Basti fulfills many needs, so the type of basti used during Panchakarma varies according to the intended purpose of the treatment. One type of basti eliminates the ama that has gathered in the colon from throughout the body. Another normalizes vata function. If the prime mover is out of balance, everything is out of balance. Once vata has returned to normal functioning, basti therapy is then used to nourish and revitalize the dhatus.
It is by far the most important procedure in Panchakarma because of its versatility. Vamana and virechana fulfill one primary objective — cleansing the body of toxins. Basti, however, accomplishes this, as well as two additional purposes. Palliative bastis balance the doshas, reduce symptoms and make the patient more comfortable. Nutritive bastis nourish and rebuild the dhatus, strengthen their activity, and restore and strengthen immunity. No other single treatment provides such direct and far-reaching benefits.
Although every major classical Ayurvedic text regards basti therapy as a major curative treatment, several different systems for classifying them have evolved. The most comprehensive system of classification concerns the site of administration. The next categorizes basti by its function. The last method refers to the frequency and duration of bastis. We’ll discuss all of these systems, beginning with the broadest.
1. Basti Classified By Site of Administration
The first major classification scheme refers to the administration site and the primary organs receiving treatment. It recognizes four areas:
Pakwashaya gata basti. Medicated liquids sent through the anus and rectum into the colon
Uttara basti. Medicated liquids sent through the vagina and cervix to cleanse and nourish the uterus
Mutrashaya gata basti. Medicated liquids introduced into the penis and urethra to treat the male genital and urinary organs
Vranagata basti. Cleansing and medicated liquids used to irrigate and heal abscesses or wounds
The Ayurvedic texts describe one final class of nutritive, palliative basti, which is not administered internally through the rectum, vagina, penis, etc., but rather externally in localized areas of the body, such as the lower back or eyes. Even though they are not introduced into the body, they are still called basti because the medicated, lubricated substances are retained in areas of the body for a period of time.
Four types of external bastis are classified according to their site of administration:
Netra basti or netra tarpana, applies medicated ghee to the eyes. The ghee is contained by a dam constructed around the eye sockets, made of the dough from black gram flour. Netra basti is highly nourishing for the eyes, removes eye strain and improves vision.
Katti basti means “retained on the lower back.” It applies medicated oils in a container of black gram dough built around the lumbosacral area. This form of external basti particularly benefits muscle spasm and rigidity of the lower spine and strengthens the bone tissue in that area.
Uro basti means “retained on the chest and heart area.” It uses medicated oils in a container — also constructed of black gram dough -— around the heart. It reduces pain in the sternum area and strengthens the heart.
Shiro basti is administered on the head through the use of a specialized leather container resembling a hat. This type of basti improves the functioning of prana vayu and revitalizes sensory functioning. It also promotes kaphagenic secretions in the para-nasal sinus zone which reduce vascular congestion in the brain. Shiro basti is extremely useful in vascular headaches, schizophrenia, obsessive-compulsive disorders, memory loss, disorientation, glaucoma and sinus headaches.
2. Basti Classified by Function
While Charaka developed and presented basti therapy in great detail, his knowledge provides general guidelines which allow experienced and well-trained Ayurvedic physicians to adapt treatment to their patients’ needs. Following Charaka, two other classical teachers, Sushruta and Vagabhata, divided basti therapy into nine types, based on their specific functions in the body. Each type has its own indications, contraindications and variations. Briefly described, they are:
1. Shodhana basti cleanses and detoxifies. It is divided into strong treatments which penetrate to the deeper dhatus, and mild treatments, which work on the more superficial level of the dhatus. Nirooha offers the prime example of this form of therapy.
2. Utklesbana basti, meaning “promoting secretions in the colon,” promotes the liquefaction of ama and mala in the colon. It helps the colon expel them. Similar to Western enemas, this basti increases colonic peristalsis, producing rapid elimination of the feces.
3. Shamana basti is palliative. It restores doshic performance, reduces symptoms and allows the patient to feel better. In cases of rectal bleeding or dysentery, the immediate objective is to stop the symptoms. For example, pichha basti, which uses astringent herbs, shrinks the capillaries or shrotas and stops the bleeding or peristalsis, ending the symptoms.
4. Lekhana basti, meaning “strong and penetrating,” resembles shodhana basti, but is stronger in its effects and generally much larger in volume. It is particularly useful for kapha and meda dhatu disorders, where excess fatty substances have accumulated that need to be eliminated, as in obesity and arteriosclerosis.
5. Bruhan basti nourishes. Highly nutritious substances are used to balance and strengthen the dhatus and their metabolism, and increase the body’s resistance to infectious diseases. Anuwasan provides the prime example of bruhan basti. There are also nutritive bastis, like ksheer bastis, which are medicated decoctions made with fresh, whole milk. These bastis are very effective in regenerating the dhatus and are specifically used to tone the muscles (mamsa) and reduce atrophy and emaciation. In addition, there are bruhan bastis which use honey, ghee, or the juices from meat, bone marrow and herbs, which have a highly nutritive value.
6. Snehana basti is similar to anuwasan because it is prepared only from oleated substances, but is larger. Because of its size, it has a greater lubricating effect on both the colon and the body in general. It has a strongly pacifying influence on vata and is particularly useful in cracking of joints and for those who have very dry skin or who are emaciated.
7. Rasayana basti rejuvenates and can be prepared to rebuild and strengthen either specific dhatus or the whole body. Bastis containing both ashwagandha and shatavari improve asthi dhatu metabolism and have a particularly beneficial effect in osteoporosis.
8. Vajikarana basti treats infertility; it increases virility and fertility and gives vigor and vitality to the body. J’ivaney’am basti, for instance, helps fertility by improving the function of shukra dhatu, the reproductive tissue.
9. Matra basti can be given any time of the day, and is particularly useful to pacify vata aggravation resulting from travel, exercise or stress. It is an oil basti that can be self-administered in very small amounts, usually about 30 ml. or 1-1/2 ounces.
3. Basti Classified By Frequency and Duration
Charaka describes three additional basti classifications which are based on specific treatment regimens: karma basti, kala basti and yoga basti. They address serious conditions arising from vata derangement, and involve various alternations of nourishing and cleansing bastis for a set number of days, finishing with several nourishing bastis.
Karma basti comprises a month-long treatment and is given to people who have Kzta-dominant constitutions and vata-related disorders. It begins with anuwasan basti and alternates with nirooha basti for twenty-five consecutive days. The thirty-day program ends with five days of anuwasan bastis.
Kala basti lasts for fifteen days and is used mainly for patients with /7/to-dominant constitutions and vata disorders. It starts with an anuwasan basti, which then alternates with nirooha bastis for ten or twelve days and concludes with three or five days of anusawan bastis.
Yoga basti, given for eight days, suits kaphic patients with vata diseases. It first gives anuwasan basti, and alternates three times with nirooha. It concludes with two days of anuwasan.