Contraindications of niruha basti- relevance in present scenario.

1. 1
CONTRA INDICATIONS OF NIRUHA BASTI
–RELEVANCE IN PRESENT DAY SCENARIO

2. CONTENTS
2
VASTI AND ITS IMPORTANCE
NEED OF THE TOPIC
CONTRA INDICATIONS TOLD IN DIFFERENT
SAMHITAS
PHYSIOLOGICAL CLASSIFICATION
PATHOLOGICAL-SROTASES WISE
CLASSIFCATION
JUSTIFICATION
CONCLUSION

3. INTRODUCTION
• Basti Chikitsa is considered to be a prime treatment modality in
Ayurveda. It has not only curative aspects but also preventive and
promotive aspects.
Niruha Basti : Kashaya is the major component of this type of Basti. It is
mainly Rukshana and shodhanatmaka in nature
Classification : Ruksha niruha(Kshara vasti,kshara vaitarana etc..) and
Napumsaka niruha basti (Madhutailika, Yapana, Yuktarakta, Siddha
Basti,pichabasti etc… -Brimhana in nature..)
RUKSHA BASTI AND ITS CONTRAINDICATION
3

4. NEED OF THE TOPIC
4
 To create an awareness about the physiological and
pathological conditions where Niruha Basti is contraindicated
and its complications.
 To create awareness about the kriya sankara/time gap
needed to do niruha basti with other Panchakarma.
 Possibilities of doing Niruha basti in
contraindicated conditions.

5. Factors to be considered
Before selecting the patient for Basti karma ,consider
the
• Arha and Anarha,
Nature of disease
Temperament of the patient
Associated complaints
• Medicines etc..
5

6. ANARHA TOLD IN DIFFERENT
SAMHITAS
अनास्थाप्यास्त्वति तिग्ध:क्षिोरस्को भृशं क
ृ श: |
आमातिसारी वतममान् संशुद्धो दत्तनावन: ||
श्वास कास प्रसेकाशो तिध्माध्मानाल्पवह्नय: |
शूनपायु: क
ृ िािारो बद्धच्छिद्रोदकोदरी |
क
ु ष्ठी च मधुमेिी च मासान् सप्त च गतभिणी ||
(AH.Su.19/4-5)
6

7. अनास्थाप्यास्तु- अजीर्ण्ितितिग्धपीििेिोच्छलिष्टदोषाल्पाति यानिान्तातिदुबिल
क्षुत्तृष्णाश्रमािाितिक
ृ श भुक्तभक्तपीिोदक वतमि तवररक्त क
ृ ि नस्त:कमि क्र
ु ध्द भीि मत्त
मूच्छिि ि प्रसक्तितदि तनष्ठीतवका श्वास कास तिक्का बद्धच्छिद्रो- दकोदराध्मानालसक
तवसूतचकामप्रजािामातिसार मधुमेि क
ु ष्ठािाि: |
(CS.Si.2/14)
7

8. ित्रोन्माद भय शोक तपपासारोचकाजीणािशि: पाण्डुरोग भ्रम मद मूिािितदि क
ु ष्ठ मेिोदर
स्थौल्य श्वास कास कण्ठशोष शोफोपसृष्ट क्षिक्षीण चिुच्छिमासगतभिणी दुबिलाग्न्यसिा बालवृध्दौ
च वािरोगादृिे क्षीणा नानुवास्या नास्थापतयिव्या: |
(SS.Chi.35/21)
8

9. Diseases contraindicated for Niruha Basti
Charaka
(CS.Si 2/14)
Susruta
(SS.Chi.35/21-22)
Vagbhata
AS.Su.28/12 & AH Su 19/4-5
ajirna Ajirna
Alasaka Alasaka
Alpagni Alpagni
Arochaka Arochaka
Arsha Arsha
9

10. Charaka
(CS.Si 2/14)
Susruta
(SS.Chi.35/21-22)
Vagbhata
(AS.Su.28/12) AH Su 19/4-5
Atidurbala
Atikrisha Atikirisha
Bala and vridha
Adhmana Adhmana
Atisnigdha Atisnigdha
Amatisara Amatisara
Bhrama
Durbalagni
Amaprajata
10

11. Charaka
(CS.Si 2/14)
Susruta
(SS.Chi.35/21-22)
Vagbhata
(AS.Su.28/12) AH Su 19/4-5
baddhodara Baddhodara
Garbhini(7 months) Garbhini upto 7th month
chidrodara Chidrodara
Kantasosha
bheeta Bhaya
Bhuktabhakta
Gudasopha
hikka hikka
11

12. Charaka
(CS.Si 2/16)
Susruta
(SS.Chi.35/21-22)
Vagbhata
(AS.Su.28/12,AH Su 19/4-5)
kasa kasa Kasa
Vatarogaadrite Kshina
Kshatakshina Urakshata
Kushta kushta kushta
mattha Mada
Krita nastakarma Nasya prasakta
Krudha
Niranna
Nistivika nistivika
ksudarta
12

13. Charaka
(CS.Si 2/14)
Susruta
(SS.Chi.35/21-22)
Vagbhata
(AS.Su.28/12)
madhumeha meha Madhumeha
murchitha Murcha
Pandu roga
Pipasa
peetodaka
Sopha
Sthoulya
swasa swasa Swasa
Shoka
Prasakta chardi chardi Prasakta chardi
13

14. Charaka
(CS.Si 2/14)
Susruta
(SS.Chi.35/21-22)
Vagbhata
(AS.Su.28/12)
snehapita
Sramarta
Trsnarta
Udakodara Udara Udakodara
Utklishta dosha Utklishta dosha
Unmada
Vamita Vamana krita
Virikta Virechana krita
Visuchika Visuchika
yanaklanta
14

15. PHYSIOLOGICAL /SWABHAVIKA
15
Garbhini vridha
Bala

16. PHYSIOLOGICAL /SWABHAVIKA ……….
Bhukta bhakta
Niranna
Trisnarta
Kshudarta
Nishtivika
Shoka
Bheeta/Bhaya
Krudha
Atidurbala
Kshina
Atikrisha
Sramarta
Yanaklanta
16

17. बाल & वृध्द
Baala :Asampurna dhatu
Vridha :Sheeryamana dhatu/Ksheena dhatu
 Chance of dehydration is high -due to the sudden electrolyte imbalance
;the onset of vegas - sudden and more vegas within a short duration.
Aushadhabala asahatwa
मृदुबिच्छस्त: प्रयोक्तव्यो तवषेशाद्बालवृध्दयो :|
ियोस्तीक्ष्ण: प्रयुक्तस्तु बच्छस्ततििंस्याद् बलायुषी || SS.Chi35/10
Mridu basti can be given specifically. Teekshna basti to baala and vridha
harms the bala and ayus.
17

18. गतभितण
• गतभिर्ण्ा: …………. ररक्तं देिं क्षिं क्षार इव दिेि् |(AS 28/13)
CI in Garbhini upto 7 months (SS ..AH)
Causes garbha srava/garbha bramsha
Pregnant lady undergoes significant anatomical and
physiological changes in order to nurture and accommodate
the developing foetus. During that time if we are giving
NB;Sudden water and electrolyte disturbance,and the
glucose deprivation in mother etc; hampers foetal
development.
18

19. यानिान्त
अतिदुबिला
क्षुधात्ताि
िृष्णात्ताि
श्रमात्ताि
19
.....क्षोभव्यापन्नो बच्छस्तराशु देिं शोषयेि् |
(CS.Si 2/15)
NB immediately causes deha sosha
(destruction of body due to the depletion of
tissues)
Body starts to use muscle protein to make glucose, a sugar that's needed for cell
metabolism
Electrolyte imbalance and glucose deprivation, lowering the levels of vitamins will
further produce weakness and cause prana uparodha by producing severe pain or
hampering circulation and oxygenation to cells and may even leads to-death

20. अतिक
ृ श
• अतिक
ृ शस्य कार्श्यिं पुनजिनयेि् | (CS.Si 2/15)
• Atikrisha – under weight in relation to age, sex
etc…
• .. NB causes more emaciation
.......अतिक
ृ शस्य च क्षोभमापन्न: शरीरमाशु पीडयेि् |
(AS.Su.28/12)
• Ashta ninditha purusha
• Vata prakopa
20
Observed in …..
 Starvation,
 Malnourishment & Wasting
Syndrome
 Anorexia nervosa,
 Severe gastroenteritis
 Advanced carcinomas,
 Gastro intestinal
malignancies. Etc..

21. तनष्ठीतवका
• ...तनष्ठीतवका... ऊर्ध्वी भूिो वायुरूर्ध्विं बच्छस्तं नयेि् |(CS.Si 2/15)
Continuous spitting due to excess salivation, movement of
aggravated vayu occurs upwards; along with basti dravya.
- Produce urdhwa jatrugata vikaras.
21

22. भुक्तभक्त & पीिोदक
• भुक्त भक्त पीिोदकयोरुच्छलिर्श्योर्ध्विमधो वा वायुबिच्छस्तमुच्छिप्य तक्षप्रं
घोरान् तवकाराञ्जनयेि् |
(CS.Si 2/15)
Person who has just taken his meal/water; NB
causes dosha utklesha and the prakupita vata moves either
upwards or downwards along with basti dravya leading to serious
ailments instantaneously.
22

23. न िु भुक्तविो देयमास्थापनतमति च्छस्थति :|
तवसूतचकां वा जनयेलितदिं वा/तप सुदारुणाम् ||
कोपयेि् सविदोषान् वा िस्मालदद्यादभोतजने|
(SS.Chi.38/19-21)
The NB shouldn’t be given to bhuktavata,..
• Visuchika (severe diarrhoea)
• Persistent chardi or
• Sarva dosha kopa
23

24. क्र
ु ध्द & भीि
• क्र
ु ध्द भीियोबिच्छस्तरूर्ध्विमुपप्लवेि्|
(CS.Si 2/15)
Person who is angry/fearful ;NB moves upwards
 काम शोक भयात्वायु: | (CS.Chi)
Vata pratiloma gati occurs
24

25. PATHOLOGICAL CLASSIFICATION BASED
ON SROTASES
25

26. ANNAVAHA SROTAS(GASTRO INTESTINAL SYSTEM)
 Ajirna
 Alasaka
 Adhmana
 Prasakta chardi/Chardi
 Arochaka
 Arsha
 Visuchika
 Alpagni/Durbalagni
 Utklishta dosha
26

27. • Vasti karma exerts a largely systemic action ,exerting local action in GIT by
operating through large intestine involving Enteric Nervous System(gut brain)
• Vasti karma can activate the autonomic nervous system and there by help in the
evacuation of vasti dravya.
• Sympathetic efferent neurons decrease muscle contractions and constrict
sphincters to diminish gastrointestinal motility. In contrast, the parasympathetic
nervous system typically stimulates the digestive tract promoting motility
(peristalsis), gastrointestinal reflexes, and secretions.
• The effects of vasti can be Encolonic(acting on the tissue of colon),endocolonic
(acting inside the colon),and diacolonic(systemic action)
27

28. अजीणि
ित्राजीणी……दू ष्योदरं मूिाि श्वयथुवाि स्याि् | CS.Si 2/15
Person suffering from ajirna, NB causes dusyodhara, murcha
or swayathu
AS- Udara,moorcha,swayathu
Sodhanas are generally contraindicated
अजीणािि् वधििे ग्लातन तवबन्धश्चातप प्रविििे।
पीिं संशोधनं चैव तवपरीिं प्रविििे ॥ (Cha/S/6/14)
 Amadosha yukta avastha
28

29. अलसक & तवसूतचक
• अलसकतवसूतचका...आमक
ृ िो दोष: स्याि् |
(CS.Si 2/15)
• Alasaka(intestinal torpor),visuchika(cholera) ,NB causes
ailments due to ama.
• अलसकािािदीनां चामदोषाि् |(ss)
Same complications occur due to ama dosha
• Ama pachana and agni deepana –prime concern
29

30. प्रसक्तितदि
• प्रसक्तितदि.... ऊर्ध्वी भूिो वायुरूर्ध्विं बच्छस्तं नयेि् |
(CS.Si 2/15)
In Continous vomiting, movement of aggravated vayu occurs
upwards; along with basti dravya.
• प्रसक्तिद्यािदीनां वायुतनिरूिमूर्ध्विं नयेि्| (AS.28/13)
Vomitting etc..vata carries the NB upwards.
• Chardi- Either a roga lakshana or upadrava
30

31. अरोचक
• अरोचकािािदीनां यथास्वमामयवृच्छध्द:|(SS.)
Disease aggravates further.
अरोचका ... यथास्वमामयवृच्छद्ध: | (AH.19/4-5 A.D Comm)
31
Seen in case of mild indigestion to severe conditions like
Anorexia nervosa, gastrointestinal cancers, debilitating illness
like sepsis etc…
Amasaya asrita vyadhi

32. अशिस्
• अशिसस्यावृिमागित्वादनागिन्बच्छस्त: प्राणान् तिंस्याि्|
(AS.28/13)
Margavarana occurs, so NB being not able to return; may affect
the life OR the basti yantra cannot be introduced due to
structutal obliteration.(AH)
• In bleeding piles –CI
• Do proctoscopic examination before administering Basti.
32

33. मन्दाति
• ... मन्दाियोररोचकस्तीव्र|
(CS.Si 2/15)
In Mandagni ,NB causes teevra arochaka
• अल्पाति ... यथास्वमामयवृच्छद्ध: | (AH.19/4-5 A.D Comm)
Seen as an Important feature of gastro intestinal malignancy whether it
is stomach, small intestine, colon and rectum.
Loss of apetite is progressive and significant in malignancy.
• उच्छलिष्ट दोष...अरोचकस्तीव्र| (CS.Si 2/15)
Utklishta dosha ,NB causes teevra arochaka
34

34. PRANAVAHA SROTAS(RESPIRATORY
SYSTEM)
 Hikka
 Swasa
 Kasa
 Kshatakshina
 Urakshata
 Kanta sosha
35

35. श्वास कास तिक्का
• ... श्वास कास तिक्कािािनामूर्ध्वी भूिो वायुरूर्ध्विं बच्छस्तं नयेि् |
(CS.Si 2/15)
Hikka, causes prakupita vata moves upwards ;along with basti
dravya.
Same complications in Swasa and kasa too.
36

36. उरक्षि
क्षिोरस्कस्य..... च क्षोभमापन्न: शरीरमाशु पीडयेि्|
(AS.Su.28/12)
If we are administering NB; Further produce adverse
effects quickly in the body.
37

37. RASAVAHA SROTAS
 Bhrama
 Mada
 Murchitha
38

38. मत्त & मूतछि ि
• मत्त मूतछि ियोभृिशं तवचतलिायां संज्ञायां तचत्तोपघािाद् व्यापि् स्याि् |
To an Intoxicated /fainted person ; Nb causes
altered state of consciousness, leading to chitta upaghata
39

39. MANOVAHA SROTAS(CENTRAL NERVOUS
SYSTEM)
 Unmada
40

40. उन्माद
• बच्छस्त तनषेध (SS)
• The patient won’t co-operate with the poorvakarma and
pradhana karmas and the pathya apathyas there after ;due to
the unstable mind.
41

41. RAKTAVAHA SROTAS
 Kushta
42

42. RAKTAVAHA SROTAS : क
ु ष्ठ
• ...क
ु तष्ठनोव्यािधे: पुनवृिच्छध्द:िस्मादेिेनास्थाप्या:|
(CS.Si 2/15)
Kushta ; Administration of NB causes further
aggravation of ailments.
• क
ु ष्ठ……यथास्वमामयवृच्छद्ध: | (AH.19/4-5 A.D Comm)
43

43. • In case of Madhu meha,kushta etc.. If we are administering NB ;it
will produce further aggravation of vyadhi. Because these diseases
are kleda pradhana janya vyadhis and niruha basti adds kledatha
to it.
• After evacuation normally NB causes rukshatha to the body, but
in these diseased conditions the kledata retains as such and
aggravates the condition.
44

44. UDAKA VAHA SROTAS
 Amatisara
 Badhodara
 Chidrodara
 Visuchika
 Sopha/Guda sopha
 Pipasa
45

45. आम प्रजािा & आम अतिसार
• आमप्रजािामातिसाररणामामक
ृ िो दोष: स्याि् |
(CS.Si 2/15)
Ama prajaata(abortion) or amatisaara ,NB causes ailments due
to ama.
46

46. • बद्धच्छिद्रोदकोदराध्मानािािनां भृशिरमाध्याप्य बच्छस्त: प्राणान्
तिंस्याि्|(CS.Si 2/15)
Badhodara ,Chidrodara,Dakodara associated with adhmana
(abdominal distension) –Nb causes further abdominal distension, and
may lead to the death.
• बध्दोदराध्याध्मानान्तानां भृशिरमाध्मानान्मृत्यु:|(AS)
Intestinal obstruction, Perforation, Ascites
47

47. Intestinal obstruction
• Classification: Congenital,acquired
48
CONGENITAL ACQUIRED
Anorectal malformations Hernia
Congenital megacolon Post operative
Adhesions Intussusception
Duodenal atresia Round worm
Intestinal atresia(ileal) Gall stone ileus
malrotation Malignancy

48. Badhodhara ..
• NB along with AB is prescribed for badhodara alone.(CS.chi 13/89)
• But it shouldn’t b given if it is associated with adhmana
• Some other acharyas opines: badhodara associated with vibandha
(constipation) NB can be given…. But without vibandha it is contra
indicated.
---(chakrrapani)
49

49. गुदशोफ़
अरोचकाल्पाति गुदशोफ़ ... यथास्वमामयवृच्छद्ध: |
(AH.19/4-5 A.D Comm)
Proctitis –Inflammation of rectum and anus
Peri anal abscess and fistula formation- Guda vidradhi and
bhagandara pidika poorvavastha.
Produce more sopha because of its ruksha, shodhana property.
50

50. MEDOVAHA SROTAS
 Madhumeha /meha
 Sthoulya
51

51. मधुमेि
• मधुमेि ... पुनवृिच्छध्द:िस्मादेिेनास्थाप्या:|
(CS.Si 2/15)
Madhumeha ; Administration of NB causes further
aggravation of ailments.
मधुमेिािािनां यथास्वमामयवृच्छद्ध: | (AH.19/4-5 A.D Comm)
52

52. स्थौल्य
 Excess body fat has accumulated to the extent which have a
negative effect on health.
 Ashta ninditha purusha
• औषधबल असिः
• Severe tiredness and profuse sweating
• Complications include Cardiovascular diseases, DM, obstructive
sleep apnoea, certain types of cancer, osteoarthritis,depression
etc..
53

53. क्षीणक्षिानां न तवशोधनीयान्न शोतषणां नो भृशदुबिलानाम् |
न मूच्छिि िानां न तवशोतधिानां येषां च दोषेषु तनबध्दमायु: ||
(CS.Si.1/37)
NB shouldn’t be given to patients suffering from
kshtakshina(wasting disease), sosha(consumption), ati durbala,
murchitha, vishodhita --- their life is dependent upon the holding
of remaining morbid dosas.
If NB- may leads to their instant death.
54

54. PANCHAKARMA RELATED
• Atisnigdha
• Snehapita
• Krita Nastakarma/Nasya prasakta
• Vamita /vamana krita
• Virikta /virechana krita
55

55. अतितिग्ध &पीििेि
........... अतितिग्ध पीििेिानां दू ष्योदरं मूिाि श्वयथुवाि स्याि् | CS.Si
2/15
Person who is atisnigdha, who has just taken snehapana
NB causes dusyodhara, murcha or swayathu(cs)
AS- Udara,moorcha,swayathu
अतितिग्धे िु पाण्डुत्वं घ्राण वक्त्र गुदस्रवा : | AH.Su.16/ 31
िेिपीिस्य वान्तस्य तवररक्तस्य स्रुिासृज :|
तनरूढस्य च कायातिमिन्दो भवति देतिन:|| ss.chi 39/3
56

56. वतमि & तवररक्त
• वतमितवररक्तयोस्तु रूक्षं शरीरं तनरूि: क्षिं क्षार इव दिेि् |
(CS.Si 2/15)
Their body is already dehydrated. if we are giving NB to such
persons ;produce severe complications
• क
ृ िवमनतवरेकयोस्तु ररक्तं देिं क्षिं क्षार इव दिेि् |(AS 28/13)
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57. After virechana Nb is C/I and
viceversa…… How long????
• नरो तवररक्तस्तु तनरूिदानं तववजियेि् सप्ततदनान्यवर्श्यम् |
शुद्धो तनरूिेण तवरेचनं च िद्ध्यस्य शून्यं तवकासेिरीरम् |
(cs.si.1/26)
Administration of Nb immediately after virechana and viceversa
is Prohibited
There must(avasyam) be a gap of 7 days.
If not ; it will cause injurious effect on the body ;which is already
emptied the nourishing material by virechana.
सद्यो तनरूदो/नुवास्य: सप्तरात्रातिरेतचि :|
(ss.chi.36/51)(AH.Su.19/83)

58. नस्य
• क
ृ ि नस्त:कमिणो तवभ्रंशं भृशसंरुध्द स्रोिस: क
ु यािि् |
(CS.Si 2/15)
Person who has taken nasya ;NB causes
• Impairment of senses &
• Srotorodha.
• क
ृ िनस्यस्यास्यतवभ्रंशं तववृिोर्ध्विस्रोिस्तया क
ु यािि् |(AS.28/13)
Produce diseases of mouth, due to the widened openings of
urdhwa srotas
59

59. CONCLUSION
60

60. REFERENCES
ASHTANGA HRIDAYAM Sutra sthana 19th ch,Kalpa sthana 4th & and 5th
chapter
ASHTANGA SANGRAHA Sutra sthana 28th ch,kalpa sthana 5th - 8th ch
CHARAKA SAMHITA Sidhi sthana 1st to 5th ,7th - 12th & vimana 8th ch
SUSRUTA SAMHITA chikitsa sthana 35th – 38th ch
MADHAVA NIDANAM
61

61. Thank you
62

62. A&P acco.to ayurveda
• Anal valves; pravahini, visarjani,samvahani
• Gudam;4 ½ angula , contains 3 segments and looks
like conch shell.
• Outer segment is called guda oshta -1/2 angula in
leng.
• Next immediate vali is 1 angula and others are 1 ½
angula in length
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63. A&P acco.to Ayurveda cont……
• Samana vayu influences digestion of food,
separation of nutrients and waste products,
absorbtion of nutrients and elimination of waste
products
• Apana vayu does the act of defaecation, which is
significantly seen with a tendency of flow
downwards.
67

64. • Mechanical movements of LI includes haustral
churning, peristalsis, and mass peristalsis.
• The last stages of chemical action occur in the LI
through bacterial action. Substances are further
brokendown and some vitamins are synthesised.
• The LI also absorbs water, electrolytes and vitamins.
• Faeces consists of water, inorganic salts, epithelial
cells,bacteria and undigested food.
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65. उदरी च प्रमेिी च क
ु ष्ठी स्थूलच्च मानव:|
अवर्श्यं स्थापनीयास्ते नानुवास्या: कथञ्चन||SS.Chi.
Patient suffering from udara, prameha,kushta,sthoola can be
given NB ,if it is required/must needed ….but they should
NEVER give AB along with.
If AB is given in such conditions ,disease bcms asaadya and if
the disease is already asaadya then it will cause gaatra saada
69

66. ??
• The sympathetic and parasympathetic nervous systems, as well as the
enteric nervous system, mediate gastrointestinal activities.
• Sympathetic nervous system fibers, arising in the thoracic and lumbar
regions of the spinal cord, innervate all areas of the gastrointestinal
tract.
• Generally, norepinephrine, released from the nerve endings, acts on
smooth muscle of the digestive tract to inhibit activity.
70