E-ISSN:2456-3110

Review Article

Manasaroga

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 8 AUGUST
Publisherwww.maharshicharaka.in

Role of Basti in Manasaroga - A Review

Raksha SD1*, Seethadevi P2
DOI:10.21760/jaims.9.8.7

1* Raksha SD, Final Year Post Graduate Scholar, Department of Panchakarma, JSS Ayurveda Medical College, Mysuru, Karnataka, India.

2 Seethadevi P, Reader, Department of Panchakarma, JSS Ayurveda Medical College, Mysuru, Karnataka, India.

Absolute health is a constitute of a healthy mind in a healthy body. While defining health, Ayurveda clarifies the importance of maintaining the clarity of mind, the sense organs, and the body’s normal physiological functions. Ayu (life) is an amalgamation of Shareera, Indriya, Satwa, and Atma which signifies the concept of psychosomatism in Ayurveda. WHO states, “Health is a complete physical, mental, and social well-being and not merely the absence of disease or infirmity. The increase in the level of stress in today’s time gives a huge surge of Manovikara. In Ayurveda many references of Manas and the treatment of Manovikara are available. Manovikara is caused by vitiated Vata Dosha i.e., (Prana, Udana, and Vyana Vayu). Vata Dosha is said to be the controller and prompter of Manah. Basti Karma is the most important among Panchakarma procedures due to its multidimensional approaches. It is the major and most successful treatment modality for Vata Vikaras, Acharya Charaka mentioned Basti Karma as Ardha Chikitsa while some authors consider it as the Purna Chikitsa for Vataja Vikaras. It is effective in treating diseases of almost all Srotas where Vata Dosha is involved. Here an attempt is made to project at one place the available references of Basti Chikitsa in Manovikara.

Keywords: Mental Illness, Enema, Manovikara

Corresponding Author How to Cite this Article To Browse
Raksha SD, Final Year Post Graduate Scholar, Department of Panchakarma, JSS Ayurveda Medical College, Mysuru, Karnataka, India.
Email: 		Raksha SD, Seethadevi P, Role of Basti in Manasaroga - A Review. J Ayu Int Med Sci. 2024;9(8):46-52.
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https://jaims.in/jaims/article/view/3530

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-07-15 2024-07-25 2024-08-05 2024-08-15 2024-08-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 14.52

© 2024by Raksha SD, Seethadevi Pand 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

In the modern era, life has become so sophisticated that over-ambitiousness, lifestyle changes, and dietary habits have led to increased mental stress, which acts as a predisposing factor to various psychological disturbances and mental disorders like anxiety, depression, insomnia, etc. Estimates suggest that nearly 15% of the Indian population grapples with some form of mental health issue.[1]

The prevalence of Anxiety neurosis is 16.5 %, Depression is 3.9%, and Insomnia is 15.4% of the general population. In Ayurveda, Manovikara is discussed under the broad spectrum of diseases like Unmada, Apsmara, Moha, Mada, Murcha, Madatyaya, etc. Vata is the predominant Dosha in all the Manovikaras, along with Pitta and Kapha, as it is said to be the controller and prompter of Manas.[2] The main action of Basti is on vitiated Vata Dosha. Thus, Basti can be considered as the choice of therapy for Manovikaras.

Mana Nirukti: “Manyata Jnana Evam Manu Avabodhini”.

Mana is one among Nava Karana Dravyas, described as Atindriya & Ubhayendriya. Tool for perceiving knowledge, experiencing happiness, agony, investigation & discussion, etc.

Mana Sthana:The main location is Hṛidaya and the functional location is Shiras. Sanchara Sthana is Sparshanendriya[3] which pervades all over the body except Kesha, Loma, Nakhagra, and others like Anna, and Mala Drava, as they are beyond the purview of consciousness.[4]

Manovaha - Rasavaha Srotas - Ojas

Rasavaha Srotamsi have their origin in Hridaya and Dasha Dhamanis similar to Manas. Rasavaha Sroto Dushti Karana includes Guru-Sheeta-Snigdha-Atimatra Ahara Sevana & Atichintana.[5]

Manas - Brain - Heart[6]

Manas is linked to the brain, and the heart supplies nutrients & oxygen to the brain. Neuroimaging has already proven the changes in cerebral blood flow during emotions and an increase in blood supply in the areas where neurons are more activated which might be the reason for mentioning the location of Manas as heart. Thus, Manas cannot be segregated from the brain.

Physiological factors of Manas: include - Prana-Udana-Vyana Vata, Sadhaka Pitta, Tarpaka Kapha, Agni, and Ojus.

Mano Artha: Chintya (Thoughtfulness), Vicharya (Reasoning, Logic & Discrimination), Uhya (Logical interpretation), Dhyeya (Goal & Aim), Sankalpa (Resolution & Determination).

Mano Karma: Indriyabhigraha (Sensory & Motor control), Swanigraha (Mental Self-control), Uhya (Guess), and Vichara (Thought).

Shareera Dosha - Manasa Dosha

Tridosha and Triguna can affect each other. Vriddhi or Kshaya of Tridosha affects Triguna & vice versa. For example: If Vata Dosha is predominant, there will be an increase in Rajo Guna leading to Kama, Shoka & Bhaya.

In the same way: Pitta Dosha à Rajo Guna à Krodha; Kapha Dosha àTamo Guna à Moha & Harsha. When allowed to persist for a long duration, these psychic diseases and somatic diseases get combined at times.[7]

For this instance, we can consider the involvement of Manasika Bhavas as Nidana in diseases like - Abhishangaja Jwara (Kama-Shoka-Bhaya-Krodha as Nidana), Aruchi (Dvishtarta Manasa, Shoka-Bhaya-Atilobha-Krodha as Nidana), etc.

And also the involvement of Manasika Bhavas as Lakshana in diseases like – Jwara (Vaichintya-Arati-Glani as Lakshana), Kamaja Jwara (Dhyana), Shokaja Jwara (Bashpa Bahulam), etc.

But in diseases like - Mada, Murcha, Sanyasa, Madatyaya, Tamaka Shwasa, Kushta, Kilasa, etc., Even though there will be involvement of Manasika Bhavas, Basti is not the choice of treatment.

Psycho-Somatic Disorders

  • The psychological factors or stress have significant effect on the immune system through a slow response mediated by the hypothalamo-pituitary-adrenal axis (HPA axis) and a fast response mediated by the sympathetic nervous system (SAM axis).
  • Activation of SAM axis results in enhanced arousal, alertness, vigilance, cognition, focused attention, and the HPA axis results in suppression of insulin, immune, inflammatory response, delayed wound healing, etc.

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  • There are three general categories of psychosomatic illness - i) Mental and Physical illness complicating each other; ii) Mental issues due to medical condition and its treatment; iii) Somatoform disorder (having mental illness, experiencing one or more physical symptoms, even if he does not have any associated medical condition).
  • Psychological factors affecting medical conditions include - Oesophageal reflux, IBS, Anorexia nervosa, Alzheimer’s disease, Migraine, Rheumatic arthritis, Psoriasis, Bronchial asthma, etc.

Manovikara

Samanya Nidana: Asatmendriyarta Samyoga, Pragnaparadha, Parinama, Vega Dharana, Sadvrutta Apalana, Rajo-tamo Guna Bahula, Alpa Satva Purusha, Dhi-Driti-Smriti Vibramsha, Purvajanmakruta Karma, Ishtasya Alabhat Labhat Cha Anishtasya.

Samanya Samprapti: Nidana Sevana by Alpasatva Vyakti aggravates Vata Dosha and Rajo-Tamo Dosha, takes Sthana Samshraya at Hridaya, leads to Manovaha Sroto Dushti which in turn leads to Manasika Bhava further leading to Manovikara.

Samanya Lakshana: Bhaya, Trasana, Asahishnuta, Mana Kshobha, Aniyantrita Chittata, Shoka, Krodha, Irshya, Kama, Lobha, Mada, Chinta.

Mano-Buddhi-Sanjna-Jnana-Smriti-Bhakti-Sheela-Cheshta-Achara Vibhrama.

Classification

Mental Origin with Mental Symptoms: Unmada, Prajñāparādha, Dhṛtināśa, Smṛtinasa, Emotional disorders like Kama, Krodha, Lobha, Bhaya, Shoka, Chinta.

Mental Origin with Physical Symptoms: Apasmara, Apatantraka, Bhayaja & Shokaja Atisāra, Nidranasha, Kamaja and Shokaja Jwara.

Physical Origin with Mental Symptoms: Atatvabhinivesha, Mada.

Physical Origin with Physical Symptoms: Murcha, Sanyasa.

Samanya Chikitsa

According to Charaka:

  • Trividha Aushadhae., Daivavyapashraya, Yuktivyapashraya and Satvavajaya Chikitsa.
  • Manonigraha from Ahita Vishayas.

According to Kashyapa: Treatment should be done similar to that of Shareerika Vyadhi.

According to Vagbhata: Treatment includes - Dhi, Dhairya, Atmadi Vijnana.

Effect of Shodhana on Manas

Through Samsodhana - the Hrdaya, Indriyas, Shira, and Koshta are cleansed as a result of which, the Mana gets refreshed and the patient gains memory as well as consciousness.[8]

Importance of Basti in Manasa Roga

  • Basti promotes longevity, strength, digestion, intelligence, voice, and complexion. It is safe to administer Basti in all age groups and it relieves all the diseases.
  • The person who undergoes a course of 324 Bastis (18 x 18) in the prescribed manner will neither become old nor sick; lives for a thousand years, a retentive memory, devoid of sins, lustrous like deities, with the sexual vigor of a stallion, with the strength of an elephant, with a steady mind, sense organs, and digestive power.[9]

Effect of Basti on mental function[10]

  • It is Medhakruta - Improves intellectual power.
  • It does Buddhi-Indriya Samprasadana - Nourishes Buddhi, Indriya and Manas.
  • It does Swapnavrutti - Induces sound sleep.
  • It does Harshana - Relieves from stress and aids in relaxation & promotes cheerfulness.

Unmada Chikitsa[11]

In Vataja Unmada, Snehapana is advised. If Vata is Kapha-Pittavruta, then Samsneha Mrudu Shodhana should be done; In Pittaja and Kaphaja Unmada, Snehana-Swedana followed by Vamana (Kaphaja) & Virechana (Pittaja), then Samsarjana Krama. Again, after Snehana-Swedana, when the patient regains strength, Niruha Basti, Anuvasana Basti & Nasya should be administered depending upon the predominance of Doshas, which is said to be administered repeatedly. Sneha Basti should be administered after subsidence of deranged Doșha.

Basti in Unmada[12]

  • Anuvasana Basti with Taila prepared with Ashvagandha, Ajagandha, Lasuna, Sarshapa, Rasna (A.S.U. 9/40-41)

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  • Anuvasana Basti (Vangasena)
  • Mustadi Yapana Basti (Si.12/15.1)
  • Rasnadi Niruha Basti in Kaphaja Unmada (Chi.38/71-76)

Ghrita Yogas which can be used for Anuvasana Basti & Snehapana in Unmada[13]

  • Tridosha Shamaka Ghritas - Purana Ghrita, Mahapaishachika Ghrita, Brahmi Ghrita, Phala Ghrita.
  • Vatahara Ghritas - Lashunadya Ghrita, Dvitiya Lashunadya Ghrita.
  • Vata-Pittahara Ghritas - Kalyanaka Ghrita, Mahakalyanaka Ghrita
  • Vata-Kaphahara Ghrita - Hingvadya Ghrita

Apasmara Chikitsa[14]

Initially, Vamana (Kaphaja) then Virechana (Pittaja), Basti (Vataja), Teekshna Nasya, Teekshna Anjana etc. should be administered to clear the obstruction of Hridaya & Manovaha Srotas, and to protect the Chethana of the patient.

Basti in Apasmara[15]

  • Vataja Apasmara (A.S) (Vangasena) (Y.R.24/11)
  • Niruha Basthi with Kwatha of Dashamoola, Bala, Rasna, Yava, Kola (A.Su.10/16)

Ghrita Yogas which can be used for Anuvasana Basti & Snehapana in Apasmara[13]

  • Tridosha Shamaka Ghritas - Mahapanchagavya Ghrita, Brahmi Ghrita
  • Vata-Kaphahara Ghrita - Saindhavadi Ghrita
  • Pittahara Ghritas - Amalakadi Ghrita, Jeevaniya Ghrita or Yamaka
  • Pitta-Kaphahara Ghrita - Panchagavya Ghrita
  • Kaphahara Ghrita - Siddhartaka Ghrita
  • Kapha-Vatahara Ghrita - Vachadi Ghrita
  • Medhyarasana - Kushmanda Ghrita

It is said that the physician if well versed in the science, has the complete liberty to try hundreds of permutation-combinations of the Basti Yogas, according to his logic and interpretations on the nature of the medicine and the disease. Thus, we can try administering various Sneha, Kalka, Kashaya Dravyas which are indicated for Manasa Roga, depending upon the Dosha-Dushya Samurchana and Rogi-Roga Bala.

Ghritas which can be used for Anuvasana Basti: (Ref : Sahasrayogam)

  • Ashtanga Grita: Vak Krit, Medhakrit, Smritikrit, Buddhikrit.
  • Kalyanaka Grita: Unmada, Apasmara.
  • Kushmanda Grita: Apasmara
  • Chetasa Grita: All types of Manasa Rogas.
  • Tiktaka Grita: Bhrama, Unmada, Apasmara.
  • Dhatryadi Grita: Unmada
  • Dhanwantara Grita: Unmada, Apasmara.
  • Panchagavya Grita: Mahagraharoga, Bhootamaya.
  • Bramhi Grita: Unmada, Graha, Apasmara, Vak Krita, Medhakrit, Smritikrit.
  • Mahakalyanaka Grita: Unmada.
  • Mahapaishachaka Grita: Unmada, Graha, Apasmara.
  • Saraswata Grita: Smritikara, Medhakara, Rakshoghna, Vishaghna.
  • Hingwadya Grita: Unmada.

Tailas which can used for Anuvasana Basti: (Ref : Sahasrayogam)

  • Chandanadi Taila: Chittavibramsha, Chittavikriti.
  • Prasarini Taila: Unmada.
  • Bala Taila: Apasmara.
  • Balashwagandha Taila: Unmada.
  • Lakshadi Taila: Unmada, Apasmara.
  • Vranabhairava Taila: Unmada, Apasmara.
  • Sahacharadi Taila: Unmada.

Ksheerapakas which can be used for Niruha Basti: (Ref : Sahasrayogam)

  • Vatyolaka Ksheerapaka: Bhrama.
  • Shatavaryadi Ksheerapaka: Bhrama
  • Shwethonmatta Payasa: Unmada

Kashayas which can be used for Niruha Basti: (Ref : Sahasrayogam)

  • Abheerumuladi Kashaya: Unmada.
  • Dashamula Kashaya: Unmada.
  • Duralabha Kashaya: Bhrama
  • Draksha Abhayadi Kashaya: Pralapa, Bhrama.

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  • Drakasha Madhukadi Kashaya: Unmada.
  • Drakasha Samangadi Kashaya: Unmada.
  • Mridvikadi Kashaya: Mativibhrama.
  • Shatavari Gopakanyadi Kashaya: Unmada.
  • Somavalyadi Kashaya: Unmada.

Kalkas which can be used for Niruha Basti: (Ref : Sahasrayogam)

Mrudveekadi Kalka - Unmada, Apasmara.

Based on current research[16]

The following drugs can be used for Kalka and Kashaya Dravyas for Basti:

  • Anxiolytic - Ashwagandha, Brahmi,
  • Antidepressants - Ashwagandha, Brahmi, Vacha,
  • Tranquilising -
  • Sedative - Shankhapushpi,
  • Anticonvulsant - Shankhapushpi,
  • Neuroleptic -
  • Neuroprotective - Ashwagandha.
  • Antiepileptic - Jatamansi, Brahmi,
  • Antiparkinson - Kapikacchu.

Mode of action of Basti in Manovikaras

The systemic action of Basti denotes its capacity to remove the vitiated Doshas from the whole body. Though it is administered in the Pakvashaya, its Veerya spreads in the entire body. Virya of the Basti à Apana Vata à Samana Vata à Vyana Vata à Udana Vata à Prana Vata à Pitta-Kapha Shamana à Sarva Shareera Poshana.

The gut-brain axis (GBA) consists of bidirectional communication between the central and the enteric nervous system, linking the emotional and cognitive centers of the brain with peripheral intestinal functions.[17] The brain sends signals to the gut through command neurons and the gut sends signals through interneurons. Both command neurons and interneurons are spread throughout the two layers of the gut tissue called ‘the myenteric plexus and the submucosal plexus’. Thus, ENS works in synergism with the CNS Major neurotransmitters like serotonin (approx. 95% of the body’s serotonin), dopamine, glutamate, norepinephrine, and nitric oxide are in the gut.

It also contains neuropeptides along with the major cells of the immune system. Deficiencies or decrease in the levels of serotonin is directly responsible for symptoms of depression, aggressive behavior, anxiety, and increased sensitivity to pain.

Basti Dravya stimulates the chemo/mechano receptors further leading to activation of the concerned part of CNS which precipitates results accordingly. It is not mandatory for a drug to stay in contact with the receptor for a long time (e.g. like in Proton Pump inhibitor where drug interact and flush out from circulation.) It is known as ‘HIT AND RUN MODULE’ of pharmacodynamics. Same module of pharmacodynamics may be hypothesized for Niruha Basti.

In Manasika Vyadhita, due to Bahudoshavasta, the Sanchita Mala might hamper the secretion and reuptake of serotonin. By Basti, the path might be cleared and biosynthesis of serotonin may be brought back to normalcy.

Discussion

Basti falls under Yuktivyapashraya Chikitsa in the Trividha Chikitsa of Manasika Vyadhi. Basti can be better administered after Koshta Shodhana like Vamana or Mrudu Virechana for its optimum results. On the basis of recent research studies, it can be inferred that Basti mainly acts by modulating the Gut-Brain axis and exerting neuro-endocrino-immunological action.Apart from this, local reflex action, and modulation of gut microflora may have some role in explaining the pharmacological activities of Basti.Further, radioisotope studies are required to study the exact pathways and distribution of Basti Dravya in the body.

Conclusion

Mind is considered as the lord of Indriyas, but the lord of Mind is Vayu. When the Vata is disturbed, the mind is disturbed, and vice-versa. Vata controls and directs the mind. It coordinates & stimulates all sense organs, and controls all the objects of sense faculties. Treatment modalities of Vata include Snehapana, Mrudu Virechana, and Basti. Apart from Bahya Chikitsa, Basti can be the choice of treatment for patients presenting with suitable Lakshanas. Vata is responsible for most of the types of diseases and when Vata is aggravated, there is no other remedy other than Basti for its alleviation.


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Basti is considered as Ardha Chikitsa and even as Poorna Chikitsa by few authors. Among the Snehadi Karmas, Basti Karma is considered to be the important one. Because of the permutation and combination of the drugs used for preparing Basti Dravya, it brings about the functions like Shodhana, Shamana and Sangrahana of the Doshas.

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12. Wisdom on Basti Chikitsa by Dr.Lohith.B.A, Chaukhambha Orientalia Publications, Page 271.
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