Preparing for Basti Therapy
As with all Panchakarma purification procedures, proper preparation is crucial for successful basti treatment. First, snehanaand swedana must loosen ama and open the body’s channels so that it can be moved out. This greatly aids the effectiveness of both the cleansing and nourishing bastis. Bastis are always administered immediately after oleation and sudation (heating). Because of these preparatory procedures, the patient feels calm and settled and his shrotas (channels) are dilated. This facilitates the work of the doshas, which is to remove ama from the colon and deliver nutritive substances to the dhatus.
Basti ingredients are freshly prepared. A typical anuwasan basti consists of approximately 60 ml. (3 ounces) of herbalized sesame oil. Nirooha bastis contain primarily herbal decoctions of water with a small amount of oil. A typical nirooha basti contains 400 ml. (1-3/4 cups) of a water decoction of dashmoola, a standard preparation consisting of a mixture of ten different herbal roots (plus additional herbs depending on the condition), 30 ml. (1-1/2 ounces) of sesame oil, a little honey and a pinch of black salt (saindhava).. The black salt is added to increase secretions in the colon. The attending physician adjusts the exact ingredients, the ratio of oil to water and the total amount of liquid, depending on the patient’s doshic make-up, the condition of the colon, the strength of the digestive agnis and the specific disorder being treated.
Basti Administration
To facilitate the movement of the basti fluids from the rectum up through the descending colon, patient always lies on the left side when receiving bastis. The patient extends his left leg, while bending his right knee and drawing it up towards the chest. This makes the anal opening more accessible to the nurse or physician administering the bastis. The patient’s head should be supported on a pillow and he should be warm and relaxed.
The basti temperature must be near or at body temperature to increase the body’s receptivity to treatment. The decoction is drawn up into a rectal syringe and introduced into the rectum through a thin rubber catheter. Both the anal opening and the catheter are lubricated to allow easier access. With the permission of the patient, the doctor or nurse introduces the catheter, slowly and gently, about six inches into the rectum while the patient inhales deeply. After the basti, the patient lies on his back and rests for ten to twenty minutes. This quiet time gives the body the chance to make the most effective use of the basti.
Because of its small volume, anuwasan basti can be easily retained for a long period of time. However, withnirooha basti, the patient is more likely to feel the urge to defecate within forty-five minutes to an hour and, in some cases, sooner. In nirooha, the ama which the doshas drew into the colon is eliminated along with much of the basti fluid and fecal matter.
In rare cases, the body holds nirooha basti for as long as six to eight hours before the patient has the urge to defecate. This is not desirable, since this basti is supposed to cleanse. However, when vata is highly deranged, the colon can become extremely dry. Much of the water in the nirooha basti is absorbed to compensate for that dryness, in spite of the cleansing and eliminative herbs used. In such cases the patient must receive a snehana basti (large oil basti) before any further cleansing bastis are attempted. The snehana basti nourishes vata dosha, lubricates the colon and starts peristalsis.
The time of basti administration is noted along with the time of each subsequent bowel movement. It is often not possible for the physician to do this, so the patient is instructed to observe and note the frequency, color, consistency, odor and other signs which can show the physician whether ama is present and what type of ama is being eliminated.
Treatment Regimen
The Ayurvedic physician always closely monitors the patient’s response to basti treatments. He then makes adjustments in the type of basti, its oil and water content, the specific herbal decoctions used and the number of bastis given. Most patients gain greatest benefit from a series of bastis which alternate nirooha with anuwasan.
Based on information presented in the Charaka Samhita, several regimens which alternate herbal water decoctions with oil bastis are employed. The specific regimen depends on the constitution of the patient and the condition of the colon. A nirooha decoction is often applied for two consecutive days and then followed by an oil-based anuwasan basti on the third. If there is greater need for cleansing, nirooha bastis can be given for three days, followed by oil on the fourth.
In most cases, this type of treatment schedule, followed for eight to ten days, cleanses ama and mala from the dhatus and assists the rebuilding of dhatu structures. This-regimen restores normal balance to the doshas and the dhatus.
It is essential to always end treatment with anuwasan basti. This guarantees that vata is operating properly and that the colon is left lubricated and nourished. When properly administered, basti treatment does not interfere with normal intestinal flora and strengthens the function of the mucous membranes lining the colon.
Bastis have proven remarkably successful in treating situations that have not responded to any other form of therapy. Their power and efficacy as a treatment modality have gone largely unrecognized by modern medicine. When the vital functions of vata dosha are not understood, it is easy to overlook the tremendous absorptive power of the colon. As a consequence, modern medicine has failed to take advantage of the colon as an important route for the administration of medicines and nutrients.
Modern application of basti therapy confirms the knowledge in the ancient classical Ayurvedic texts: Of all the possible routes of administration, the colon most readily absorbs substances into the body. In addition, because the colon is so intimately linked to the body’s tissues, it is the best organ to eliminate toxins and mala.
An example from my own clinical practice dramatically demonstrates the utility of basti therapy. Some years ago a young girl was brought to me by her parents. She had cancer and had been treated by chemotherapy to no avail. She had grown progressively weaker until her body could not assimilate any medications or food taken orally. By the time she came to my clinic, her condition had severely deteriorated.
I decided as a last resort to use the colon to supply nutrition to her emaciated body. She was put on a course of basti treatment that alternated nourishing bruhan bastis with oleating snehana bastis. Her body responded well to this treatment. In a short time she regained her strength and was able to accept food by mouth.
This experience proved to me how powerful the colon is as an organ of assimilation. It can be counted on to absorb and utilize nutritive and medicated substances when all else fails. This approach not only provided her body with desperately needed nutrition, but also normalized her metabolism by correcting vata function and removing ama. It quickly restored her ability to take food and medicines by mouth. As I stated in the introduction of this book, it has been gratifying to find the solutions to difficult medical problems consistently and clearly elaborated in the ancient Ayurvedic texts, some of which are over 5,000 years old.