Vasti ksr

doctorksrprasad@gmail.com doctorksrprasad@aol.in

Validation of Vasti for futurity

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

28-05-2008 doctorksrprasad@gmail.comdoctorksrprasad@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

• Over loading oral drug administrations making tender stomach to get gastritis & other complications

• The alternative Controlled-Release Preparations, Sublingual, TransdermalSubcutaneous, 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 vomitingis present - a situation particularly relevant to young children.

• Approximately 50% of the drugthat 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 routeTunes 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 indications3. Check the Ingredients (Contents)4. Prepare medicine methodically 5. Find proper Instruments6. Standardize the entire situation7. Administration (Time /Procedure)

Dimensions & Definition

• uÉÎxiÉÍpÉSÏïrÉiÉårÉxqÉÉ¨ÉxqÉÉ²ÎxiÉËUÌiÉ xqÉ×iÉ:-AÉ WÛû xÉÔ 19/1

• An injection syringe made of bladder or the injection it self, Kwathas

• uÉxÉÑ ÌlÉuÉÉxÉå – uÉxÉÑ AÉcNûÉSlÉå

Charaka Siddhi 1/38-40

No disease is with out VataNo 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 janyavyadhi, Pureeshaadhana / srotas janya vyadhi, Shodhanaarha vyadhi, Brumhanadikramoyogam

• 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• Susruta affirms that –

– Utkleshana– Doshahara– Samshamana – are

offered discriminatively • Where in Charaka

enumerates as Dosha Apakarshana in sequence of –– Vata– Pitta– Kapha – are undertaken

by the Trayo vasti

(Cha.Si.3/26)

(Su.Chi.38/92)

• We are following Charaka statement but not valuing the Susruta

• Avapaka/additives such as –(Ch. Vi. 8/175-176, AH Su 10/22-24, Su Chi 38/24) –

Anuvasanopaga, Asthapanopaga, Nirooha Varga, Asthapana Varga, Shadasthapana (Madhuradi) 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 PrasrutiSneha = 3 PrasrutiKalka = 1 Prasruti

Kashaya = 4 PrasrutiAvapadravya = 2 Prasruti

Total = 12 Prasruti = 1200 ml

Su Chi 38/37-39

Sneha (Lipoprotein)/Kalka quantity

• Vata = ¼ = 3 Prasruta, Pitta = 1/6 = 2 Prasruta and Kapha = 1/8 = 1 ½ Prasruta Dosha based snehaquantity

• The unctuous substance either oil / Ghee gets digested by the Ushma of Jatharagni and the KalkaDravya (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 Dravyastold in –

• Dashemaniya, Ksheera, Mamsarasa, Gomootra, Amla varga, etc

• Vata = Veerataruvadi, Bhadradarvadi

• Pitta = Nyagrodhadi, Kakolyadi

• Kapha = Aragwadhadi, Pippalyadi

• Quantity = 1: 2 ratio of Avapa : Kashaya (Avapadravya includes in the quantity told for kashaya)

Cha si 3/23

• - - UxÉ xÉÇxÉaÉï ÌuÉMüsmÉ ÌuÉxiÉUÉã½åwÉÉÇAmÉËU xÉÇZrÉårÉ: - xÉqÉuÉåiÉÉlÉÉÇ UxÉÉlÉÉÇAÇzÉÉÇzÉ oÉsÉ ÌuÉMüsmÉÌiÉ oÉWÒûiuÉÉiÉç• – cÉ ÌuÉ 8/175-176

AS Su 28/42

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, Kostakrura/ Mardavatwa, Aushadha Mardava / Teekshnatwa and Ushna /Sheeta guna along with Aushadha Dravya veerya / Bhajasa Gunasamparka

• 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

Shape of abdomen for Vasti quantity fixation

Apple Vs Pear shapeApart 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• Na ati Kshuda artam

(Na ati bubukshita) • Savya parshwa

shayanam• Na Ati unnata

sheersham• Vaamam prasarya• as – Grahani and

Guda are vamashraya.

Charaka Siddhi 3/24-25

Charaka Siddhi 3/17

• 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

Vasti Adana

• 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 Bhuktapatient

• 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

Samyagyoga / Ayoga• Aushadha

Vyapakatasamyak/ Vedana

• Dosha kshaya(Vilodya) / Shotha

• Shakrut Kshaya(vilodya)/ Sanga

• SamsnehyaKayam / Hrullasa

• AnaayaasaPureesha, Dosha nirharana / Swasa

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£üuÉzzÉqÉqÉçAjÉuÉÉiÉÉÍkÉïiÉÇ 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 endings in the hypo gastric & sacral plexus relived by removal of faecal & flatus

24 May 1887

At the interest

of developing

Utility based Value added

Panchakarma• doctorksrprasad@gmail.com

• doctorksrprasad@aol.in

Vasti ksr

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