Enema Therapy(VASTI)


The term basti has been derived from the fact that the Basti yantra (apparatus) used for introducing medicated materials is made up of Basti or animals’ urinary bladder. Basti is among the major panchakarma procedures and is used to cure vatic disorders. The process of enema therapy is resorted to eliminate toxins from colon and strengthens the tissues.

Vasti is essentially of two types

A) Nirooha that cleanses toxins from the dhatus and removes naturally accumulated malas (body waste) from the colon.

B) Anuwasana that which is meant to be retained in the body for a longer period of time in order to have its intended effect.

Considered the best treatment for a deranged vata, it purifies and rejuvenates the colon that then nourishes the entire body and helps to gain control of the disease process before it goes into a migratory phase. Classified into Oily Enema, Decoction Enema, and Enema therapies, it is administered through the anal passage or vagina

Vata’s predominant site is the colon. Ayurvedic basti involves the introduction into the rectum of herbal concoctions of sesame oil, and certain herbal preparations in a liquid medium. Basti, is the most effective treatment of vata disorders, although many enemas over a prescribed period of time are usually required. It relieves constipation, distention, chronic fever, cold, sexual disorders, kidney stones, heart pain, backache, sciatica and other pains in the joints. Many other vata disorders such as arthritis, rheumatism, gout, muscle spasms and headaches may also be treated with basti.

Vata is a very active principle in pathogenesis. If we can control vata through the use of basti, we have gone a long way in going to the root cause of the vast majority of diseases.

Vata is the main etiological factor in the manifestation of diseases. It is the motive force behind the elimination and retention of feces, urine, bile and other excreta. Vata is mainly located in the large intestine, but bone tissue (asthi dhatu) is also a site for vata. Hence the medication administered rectally effects asthi dhatu. The mucus membrane of the colon is related to the outer covering of the bones (periosteum), which nourishes the bones. Therefore, any medication given rectally goes into the deeper tissues, like bones, and corrects vata disorders. 
Because vata is the force behind retention or elimination of all items, its imbalance is the root cause of diseases related to tissues and organs of the body. This therapy thus proves effective for nearly all types of ailments discussed in Ayurveda. Helping rejuvenate the body and providing strength and long life.

But it cannot be applied in case of particular skin diseases, obese patients, problems of the gastro-intestinal tracts, loss of appetite, enlargement of liver & spleen, thirst, dyspnea, edema and in states of grief and shock.

Basti (Medicated Enema)
Basti Karma is one of the main procedures of Panchakarma Chikitsa. Various medicated enemas are introduced into the large intestine through the rectum with the help of an enema pot or special bag made for this purpose. “Basti” literally means the urinary bladder. In ancient times, sterilized urinary bladders of animals was used to instill the enema, hence the name of the procedure is Basti Karma. The extent of Ayurvedic Basti is very significant and hence cannot be compared with contemporary enema, which is used for bowel cleansing or nutritive therapies. As per Ayurveda, treatment of Vata Dosha is mandatory in treating any disease, since Vata Dosha is known to be the main cause in initiating ailments. Basti chikitsa is the most important treatment to subdue the elevated Vata Dosha, hence it is considered as most important procedure in Panchakarma Chikitsa. If administered properly this therapy can cures most health complaints and promote good health.

Functions of Basti
It cleanses and detoxifies the body.
It is divided into strong treatment that penetrates in to deeper dhatus and mild treatment, which work on the superficial level of dhatus.
It means promoting secretions in the colon.
It promotes the liquefaction of ama and mala (waste products) in the colon.
It helps the colon expel them. Similar to western enemas, this basti increases colonic peristalsis, producing rapid elimination of the faeces.
It is palliative

there are eight main types of basti, according to traditional texts, each with their own indications and contra-indications as listed below.

1. Anuvasana (oil enema) is used in pure vata disorders and when a person is having excess hunger or dryness related to vata imbalances.

2. Niruha-Asthapana (decoction enema) is used, among other conditions, for evacuation of vata, nervous diseases, gastro-intestinal vata conditions, gout, certain fever conditions, unconsciousness, certain urinary conditions, appetite, pain, hyperacidity and heart diseases.

3. Uttara Basti (through the urethra with men or vagina with women) is used for selected semen and ovulation disorders and for some problems involving painful urination or bladder infections. This is not to be used for someone with diabetes.

4. Matra Basti (daily oil enema) is used by someone emaciated by overwork or too much exercise, too much heavy lifting, walking too long of a distance, too much sexual activity or someone with chronic vata disorders. It does not need to be accompanied by any strict dietary restriction or daily routine and can be administered, in the appropriate cases, in all seasons. It gives strength, promotes weight and helps elimination of waste products.

5. Karma Basti (schedule of 30 bastis)

6. Kala Basti (schedule of 15 bastis; 10 oil + 5 decoction)

7. Yoga Basti (schedule of 8 bastis; 5 oil + 3 decoction)
In karma, kala and yoga bastis, it is better to give both types of basti in combination and not the oil and decoction separately. The conditions under which these are recommended are too detailed to be able to list in this article. In general, the indications and contra-indications that apply to basti also apply here.

8. Bruhana Basti (nutritional enema) is used for providing deep nutrition in select conditions. Traditionally, highly nutritive substances have been used, such as warm milk, meat broth, bone marrow soup and herbs like shatavari or ashwagandha.

Indications for Niruha Basti
All arthritic conditions and nervous disorders, obstruction of urine, stools and flatus; amenorrhoea, infertility, etc. are the diseases, which can be treated with Niruha Basti.

Contraindications for Niruha Basti
Malnourished, weak persons, or those suffering from tuberculosis, ascites, peritonitis, intestinal obstruction, dysentery, diabetes, skin diseases, asthma, etc., Niruha Basti should not be employed.

Indications for Anuvasan Basti
All persons in whom Niruha basti is contra indicated should be treated with Anuvasan Basti. 

Contraindications for Anuvasan Basti
Persons in whom Niruha basti is advised; persons suffering from anaemia, jaundice, obesity, piles, intestinal worms, etc., should not be treated with Anuvasan Basti.

It is given like any other enema. The only difference is that Anuvasan Basti should be retained in the body, therefore patient has to lie down in the lateral position for 6-8 hours; therefore it is employed at the bedtime.

Complications of Basti therapy
When Basti therapy is incomplete, spasmodic pains, burning sensation, anorectal itching and pain, anorexia, blockage of stools and flatus are noticed. If given in excess, it causes anorectal inflammation and ulceration, fissure, weakness, and muscular cramps.

 Uttar basti : It is the vaginal douche, given with medicinal decoctions for various gynaecological complaints, such as uterine prolapse, leucorrhoea, mennorhagia, urinary obstruction, habitual abortions, infertility, etc.

 Matra basti : In Matra basti, enema is given with 50 cc of medicated oils. It is recommended for otherwise healthy persons who undergo daily excessive physical exertion, and who are weak and malnourished. Matra basti also works as rejuvenator, immuno-modulator, and nutrient and it also subdues elevated Vata Dosha.