Urovasti Treatment Benefits, Procedure, Precautions, Limitations

Article by Dr Raghuram Y.S. MD (Ay)
Urovasti is a specialized treatment which is done for effectively combating the respiratory and circulatory diseases, especially Vataja Kasa (dry, painful and hacking cough), Shwasa (dyspnoea, breathing trouble), Hridroga (heart diseases) Hriddrava (palpitations) etc diseases. It is a local oil pooling treatment done over the chest. In this an elevated cabin is constructed over the chest region using wet dough of flour of black gram, herbal oils are filled in the cabin and left in place for a fixed amount of time.

Uro Vasti is an extension over similar local oil pooling treatments like
Kati Vasti (oil pooling treatment done for combating low back pain),
Greeva Vasti (oil pooling treatment done for combating neck pain),
Janu Vasti (oil pooling treatment done for combating knee pain), Shiro Vasti (oil pooling done over the head) etc.

The method of conducting the treatment also resembles the above said types of local oil pooling treatments.
Now let me take the privilege of introducing this treatment to you

What is Urovasti?

What is Urovasti (Uro Basti)?
The term has 2 terms –
Uro – means chest or thoracic cage
Vasti – means to hold (compartment which holds)

Thus Uro Vasti means a treatment in which medicated oils are poured and pooled for a fixed duration of time in a compartment or a cabin constructed over the chest area using wet flour of black gram, covering the areas of heart and lungs.

In simple words, Uro Basti is oil-pooling treatment conducted for treating chest conditions mainly heart and lung disorders.

Vasti or Basti is a term used to describe the urinary bladder in Ayurveda. Urinary bladder is a bag which holds urine for a certain amount of period till it is voided.

Similarly in Urobasti a compartment is constructed over the chest area by using flour of black gram and the medicated (herbal) oils are pooled in this compartment for a fixed duration of time. Therefore the procedure is called Uro Vasti.

Benefits, indications

Benefits and Indications of Urovasti –
Uro Vasti is highly beneficial in the below said conditions –

Vatika Kasa or Vataja Kasa – Dry, hacking, painful cough (little or no phlegm is produced, associated with chest and throat pain, produces heavy sounds), Whooping cough, Bronchitis, smokers cough, allergic cough, seasonal cough especially that which occurs or worsens in monsoon, cough exacerbated by consumption of excessive cold and dry foods etc can be considered in this type of kasa.

Uro Vasti is preferred in conditions which have become chronic and stubborn and are not responding to any medication, in people with low respiratory immunity and people who have recurrent cough.

Shwasa or Shwasa krichchrata – Uro Vasti is preferred in conditions wherein patient is suffering from difficulty in breathing, dyspnoea especially having its origin in lungs or heart. The causes for shwasa should be found out before administering the treatment.

Conditions like dyspnoea due to chronic systemic illness other than lung and heart pathology, anaemia, malnutrition, etc should be ruled out.

Sudden shortness of breath – When you find sudden shortness of breath, you may be having:
Problem with your lungs or airways like an asthma attack, pneumonia (lung inflammation) or worsening of chronic obstructive pulmonary disease (COPD)

Heart conditions like a ‘silent’ heart attack, heart fibrillation, atrial fibrillation (an irregular and fast heart rate) or supra-ventricular tachycardia (regular and fast heart rate)

Panic attack or anxiety – can also cause acute shortness of breath

Other unusual causes:
Severe allergic reaction (anaphylaxis)
Pneumothorax (partial collapse of your lungs caused by a tear in lung surface which allows air to be trapped in the space around your lungs)
Pulmonary embolism – blockage in one of the blood vessels in the lung
Idiopathic pulmonary fibrosis – scarring of lungs
Pleural effusion – collection of fluids next to the lungs or in the cavities around the lungs
Diabetic ketoacidosis – complication of diabetes, acid levels become high in the blood and urine
Long term breathlessness – The below said are some of the conditions which cause long term breathlessness of a chronic nature –
Obesity
Poorly controlled or uncontrolled asthma
COPD (permanent damage to the lungs usually caused by years of smoking)
Anaemia – low oxygen in the blood caused by lack of red blood cells or haemoglobin
Heart failure – heart having trouble in pumping enough blood throughout the body etc

Unusual causes –
Bronchiectasis – abnormal widening of airways, cough with phlegm
Pulmonary embolism – recurrent blockage in blood vessel in the lungs
Partial collapse of your lung
Pleural effusion
Narrowing of main heart valves
Frequent panic attacks etc

All these conditions should be differentially diagnosed by an expert physician before the treatment is undertaken. Many cases of shortness of breath might be of medical emergency, especially the acute causes.

Some cases might not fall into the category of uro vasti, example, breathlessness caused by anaemia (haemoglobin level has to be increased to improve breathlessness), obesity (weight reduction should be done to improve shortness of breath) etc.

Uro Vasti is done in most chronic and stubborn conditions of shortness of breath, but the physician should take a call if Uro Vasti is the best option in a given case or if a better option exists. Generally uro vasti is preferred in conditions in which the conditions cannot be managed with oral medications.

Hrid-Roga – Heart diseases especially those caused due to Vata can be effectively dealt with Uro-Vasti. Chest pain, shortness of breath, palpitations (feeling of one’s heart beats) etc are the symptoms.
Hrudroga associated with Ayama – cardiomegaly (enlargement of heart)
Hrut shula – Pain of cardiac origin, chest pain (may be a symptom of Hridroga or shwasa also)

Arochaka – anorexia, tastelessness of chronic nature
Bhaktarodha – aversion towards food
Chardi – Vomiting
Jihwa stambha – stiffness of tongue

Reference

The reference of Uro Vasti or Uro Basti has been found quoted and explained in the context (chapter) of Bhaktarodha (aversion towards food) in Yogamrita text and also in Chikitsamanjari

Procedure

How is Urovasti done?
Uro vasti is done in the below said method –

Purvakarma

Purvakarma (Pre-treatment procedures): This includes –
Preparation of the patient:
The patient is thoroughly examined. The Prakriti (basic constitution) and Vikriti (details of morbidity) are documented in detail. The disease is also examined. The treatment line-up, materials and medicines which need to be used are enlisted.

Preparation for the treatment:
Materials needed for the treatment are collected beforehand. They are:
For Uro Vasti (oil pooling) – Taila (medicated oil), Ghee (medicated ghee) or both suitable to the disease and diseased are collected and stored beforehand.

The below mentioned medicines may be procured beforehand: 
Tila taila (sesame oil), Bala taila oil or Rasna jivaka oil – can be used for Hridroga (heart disease) associated with dyaama (expansion i.e. enlargement of heart) and hriddrava (palpitation)
Amrita-baladi ghee – intense cardiac pain
Baladi taila is the oil prepared or processed using decoction of bala (Sida cordifolia), shatavari svarasa (juice of Asparagus racemosus), milk, Masha yusha rasa (filtrate of soup prepared using black gram) added with pastes of Rasna, Devadaru(Cedrus deodara), Bala (Sida cordifolia) and Ashwagandha (Withania somnifera) is used for Urovasti in Shwasa (dyspnoea, shortness of breath, breathlessness)
Milk – for uro vasti in chardi (vomiting) along with kshiradhara (stream pouring of medicated milk over the head and body) and stanya nasya (nasal instillation of breast milk)
Kshirabala taila – for urovasti in arochaka (anorexia), should be done after shodhana (cleansing treatments)
Dhanvantara taila or Bala taila or Kshirabala taila or butter – for uro vasti in bhaktarodha (difficulty in eating or swallowing, or lack of interest in food)
The above mentioned medicines should be collected before treatment (as and when required)

Other materials required for Uro Vasti –
Flour of black gram
Water
Stove, bowls, vessels, spoons etc
Sterile cloth, tissue papers

Pradhana karma

Pradhana Karma (Treatment proper):
Uro Vasti –
Positioning of the patient:
Uro vasti can be done at any time of the day. But to be specific, when kapha symptoms like stiffness, heaviness etc manifest, uro vasti shall be done in the morning time (early morning), if pitta symptoms or pitta related chest conditions (pitta janya hrid roga or pitta disorders of heart, mainly inflammatory in origin and pitta type of kasa or cough), uro vasti should be done at noon and when vata predominant symptoms or vata disorders of heart, lungs and chest, dry cough etc conditions occur, uro vasti can be administered in the evening. In emergency conditions, uro vasti can be done at any time.

The patient is asked to come or attend the treatment on empty stomach because while doing Uro Vasti, the patient should not be suffering from chest pressure occurring due to pressure of the food in the stomach.
The patient is positioned and made to lie on his back i.e. in prone position on a comfortable couch

Preparing the wet flour for the treatment:
Finely pounded black gram flour is taken in a sterile bowl or vessel. Water is added to it (preferably warm water) and kneaded well so as to prepare a bolus.

Preparation and construction of Uro Vasti ring / compartment:
From this bolus a ring is made, 3 angulas in height (wall of 2 ¼ inches height). The ring should be having a diameter so as to accommodate and enclose the region of heart.

If the uro vasti is being done for conditions involving lung and heart pathology and also in conditions like indigestion, vomiting, anorexia etc, the cabin should be covering the entire chest region enclosing the lungs and heart within the circumference of the flour container.

The junction of the ring and skin is sealed with wet flour. A small amount of oil is now poured in the ring (compartment) of flour and checked for leakage. Uro Vasti should be started after confirming that there is no leakage at the base of the walls of the ring.

Method of oil pooling:
The chosen medicated oil is heated passively. Required quantity of oil (sufficient enough to fill the space within the ring of wet flour) is taken in a small bowl.

The bowl is kept in the vessel filled with hot water. When the oil gets warm, the bowl is removed. Oil is poured into the compartment (space within the constructed ring of wet flour).

The oil or ghee or any liquid medicine (milk, butter etc) used for uro vasti should be warm in Vata and Kapha disorders. It may be mildly warm or cold in case of pitta disorders.

Recycling the oil:
Care should be taken to maintain the temperature of the oil in the Uro Vasti pool. The temperature should be kept uniform throughout the procedure (until the procedure is completed).

For this to happen, the oil from the pool is removed at regular intervals (leaving some oil in it i.e. oil should not be completely removed) and replaced by warm oil (on the other side, simultaneously oil is passively heated).

Paschat karma

Paschat Karma (Post-treatment procedures):
Removal of oil, ghee or other medicines used for uro vasti and flour cabinet:
At the end of fixed duration meant for completing a schedule (40-60 minutes roughly) the liquid medicines are slowly removed from the pool and stored in a container or bottle.

On the next day, the same oil or ghee shall be reused after adding some more oil to replace the quantity consumed for treatment procedures on the previous day. The whole oil or ghee shall be replaced on the 4th day of the treatment.

Actually it is good to take new oil or ghee every day but practically it becomes unaffordable from the patients perspective. The flour cabinet (uro vasti ring) is also removed thoroughly. Milk, butter etc should be taken fresh every day. It is also good to prepare new flour dough ring every day.

With the help of the sterile cloth or tissue papers, the remnants of the treatment should be thoroughly wiped and cleaned. The patient is advised to rest for a while.

Snana – Bath: 
The person is allowed to rest for about 3 muhurtas (2 ½ hours approximately). Later the person is advised to take warm water shower. He should be using green gram powder to rub his body.

Siddhartha Snana churna (bathing powder) or any herbal powder can also be used alternatively. If the patient is being treated as outpatient, the patient is advised to take a bath at home after an hour or couple of hours.

Matra Vasti –
Vasti (Basti) – medicated Enema’s are the best to control morbid Vayu and hence the painful conditions caused by it, including low back pain.

Matra Vasti is a subtype of Vasti procedure wherein a small quantity of enema using medicated oil or ghee or a combination of both is given daily. Usually 50-75 ml is given after food.

It can be planned as a part of post-treatment procedures as far as Vata type of heart and lung disorders are concerned wherein pain, wasting of tissues, weakness, fatigue, dryness (like dry cough etc) are predominant complaints.

Nitya Virechana – Daily metered dose of purgation with purgative decoctions or oils like Gandharvahastadi Kashayam, Gandharvahastadi Eranda tailam, Nimbamritadi Eranda Tailam etc can be administered if a small amount of detoxification is essential on a daily basis or if morbid Vata and Pitta need to be tackled (optional and strictly based on the decision of the doctor).

This can be thought of when Virechana is needed during uro vasti. Nitya Virechana can also be a part of follow up. Nitya Virechana should never be administered when Matra Vasti is planned in the protocol of treatment.

Nitya Virechana and Matra Vasti – They also cleanse the bowel and bladder, thus minimizing the pressure of bowel and bladder on the thoracic (chest) organs.

Generally it is a principle to inculcate cleansing measures like virechana etc during the external treatments like uro vasti etc. Though they are external therapies, they will have a systemic impact.

During external treatments, there will be release of toxins and these toxins need to be flushed out by administration of virechana. Matra vasti is more supportive and helps in keeping vata and pitta under good control

External treatments like Shiro dhara (stream pouring of medicinal fluids over the head) Shiro Vasti (medicated oil pooling over the head), Sarvanga dhara (stream pouring of medicinal liquids like oil, ghee, milk etc over the body) etc forms effective combinations with uro vasti.

The mentioned treatments effectively control prana vayu and its control over other vayus including vyana vayu which helps in circulation.

Ahara – Light diet in the form of Peya (thin gruels) mixed with ghee (ghrita) and alkali (kshara) should be administered to the patients undergoing uro vasti treatment

Discharge – The patient is discharged on daily basis (out-patient) or after the course has been completed (in-patient) after giving proper lifestyle and diet advices along with suitable medicines (oral).

The patient is also advised to undergo the treatment twice or thrice in a year as a part of maintenance and to avoid recurrence. Chronic diseases if any should be attended by prompt intake of medication.

Duration

Duration of the course –
The number of days of treatment varies from 7-14 days depending on the nature and intensity of the disease
Treatment (only Uro Vasti) is done for a period of 40-60 minutes per session (Treatment duration will extend beyond this if it is combined with other treatments mentioned above)

Parallel Ayurvedic medicines

Oral medications for follow up (for diseases treated with Uro Vasti) –
For Kasa, Shwasa, Hridroga –
Elakanadi Kashayam
Nayopayam Kashayam
Brihat Nayopayam Kashayam
Drakshadi Kashayam
Dashamula Kashayam
Maharasnadi Kashayam
Gandharvahastadi Kashayam
Arjunarishtam / Parthadyarishtam
Dashamoolarishtam
Draksharishtam / Drakshasavam
Ayaskrity
Kanakasavam
Vasarishtam
Sitopaladi churna
Talisadi churna
Yashtimadhu churna
Shwasanandam gulika
Prabhakara vati
Hridayarnava ras
Dhanwantaram gulika
Vayu gulika
Shwasa-kasa chintamani ras
Shwasa kutara ras
Laghu sutasekara ras
Agastya Haritaki Rasayanam
Chyavanaprash
Chitraka Haritaki Rasayana
Talisapatradi leham
Drakshadi Leham
Dashamula Rasayanam
Ela dashamuladi rasayanam
Vasavaleha
Kushmanda rasayana
Kantakari ghritam
Arjuna ghrita
Rasnadi Ghritam
Brihat Chagaladya Ghritam
Amritaprasha Ghritam etc

For Arochaka, Bhaktarodha, Chardi etc conditions –
Indukantam Kashayam
Guluchyadi Kashayam
Amrutottaram Kashayam
Drakshadi Kashayam
Pachanamritam Kashayam
Draksharishtam
Lohasavam
Hingwashtaka Churnam
Panchakola Churnam
Trikatu Churnam
Lavana Bhaskara Churnam
Talisapatradi Churnam
Sitopaladi Churnam
Chitrakadi Vati
Raja Bati
Kravyada Rasa
Arogyavardhini Ras
Dhatri Lauha
Vilwadi Leham
Gudardrakam
Talisapatradi leham
Indukanta Ghritam etc

Limitations, precautions

Respiratory and cardiac disorders are many times dangerous and life-threatening in nature. The selection of the patients for Uro-vasti is the key.

Chest pain, breathlessness of chronic nature, chest conditions with effusion (fluid accumulation), compromised heart or the heart which has undergone surgical procedures and other critical conditions should be properly analyzed and skilfully planned if Uro Vasti is the right treatment in the given condition.

Similarly, there is no fun in conducting Uro vasti in patients who present with lung and heart conditions which are secondary to diseases like obesity, anaemia etc unless the primary disease is dealt with.

To sum up,
Uro Vasti is the best treatment which Ayurveda provides for heart and lung disorders. All you need to do is to meet an experienced Ayurvedic doctor and put forth your problems.

The doctor will help you to get your sore back into its rhythm. Proper choice of the conditions in which uro vasti needs to be done is the key.

Uro vasti can also be administered to healthy and or susceptible people who are susceptible to suffer from heart and lung ailments, as evidenced by family history or previous history. Thus Uro Vasti forms an important part of prophylactic chest care, a part of ‘prevention is better than cure’ mantra.

Isn’t it good news that Ayurveda has best options to tackle the most difficult heart and lung ailments?
Indeed it is, especially when we learn that the healing will be herbal and in a natural way!!
Get rid of your chest complaints naturally, through Ayurvedic approach…and enjoy your health as never before!!
Click to Consult Dr Raghuram Y.S. MD (Ayu) in Bangalore – drraghuramys@gmail.com