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Review Article

Niruha Basti Formulation

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 4 April
Publisherwww.maharshicharaka.in

A Critical Review on Concept of Niruha Basti Formulation

Madhukarrao Maske V.1*, Narayanrao Manwatkar M.2
DOI: http://dx.doi.org/10.21760/jaims.8.4.25

1* Vijay Madhukarrao Maske, Assistant Professor, Department of Kayachikitsa, SSVP Ayurved College and Research Institute, Hatta, Hingoli, Maharashtra, India.

2 Mayuri Narayanrao Manwatkar, Assistant Professor, Department of Kayachikitsa, SSVP Ayurved College and Research Institute, Hatta, Hingoli, Maharashtra, India.

Niruha Basti (decoction enema) has been given importance in classical texts of Ayurveda as well as is widely practiced by physicians as it can be given in patients of all ages and of all diseases. Basti formulation and administration greatly impact the therapeutic effects. The contents, their dosage, properties, order and method of mixing, characteristics of well-prepared Niruha Basti, rationality behind sequential mixing and need for Basti formulation should be studied thoroughly so as to understand the essence of science, to achieve desired therapeutic effects and to avoid complications. So, here is an attempt to understand the entire concept of Niruha Basti formulation with the help of references from classical texts, textbooks, previous articles on this topic from reputed journals.

Keywords: Niruha Basti, Formulation, Order of mixing, Therapeutic effects

Corresponding Author How to Cite this Article To Browse
Vijay Madhukarrao Maske, Assistant Professor, Department of Kayachikitsa, SSVP Ayurved College and Research Institute, Hatta, Hingoli, Maharashtra, India.
Email: 		Vijay Madhukarrao Maske, Mayuri Narayanrao Manwatkar, A Critical Review on Concept of Niruha Basti Formulation. J Ayu Int Med Sci. 2023;8(4):147-154.
Available From
https://jaims.in/jaims/article/view/2272

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-02-25 2023-02-27 2023-03-06 2023-03-13 2023-03-19
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 16%

© 2023by Vijay Madhukarrao Maske, Mayuri Narayanrao Manwatkarand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Sages of authority hold an application of the Basti (enema) to be the best of all measures because on account of its varied functions and of its being compared of various kind of medicinal drugs, it helps to restrain, pacify and cleanse different Dosha (humors) of body.[1] It is considered to be the prime treatment in Vata disorders[2,3,4] and is also efficacious in diseases due to deranged Pitta, Kapha, Rakta, any two or three of them.[5,6]

Niruha Basti is amongst the types of Basti which is used widely by practitioners as it expels the Dosha from the system, cures the disease, rejuvenate the organism and produce longevity.[7-9] The desired effect of Niruha Basti depends on several determinants and Basti formulation is one of the important determinant variables.[10]

The main classical texts of Ayurveda have highlighted the contents, their dosage, properties, order and method of mixing, characteristics of well-prepared Basti, rationale behind sequential mixing. The endeavours of a man who has studied the entire Shastra (classical text) but fails to make a clear exposition of the same, are vain like the efforts of an ass that carries a load of sandalwood.[11] So, it is important to study the entire concept of Niruha Basti formulation from classical texts and to understand the rationale behind it for practical application.

As Acharyas has stated that by studying single Shastra, a man can never catch the true input of this. Therefore, a physician should study as many altered branches as possible.[12] So, the logic behind Niruha Basti formulation should also be studied with the help of modern principles like emulsion, collision system, particle distribution, etc which makes it easier to understand. The well formed Niruha Basti only produces desired therapeutic effects without any complications. So, here is an attempt to study the concept of Niruha Basti formulation from Ayurvedic and modern view.

Materials and Methods

References about this topic from three main classical texts of Ayurveda along with their commentaries, books and articles from reputed journal were studied; analysed and important things are compiled in this article.

Result

The contents, their quantity, properties, order and method of mixing, characteristics of well-prepared Basti, rationality behind sequential mixing and need for Basti formulation are as explained below.

Contents of Niruha Basti - are explained in table below

Table 1: Contents of Niruha Basti

SN Samhita Contents of Niruha Basti
1. Charak Samhita Madhu (honey), Saindhav (salt), Sneha (oleaginous substance), Kalka (herbal paste), Kwatha (decoction)[13]
2. Sushrut Samhita Saindhav, Madhu, Sneha, Madanfal Kalka, Mamsarasa (meat soup), Ksheer (milk), Kanji (rice gruel), Mutra (urine), Kwatha[14,15]
3. Ashtanga Hriday Makshik, Lavana, Sneha, Kalka, Kwatha[16]

Quantity of contents: Acharya Vagbhata has quoted the Dash Prasrutik Niruha Matra (940ml),[17] while Acharya Charaka,[18] Sushruta,[19] Kashyapa,[20] Chakradatta,[21] Sharangdhara[22] and Vangsena[23] have quoted the Dwadash Prasrutik Niruha Matra (1152 ml) as an ideal dosage for an adult. The quantity of each content mentioned by main three classical texts of Ayurveda are given in table below-

Table 2: Quantity of contents

SN Ingredients Charak Samhita[18] Sushrut Samhita[19] Ashtang Hriday[24]
1. Makshik 192gm 192gm 144gm
2. Lavana 12gm 12gm 6gm
3. Sneha 288gm 192gm 144gm
4. Kalka 96gm 144gm 96gm
5. Kwatha 480gm 384gm 480gm
6. Avapa 192gm 192gm -

However, the quantity of ingredients varies according to the Dosha predominance.[22,25-29] Also, it is only explained as an example and the Vaidya (physician) has to fix the dosage of Niruha Basti Dravya after complete evaluation of Vaya(age), Rugna Bala (strength of patient) and Vyadhi Bala (strength of disease).[30]

Properties of ingredients

1. Makshik (Honey): It is considered as Auspicious [20] It is having sweet and astringent taste, Ruksha (dry) Guna (property) and Ushna Veerya (hot potency).[31-33]


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The most important properties of honey in context of Basti Karma are Yogavahitva (synergistic) and Sukshma Marga Anusaritva (potency to penetrate into minute channels of body).[32] It acts as emulsifier which stabilises an emulsion.[34] It is ambiphilic in nature. It has fructose, glucose, sucrose, etc. which get quickly absorbed by digestive system and are converted into energy so acts as instant energizer. It has high nutritive value due to presence of vitamins, minerals, amino acids, fat, etc. It is a very good antioxidant[35] and has simulative effect on colonic probiotic bacteria.[36] It also has specific therapeutic effects like Vrushya (aphrodisiac), Chakshushya (good for eye health), Chedan (excision), Lekhana (scraping).[31-33]

2. Lavana (salt): It is salty and mild sweet in It has Laghu (light), Sukshma (minute), Teekshna (sharp), Snigdha (oily) properties and is of Anushna Veerya (not so hot).[37-39] Due to its Sukshma property, it reaches upto microchannels of body. Due to its Teekshna property it breaks down the morbid Malas and clears the channels. Due to Snigdhaguna it liquifies the Dosha. Due to its irritant property it helps to eliminate the Basti Dravya.[40] It contains 21 essential and 30 accessory minerals, 98% NaCl and traces of K.[35] It helps in absorption and bio purification process of Basti.[36]

3. Sneha: Snigdha Guna produces unctuousness in body which in turn helps in easy elimination of Dosha and Mala (wastes). It pacifies Vata Dosha, softens microchannels and remove obstruction in [41] It protects mucous membrane from untoward effect of irritant drugs in Basti.[42] It helps to form emulsion which has got cleaning and healing effect.[34]

4. Kalka: Main drug which gives potency to the whole [35] It helps to disintegrate Mala by increasing osmotic permeability of solution.[42] It helps to form colloidal solution, increase surface area and accelerate absorption of Basti.[35] Irritation property along with other ingredients may induce colonic distension and stimulate the process of evacuatory reflex.[42] It gives required thickness to Basti.[36] It can be Utkleshan (provocation), Doshahara (extraction), Dosha Shamana (pacification).[43]

5. Kwatha: It increases volume of Basti which in turn lead to increased ability to spread in colon and accelerate absorption of Basti Dravya

by increasing surface It helps in spreading and cleaning. It helps in homogenization of mixture. It has different therapeutic effects.[42] Kalka and Kwatha drugs are selected on the basis of Dosha, Dushya (body tissue) and Srotasa (circulating body channels) involved in pathogenesis of disease, So, they are the main constituents.[44]

6. Avapa:  added if the disease is chronic and [42]

Order of mixing of ingredients

1. Acharya Charaka,[13] Vagbhata[16] and Kashyapa[30] has quoted the order of mixing as -

Makshik – Lavana – Sneha – Kalka – Kwatha – Avapa

2. Acharya Sushruta,[14] Chakradatta,[21] Vangsena[23] quoted the sequence as -

Saindhav – Madhu – Sneha – Kalka – Avapa – Kwatha.

Method of mixing of ingredients

Acharya Charaka[13] and Vagbhata[16] has explained the mixing of ingredients with the help of churner. While Acharya Sushruta explained that it should be mixed in a vessel with hand and once Kashaya is added it should be mixed up to time of administration.[14] Previous research states that if the mixture is done with the help of churning, the mixing is unidirectional with application of manual pressure. Each and every particle passes in between churner and base of vessel and makes the drugs to be miscible with each other and the formulation remains stable for long time.

If the mixture is done with the help of hand in a vessel, it will increase the surface area and aids the formation of more collision, as particle size and surface area of drug are inversely proportional to each other. Thus, the increased surface area exposes drug particles more to the drug media which enhances the rate of reaction. Large surface area exposed to the atmosphere helps in oxidation of active constituents of drug by atmospheric oxygen.

The research conducted on mixing the ingredients with mixer states that the ingredients rotate in single direction with fixed base. No pressure is applied on particles. Moreover, mixer gets heated up while doing the preparation. Hence, the temperature has its impact on final formulation. Separation rate is mild in this method.


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If mixed with edge runner, it rotates in circular motion with two stands running opposite to each other. This produces both positive and negative mixing, results in union and separation at the same time. As soon as Taila and Kwatha are mixed they get separated into 2 layers. Here, particles loose attraction towards each other. So, it takes much time to mix immiscible ingredients like Kalka and Kwatha. Separation rate is rapid in this method.[45]

One research states that, in the initial step of Basti preparation while mixing Makshika and Saindhava classically it is said that one has to continue the levigation till the sticky sound goes off and it was observed that sticky sound disappears by 30 minutes of levigation. Homogeneity of final product depends mainly on these 2 steps. Other steps of mixing depend on initial 2 steps of mixing and if these are properly done then other 2 steps do not require more time to form a harmonized mixture. So, 30 minutes for each step was the fixed duration.[46]

According to the previous research Basti prepared with Khalwa (mortar) was stable due to proper trituration while Basti prepared by house hold blender was not stable even for some seconds.[44] According to the previous research conducted on the time required to mix Basti Dravya can be fixed for 10-15 mins in each step and complete mixing for 30-45 min. Basti Sammilana (formulation) by Hasta Tala (palm of hand) stands best method because the homogenous Basti Dravya is formed and retention time more compared to the conventional method.[35]

Criteria’s to be observed during mixing of Basti Dravya (ingredients)

Ardrata (misture), Kardamabha (mice like consistency), Samplavan (immersion), Ekibhuta (homogenous mixture).[35]

Characteristics of a well prepared Basti Dravya

1. It should not easily flow off and stick to the

2. It should not form different layers of ingredients added to

3. Should form a uniform homogenous [47]

Ayurvedic view behind sequential mixing of ingredients of Basti

Acharya Kashyapa has stated that honey being auspicious is first of all poured

for the preparation. Salt by its sharpness disintegrates sliminess, denseness and astringentness in honey. These results in compound formation, which is the reason after honey, salt is poured. Then when Sneha is added it brings about uniformity i.e., the contents are properly mixed together. The Kalka added further gets mingled quickly. The decoction brings about homogeneity. The urine poured to this brings sharpness and increases the potency.[20] Acharya Arundatta also stated that the sequential approach towards Basti formulation makes it homogenous i.e., Samarasatam Yati.[48]

Modern view behind sequential mixing of ingredients of Basti

In the preparation of Niruha Basti, honey and salt are mixed together vigorously to form a stabilizing agent - soaping which gives the stability. Sodium in Saindhava helps in breakdown of glucose in honey to hydrogen peroxide. Next Sneha should be added because it is a dispersed liquid. It also helps in formation of emulsion. Short chain free fats are produced due to the breakdown of this Sneha, and these are absorbed fast in rectum and small intestine, more in presence of Na, where is the role of Saindhava. Unionized and lipid soluble substances are readily absorbed. Now the mixture is once again subjected to vigorous churning process till the dispersed liquid gets mixed properly with the stabilizer. Next Kalka should be added because it forms colloidal solution, increases surface area and accelerates absorption of Basti. Next Kwatha should be added as after adding it the Sneha Dravya gets equally distributed throughout the Kwatha with the help of stabilizer which makes it stable. The mixture thus produced acquire a physical state of emulsion which retains it stable for considerable time.[51]

According to the previous research even if all ingredients were added collectively does not affect the end product but after preparation there were lot of bubbles on the surface which may increase Vata in Basti and also contain some oil particles, but this does not produce any complications or reduced efficacy.[48]

Need for Basti formulation

1. A highly effective measure having therapeutic value administered through rectal

2. Simultaneous administration of multiple drugs of varied nature medium is


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3. Difficulty or impractical to use Kalka or Saindhavaas

4. Uniform distribution of fine molecules of Sneha and Kalka Dravya throughout the Kwatha makes it

5. The formation makes dispersed particles into exceptionally fine molecules for faster and better

6. Provides more viscosity by Kalka which helps in

7. Warm stage of Basti makes it more stable and helps in better absorption.[49]

Discussion

Basti is described as half of the treatment for almost all diseases and some others opine that it is full treatment even.[50] Niruha Basti is used extensively by physicians because of its varied nature of functions like it prevents ageing, promotes sturdiness, enriches semen, etc.[9] The properly formed and well administered Basti is only able to give the desired therapeutic effects.[51] So, immense importance has been given to the process of Niruha Basti formulation by all classical texts of Ayurveda.

It is important to study the contents of Niruha Basti, their quantity, properties, order and method of mixing, characteristics of well-prepared Basti, Ayurvedic and modern view on rationality behind sequential mixing and need for Basti formulation for understanding what the proper formulation exactly means which is depicted in figure below –

jaims_2272_01.JPGFigure 1: Concept of Niruha Basti formulation

All classical texts have quoted Makshik (honey), Lavana (salt), Sneha, Kalka, Kwatha and Avapa as an ingredient of Niruha Basti. Many of the classical

texts had given Dwadash Prasrut as an ideal dosage of Niruha Basti for an adult. But the total amount and quantity of individual ingredients may vary from patient to patient considering the Dosha, Dushya, Bala, etc. The quantity of ingredients if not decided carefully considering the above mentioned parameters like excess salt or less amount of salt leads to various complications.[52-56] Every ingredient holds some important characteristics in perspective of Basti which are summarised shortly in table below –

Table 3: Properties of ingredients of Niruha Basti

SN Ingredient of Niruha Basti Properties
1. Makshik (honey) Auspicious, Yogavahi, Sukshma Marganusari, emulsifier, instant energizer, antioxidant, stimulates colonic probiotic bacteria, specific therapeutic effects like Vrushya, Chakshushya, Chedana, Lekhana, etc.
2. Lavana (salt) Sukshma, Teekshna, Snigdha, Laghu, helps to eliminate Basti Dravya, helps in absorption and bio-purification process of Basti.
3. Sneha Snigdha, Sukshma, Mrudu, protects mucous membrane from irritation, helps to form emulsion.
4. Kalka Easy dispersion, most potent, helps to disintegrate Mala, helps to form colloidal solution, irritant and other properties may induce colonic distension and stimulate the process of evacuatory reflex, and gives required thickness to Basti Dravya.
5. Kwatha Helps in maintenance of Basti volume, it is having different therapeutic effects, helps in spreading and cleaning, accelerate absorption, helps in homogenization.
6. Avapa Adds potency

As these ingredients are immiscible with each other classically, a systematic stepwise procedure is explained for its preparation. Some classical texts have quoted honey as the first drug due to its auspiciousness while others have put salt first. The Basti formed by sequential approach makes the mixture uniformly homogenous and helps to retain stability for considerable time and easily gets absorbed and eliminated in proper time. The mixture done by Hasta Tala stands as best method according to previous research as it increases surface area which results in enhanced rate of reaction and aids in formation of more collision which makes the Basti Dravya homogenous and retains for longer period. Homogeneity of mixture depends on initial two steps of mixing.


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10-15 minutes is the time required for each step and whole procedure completes in 30 - 45 minutes.

The physical tests quoted in classical texts also holds clinical importance as Basti Dravya of thin consistency eliminates rapidly [57,58] while it is difficult to administer thick Basti Dravya and it may not come out easily.[52-54] Samarasatam Yati or Ekibhavay Kalpate means the formation of homogenous mixture is the ultimate aim behind sequential mixing of ingredients as mentioned in classical texts. The same can be understood with the help of modern concepts like dispersion collision system, emulsion, homogenization, etc. As it is difficult to administer individual contents of various nature simultaneously, also if order of mixing is not followed properly, homogenous mixture is not formed which leads to difficulty in administration and can lead to various complications. So, it is important to formulate the Niruha Basti properly as per classics only. The desired therapeutic effects of Niruha Basti are dependent on its proper formulation so, it is important to study it thoroughly and apply it clinically.

Conclusion

Niruha Basti holds a key place in therapeutics due to its varied actions. Proper formulation and administration of Niruha Basti can only give the desired effects. It is important to study the contents of Niruha Basti, their quantity, properties, order and method of mixing, characteristics of well-prepared Basti, Ayurvedic and modern view on rationality behind sequential mixing and need for Basti formulation for understanding what the proper formulation exactly means.

Formulation of homogenous mixture which can retain stability for considerable period and can give desired therapeutic effect with faster absorption and elimination in proper time is the basic thing to be achieved by proper Basti formulation. The procedure of formulation if not followed properly results in various complications. So, it is important to study every aspect of Niruha Basti formulation to understand essence of science, to get desired therapeutic effects and to avoid the complications. Like the concept of Niruha Basti formulation every “word” from classical texts should be studied and analysed thoroughly and should be applied in the “ward” clinically.


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Journal of Ayurveda and Integrated Medical Sciences 2023;8(4)154