Ayurvedic Vasti Therapy: Rectal Administration for Futurity

Validation of
Vasti for futurity

Dr. K. Shiva Rama Prasad
M.D.(Ay) COP (German), M.A, Ph.D. (Jyotish)

28-05-2008 doctorksrprasad@gmail.com 1
doctorksrprasad@aol.in

Futurity Vs Futility

• Futurity =The time yet to come
• or
• The quality of being in or of the future
• Futility = Uselessness as a
consequence of having no practical result
doctorksrprasad@gmail.com 2

• Over loading oral drug administrations making
tender stomach to get gastritis & other
complications
• The alternative Controlled-Release
Preparations, Sublingual, Transdermal
Subcutaneous, Parenteral, Intravenous,
Intramuscular, Intraarterial, Pulmonary,
Topical, etc are not equals Ayurveda
Panchakarma - Vasti – As it is -

Present trends


Rectal
Administration
• The rectal route often is useful
when oral ingestion is precluded
because the patient is
unconscious or when vomiting
is present - a situation particularly
relevant to young children.
• Approximately 50% of the drug
that is absorbed from the rectum
will bypass the liver; the potential
for hepatic first-pass metabolism
thus is less than that for an oral
dose.
• However, rectal absorption often
is irregular and incomplete, and
many drugs can cause irritation
of the rectal mucosa.


Practice • Ayurveda suggests many
methods of disease and healthy
managements from ages, using
the naturally available adopted
• It offers Oral route, Trans dermal
route, Trans Rectal route, etc
• One has to practice for perfection
understanding methods properly
• Does Ayurveda requires any
adoptions and updates in the
systems according to the present
technology or not is a debate
• Change is Unavoidable under any
circumstances


Tunes of Trans Rectal route

Vasti or Basti

• The pronunciation of the Technical term
itself is first problem
• Many times not undergone the concepts
• Following colloquially
• Not having touch with Instruments /
Mechanism /Drug qualities /etc


7 steps to success
1. Prepare patient (Physically / Mentally)
2. Follow indications
3. Check the Ingredients (Contents)
4. Prepare medicine methodically
5. Find proper Instruments
6. Standardize the entire situation
7. Administration (Time /Procedure)


Dimensions & Definition

• uÉÎxiÉÍpÉSÏïrÉiÉå
rÉxqÉÉ¨ÉxqÉÉ²ÎxiÉËUÌiÉ xqÉ×iÉ:-
AÉ WÛû xÉÔ 19/1
• An injection syringe made
of bladder or the injection
Charaka Siddhi 1/38-40
it self, Kwathas
No disease is with out Vata • uÉxÉÑ ÌlÉuÉÉxÉå – uÉxÉÑ AÉcNûÉSlÉå
No other than Vasti treat Vata


• Enema = An injection of a
liquid through the anus to
stimulate evacuation;
sometimes used for
diagnostic purposes
• Many varieties of
nomenclature based upon the
site of administration –
Shirovasti, Urovasti,
Kativasti, Uttaravasti, Vasti
= Niruha, Anuvasana


Preparation & Understanding
patient (Physically / Mentally)
Pareekshya Bhava
(C.Su.15/5; C.Ni.3/6; Su.Chi.38/91-92)

1. The patient subjected for examination for
assessment of Kaala, Bala, Dosha and
Disease in detail.
2. Later looking at the Vasti Dravya Bala the
quantity and time of administration is
decided.

• In this course of preparation –
– In Kaala - Rutu kaala, Vayo kaala, Vyadhi
Kriyakaala, Ahara kaala
– In Bala – Rogi bala (Physical /psychological),
Roga Bala, Aushadha Bala
– In Dosha - sansargatwam – Vruddhi, Ksheena,
Urdhwa /Adho gati, etc
– In Vyadhi - Rogamarga - Shakha /Kosta/Marma,
Swatantra / Paratantra, Vata vyadhi, Vata
sthaana janya vyadhi, Shakha /Kosta janya
vyadhi, Pureeshaadhana / srotas janya vyadhi,
Shodhanaarha vyadhi, Brumhanadi
kramoyogam


• Based upon the site/ Organ Vasti – Pakwashaya,
Mootrashaya, garbhashaya
• Based upon the Drug content / material – Nirooha,
Anuvasana
• Based upon the Quantity of the material – Sneha,
Anuvasana, Matravasti
• Based upon the function – Shodhana, Shamana
• Based upon the number of administrations – Karma, Kala,
Yoga
• Based upon the utility – Yapana, Siddha, Piccha, Rakta,
Prasruta Yogiki, etc
• Based upon the Karmukata (purpose /intentions) –
Vajikarana, Brumhana, Lekhana, Vandhtwahara, Teekshna,
Mrudu, Krimighna, Chakshushya, Malabhedana, etc

Vasti classification

Trayovasti (Su.Chi.38/92)
• Susruta affirms that –
– Utkleshana
– Doshahara (Cha.Si.3/26)
– Samshamana – are • We are following Charaka
offered discriminatively statement but not valuing the
• Where in Charaka Susruta
enumerates as Dosha • Avapaka/additives such as –
Apakarshana in (Ch. Vi. 8/175-176, AH Su 10/22-24, Su Chi 38/24) –

sequence of – Anuvasanopaga,
– Vata Asthapanopaga, Nirooha Varga,
– Pitta Asthapana Varga,
– Kapha – are undertaken Shadasthapana (Madhuradi)
by the Trayo vasti Skandha gana dravyas are not
used in practice

Tridosha & Trayovasti

• One Snigdha & Ushna with Mamsa for Vata
• Two swadu & sheeta with Milk for Pitta
• Three katu & Ushna, Teekshna with Mootra
for Kapha
• Never more than the prescribed


Vasti - Discrimination
• §ÉrÉ¶É xÉÍ³ÉmÉÉiÉåÅÌmÉ SÉãwÉÉlÉç blÉÇÎliÉ rÉiÉ: ¢üqÉÉiÉç
- A WØ xÉÔ 19/59
• lÉ mÉUÇ ÌuÉkÉãrÉÉ – cÉ ÍxÉ 3/69
• xÉqrÉÎglÉÃRûÍsÉlaÉÇiÉÑ mÉëÉmiÉå uÉÎxiÉÇ ÌlÉuÉÉUrÉåiÉç
– xÉÑ ÍcÉ 38/7û
•Indications
•Vata Vyadhi
•Vata Sthaana Janya Vyadhi
•Kosta Janya Vyadhi
•Pureeshadhaana / Srotas Janya Vyadhi
•Shodhanarha Vyadhi
•Shodhanadi Krama Rasayana Vidhi
•Brumhanadi Kramopayogam

Vasti Poorvakarma


Sequence of Material
• oÉsÉ SÉãwÉ mÉëqÉÉhÉ AlÉÑÃmÉ AÉæwÉkÉqÉç
Saindhava = 1 Aksha,
Madhu = 2 Prasruti
Sneha = 3 Prasruti
Kalka = 1 Prasruti
Kashaya = 4 Prasruti
Avapadravya = 2 Prasruti
Total = 12 Prasruti = 1200 ml

doctorksrprasad@gmail.com Su Chi 38/37-3917

Sneha (Lipoprotein)/Kalka quantity

• Vata = ¼ = 3 Prasruta, Pitta = 1/6 = 2 Prasruta and
Kapha = 1/8 = 1 ½ Prasruta Dosha based sneha
quantity
• The unctuous substance either oil / Ghee gets
digested by the Ushma of Jatharagni and the Kalka
Dravya (Shatapushpa)
• Kalka dravya in Vasti is a Pachana dravya which
assimilates the Vasti draya but not increase the
Jatharagni
• The ratio of Vasti dravyas are 1:2:3:4 for Kalka,
Madhu, Taila, Kashaya respectively to make a
solution of mucosal permeable


• Avapa dravya = many
dravyas based upon
Rasa or Gana Dravyas
Cha si 3/23
told in –
• Dashemaniya, Ksheera,
Mamsarasa, Gomootra,
Amla varga, etc
• Vata = Veerataruvadi,
Bhadradarvadi
• Pitta = Nyagrodhadi,
AS Su 28/42 Kakolyadi
• Kapha = Aragwadhadi,
Pippalyadi
• Quantity = 1: 2 ratio of
• - - UxÉ xÉÇxÉaÉï ÌuÉMüsmÉ ÌuÉxiÉUÉã½åwÉÉÇ Avapa : Kashaya (Avapa
AmÉËU xÉÇZrÉårÉ: - xÉqÉuÉåiÉÉlÉÉÇ UxÉÉlÉÉÇ dravya includes in the
AÇzÉÉÇzÉ oÉsÉ ÌuÉMüsmÉÌiÉ oÉWÒûiuÉÉiÉç quantity told for kashaya)
• – cÉ ÌuÉ 8/175-176

Sequence Importance
• The salt is granular needs grinding
• Honey is monosaccharide adds with salt to
become amalgam
• The amalgam facilitates bonding with –
alkaloid bounded lipoproteins of Sneha (Oil
/Ghee, etc) to become free ionized negatively
charged lipoproteins
• These free lipid soluble alkaloid added
amalgam freely mixed to become an isotonic
solution which is a mucosal barrier

Vasti quantity?
• Vasti quantity has to fixed not just by the age
factor as told in Samhita but require karshya
/Sthoulya, Shareera Dairghya / Pramana, Kosta
krura/ Mardavatwa, Aushadha Mardava /
Teekshnatwa and Ushna /Sheeta guna along with
Aushadha Dravya veerya / Bhajasa Guna
samparka
• The quantity 1200 ml told for a Purusha of
Susruta told 84 Angula = 7 feet
– i.e. each Inch of height requires 14.28 ml
– According to the height of patient one has to
decide the dose of vasti.
– i.e. 5 feet 6 inches patient requires 66 x 14.28 =
942.48 ml doctorksrprasad@gmail.com 21

Shape of abdomen for
Vasti quantity fixation
Apple Vs Pear shape
Apart from this another point of interest is the
shape of the abdomen in patient also requires for
the assessment of Vasti quantity

• Colonic flexures in Apple
are wide open and
facilitates easy
movements and rapid
evacuation
• Pear colonic flexures are
acute angled requires
full pressure and that
restricts the evacuation

Left lateral position
(for Niruha)

• Tailakta gatram –
• kruta mootra vitkam
Charaka Siddhi 3/17 • Na ati Kshuda artam
(Na ati bubukshita)
• Savya parshwa
shayanam
• Na Ati unnata
Charaka Siddhi 3/24-25 sheersham
• Vaamam prasarya
• as – Grahani and
Guda are
vamashraya.

• Traditional Vasti netra is a 6” long with
three whorls – the first 3” from tip to insert
in anus
• The second & third at other edge to tie the
Vasti Putaka – the leather bag for Vasti
dravya
• Instrument – Material, Model, Mechanism,
where it reach, problems of insufficiency /
excessive insertion (Normal = 1/4th length)

Vasti netra
• Modified Vasti putaka is with 3”
nozzle to insert in anus
• The second part of Putaka
which bears the kashaya is
attached connected to nozzle

• Unctuous rectum (Tailakta gatram)
facilitates the insertion of nozzle
• 3” nozzle is administered inside
anus
• A regulated forceful squeeze of
Putaka helps the Vasti Dravya to
reach high colon
• An anti clock wise massage on
abdomen facilitate the reverse
peristalsis for – Na Ati Bhukta
patient
• Wait for the muhurtha (48 minutes)
for evacuation
• An clock wise massage on abdomen
facilitate the active peristalsis
• If not evacuated after 2 muhurtha,
forcible evacuation required
• If Vata increases – Anuvasana is
required or Sneha orally also
administered Vasti Adana

Samyagyoga / Ayoga
• Aushadha
Vyapakata
samyak/ Vedana
• Dosha kshaya
(Vilodya) / Shotha
• Shakrut Kshaya
(vilodya)/ Sanga
• Samsnehya
Kayam / Hrullasa
• Anaayaasa
Pureesha, Dosha
nirharana / Swasa
doctorksrprasad@gmail.com
26

Paschat karma
• Pratyaagamana kaala = 1 Muhoorta (Su chi 38/18)
• If retains more may cause – Shoola, Anaha, Jwara,
Marana, etc
• Parihaara kaala is 3 days
• ÌuÉMüÉUÉ rÉå ÌlÉÃWûxrÉ pÉuÉÇÌiÉ mÉëcÉsÉæqÉïsÉæ:
iÉå xÉÑZÉÉãwhÉÉÇoÉÑÍxÉ£üxrÉ rÉÉÇÌiÉ pÉÑ£üuÉzzÉqÉqÉç
AjÉuÉÉiÉÉÍkÉïiÉÇ pÉÔrÉxxÉ± LuÉÉlÉÑuÉÉxÉrÉåiÉç (A H su 19/51-52)
• Sukhoshna snaana -
• Bhojana “Tribhaaga” (Su chi 38/12)
– Teekshna – ¾
– Madhya – ½
– Alpa – ¼
• Anuvasana Vasti on same day (if vata nipeedita)
– Vata = Bilwa Taila
– Pitta = Jeevaneeya Taila
– Kapha = Phala Taila
• xÉuÉÉïÎluÉMüÉUÉlÉç zÉqÉrÉåÍ³ÉÃWû: - - - AlÉÑuÉÉxrÉ mÉËUoÉ×ÇWûhÉÉjÉïqÉç - cÉUMü

Nireekshana
• Sequence of – Mala –
Vata – Pitta – Kapha is
noticed
• Examination of the
content
• If Vasti not evacuated
than Teekshna Niruha or
Phala varti is
administered
• If Vasti is evacuated
with out eliminating
Dosha 2 - 4 Niruha are
given till the “Su-
Niruda” is obtained

Vyapat

Prateekaara

Pharmaco-dynamics
• The isotonic solute bears the buffers
(Satapushpa) to enhance the alkaloid
bonded lipids
• The broken small lipid chains cross
mucosal barrier and bypass the Liver to
reach site of disease through systemic
circulation
• The action potential negatively charged
lipoprotein bonded alkaloids regulate the
systemic damage and restore to normal
• At the same time pressure on nerve
24 May 1887
endings in the hypo gastric & sacral plexus
relived by removal of faecal & flatus


At the
interest
of
developing
Utility based
Value added
Panchakarma
• doctorksrprasad@gmail.com
• doctorksrprasad@aol.in

Ayurvedic Vasti Therapy: Rectal Administration for Futurity

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Ayurvedic Vasti Therapy: Rectal Administration for Futurity