Vasti ksr

Validation of Vasti for futurity

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Validation of
Vasti for futurity
Dr. K. Shiva Rama Prasad
M.D.(Ay) COP (German), M.A, Ph.D. (Jyotish)
28-05-2008
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Futurity Vs Futility
•
Futurity
=
The time yet to come
•o
r
•
T
he quality of being in or of the future
•
Futility
= Uselessness as a
consequence of having no practical result

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•
O
ver loading oral drug administrations making
tender stomach to get gastritis & other complications
•
T
he alternative Controlled-Release
Preparations, Sublingual, Transdermal Subcutaneous, Parenteral, Intravenous, Intramuscular, Intraarterial, Pulmonary, Topical, etc are not equals Ayurveda Panchakarma -
V
asti –
A
s it is -
Present trends

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Rectal
Administration
•
T
he rectal route often is useful
when oral ingestion is precluded because the patient is unconscious
or when
vomiting
is present -
a
situation particularly
relevant to
y
oung children
.
•A
p
p
r
o
x
im
a
t
e
ly

50% of the drug
that 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
.
•
H
owev
er, rectal absorption often
is
irregular and incomplete
, and
many drugs can cause
irritation
of the rectal
muco
sa.

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Practice
•
Ayurveda
suggests many
methods of disease and healthy managements
from ages, using
the naturally available adopted
•I
t

offers
Oral route, Trans dermal
route,
Trans Rectal route
, etc
•
O
ne has to
practice
for perfection
understanding methods properly
•
D
oes Ayurveda
requires
any
adoptions and updates in the systems according to the present technology
or not is a debate
•
C
hange is Unavoidable under any
circumstances

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Tunes of Trans Rectal route Tunes of Trans Rectal route Vasti or Basti
•
T
he pronunciation of the Technical term
itself is first problem
•
M
any times not undergone the concepts
•
F
ollowing colloquially
•
N
ot having touch with Instruments /
Mechanism /Drug qualities /etc

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7 steps to success
1.
Prepare patient (Physically / Mentally)
2.
Follow indications
3.
Check the Ingredients (Contents)
4.
Prepare medicine methodically
5.
Find proper Instruments
6.
Standardize the entire situation
7.
Administration (Time /Procedure)

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Dimensions &
Definition
•
uÉÎxiÉÍpÉSÏïrÉiÉå rÉxqÉɨÉxqÉɲÎxiÉËUÌiÉ
xqÉ×iÉ:-
AÉ
WÛû
x
ÉÔ
19/1
•
A
n injection syringe made
of bladder or the injection it self, Kwathas
•
uÉxÉÑ
ÌlÉuÉÉxÉå
–
uÉxÉÑ
A
ÉcNûÉSlÉå
Charaka Siddhi
1
/38-40
No disease is with out Vata
No other than Vasti treat Vata

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•
Enema
= An injection of a
liquid through the anus to stimulate evacuation; sometimes used for diagnostic purposes
•
M
any varieties of
nomenclature based upon the site of administration – Shirovasti, Urovasti, Kativasti, Uttaravasti, Vasti = Niruha, Anuvasana

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Preparation & Understanding
patient (Physically / Mentally)
Pareekshya
B
hava
(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.

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•
In this course of preparation –
–
In Kaala
-
Rutu
kaala, Vayo
kaala, Vyadhi
Kriyakaala, Ahara
k
aala
–
In Bala
–
R
ogi
bala
(Physical /psychological),
Roga
Bala, Aushadha
Bala
–
In Dosha -
sansargatwam
–
Vruddhi, Ksheena,
Urdhwa
/
Adho
gati, etc
–
In Vyadhi -
R
ogamarga
-
Shakha
/Kosta/Marma,
Swatantra
/
Paratantra, Vata vyadhi, Vata
sthaana
j
anya
vyadhi, Shakha
/Kosta
janya
vyadhi, Pureeshaadhana
/ srotas
janya
v
yadhi,
Shodhanaarha
vyadhi, Brumhanadi
kramoyogam

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•
B
ased upon the
site/ Organ
Vasti –
P
akwashaya,
Mootrashaya, garbhashaya
•
B
ased upon the
Drug content / material
–
N
irooha,
Anuvasana
•
B
ased upon the
Quantity of the material
–
S
neha,
Anuvasana, Matravasti
•
B
ased upon the
function
–
S
hodhana, Shamana
•
B
ased upon the
number
of
administrations
–
K
arma, Kala,
Yoga
•
B
ased upon the
utility
–
Y
apana, Siddha, Piccha, Rakta,
Prasruta
Yogiki, etc
•
B
ased upon the
Karmukata
(
purpose /intentions)
–
Vajikarana, Brumhana, Lekhana, Vandhtwahara, Teekshna, Mrudu, Krimighna, Chakshushya, Malabhedana, etc
Vasti classification

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Trayovasti •
Susruta affirms that –
–
Utkleshana
–
Doshahara
–
Samshamana
–
a
re
offered discriminatively
•
Where in Charaka enumerates as Dosha Apakarshana
in
sequence of –
–
Vata
–
Pitta
–
Kapha –
a
re
undertaken
by the Trayo
vasti
(Cha.Si.3/26)
(Su.Chi.38/92)
•
W
e are following Charaka
statement but not valuing the Susruta
•
A
vapaka/additives such as –
(Ch. Vi. 8/175-176, A
H
Su 10/22-24, Su Chi 38/24)
–
Anuvasanopaga, Asthapanopaga, Nirooha
Varga,
Asthapana
V
arga,
Shadasthapana
(
Madhuradi)
Skandha
g
ana
d
ravyas
are not
used in practice

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Tridosha
& Trayovasti
•
O
ne Snigdha
& Ushna
with Mamsa
f
or Vata
•
T
wo swadu
& sheeta
with Milk for Pitta
•
T
hree katu
& Ushna, Teekshna
with Mootra
for Kapha
•
N
ever more than the prescribed

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Vasti -
D
iscrimination
•
§ÉrɶÉ
xÉͳÉmÉÉiÉåÅÌmÉ
S
ÉãwÉÉlÉç
blÉÇÎliÉ
r
ÉiÉ: ¢üqÉÉiÉç
-
A
WØ
xÉÔ
1
9/59
•
lÉ
mÉUÇ
ÌuÉkÉãrÉÉ
–
cÉ
ÍxÉ
3/69
•
xÉqrÉÎglÉÃRûÍsÉlaÉÇiÉÑ
mÉëÉmiÉå
uÉÎxiÉÇ
ÌlÉuÉÉUrÉåiÉç
–
xÉÑ
ÍcÉ
38
/7û
•
Indications
•
Vata Vyadhi
•
Vata Sthaan
a
Janya
Vyadhi
•
Kosta
J
anya
Vyadhi
•
Pureeshadhaana
/
Srotas
Janya
Vyadhi
•
Shodhanarha
V
yadhi
•
Shodhanadi
Krama
R
asayana Vidhi
•
Brumhanadi
Kramopayogam

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16Vasti Poorvakarma

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Sequence of Material
•
oÉsÉ
SÉãwÉ
m
ÉëqÉÉhÉ
A
lÉÑÃmÉ
AÉæwÉkÉqÉç
Saindhava
= 1 Aksha,
Madhu
= 2 Prasruti
Sneha
=
3 Prasruti
Kalka
=
1 Prasruti
Kashaya
=
4
Prasruti
Avapadravya
=
2
Prasruti
Total = 12 Prasruti
=
1200 ml
Su Chi 38/37-39

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Sneha
(
Lipoprotein)/Kalka
quantity
•
Vata = ¼
=
3 Prasruta, Pitta = 1/6 = 2 Prasruta
and
Kapha = 1/8 = 1 ½
P
rasruta
D
osha based sneha
quantity
•
The unctuous substance either oil / Ghee gets digested by the Ushma
o
f Jatharagni
and the Kalka
Dravya
(Shatapushpa)
•
Kalka
d
ravya
in Vasti is a Pachana
d
ravya
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

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•
A
vapa
dravya
= many
dravyas
based upon
Rasa or
Gana
Dravyas
told in –
•
D
ashemaniya, Ksheera,
Mamsarasa, Gomootra, Amla
varga, etc
•
V
ata = Veerataruvadi,
Bhadradarvadi
•
P
itta = Nyagrodhadi,
Kakolyadi
•
K
apha = Aragwadhadi,
Pippalyadi
•
Q
uantity = 1: 2 ratio of
Avapa
:
Kashaya
(
Avapa
dravya
includes in the
quantity told for kashaya)
Cha si
3/23
•
-
-
UxÉ
x
ÉÇxÉaÉï
ÌuÉMüsmÉ
ÌuÉxiÉUÉã½åwÉÉÇ
AmÉËU
x
ÉÇZrÉårÉ: -
x
ÉqÉuÉåiÉÉlÉÉÇ
UxÉÉlÉÉÇ
AÇzÉÉÇzÉ
oÉsÉ
ÌuÉMüsmÉÌiÉ
o
ÉWÒûiuÉÉiÉç
•
–
cÉ
ÌuÉ
8
/175-176
AS Su 28/42

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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

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Vasti quantity?
•
Vasti quantity has to fixed not just by the age factor as told in Samhita but require karshya /Sthoulya, Shareera
Dairghya
/ Pramana, Kosta
krura/ Mardavatwa, Aushadha
Mardava
/
Teekshnatwa
a
nd Ushna
/
Sheeta
guna
along with
Aushadha
Dravya
veerya
/
Bhajasa
Guna
samparka
•
The quantity 1200 ml told for a Purusha
o
f
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

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Shape of abdomen for Vasti quantity fixation
Apple Vs Pear shape
Apart 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

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Left lateral position
(for Niruha)
•
Tailakta
g
atram
–
•
kruta
m
ootra
v
itkam
•
Na ati
K
shuda
artam
(Na ati
b
ubukshita)
•
Savya
parshwa
shayanam
•
Na Ati
unnata
sheersham
•
Vaamam
prasarya
•
as –
G
rahani
and
Guda
are
vamashraya.
Charaka Siddhi
3
/24-25
Charaka Siddhi
3
/17

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•
T
raditional Vasti netra
is a 6”
long with
three whorls –
t
he first 3”
from tip to insert
in anus
•
T
he second & third at other edge to tie the
Vasti Putaka
–
t
he leather bag for Vasti
dravya
•
I
nstrument –
M
aterial, Model, Mechanism,
where it reach, problems of insufficiency / excessive insertion (Normal = 1/4
th
length)
Vasti netra
•
M
odified Vasti putaka
is with 3”
nozzle to insert in anus
•
T
he second part of Putaka
which bears the kashaya
is
attached connected to nozzle

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Vasti Adana
•
Unctuous rectum (Tailakta
g
atram)
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 rev
e
rse
peristalsis for –
N
a Ati
B
hukta
patient
•
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 –
A
nuvasana
is
required or Sneha
o
rally also
administered

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Samyagyoga
/
Ayoga
•
Aushadha Vyapakata samyak/
Vedana
•
Dosha kshaya (Vilodya) /
Shotha
•
Shakrut
K
shaya
(vilodya)/
Sanga
•
Samsnehya Kayam
/

Hrullasa
•
Anaayaasa Pureesha, Dosha nirharana
/

Swasa

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Paschat
karma
•
Pratyaagamana
kaala
=
1 Muhoorta
(Su chi 38/18)
•
If retains more may cause –
S
hoola, Anaha, Jwara,
Marana, etc
•
Parihaara
kaala
is 3 days
•
ÌuÉMüÉUÉ
r
Éå
ÌlÉÃWûxrÉ
p
ÉuÉÇÌiÉ
m
ÉëcÉsÉæqÉïsÉæ:
iÉå
x
ÉÑZÉÉãwhÉÉÇoÉÑÍxÉ£üxrÉ
r
ÉÉÇÌiÉ
pÉÑ£üuÉzzÉqÉqÉç
AjÉuÉÉiÉÉÍkÉïiÉÇ
p
ÉÔrÉxxɱ
L
uÉÉlÉÑuÉÉxÉrÉåiÉç
(
A H su
19/51-52)
•
Sukhoshna
snaana
-
•
Bhojana
“
Tribhaaga”
(Su chi 38/12)
–
Teekshna
–
¾
–
Madhya –
½
–
Al
pa
–
¼
•
Anuvasana
Vasti on same day (if vata
nipeedita)
–
Vata = Bilwa
T
aila
–
Pitta = Jeevaneeya
T
aila
–
Kapha = Phala
T
aila
•
x
Éu
ÉÉïÎl
u
ÉM
üÉU
Él
Éç
z
Éq
Ér
Éåͳ
ÉÃ
W
û:
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l
ÉÑu
ÉÉx
r
É
m
ÉËU
o
É×ÇW
ûh
ÉÉj
Éïq
Éç-c
ÉU
M
ü

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Nireekshana
•
Sequence of –
M
ala –
Vata –
P
itta –
K
apha is
noticed
•
Examination of the content
•
If Vasti not evacuated than Teekshna
Niruha
or
Phala
v
arti
is
administered
•
If Vasti is evacuated with out eliminating Dosha 2 -
4
Niruha
are
given till the “Su- Niruda”
i
s obtained

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29Vyapat
Prateekaara

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Pharmaco-dynamics
•
T
he isotonic solute bears the buffers
(Satapushpa) to enhance the alkaloid bonded lipids
•
T
he broken small lipid chains cross
mucosal barrier and bypass the Liver to reach site of disease through systemic circulation
•
T
he action potential negatively charged
lipoprotein bonded alkaloids regulate the systemic damage and restore to normal
•
A
t the same time pressure on nerve
endings in the hypo gastric & sacral plexus relived by removal of faecal & flatus
24 May 1887

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At the
interest
of
developing
Utility based Value added
Panchakarma
•
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•
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