Due to the importance of the colon’s eliminative and rejuvenating functions, Panchakarma largely employs pakwashaya gata bastis. We will now discuss the two main types of pakwashaya gata bastis given during this therapy. They are called nirooha and anuwasan basti. All other bastis, whether based on administrative site or specific purpose, serve only an adjunctive function in Panchakarma.
Nirooha Basti: Cleansing Basti
Nirooha, which means “that which gets eliminated,” cleanses toxins from the dhatus and removes naturally accumulated malas from the colon. The Charaka Samhita has indicated that this shodhana type of basti is capable of cleansing the entire body. These bastis primarily, but not exclusively, use water-based decoctions of purifying herbs. The quantity of liquid administered is approximately 400 ml. (1-3/4 cups), though the dosage may vary from individual to individual.
The quantity is always less than in enemas, since the bastis efficacy and specific action is not based on the volume of the liquids, but on the effects of the herbs. In nirooha, or purifying bastis, the liquid is retained in the colon for approximately forty-eight minutes. During this time, some of the ingredients get absorbed and their purifying influence moves throughout the body. The rest gets expelled along with fecal matter and toxins.
Nirooha bastis are given in a series of treatments over a period of several days. These bastis, along with the preparatory procedures, allow the cleansing process to reach deeper and deeper into the tissues with each passing day. The benefits resemble those which snehana (oleation) produces in the dhatus.
The first day of this basti treatment cleanses the colon of ama and mala. The second day of nirooha balances and nourishes vata producing increased mental calm and clarity. Because the vata zone has now been cleared, the third day pulls out ama and toxins from the pitta zone. This balances and nourishes pitta function and, in turn, purifies and strengthens both rasa and rakta dhatu. The patient experiences more strength as rasa improves, and better skin color and texture as rakta gains in health.
On the fourth and fifth days of administration, toxins get pulled out of the kapha area. Kapha resides in two major sites, other than the stomach: mamsa (muscles) and meda (adipose tissue), and this cleansing automatically purifies and strengthens both of them. On the sixth and seventh days, the bastis benefits reach the deeper dhatus, asthi (bone) and majja (bone marrow), and the eighth day works on shukra (semen or ovum). This sequential cleansing process stimulates the natural absorptive and eliminative functions of the colon to remove ama and malas from all the tissues of the body.
The colon demonstrates an amazing absorptive capacity, and the rejuvenating and cleansing herbs administered through basti easily penetrate the body and bring their healing influence from the more superficial levels of the dhatus to its deeper structures. It is this type of cleansing action that led Charaka to exclaim, “Basti works from head to toe.”
Anuwasan Basti; Nourishing Basti
Anuwasan basti, the second major type of pakwashaya gata basti, has as its purpose to nourish the body. It does so through the application of herbalized oils. Oil naturally lubricates and nourishes the dhatus, an effect which is opposite to the drying and wasting influence of excessive vata. Therefore, this class of bastis is particularly successful in the treatment of vata disorders. Because the disease process almost always involves some vata derangement, the lubricating and strengthening actions of anuwasan bastis are helpful in all situations calling for basti therapy.
Anuwasan bastis are usually administered after a cleansing course of nirooha bastis to insure that vata dosha is operating properly. They not only restore health to the colon, but also lubricate and nourish all the dhatus. This counteracts the debilitating influence of ama and toxins on the tissues and helps restore them to normality, the primary purpose of anuwasan basti.
The word anuwasan refers to “that which is to remain in the body for a while.” For this type of basti, it is optimum if it can be retained in the body for a longer period of time in order to have its intended effect. Three to six hours is the ideal retention time. If it is administered in the evening, it is best if it can be held overnight. Occasionally, because of a reflexive colonic response, the patient will not be able to keep even a small anuwasan basti. Patients are instructed never to strain to hold any basti, but to go with their natural response. In such cases, a second oil basti should be given immediately.
Bastis are always applied slowly, but anuwasan should be introduced extremely slowly, ideally, a drop at a time. This is particularly important for individuals with irritable bowel syndrome. Slow administration reduces the possibility that a hyperactive colon will go into a reflexive response and reject the basti, and insures that the bastis nourishing ingredients will soothe and restore normal function to the colon.
Anuwasan bastis are prepared in a wide variety of ways, depending on the specific nutritive requirement. They can benefit neuromuscular disorders, in which every dhatu is impaired, including muscles, bone, bone marrow and nerve tissue.