E-ISSN:2456-3110

Review Article

Vaitarana Basti

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 12 DECEMBER
Publisherwww.maharshicharaka.in

Revisiting Vaitarana Basti: A Conceptual Study in the Present Era

Bhaduri T1*, Roy S2
DOI:10.21760/jaims.9.12.17

1* Tapas Bhaduri, Reader Head, Department of Kayachikitsa, Institute of Post Graduate Ayurvedic Education Research At Shyamadas Vaidya Shastra Pith Svsp, Kolkata, West Bengal, India.

2 Suvajit Roy, Post Graduate Scholar, Department of Kayachikitsa, Institute of Post Graduate Ayurvedic Education Research At Shyamadas Vaidya Shastra Pith Svsp, Kolkata, West Bengal, India.

Among all Vasti Chikitsa, Vaitarana Vasti stands out for its unique formulation and specific uses. Derived from Vaitarani Mahatmya, it signifies a therapy that restores health from diseases. Today, Vaitarana Vasti is widely used to treat conditions like Amavata (rheumatoid arthritis), Katisoola (low back pain), and Gridhrasi (sciatica) underscores its therapeutic potential, with references in texts like Chakradutta and Vrindhamadhava. The absence of direct references in the Brihat Trayee (Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya) does raise interesting debates, especially concerning ingredient formulations, Drava Dravya (liquid medium), and dosages. The variations among practitioners in ingredient proportions and the lack of standardized guidelines highlight the need for further clinical and pharmacological studies. Through this conceptual discussion, researchers may gain a deeper understanding of Vaitarana Vasti's complexities, paving the way for its standardization and broader adoption in integrative medicine.

Keywords: Vaitarana Vasti, Conceptual Study, Literature Review, Drava Dravyas, Pharmacokinetics, Pharmacodynamics

Corresponding Author How to Cite this Article To Browse
Tapas Bhaduri, Reader Head, Department of Kayachikitsa, Institute of Post Graduate Ayurvedic Education Research At Shyamadas Vaidya Shastra Pith Svsp, Kolkata, West Bengal, India.
Email: 		Bhaduri T, Roy S, Revisiting Vaitarana Basti: A Conceptual Study in the Present Era. J Ayu Int Med Sci. 2024;9(12):140-150.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-11-15 2024-11-25 2024-12-05 2024-12-16 2024-12-27
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© 2024by Bhaduri T, Roy Sand 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].

J Ayu Int Med Sci 2024;9(12)140
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Suvajit R et al. Revisiting Vaitarana Basti: A Conceptual Study in the Present Era

Introduction

Vasti Chikitsa, a significant part of Panchakarma in Ayurveda, is considered as Ardha Chikitsa (half of all treatments)[1], emphasizing its importance in the Ayurvedic therapeutic approach. This procedure involves administering medicated oil or decoctions into the colon (Pakwashaya), uterus (Garbhashaya), or bladder (Mutrashaya) using a specialized instrument called Basti Yantra. There are two primary types of Vasti, Niruha Vasti (decoction enema) & Sneha Vasti (oil enema)[2].

Niruha Vasti is typically used to remove toxins and balance Vata Dosha. Sneha Vasti involves administering medicated oils to nourish and lubricate the colon. Vaitarana Vasti, a subtype of Niruha Vasti, has a distinct formulation and is indicated for specific health conditions.

Concept of Basti

The term Basti indeed translates to "Bladder" in Sanskrit. Historically, in ancient Ayurvedic practices, the urinary bladders of animals like buffalo or goats were used as Basti Yantra (instruments) for administering medicated substances during Vasti therapy. This traditional method gave the procedure its name, as these animal bladders served as natural containers for the therapeutic oils or decoctions used in the treatment.

Concept of Vasti

Vasti is a Karma or process in which medicated oil or decoction is administered into the Pakwashaya (colon), Garbhashaya (uterus), or Mutrashaya (bladder) using the Basti Yantra is known as Vasti. Acharya Charaka, one of the principal contributors to Ayurvedic literature, specifically used the term “Vasti” to refer to Niruha Vasti (decoction enema), highlighting its significance in the therapeutic regimen for cleansing and balancing the body.

Historical Significance of Vaitarana & Etymological concept of Vaitarana

The term Vaitarana originates from the word "Vitaranam," meaning to donate, to go across, or leave, indicating its role in expelling Doshas. Vaitarana Vasti is named after the river Vaitarani which is believed to be lies between the earth and the infernal Naraka, the realm of Yama, Hindu God of death[3].

Also, Vaitarani River is mentioned in other texts like Harihareshwara Mahatmya, Tirtha Yatra Parva of Mahabharat, Matsya Purana, Vamana Purana and Padma Purana. Lastly, it is the Padma Purana which reveals the etymology of Vaitarani in Vaitarani Mahatmya, asVai(truely)Tarini(saving).[4]

According to Sikhism, This River is a river full of blood, pus, urine and other filthy things. This river has a very bad smell to it due to it being a river full of filth & this river's content is extremely hot. Later the termVaitaranais used as a name associated withSalyatantra Acharyain Sushruta Samhita[5].

From the above references, it may be conceptualizing that the crossing of a river symbolizes a transition - perhaps from life to death, or death to another life or suffering to liberation. Here the crossing of river can be correlate with the administration of Vaitarana Vasti which itself is painful to hold. It seems to parallel the idea that enduring temporary pain or hardship can lead to profound relief or transformation.

Here in the context of Vaitarana Vasti, it implies that the timely administration of this Vasti restores the health of the person from the hell of Rogas. Different Acharya provides slightly varied formulations, reflecting the versatility and adaptability of the therapy.

In modern clinical practice, practitioners also often customize the ingredients of Vaitarana Vasti based on the specific disease and patient condition to ensure optimal therapeutic outcomes. The formulation typically includes ingredients with properties that detoxify the body, reduce inflammation, and balance doshas, particularly Vata and Kapha.

Classification of Vasti

According to Adhisthana

(a) Pakwasayagata Vasti (Rectum Route)

(b) Mootrashayagata Vasti (Urethral Route)

(c) Garbhashayagata Vasti (Vaginal Route)

(d) Vrana Vasti (Trough Wound).

According to Dravya

  • Matra Vasti (minimal) /Anuvasana Vasti (medium dose) / Sneha Vasti (maximum dose) - Enema with Oil

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  • Niruha Vasti / Asthapana Vasti. (Enema with decoction)

Classification of Sneha Vasti on the basis of dose:

1. Sneha Vasti: The quantity of Sneha Basti is 1/4th of Niruhae., 6 Pala (240 ml).
2. Anuvasana Vasti: The quantity of Sneha is ½ of Sneha Bastie., 3 Pala (120ml).
3. Matra Vasti: Minimum quantity of Snehae., 1 & 1/2 Pala (60ml).

Classification of Vasti on the basis of Sankhya (Numbers):

1. Karma Vasti: comprises of 30 Vasti (18 Anuvasana and 12 Niruha)

A specific action which has fruitful result can be correlate as Karma, here in this Vasti, Karma is mainly focused, Vasti which are to be administered to get a specific result may be consider as Karma Vasti.

Schedule of Karma Vasti:

A - Anuvasana, N - Niruha

1st A + 12N & 12A (Alternately) + 5 A

Table 1: Schedule of Karma Vasti

12345678910
ANANANANAN
11121314151617181920
ANANANANAN
21222324252627282930
ANANAAAAAA

2. Kala Basti: comprises of 16 Vasti (10 Anuvasana and 6 Niruha)

Kala means time and time could be represent as week, month, season or years. Here it could be correlate that the Vasti which are mainly administer on basis of time to get a better result is Kala Vasti.

Schedule of Kala Vasti:

A - Anuvasana, N - Niruha

1st A + 6N & 6A (Alternately) + 3 A

Table 2: Schedule of Kala Vasti

12345678
ANANANAN
910111213141516
ANANAAAA

3. Yoga Vasti (Enema as an Adjuvant therapy): It comprises of 8 Vasti (5 Anuvasana and 3 Niruha)

Yoga means union or integration, so it may be considered that when Vasti is applied in a manner that synergizes its therapeutic effects with other treatments, it can be considered a Yoga Vasti. This approach suggests that Vasti is not just a standalone procedure but an adjuvant therapy that unites with other treatments (like internal medicines, diet, and lifestyle changes) to produce a holistic healing effect.

Schedule of Yoga Vasti:

A - Anuvasana, N - Niruha

1st A + 3N & 3A (Alternately) + 1A

Table 3: Schedule of Yoga Vasti

12345678
ANANANAA

Different types of special Basti according to Acharyas:

1. Vaitarana Basti (Enema that can restore health from severe painful condition)
2. Siddha Basti (Effective in Specific Disease)
3. Pichchha Basti (Vasti made of Picchila Dravyas to treat inflammation and ulcer in colorectal disorders)
4. Yapana Basti (Can be given at any time, provides longevity and support life, neither Ruksha nor Sneha) e.g. Madhutailika Basti

Therapeutic value of Vaitarana Vasti

Table 4: Therapeutic indications of Vaitarana Vasti as per different Acharyas.

Chakradutta[6]Vrindhamadhava
[7]		Vangasena[8]
Soola (Severe Pain), Anaha (Constipation due to obstruction), Amavata (Rheumatoid Arthritis)Soola (Severe Pain), Anaha (Constipation due to obstruction), Amavata (Rheumatoid Arthritis)Soola (Severe Pain), Amavata (RA), Sopha of Kati, Uru, Prushta (Inflammatory swelling in pelvis, thigh, back),
Urusthambha (Spasticity of thigh), Gridhrasi (Sciatica), Janusamkocham (Knee Contracture), Vishama Jwara (Intermittent Fever), Klaibya (Impotency)

Therapeutic Contraindication

Vridhha (>60 years), Garbhini (Pregnancy), Duarbalya (Weakness), Shramata (Fatigue),


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Kshudartha (Hungry Person) and in Arsha (Haemorrhoids) etc.

Here key challenges in administering Vaitarana Vasti could be calculable, as ingredients are hot and penetrating in nature, Vaitarana Vasti often causes urge of immediate evacuation also, which makes it more challenging for patients to hold it long enough for optimal absorption. So, it can be assumed that sufficient strength and endurance to patients is required first. Patients could be asked to do Kegel exercise to make pelvic floor muscle strong enough to hold Vasti.

Dose of ingredients of Vaitarana Vasti as per different Acharyas.

The general ingredients of Vaitarana Vasti are Saindhava Lavana (Rock Salt), Guda (Jaggery of Sugarcane or Date palm), Amlika (Tamarind), Gomutra (Cows urine) and Ishat Taila (little quantity of Sesame oil) in prescribed quantity. Ingredients as per different Acharay’s are given below.

Table 5: Dose of ingredients of Vaitarana Vasti as per different Acharyas

IngredientsChakradutta[9]Vrindha Madhava[10]Todarmalla**Vangasena
[11]		Ayurvedasara of Acyuta
Saindhava1 Karsha (12gm)1 Karsha1 Karsha (12gm)
Guda1 Sukti (24gm)½ Pala1 Sukti (24gm)
Amlika1 Pala (48gm)1 Pala1 Pala (48gm)
TailaQuantity not mentionedQuantity not mentioned
(Ishat Taila)		Tila Tailam - 1 Pala
Drava DravyasGomutra - 1 Kudava Surabhi PayaGomutra - 1 Kudava

**Todaramalla’s Ayurvedasaukhyam, Vol-3, chapt. 14/62-63

Different Drava Dravyas of Vaitarana Vasti mentioned in different classics[12]

Drava Dravya is a word that means "fluid substance. Out of 5 ingredients; 4 i.e., Saindhava, Guda, Taila & Amlika are found common in most of the formulation of Vaitarana Vasti. There is only difference in the opinion of Drava Dravya only. In clinical practice, different Drava Dravyas are used like Dhanyamla (Fermented liquid made of Millets, Barley), Kulatha Kwatha (Decoction made from Horse Gram), Gomutra (Cow Urine) and Gokshira (Cow Milk) etc.

There is different classical controversy about the Drava Dravya. So critical analysis is needed while selecting Drava Dravya.

The first reference regarding Vaitarana Vasti may probably found in Vrindamadhava (chapter 75.3) where 1 Kudava of Gomutra is mentioned as a Drava Dravya, Todaramalla’s Ayurvedasaukhyam describe the formula of Vaitarana Vasti using similar verses as in Vrindamadhava. Cakrapanidatta also accepts the same formula.

In Anandasrama edition of Vrndamadhava it is explained as a separate section after Niruha Adhikara as this formulation does not satisfy the common pattern of the combination observed in the preparation of Niruha Vasti.

The critical edition of Vrindha Madhava by Dr. Premavati Tiwari and Dr. Ashakumari reports a variant reading where Guda is replaced by Hingu “Amlika Hingu Sindhujanma Gomutraih”.

Vangasena Chikitsa Sangraha has mentioned ‘Surabhi Payah (Cow’s Milk)’ instead of Gomutra (Cow’s urine).

The concept of the Vaitarana Vasti formulation become confused to some extent when one refers to Lala Saligrama Vaidya’s Hindi translation of Vangasena Samhita, which includes Gomutra instead of Cows milk as a constituent. The reason may be the influence of former treatises like Vrindha Madhava and Chakradutta.

As per Srikantha Dutta and Sivadas the tradition of adding double the quantity of Drava Dravya (liquid substances) explained in the formulae as per the Paribhasa of Dravadvaigunyam.

It is interesting to note that Adhamalla who closely follows Srikantha Dutta has been replaced the Vaitarana with Kshira Vaitarana.

Nischalakara and Sivadasa Sen stipulate the quantity of Taila as 1 Pala based on existing clinical tradition (“Ishat Tailamiti Palamiti Vyavaharanti Vriddah”).

Tatwachandrika Tika presents the practice of adding 1 Madanaphala to Vaitarana Vasti which is (usually) added to every Niruha Vasti.[12]

Material and methods of Vaitarana

Vasti according to Acharya Chakradatta[9]


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Ingredients:

1. Saindhava Lavana - 1 Karsha (12 gms)
2. Guda - ½ Pala (24gm)
3. Tila Taila - Eshat (may be considered as 60-70 ml, lesser than another Niruha Vasti dose)
4. Amleeka (Chincha or Tamarind) - 1 Pala (48gms)
5. Gomutra - 1 Kudava (Approx. 192ml)

Anuvasan Vasti

Ingredients:

Tila Taila Approx. 120 ml (Medium Dose), It could be also altered as per the requirement.

Note:

Vaitarana Vasti is mentioned in Niruhadhikara and has Teekshana and Shodhana properties and can be administered as Yoga Vasti or Kala Vasti schedule as per requirement. Anuvasana Vasti may be given before and after each Vaitarana Vasti to balance its strong action on the body.

However, in case of chronic disease, joint deformities or severe painavoid Anuvasan Vasti may yield better results. Selection and Dose of Drava Dravyas can be modify according to the severity of the disease and strength of the patient or requirement of the physician.

Requirements:

  • Enema pot
  • Vasti Netra (rubber catheter 10 no.)
  • 100 ml Syringe
  • Prescribed medicines
  • Cotton
  • Hand gloves
  • Kidney tray
  • Measuring jug

Procedure[13]

Poorva Karma (Pre-Operative Procedure)

Preparation of Basti Dravya: In Vaitarana Vasti first Saindhava is ground well and then syrup of Purana Guda is added to Saindhava. Then Talia is added to a thin stream and mixed well. The Chincha (Tamarind) devoid of seeds ground well and made into a paste is added to the above mixture. To this mixture, Drava Dravya (Liquid Substances) is added slowly and mixed thoroughly.

This solution is filtered and made lukewarm by keeping over a water bath.

Pradhana Karma (Main Operative Procedure)

After Mala Mutra Veganivarana (After passing stool and urine), Sthanika Snehana (Local massage with Tila Taila) and Sthanika Swedana (Local Sudation) should be done. Patient should advise to lie down in the left lateral position on the Droni (Vasti table) with straight body and left hand kept as pillow. The right leg is folded at knee joint and made to rest flat over the straight left leg. Then Sukhoshna Sneha (Luke warm oil) is to be applied in the anal region and on the Vasti Netra (Nozzle). Introduce the Vasti Netra slowly up to 1/4 part of the Vasti Netra. Lukewarm Vasti should be administered slowly.

Note:

Anatomically, when a patient lies on their left side, Guda (Rectum) is positioned in alignment with gravity, allowing for optimal absorption of Vasti Dravya; this position also helps to keep the mucosal folds submerged, maximizing the therapeutic benefit.

Different opinions of time of administration:

Since it comes under the category of Niruha Vasthi the general time for administering Niruha Vasti i.e., “Madhyahne Kinchidavarthe” [14] can be adopted here also. A day can be divided into 3 Ahnas i.e., Purvahna, Madhyahna and Aparahna. Madhyahna falls in the period between 10am to 2pm. Hence Niruha Vasti is given in this time when the patient feels not so much hunger. Vrindha Madhava and Vangasena explain that Vaitarana Vasti can be administered to all types of patients; it can be given even after consumption of food[15], which deviates from the general norm of administering Niruha Vasti. According to Vrindhamadhava, it can be administered during the evening time also.

Different Lakshanas to be observed during Vasti Karma[16]

1. Samyoga Lakshanas: Prasasta Vidamutra - Mala-Mutra Pravartana (Smooth Evacuation), Agni Vriddhi (Improve digestive power), Laghuta (Feeling of lightness), Roga Shanti (Relief from pain and stiffness) and Bala Vriddhi (Enhance Strength).

2. Ayoga Lakshanas: Shiro-Hridaya-Guda-Basti-Medhra Vedana (Headache, Chest pain, Pain in Pelvis region),


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Shotha (Inflammation), Pratishyaya (Rhinitis), Parikartika (Anal Fissure), Hrillasa & Chhardi (Nausea & Vomiting), Adhmana (Retention of flatus).

3. Atiyoga Lakshanas: Atidrava Mala Mokshan (Excessive Loose Stool), Udarshula (Abdominal Cramp) Parisrava (Excessive Salivation), Shwasa (Dyspnoea), Hridgraha (Cardiac Pain), Vibhramsha (Lack of Consciousness), Daurbalya (Excessive Fatigue).

Pashchat Karma of Vasti (Post Operative Procedure)

1. Removal of Netra (Nozzle) from Rectum: After the instillation of Vasti Dravya, the Netra (nozzle) is carefully removed from the rectum. This is done gently and slowly to prevent discomfort or irritation to the anal region.

2. Vasti Tadana (Thigh & Buttock Stimulation): Mild tapping or massaging is done on the thighs and buttocks to: Stimulate peristalsis (bowel movement), ensure uniform distribution of the medicine in the colon, prevent retention of Vasti Dravya beyond the desired time.

3. Changing Postures for Better Absorption: The patient is guided through a series of postural changes to facilitate uniform spread and absorption of the enema in the colon:

  • Left Lateral Position (Initially maintained during administration)
  • Prone Position (Lying on the stomach)
  • Right Lateral Position
  • Supine Position (Lying on the back)

These posture changes ensure maximum retention and uniform absorption of the Vasti Dravya. It also helps in avoiding localized pooling of medicine in one area of the colon.

4. Observing Retention & Expulsion (Basti Pratyagamana): In Vaitarana Vasti, the urge for evacuation generally may occurs after 10 to 15 minutes after the administration, if it is occurred immediate after the administration, it may suggest either the dose is not chosen optimally or the patient is not capable to hold the Vasti. In Anuvasana Vasti, retention is encouraged for a longer duration, may be 24 hours for nourishing effects.

5. Dietary & Lifestyle Guidelines Post-Vasti: Light, easily digestible food (Peya, Yusha, Manda) should be given after Vaitarana Vasti. Avoid heavy, oily, and difficult-to-digest foods & the patient should rest and avoid exertion.

Mechanism of action of Vasti[17]

पक्वाशयाद्वस्तिवीर्यं खैर्देहमनुसर्पति | वृक्षमूले निषिक्तानामपां वीर्यमिव द्रुमम् || (Su. Chi. 35/25)

Acharya Sushruta mentioned that Vasti given through the rectum reaches the whole body just like water poured at the roots reaches all the parts of the tree. Thus, according to Ayurveda, the Veerya (active principles) of the Vasti gets absorbed and then, through the general circulation reaches the site of the lesion and relieves the disease.

The active components of Vasti Dravya get absorbed through the intestinal and rectal mucosa and enter systemic circulation. Modern pharmacokinetic studies have also proved that drug administration through the rectum achieve higher blood circulation than the drug administered through the oral route due to partial avoidance of hepatic first-pass metabolism.

Mode of action of different ingredients of Vaitarana Basti[18]

Vaitarana Basti works by virtue of the action of ingredients present in it. The action of each ingredient can be described as follows:

Saindhava Lavana[19]: Sukshma Guna of Saindhava Lavana (Subtle) reaches up to the microchannel of the body. Tikshna Guna (Sharp) breaks down the morbid Mala (Waste product of body) and Dosha Sanghatana (two or more Dosha attaching together in the body, creating an imbalance) while Snigdha Guna liquefies the Dosha. Irritant property eliminates the Dosha.

Guda: In Vaitarana Vasti instead of Madhu, Guda is used. Purana Guda (Old Jaggery) is ideal for Vaitarana Vasti as it is Laghu (Lighter to digest), Vitmutraamayasodhaka (Cleanses feces urine and stomach), Agnideepana (Promotes digestive strength) and Vata-Pittaghna Tridoshagna (balance Vata Pitta as well Tridosha), Jvarahara, Pathya. It also helps in carrying the drug up to the micro-cellular level. It along with Saindhava makes a homogenous mixture, to form a solution having high permeability to the water in the rectum.


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Taila: Sneha Dravya reduces Vata Dushti, softens micro-channels, destroys the compact Mala, and removes the obstruction in the channels. (Ch.Si.1/7). In this Vasti, Tila Taila mixed with the mixture of Guda and Saindhava help in forming the uniform mixture. It also protects the mucus membrane from the untoward effect of irritating drugs in the Vasti Drava.

Amleeka or Chincha (Tamarind)[20]: Amleeka is having property Vata Kapha Shamaka, Ruksha and Ushna properties. Ruksha Guna helps in counteracting the Ama which is the chief pathogenic factor.

Gomutra: Gomutra owing Katu Rasa, Katu Vipaka, Ushna Virya, Laghu, Ruksha, Tikshna properties pacify the Kapha. The Ruksha Guna of Gomutra is very helpful in the diseased where Kapha is predominant like in the painful stage of Amavata. It is useful for Vaitarana Vasti owing to its Tridoshahara, Agnideepana, Pachana, Srotovishodhana, and Vatanulomaka properties. Thus, it works as a curative as well purification measure.

Go-dugdha: It calms Vata Pitta, increases Kapha. In the acute condition where Vata Pitta is involved, Go-dugdha is ideal as a Drava Dravya. Godugdha may bring the quality of Medhya (enhance intelligence), Balya (enhance strength), Rasayana (Rejuvenative), Jeevaniya (Antiaging). Suitable for Yoga Vasti.

Comparison between Vaitarana Vasti and Niruha Vasti[22]

The ingredients in classical Niruha Vasti are Makshkika (Honey), Lavana, Sneha, Kalka and Kwatha.[13] Vaitarana Vasti is considered as a variant of Niruha but does not satisfy the classical combination of ingredients in Niruha Vasti. The ingredients used in Vaitarana Vasti are Saindava, Guda, Chincha, Taila, and Drava Dravya. Both the Vasti have Saindhava as the common ingredient. In Vaitarana Vasti, Guda is mentioned instead of Makshika (Honey). This may be due to the influence of Jainism as they might have consciously avoided the Jangama Dravya. Apart from this while describing the Abhava Dravya (Substitute), in the absence of Makshika (Honey), Purana Guda (Old Jaggery) can be substituted. In Vaitarana Vasti, only Chincha (Tamarind) serves the role of Kalka (Paste) whereas in Niruha Vasti,

Kalka could be made of Yastimadhu (Glycyrrhiza glabra), Pippali (Piper longum), Methi (Trigonella foenum freacum) etc. Since it is a Ruksha Vasti the amount of Sneha should be lesser amount than Niruha Vasti.

That might have been the reason for stating “Eshat Taila” or “Taila Yutho” inspite of stating the exact quantity of Sneha Dravya.

Pharmacodynamics of Vasti:

1. Systemic Absorption: The rectal mucosa is highly vascularized, allowing direct absorption into circulation. It bypasses first-pass metabolism in the liver, leading to faster systemic effects.

2. Local Action in the Colon: Stimulates peristalsis (bowel movement), Lubricates the mucosa, easing stool passage (in cases of constipation), regulates gut microbiota, acts as an anti-inflammatory in colonic disorders.

3. Neural Reflex Stimulation: The rectal region is rich in autonomic nerve endings, influencing gut motility and nervous system function. Certain Vasti Dravyas (like medicated oils or decoctions) can modulate neurotransmitter release, impacting pain perception and inflammation control.

Pharmacokinetics of Vasti

Pharmacokinetics refers to the absorption, distribution, metabolism, and excretion (ADME) of substances administered through enema (Vasti). Since enema bypasses the oral route, its pharmacokinetics differs from conventional oral drug administration.

Absorption: The rectal mucosa is highly vascularized, allowing for rapid absorption of Vasti Dravyas. Absorption occurs through two primary routes:

  • Inferior & Middle Rectal Veins → Systemic Circulation (bypassing the liver, avoiding first-pass metabolism).
  • Superior Rectal Vein → Portal Circulation → Liver Metabolism (for partial metabolism).

Fat-soluble substances (e.g., Sneha Vasti with oils/ghee) absorb slowly but have longer retention in the body. Water-soluble substances (e.g., Kashaya Vasti with decoctions) absorb rapidly, showing quick systemic action.


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Distribution:

Systemic Distribution: Active components travel through circulation and reach the target organs, especially influencing Vata-dominant areas (joints, nervous system, and gut).

Local Distribution: Some part remains in the rectum/colon, exerting local anti-inflammatory, lubricating, or cleansing effects. Oil based Vasti (Anuvasana) penetrates deeper into cell membranes and lipid-rich tissues like nerves and joints.

Metabolism:

Liver Metabolism (for partially absorbed components): Water-based Niruha Vasti components undergo hepatic metabolism after partial absorption via the portal system. Herbal decoctions may be broken down into smaller active molecules before systemic circulation.

Colon Microbiota Metabolism: Some herbal components interact with gut bacteria, forming secondary metabolites that influence gut health,

neurotransmitters, and immune responses.

Minimal Metabolism of Oils (Anuvasana Vasti): Oils primarily act locally and are slowly absorbed, providing sustained nourishment.

Excretion:

Primary Excretion via Feces:

Unabsorbed or partially metabolized components are eliminated with stool.

Secondary Excretion via Urine:

Water-soluble metabolites of Vasti Dravyas may enter systemic circulation and be filtered by the kidneys.

Recent researches done on Vaitarana Vasti

Vaitarana Vasti gained prominence after the research conducted at Government Ayurveda College in 1991 by P. Sankarankutty, M.R. Vasudeva Namoodiri, and V.K. Sasikumar. Their work was inspired by the compilation of Bastiyogas by Dr. K. Rajagopalan.

Table 6: A glance on Recent Reviews and Clinical Research done on Vaitarana Vasti

Research TitleStudy Type
An Analysis of Formulation of Vaitarana [Basti] on The Basis Of Ayurvedic Texts And Commentaries Manoj Sankaranarayana* (Received 16 October 2008; revised 17 November 2008)A Conceptual Study
Role of Valuka Sweda and Vaitarana Basti in the management of Amavata (Rheumatoid Arthritis); Pooja B.A et al; Int. J. Res. Ayurveda Pharm. 4/ (5), Sep-Oct 2013.A Clinical Study
A piloting study on Godugdha Yukta Vaitarana Basti in Vataj Gridhrasi (Sciatica); Shriram Chandra Mishra; Int J Ayu Pharm Chem Vol. I, Issue 1, 2014.A Clinical Study
Efficacy of Vaitarana Vasti and Simhanad Guggulu in Amavata; Wadhava Ritu S, Ghore Jaya K; International journal of applied Ayurveda research ISSN: 2347-6362; Vol II Issue II Jul-Aug 2015.A Clinical Study
Evaluation of the effect of Vaitarana Basti in Sandhigata Vata (Upastambhit) w.s.r to inflammatory arthritis; Chaudhari Tejasini et al; Ayushdhara/ Sep-Oct 2016/Vol 3/Issue 5A Clinical Study
Vaitarana Basti in – Amavata A pilot study; Dr Rahul M. Wanole, Dr. D.S Chothe; ejpmr, 2016, 3(11), 379-382A Clinical Study
A Clinical Study of Vaitarana Vasti and Vatari Guggulu in Aamvata (Rheumatoid Arthritis) Dr Manoj Virmani et al, PARIPEX Indian journal of Research; Volume 6/Issue- 11/November-2017A Clinical Study
Aswani P. S., Kshirod Kumar Ratha, Dighe Dattatray Pandurang, M. M. Rao, Remya Vijayan.Vaitarana Vasti - A Conceptual Study. Res. J. Pharmacology and Pharmacodynamics.2018;10(1): 45-50. doi: 10.5958/2321-5836.2018.00008.3 Published In: Volume - 10, Issue - 1, Year2018A Conceptual Study
Nagalakshmi B, Vinaykumar K N. An Observational study to evaluate the effect of Vaitarana Basti in the management of Vatakaphaja Gridhrasi vis-à-vis Sciatica. J Ayurveda Integr Med Sci 2021; 1:73-79. http://dx.doi.org/10.21760/jaims.6.1.10An Observational study
Shiny Singh, Arvind Gupta, Vandana and Roopali Barmola, A REVIEW ARTICLE ON VAITARANA BASTI AND VAISHWANARA CHURNA BASTI IN AMAVATA (RHEUMATOID ARTHRITIS), ISSN 2455-3301
Wjpmr, Article Accepted on 19/07/2023		A Review Article
Murshida banu, Waheeda banu. Management of Amavata Through Vaitarana Basti w.s.r to Rheumatoid Arthritis. AYUSHDHARA, 2023;10(6):183-188. https://doi.org/10.47070/ayushdhara.v10i6.1456A Case Study
Anusree D, Gopesh Mangal. Evaluation of the Efficacy of Vaitarana Basti in the Management of Amavata: A Case Series. AYUSHDHARA, 2024;11(5):59-67. https://doi.org/10.47070/ayushdhara.v11i5.1752A Case Study

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Suvajit R et al. Revisiting Vaitarana Basti: A Conceptual Study in the Present Era

Conclusion

Vaitarana Vasti can be administered after proper examining Sara (Physical Essence), Satva (Mental Strength), Bala (Physical Strength), Agni (Digestive Fire), Oja (Immunity) of a Patients. Vaitarana Vasti is ideally could be given as a Yoga Vasti, as it is safe and can be balance with other treatment also. Vaitarana Vasti could be selected only in case of Severe Painful Condition.

Selection and dose of Drava Dravyas can be modify according to the severity of the disease and strength of the patient or requirement of physician. Vaitarani Vasti offers both local and systemic effects with variable absorption rates depending on the Dravyas (Active Ingredients). It exhibits fast-acting, detoxifying properties, efficiently removing toxins via the colon. Anuvasana Vasti (oil-based) shows slow, sustained absorption, nourishing deep tissues (Majja, Asthi, Snayu) which is also important to balance the effect of Vaitarana Vasti.

Since its revival and documentation in the 1990s, the practice of Vaitarani Vasti has shown considerable variation across institutions and practitioners, reflecting differences in interpretation, formulation, and administration techniques. This variability highlights adaptability of Ayurveda while also emphasizing the need for standardization in clinical practice.

Declaration of generative AI and AI-assisted technologies in the writing process

During the preparation of this work the author(s) used Chat GPT in order to write sentences & after using this tool, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication.

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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