पञ्चत्रिंशोऽध्यायः । अथातो नेत्रबस्तिप्रमाणप्रविभागचिकित्सितं यथोवाच भगवान् धन्वन्तरिः ।। १ ।। व्याख्यास्यामः,
Now we shall discourse on the dimensions and classifications of a Netra and a Basti (pipes, nozzles and apparatus) with their therapeutic applications (Netra-Basti-Pramana-Pravibhaga-Chikitsa). 1
तत्र स्नेहादीनां कर्मणां बस्तिकर्म प्रधानतममाहुराचार्या: । कस्मात् ? अनेककर्मकरत्वाद् बस्तेः । इह खलु बस्तिर्नानाविधद्रव्य संयोगाद् दोषाणां संशोधनसंशमनसंग्रहणानि करोति, क्षीणशुक्रं वाजीकरोति, कृशं बृंहयति, स्थूलं कर्शयति, चक्षुः प्रीणयति, वली – पलितमपहन्ति, वयः स्थापयति ।। २ ।।
Sages of authority hold an application of he Basti to be the best of all measures such as, the application of a Sneha, etc.; and why? Because on account of its varied functions and of its being composed of the various kinds of medicinal drugs a Basti helps to restrain ( Sangraha ), pacify ( Sansamana) and cleanse (Sarnsodhana) the different Dosas (morbific principles) of the body. It helps the recreation and growth of fresh semen, contributes to the building up of an emaciated frame, reduces corpulency, invigorates eyesight, retards formation of wrinkles and greying of hair, arrests premature old age and tends to rejuvenate. 2
शरीरोपचयं वर्णं बलमारोग्यमायुषः । करोति परिवृद्धिञ्च बस्तिः सम्यगुपासितः ।। ३ ।।
A regular and proper use of a Basti tends to improve one’s complexion and bodily strength, imparts longevity, contributes to the growth of the body and ensures the enjoyment of sound health. 3
तथा ज्वरातीसारतिमिरप्रतिश्यायशिरोरोगाधिमन्थार्दिताक्षेपकपक्षाघातैकाङ्गसर्वाङ्गरोगाध्मानोदर-योनिशूल-शर्कराशूलवृध्युपदंशानाहमूत्र-कृच्छ्रगुल्मवातशोणित-वातमूत्रपुरीषोदावर्त – शुक्रार्तवस्तन्यनाश हद्धनुमन्या ग्रहार्शोऽश्मरीमूढगर्भप्रभृतिषु चात्यर्थमुपयुज्यते ।। ४ ।।
Applications of Bastis are highly efficacious in cases of fever, diarrhoea, cataract, catarrh, diseases of the head, Adhimantha, vomiting, facial paralysis, epileptic fits, convulsions, ( Aksepaka), hemiplegia, locomotor ataxy (Ekaiiga) and paraplegia (Sarvanga-Roga), tympanitis, ascites or abdominal dropsy, Sarkara (gravels or urinary concretions), gastralgia (sula), scrotal tumours (including hydrocele, hernia, etc.), Upadansa, retention of stool and urine (anaha), strangury (MutraKrcchra), Gulma, Vata-rakta, upward coursing of urine, stool and Vayu, loss of semen, breast-milk and of catamanial fluid, Hrd-graha (catching pain in the chest), Manyagraha (wryneck), Hanu-graha (numbness of the jaws) haemorrhoids, Ashmari (stone) and Mudhagarbha (false presentation and difficult labour). 4
भवति चात्र
बस्तिर्वाते च पित्ते च कफे रक्ते च शस्यते । संसर्गे सन्निपाते च बस्तिरेव हितः सदा ॥ ५ ॥
Memorable Verse: Applications of Basti are always efficacious in diseases due to the action of the deranged Vayu, Pitta and Kapha, in those diseases due to the vitiated condition of blood and in those brought on by the concerted action of any two or all of them. 5
Dimensions of the pipe
तत्र सांवत्सरिकाष्टद्विरष्टवर्षाणां षडष्टदशाङ्गुलप्रमाणानि कनिष्ठिकानामिकामध्यमाङ्गलिपरिणाहानि अग्रेऽध्यर्धाङ्गुलद्वचङ्गुलार्धतृतीयाङ्गुलसन्निविष्टकर्णिकानि कङ्कश्येनबर्हिणपक्षनाडीतुल्यप्रवेशानि मुद्द्रमाषकलायमात्रस्त्रोतांसि विदध्यात् नेत्राणि । तेषु त्वास्थापन द्रव्यप्रमाणमातुरहस्तसम्मितेन प्रसृतेन सम्मितौ प्रसृतौ द्वौ चत्वारोऽष्टौ च विधेयाः ।। ६ ॥
Dimensions of the pipe : The length of the pipe of a Basti should be made six fingers in respect of an infant of one year and eight and ten fingers in respect of a boy of eight and an adult of sixteen years respectively, the girth of its calibre being respectively equal to those of the small finger, the ring finger and the middle finger respectively in the three afore-named instances. The pipe should have Karnikas or bulb-like protrusions attached to it at one of the ends above a space of one finger and a half, two fingers and two fingers and a half respectively in the three afore-said forms of the apparatus. The girth of their mouths (to be introduced into the rectum) should be respectively made to equal those of the calibres of feathers of a crow, a falcon and a peacock, and the girth of the channels of the main body of the pipes should respectively be such as to let a Mudga pulse, a Masa pulse and a Kalaya pulse to ass through them. The quantity of the fluid with which an Asthapana-Basti should be charged is equal respectively to two. four. and eight Prasrtas² (in volume). A Prasrta measure being here equal to what can be contained in the hollow of the patient’s own palms (in each particular case). 6
भवति चात्रवर्षान्तरेषु नेत्राणां बस्तिमानस्य चैव हि । वयोबलशरीराणि समीक्ष्य वर्द्धयेद् विधिम् ॥ ७ ॥
Memorable Verse: The length of the pipe and the quantity of the fluid to charge with should be gradually increased with the progress of the patient’s age and in consideration of his strength and bodily capacity. 7
पञ्चविंशतेरूर्ध्वं द्वादशाङ्गुलम् मूलेऽङ्गष्ठोदरपरीणाहम् अग्रे कनिष्ठिकोदरपरीणाहम् अग्रे त्रचङ्गुलसन्निविष्टकर्णिकं गृध्रपक्षनाडीतुल्यप्रवेशं कोलास्थिमात्रच्छिद्रं क्लिन्नकलायमात्रच्छिद्रमित्येके; सर्वाणि मूले
1. The Karnikas are attached to the pipes for guarding against their being thrust into the rectum.
2. A Prasrta measure is generally equal to two Palas, i.e. sixteen Tolas. But here it has the particular meaning as given in the text.
बस्तिनिबन्धनार्थं द्विकर्णिकानि | आस्थापनद्रव्यप्रमाणन्तु विहिता द्वादश प्रसृताः ।
सप्ततेस्तूर्ध्वं नेत्रप्रमाणमेतदेव, द्रव्यप्रमाणन्तु द्विरष्टवर्षवत् ॥ ८ ॥
The pipe of a Basti in respect of an adult above tweny-five years of age, should be made twelve fingers in length having a girth equal to that of his thumb at its base and a girth equal to that of the small finger at its mouth. At a distance of three fingers from above the mouth the Karnikas should be fixed. The bore should be suck as to allow a feather of a vulture to pass through it, while the fissure at the mouth would have a girth to allow the stone of a Kola fruit or of a boiled Kalaya pulse. The pipe should in all cases be supplied with two Karnikas at its root, for the purpose of firmly securing it to the mouth of the Basti (bladder). The quantity of the fluid to charge with in the case of an Asthapana Basti is twelve Prasrtas. The length of the pipe in respect of persons above seventy years of age should be like that in the preceding case but the quantity of the fluid to charge with should be made as in the case of a youth of sixteen. 8
मृदुर्बस्तिः प्रयोक्तव्यो विशेषाद् बालवृद्धयोः । तयोस्तीक्ष्णः प्रयुक्तस्तु बस्तिर्हिस्याद् बलायुषी ।। ९ ।।
The mild Basti should be used specially in children and elderly persons. The srong enema used in such cases harms the strength and life of the patient. 9
व्रणनेत्रमष्टाङ्गलं मुद्गवाहिस्त्रोतः, व्रणमवेक्ष्य यथास्वं स्नेहकषाये विदधीत ।। १० ।।
The length of a Vrana-Netra (pipe used for irrigation of ulcers) should be eight fingers and its aperture should be so wide as to admit a mudga. After assessing the ulcer, a decoction should be used according to the dosas involved. 10
Materials of the pipes
तत्र नेत्राणि सुवर्णरजतताम्रायोरीतिदन्तशृङ्गमणितरुसारमयानि श्लक्ष्णानि दृढानि गोपुच्छाकृतीन्यूजूनि गुटिकामुखानि । बस्तयश्च बन्ध्या मृदवो नातिबहला दृढाः प्रमाणवन्तो गोमहिषवराहाजोरभ्राणाम् ।। ११ ।।
Materials of the pipes : The pipe should be made either of gold, silver, copper, iron, brass, ivory, horn, gems or wood. It should be straight, smooh and firm, tapering at the top like the tuft of hair in the tail of a cow, and bulbular (i.e. not pointed) at its mouh. The Basti¹ ( even bag) should be taken from barren animals; it should be tender, not very thick, firm and of proper size. It should be made from the urinary bladder of a cow, buffalo, pig, goat and sheep having well nourished body. 11
नेत्रालाभे हिता नाडी नलवंशास्थिसम्भवा । बस्त्यलाभे हितं चर्म सूक्ष्मं वा तान्तवं घनम् ।। १२ ।।
Metrical Text : In the absence of a pipe a reed, bamboo, or horn might serve the purpose. In the absence of the bladder of any of the foregoing animals, the Basti should be made of skin or of thick linen. 12
Construction of the Basti
बस्तिं निरुपदिग्धन्तु शुद्धं सुपरिमार्जितम्। मृद्वनुद्धतहीनञ्च स्नेहविमर्द्दितम् ।। १३ ।।
मुहुः नेत्रमूले प्रतिष्ठाप्य न्युब्जन्तु विवृताननम्। बद्ध्वा लोहेन तप्तेन चर्मस्त्रोतसि निर्दहेत् ॥ १४ ॥
परिवर्त्त्य ततो बस्ति बद्ध्वा गुप्तं निधापयेत् । आस्थापनञ्च तैलञ्च यथावत् तेन दापयेत् ।। १५ ।।
Construction of the Basti: The bladder (of which a Basti should be made) should be free from muscles and blood, cleansed, tanned and dyed (disinfected). It should be softened and repeatedly lubricated with a Sneha. It has generally a wide mouth which should be bent and lightly fitted to the butt end of the pipe (Netra). The mouth of the bladder should then be tied above the (Karnika). The whole bladder should be heated with a piece of hot iron (in order to polish the surface and remove the pores therein, if any). The mouth of the bladder should then be folded and again tied (below the Karnika ). The whole should then be carefully preserved. The Astkapana or the oily (Snaihika) Basti should be applied, as the case may be, with the help of such a Basti. A mild Basti should be applied specially to infants and old men. since a strong one is likely to injure their health and strength. 13-15
1. The Basti is so called from its being prepared with the bladder ( Basti) of an animal. Dalhana notes in this connection that the bladder of an ox, buffalo, or a hog, should be used in the Ashapana and Anuvasana measures, and the bladder of a goat or a sheep should be used in the Uttara-Basti.
तत्र द्विविधो बस्तिः – नैरूहिकः, स्नैहिकश्च । आस्थापनं निरूह इत्यनर्थान्तरम्, तस्य विकल्पो माधुतैलिकः; तस्य पर्य्यायशब्दो यापनो युक्तरथ: सिद्धबस्तिरिति । स दोषनिर्हरणाच्छरीररोगहरणाद् वा निरूहः, वयःस्थापनादायुः स्थापनाद् वा आस्थापनम् । माधुतैलिक – विधानञ्च निरूहोपक्रमचिकित्सिते वक्ष्यामः । तत्र यथाप्रमाणगुणविहितः स्नेहबस्ति – विकल्पोऽनुवासनः पादाव (प) कृष्ट: । अनुवसन्नपि न दुष्यत्यनुदिवसं वा दीयत इत्यनुवासनः । तस्यापि विकल्पोऽधर्धमात्रावकृष्टोऽपरिहार्यो मात्राबस्तिरिति ।। १६-१७ ।।
Bastis may be grouped under two heads– Nairuhika (dry or oilless) and Snaihika (oleaginous). The term Asthapana is synonymous with Niruha. The Basti known as the Madhu-Tailika is only an alternative of a Niruha-basti. The terms Yapana, Yukta-ratha, and Siddha-basti convey also the same meaning. A Niruha-basti is so called from the fact of its expelling the Dosas (morbific diatheses) from the system and from its curing the diseases of the body; while Asthapana is so named from its virtue of rejuvenating the organism or producing longevity. The process of Madhu-tailika would be described in connection with the mode of applying a Niruha-basti.
The Anuvasana is only an alternaive of a Sneha-Basti, but (with this difference that) the quantity of the fluid to charge with should be three-fourths, and the amount of the good effect therefrom would also be three-fourths. An Anuvasana basti is so called from the fact of its not injuring the system even in the event of its being retained in the bowels a whole day, or from the fact of its being adapted to daily application. The Matra-basti again which is applicable in all cases, is an alternative to an Anuvasana-basti, but should be charged with only a half part of the fluid of that used in an Anuvasana-basti. 16-17
निरूहः शोधनो लेखी स्नैहिको बृंहणो मतः । निरूहशोधितान् मार्गान् सम्यक् स्नेहोऽनुगच्छति ।। १८ ।।
अपेतसर्वदोषासु नाडीष्विव वहज्जलम् । सर्वदोपहरश्चासौ शरीरस्य तस्माद् विशुद्धदेहस्य च जीवनः । स्नेहबस्तिर्विधीयते ।। १९ ।।
Metrical Texts: A Niruha-basti acts as a cleanser of the system (sodhana).Itis anti-fat (Lekhana), emulsive (Snehana) and constructive (Brithana). Oleaginous matter ( Sneha ) may freely enter into the organism when all its ducts and channels have been previousily cleansed by the application of a Niruha-basti. As water will freely run through channels previously cleansed of all refuse matter, so does an Anuvasana tend to cleanse the organism of all Dosas (morbific diatheses) and to increase the vitality of the organism. A Sneha-basti should therefore, be applied to a person previously purged of all Dosas by the application of a Niruha-basti. 18-19
तत्रोन्मादभयशोक पिपासारोचकाजीर्णार्शः पाण्डुरोग-भ्रममदमूर्च्छाच्छर्दिकुष्ठमेहोदरस्थौल्य-श्वासकासकण्ठशोष-शोफोपसृष्ट-क्षतक्षीणचतुस्त्रिमासगर्भिणीदुर्बलाग्न्यसहा बालवृद्धौ च वातरोगादृते क्षीणा नानुवास्या नास्थापयितव्याः ॥ २० ॥
Both the Anuvasana and the Asthapana Bastis should be regarded as forbidden in cases of insanity, in the mental conditions of terror and grief, of a thirsty state of the body, of aversion to food and of indigestion piles, anaemia ( Pandu), giddiness, delirium, epilepsy, vomiting, Kustha, Meha, ascites obesity. asthma, cough. dryness of the throat and oedema as well as in respect of a Ksata-Ksina patient and a pregnant woman in (and before) the third or the fourth mouth of her gestation, in the case of a person suffering from dulness of appetite. impatient and incapable of bearing the least pain as well as in respect of infants, old men and persons emaciated by a bodily distemper other than one due to Vayu. 20
उदरी च प्रमेही च कुष्ठी स्थूलश्च मानवः । अवश्यं स्थापनीयास्ते नानुवास्याः कथञ्चन ॥ २१ ॥ असाध्यता विकाराणां स्यादेषामनुवासनात् । असाध्यत्वेऽपि भूयिष्ठं गात्राणां सदनं भवेत् ॥ २२ ॥
Metrical Text: The Asthapana-basti should be exclusively applied in cases of ascites, urinary complaints ( Meha), Kustha and obesity. The application of an Anuvasna-basti is entirely forbidden in those cases inasmuch as it might make the disease run into an incurable type, and a great amount of lassitude of the body would be the consequence. 21-22
As the aggravation of all the Dosas (morbific principles) of the body is principally dependent on the derangement of the bodily Vayu; an aggravated condition of the latter may hence lead to the dissolution of the body, and consequently the application of a Basti, and nothing else, is the only means of coping with the aggravation of the Vayu (by subduing and restoring it to its normal condition), just as the sea-coast is the only barrier to the swollen and wind-agitated surf of the sea. A well-applied Basti contributes to the growth, health, strength, longevity of the body and to the improvement in its complexion. 28-30
The different defects of Basti
अत ऊर्ध्वं व्यापदो वक्ष्यामः । तत्र नेत्रं विचलितं विवर्त्तितं पाश्र्ववपीडितम् अत्युत्क्षिप्तमवसन्नं तिर्यक्षिप्तमिति षट्प्रणिधानदोषाः । अतिस्थूलं कर्कशम् अवनतं, अणुभिन्नं सन्निकृष्टविप्रकृष्टकर्णिकं सूक्ष्मातिच्छिद्रमतिदीर्घमतिह्रस्वम् अस्त्रिमदित्येकादश नेत्रदोषाः । बहलबहलता, अल्पता, सच्छिद्रता, प्रस्तीर्णता, दुर्बद्धतेति पञ्च बस्तिदोषाः । अतिपी-डितता शिथिलपीडितता भूयोभूयोऽवपीडनं कालातिक्रम इति चत्वारः पीडनदोषाः । आमता हीनतातिमात्रतातिशीततात्युष्णतातितीक्ष्णताति-मृदुतातिस्निग्धतातिरुक्षतातिसान्द्रतातिद्रवता इत्येकादश द्रव्यदोषाः, अवाक्शीर्षोच्छीर्षन्युब्जोत्तानसङ्कचितदेहस्थितदक्षिणपार्श्वशायिनः प्रदा- नमिति सप्त शय्यादोषाः । एवमेताश्चतुश्चत्वारिंशद् व्यापदो वैद्यनिमित्ताः । आतुरनिमित्ताः पञ्चदश आतुरोपद्रवचिकित्सिते वक्ष्यन्ते ।। ३१ । ।
The different defects of Basti: Now we shall deal with the defects and the evil effects which are consequent upon the wrong and injudicious application of a Basti. The defects of wrongly handling a Basti (Pranidhana-dosa) are six in number, viz.. the pipe may shake or revolve; it may also be pressed side-wise or thrown upwards; and it may sink down or may be pressed slantingly. Excessive thickness. coarseness, bending down, having minute cracks, nearness or distance of the tying bands (Karnika), narrowness or excessive width of its internal aperture, excessive length or extreme shortness are the eleven defects which the pipe of a Basti (Netra-dosa) may have. The five objectionable fcatures in the bladder (Basti-dosa) are an excessive flabbiness, narrowness, width of its internal aperture, leakiness and an imperfect bending at its mouth (neck). Variation in pressures put upon a Basti (Enema syringe) during its application may be attended with any of the four objectionable features (Pidana-dosa), viz., overpressure (pressing the injection into the rectum with an injuriously excessive force), under-pressure, repeated pressures and pressure at long intervals. The eleven defects in the ingredients of the Basti (Dravya-dosa) are insufficient cooking, excessive or insufficient quantity, extreme coldness, excessive heat, extreme keenness of potency, excessive mildness, excess or want of oiliness (Sneha), extreme thickness of consistency and over-fluidity. Lying with the head raised up or hung down or in a bent or sitting posture or resting on one’s back or in a contracted posture or on one’s right side are the seven defective postures (Sayya-dosa) in which a patient should never be laid during the application of a Basti. These are the forty-four defects which attend the wrong application of a Basti owing to the ignorance or inexperience of a physician, while those which are the effects of the injudiciousness of a patient are fifteen in number and would be described in the chapter on Aturopadrava-Chikitsa (Chapter XXXIX, Chikitsa-sthana). 31
स्नेहस्त्वष्टाभिः कारणैः प्रतिहतो न प्रत्यागच्छति – त्रिभिर्दोषैः अशनाभिभूतो, मलव्यामिश्रौ, दूरानुप्रविष्टोऽस्विन्नस्यानुष्णोऽल्पंभुक्तवतोऽल्पाशनस्य चेति वैद्यातुरनिमित्ता भवन्ति । अयोगस्तूभयोराध्मानं परिकर्तिका परित्रावःप्रवाहिका हृदयोपसरणमङ्गप्रग्रहोऽतियोगो जीवादानमिति नव व्यापदो वैद्यनिमित्ता भवन्ति ।। ३२ ।।
The Sneha injected into the bowels by a Basti is obstructed in its passage and cannot consequently leave the system but is retained in it due to any of the following eight causes, viz, obstruction of the food by the three Dosas, its admixture with the foecal matter (accumulated in the bowels), its being injected too high up into the intestines, an omission to foment (the patient’s body), using the Sneha in a cold state and lastly use of no meals or of scanty meals by the patient previous to the application of a Basti. These (retentive conditions) are due to the indiscretion of both the physician and the patient. Nine distressing symptoms (Vyapad) namely as a defective application of either the Anuvasana or the Asthapana Bastis, distension of the abdomen, (Adhmana), a cutting pain in the region of the anus, (Parikartika), Discharge (Parisrava) Dysentry (Pravahika), affecting the heart (Hrdayopasarana), catching pain in the limbs, over-dosage and haemorrhage manifest themselves in consequence of any act of indiscretion of the physician in attendance. 32
भवति चात्र
षट्सप्ततिः समासेन व्यापदः परिकीर्तिताः । तासां वक्ष्यामि विज्ञानं सिद्धिञ्च तदनन्तरम् ॥ ३३ ॥
Memorable Verse: The seventy-six kinds of the distressing symptoms (Vyapad) have been briefly described above. Their symptoms and treatment would be described in the following chapter. 33
इति सुश्रुत संहितायां चिकित्सितस्थाने नेत्रबस्तिप्रमाणप्रविभागचिकित्सितं नाम पञ्चत्रिंशोऽध्यायः ।। ३५ ।।
Thus ends the Thirty-fifth Chapter in the Chikitsa Sthana in the Susruta Samhita which deals with the dimensions, classifications and therapeutical applications of a Netra and a Basti.
