Charaka Siddhisthana Chapter 4 – Sneha Vyapat Siddhi

This article explains the fourth chapter of siddhisthana of Charaka samhita called ‘Snehavyapat Siddhi Adhyaya’. In this chapter, management of complications arising from the administration of anuvasana basti are explained.

Prologue
अथातः स्नेहव्यापत्सिद्धिं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
athātaḥ snehavyāpatsiddhiṃ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātreyaḥ||2||

We shall now explore the chapter dealing with “the management of complications arising from the Administration of Anuvasana Basti (unctuous enema)”. Thus, said Lord Atreya [1-2]

Topics covered

स्नेहबस्तीन्निबोधेमान् वातपित्तकफापहान्|
मिथ्याप्रणिहितानां च व्यापदः सचिकित्सिताः||३||
snehabastīnnibodhemān vātapittakaphāpahān|
mithyāpraṇihitānāṃ ca vyāpadaḥ sacikitsitāḥ||3||

Sage Atreya to Agnivesha and other disciples: Now listen to the description of the following topics:
Recipes for Sneha or Anuvasana Basti for the treatment of diseases caused by Vata, Pitta and Kapha,
Complications arising from their wrongful administration and
Treatment of these complications [3]

Anuvasana Recipe for Vata (Bilva Taila)

दशमूलं बलां रास्नामश्वगन्धां पुनर्नवाम्| गुडूच्येरण्डभूतीकभार्गीवृषकरोहिषम्||४||
शतावरीं सहचरं काकनासां पलांशिकम् | यवमाषातसीकोलकुलत्थान् प्रसृतोन्मितान्||५||
चतुर्द्रोणेऽम्भसः पक्त्वा द्रोणशेषेण तेन च| तैलाढकं समक्षीरं जीवनीयैः पलोन्मितैः||६||
अनुवासनमेतद्धि सर्ववातविकारनुत्|
daśamūlaṃ balāṃ rāsnāmaśvagandhāṃ punarnavām| guḍūcyeraṇḍabhūtīkabhārgīvṛṣakarohiṣam||4||
śatāvarīṃ sahacaraṃ kākanāsāṃ palāṃśikam | yavamāṣātasīkolakulatthān prasṛtonmitān||5||
caturdroṇe’mbhasaḥ paktvā droṇaśeṣeṇa tena ca| tailāḍhakaṃ samakṣīraṃ jīvanīyaiḥ palonmitaiḥ||6||
anuvāsanametaddhi sarvavātavikāranut|

One Pala each of Dashamoola, Bala, Rasna, Asvagandha, Punarnava, Guduchi, Eranda, Bhutika (Yavani) Bhargi, Vrushaka (Vasa), Rohisa, Shatavari, Sahacara as well as Kakanasa (Vayasi Phala), and one Prasruta (two Palas) each of Yava, Atasi, Kola as well as Kulattha is added with four Dronas (one Drona= 256 Palas) of water, and cooked till one Drona of the liquid remains. To this decoction, one Adhaka (64 Palas) each of oil and milk, and the paste of one Pala each of Jivaka, Rsabhaka, Meda, Mahameda, Kakoli, Ksirakakoli, Mudgaparni, Mashaparni, Jivanti and Madhuka are added. Anuvasana Basti (unctuous enema) with this recipe cures all the diseases caused by vata. [4 – ½ 7]

Other Anuvasana Recipes for vata:

आनूपानां वसा तद्वज्जीवनीयोपसाधिता||७||
शताह्वायवबिल्वाम्लैः सिद्धं तैलं समीरणे|
सैन्धवेनाग्नितप्तेन तप्तं चानिलनुद्धृतम्||८||
ānūpānāṃ vasā tadvajjīvanīyopasādhitā||7||
śatāhvāyavabilvāmlaiḥ siddhaṃ tailaṃ samīraṇe|
saindhavenāgnitaptena taptaṃ cānilanuddhṛtam||8|

Anuvasana Basti prepared of vasa (muscle fat) of animals inhabiting marshy land (Anupa desha), boiled with drugs belonging to Jivaniya group (Jivaka, Rsabhaka, Meda, Mahameda, Kakoli, Ksirakakoli, Mudgaparni, Mashaparni, Jivanti and Madhuka), similarly cures Vatika diseases.
Anuvasana Basti with the oil cooked by Satahva, Yava, Bilva and sour juice is also useful in vatika diseases.
Anuvasana Basti with ghee which has been heated by the immersion of hot rock-salt cures diseases caused by vata. [7 ½ – 8]

Recipe of Anuvasana Basti for Pitta (Jivaniya –Yamaka)

जीवन्तीं मदनं मेदां श्रावणीं मधुकं बलाम्| शताह्वर्षभकौ कृष्णां काकनासां शतावरीम्||९||
स्वगुप्तां क्षीरकाकोलीं कर्कटाख्यां शटीं वचाम्| पिष्ट्वा तैलं घृतं क्षीरे साधयेत्तच्चतुर्गुणे||१०||
बृंहणं वातपित्तघ्नं बलशुक्राग्निवर्धनम्| मूत्ररेतोरजोदोषान् हरेत्तदनुवासनम्||११||
jīvantīṃ madanaṃ medāṃ śrāvaṇīṃ madhukaṃ balām| śatāhvarṣabhakau kṛṣṇāṃ kākanāsāṃ śatāvarīm||9||
svaguptāṃ kṣīrakākolīṃ karkaṭākhyāṃ śaṭīṃ vacām| piṣṭvā tailaṃ ghṛtaṃ kṣīre sādhayettaccaturguṇe||10||
bṛṃhaṇaṃ vātapittaghnaṃ balaśukrāgnivardhanam| mūtraretorajodoṣān harettadanuvāsanam||11||

Ghee and oil taken together may be cooked by adding four times of milk along with the paste of Jivanti, Madana Phala, Meda, Sravani, Madhuka, Bala, Satahva, Rsabhaka, Krsna (Pippali), Karkanasa, Shatavari, Svagupta (Atmagupta), Ksirakakoli, Karkatakhya (Karkata Srngi), Sati and Vaca. Anuvasana Basti with this recipe is nourishing, alleviator of vata and Pitta, promoter of strength, semen and Agni (power of digestion including metabolism) and curative of urinary, seminal and menstrual morbidities. [9-11]

Another Anuvasana Recipe for Pitta

लाभतश्चन्दनाद्यैश्च पिष्टैः क्षीरचतुर्गुणम्| तैलपादं घृतं सिद्धं पित्तघ्नमनुवासनम्||१२||
lābhataścandanādyaiśca piṣṭai kṣīracaturguam| tailapāda ghta siddha pittaghnamanuvāsanam||12||
Ghee cooked with four times of milk, one fourth in quantity of oil, and the paste of drugs belonging to Chandanadi group whichever are available, is used for anuvasana basti which alleviates Pitta. [12]

Anuvasana Recipe for Kapha

सैन्धवं मदनं कुष्ठं शताह्वां निचुलं वचाम्| ह्रीवेरं मधुकं भार्गीं देवदारु सकट्फलम्||१३||
नागरं पुष्करं मेदां चविकां चित्रकं शटीम्| विडङ्गातिविषे श्यामां हरेणुं नीलिनीं स्थिराम्||१४||
बिल्वाजमोदे कृष्णां च दन्तीं रास्नां च पेषयेत्| साध्यमेरण्डजं तैलं तैलं वा कफरोगनुत्||१५||
व्रध्नोदावर्तगुल्मार्शःप्लीहमेहाढ्यमारुतान्| आनाहमश्मरीं चैव हन्यात्तदनुवासनात्||१६||
saindhavaṃ madanaṃ kuṣṭhaṃ śatāhvāṃ niculaṃ vacām| hrīveraṃ madhukaṃ bhārgīṃ devadāru sakaṭphalam||13||
nāgaraṃ puṣkaraṃ medāṃ cavikāṃ citrakaṃ śaṭīm| viḍaṅgātiviṣe śyāmāṃ hareṇuṃ nīlinīṃ sthirām||14||
bilvājamode kṛṣṇāṃ ca dantīṃ rāsnāṃ ca peṣayet| sādhyameraṇḍajaṃ tailaṃ tailaṃ vā kapharoganut||15||
vradhnodāvartagulmārśaḥplīhamehāḍhyamārutān| ānāhamaśmarīṃ caiva hanyāttadanuvāsanāt||16||
Castor oil, sesame oil is cooked by adding the paste of Saindhava (rock-salt), Madana, Kustha, Satahva, Nicula, Vaca, Hrivera, Madhuka, Bhargi, Devadaru, Katphala, Nagara, Puskara, Meda, Cavika, Chitraka, Sati, Vidanga, Ativisa, Syama, Hraenu, Nilini, Sthira, Bilva, Ajamoda, Krsna, Danti and Rasna. Anuvasana Basti with this medicated oil cures the below mentioned diseases –
Kaphaja diseases,
Bradhna (inguinal enlargement),
Udavarta (upward movement of wind in the abdomen),
Gulma (phantom tumour),
Arshas (piles),
Plihan (splenic disorders),
Meha (obstinate urinary diseases including diabetes),
Adhya-vata (a joint disease), Anaha (tympanites) and
Asmari (calculus) [13-16]
Read: Basti Chikitsa: Benefits, Routes, Types, Indications, Equipment

Another Anuvasana recipe for kapha (Madana- Taila)

मदनैर्वाऽम्लसंयुक्तैर्बिल्वाद्येन गणेन वा| तैलं कफहरैर्वाऽपि कफघ्नं कल्पयेद्भिषक्||१७||
madanairvā’mlasaṃyuktairbilvādyena gaṇena vā| tailaṃ kaphaharairvā’pi kaphaghnaṃ kalpayedbhiṣak||17||
Oil cooked with Madana Phala by adding sour liquid (vinegar etc.) or by adding (the decoction as well as paste of) Bilva, Syonaka, Gambhari, Patala, Ganikarika, Salaparni, Prsniparni, Brhati, Kantakari and Gokshura, or by adding Kapha alleviating drugs may be used for Anuvasana Basti for the alleviation of kapha. [17]

Recipe for Anuvasana Basti

विडङ्गैरण्डरजनीपटोलत्रिफलामृताः| जातीप्रवालनिर्गुण्डीदशमूलाखुपर्णिकाः||१८||
निम्बपाठासहचरशम्पाककरवीरकाः| एषां क्वाथेन विपचेत्तैलमेभिश्च कल्कितैः||१९||
फलबिल्वत्रिवृत्कृष्णारास्नाभूनिम्बदारुभिः| सप्तपर्णवचोशीरदार्वीकुष्ठकलिङ्गकैः||२०||
लतागौरीशताह्वाग्निशटीचोरकपौष्करैः | तत् कुष्ठानि क्रिमीन् मेहानर्शांसि ग्रहणीगदम्||२१||
क्लीबतां विषमाग्नित्वं मलं दोषत्रयं तथा| प्रयुक्तं प्रणुदत्याशु पानाभ्यङ्गानुवासनैः||२२||
viḍaṅgairaṇḍarajanīpaṭolatriphalāmṛtāḥ| jātīpravālanirguṇḍīdaśamūlākhuparṇikāḥ||18||
nimbapāṭhāsahacaraśampākakaravīrakāḥ| eṣāṃ kvāthena vipacettailamebhiśca kalkitaiḥ||19||
phalabilvatrivṛtkṛṣṇārāsnābhūnimbadārubhiḥ| saptaparṇavacośīradārvīkuṣṭhakaliṅgakaiḥ||20||
latāgaurīśatāhvāgniśaṭīcorakapauṣkaraiḥ | tat kuṣṭhāni krimīn mehānarśāṃsi grahaṇīgadam||21||
klībatāṃ viṣamāgnitvaṃ malaṃ doṣatrayaṃ tathā| prayuktaṃ praṇudatyāśu pānābhyaṅgānuvāsanaiḥ||22||
Oil is cooked by adding the decoction of Vidanga, Eranda, Rajani, Patola, Haritaki, Amalaki, Amrta, tender leaves of Jati, Nirgundi, Bilva, syonaka, Gambhari, Patala, ganikarika, Salaparni, Prsniparni, Brhati, Kantakari, Gokshura, Akhuparni, Nimbi, Patha, Sahacara, Sampaka, and Karavira and the paste of Madana phala, Bilva, Trivrt, Krsna, Rasna, Kalinga, Lata (manjistha), Gauri (haridra), Satahva, Agni, Sati, Coraka and Puskaramula.
Administration of this medicated oil as potion, for massage or for Anuvasana Basti immediately cures –
Kustha (skin diseases),
Krimi (parasitic infestation),
Meha (obstinate urinary disorders including diabetes),
Arshas (piles),
Grahani (sprue),
Klibata (impotency),
Visamagni (irregular digestion),
Mala (production of morbid matter in excess) and
diseases caused by all the three Doshas [18-22]

Effects of Anuvasana Basti in General

व्याधिव्यायामकर्माध्वक्षीणाबलनिरोजसाम्| क्षीणशुक्रस्य चातीव स्नेहवस्तिर्बलप्रदः||२३||
पादजङ्घोरुपृष्ठांसकटीनां स्थिरतां पराम्| जनयेदप्रजानां च प्रजां स्त्रीणां तथा नृणाम्||२४||
vyādhivyāyāmakarmādhvakṣīṇābalanirojasām| kṣīṇaśukrasya cātīva snehavastirbalapradaḥ||23||
pādajaṅghorupṛṣṭhāṃsakaṭīnāṃ sthiratāṃ parām| janayedaprajānāṃ ca prajāṃ strīṇāṃ tathā nṛṇām||24||

Sneha or Anuvasana Basti [administered with the above mentioned medicated oils] promotes excessive strength of persons who are emaciated and debilitated because of long suffering from diseases, excessive exercise, hard labour, walking long distance, loss of Ojas (vital essence) and diminution of semen. It causes excellent stability of feet, calves, thighs, back, shoulder and lumbar region. It helps in the procreation of off springs by the sterile men and women. [23-24]
Read: Anuvasana Basti: Method, Benefits, Mode Of Action, Contra Indications

Conditions Leading to Complications

वातपित्तकफात्यन्नपुरीषैरावृतस्य च| अभुक्ते च प्रणीतस्य स्नेहबस्तेः षडापदः||२५||
vātapittakaphātyannapurīṣairāvṛtasya ca| abhukte ca praṇītasya snehabasteḥ ṣaḍāpadaḥ||25||
Improper administration of Anuvasana Basti may give rise to complications in following six conditions:
Vatavruta Sneha – Occlusion of the enema-fluid by vata
Pittavruta Sneha – Occlusion of the enema-fluid by Pitta
Kaphavruta Sneha – Occlusion of the enema – fluid by kapha
Ati anna avruta Sneha – Occlusion of the enema-fluid by food, taken in excess
Pureeshavruta sneha – Occlusion of enema- fluid by faeces; and
Administration of enema on empty stomach [25]

Factors responsible for occlusion of enema-fluid

शीतोऽल्पो वाऽधिके वाते पित्तेऽत्युष्णः कफे मृदुः| अतिभुक्ते गुरुर्वर्चःसञ्चयेऽल्पबलस्तथा||२६||
दत्तस्तैरावृतः स्नेहो न यात्यभिभवादपि [१] |अभुक्तेऽनावृतत्वाच्च यात्यूर्ध्वं तस्य लक्षणम्||२७||
śīto’lpo vā’dhike vāte pitte’tyuṣṇaḥ kaphe mṛduḥ| atibhukte gururvarcaḥsañcaye’lpabalastathā||26||dattastairāvṛtaḥ sneho na yātyabhibhavādapi [1] |abhukte’nāvṛtatvācca yātyūrdhvaṃ tasya lakṣaṇam||27||
The Sneha (unctuous fluid of anuvasana basti) being occluded does not reach its destination because of the following:
Sheeta – If cold recipe is used
Alpa – small quantity for unctuous enema when vata is aggravated;
If excessively hot recipes are used for unctuous enema when Pitta is aggravated;
If mild recipe is used for unctuous enema when Kapha is aggravated;
If heavy recipe is used for unctuous enema when the patient has consumed food in excess quantity
If a recipe of mild nature is used for unctuous enema when there is accumulation of stool; and
If the recipe is afflicted because of excessively aggravated Doshas
If the patient has not taken food before the administration of unctuous enema the enema recipe reaches upwards much above the desired level because of the absence of any obstruction.
Hereafter, the signs of different impediments will be described. [26-27]

Signs of impediments by Vata

अङ्गमर्दज्वराध्मानशीतस्तम्भोरुपीडनैः पार्श्वरुग्वेष्टनैर्विद्यात् स्नेहं वातावृतं भिषक्||२८||
aṅgamardajvarādhmānaśītastambhorupīḍanaiḥ pārśvarugveṣṭanairvidyāt snehaṃ vātāvṛtaṃ bhiṣak||28||
The physician should ascertain the obstruction of the unctuous fluid by Vata from the signs and symptoms like malaise, fever, adhmana (flatulence), sita (feeling of cold), stambha (stiffness), uru pidana (pain in the thighs), Parsvaruk (pain in the sides of the chest) and Parsva vestana (cramps in the sides of the chest). [28]

Treatment of Vata Impediment vatavruta Sneha

स्निग्धाम्ललवणोष्णैस्तं रास्नापीतद्रुतैलिकैः |सौवीरकसुराकोलकुलत्थयवसाधितैः||२९||
निरूहैर्निर्हरेत् सम्यक् समूत्रैः पाञ्चमूलिकैः| ताभ्यामेव च तैलाभ्यां सायं भुक्तेऽनुवासयेत्||३०||
snigdhāmlalavaṇoṣṇaistaṃ rāsnāpītadrutailikaiḥ |sauvīrakasurākolakulatthayavasādhitaiḥ||29||
nirūhairnirharet samyak samūtraiḥ pāñcamūlikaiḥ| tābhyāmeva ca tailābhyāṃ sāyaṃ bhukte’nuvāsayet||30||
The occlusion [of the enema-fluid by Vata] is removed by the administration of Niruha-Basti with the recipes of Rasnadi Taila and Pitadru Taila having the characteristic features as follows:
those which are added with unctuous, sour, saline and hot ingredients
those which are prepared by adding sauviraka (vinegar), Sura (alcohol), Kola Kulattha and Yava and
those which are mixed with cow’s urine, and the decoction of Bilva, Syonaka, Gambhari, Patala and Ganikarika.
After the evening meals, the patient is given anuvasana basti with the above mentioned Rasna Taila and Pitadru Taila. [29-30]

Signs and treatment of Pitta Impediments Pittavruta sneha

दाहरागतृषामोहतमकज्वरदूषणैः| विद्यात् पित्तावृतं स्वादुतिक्तैस्तं बस्तिभिर्हरेत्||३१||
dāharāgatṛṣāmohatamakajvaradūṣaṇaiḥ| vidyāt pittāvṛtaṃ svādutiktaistaṃ bastibhirharet||31||
The occlusion [of the unctuous enema-fluid] by Pitta can be confirmed by the presence / manifestation of burning sensation, redness, morbid thirst, unconsciousness, tamaka (entering into darkness) and fever.
This occlusion can be removed by the administration of enema containing sweet and bitter ingredients. [31]

Signs of kapha Impediments Kaphavruta Sneha

तन्द्राशीतज्वरालस्यप्रसेकारुचिगौरवैः| सम्मूर्च्छाग्लानिभिर्विद्याच्छ्लेष्मणा स्नेहमावृतम्||३२||
tandrāśītajvarālasyaprasekārucigauravaiḥ| sammūrcchāglānibhirvidyācchleṣmaṇā snehamāvṛtam||32||
The occlusion of the unctuous enema fluid by Kapha can be ascertained from the affliction of the patient by drowsiness, cold fever, indolence, salivation, anorexia, heaviness, fainting and depression (Glani). [32]
Read: Uttara Basti: Method, Indications, Mode of Action

Treatment of Kapha Impediments

कषायकटुतीक्ष्णोष्णैः सुरामूत्रोपसाधितैः|फलतैलयुतैः साम्लैर्बस्तिभिस्तं विनिर्हरेत्||३३||
kaṣāyakaṭutīkṣṇoṣṇaiḥ surāmūtropasādhitaiḥ|phalatailayutaiḥ sāmlairbastibhistaṃ vinirharet||33||
The occlusion (of the unctuous fluid by Kapha) can be removed by the administration of Basti prepared by alcohol and cow’s urine by adding Madana Phala Taila, as well as astringent, Pungent, sharp hot and sour ingredients. [33]

Signs of impediments by Intake of Food in Excess

छर्दिमूर्च्छारुचिग्लानिशूलनिद्राङ्गमर्दनैः|आमलिङ्गैः सदाहैस्तं विद्यादत्यशनावृतम्||३४||
chardimūrcchāruciglāniśūlanidrāṅgamardanaiḥ|āmaliṅgaiḥ sadāhaistaṃ vidyādatyaśanāvṛtam||34||
The occlusion (of the unctuous fluid) by the intake of food in excess can be ascertained from the afflictions of the patient by vomiting, fainting, anorexia, depression, colic pain, excessive sleep, malaise, signs of Ama (caused by the product of improper digestion and metabolism) and burning sensation. [34]
Read: Matra Basti: Indications, Benefits, Contra Indications

Treatment of Impediments Caused by Intake of food in Excess

कटूनां लवणानां च क्वाथैश्चूर्णैश्च पाचनम्| विरेको मृदुरत्रामविहिता च क्रिया हिता||३५||
kaṭūnāṃ lavaṇānāṃ ca kvāthaiścūrṇaiśca pācanam| vireko mṛduratrāmavihitā ca kriyā hitā||35||
For the type of occlusion (of unctuous fluid by the intake of food in excess), Pacana (metabolic transformation of the undigested products) with pungent and saline decoctions as well as powders, mild purgation and therapies prescribed for correcting Ama (product of improper digestion and metabolism) are useful. [35]

Signs and Treatment of Impediments by Stool

विण्मूत्रानिलसङ्गार्तिगुरुत्वाध्मानहृद्ग्रहैः| स्नेहं विडावृतं ज्ञात्वा स्नेहस्वेदैः सवर्तिभिः||३६||
श्यामाबिल्वादिसिद्धैश्च निरूहैः सानुवासनैः| निर्हरेद्विधिना सम्यगुदावर्तहरेण च||३७||
viṇmūtrānilasaṅgārtigurutvādhmānahṛdgrahaiḥ| snehaṃ viḍāvṛtaṃ jñātvā snehasvedaiḥ savartibhiḥ||36||
śyāmābilvādisiddhaiśca nirūhaiḥ sānuvāsanaiḥ| nirharedvidhinā samyagudāvartahareṇa ca||37||

The occlusion (of the unctuous enema-fluid) by stool can be ascertained from the afflictions of the patient by the obstruction to the passage of stool, urine and flatus, pain heaviness, flatulence and cardiac spasm.
Such a patient is treated by oleation, fomentation and Phala Varti (medicated suppository) therapies with Syama, Bilva, etc., Niruha Basti followed by Anuvasana Basti is given appropriately for the removal of obstruction. The treatment of Udavarta (an ailment characterized by upward movement of wind) too shall be considered. [36-37]

Ailments caused by Basti on Empty Stomach, Treatment

अभुक्ते शून्यपायौ वा वेगात् स्नेहोऽतिपीडितः|धावत्यूर्ध्वं ततः कण्ठादूर्ध्वेभ्यः खेभ्य एत्यपि||३८||
मूत्रश्यामात्रिवृत्सिद्धो यवकोलकुलत्थवान्|तत्सिद्धतैल इष्टोऽत्र निरूहः सानुवासनः||३९||
कण्ठादागच्छतः स्तम्भकण्ठग्रहविरेचनैः|छर्दिघ्नीभिः क्रियाभिश्च तस्य कार्यं निवर्तनम्||४०||
abhukte śūnyapāyau vā vegāt sneho’tipīḍitaḥ|dhāvatyūrdhvaṃ tataḥ kaṇṭhādūrdhvebhyaḥ khebhya etyapi||38||
mūtraśyāmātrivṛtsiddho yavakolakulatthavān|tatsiddhataila iṣṭo’tra nirūhaḥ sānuvāsanaḥ||39||
kaṇṭhādāgacchataḥ stambhakaṇṭhagrahavirecanaiḥ|chardighnībhiḥ kriyābhiśca tasya kāryaṃ nivartanam||40||
If the Anuvasana Basti is given on an empty stomach or on an emptied bowel or if the enema-fluid is injected with great force it goes up speedily, and comes out from the throat or through the orifices in the upper part of the body.
In this condition, oil cooked with cow’s urine, Syama Trivrt, Yava, Kola and Kulattha is used for giving Niruha and anuvasana types of medicated enema.
If the enema-fluid starts coming out of the throat, then the patient is given Stambhana therapies (like fanning and sprinkling with cold water); pressure is applied over his throat [to prevent further upward movement of the enema- fluid], and he is given purgative and anti-emetic therapies. [38-40]

Non- elimination of Enema-fluid

यस्य नोपद्रवं कुर्यात् स्नेहबस्तिरनिःसृतः| सर्वेऽल्पो वाऽऽवृतो रौक्ष्यादुपेक्ष्यः स विजानता||४१||
yasya nopadravaṃ kuryāt snehabastiraniḥsṛtaḥ| sarve’lpo vā”vṛto raukṣyādupekṣyaḥ sa vijānatā||41||
If because of un-unctuousness, the unctuous enema fluid, being obstructed, does not get eliminated totally or partially, but the condition is not associated with complications, then an expert physician should leave the patient alone (i.e., he should not try to bring out the fluid by therapies) [41]

Diet after Anuvasana Basti

युक्तस्नेहं द्रवोष्णं च लघुपथ्योपसेवनम्| भुक्तवान् मात्रया भोज्यमनुवास्यस्त्र्यहात्त्र्यहात्||४२||
yuktasnehaṃ dravoṣṇaṃ ca laghupathyopasevanam| bhuktavān mātrayā bhojyamanuvāsyastryahāttryahāt||42||
After appropriate administration of Anuvasana Basti, the patient is given liquid, hot, light and wholesome food. After the intake of this food in appropriate quantity, the patient may repeatedly be given Anuvasana Basti every third day. [42]

Hot water

धान्यनागरसिद्धं हि तोयं दद्याद्विचक्षणः| व्युषिताय निशां कल्यमुष्णं वा केवलं जलम्||४३||
स्नेहाजीर्णं जरयति श्लेष्माणं तद्भिनत्ति च| मारुतस्यानुलोम्यं च कुर्यादुष्णोदकं नृणाम्||४४||
वमने च विरेके च निरूहे सानुवासने| तस्मादुष्णोदकं देयं वातश्लेष्मोपशान्तये||४५||
dhānyanāgarasiddhaṃ hi toyaṃ dadyādvicakṣaṇaḥ| vyuṣitāya niśāṃ kalyamuṣṇaṃ vā kevalaṃ jalam||43||
snehājīrṇaṃ jarayati śleṣmāṇaṃ tadbhinatti ca| mārutasyānulomyaṃ ca kuryāduṣṇodakaṃ nṛṇām||44||

vamane ca vireke ca nirūhe sānuvāsane| tasmāduṣṇodakaṃ deyaṃ vātaśleṣmopaśāntaye||45||
In the next morning, after the night, the expert physician should be given water boiled with Dhanyaka and Nagara (Sunthi) or simple warm water.
This warm water helps the patient in the digestion of undigested fat and it disintegrates Kapha. Therefore, after emesis, purgation, Niruha and Anuvasana therapies, warm water is to be given to the patient for the alleviation of Vata and Kapha. [43-45]
Read: Vaitarana Basti – Ingredients, Benefits

Frequency of Anuvasana Basti

रूक्षनित्यस्तु दीप्ताग्निर्व्यायामी मारुतामयी| वङ्क्षणश्रोण्युदावृत्तवाताश्चार्हा दिने दिने||४६||
एषां चाशु जरां स्नेहो यात्यम्बु सिकतास्विव| अतोऽन्येषां त्र्यहात्प्रायः स्नेहं पचति पावकः||४७||
rūkṣanityastu dīptāgnirvyāyāmī mārutāmayī| vaṅkṣaṇaśroṇyudāvṛttavātāścārhā dine dine||46||
eṣāṃ cāśu jarāṃ sneho yātyambu sikatāsviva| ato’nyeṣāṃ tryahātprāyaḥ snehaṃ pacati pāvakaḥ||47||
Anuvasana Basti can be given every day in the below mentioned conditions / persons –
Persons who are habituated to taking un-unctuous food,
Those who have strong Agni (power of digestion and metabolism),
Those who perform physical exercise,
Those who are afflicted with Vatika diseases,
Those whose pelvic region and hip region are afflicted with Vata, and
Those who are suffering from Udavarta – bloating (upward movement of Vata)
As the water falling over sand gets absorbed immediately, similarly the fat given to these patients gets immediately digested.
In the case of others, the Agni (digestive enzymes) generally digests Sneha (fat) in three days. [46-47]

Prohibition of Uncooked fat

न त्वामं प्रणयेत् स्नेहं स ह्यभिष्यन्दयेद्गुदम्| सावशेषं च कुर्वीत वायुः शेषे हि तिष्ठति||४८||
na tvāmaṃ praṇayet snehaṃ sa hyabhiṣyandayedgudam| sāvaśeṣaṃ ca kurvīta vāyuḥ śeṣe hi tiṣṭhati||48||
Uncooked fat is not used for Anuvasana Basti as it produces stuffiness (Abhisyanda) in the rectum.
Some portion of the fat (enema- liquid) is allowed to remain in Basti (bladder -which is used as receptacle of enema-fluid) because it contains air. [48]

Prohibition of fat after Anuvasana

न चैव गुदकण्ठाभ्यां दद्यात् स्नेहमनन्तरम्| उभयस्मात् समं गच्छन् वातमग्निं च दूषयेत्||४९||
na caiva gudakaṇṭhābhyāṃ dadyāt snehamanantaram| ubhayasmāt samaṃ gacchan vātamagniṃ ca dūṣayet||49||
After the administration of anuvasana Basti, fat should not be given through the anus or mouth, because the fat coming from both the sides (upper and lower) simultaneously vitiates Vata and Agni (enzymes responsible for digestion). [49]

Prohibition of Exclusive administration of Niruha and Anuvasana

स्नेहबस्तिं निरूहं वा नैकमेवातिशीलयेत्| उत्क्लेशाग्निवधौ स्नेहान्निरूहात् पवनाद्भयम्||५०||
तस्मान्निरूढः संस्नेह्यो निरूह्यश्चानुवासितः| स्नेहशोधनयुक्त्यैवं बस्तिकर्म त्रिदोषनुत्||५१||
snehabastiṃ nirūhaṃ vā naikamevātiśīlayet| utkleśāgnivadhau snehānnirūhāt pavanādbhayam||50||
tasmānnirūḍhaḥ saṃsnehyo nirūhyaścānuvāsitaḥ| snehaśodhanayuktyaivaṃ bastikarma tridoṣanut||51||

Either Niruha or Anuvasana should not be taken in excess (without interruption by the other). Excessive administration of Anuvasana [exclusively] gives rise to Utklesa (excitement of Kapha and Pitta) and suppression of the power of digestion. Excessive administration of Niruha [exclusively] leads to the risk of Vata getting aggravated.
Therefore, after Niruha-Basti, the patient is given Anuvasana Basti, and after Anuvasana Basti, Niruha Basti is given. Thus, by giving anuvasna and Niruha appropriately (one after the other), this Basti therapy cures the diseases caused by all the three Doshas. [50-51]

Matra-Basti

कर्मव्यायामभाराध्वया(पा)नस्त्रीकर्षितेषु च| दुर्बले वातभग्ने च मात्राबस्तिः सदा मतः||५२||
यथेष्टाहारचेष्टस्य सर्वकालं निरत्ययः| ह्रस्वायाः स्नेहमात्राया मात्राबस्तिः समो भवेत्||५३||
बल्यं सुखोपचर्यं च सुखं सृष्टपुरीषकृत्| स्नेहमात्राविधानं हि बृंहणं वातरोगनुत्||५४||
snehabastiṃ nirūhaṃ vā naikamevātiśīlayet| utkleśāgnivadhau snehānnirūhāt pavanādbhayam||50||
tasmānnirūḍhaḥ saṃsnehyo nirūhyaścānuvāsitaḥ| snehaśodhanayuktyaivaṃ bastikarma tridoṣanut||51||
Matra Basti is always useful for persons emaciated by Karma (playing with ball, etc.), Vyayama (practicing archery etc.), carrying heavy load, long way-faring, riding vehicles or indulging in sexual intercourse with women and for persons who are weak and who are afflicted with Vatika diseases.
While taking Matra basti, a person can take any food, and may do any work as he likes. It can be safely administered in all the seasons.
The dose of Matra Basti is equal to the minimum quantity in which Anuvasana Basti is prescribed to be administered. This Matra Basti which is a form of Anuvasana basti promotes strength and can be administered easily. It helps in easy voiding (elimination) of stool. It causes nourishment, and cures diseases caused by aggravated Vata. [52-54]

Epilogue
तत्र श्लोकौ-
वातादीनां शमायोक्ताः प्रवराः स्नेहबस्तयः| तेषां चाज्ञप्रयुक्तानां व्यापदः सचिकित्सिताः||५५||
प्राग्भोज्यं स्नेहबस्तेर्यद् ध्रुवं येऽर्हास्त्र्यहाच्च ये स्नेहबस्तिविधिश्चोक्तो मात्राबस्तिविधिस्तथा||५६||
To sum up tatra ślokau-
vātādīnāṃ śamāyoktāḥ pravarāḥ snehabastayaḥ| teṣāṃ cājñaprayuktānāṃ vyāpadaḥ sacikitsitāḥ||55||
prāgbhojyaṃ snehabasteryad dhruvaṃ ye’rhāstryahācca ye snehabastividhiścokto mātrābastividhistathā||56||:

In this chapter, the topics described are as follows:
1. foremost recipes of Anuvasana Basti for the alleviation (elimination) of aggravated Vata etc., (vide verse nos. 4-24)
2. complications arising out of their administration by ignorant persons, and treatment of these complications (vide verse nos. 25-41)
3. diet to be given before the administration of Anuvasana Basti (vide verse nos. 42-45)
4. persons for whom anuvasana basti is indicated to be taken every day and for whom it is indicated on every third day; (vide verse nos, 46-47)
5. the method of administration Anuvasana Basti and (vide verse nos. 48-51)
6. the methods of administering Matra Basti (vide verse nos. 52-54)

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते सिद्धिस्थाने स्नेहव्यापत्सिद्धिर्नाम चतुर्थोऽध्यायः||४||
ityagniveśakṛte tantre carakapratisaṃskṛte’prāpte dṛḍhabalasampūrite siddhisthāne snehavyāpatsiddhirnāma caturtho’dhyāyaḥ||4||

Thus ends the fourth chapter in Siddhi-Sthana dealing with “the successful treatment of complications arising out of unctuous enema” in the text composed by Agnivesha, redacted by Caraka and because of its Non-availability, supplemented by Drdhabala.

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