex his right leg, keeping the left leg straight (fully extended).
The anus of the patient is lubricated, and the lubricated nozzle is inserted into it up to one fourth part from the top slowly and straight following the position of the vertebral column.
The physician should not shake or tremble his hand, and quickly compress the bladder (enema - receptacle) so that the recipe goes inside at one stretch. Thereafter, he should remove the nozzle slowly. [13 2/4 - 2/4 20]
Read: Mode Of Action Of Basti Panchakarma Treatment

Improper Administration of Basti

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tiryak pranite tu na yati dhara gude vranah syaccalite tu netre||20||
dattah sanairnasayameti bastih kantham pradhavatyatipiditasca|
sitastvatistambhakaro vidaham murccham ca kuryadatimatramusnah||21||
snigdho'tijadyam pavanam tu ruksastanvalpamatralavanastvayogam|
karoti matrabhyadhiko'tiyogam ksamam tu sandrah sucirena caiti||22||
dahatisarau lavano'ti kuryattasmat suyuktam samameva dadyat|23|

If the nozzle is obliquely inserted, then the fluid will not flow into the rectum. If the nozzle is shifted from one place to the other, then this may cause anal ulcer. If the bladder is compressed slowly, then the enema-fluid may not reach the colon. If the bladder (Basti) is strongly compressed, then the fluid may rush very fast [in the alimentary tract] even up to the throat.

Therefore, Basti should be properly and uniformly administered. [20 2/4 - 2/4 23]

Order of adding ingredients of different categories

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purvam hi dadyanmadhu saindhavam tu sneham vinirmathyam tato'nu kalkam||23||
vimathya samyojya punardravaistam bastau nidadhyanmathitam khajena|24|

In the beginning, honey and rock-salt is added to the fat (ghee and oil) and stirred. Thereafter, the paste of drugs is added and stirred again. To this, the liquid (decoction) is added and stirred further with the help of a stirrer. This recipe should thereafter, be placed in the Basti (enema - receptacle). [23 2/4- 2/4 24]

Posture of Body during Basti

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vamasraye hi grahanigude ca tat parsvasamsthasya sukhopalabdhih||24||
liyanta evam valayasca tasmat savyam sayano'rhati bastidanam|25|

As the Grahani (organ of assimilation, i.e duodenum and upper part of the small intestine) and rectum are located in the left side of the body, administration of Basti (enema) while the patient is lying in his left side would bestow pleasant benefits. The patient laying in his left side keeps the sphincters (valayas) submerged [into the surrounding musculature]. Therefore, Basti is given when the patient is lying in his left side. [24 2/4 - 2/4 25]

Management of Complications

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vidvatavego yadi cardhadatte niskrsya mukte pranayedasesam ||25||
uttanadehasca krtopadhanah syadviryamapnoti tatha'sya deham |26|

While administering enema, if in the middle, the patient gets an urge to void feces or flatus, then the nozzle is taken out, and after the patient has voided stool or flatus, the remaining enema- fluid is injected. The patient should thereafter, be made to lie down on his back with a pillow below his head. By doing so, his body gets invigorated with the effect of enema. [25 2/4 - 2/4 26]

Effect of Three Bastis

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eko'pakarsatyanilam svamargat pittam dvitiyastu kapham trtiyah||26||

The first enema helps in the elimination of Vata, the second enema helps in the elimination of pitta, and the third enema helps in the elimination of Kapha from their own channels. [26 2/4]

Post therapeutic measures

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pratyagate kosnajalavasiktah salyannamadyattanuna rasena|
jirne tu sayam laghu calpamatram bhukto'nuvasyah paribrmhanartham||27||
niruhapadamsasamena tailenamlanilaghnausadhasadhitena|
dattva sphicau panitalena hanyat snehasya sighragamaraksanartham||28||
isacca padanguliyugmamancheduttanadehasya talau pramrjyat|
snehena parsnyangulipindikasca ye casya gatravayava rugartah||29||
tamscavamadgita sukham tatasca nidramupasita krtopadhanah|30|

After the enema-fluid has returned, the patient is sprinkled with tepid water, and thereafter, given the diet containing Sali rice along with thin meat soup.
In the evening, after the previous meal is digested, the patient is given light food in small quantities.
Thereafter, Anuvasana Basti (unctuous enema) is given to the patient for all round nourishment of his body.
For anuvasana basti, medicated oil cooked by adding sour and vayu-alleviating drugs should be used. This oil is one-fourth in quantity of the fluid used for
Niruha Basti. After the administration of oil, the buttocks of the patient are tapped (pressed) with the palms to prevent early return of reciepe (medicated oil) from the anus.
The patient should lie on the bed in supine position, and the toe joints of both of his legs are pulled gently. The soles of his feet are massaged with oil. His heels, toes, calf regions and such other parts which are painful should also be massaged with oil. Thereafter, the patient should sleep comfortably by keeping his head over a pillow (and he should not do any other work) [27- 2/4 30]

Proportion of Ingredients in Basti dravya

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bhagah kasayasya tu panca, pitte snehasya sasthah prakrtau sthite ca||30||
vate vivrddhe tu caturthabhago, matra niruhesu kaphe'stabhagah|31|

In the recipe of Niruha Basti (total quantity: twelve Prasrutas or 24 Palas) the decoction is five parts (five Prasritas or ten Palas). If this is intended to be given to a patient suffering from Paittika diseases or to a healthy person, then the quantity of Sneha (fat) is one sixth of the total quantity (i.e two Prasritas or four Palas). For Vaittika diseases, the quantity of Sneha (fat) is one-fourth of the total quantity (i.e., three Prasritas or six Palas). For Kaphaja diseases, the quantity of Sneha is 1/8 th of the total quantity (i.e 1 1/2 Prastas or three palas). [30 2/4- 2/4 31]

Dose of Niruha Basti for Different Age groups

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niruhamatra prasrtardhamadye varse tato'rdhaprasrtabhivrddhih||31||
advadasat syat prasrtabhivrddhirastadasad dvadasatah param syuh|
asaptatestadvihitam pramanamatah param sodasavadvidheyam||32||
niruhamatra prasrtapramana bale ca vrddhe ca mrdurvisesah|33|

For the one-year-old, the dose of niruha recipe is half Prasrta (one Pala). Thereafter, for each year of age, the dose is increased by half Prasrta up to twelve years. [For the patient of twelve years old, the dose of Niruha recipe should, therefore, be six Prasritas].
After twelve years of age, the dose of Niruha is increased by one Prasrta for each (of age) till eighteenth year of age. [For the patient of eighteen years old the dose of Niruha should therefore be twelve Prasthas, which is the maximum dose]. This dose of Niruha is prescribed up to the age of seventy. After seventy years of age, the dose of Niruha should be similar to that of a patient of sixteen years old [i.e ten Prasritas]
Thus, the dose of Niruha is described for patients of different age groups in terms of Prasrta.
For infants and old people, the ingredients of enema recipe are specifically mild in nature. [31 2/4- 2/4 33]
Read: Niruha Basti (Kashaya Basti) Panchakarma Method, Uses, Side Effects

Bed after Basti

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natyucchritam napyatinicapadam sapadapitham sayanam prasastam||33||
pradhanamrdvastaranopapannam praksirsakam suklapatottariyam|34|

After the administration of the therapy is over, the patient should lie down on a bed which is neither too high nor with too low pedestal. This bed should have a foot-rest, and is spread with an adequately big and soft mattress. The patient should lie with his head towards the east, and cover himself with white linen. [33 2/4- 2/4 34]

Diet after Basti

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bhojyam punarvyadhimaveksya tadvat prakalpayedyusapayorasadyaih||34||
sarvesu vidyadvidhimetamadyam vaksyami bastinata uttariyan|35|

The diet of the patient after the therapy is determined on the basis of the nature of his disease. It should consist of vegetable soup, milk, meat soup, etc. This is the primary and general principle to be followed in all the conditions. Hereafter, the recipes for the Niruha Basti will be described. [34 2/4- 2/4 35]
Read: Anuvasana Basti: Method, Benefits, Mode Of Action, Contra Indications

Recipe of Niruha (first Recipe)

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dvipancamulasya raso'mlayuktah sacchagamamsasya sapurvapesyah||35||
trisnehayuktah pravaro niruhah sarvanilavyadhiharah pradistah|

The recipe containing decoction of Dvi Panchamoola (Dashamoola) is added with sour juice, soup of goat-meat, the paste of drugs described earlier in the verse no. 13 (viz, Bala, Guduchi, Haritaki, Vibhitaka, Amalaki, Rasna, Bilva, Syonaka, Gambhari, Patala, Ganikarika, Salaparni, Prsniparni, Brhati, Kantakari and Goksura), and three types of fat (ghee, oil and muscle fat) is excellent for Niruha Basti to be given for curing all the diseases caused by aggravation of Vayu. [35 2/4 - 2/4 3]

Second Recipe of Niruha

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sthiradivargasya balapatolatrayantikairandayavairyutasya||36||
prastho rasacchagarasardhayuktah sadhyah punah prasthasamastu yavat|
priyangukrsnaghanakalkayuktah satailasarpirmadhusaindhavasca||37||
syaddipano mamsabalapradasca caksurbalam capi dadati bastih |

One Prastha of the decoction of drugs belonging to Sthiradi - group (sthira or Vidarigandha, Prsniparni, Brhati, Kantakari, Eranda, Kakoli, Chandana, Usira, Ela and Madhuka- vide Sutra 4: 170 Bala, Patola, Trayantika, Eranda (it is a repetition) and Yava, and half a Prastha of the liquid remains. To this, the paste of Priyangu, Krsna and Ghana, oil, ghee, honey and rocksalt is added, and used for enema. It stimulates the power of digestion, provides strength to the muscle tissue and even promotes the strength of the eyes. [36 2/4 - 2/4 38]

Third Recipe of Niruha Eranda-Basti

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erandamulam tripalam palasa hrasvani mulani ca yani panca||38||
rasnasvagandhatibalaguduci punarnavaragvadhadevadaru|
bhagah palamsa madanastayukta jaladvikamse kvathite'stasese||39||
pesyah satahva hapusa priyanguh sapippalikam madhukam bala ca|
rasanjanam vatsakabijamustam bhagaksamatram lavanamsayuktam||40||
samaksikastailayutah samutro bastirnrnam dipanalekhaniyah|
janghorupadatrikaprsthasulam kaphavrtim marutanigraham ca||41||
vinmutravatagrahanam sasulamadhmanatamasmarisarkare ca|
anahamarsograhanipradosanerandabastih samayet prayuktah||42||

Three Palas of the root of Eranda, one Pala each of the Pastes of Palasha (Sati), Salaparni, Prsniparni, Brhati, Kantakari, Goksura, Rasna, Asvagandha, Atibala, Guduchi, Punarnava, Aragvadha and Devadaru and the paste of eight seeds of Madana is added with two Kamsas (512 Tolas) of water and boiled till one-eighth of the liquid remains.
To this decoction, the paste of one Aksa or Tola each of Sarahva, Hapusa, Priyangu, Pippali, Madhuka, Bala, Rasanjana, seeds of Vatsaka and Musta along with appropriate quantity of rock-salt, honey, oil and cow's urine is added. Administration of this recipe as enema is dipaniya (stimulant of the power of digestion) and Lekhaniya (which scraps out the morbid matter from the body). Administration of the Eranda-Basti cures pain in the calf region, thighs, feet, lumbar region and back, Kaphavrti (occlusion of vayu by kapha), Maruta Nigraha (immobility of Vata), obstruction to the voiding of stool, urine and flatus associated with pain, Adhmanata (tymphanites), Asmari (stone in the urinary tract), Sarkara (Gravel in urine), Anaha (constipation), Arsas (piles) and Grahani Dosha (Sprue syndrome) . [38 2/4 - 42]

Fourth Recipe of Niruha

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??? ??????? ????????????????????????????????????????? ||??||
catuspale tailaghrtasya bhrstacchagacchatardho dadhidadimamlah|
rasah sapesyo balamamsavarnaretognidascandhyasirortisastah ||43||

Fifty Palas of the soup of goat-meat should be sizzled with four Palas of ghee and oil, made sour by adding Dadhi (yogurt) and Dadima, and added with the paste (of bala, etc. described earlier in verse no. 13)
Use of this recipe for enema promotes strength, muscles, complexion, semen and agni (power of digestion as well as metabolism), and cures blindness as well as headache. [43]

Fifth recipe of Niruha

????????????????? ??????? ??????? ???????????????????|
????????????????????????? ?????? ??????????????? ????||??||
???????? ??????????? ????? ???? ?????? ??????????|
???????????????????????? ?????????????????? ? ???????||??||
jaladvikamse'stapalam palasat paktva raso'rdhadhakamatrasesah|
kalkairvacamagadhikapalabhyam yuktah satahvadvipalena capi||44||
sasaindhavah ksaudrayutah satailo deyo niruho balavarnakari|
anahaparsvamayayonidosan gulmanudavartarujam ca hanyat||45||

Eight Palas of Palasha is added with two Kamsas (128 Palas) of water, and boiled till the liquid is reduced to half Adhaka (32 Palas). To this decoction, the paste of one Pala each of Vaca and magadhika, and two Palas of Satahva along with rock- salt, honey and oil are added. This recipe is used for Niruha.
It promotes strength and complex. It cures (Constipation), parsvamaya (pain in the sides of the chest), Yoni-Dosha (gynecic diseases), Gulma (phantom tumour) and Udavarta (upward movement of wind in the abdomen). [45]

Six Recipes of Niruha

?????????????????????? ?????? ??? ???????????????????|
?????? ??????????? ????????????????????????? ??????||??||
yastyahvayasyastapalena siddham payah satahvaphalapippalibhih|
yuktam sasarpirmadhu vataraktavaisvaryavisarpahito niruhah||46||

Milk boiled by adding eight palas of Yastimadhu is mixed with [the paste] of satahva, Phala (Madanaphala) and Pippali, ghee and honey. Administration of this recipe in the form of Niruha Basti cures Vatarakta (gout), vaisvarya (hoarseness of voice) and Visarpa (erysipelas). [46]

Seventh recipe of Niruha

??????????????????????????? ???? ?????????? ????????????|
??????? ??????????? ?????? ??????????? ????? ?????????||??||
yastyahvalodhrabhayacandanaisca srtam payo'gryam kamalotpalaisca|
sasarkaram ksaudrayutam susitam pittamayan hanti sajivaniyam||47||

The milk boiled with Yastimadhu, Lodhra, Abhaya (Usira), Chandana, Kamala and Utpala is added with sugar as well as honey, and cooled. To this, the [paste] of drugs belonging to Jivaniya- group (Jivika, Rsabhaka, Meda, Maha-meda, Kakoli, Ksirakakoli, Mudgaparni, Masaparni, Jivanti and Madhuka: vide Sutra 4:9) is added.
Niruha -basti administered with this recipe cures diseases caused by aggravated Pitta. [47]

Eighth recipe of Niruha

????????????????????????????????????????????????????????|
???????????????????????????????????????????????? ||??||
???? ???????????? ???? ??? ???? ????????????????????|
????????????????????????????????????????????????||??||
??????????????????? ????????????? ????????????|
?????????????????????????????????????? ?????????????||??||
?????????????????????????????? ???????? ??????? ???????|
?????????? ???????? ?????? ??????? ????????? ??????????????||??||
??????????????????????????????????????? ????????? ?|
???????????????????????? ?????????? ??????????????????||??||
dvikarsikascandanapadmakardhiyastyahvarasnavrsasarivasca|
salodhramanjisthamathapyanantabalasthiraditrnapancamulam ||48||
toye samutkvathya rasena tena srtam payo'rdhadhakamambuhinam|
jivantimedardhisatavaribhirviradvikakolikaserukabhih||49||
sitopalajivakapadmarenu prapaundarikaih kamalotpalaisca|
lodhratmaguptamadhukairvidarimunjatakaih kesaracandanaisca||50||
pistairghrtaksaudrayutairniruham sasaindhavam sitalameva dadyat|
pratyagate dhanvarasena salin ksirena va'dyat parisiktagatrah||51||
dahatisarapradarasrapittahrtpandurogan visamajvaram ca|
sagulmamutragrahakamaladin sarvamayan pittakrtannihanti||52||

Two Karsas (tolas) each of Chandana, Padmaka, Rddhi, Yastimadhu, Rasna, Vrsa, Sariva, Lodhra, Manjistha, Ananta (Utpala-Sariva), Bala, Vidarigandha, Prsniparni, Brhati, Kantakarika, Eranda, Kakoli, Chandana, Usira, Ela, Madhuka (vide Sutra 4:17), Sali, Kasa, Darbha and Iksu (vide Cikista 1:1:44) is boiled by adding water.
To this decoction, half Adhaka (72 Palas) of milk is added and boiled till the moisture / water content of the liquid gets evaporated, i.e only 72 Palas of milk remains. Thereafter, to this milk, the paste of Jivanti, Meda, Rddhi, Satavari, Vira, Kakoli, Ksirakakoli, Kaseruka, Sitopala (crystal sugar), Jivaka, anthers of lotus, Prapanudarika, Kamala, Utpala, Lodhra, Atmagupta, Madhuka, Vidari, Munjataka, Kesara and Chandana along with ghee, honey and small quantity of rock-salt is added. This recipe, when cold, is given as Niruha basti.
After the return of enema fluid, the patient's body is sprinkled with water, and he is given Sali type of rice either with meat of animals inhabiting arid zone (jangala-mamsa) or milk.
This type of enema cures Daha (burning sensation), Atisara (diarrhoea), Pradara (menorrhagia), Raktapitta (an ailment characterised by bleeding from different parts of the body), Hrdroga (heart- diseases), Pandu Roga (anemia), Visama-Jvara (irregular fever), Gulma (phantom tumour), Mutra-Graha (anuria), Kamala (jaundice) etc. and all the other diseases caused by aggravated Pitta. [48-52]

Ninth recipe of Niruha

????????????????????????????? ??????????????????????|
??? ???? ????????????????????????????????????????????||??||
?????????????? ?????????????? ????????????????????????????|
????????????????????????? ?????? ???? ???????? ?????????||??||
??????????????????????????? ????????????? ? ??????????????|
?????? ????? ????? ???? ????? ????????????? ? ????? ????????||??||
draksadikasmaryamadhukasevyaih sasarivacandanasitapakyaih|
payah srtam sravanimudgaparnitugatmaguptamadhuyastikalkaih||53||
godhumacurnaisca tatha'ksamatraih saksaudrasarpirmadhuyastitailaih|
pathyavidariksurasairgudena bastim yutam pittaharam vidadhyat||54||
hrnnabhiparsvottamadehadahe dahe'ntarasthe ca sakrcchramutre|
ksine ksate retasi capi naste paitte'tisare ca nrnam prasastah||55||

Milk boiled with Draksa (and such other sweet ingredients), Kashmarya, Madhuka, Sevya, Sariva, Chandana and Sitapaki (Sitali) is added with the paste of one Karsa (tola) each of Sravani, Mudgaparni, Tugaksiri, Atmagupta and Madhuyasti as well as with one Aksa of wheat-flour. To this, honey, ghee, Madhuyasti, oil, haritaki, vidari, sugarcane juice and jaggery is added and given as Basti (medicated enema). This alleviates aggravated Pitta. It is an excellent remedy for the patients suffering from burning sensation in the cardiac region, umbilicus, sides of the chest, head and the interior part of the body, Mutra-Krcchra (Dysuria), Ksina (consumption), Ksata (phthisis), loss of semen and Paittika type of Diarrhoea. [53- 55]
Read: Effective Basti Treatments for Vata disorders

Tenth recipe of Niruha

????????????????????????????????????????????????? |
??????? ????????? ?????? ? ???? ????? ???? ??????? ?? ?????||??||
???? ????????????? ??????????????????? ?????????? ????????|
???????????? ??????????? ???????? ?????? ? ?????????||??||
????????????? ???????? ???? ?????????? ????????????? ?|
kosatakaragvadhadevadarusarngestamurvakutajarkapathah |
paktva kulatthan brhatim ca toye rasasya tasya prasrta dasa syuh||56||
tan sarsapailamadanaih sakusthairaksapramanaih prasrtaisca yuktan|
phalahvatailasya samaksikasya ksarasya tailasya ca sarsapasya||57||
dadyanniruham kapharogine jno mandagnaye capyasanadvise ca|

Ten Prasritas (one Prasrta = two palas) of decoction is prepared by boiling kosataka, Aragvadha, devadaru, Sarngesta (Gunja), Murva, Kutaja, Arka, Patha, Kulattha and brhati with water. To this, the paste of one Aksa each of Sarsapa, Ela, Madana and Kustha, and one Prasta each of Madana-Phala, oil, honey, Ksara (Alkali preparation) and mustard oil, honey, Ksara (alkali preparation) and mustard oil is added. An expert physician should use this recipe as niruha basti for the patients suffering from diseases caused by aggravated kapha, Mandagni (suppression of the power of digestion) and asana Dvesa (aversion to food). [56- 2/4 58]
Read: Effective Basti Treatments For Pitta Disorders

Eleventh recipe of Niruha

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patolapathyamaradarubhirva sapippalikaih kvathitairjale'gnau||58||

Alternatively, water is boiled over fire by adding Patola, Pathya, Devadaru and Pippali. [With this decoction, enema is given according to the procedure described for the tenth recipe.] [58 2/4]

Twelfth recipe of Niruha

???????????? ???????? ???????? ????? ??????????? ?????|
?????????????????????? ???????? ????????? ?????||??||
??????????? ?????? ???????? ??????????????????????|
?????????? ??????????????? ???????????????????? ?????||??||
dvipancamule triphalam sabilvam phalani gomutrayutah kasayah|
kalingapathaphalamustakalkah sasaindhavah ksarayutah satailah||59||
niruhamukhyah kaphajan vikaran sapandurogalasakamadosan|
hanyattatha marutamutrasangam bastestatha"topamathapi ghoram||60||

To the decoction of Dvi Panchamula (Dashamoola), Triphala, Bilva (fruit) and Madana phala and Musta prepared by adding cow's urine, the paste of Kalinga, Patha, Madana phala is added. This recipe is mixed with rock-salt, Ksara (Yava-Ksara: and alkali preparation) and oil, and used for Niruha basti. It is excellent for curing diseases caused by aggravated kapha, Pandu-roga (anaemia), Alasaka (intestinal topor), ailments caused by Ama (product of improper digestion and metabolism), obstruction to the improper digestion and metabolism), obstruction to the voiding of flatus as well as urine, and serious types of bladder distension. [59-60]
Read: Effective Basti Treatments For Kapha Disorders

Thirteenth recipe of Niruha

????????????????????????????????????????????????????|
??????????????????????????????????????????????||??||
???????????????????????????? ?????? ??????????????????|
???????????????????????????????????????????????????||??||
????????????????????????? ?????? ????????????????????|
??? ?????? ????????????????????????????????????????||??||
???????????????????????? ????? ????????? ????? ?????|
?????? ???? ?????? ???????? ??????? ???????? ??? ?????||??||
rasnamrtairandavidangadarvisaptacchadosirasurahvanimbaih|
sampakabhunimbapatolapathatiktakhuparnidasamulamustaih||61||
trayantikasigruphalatrikaisca kvathah sapinditakatoyamutrah|
yastyahvakrsnaphalinisatahvarasanjanasvetavacavidangaih||62||
kalingapathambudasaindhavaisca kalkaih sasarpirmadhutailamisrah|
ayam niruhah krimikusthamehabradhnodarajirnakaphaturebhyah||63||
ruksausadhairapyapatarpitebhya etesu rogesvapi satsu dattah|
nihatya vatam jvalanam pradipya vijitya rogamsca balam karoti||64||

To the decoction of Rasna, Amrta, Eranda, Vidanga, Daruharidra, Saptacchada, Usira, Surahva, Nimba, Sampaka, Bhunimba, Patola, Patha, Tikta, Akhuparni, Dashamoola, Musta, Trayantika, Sigru, Haritaki, Vibhitaka, Amalaki, the decoction of Pinditaka (madana phala) and Mutra (cow's urine) is added. To this liquid, the paste of madhuyasti, krsna (pippali), Phalini, satahva, Rasanjana, Sveta vaca, Vidanga, Kalinga, Patha, Ambuda (musta) and rock-salt along with ghee, honey and oil is added.
Administration of this recipe for Niruha basti cures Krmi (intestinal parasites), Kustha (skin diseases), meha (obstinate urinary disorders including diabetes), bradhna (inguinal swelling), udara (obstinate abdominal diseases including ascites), Ajirna (indigestion) and diseases caused by Kapha. Administration of this Niruha Basti to the aforesaid patients, who are emaciated because of the use of un-unctuous medicines alleviates Vayu, stimulates Agni (power of digestion and metabolism), cures diseases and promotes strength. [61-64]

Recipe of niruha for combined Doshas

??????????????????????????????????????????? |
???????????? ? ?????????? ?????????? ?????? ????? ??????||??||
?????? ????? ??????????????????? ??? ???????????????|
???????????????????? ??? ??????????? ??????????????||??||
???????????????????????????????????????????????????? |
?????????????? ??????? ?????? ????????????? ???????????????||??||
?????????? ?????? ? ????????? ???? ?????? ?????????????????? |
????????????? ?????? ???????? ? ????????????????????||??||
punarnavairandavrsasmabhedavrscirabhutikabalapalasah |
dvipancamulam ca palamsikani ksunnani dhautani phalani castau||65||
bilvam yavan kolakulatthadhanyaphalani caiva prasrtonmitani|
payojaladvyadhakavacchrtam tat ksiravasesam sitavastraputam||66||
vacasatahvamaradarukusthayastyahvasiddharthakapippalinam |
kalkairyavanya madanaisca yuktam natyusnasitam gudasaindhavaktam||67||
ksaudrasya tailasya ca sarpisasca tathaiva yuktam prasrtaistribhisca |
dadyanniruham vidhina vivijnah sa sarvasamsargakrtamayaghnah||68||

One Pala each of Punarnava (red variety), eranda vrksa (Vasaka) Asmabheda (Pasana- Bheda), Vrscira (sveta or white variety of Punarnava), Bhutika, bala, Palasha, bilva, syonaka, gambhari, patala, Ganikarika, Salaparni, Prsniparni, Brhati, Kantakari and Goksura and eight fruits of madana-phala is cut into pieces and washed. To this, one Prashta (two Palas) each of Bilva, Yava, Kola, Kulattha, Dhanyaka and madana phala, and two adhakas each of milk and water is added and boiled till the milk i.e., two adhakas of the liquid remains. The milk should then be filtered out through a white cloth. To this milk, the paste of Vaca, satahva, Devadaru, Kustha, Yastimadhu, Siddharthaka, Pippali, yavani and Madana phala is added. When lukewarm, jaggery, rock-salt, one prasrta each of honey, oil and ghee is added to this recipe, and administered as Niruha basti appropriately by a physician well versed in this field. It cures all the diseases caused by samsarga (combination of aggravated Doshas). [65-68]

Number of Bastis for Different Doshas

??????????? ??? ???? ?????? ???? ?????????? ???? ? ??????|
????? ???????? ????????????????? ??? ?????? ? ??? ???????||??||
snigdhosna ekah pavane samamso dvau svadusitau payasa ca pitte|
trayah samutrah katukosnatiksnah kaphe niruha na param vidheyah||69||

Patients suffering from Vatika diseases are given one Niruha Basti which is unctuous and warm, and which contains meat-soup. For the patients suffering from Paittika diseases, two Niruha bastis which are sweet and cold, and which contain milk is given. Patients suffering from Kaphaja diseases are given three Niruha Bastis which contain cow's urine and which are pungent, hot as well as sharp.
Niruha Basti should not be given in excess of these specified numbers. [69]

Regimen after Niruha basti

???? ???? ?????????? ?????? ??????? ?????? ?? ??? ? ?????|
?????????????? ? ????????? ????????????? ???????? ?||??||
rasena vate pratibhojanam syat ksirena pitte tu kaphe ca yusaih|
tatha'nuvasyesu ca bilvatailam syajjivaniyam phalasadhitam ca||70||

After the administration of Niuha basti, the patient suffering from vatika diseases is given meat-soup; the patient suffering from Paittika diseases is given milk and the patient suffering from kaphaja diseases is given vegetable soup as a diet.
After the administration of niruha basti (evacuative type of medicated enema), those requiring Anuvasana basti (unctuous type of medicated enema) are given this enema containing Bilva Taila (if the diseases are caused by Vayu), Jivaniya taila (if the disease is caused by Pitta) or Madhu Phala Taila (if the disease is caused by Kapha). [70]

?????????? ?????? ???????????????????? ?????????????|
???????? ????????? ????????? ????? ???? ???? ? ????????||??||
itidamuktam nikhilam yathavadbastipradanasya vidhanamagryam|
yo'dhitya vidvaniha bastikarma karoti loke labhate sa siddhim||71||

Thus, the foremost methods of the administration of basti are fully described. The wise physician, who, after studying this, practises Basti (medicated enema) therapy, achieves success in this world. [71]

??????????????? ??????? ????????????????????????? ?????????????? ???????????? ??????????????????????? ?????????????||?||
ityagnivesakrte tantre carakapratisamskrte'prapte drdhabalasampurite siddhisthane bastisutriyasiddhirnama trtiyo'dhyayah||3||

Thus, ends the third chapter describing "thePrinciples of Basti" in the text composed by Agnivesha, redacted by Charaka, and because of its non- availability, Supplemented by Drdhabala.

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