Basti Karma is one of the modalities among the five biocleansing/detoxifying procedures (Panchakarma procedures/ Samshodhan Chikitsa) advocated in Ayurveda as i.e.Vaman (Therapeutic emesis), Virechan (Therapeutic Purgation), Basti (Medicated Enema), Nasya (Infiltration of drugs through nostrils) & Raktamokshana (Bloodletting by different methods). In Basti Karma the medicated oil or herbal decoction is administered through the anal route. In modern medicine enemas are most commonly given to clean the lower bowel as a last resort for constipation treatment when, all other methods fail. But rather than this, Basti Karma mentioned in Ayurvedic classics is having broader therapeutic action on almost all the tissues of the body and have rejuventive , curative, preventive and health promotive actions.
Lipid soluble drugs are absorbed by passive diffusion and some of the active ingredients are absorbed through active transport. The bioavailability of the drug i.e the part of the drug which is able to produce an active effect on the body, will be higher when given as Basti. As per Ayurvedic classics Basti works as plant watered at its root & then root circulate it in all branches (su.ch.35/24-25). It has also been described as Ardha Chikitsa (Ch.si.1/39). i.e. half treatment for management of diseases.
Basti have been categorised into various types according to type of ingredients action of Basti & number of Basti. Medicines/ ingredients used in Basti Karma are selected as per the condition of disease & condition of the patient. Basti is commonly used alone or along with Ayurveda medication, in all Vata Vyadhi (neurological disorders) & is also indicated in various diseases as Anaha (Distended Abdomen), Malavrodh (Constipation), Rajokshay (Amenorrhea), Adhman (Abdominal spasmodic Pain), Vatrakta (Gout), Pleeha (splenomegaly) Parshva graham (Slipped Disc), Prishta graham (Spondylosis), Akshepak (Paralysis) etc. It is also used for increasing weight in emaciated peoples (by Brihan Basti), & for reduce weight in obese (by Lekhan Basti). It can also be used in children as well but with utmost care under physician’s supervision.
Basti Karma is broadly divided in two types according to the consistency of the drugs Sneha Basti(Anuvasan) and Niruha Basti (Aasthaapana) . In Sneha Basti/ Anuvasan Basti i.e. in this type medicated Oil/ Ghee, lipids are used, word Anuvasan indicates “To stay”, the administrated medicines stay inside for a longer duration, but still do not cause any untoward problem. In Niruha Basti/ Aasthaapana Basti, decoction of medicinal plants is the main content wherein other ingredients like honey, salt, lipids & other drugs are incorporated to form a colloid or a suspension. Word Niruha, indicates “To eliminate” or eliminate morbid Doshas or Disease from body, & its synonym word “Asthapan” indicates “establish life span & age (Su.Chi 35/38).
In Ayurvedic classics its Contraindications, features of Samyak, asmyak, (proper/inadequate) Basti & Vyapad (compliations) have been described in details. Basti Karma is though seems to be the simple procedure, but should be carefully done only under the supervision of ayurvedic physician and pre & post procedure along with do’s & don’ts are to be followed strictly.
Dr Sree Deepthi