BHARATI VIDYAPEETH DEEMED UNIVERSITY

COLLEGE OF AYURVED, PUNE- 43

CERTIFICATE

This is to certify that Dr. Priyadarshani A. Kadus, a Ph.D scholar in

the speciality of Panchakarma has successfully completed her thesis

entitled „ STUDY OF ANUVASAN BASTI AS AN ALTERNATIVE

PURVAKARM FOR SNEHAPAN IN VAMAN AND VIRECHAN.‟ for the

degree of Ayurved Varidhi (Doctor of Philosophy) Under the direct

supervision and guidance of Prof. Dr. Surendra M. Vedpathak.

The scholar has presented her research work before the experts

committee of Institutional Research and Ethical Committee (IREC) and

in Pre-Ph.D seminar on 6th January 2011 and 2nd July 2014

respectively. The suggestions given by the subject expert are

incorporated in this thesis.

The scholar has put up hard work in bringing about this thesis after

making an intensive study of the subject on the subject from

Ayurvedic and allied literature for the conceptual as well as clinical

study. This work makes a distinct advance on scientific lines in this

subject. This is further certified that she has completed all the

formalities laid down in the regulations governing the award of

„Ayurved Varidhi‟ Ph.D Degree of Bharati Vidyapeeth deemed

university, Pune.

Hence, her thesis is recommended for being submitted to the

adjudication for the award of Ph.D degree in Panchakarma.

Place: Pune Prof. Dr.A.B.Patil Date: Dean and Principal B.A.M.S.,D.T.F.M.Ph.D

Bharati Vidyapeeth Deemed University

College of Ayurved Pune-43

BHARATI VIDYAPEETH DEEMED UNIVERSITY

COLLEGE OF AYURVED, PUNE- 43

DEPARTMENT OF PANCHAKARMA

CERTIFICATE OF THE GUIDE

This is to certify that the work incorporated in the thesis

„STUDY OF ANUVASAN BASTI AS AN ALTERNATIVE

PURVAKARM FOR SNEHAPAN IN VAMAN AND

VIRECHAN.‟ Submitted by Dr. Priyadarshani A. Kadus, was

carried out under my supervision/ guidance. Such material

as has been obtained from other sources has been duly

acknowledged in the thesis.

Place :-Pune Guide

Date :- Prof. Dr.S.M.Vedpathak

MD (Ayu),Ph.D,MBA(HR)

Head Department of Panchakarma

Vice Principal, BVDU,

College of Ayurved, Pune-43

DECLARATION BY THE CANDIDATE

I declare that the thesis entitled „STUDY OF ANUVASAN BASTI

AS AN ALTERNATIVE PURVAKARM FOR SNEHAPAN IN VAMAN

AND VIRECHAN.‟ submitted by me for the degree of Doctor of

Philosophy is the record of work carried out by me during

the period from 5th August 2010 to 2nd July 2014 under the

guidance of Prof. Dr.S.M.Vedpathak and has not formed the

basis for the award of any degree, diploma, associate ship,

fellowship, titles in this or any other university or other

institution of higher learning.

I further declare that the material obtained from other

sources has been duly acknowledged in the thesis.

Place: Pune

Date:

Dr. Priyadarshani Arvind Kadus

Research Scholar

INDEX

No. Name of the Topic Page No. Acknowledgement

Key to Transliteration

Abbreviation

Introduction Section A Conceptual Study 01-56

I Historical review of Snehana 01-02

II Literary review of Snehapāna 03-18

III Historical review of Basti Karma 19-20

IV Literary review of Anuvāsana Basti

21-33

V Pharmacodynamics of Basti 34-35

VI Drug review 36-37

VII Review of previous work done 38-39

VIII Concept of Anuvāsana Basti as an

alternative for Snehapāna.

40-41

IX References 42-56

Section:B Clinical Study 57-118

I Aim and Objectives 57

II Materials and Methods 58-62

III Observations and Results 63-118

Section:C Discussion. 119-134

I Discussion 119-129

II Further scope of study 130

III References 131-134

Section:D Conclusion 135

Section:E Summary 136

Section:F Bibliography 137-139

Section:G Annexure

Case paper with Prakṛti, Koṣṭha

and Agni Parikṣaṇa and written

consent.

Letter of Standardization of Mūrcchita Tila Taila.

ACKNOWLEDGEMENT

Firstly I salute God of Vaidyas, Lord Dhanvantari and God of

intelligence Ganesha and Saraswati for bringing about the completion

of this project smoothly.

It is with heart full of gratitude that I acknowledge my guide Dr.

Surendra Vedpathak, Professor and Head Department of

Panchakarma, for his constant inspiration and guidance befitted me to

complete this creative work.

I solicit my gratitude to Chancellor, BVDU, Dr. Patangarao Kadam

and Vice Chancellor, BVDU, Dr. Shivajirao Kadam for giving me

opportunity to seek Ph. D degree from this university.

I am thankful to Dr. Abhijit Patil, Principal, Dr. V.V.Bhalsing and Dr.

S.M.Vedpathak, Vice- Principal, BVDU, College of Ayurved and Dr.

Shubhangi Katkar, Director, Bharati Ayurved Hospital, for providing

me best available facilities for the work.

I am deeply indebted to my Guru Dr. Vivek Sane for his timely

encouragement for selection of this topic for Ph. D.

With deep sense of gratitude, I convey my thanks to Dr. S.M. Sathye

for his guidance.

I wish to extend my special thanks to Dr. Supriya Bhalerao, research

scientist, IRSHA, for her efforts to bring perfection in this work.

I aknowledge Dr. Arvind Kadus, Propritor, Agasti Pharmaceuticals,

Pune for providing specially prepaired Basti pouches with required

quantity of Mūrcchita Tila Taila and Saindhava.

I must give my sincere thanks to all my patients who have actively

participated in the clinical trial, without them this work would not

have been successful.

I am thankful to my departmental colleagues Dr. Santosh Chavan and

Dr. Minaj Kulkarni for their support. I express my gratitude to Dr.

Manju Chavan, Dr. Sunanda Ghare, Dr. Snehalata Salunke, Dr.

Seema Gholap, Dr. Mrudula Kulkarni, Dr. Rahul Gujrathi who

believed me and provided their patients for this trial due to which this

study could take a shape.

Male and female therapists of our department gave their best for

administration of Anuvāsana Basti as per the protocol of this work. It‟s

my duty to convey my thanks to our therapists; Jyothi, Seema,

Vanita, Swati, Ravi, Ramdas, Sunil and Kumbhar.

I am thankful to my students; Dr. Bharati, Parag , Archana, Amit,

Abhishek, Pratik, Mayur, Jaydatt for observing and proper counselling

the patients.

I am grateful to Dr. Asavari Kanade and Dr. Gauri Joshi for providing

me accurate statistics required for this study.

I am also thankful to my friends Dr. Swapnali and Dr. Suwarna who

always kept me alert and fresh.

My sincere thanks to Mr. Rakesh, Swami Enterprises for his

appropriate art work and designing which made this work presentable.

I experience the blessings of the god in my parents, Mrs. Sandhya

Bapat and late Mr. Avdhut Bapat. My vocabulary falls short to express

my regards to them.

My other family members, my sisters Mrs. Rashmi, Mrs. Nita and

Shilpa, my brother in law Mr. Sanjay, Mr. Bhalchandra, Mr. Atul, Mr.

Avinash, my sister in law Mrs. Arti and Mrs. Rohini always supported

me in every way to complete this work. I must express my sincere

thanks to them.

Even though my kids Arya and Parth are too small to understand the

meaning and importance of this work, they gave me constant

encouragement and support in their own innocent way, which helped

me to stabilize my mind.

My inner strength, really none other than my husband, Dr. Arvind,

whose timely encouragement made me aware of my aims and

capacities without which it was impossible for me to reach this stage

of life. He gave me unshaken support, care and stood solidly besides

me in each and every movement of my life. It is really beyond the

reach of my language to express my gratitude for him.

KEY TO TRANSLITERATION

A a Aa ā [ i

[- ī ] u } ū

e e eO ai Aao o

AaO au AM aṃ A: aḥ

k ka K kha ga ga

Ga gha = ṅa

ca ca C cha ja ja

Ja jha Ha ña

T ṭa z ṭha D ḍa

Z ḍha Na ṇa

t ta qa tha d da

Qa dha na na

p pa f pha ba ba

Ba bha ma ma

ya ya r ra la la

va va Sa śa Ya ṣa

sa sa h ha L la

xa kṣa & jña

? ṛa Ea ṣra

ABBREVIATION

Aṣtanga Hṛday A.). Vātānulomana VA

Caraka Saṃhitā ca. Angalāghava AL

Cakradatta cak`. Asaṃhata Varca AV

Sutra Sthāna saU. Klama KL

Kalpa Sthāna k. Snigdha Twak ST

Nidāna Sthāna ina. Samyak Snigdhatā Lakṣaṇa

SSL

Vimāna Sthāna iva. Anuvāsana Basti AB

Aṣtanga Saṃgraha A.saM Vāta Pitta Prakṛti VP

Suśruta Saṃhitā sau. Vāta Kapha Prakṛti VK

Kaśyapa Saṃhitā ka. Pitta Vāta Prakṛti PV

Cikitsā Sthāna ica. Pitta Kapha Prakṛti PK

Siddhi Sthāna isa. Kapha Vāta Prakṛti KV

Uttar Tantra ]. tM. Kapha Pitta Prakṛti KP

Uttama Śuddhi US

Madhyama Śuddhi MS

Hīna Śuddhi HS

INTRODUCTION

Pañcakarma is not merely a Śodhana therapy as it is understood, but

also having larger range of therapeutics such as Snehana, Swedana,

Stambhana etc. Out of these internal and external Snehana and

Swedana are considered as preparatory procedures or Purvakarma of

Śodhana. Ābhyantar Snehana is in practice since ancient times which

aims to prepare the body for expelling out the Doṣa and to protect the

body from Vātaprakopa after Śodhana.

In present days Ᾱyurveda physicians are showing much interest in

Śodhana Cikitsā, but many times they come across some difficulties in

administrating Purvakarma i.e. Snehapāna. They often experience a

poor compliance for oral administration of medicated fats (Snehapāna)

Patients are not ready to take Sneha orally even though they are

willing to undergo Vamana or Virecana. Patients have the major

problem in terms of quantity, taste, smell and oiliness of Sneha. In

our experience, at least 10 – 15 % patients are seen complaining about

having Sneha orally. It has also been observed that some patients

drop this treatment during the course. Incomplete Snehapāna or

premature development of Snehodwega cause discontinuation of

Snehapāna. All these conditions ultimately pose a problem for a

physician to prepare the patient for Śodhana process.

In other words, to convince the patient for taking Sneha orally is a

major problem for an Ᾱyurveda practitioner. These inconveniencies

made us think about effective alternative to counter drawbacks of

Snehapāna. Obviously, the alternative for having medicated fat orally

needs to be „Patient Friendly‟. Development of such alternative is the

need for today‟s era. This may further help popularising „Pañcakarma

processes‟ among the patients. Hence the present study was planned

to evaluate whether sign and symptoms of proper Snehana could be

achieved by administration of Anuvāsana Basti instead of Snehapāna.

There are no direct references available in texts which can point out

the use of Anuvāsana Basti as an alternative for Snehapāna; but with

the help of Yuktī Pramāṇa, it was taken into consideration that

Anuvāsana Basti can be used instead of Snehapāna. As the original

dose of Anuvāsana Basti is 120 ml; constant dose was administered in

one group. Generally dose of Ābhyantar Snehapāna is kept escalating;

hence Anuvāsana Basti was also administered in the escalating dose

in another group.

The scope of this study is,

Convenient for the patients who have aversion to Snehapāna.

The major problem for the doctors, to convince the patient

regarding Snehapān can be solved.

In this present study, Anuvāsana Basti is used as an alternative for

Snehapāna. Mūrcchit Tila Taila has been used along with Saindhava

for Anuvāsana Basti.

Hypothesis

Even though, Basti is a rectal rout of drug administration; it is

considered as an internal route of drug administration by Dalhaṇa. It

was therefore thought that Anuvāsana Basti of Mūrcchita Tila Taila

along with Saindhava can prove as an effective modality to achieve

symptoms of proper Snehana.

In this study; the subject has been elaborated as follows:-

Introduction: - Significance and scope of present study, hypothesis,

are discussed in the topic of introduction. Overall concept of the study

is put forth.

Conceptual Study:-

Review of literature: - In this topic review of Snehapāna Vidhī,

Vicāraṇā Sneha, Anuvāsana Basti, Tila Taila, Saindhava is taken

from various Saṃhitā. Previous work related to the subject has

been studied. Rectal route of administration of drug is also

studied available on web sites. On the basis of all these

references a concept of Anuvāsana Basti as an alternative for

Snehapāna has been discussed.

Clinical Study:-

Aim and objectives: Aim of the study regarding achieving

Samyak Snigdha Lakṣhaṇa by administration of Anuvāsana

Basti and objectives related to Koṣṭha are written in this topic.

Materials and Methods: In this section, material used for

Anuvāsana Basti with SOP of Anuvāsana Basti, inclusion and

exclusion criteria, drug administration criteria are discussed.

Scoring pattern and grades of Samyak Snigdhatā are also noted

in this topic. Two groups have been made. In group A dose of

Anuvāsana Basti was kept constant for minimum 3 and

maximum 7 days i.e. 120ml Murchita Tila Taila + 500mg

Saindhava. In group B, the dose was kept escalating i.e. 120ml

Murchita Tila Taila + 500mg Saindhava on 1st day increasing

with 25ml Murchita Tila Taila + 100mg Saindhava every day

minimum for 3 days and maximum for 7 days.

Observations and Results: Results have been drawn by

considering various observations. Observations are based upon

the statistical analysis of symptoms of Samyak Snigdhata;

Vātānulomana, Angalāghava, Asaṃhata Varca, Klama and

Snigdha Twak. Various statistical tests like Chi square test,

paired and unpaired t test have been applied to analyse the

data. To our surprise, in Gp. B i.e. in escalating dose of

Anuvāsana Basti, 58% patients showed symptoms of Pravara

Snigdhatā. No one was observed Asnigdha in this group.

Outcomes of Vamana and Virecana were also observed.

Discussion: The observations are discussed elaborately

according to various references. Main topics for discussion are;

Vicāraṇā Sneha, mode of action and Utkleśana Karma of

Anuvāsana Basti, Samyak Snigdhatā Lakśaṇa and consideration

of Basti Karma as an internal route of drug administration.

Observations are also discussed in this topic. Some limitations

and further scope regarding this study have been discussed

here.

Conclusion: On the basis of observations and discussions,

conclusions have been drawn. Anuvāsana Basti especially in

escalating dose can be a trend alternative for Snehapāna.

Summary: - The whole study has been summarised in this

topic, as Anuvāsana Basti is considered as an internal route of

drug administration; Snehana is possible through this route. In

the present study, this is proved.

Bibliography: According to the APA format, bibliography has

been written.

I. HISTORICAL REVIEW OF SNEHANA

(A) Veda

1) Ṛgveda:- the word Ghṛta is used as a synonym for nutritious

diet. Capacity of Ghṛta to inflame Agni is also described.

2) Atharvaveda: Ghṛta has been much complemented.

(B) Purāṇa

In Mārkandeya Purāna; Ghṛta, Taila, Vasā and Majjā were quoted as

Snehadravya.

(C) Saṃhitā Kāla

Caraka Saṃhitā

Contains a lot of information regarding Snehapāna but in scattered

manner.

Sūtra Sthāna:-

First chapter contains Mahāsneha, Guṇa and Karma of Caturvidha

Sneha.

Second chapter denotes Snehana and Swedana as a Purvakarma of

Pañcakarma.

Thirteenth chapter is totally devoted for Sneha. The sources, qualities

of Sneha, proper season of uses of each Sneha, concept of Vicaranā,

indications, contraindications of Sneha, dosage form of Sneha and

classification are described.

Twentysecond chapter contains six fold treatments with definition of

Snehana.

Vimāna Sthāna:-

Sixth chapter describes Snehana as a treatment of Vāta and Pitta.

Cikitsā Sthāna:-

Many references are available in the form of Sneha preparations and

as a treatment of Vātavyādhī.

Siddhī Sthāna:-

In first chapter, qualities of Saṃśodhanārtha Snehapāna are described

along with maximum period required for Snehana.

Suśruta Saṃhitā

The description about Pañcakarma is started from Snehopayogitā

Cikitsā Adhyāya of Cikitsā Sthāna. All information regarding all types

of Sneha is quoted.

Aṣtāṅga Saṃgraha and Aṣtāṅga Hṛdaya

In Snehādhyāya, total Sneha Vidhī is described in elaborated manner.

Śārangadhara Saṃhitā

In Uttarakhanḍa, a separate chapter is devoted for Snehanakarma, in

which Snehana Vidhī, dose, duration, indications, contraindications,

Samyak Yogadī Lakṣaṇa are described. The numerical values of Sneha

i.e. Pala, Karṣa are given.

Bhāvaprakāśa

A full description on Snehapāna Vidhī has been given in Purvakhanḍa.

The days for Snehana and Mātrā are discussed on the basis of types of

Koṣṭha and Agni.

Kaśyapa Saṃhitā

Kaśyapa has devoted total Adhyāya for Snehana Karma. Snehana

types, discussion on Śamana and Śodhana Sneha has been done.

Bhela Saṃhitā

In fourteenth chapter of Sutrasthāna, Snehana Karma has been

described. The mode of action of Snehapāna as a Purvakarma is

beautifully narrated. Bhela has given simily that the water flows from

upper side to lower level, likewise after Snehana, Doṣā come to Koṣṭha

from Śākhā.

Cakradatta

In chapter of Snehādhikāra; Snehana procedure is described.

Vangasena

In Snehapānādhikara chapter, the entire dose schedule of Jaghanya,

Madhyama and Uttama Mātra is given. Vardhamāna Mātrā of Sneha

for Śodhana is first time discussed.

II. LITERARY REVIEW OF SNEHAPĀNA

Śodhanārth Ābhyantara Snehapāna:

Śodhana therapy is meant for purification of body, through which all

the morbid Doshās are expelled out to maintain the proper functioning

of the body. This is the specialty of Āyurveda.

Śodhana procedure especially Vamana and Virecana is three fold

therapy. Certain preparatory procedures known as Purvakarma are

preceded by main procedures i.e. Pradhāna Karma followed by post

operative i.e. Paścāta Karma. The whole Śodhana procedure depends

upon the proper mobilization of Doṣas from Śākhā to Koṣṭha and

Utkleśa of Doṣas which are to be achieved by Snehana and Swedana.

Out of these two; Snehana has got importance which helps Doṣas to

move towards Koṣṭha by Vṛddhī and Abhiṣyanda of Doṣas.(1,2)

Etymology of the word „Sneha‟:

The word „Sneha‟ is derived from the ‘isnah\’ with iNaca\ p`%yaya. (vaacasp%yama\)

It has two meanings. One being „Snih-prītau‟ means to render affection

and the other „Snih-Snehane‟ meaning to render lubrication.

Snehana:

Snehana is the word to denote a therapy which promotes mainly

Snigdha Guṇa in a body. In Śabdastoma Mahānidhī, the term

Snehana is used only for external application of Sneha to the body.

Where as in Āyurvedic texts it is often used for internal administration

of Sneha.

Nirūkti / Definition:

The procedure by which Snigdhatā, Viṣyandana, Mārdavatā, and

Kledana are brought about is known as Snehana.(3) This particular

quotation has got extreme importance regarding Śodhanārtha

Ābhyantara Snehpāna. Snehana indicates Snigdhatā i.e. unctuousness, oiliness. Viṣyandana refers to Vilayana; i.e. dissolution

or diffusion, fluidity or liquification. After diffusion; excretion and

overflowing of Sneha is known as Viṣyandana. Mārdavata means

softness. Kleda is moistness or wetness. Kleda signifies the increase of

Ãpya Guṇa in the body or Utkleśāvasthā. These four are to be

considered as the cardinal features which work as a tool for the

assessment of Snehana Karma. In which;

Snehana is to be assessed by the unctuousness of the body, stool and

skin.Viz Gātra, Puriṣa and Twak Snigdhatā.

Viṣyandana is observed by excretion of Sneha with or without stool.Viz

Snigdha Mala and Adhastāt Snehadarśana.

Mārdavatā is assessed by Gātra Mārdava and Twak Mārdava.

Kledana is observed by consistency of stool i.e Asaṃhata Varcas.

The other term Sneha indicates Sneha Dravya. The substances which

bring about oiliness, unctuousness are Sneha drugs. For eg. Ghṛta,

Taila, etc. It is also defined as the substance, which help combustion.

Sneha is also one of the twenty four Guṇas of the Nyāyavaiśeṣika

branch of philosophy.

Properties of Sneha : (4)

Property of Sneha Dominant Mahābhuta Main action

Drava Āpa Prakledana, Viloḍana,

Prasārī

sukṣma Teja, Vāyu, Āpa Sroto Viśodhana,

Vivaraṇa

Sara Āpa Anuloma,

Prasāraṇaśīla

Snigdha Āpa, Teja Snehana, Mārdava,

Kledana, Bandhana,

Viṣyandana

Picchila Āpa Lepana, Jīvana, Balya,

Saṃghāta

Guru Āpa, Pṛthvī Bṛmhaṇa, Balakara

Malavṛddhikara,

Angasāda/

Agnisādakara,

Śīta Āpa, Vāyu Sthambhaka,

Alhādana,

Manda Āpa, Akaśa Śamana

Mṛdu Āpa, Akaśa Mārdava / Śaithilya

Importance of Snehpāna:

The person using Sneha regularly, possess ignited internal fire

(digestion), evacuated bowels, fresh Dhātu, superior strength and

complexion, firm organs, delayed senility and lives hundred years. In

the diseased person, Sneha is useful for stimulating weak physique

and digestion; these two (physique and digestion) when strengthened

cannot be overcame by ill effects of food. (5)

Not only Kāyacikitsā gives importance of Snehana Karma but also

Ācārya Suśruta, the follower of Śalya-Śalakya Cikitsā advises

Surgeons to acquire the knowledge of Sneha Kriyā thoroughly.(6)

1.Śodhana and Śamana Cikitsā are advised in Āyurveda to cure

disease. The diseases eliminated by Śodhana will not recur.(7) Before

administrating Śodhana therapy, it is necessary to do Snehana and

Swedana. The idea of Snehana and Swedana is to bring out vitiated

Doṣa to suitable state so they can be expelled out easily. This stage is

called as „Utkliśṭa Doṣavasthā‟.(1) Snehana and Swedana consequently

brought the Doṣas to Koṣṭhamārga. Doṣas which are in the Līnāvasthā

(the deep seated Doṣa) change to Pravāhaṇa Avasthā, due to which

they could be removed easily.(8,9) The Doṣas become moistened with

Sneha, and liquefied by Swedana. Thus it becomes easy to expel them

by Śodhana.(10)

2. Ācārya Vāgbhaṭa has classified treatment into two categories. They

are, Santarpaṇa Cikitsā and Aptarpaṇa Cikitsā. Rūkṣana, Swedana

and Langhana come under Aptarpaṇa Cikitsā while Snehana ,

Stambhana and Bṛṃhaṇa come under Santarpaṇa Cikitsā.(11) These six

are called as Ṣadupakramas (six therapeutic principles). By this it can

be well understood that Snehana is one of the fundamental

therapeutic measure in Āyurveda.

3. As the body is originated from Śukra and Ãrtava which are

Snehatama Dhātus of the body; it has got a special affinity towards

Sneha. So body is considered as „Sneha Sāra‟.(12) Morever from the

childhood Snigdha Āhāra are habituated. A person who can be called

as „Snehasāra‟ may not be susceptible to diseases like Rājayaksmā etc

(13)

4. Pitta and Kapha are two Doṣas which have Snigdha Guṇa.(14)

Vitiation of Vāta especially by Rūkṣaṇa gets pacified by Sneha Kriyā.

5. Rasa, Rakta, Māṃsa, Meda, Majjā and Śukra Dhātus have Snigdha

Guṇa. These Dhātus maintain the normal body function by their

Snigdha property. Snigdha Guṇa increases as the Dhātus get

upgraded from Rasa to Śukra.(15)

6. The Upadhātus namely Vasā, Stanya and Oja have dominance of

Snigdha. Malas like Puriṣa, Mūtra, and Sweda are also having Snigdha

Guṇa and its deficiency indicates disease.(16,17)

7. In Bāla Cikitsā, the young children are considered always being

oleated because they are fed mainly with Shigdha Āhāra like breast

milk, or cow‟s milk, Ghī etc. So they are directly subjected to Śodhana

Cikitsā (mild) when necessary.

In nutshell, Sneha Guṇa exists in Doṣa, Dhātu, Upadhātu and Mala

which constitute our body.

Classification of sneha:

1. Classification of Sneha Dravya according to their

origin(18,19)

Sthāvara :- (Plant origin)

Seed eg. Tila, Eranda, Atasī, Karanja

Bark eg. Twak (Dālchinī)

Core eg. Chandan

Leaf eg. Eucalyptus, Lemon grass

Suśruta has described 12 Sthāvara Sneha with different functions (20)

Virecanopaga : Eranda, Tilwak, Jaypal

Vamanopayogī : Jimutaka, Kutaj

Śirovirecanopayogī : Vidanga, Jyotiṣmati

Duṣta Vraṇopayogī : Karanja, Puti Karanja

Mahāvyādhyupayogī : Bhallātaka, Kampillaka

Mutrasaṅga : Kuṣmāṇḍa

Aśmarīghna : Harītakī

Pramehopayogī : Sarṣapa, Nīma

In Pitta saṃsṛṣṭa Vāyu : Nārikela, Priyal

Kṛṣṇikaraṇopayogī : Bibhītaka, Bhallataka

Pāndukaraṇopayogī : Ṣyonaka, Priyangu

Dadru/ Kitibha kuṣthaghna : Agaru, Devadāru

Jaṅgama :- (Animal origin)(19)

Animal source of oils and fat (Jangama Sneha) ; Matsya (fish toothed

animals), Pakṣī (avians), constitute the animals fats.

Dadhī (curd), Kṣīra (milk), Ghṛta (Ghī), Amiṣa (meat), Vasā (fat), Majjā

(bone marrow) of these animals and birds.

2. Classification of the Snehana on the basis of their route of

administration (21,22,23,24)

a) Abhayantara –

Pāna

Basti

Nasya

Bhojana

b) Bāhya –

Abhyanga

Lepa

Mardana

Udvaratana

Saṃvāhana

Pādāghāta

Murdhataila

Ganduṣa

Karṇa Pūraṇa

Akṣī Pūraṇa

Parīṣeka

Picu

3. Classification of Sneha on the basis of Mātrā (25)

1) Hraswa Mātrā is that Mātrā which is digested in 6hrs.

2) Madhyam Mātrā is digested in 12hrs.

3) Uttama Mātrā is digested in 24hrs.

4) Hrasīyasī Mātrā is described by Vāgbhaṭa. The Mātrā which

would digest in half time of Hraswa Mātrā that means in 3hrs is

called as Hrasīyasī.

4.Classification of Sneha on the basis of their combination(26)

1) Yamaka Sneha- the combination of two Sneha. E.g.

Sarpi+Taila, Taila+Majjā etc.

2) Trivṛta Sneha- the combination of three Sneha. E.g.

Sarpi+Taila+Vasā.

3) Mahā Sneha- the combination of four Sneha. E.g.

Sarpi+Taila+Vasā+Majjā.

5. Classification of Sneha on the basis of its preparation

1) Accha Sneha

Accha Sneha is one, when it is used internally as it is i.e.unmixed and

in large quantity. The external application of unmixed Sneha, is not

Accha Sneha as it does not come in contact of Jāṭharāgni directly.(26)

In Amara Kośa the meaning of word „Accha‟ is given as clear and

clean. Accha also means that which is not solid (Aghana). The

synonym of Accha Sneha is Kevala Sneha which means a medicated

or not medicated (Samskṛtam- Asamskaṛtam va) Sneha when given

alone (27)

Accha Peya is of two types-

Saṃśodhan Accha Snehas (Purificatory simple oleation )

Saṃśamana Accha Peya (Palliative simple oleation)

Accha Sneha is administered in persons, who are Sātmya to Sneha

and those who can sustain physical strain. This is administered in

such a period, when it is neither Śīta nor Uṣṇa.(28)

2. Vicāraṇā Sneha (29)

Sneha along with various preparations like with Odana, Vilepī,

Yavāgu.

Route of administration is different than oral. Eg. Abhyanga,

Anuvāsana Basti, Karṇa Tarpaṇa.

Vicāraṇā Sneha is prescribed to those persons who have aversion for

taking Sneha substances, those who are in the habit of Madyapāna,

those who are having Mṛdu Koṣṭha, those who cannot resist to physical

strain.(30) Suśruta further added as this should also prescribed in the

condition of Tṛṣṇa and in Uṣṇa Kāla.(31)

6. Classification of Sneha on the basis of Kārmukatā (32)

1. Śodhana Sneha-

Sneha- employed as the preparatory procedure for Śodhana Karma. It

is to be given in more quantity, in the morning when the meal taken

in the previous night gets digested.

2. Śamana Sneha-

The one, which will not increase or decrease the Doṣa is called as

Śamana. The Sneha employed for Kuṣṭha, Duṣṭa Vraṇa, Pāṇdu etc.

comes under this type. The Śamana Sneha is administered when the

person feels hungry. It is given in Madhyama Mātrā.

It kindles the Agni, cleanses the Koṣṭha, increases Dhātu, Bala, Varṇa.

Due to Śamana Sneha; Indriya becomes strong, aging process

delays.(5)

3. Bṛṃhaṇa Sneha-

The Sneha which is administered for Bṛṃhaṇa of body is called as

Bṛṃhaṇa Sneha. It is given with Māṃsa, Madya or with meal, in Alpa

Mātrā.

It is indicated in Bāla, Vṛddha, Pipasārta, Snehadweṣī, Madyaśīla.

7) According to Pāka(33)

Mṛdu

Madhyama

Khara

Sr.

No.

Use of Sneha Ca. Su. Ah. Sha.

1 Abhyanga Khara Madhyama Khara Madhyama

2 Pāna Madhyama Mṛdu

Cikkaṇa Madhyama

3 Nasya Mṛdu Madhyama Mṛdu Mṛdu

4 Basti Madhyama Khara Cikkaṇa Madhyama

5 Karṇapuraṇa Khara

FOUR BEST SNEHA - DRAVYA WITH THEIR GUṆA

A) Ghṛta Guṇa (34)

Pitta – Vāta Śamana

Dāha Śamana

Swara-Varṇa Prasādana

Gātra Mārdava- Increases Rasa , Śukra, Ojas

Increases Dhī, Dhṛtī, Smṛti, Agni and Bala.

Best for eye diseases.

Vayasthāpana.

Best of Kṣatakṣīṇa , Śoṣa

Sevana Ṛtu -(47) Śarada

Indications for Ghṛta Snehana-(35)

Vāta-Pitta Prakṛti

Vāta-Pitta Vikārī

Cakṣukāmā

Kṣatakṣīṇa

Vṛddha, Bāla

Abala

Āyuprakarśakāmī

Bala-Varṇa-Swarārthinah

Puṣtikāmā.

Prajākāma.

Saukumāryārthina.

Dāha-Śastra-Viśa Pidita etc.

B) Taila Guṇa(36)

Āgneya, Uṣṇa, Tīkṣṇa, Madhura Vipāki, Vyavāyi, Sukṣma,

Viśada,Vikāsī, Guru, Sara, Lekhana.

Vāta Kapha Naśaka.

Twacya, Netrya, Kṛmighna.

Yoni - Sirā - Garbhāśaya Śulaghna.

Karṇa Śulaghna.

Śarira Mārdavakara, Māṃsabalya.

Sevana Kāla(47) – Pravṛṣa, Śitala Kāla .

Indications of Taila Snehana –(37)

Pravṛddha Sleṣma Medaska

Cala Sthula Gala Udar

Vātavyādhi

Vāta Prakṛti

For Bala, Tanutwa, Laghutā, Dṛḍhatā Sthir Gātratā

Kṛmi Koṣṭha

Krūra Koṣṭha

Nādivraṇa

C) Vasā Guṇa (38)

It is the Updhātu of Māṃsa Dhātu

Vasā of Grāmya, Anupa, Audaka animals is Guru, Uṣṇa, Madhura,

Vātaghna. Vasā of Jāṅgala, Ekasapha, Kravyāda animals is Śita,

Laghu, Kaṣaya, Raktapittanāśaka, Vasā of Pratuda and Viṣkira is

Kaphanāśaka.

Sevana Kāla(47) - Mādhava

Indications for Vasā Snehana – (39,40)

Vātātapasahā

Rukṣa

Bhārādhwa Karśita

Rujā in Asthi, Sandhi, Snāyu, Marma, Koṣṭha.

Āvaraṇa of Balawāna Vāyu on the Srotasa

Saṃśuṣka Retas, Rudhira

Nispīta Kapha Medas.

Mahat Agnibala

Vasā Sātmya

D) Majjā Guṇa (41)

Majjā is situated deeply inside the Asthi. The main function of it is

Purāṇa.

Guru among all the Snehas

Bāla Vardhaka

Rasa-Kapha-Majjā Vardhaka.

Asthi Dṛḍhikarṇa

Sevana Kāla(47) – Mādhava

Indications of Majjā Snehana – (42)

Dīptāgni

Kleśasaha

Ghasmara

Snehsevi

Vātarakta

Krura Koṣṭha

Snehana, Jīvana, Varnya, Bala-Upacaya Vardhana and Kaphāpaha.(43)

According to Kāśyapa, among all the four Uttama Snehas – Ghṛta,

Taila, Vasā, and Majjā are the Śreṣṭha Purvāpurvo which means Ghṛta

is best among all. Taila comes after Ghṛta then Vasā and Majjā in

sequences.(44) In the same manner they are Pittaśāmaka.(45) Majjā has

got the most Guru property than Ghṛta.(46)

Indications of Snehapāna :(48)

All fit for Sweda and Śodhana.

Vāta Roga: Rukṣa Guṇa. Eg. Ati Vyavāya, Ati Madyapāna, Ati

Cintā.

With Rukṣa and Cala Guṇa. Eg. Ati Vyāyāma.

Kṣīṇa Dhātu

Aged/ children/ ladies

Contra- indications of Snehana :(49)

Agni Vikṛtī : Ati Mandāgni, Tikṣṇāgni

Āmaja Vikāra : Atisāra, Chardī, Apaprasūta, Aruci, Tṛṣṇā

Kapha dominant / Srotorodhajanya diseases: Urustambha, Udara,

Sthaulya

Madya / Gara Viṣapidita

Immediate after Śodhana like Virecana, Nasya, Basti

Samyak Snigdha Lakṣaṇa: (50)

Careful assessment of Samyak Snigdha Lakṣaṇa is very important for

deciding further Śodhana procedures.

Vātānulomana: Proper Evacuation of flatus, faeces and urine

Diptogni: proper ignition of Agni

Snigdha Varca along with Asaṃhata Varca: it denotes the saturation of

Sneha in Varca.

Klama: exausion without much exersion.

Twak Snigdhatā/ Gātra Mārdavatā:

Asnigdha Lakṣaṇa: (51)

Appearance of symptoms like Grathita and Rukṣa Purīṣa, Vāta

Pratilomatā, Agnimāndya, Gātra Rukṣatā/ Kharatā etc during

Snehapāna is known as Asnigdha Lakṣaṇa. Actually these symptoms

may be present prior to Snehana therapy, but when Snehana is

not done properly, these symptoms persist.

Atisnigdha Lakṣaṇa: (52)

If Snehapāna is given in larger dose even after appearance of Samyak

Snigdhatā; Atisnigdha Lakṣaṇa may appear.

Pāṇdutā, Gaurava, Jāḍya, Avipakwa Puriśa, Tandrā, Aruci and Utkleśa

are some symptoms of Atisnigdhatā.

Sneha Jīrṇājīrṇa Lakṣaṇa:(53)

During the period of digestion of Sneha, some symptoms are produced

which are called as Sneha- Jīryamaṇa Lakṣaṇa. These symptoms

disappear after digestion of Sneha and don‟t require any sort of

therapeutic intervention. In case of doubt regarding digestion or

indigestion of Sneha, one should take hot water which brings Śuddha

Udgāra.

Jīryamaṇa Lakṣaṇa Jīrṇa Lakṣaṇa

Śirorujā Śirorujādi Lakṣaṇa Praśamana

Bhrama Vātānulomana

Niṣthīva kṣudha

Murccha Tṛṣṇa

Sāda Udāgra Śuddhi

Arati Laghutā

Klama

Tṛṣṇa

Snehavyāpad: (54)

Due to faulty administration of Sneha, one may have to come across

the complications. These mistakes may occur either by physician or by

patients.

Mistakes of physician:

1) Due to improper judgement of dose of Sneha and Koṣṭha of the

patient.

2) Improper consideration of time.

3) Improper selection of patient for Snehapāna.

Mistakes of patients:

1) If patient fails to follow the do‟s and don‟ts after Snehapāna.

2) If patient fails to have proper dose of Snehapāna recommended

by the physician.

Snehavyāpad

No. Āśu Utpanna Cira Utpanna

1 Ajīrṇa, Aruci Kaṇdu, Kuṣṭha

2 Śula Grahaṇī

3 Stambha Paṇḍu

4 Tṛṣṇa Arśa

5 Utkleśa Śotha

6 Stambha Udara

7 Vak Graha

Sneha Prakarṣa Kāla: (55) and Koṣṭha Vicara: (56)

It is optimum duration required for Snehapāna. This duration depends

upon the Koṣṭha.

For Krura Koṣṭha: 7 days

For Madhyama Koṣṭha: 5 days

For Mṛdu Koṣṭha: 3 days

Pathāypathya after Snehapāna: (57)

Some do‟s and don‟ts are prescribed by Ācaryas after Snehapāna to

achieve optimum benefits and to avoid complications.

Pathyas: As Śīta property increases Abhiṣyanda, Uṣṇopacāra like using

warm water or avoiding cool breeze is advised.

To avoid Vātaprakopa, abstinence from sexual activity is must.

As day sleep enhances Kapha, only night sleep is advisable.

Apathya: these are prescribed to avoid Vātaprakopa especially. Eg.

Vegāvarodha, Ucca Vacana, Śoka, Krodha, Yānāyāna, Vyāyama etc.

Vamana/ Verecana after Snehapāna: (58)

Śodhana Sneha Viśrama Kāla Diet advised

Vamana 1 day Kaphotkleśakara Āhār

like Māṣa, Dadhī

Virecana 2 or 3 days Laghu, Drava, Uṣṇa

Āhār, Maṃsarasa

III. HISTORICAL REVIEW OF BASTI KARMA

(A) Veda

The Kauśika Sutra of Atharvaveda, Basti is indicated as a substitute

for minor operation. (K.S. Darila 25/127).

(B) Purāṇa

In Agnipurāṇa, Basti is indicated as a principle treatment in

complaints marked by predominance of Vāta (A. P. 279/63). In Aśwa

Cikitsā Kathana, Taila Basti is recommended in horses to relieve their

fatigue immediately (A. P. 284/14). It is also stated that according to

season different Sneha should be used for Basti (A. P. 289/46).

(C)Yogic Literature

Gheraṇḍa Sam hitā

Basti is included in Ṣaṭkarma. Two kinds of Bastis are described there.

Procedure of Basti explained in detail in [1/44-48]

1) Jala Basti – To be done in water

2) Suşka Basti – To be done always on land.

(D) Saṃhitā Kāla

Caraka Sam hitā

The scattered references regarding Basti are available in various

chapters of Caraka Sam hitā, but in Siddhīsthāna out of 12 chapters, 8

chapters are devoted to Basti. First two chapters of Siddhīsthāna deals

with properties of Basti, Samyakyoga, Atiyoga, Ayoga Lakṣaṇas,

indications and contraindications of Basti.This denotes the importance

of Basti in the field of Kāyacikitsā.

Suśruta Sam hitā

In Sus ruta Sam hitā, four chapters have been devoted completely for

the description of the Basti in Cikitsāsthāna. In these chapters, detail

information regarding Bastinetra, indication, contra-indications,

complications, classification of Basti etc. are available. Other various

references of Basti are also available in this Sam hitā.

Aştāṅga Saṃgraha

In 19th chapter of Sutrasthāna classification, indication, contra-

indication, Dosage, process of administration etc. have been described

in detail. Also four chapters of Kalpasthāna have been contributed to

Basti. In these chapters, description regarding importance of Basti,

different types of Basti, Sneha Basti Vyāpada etc. are available.

Aştāṅga Hṛdaya

In 19th chapter of Sutrasthāna, Basti Vidhī is described. In 4th and

5th chapter of Kalpasthāna named as Basti Kalpa and Basti Vyāpada

Siddhī respectively, every aspect of Basti has been explained.

Kaśyapa Samhitā

In Kaśyapa Sam hitā, Basti has been explained in detail in

Siddhīsthāna and Khilasthāna.

Bhela Sam hita

In Bastimātrīya Siddhī, Upakalpa Siddhī, Phala Mātrā Siddhī and

Doṣa Vyāpadikā Basti Siddhī of Siddhīsthāna description of Basti is

available.

Hārita Saṃhitā

In this text, only 3rd chapter of Sūtrasthāna deals with Basti.

Cakradatta

In this text, two chapters named Anuvāsanādhikāra and

Niruhādhikāra are dealt with Anuvāsana and Niruha Basti

respectively.

Śārañgadhara Saṃhitā

In Uttara Khaṇḍa 5th, 6th, 7th chapter, description of Basti is

available in detail. Some of the contributions are like Paribhāṣā of

Basti, Āsthāpana etc are noted.

Bhāva Prakāśa

Basti is explained in detail in Pūrvakhaṇḍa. Most of the explanations

are similar to Suśruta and Śārangadhara.

IV. LITERARY REVIEW OF ANUVĀSANA BASTI

Derivation of Basti:

vasau inavaasao vasa\ AacCadnao vasa\ vaasanao sauriBakrNao |

baist: basto: AavaRNaaoit maUHama\ | naaBao: AQaaoBaagao maUHaaQaaro sqaanao |

It means to lie or to reside.

It means to cover.

Basti is that which covers Mūtra.

Niruktī /Defination of Basti(59,60)

1) The treatment which is given by using Basti, i.e. urinary bladder

of animal is called as Basti.

2) Basti means Mutrāśaya i.e bladder. The process in which

Mutrāśaya is used is called as Basti.

3) Basti word is used to demonstrate anatomical organ bladder.

4) Ācārya Caraka mentioned that, the process through which

medicine reaches up to Kaṭī Pārśva, Kukṣī, spreads and oleates

the body, destroys Bandha of Doṣas and Malas and expelled

them out from the body, is called as Basti.

Types of Basti

According to Adhiṣhṭhāna:

1. Internal: Pakwāśayagata, Mutrāśayagata, Garbhāśayagata

(uttarabasti), Vraṇabasti.

3. External: In this type medicated oil is retained over the affected

part for a prescribed time therefore it is called as Basti.

According to the body part, the names are given eg. Śirobasti,

Katibasti etc.

According to Basti Dravya (61)

1. Niruh: decoction or any Drava-dravya is used eg Yāpana Basti,

Picchā Basti, Kṣāra Basti, Takra Basti, Kṣīra Basti, Mam sarasa

Basti, Gomūtra Basti, Dadhimastu Basti, Amlakāñjī Basti,

Prasannā/ Surā/ Āsava Basti.

2. Anuvāsana Basti: in which Snehadravya is used.

According to Sankhya : (62)

1. Karma: 18 Anuvāsana+12 Niruha = 30 Basti

2. Kala: 10 Anuvāsana+ 6Niruha = 16 Basti

3. Yoga: 5 Anuvāsana+ 3Niruha = 8 Basti

According to Matra: (63)

1. Dvādaśa Prāsṛta Basti

2. Ekādaśa Prāsṛta Basti

3. Nava Prāsṛta Basti

4. Aṣṭa Prāsṛta Basti

5. Sapta Prāsṛta Basti

6. Ṣaḍ Prāsṛta Basti

7. Pañca Prāsṛta Basti

8. Catuh Prāsṛta Basti

On the basis of the Rasa of the Basti Dravya: (64)

1. Madhura Rasa Dravya Basti

2. Āmla Rasa Dravya Basti

3. Lavaṇa Rasa Dravya Basti

4. Kaṭu Rasa Skandha Basti

5. Tikta Rasa Skandha Basti

6. Kaṣāya Rasa Dravya Basti

On the basis of the nature of the Basti Dravya: (65)

1. Mṛdu Basti: Snehadravyas are used.

2. Madhyama Basti: Decoctions like Erandamūla are used.

3. Tīkṣṇa Basti: Tīkṣna Dravyas like Gomutra, Kañjī are used.

On the basis of action on Doşa:

1. Utkleśana Basti

2. Śodhana Basti

3. Śamana Basti

4. Vātahara Basti

5. Pittahara Basti

6. Kaphahara Basti

7. Doṣa-Sansargahara Basti

8. Śoṇita Doṣahara Basti

9. Snehana Basti

10. Bṛṃhaṇa Basti

11. Sangrāhika Basti

12. Vājīkaraṇa Basti

13. Rasāyana Basti

14. Balavarṇakṛta Basti

15. Dīpana Basti

16. Pakvāśaya Śodhana Basti

17. Lēkhana Basti

18. Cakṣuṣya Basti

19. Raktapittahara Basti

20. Pramehahara Basti

21. Kuṣṭhahara Basti

22. Visarpahara Basti

23. Vātaraktahara Basti

24. Abhiśyandahara Basti

25. Dāhaghna Basti

26. Kṛmihara Basti

27. Mūtrakṛcchrahara Basti

28. Parīkartikāhara Basti

On the basis of speciality of names:

1. Mādhutailika Basti

2. Siddha Basti

3. Yuktaratha Basti

4. Yāpana Basti

5. Picchā Basti

6. Vaitaraṇa Basti

7. Picchīla Basti

These classifications are based on different aspects of Basti. But

practically only Niruha and Sneha Basti are main two types which

include all above classification. As this work deals with Anuvāsana

Basti; details of Anuvāsana Basti are mentioned.

Definition of Anuvāsana Basti: (66)

Anuvāsana literally means that which remains in the body for some

time without causing any adverse effect and it can be given every day.

Anuvāsana Basti means administration of Sneha through Basti.

According to Caraka, there are three dosage forms of Anuvāsana Basti.

They are as follows :( 67)

1. Sneha Basti:

Ācārya Suśruta and Caraka mentioned the dose of Sneha Basti as

1∕4th of Niruha Basti.(68) It is considered as Uttama Mātrā of

Anuvāsana Basti.

2. Anuvāsana Basti:

Basti which is given in half dose of Sneha Basti is called as Anuvāsana

Basti.(69)

3. Mātrā Basti:

Mātrā Basti is a type of Snēha Basti/ Anuvāsana Basti. The dose of

Snēha used in it is very less as compared to the dose of Snēha Basti.

Acārya Vāgbhaṭa has defined the Mātrā Basti as the Basti in which

the dose of Snēha is equal to Hrasva Mātrā of Snehapāna.(70)

Ācārya Suśruta mentioned Basti which is given in half dose of

Anuvāsana Basti is called as Mātrā Basti.

Points to be considered for administration of Anuvāsana Basti:

1. Kāla Vicāra:

A. Anuvāsana Basti yogya Kāla: (71)

It should be administered during day time; as Agni is in its normal

state and Srotomukha are open to receive the Vīrya of Sneha.

B.Anuvāsana Basti Ayogya Kāla: (72,73)

Anuvāsana Basti is not advisable to give at night as Srotomukha

are closed; the Vīrya of Sneha can‟t spread throughout the body.

As night is Śīta by nature; Utkleśa of Doṣa takes place.

C. Kāla Viśeṣa Vicāra:

In Śīta and Vasanta Rṛtu: in day time (74)

Śarada and Griṣma: in night ( Prathama Prahara)

If patient is suffering from Tīvra Rujā with extreme vitiation of

Vāta; then Anuvāsana Basti can be administered at any time after

consuming the food.

Anuvāsana Basti can be given daily in the conditions like Rukṣa

and Bahuvātāvasthā. (75)

2. Agni Vicāra:

Even though; Anuvāsana Basti is administered in Pakwāśaya, the

consideration of Jātharāgni is very necessary. Proper functioning

of Anuvāsana Basti depends upon the absorption capacity of Agni

present in Pakwāśya.(76) This capacity is ignited and supported by

Jātharāgni itself. Further digestion and assimilation of Sneha

depends upon the proper condition of Dhātvāgni and Bhutāgni.

3. Rules to be followed regarding position:

A. Significance of Vāma Pārśva/ left lateral position: (77)

There are three valves in the rectum. Out of that, middle valve is

important anatomically, physiologically and functionally also. It is

situated in the right side of the rectum. It plays important role in

the defecation process. Any injury to this valve may cause fecal

incontinence.

Lying on the left lateral keeps the sphincters submerged into the

musculature. This position helps in gravity because of the

anatomical slope which facilitates passing of Basti Dravyas across

the rectum to other areas.

The absorptive area of mucosa is also more on the left side.

B. The table on which patient takes the left lateral position

should not be too high or too low. Head of the patient must be

towards east. It should be sufficient to accommodate the patient

with soft and clean covering. (78)

4. Indications of Anuvāsana Basti:

Those who are indicated for Āsthāpana Basti are indicated for

Anuvāsana Basti also. (79)

Sarvāngagata Vāta, Ekānga Vāta, Varca- Mutra Sanga, Karṇaśula,

Hṛday, Pṛṣtha, Katigraha, Pliha, Gulma, Hṛdroga, Bhagandara,

Unmāda etc. Especially Rukṣa, Tīkṣṇāgni, Kevala Vāta Roga. (80)

5. Contraindications of Anuvāsana Basti:

Those who are contraindicated for Āsthāpana Basti are

contraindicated for Anuvāsana Basti also. (81)

Navajwara, Pāṇdū, Kāmalā, Meha, Arśa, Pratiśyāya, Pīnasa,

Plīhāroga, Atisāra, Kaphodara, Gurukoṣṭha, Ślīpada, Galadaṇḍa,

Apaci, Abhiśyanda, Atikṛśa, Sthula, Kṛmikoṣṭha, and Abhukta.

6. Rules to be followed before administration of Anuvāsana

Basti:

A. Patient should be asked to evacuate faeces and urine prior to

Anuvāsana Basti so that it can entre without any obstruction. (82)

B. Anuvāsana Basti should be given after having food. Sneha has

got Vyavāyī, Tīkṣṇa, Uṣṇa and Sukṣma properties due to which the

Sneha will move to the upper part of the colon and can destroy the

digestive power. It will cause some adverse effects like

Agnimāndya, Cardī, Bhrama etc. (83) Suśruta emphasizes to give

Anuvāsana Basti immediate after having food by quoting the

specific word Ādrapāṇī i.e. immediate after having food when

palms are wet. If it is given in the Vidagdhāvasthā of Anna; Jwara

can be seen. Even it should not be administered after having

Snigdha food as it may cause Mada and Mūrcchā. Alpa Snigdha

food is advisable before it‟s administration as Rukṣa food destroys

Bala and Varṇa. It is better to consume 1/4th less amount of food

than normal capacity prior to Anuvāsana Basti. (84)

Dose of Anuvāsana Basti according to age: (67)

Dose of Anuvāsana Basti should be 1/4th of that of Niruha Basti

prescribed as per the the age. For example as 12 Prasṛta is the dose

for the patient of 20 years, then dose of Sneha Basti should be 3

Prasṛta i.e. 24 Tola. As dose of Anuvāsana is ½ of Sneha Basti; it‟s

dose must be 12 Tola.

Daywise spreading of Anuvāsana Basti: (85)

Days of

Administration

of AB

Spreading of AB

Suśruta Śārañgadhra

1st Vankṣana and Basti Vankṣana and Basti

Snigdhtā

2nd Śirogata Vāta Śamana Śirogata Vāta Śamana

3rd Bala,Varṇa Janana Bala, Varṇa Janana

4th Rasa Snigdhtā Rasa Snigdhtā

5th Rakta Snigdhtā Rakta Snigdhtā

6th Mām asa Snigdhtā Māmasa Snigdhtā

7th Meda Snigdhtā Meda Snigdhtā

8th Asthī Snigdhtā Asthī Snigdhtā

9th Majjā Snigdhtā Majjā Snigdhtā

Anuvāsana Basti Sankhyā according to Doṣa: (86)

For vitiation of Vāta: 9 – 11

For vitiation of Pitta: 5 – 7

For vitiation of Kapha: 1 -3

Anuvāsana Basti Vidhī: (87)

After Snehana, patient is asked to take hot water bath.

Patient is asked to take light, little unctuous, warm meal which

is 1/4th less of his normal diet.

On comfortable bed, patient lays in left lateral position with

flexed right thigh and leg at hip and knee joint respectively and

extended left leg.

Patient is asked to exel and insert Snigdha Basti Netra not too

slow not too fast and without shaking hands into the anus

which is previously applied with Ghī.

Basti Putaka must be squeezed steadily with some oil remaining

in it.

Give blow with palm of hand for 3-4 times on buttocks of the

patient who is in prone position.

Lift legs and heels of patient above bed for 3 times.

Then Mardana of the patient should be done with feast so that

pain is relived and Sneha doesn‟t come out immediately.

When Sneha comes out, patient is asked to have light food at

evening.

All Acāryas also described the process in the same way.

Śarangadhara specifies duration required for administration of

Anuvāsana Basti i.e. 300 Mātrā. (88)

Suśruta also advises to keep the patient in supine position up to

counting of 100 numbers. (89)

Samyak Lakṣaṇa of Anuvāsana Basti: (90,91,92,93)

Lakṣaṇa C.S S.S A.H. K.S

Sānil Snēha Pratyāgamana - + + -

Saśakrut Taila Pratyāgamana + + + -

Raktādi Dhātu Prasādana + - - -

Buddhī, Indriya Man Prasādana + - - -

Swapna Anubhutī + - - -

Laghutā + - - -

Bala + - - -

Saṃsṛṣṭa Vega + - - -

Agni Dīpti, - - - +

Vayasthāpan - - - +

Puṣṭī - - - +

Varṇa - - - +

Dhṛti - - - +

Vātanulomana - - - +

Atiyoga Lakṣaṇa of Anuvāsana Basti: (94,95)

Lakṣaṇa C.S S.S A.S KS VS Sh.S

Hṛllās + - - - - -

Mōha + - - - - -

Sāda + - - - - -

Mūrchā + - - - - -

Vikartikā + - - - - -

Klam + + - - + +

Jwara - + - - - -

Dāha - + - - + -

Śūla - + - - - -

Pipāsā

- - - - + -

Indriya Upalēpa

- - - - + -

Snēha Gandhī

Mukha

- - - - + -

Kāsa

- - - - + -

Śwāsa

- - - - + -

Arōcak

- - - + + -

Viśad

- - - + - -

Trupti

- - - + - -

Atisāra - - - - - +

Ānāha - - - - - +

Ayoga Lakṣaṇa of Anuvāsana Basti: (96,97,98,99)

Lakṣaṇa C.S S.S A.H. K.S V.S

Adhah Śarīra Udar Bahu

Prustha Pārśva Rūk

+ - - - -

Gātra Rūkśa Kharatā

+ - - - -

Vistabdhānila

+ + - - +

Vistabdha Viṇmūtra

+ + - - +

Viṣtabha

- - - + -

Gāḍhavarcas

- - - + -

Rogvṛddhī

- - - + -

Vivarṇata - - - + -

Vepathu - - - + -

Vāta Vṛddhī

- - - + -

Retention period of Anuvāsana Basti: (100)

The normal Pratyāgamana Kāla of Anuvāsana Basti is 3 Yāma i.e. 9

hours. There is no harm if Anuvāsana Basti retains for a whole day.

If Anuvāsana Basti comes out immediately, another Basti can be given

to get better Snehana.

Sneha Basti Vyāpad (101, 102)

Complications may produce if Doṣas present in Koṣṭha are dominant

and Anuvāsana Basti has got Alpa Vīrya. The another cause is Mithyā

Praṇihita Basti i.e. administration of Anuvāsana Basti without proper

precausions as prescribed earlier.

Vyāpad Causes Symptoms Treatment

Vāta

Avṛta

Sneha

When

Koṣṭha is

full of Vāta,

and Basti is

given with

cold Sneha

or in small

quantity.

Aṅgamarda,

Jwara,

Ādhmāna,

Stambha, Urah,

Parsvaśūla

Niruha Basti of Pañcamula

Kwātha and Gomūtra,

Rāsnā Taila prepared by

Pitadāru, Tilvak, Surā,

Sauviraka, Kola, Kulattha,

Yava, Kwātha mixed with

Kalka of Snigdha, Uṣṇa, Āmla,

Lavaṇa Dravya is given to

eliminate the Vātavṛta Sneha

Pitta

Avṛta

If excessive

Basti is

Udara Dāha,

Raga, Truşņā,

Niruha Basti prepared with

Madhura and Tikta Dravyas

Sneha given in

Pitta

dominance

Moha,

Tamakaśvāsa

and Jwara.

should be given.

Kapha

Avṛta

Sneha

If Mṛdu

Basti is

given in

condition of

dominance

of Kapha.

Tandrā, Jwara,

Ālasya,

Praseka, Arucī,

Gaurva,

Mūrchā and

Glānī

Anuvāsana Basti of Tila Taila

prepared by Kaṣāya, Kaţu,

Tīkṣṇa and Uṣṇa Dravya, Surā

Gomūtra and mixed with

Madana Phala and Āmla

Dravya Kalka is given.

Anna

Avṛta

Sneha

After having

a heavy

meal; Basti

administere

d which is

prepared

with Guru

Dravya.

Chardī,

Mūrchā, Arucī,

Glāni, Śūla,

Nidrā,

Agnimāndya

and Āma

Lakṣaṇa, Dāha.

For proper digestion, Kaṣāya

and Cūrṇa of Kaţu

Dravya with Lavaṇa should be

given.

Mṛdu Virecana should be

given.

The treatment for Āma should

be done.

Purīṣa

Avṛta

Sneha

Anuvāsana

Basti

of Alpa

Bala is

administere

d, when

Mala

Sañcaya is

present in

Pakwāśaya

Purīṣasanga,

Mūtrasanga,

Vātasanga,

Śūla, Gaurava,

Ādhmāna and

Hṛdroga.

Snehana, Swedana should be

done.

Guḍa vartī should be placed in

anus. Anuvāsana Basti and

Niruha Basti prepared with

Śyāmā, Bilva, Daśamula

Kaṣāya and Kalka should be

given.

Abhukt

āvasthā

Basti is

given in a

It reaches up to

throat and

Niruha Basti and Anuvāsana

Basti of Sneha prepared with

Basti

Vyāpad

person with

empty

stomach.

may come out

from the

mouth.

Gomūtra, Śyāmā, Trivṛtta,

Yava, Kola, Kulattha should

be given.

Little pressure should be

given on throat.

Tīkṣṇa Virecana should be

given.

Treatment prescribed for

Vamana should be given.

V. PHARMACODYNAMICS OF BASTI

Basti is one of the important therapies amongst all the treatments of

Āyurveda. Hence it can be used in various diseases and conditions. As

it‟s action is multidimensional; it can be used not only for Vātavyādhī;

but for Pittaja, Raktaja, Sannipātaja and Saṃsargajanya Vyādhi

also.(117)

In Āyurvedic classics Ācaryas have tried to explain actions of Basti

hypothetically with suitable analogies. Recent studies also show

similarities in the concept of absorption of Basti. They are:

As tree irrigated in its root level attains branches with beautiful

tender leaves, flowers and fruits; in the same way Basti which is

administered in rectum performs significant results up to head

to toe. ( Āpāda Mastaka )(113)

Ācarya Parāśara opined that Guda is the main root of the body

and having blood vessels in it. Basti administered in the rectum

nourishes all the limbs and organs of the body through these

blood vessels.(118)

While describing action of Basti; Ācarya Suśruta says that Sun

stands millions of kilometres away from the Earth evaporates

the water with powerful sun rays, in the same manner Basti

retains in Pakwāśaya and dwells Doṣas from all over the

body..(119)

Suśruta explains the importance of Basti and says that Basti

only can pacifies the provocated Vāta like cyclonic storm is

sustained and controlled by waves of the sea.(120)

Recent studies shows that, the rectal administration has become

more popular since the side effects of the intra-muscular

injection are noted. “ Noboru yata” et al (1985) reported that the

tight junction of the epithelia of the rectum will be markedly

influenced by the pressure of adjuvant especially in the

hypotonic solution. Further he explains that volume of secreted

fluids in the rectum is generally considered to be small. In that

situation the osmolarity of the secreted fluids will be increased

by dissolving the drugs and adjuvant. The increased osmolarity

of the rectal fluids may influence the absorption promoting the

effect of the drug.(121)

Medicines which are administered through rectal route are

absorbed in rectum and large intestine. The rectum has rich

blood and lymph supply and drugs can cross through the rectal

mucosa like other lipid membranes. The portion which is

absorbed from upper part rectal mucosa is carried by the

Superior Haemorrhoidal vein into the portal circulation, where

as the Middle and Inferior Haemorrhoidal veins absorb from the

lower rectal mucosa enters directly into Systemic circulation.

The rectum with its vascularity and venous plexus provides a

good absorbing surface and many soluble substances produce

their effect more quickly without passing the liver where they

may be destroyed.(121) This was investigated and proved with

lidocaine, a hepatic high clearance drug.(122)

Absorption of drugs from rectal epithelium involves two

transport routes: the trans cellular and para cellular. An uptake

mechanism in trans cellular route depends on lipophilicity

where para cellular route is drug diffusion through a space

between epithelial cells.(122)

VI. DRUG REVIEW

Mūrcchita Tila Tail and Saindhava were used in Anuvāsana Basti as a

Sneha Dravya. Mūrcchana of Tila Taila is done by Manjiṣṭhā and

Harīdrā to reduce its Sāmatā according to Āyurved Sāra Saṃgraha.(123)

Therefore review of Tila Tail and Saindhava have been taken.

REVIEW OF TILA TAILA:

The term Taila is derived from Tila itself. ( itlaat\ tOlama\ )

It is a type of Sthāvara Sneha which is taken out by seeds. Tila Taila is

the main Sneha among Sthāvara Sneha. (103)

Properties of Tila: (104)

Rasa :Tikta, Katu, Kaṣāya, Madhura

Vīrya :Uṣṇa

Vipāka :Katu

Guṇa :Guru,

Karma :Vātaghna, Kapha- Pitta Kara

Twacya, Keśya, Balya, Medhakṛta, Agnivardhaka,

Alpamutrakara, Hima Sparśa.

Latin Name :Sesamum indicum

Properties of Tila Taila: (105)

Rasa: Madhura, Tikta, Kaṣaya

Vīrya: Uṣṇa

Vipāka: Madhura

Guṇa: Guru, Tīkśṇa, Vyavāyī, Viṣada, Vikāsi, Sara, Sukṣma,

Karma: Vāta- Kaphaghna, Twacya, Keśya, Balya, Medhākṛta,

Agnivardhaka, Varṇya, Bṛṃhaṇa, Alpamutrakara, Karṇa

Śulaghna, Śarīra Mārdavakara, Maṃsabalya, Kṛmighna,

Lekhana, Cakṣuṣya, Pācana, Yoni, Śira, Karṇa

Śulapraśamana, Bhagnahara, Kṣāra, Agnidagdhahara

Uses: Basti, Pāna, Nasya, Karṇa- Akṣipuraṇa

Caraka also describes the same properties of Tila Taila. But he

adds Saṃyoga Saṃskārānuvarti property of Tila Taila. (106)

Mahābhuta: Agni, Āpa

Indications for Snehana by Tila Tail: (37)

Pravṛddha Śleśma- Meda

Cala Sthula Gala Udara

Vātavyādhī

Vātaprakṛti

For Bala, Laghutā, Tanutwa, Dṛdhatā, Sthiragātratā

In Kṛmikoṣṭha, Krurakoṣṭha and Nādivraṇa.

REVIEW OF SAINDHAVA:

Saindhava is considered as the best among all Lavaṇa. (107,108,109)

Rasa: Lavaṇa, Madhura

Vipāka: Madhura

Virya: Uṣṇa/ Śīta/ Anuṣṇa

Guṇa: Snigdha, Laghu

Doṣaghnatā: Tridoṣaghna

Karma: Rocana, Dīpana, Vṛṣya, Cakṣuṣya, Avidāhī , Hṛdya,

Rucya, Agnidīpana, Pathyakara

If it is mixed with Sneha, Snehana takes place earlier. Hence it

is used in preparations of Sadyosnehana.(110)

As it is Sukṣma, Arukṣa, Uṣṇa, Vyavāyi and Doṣasanghāta

Vicchedaka; it is used along with Sneha.(111)

VII. REVIEW OF PREVIOUS WORK DONE

Previous work related with this topic was studied. Some concepts like

anal route of drug administration, Utkleśana Karma of Basti were

studied available from MD or Ph.D work and even from internet also.

1. To ascertain the mode of action of Utklesion Basti with reference

to it‟s indications and contraindications.

By Vd. Monika Vanarase, Guide: Vd. Vilas Nanal. Pune, (MD

work). 2000.

In this work, Utkleśana Basti was given instead of Utkleśaka

āhara prior to Vamana and Virecana. It was given in Sadyo

Vamana also as a Snehana. Oil was prepared with Suśrutokta

Utkleśana Basti Dravya. Utkleśana Karma was observed in the

diseases like Śwasa, Udara and Āmavātā.

2. Arohanakrama Mātrā Basti an effective alternate for Snehapāna.

By Dr. Basavajyoti, Guide: Dr. Sudhir, Bangalore, (MD work).

2005

In this study, Mātrā Basti is given in Arohaṇa Mātrā starting

from 24 ml upto 72 ml. and Utkleśana was observed.

3. Study of organs during Basti Karma w. s. r. to Rachana and

Kriya.

By Dr. Kanthi G. Manappa. Guide Dr. Doiphode, ( Ph.D. Work ).

In this work, Yoga Basti was administered and anatomical

involvement of organs like Pakwaśaya was studied.

4. Lakshmi P. J., Deepthi B., Rama Rao N. Rectal drug delivery: A

promising route for enhancing drug absorption. Asian J. Res.

Pharm. Sci. 2012;

Available from:

http://www.asianpharmaonline.org/AJPS/6_AJPS_2_4_2012.p

df

5. Mirteimouri M , Tara F, Teimouri B, Sakhavar N and Vaezi A.

Efficacy of Rectal Misoprostol for Prevention of Postpartum

Haemorrhage. Iran J Pharm Res. 2013 Spring.

Available from:

http://www.ncbi.nlm.nih.gov/pubmed/24250623

Recent researches have suggested that rectal absorption can prove the

good alternative rout of drug administration as it provides partial

avoidance of first portal pass metabolism. It has been demonstrated

that the rectal rout is more efficient than even intravenous route.

VIII. CONCEPT OF ANUVĀSANA BASTI AS AN ALTERNATIVE FOR

SNEHAPĀNA IN VAMANA AND VIRECANA.

Many methods of Snehana like Abhyaṅga, Pāna, Anuvāsana Basti,

Māstiṣkya etc. are described by Suśruta.(22) It is clearly mentioned that

out of these; the proper method of Snehana should be chose by using

Yuktī Pramāṇa.(23) It means according to Doṣa, Duṣya, physical and

mental condition of the patient, the method of Snehana can vary.

Vicāraṇā Sneha is a concept in which Accha Snehapāna has been

substituted by adding some dietary items with Sneha, for eg. Yavāgu

or by changing the route of administration of Sneha for eg.

Anuvāsana Basti through anus.(29)

While describing indications of Vicārana Sneha.; Caraka quotes that

the patients who have aversion for Sneha are fit for Vicārana Sneha.

This study deals with these patients only.(30)

As Anuvāsana Basti is not only one of the method of Snehana and

Vicārana, but rectal route is considered as an internal route of drug

administration; it can be considered as an alternative for

Snehapāna.(24)

Definition of Basti clearly indicates the spreading and oleating

properties of Basti. It also mentions the Vilodana of Doṣas through

Basti.(60)

Suśruta even explains the spreading of Vīrya of Basti according to

days.(85) This suggests, Sneha present in Anuvāsana Basti can reach

throughout the body. To support this phenomena, Suśruta says, even

though roots of a tree are irrigated; the tender leaves, flowers and

fruits get nourished.(113) In the same manner even though Basti is

administered in rectum, the Vīrya of Basti spreads and acts on every

Srotasa, Dhātu and subtle elements.

Anuvāsana Basti gets absorbed by Apāna and gradually by Samāna,

Vyāna, Udāna and Prāṇa.(116) Hence Vīrya of Basti can reach

throughout the body and can act on Śākhāgata Doṣa which may be in

Līnāvasthā.

Vṛddhī, Abhiśyanda, Kledana and ultimetly Utkleśa of Doṣa are

expected when Śodhanānga Snehapāna is given(2,112) so that Doṣas

present in Śākhā are forced to move towards Koṣṭha. Jātharāgni,

Dhātvāgni and Bhutāgni digest the Sneha taken orally and thus

Sneha spreads all over the body.

Utkleśana of Doṣa is possible through Anuvāsana Basti also if it is

given continuously.(114) It has got capacity to control Vāta Doṣa in

Koṣṭha which is expected in Śodhanānga Snehapāna. Suśruta has

described Utkleśana Basti, Śodhana Basti and Śamana Basti in a

sequence. It indicates Śodhana of Doṣa after Utkleśana and Śamana of

Doṣa after Śodhana.(115) This process is exactly same as that of

Śodhanānga Snehapāna, Śodhana and Śamana Cikitsā thereafter.

Anuvāsana Basti doesn‟t get digested by Jātharāgni directly. Śoṣaṇa

Karma of Jātharāgni can be seen in Pakwāśaya.(76) Hence without

actual digestion, Basti can reach throughout the body. This

phenomenon is already explained in the chapter Pharmacodynamics of

Basti. From the point of view of anatomy and physiology also this can

be explained. Superior, Middle and Inferior Rectal Veins are present

in rectum. Out of these three; Middle and Inferior Rectal Veins directly

drains into Inferior Vena Cava. Hence Basti can directly reach in

systemic circulation and may act fast. Only Superior Rectal Vein

drains into the Portal vein and subsequently into the liver. It indicates

that very little amount of Vīrya of Basti spreads through Portal

circulation.

Collectively we can say that Anuvāsana Basti can be considered as an

alternative for Snehapāna.

IX. REFERENCES

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kfadya : pNaudyanto isnagQaa_oha<aqaaOYaQaO : I I

Aad-M kaYzM yaqaa vai*naiva-Yyandyait sava-t : I

yaqaa isnagQasya vaO daoYaana\ svaodao ivaYyandyaot\ isqarana\ I I

i@laYTM vaasaao yaqaao%@laoSya mala : saMSaaoQyato | mBasaa I

snaohsvaodOstqaao%@laoSya SaaoQyato SaaoQanaOma-la : I I ca.isa. 6/11 – 13

11 snaohnaM $xaNaM kma- svaodnaM stMBanaM ca yat\ l

BaUtanaaM tdip dvaOQyaaid\vatyaM naaitvat-to l l A.).saU. 14 /3

12 snaoohsaarao|yaM pu$Ya : paNaaSca snaohBaUiyaYTa : snaohsaaQyaaSca Bavaint l

13 saahsaM vaogasaMraoQa : Sauk`aOja : snaohsaMxaya :

AnnapanaivaiQa%yaagaSca%vaarstsya hotva : l l A.).ina. 5 /4

14 ip<aM sasnaohtIxNaaoYNaM laGau ivasaM sarM dvama\ l

isnagQa : SaItao gau$ma-nd : SlaxNaao : maR%sna : isqar : kf : l l A.).saU. 1 /11

15 t~asqaina isqatao vaayau : ip<aM tu svaodr>yaao : l

SlaoYmaa SaoYaoYau tonaOYaamaaEayaaEaiyaNaaM imaqa : l l A.*.saU. 11 /26

16 Aaoja : saaomaa%makM isnagQaM Sau@laM SaItM isqarM sarma\

ivaiva>M maRdu maR%snaM ca Pa`aNaayatnamau<amama\ l l sau.saU. 15 /21

17 SaoYaoYau rsamaaMsamaodaomajjaaSaukmaU~purIYaaidYau l A.*.saU. 11 /26 iTka Aayauvao-drsaayana

homaaid`

18 Aqa t%saMSayacCo<aa p%yauvaaca punava-sau : I

snaohanaaM idvaivaQaa saaOmya yaaoina : sqaavarja=maa I I ca.saU.13/9

19 t~ jaMgamaoByaao gavyaM GaRtM p`QaanaM sqaavaroByaaistlatOlaM p`Qaanaimait I sau. ica.31/4

20 At }Qva-M yaqaapyaaojanaM yaqaapQaanaM ca sqaavarsnaohanaupdoxyaama : I sau. ica.31/5

21 ]pyaaojanama\ ]pyaaogaao baa*ya AaByantrSca t~ baa*yaao|Bya=gaaid : AaByantr : panaaid l

sau. ica.31/2 DlhNa

22 snaohao ih panaanauvaasanamaistYkiSaraobas%yau%trbaistnasyakNa-

pUrNagaa~aByaMgaBaaojanaoYaUpyaaojya : l sau. ica.31/3

23 yau@%yaa|vacaaryao%snaohM BaxyaaVnnaona baistiBa : l

nasyaaByaMjanagaNDUYamaUw-kNaa-ixatp-NaO : ll A.).saU. 16/14

24 t~ baa*ya : snaohsvaodaBya=gapirYaokaopnaahiSaraobaistnasyaaid : AaByantrstu

snaohpanaanauvaasanaina$haid : l sau. ].26/2,3 DlhNa

25 WaByaaM catuiBa-rYTaiBayaamaOjaI-ya-it yaa kmaat\ l

*svamaQyaao%tmaa: maa~astastaByaSca *saIyasaIma\ I A.).saU.16/17,18

26 WaByaaM i~iBaScatuiBa-stOya-makis~vaRtao mahana\ I A.).saU. 16/4

26 AcCpoyastu ya: snaohao na tamaahuiva-caarNaama\ l

snaohsya sa iBaYagdRYT klp p`aqama kilpk: ll ca.saU. 13/26

27 kovalamacCpoyama\ l sau. ica.31/21 DlhNa

28 snaoho saa%mya: @laoSasah: kalao naa%yauYNa SaItlao I

AcCmaova ipbaot\ snaohM AcCpanaM ih pUijatma\ I I ica.31/21

29 AaodnaSca ivalaopI ca rsaao maaMsa pyaao diQa l

yavaagaU: saUpSaakaO ca kambailak: KD: l

sa>vaistlaipYTM ca maVM laohastqaOva ca l

BaxyamaByaHjanaM baiststqaa caao<arbastya: l

gaNDUYa: kNa-tOlaM ca nast: kNaa-ixatPa-Nama\ l

catuiva-MSaitir%yaota: snaohsya pivacaarNaa: l l ca.saU.13 /23,25

30 snaohiWYa: snaohina%yaa maRdukaoYzaSca yao nara: l

@laoYaasaha maVina%yaastoYaaimaYTa ivacaarNaa l l ca.saU. 13 /82

31 saukumaarM kRSaM vaRwM iSaSauM snaohiWYaM tqaa l

tRYNaa<a-mauYNakalao ca sah Ba@tona payayaot\ l l sau. ica.31/ 37

32 *yastnao jaINa- evaannao snaohao|cC: Sauwyao bahu: I I

Samana: xauWtao|nannaao maQyamaa~Sca Sasyato I

baRMhNaao rsamaVaVO: saBa>ao|lp: I

baalavaRd\Qaippasaat-snaohiWramaVSaIilaYau I A.).saU.16/19, ca.saU.13 /61

33 KraoByaMga : smaRt : pakao maRduna-st : ik`yaasau ca I

maQyapakM tu panaaqao- bastI ca ivainayaaojayaot\ l l ca.k. 12 /201

34 GaRtM ip%tainalahrM rsaSauk`aOjasaaM ihtma\ I

inavaa-pNaM maRdukrM svarvaNa-psaadnama\ l l ca.saU. 13 /14

35 vaatip<ap`kRtyaao vaatip<aivakairNa: I

caxau:kamaa: xata: xaINaa vaRwa baalaastaqaa|balaa: I

Aaya:pkYa-kamaaSca balavaNa-svaraiqa-na: I

puiYTkamaa: pjaakamaa: saaOkumaayaa-iqa-naSca yao I

dIPtaoja: smaRitmaoQaaignabauwIindyabalaaiqa-na: I

ipbaoyau: saip-rata-Sca dahSas~ivaYaaignaiBa: I I ca.saU. 13 /43, 44

36 maa$tGnaM na ca SlaoYmavaw-naM balavaQa-nama\ I

%vacyamauYNaM isqarkrM tOlaM yaaoinaivaSaaoQanama\ I I ca.saU. 13 /15

37 p`vaRwSlaoYmamaodskaScalasqaUlagalaaodra: I

vaatvyaaiQaiBaraivaYTa vaatp`kRtyaSca yao I

balaM tnau%vaM laGautaM dRZtaM isqargaa~tama\ I

isnagQaSlaxNatnau%va>aM yao ca kaMxaint doihna: I

kRimakaoYza : k`urkaoYzastqaa naaDIiBarid-ta: I

ipbaoyau : SaItlao kalao tOlaM tOlaaoicataSca yao I I ca.saU. 13 /45,46

38 ga`amyaanaUpaOdkanaaM ca vasaamaodaomajjaanaao gau$YNamaQauravaatGnaa :

jaa=galaOkSafk`vyaadadInaaM laGauSaItkYaayaa r>ip<aGnaa : ptudivaiYkraNaaM SlaoYmaGnaa I

sau. saU. 45 /131

39 vaatatpsaha yao ca $xaaBaaraQvakiSa-ta: I

saMSauYkrotao$iQara inaYpItkfmaodsa: I

AisqasaMiQaisarasnaayaumama-kaoYzmaha$ja: I

balavaanmaa$tao yaoYaaM Kaina caavaR%ya itYzit I

mahccaaignabalaM yaoYaaM vasaasaa%myaaSca yao nara: I

toYaaM snaohiyatvyaanaaM vasaapanaM ivaQaIyato I I ca.saU. 13 /47-49

40 ivawBagnaahtBaYTyaaoinakNa-iSarao$ija I

paO$Yaao pcayao snaoho vyaayaamao caoYyato vasaa I I ca.saU. 13 /16

41 balaSaukrsaSlaoYmamaodaomajjaivavaw-na : I

majjaa ivaSaoYatao|sqnaaM ca balakR%snaohnao iht : I I ca.saU. 13 /27

42 dIPtagnaya : @laoSasaha Gasmara : snaohsaoivana: I

vaatata- : kurkaoYzaSca snao*yaa majjaanamaaPnauyau: I ca.saU. 13 /50

43 snaohnaa jaIvanaa vaNyaa- balaaopcayavaQa-naa :

snaoha *yaoto ca ivaihta vaatip<akfapha : I I ca.saU. 1 /88

44 GaRttOlavasaamajjaaM pUva- : pUvaao- varao|nyaoBya : I ka.saU. 22

45 ip<aGnaasto yaqaapUva-imatrGnaa yaqaao<arma\ I A.).saU.16/3

46 GaRta<aOlaM gau$ vasaa tOlaanmajjaa ttao|ip ca I A.).saU.16/4

47 saip- : Sarid patvyaM vasaa majjaa ca maaQavao I

tOlaM p`avaRiYa naa%yauYNaSaIto snaohM ipbaonnar : I I ca.saU. 13 /18

48 svaoVsaMSaaoQyamaVs~I vyaayaamaasa@ticaMtka: l

vaRwbaalaabala $xaa kRSaa xaINaasarotsa: l

vaatat-syaand itimar da$Na: pitbaaoiQana: ll A.).saU. 16/56

49 snao*yaa

na %vaitmandaignatIxNaaignasqaUladuba-laa: I

}$stMBaaitsaaramagalaraogagaraodrO: I I

maUcCa-cCV-$icaSlaoYmatRYNaamaVOScapIiDta: I

App`saUta yau>o ca nasyao bastaO ivarocanao I I A.).saU. 16/6,7

50 vaatanaulaaomyaM idPtao|ignava-ca-O: isnagQamasaMhtma\ l

maad-vaM isnagQata caaMgao isnagQaanaamaupjaayato l l ca.saU.13 / 57

51 paNDUta gaaOrvaM jaaDyaM puirYasyaaivap@vata l

tnd`a$ica$%@laoSa: syaaditisnagQasyalaxaNama\ l l ca.saU.13 / 58

52 puirYaM gaiqatM $xaM vaayaurp`gauNaao maRdu: l

p@ta Kr%vaM raOxyaM ca gaa~syaaisnagQa laxaNama\ l l ca.saU.13 / 59

53 tRNmaUcCa-mauKSaaoYaO : SabdWoYaa=gamad-jaRmBaaiBa :

tnd`IvaagdohsaadO : snaohjaa jaIya-tI%yaah

]dgaarsya ivaSauwI : kaMxaa isqarta laGau%vamaivaYaad :

Balavaaigaind`yasaMpjjaINao- snaoho balasauKo ca

kNaa-ixap`aNabalaM smaRitkoSaaojasaaM vaRiw QaRitpuiYT :

Saaintstd\vyaaQaInaaM Bau@%vaa|nau snaohpItsya l l ka.saU.22 / 41

54 tnd`a saao%@laoSa Aanaahao jvar : stMBaao ivasaM&ta l

kuYzaina kNDU : paNDU%vaM SaaofaSaa-Msya$icastRYaa l l

jazrM gahNaIdaoYa stOima%yaM vaa@yainagah : l

SaUlamaamapdaoYaaSca jaayanto snaohivaBa`maat\ l l ca.saU.13 /75,76

55 snaohsya p`kYaaO- tu saPtra~ai~ra~kaO

ekamuau<amaa poyaa Hyahmaova tu maQyamaa l l ca.saU.13 / 51

56 maRdukaoYzis~ra~oNa isna*ya%yacCaopsaovayaa l

isna*yait kUrkaoYzstu saPtra~oNa maanava : l l ca.saU.13 / 65

57 ]YNaaodkaopcaarI syaat\ ba`*macaarI xapaxaya: I

SakRnmaU~ainalaaod\gaaranaudINaa-MSca na Qaaryaot\ I

vyaayaamamauccaOva-canaM kaoQaSaaokaO ihmaatpaO I

vaja-yaodpvaatM ca saovaot Sayanaasanama\ II ca.saU.13/62,63

58 ekahaoprtstWdBau@%vaa pcCd-naM ipbaot\ I

snaohat\ p`skndnaM jantuis~ra~aoprt : ipbaot\ I

snaohvad\d`vamauYNaM ca ~yahM Bau@%vaa rsaaOdnama\ II ca.saU.13/80

59 baistiBadI-yato yasmaat\ tsmaad\ baistiritsmaRt : I Saa. ]. 4

60 naaiBap`doSaM kiTpaSva-kuixaM l

ga%vaa SakRd\daoYacayaM ivalaaoDya l

saMsnao( kayaM sapuirYadaoYa: l

samyak\ sauKonaOit ca ya: sa baist: l ca.isa. 1/40

61 t~ iWivaQaao baist : naO$ihk : snaOihkSca l sau. ica. 35/18

62 i~MSanmat : kma- nau bastyaao ih l

kalasttao | Qao-na ttSca yaaoga : l

saanvaasanaa WadSa vaO ina$ha : l

p`ak\ snaoh ek : prtSca pMca l

kalao ~yaao | nto purststqaOk : l

snaoha ina$hantirtaSca YaT\syau : l

yaaogao ina$has~ya eva doya : l

snaohaSca pMcaOva praid maQyaa : l l ca.isa. 1/47-49

63 Aqaomaana\ saukumaaraNaaM ina$hana\ snaohnaana\ maRdUna\

kma-Naa ivaPlautanaaM ca vaxyaaima p`saRtO : pRqak\ l l ca.isa. 8/3

64 YaD\ vagaa- : pirsaM#yaata ya eto rsaBaodt :

AasqaapnamaiBapo%ya tainvaVa%saava-yaaoigakana\ l l ca.iva. 8/148

65 tIxNa%vaM maU~pIlvaisnalavaNaxaarsaYa-pO :

P`aaPtkalaM ivaQaatvyaM xaIraVOmaa-d-vaM tqaa l l ca.isa. 7/63

66 Anauvasana\ Aip na duYya%yanauidvasaM vaa dIyat [it Anauvaasana: l sau.ica.35/18

67 ina$hpadaMSasamaonatOlaonaoit ina$hpadpmaaNaona , catuiva-MSaitplao ina$ho YaT\plaona

snaohonao%yaqa- : , [yaM caao<amamaa~a | nauvaasanasya, ]@tM (nya~ ]<amaa YaT\plaIp`ao@ta

maQyamaai~plaI Bavaot\ l knaIyasaIsaaQa-plaa, i~Qaamaa~a | nauvaasanao [it l

sauEauto | Pyaotavanmaanamaova snaohsyaanauvaasanamaa~a maa~abaistivaBaagaonaanauvaasanao ]@tma \ l

cak`paiNa

68 yaqaavayaao ina$haNaaM yaa maa~a : pirkIit-ta :

padavakRYTasta : kayaa- : snaohbaistYau doihnaama\ l sau.ica.37/4

69 ]<amaa syaa%plaO : YaD\iBama-Qyamaa syaa%plaOis~iBa : l

tdwo-na ca hInaa syaai~Qaamaa~anauvaasanao l l cak`d<a

70 )svayaa snaohpanasya maa~ayaa yaaoijat: sama:

maa~abaist : smart : snaoh : l l A.).saU. 19 /67

71 Ainhsqaanaisqato daoYao vanhaO caannarsaainvato l

sfuT saaotaomauKo doho snaohaOja: pirsap-it l l sau.ica.37 / 48

72 ra~aO baistM na dVa%tu daoYaao%@laoSaao ih ra~Ija: l

snaohvaIya-yaut: kuyaa-daQmaanaM gaaOrvaM jvarma\ l l sau.ica.37 /47

73 na ra~aO p`Nayaod\baistM snaohao%@laoSaao ih ra~Ija :

snaohvaIya- yaut : kuyaa-daQmaanaM gaaOrvaM jvarma\ l l A.saM.saU. 28 / 25

74 SaIto vasanto ca idvaa | nauvaasyaao

ra~aO Sard\ga`IYmaGanaagamaoYau l

tanaova daoYaana\ pirrxata yao

snaohsya panao pirkIit-ta : p`ak\ l l ca.isa.1 /22,23

75 Ahaora~sya kalaoYau savao -YvaovaainalaaiQakma\

tIva`ayaaM $ija jaINaa-nnaM Baaojaiya%vaa | nauvaasayaot\ l l sau.ica.37 /52

76 p@vaaSayaM tu p`aPtsya SaaoYyamaaNasya vainhnaa l ca.ica.15 /11

p@vaaSayaM tu p`aPtsyaoit mala$ptyaa p@vaaSayaM gatsya l SaaoYyamaaNasya vainhnaoit

yaVPyaUQva-dahxamaao vai*na : , tqaa | PyasyaaQaaogatsya vai*nana SaaoYyamaaNa%vaM

p@vaaSayagatsyaaPyauppnnama\ l yatScaaQaaogamanao samyagvai*navyaaparao naaist At :

‘ pcyamaanasya ’ [it pdM pir%yajya ‘ SaaoYyamaaNasya ’ [it kRtma\ l ca.ica.15 /11

cak`paiNa

77 vaamaaEayao ih ga`hNaIgaudo ca

tt\ paSva-saMsqasya sau#aaoplaibQa : l l

laIyant evaM valayaSca tsmaat\

savyaM Sayaanaao |h-it baistdanama\ l ca.isa.3 /24

78 naa%yauicC/tM naaPyaitnaIcapadM

sapadpIzM SayanaM p`Sastma\ l l ca.isa.3 /33

p`QaanamaRWastrNaaoppnnaM

p`ak\SaIYa-kM Sau@lapTao<arIyama\ l

79 evaasqaaPyaast evaanauvaasyaa: ivaSaoYatstu $xatIxNaagnaya: kovalavaatraogaat-Sca ll

ca.isa.2 /16

80 SaoYaas%vaasqaaPyaa : ivaSaoYatstu savaa-M=gaOka=gakuixaraogavaatvacaao -

maU~Sauk`sa=gabalamaaMsarot : xayadaoYaaQmaanaa=gasauiPtik`imakaoYzaodavat-Sauwaitsaarpva-

BaodaiBatapiPlahgaulmaSaUla*Rd`aogaBagandraonmaadjvarba`GnaiSar : kNa-SaUla*RdyapaSva-

pRYzkTIga`hvaodnaaxaopkgaaOrvaaitlaaGavarja:xayaat-

ivaYamaaignaisfgjaanauja=Gaao$gaulfpaiYNa-p`pdyaaoinbaa*va=gauilastnaantdntnaKpvaa-

isqaSaUlaSaaoYastmBaan~kUjanapirkit-kalpalpsaSabdaoga`ganQaao%qaanaadyaao vaatvyaaQayaao

ivaSaoYaoNa maharaogaaQyaayaao>aSca etoYvaasqaapnaM p`Qaanatmaima%yau@tM

vanaspitmaUlacCodvat\ l l ca.isa.2 /16

81 ya evaanaasqaaPyaast evaananauvaasyaa: syau: ivaSaoYats%vaBau@tBa@tnavajvarpaNDuraoga

kamalaapmaohaSa-: p`itSyaayaaraocakmandaignaduba-laPlaIhkfaodrrao$stMBavacaao -Baod ivaYa

garpItip<akfaiBaYyandgau$kaoYz SlaIpd galgaNDapicaik`imakaoiYzna: ll

ca.isa.2 /17

82 ]%saRYTainalaivaNmaU~o naro baistM ivaQaapyaot\

etOih- ivaht: snaohao naOvaant p`itpVto l l sau.ica. 37 /5

83 na caaBau@tvat: snaoh: p`iNaQaoya: kqaMcana

Sauw%vaacCUnyakaoYzsya snaoh }Qva-M samau%ptot\ l l sau.ica. 37 /53

84 sada|nauvaasayaoccaaip Baaojaiya%vaa||d`-paiNanama\

jvarM ivadgQaBau@tsya kuyaa-t\ snaoh: p`yaaoijat:

na caait isnagQa SamanaM Baaojaiya%vaa|nauvaasayaot\

madM maUcCa- ca janayaod\ iWQaa snaoh: p`yaaoijat:

$xaM Bau@tvatao (nnaM balaM vaNa- ca hapyaot\

yau@tsnaohmatao jantuM Baaojaiya%vaa|nauvaasayaot\

yaUYaxaIrrsaOstsmaaVqaavyaaiQa samaIxya vaa

yaqaaoicatat\ padhInaM Baaojaiya%vaa|nauvaasayaot\ l l sau.ica. 37 /54-58

85 d<astu p`qamaao baist: snaohyaod\baistva=xaNaaO

samyagdtaO iWtIyastu maUQa-sqamainalaM jayaot\

janayaod\balavaNaaO- ca tRtIyastu p`yaaoijat:

rsaM catuqaao- r@tM tu pMcama: snaohyao<aqaa

YaYzstu snaohyaonmaaMsaM maod: saPtma eva ca

AYTmaao navamaScaaisqa majjaanaM ca yaqaak`mama\

evaM Sauk`gatana\ daoYaana\ iWgauNa: saaQau saaQayaot\ l l sau.ica. 37 /71-74

86 ekM tqaa ~Ina\ kfjao ivakaro

ip<aa%mako pMca tu saPt vaa|ip l

vaato navaOkadSa vaa punavaa-

bastInayaugmaana\ kuSalaao ivadQyaat\ l l ca.isa.1/25

87 naa%yauicC/to na caaocCIYao - saMivaYTM vaamapaSva-t: I

sa=kaocya dixaNaM sai@qa p`saaya- ca ttao|prma\ I I

Aqaasya nao~M p`Nayaoi%snagQao isnagQamauKM gaudo I

]cCvaasya bastova-dnao bawo hstmakmpyana\ I I

pRYzvaMSaM p`it ttao naaitd`utivalaimbatma\ I

naaitvaogaM na vaa mandM sakRdova p`pIDyaot\ I I

saavaSaoYaM ca kuvaI-t vaayau: SaoYao ih itYzit I

d<ao tU<aanadohsya paiNanaa taDyaoi%sfjaaO I I

t%paiYNa-ByaaM tqaa SayyaaM padtSca i~$i%xapot\ I

tt: p`saairta=gasya saaopQaanasya paiYNa-ko I I

AahnyaanmauiYTnaa|=gaM ca snaohonaaByajya mad-yaot\ I

vaodnaat-imait snaohao na ih SaIGa`M inavat-to I I

Yaaojya: SaIGa`M inavaR<ao|nya: snaohao|itYznnakaya-kRt\ I

dIPtaignaM %vaagatsnaohM saayaa*Nao BaaojayaollaGau I I A.).saU. 19/23-30

88 i~MSanmaa~aimat: kala: p`ao@tao bastostu pIDnao

tta: p`iNaiht: snaoh ]<aanaao vaa@SatM Bavaot\ I I Saa.saM.

89 tt: p`iNaihtsnaoh ]<aanaao vaak\SatM Bavaot\ I I sau.ica. 37/60

90 p`%yao%yasa@tM saSakRcca tOlaM

r@taidbauwIind`ya saMp`saad: l

svaPnaanauvaRi<ala-Gauta balaM ca

saRYTaSca vaogaa: svanauvaaisato syau: l l ca.isa.1/44

91 saainala: sapuirYaSca snaoh: p`%yaoit yasya tu l

AaoYacaaoYaaO ivanaa SaIGa`M sa samyaganauvaaisat: I I sau.ica. 37/67

92 ikMica%kalaM isqatao yaSca sapurIYaao inavat-to l

saa|naulaaomaa|inala: snaohsti%sawmanauvaasanama\ I I A.).saU. 19/42

93 AignadIiPtva-ya: sqaanaM puiYTvaNaao- QaRitba-lama\

vaatanaulaaomata Saaint : svanauvaaisatlaxaNama\ I I ka.saM. 2

94 )llaasamaaoh@lamasaadmaUcCa-

ivakit-ka caa%yanauvaaisatsya l l ca.isa.1/46

95 dahjvar ippasaait-krScaa%yaanauvaasanao I I sau.ica. 37/66

96 AQa: SarIraodrbaahupRYzpaSvao-Yau $xaKrM ca gaa~ma\ l

ga`hSca ivaNmaU~samaIrNaanaamasamyagaotanyauvaaisatsya l l ca.isa.1/45

97 ivaYTbQaainala ivaNmaU~: snaohao hInao|nauvaasanao l sau.ica. 37/66

98 tsya hIna samyagaityaaogaa: snaoh pItvat\ l

samyagQaInaaityaaogaaSca tsya syau: snaohpItvat\ I I A.).saU. 19/41

99 ivaYTmBaao gaaZvaca-s%vaM raogavaRiwiva-vaNa-ta l

vaopqauvaa-tvaRiwSca $paM durnauvaaisato l l ka.isa. 2

100 yasyaoh yaamaananauvat-to ~Ina\

snaohao nar: syaat\ sa ivaSauw doh: l

AaSvaagato|nyaostu punaiva-Qaoya:

snaohao na saMsnaoh yait *yaitYzna\ l l ca.isa.1/46

101 balavantao yada daoYaa: kaoYzo syaurinalaadya: l

AlpvaIya-M tda snaohmaiBaBauya pRqaigvaQaana l l sau.ica. 37/82

102 vaatip<akfa%yanna puirYaOravaRtsya ca l

ABau@to ca p`NaItsya snaohbasto: YaDapda: l l ca.isa.4/24

103 sqaavaroByaistlatOlaM p`Qaanaimait l sau.ica. 31/3

104 ]YNas%vacyaao ihma: spSao- koSyaao balyaistlaao gau$:

AlpmaU~ : kTu : pako maoQaa|ignakfip<akRt\ I I A.).saU. 6/23

105 tOlaM %vaagnaoyamauYNaM tIxNaM maQaurM maQaurivapakM baRMhNaM vyavaaiya saUxmaM ivaSadM gau$

sarM ivakaisa vaRYyaM %vak\p`saadnaM maoQaamaad-vamaaMsasqaOya-vaNa-balakrM caxauYyaM bawmaU~M

laoKnaM it@tkYaayaanaursaM pacanamainalabalaasaxayakrM ik`imaGnamaiSatip<ajananaM

yaaoinaiSar:kNa-SaUlap`SamanaM gaBaa-SayaSaaoQanaM ca tqaa iCnnaiBannaivawaoi%pYTcyaut

maiqatxatipiccatBagna sfuiTtxaaraignadgQaivaiSlaYTdairtaiBahtduBa-

gnamaRgavyaalaivadYTp`BaRitYau ca pirYaokaBya=gaavagaahaidYau itlatOlaM p`Sasyato l l

td\baistYau ca panaoYau nasyao kNaa-ixapUrNao l

AnnapanaivaQaaO caaip p`yaaojyaM vaatSaantyao l l sau.saU. 45/112,113

106 tOlaM saMyaaogasaMskarat\ sava-raogaaphM matma\ l l ca.saU. 27/287

107 raocanaM dIpnaM vaRYyaM caxauYyamaivadaih ca l

i~daoYaQnaM samaQaurM saOMQavaM lavaNaao<amama\ l l ca.saU. 27/300

108 caxauYyaM saOMQavaM *RdyaM $cyaM laGvaignadIpnama \

isnagQaM samaQaurM vaRYyaM SaItM daoYaGnamau<amama\ l l sau.saU. 46/314

109 saOMQavaM t~ sasvaadu vaRYyaM *RdyaM i~daoYanaut\

laGvanauYNaM dRSa : pqyamaivada*yaignadIpnama\ I I A.).saU. 6/144

110 saPtOt snaohnaa: saV: snaohaSca lavaNaaolbaNaa: I I A.).saU. 16/42

111 lavaNaaopihta : snaoha: snaohyan%yaicarannarma\

twyaiBaYyanV$xaM ca saUxmamauYNaM vyavaaiya ca l l ca.saU. 14/98

112 vaRwyaa ivaYyandnaa%pakat\ sa`aotaomau#aivaSaaoQanaat\ l

Saa#aaM mau@%vaa malaa: kaoYzM yaaint vaayaaoSca inagahat\ l l ca.saU. 28/47

113 p@vaaSayaad\baistvaIya-M KOdo-hmanausaip-it l

vaRxamaUlao inaiYa@tanaamapaM vaIya-imava dumama\ l l sau.ica. 35/25

114 snaohbaistM ina$hM vaa naOkmaovaaitSaIlayaot\ l

snaohadignavaQaa%@laoSaaO ina$hat\ pvanaad\Bayama\ l l sau.ica. 37/77

115 dVadu%@laoSanaM pUva-M maQyao daoYahrM puna : l

pScaat\ saMSamanaIyaM ca dVaWistM ivacaxaNa : l l sau.ica. 38/92

116 ya<a~aOYaQa vaIya-M ih tdpanaona vaayaunaa l

Payaa-Ptmaicaradova samaana : pitpVto l l

samaanaadU<arM caOvaM vyaanaaVa : pvanaakmaat\ l

to tRPta : pkRitM yaaint SarIranaugaho isqata : l l A.).isa. 5

117 baistvaa-to ca ip<ao ca kfo r@to ca Sasyato

saMsagao- sainnapato ca baistrova iht: sada l l sau.ica. 35/6

118 ]@tM ih praSaro maUlaM gaudM Sairrsya isarst~ p`itiYzta :

sava- SarIrM puYNaait maUQaa-naM yaavadaiEata : l l ca. isa.9/50

119 vaIyao-Na baistrad<ao daoYaanaapadmastkat\

p@vaaSayasqaao|mbargaao BaUmaorkao- rsaainava l l sau.ica. 35/28

120 vaayaaoiva-Yahto vaogaM naanyaa basto?-toik`yaa

pvanaaivaw taoyasya vaolaa balamaaraogyamaayauYa : l l sau.ica. 35/30

121 Clinical Pañcakarma by Dr. Yadaiah Polepally Pg No. 93, 94.

122 Laxmi Prasanna J. Rectal drug delivery: a promising route for

enhancing drug absorption. From: www.asianpharmaonline.org,

vol.2,issue 4, page 143-149.

123 Ayurved Sara Sangraha, 20th edition, Pg. No. 678.

I. AIM AND OBJECTIVES

Aim of the research work

To evaluate Samyak Snigdha Lakṣaṇa achieved by

administration of Anuvāsan Basti.

Research objectives

To study the dose and duration of Anuvāsana Basti according to

Koṣṭha.

To evaluate Samyak Śuddhi Lakṣaṇas of Vamana and Virecana

after administration of Anuvāsana Basti as an alternative for

Snehapāna.

II. MATERIALS AND METHODS

Materials:

Mūrcchita Tila Taila (Batch No 11119) was purchased from Agasti

Pharmaceuticals, Pune. Standardization was done in Hi – Tech Lab,

Pune. Some physico-chemical tests like Refractive Index (1.47 at

250C), Iodine value (6.748), Moisture content (below detection limit),

Saponification value (193.45), Microbial tests like tests for pathogens

like E. Coli, Salmonella, S. aureus etc. were done. The oil found free

from pathogens.

Special Basti Puṭakas (Basti pouches attached with catheter) were

prepared according to quantity required of Mūrcchita Tila Taila and

Saindhava by Agasti Pharmaceuticals, Pune.

Special case paper was prepared, in which Daṣavidha, Aṣtavidha and

Srotasa Parīkṣaṇa were done. Separate questions were asked to the

patients to assess Prakṛti, Agni and Koṣṭha.

Total plan of the treatment was explained to patients in their own

language.

Written consent was taken by the patient.

Methodology:

After obtaining Institutional Ethic committee Ethical permission, a

randomized open label clinical study was carried out. The study has

been registered with CTRI (No CTRI/2013/07/003832).

This study was carried out in two steps:

I. Pilot study was carried out in 10 patients. Two groups of 5 patients

each were done. On the basis of conceptual study; it was taken into

granted that Anuvāsana Basti could be given as an alternative for

Snehapāna. So group A was kept as a control group in which

Anuvāsana Basti was given with constant dose of 120 ml of Tila Taila

along with 500 mg Saindhava for minimum 3 and maximum 7 days.

Group B was experimental group, in which escalating dose of

Anuvāsana Basti was administered. In this group starting dose of

Anuvāsana Basti was 120 ml Tila Taila with 500 mg Saindhava

increasing with 25 ml Tila Taila and 100 mg Saindhava daily for

minimum 3 days and maximum 7 days. As Anuvāsana Basti is

considered as an internal route of drug administration, maximum

period of administration of Anuvāsana Basti was kept 7 days i.e. same

as that of Sneha Prakarṣa Kāla.

Symptoms of Samyak Snigdhatā of either group were observed.

Adverse effects (Vyāpad of Anuvāsana Basti) if any were studied. No

patient was found having any adverse effect of Anuvāsana Basti.

II. Total 105 patients were allocated for this study. Group A was

observed with constant dose and Group B with escalating dose of

Anuvāsana Basti. In group A, 52 patients were enrolled; but 2 patients

discontinued the treatment. In group B, 53 patients were allocated.

Out of these, 3 patients were dropped out. Thus two groups of 50

patients each were done.

Inclusion criteria:-

1. Patients between age group of 20 to 60 yrs.

2. Patients of either gender.

3. Patients who were advised Vamana or Virecana treatment

irrespective of the disease and especially having aversion for

Snehapāna. (Patients with Bahudoṣāvasthā or Utkliṣṭa

Doṣāvasthā.)

Exclusion criteria:-

1. Patients who were suffering from anal diseases like Arśa,

Bhagandara, Parīkartikā etc. (which have been described as

contra-indications for Basti)

2. Patients with Alpadoṣāvasthā.

Daṣavidha and Aṣṭavidha Parikṣaṇa were done in every patient.

Diagnosis of the disease along with Doṣāvasthā was assist. If

Samāvasthā of Jivhā was observed; Hingvāṣṭaka Cūrṇa in the dose of

1gm was given before meal for 3 to 5 days.

Gandharva Harītakī in the dose of 5 gms was given to the patient

before bed time to assess the Koṣṭha.

Administration criteria for the procedure i.e. Anuvāsana Basti:

Group A Group B

Sneha Dravya Mūrcchita Tila Taila

+Saindhava

Mūrcchita Tila Taila

+Saindhava

Route of

administration

Guda ( Anus ) Guda ( Anus )

Mātrā Constant dose of

120 ml of Mūrcchita

Tila Taila and 500 mg

Saindhava.

120 ml of Mūrcchita Tila

Taila and 500 mg

Saindhava on 1st day

increasing 25 ml Tila

Taila along with

Saindhava 100 mg per

day.

Time for

Administration

After Breakfast

(approximately at

9.30 am.)

After Breakfast

(approximately at 9.30

am)

Duration of the

treatment

3 to 7 days till

achievement of

Samyak Snigdha

Lakṣaṇas

3 to 7 days till

achievement of Samyak

Snigdha Lakṣaṇas

Follow up during

treatment

Every day Every day

Assessment after

the treatment

3 to 7 days 3 to 7 days

Standard Operative Procedure for Anuvāsana Basti :

Every patient was asked to come to Pañcakarma department

immediately after having a breakfast (around 9.30 - 10 am). Sthānika

Snehan (Tila Taila), Swedana (Nādi Sweda) was done. Left Lateral

position was given to the patient with left leg extended and right leg

flexed at knee joint. Specially designed Basti pouch with prescribed

quantity of Mūrcchita Tila Taila and Saindhava was kept in warm

water for 15 minutes to make the contents warm.

Lubricated Basti Netra was inserted inside the anus up to four Angula.

Oil was pushed inside slowly and steadily. Buttocks were patted 3 to 4

times. Patient was asked to lie on the bed with his legs in elevated

position for 5 to 10 minutes. Patient was advised to drink warm water

throughout the day and immediate after administration of Anuvāsana

Basti. Kṣudbodha of every patient was observed and accordingly he

was advised to have light diet preferably Mudga Yuṣa whenever he

feels hungry. Dhāraṇa Kāla of Anuvāsana Basti i.e. retention period

was noted. Daily assessment was done for the symptoms of Samyak

Snigdhatā.

Other procedures like Viṣrāma, Doṣotkleśaka Āhara, Bāhya Snehana

and Swedana were carried out in the same manner as that of our

routine Vamana and Virecana. For Vamana, oil application and

fomentation were carried out on the last day of Anuvāsana Basti, one

day prior to Vamana and on Vamana day. The patients were asked to

eat curd, jaggery, and banana with milk for aggravation of Kapha or as

Doṣotkleśaka Āhara. This diet facilitates elimination of Doṣas through

Vamana. For Virecana, oil application and fomentation were carried

out for three days, after completion of administration of Anuvāsana

Basti. On the third day of oil application and fomentation; patient had

asked to include Kokam Śerbet in his diet which is considered as

Anulomaka i.e. helpful for therapeutic purgation. Vamana or Virecana

was given with appropriate medicines according to the disease. For

Vamana, Madanaphala and Yashtīmadhū Kaṣāya were used. For

Virecana, Abhayādi Modaka or Trivṛta Leham with Virecana Kaṣaya

was used.

Assessment was done on the basis of Samyak Snigdha Lakṣaṇas.

Agnidīpti and Varca Snigdhatā were excluded from assessment.

Criteria for assessment for Samyak Snigdha Lakṣaṇas:

To give objectivity, score was assigned to all Samyak Snigdha

Lakṣaṇas. The detail Score pattern is as follows:

Sco

re

Vātānu lomana Anga

lāghava

Klama Snigdha

Twak

Asaṃhat

a Varca

0 Improper Evacuation of

flatus, faeces,

urine and absence

of Udgār

Usual lightness

As usual Softness of skin

Soft stool

1 Urdhwavātapravṛt

ti, Ādhmāna,

Udgārbāhulya

Heaviness Enthusi

astic

Dryness

of skin

Hard

stool

2 Proper Evacuation

of flatus, faeces

and urine

Lightness Klama Oiliness

of skin

Loose

stool

Assessment of Snigdha Twak: (Pin Test)

A drop of Tila Taila ( in the size of pin head ) was kept on the

dorsal part of the palm and the time of absorption in seconds

was recorded before and after completion of the Anuvāsana

Basti course. (Ref. of Sangamkar A, Sathe S.M.1993-95

Drushtikonatun Prakrut Stricha Abhyas, Marathwada

Vidyapeeth)

Grades of Snigdhatā:

Snigdhatā Lakṣaṇa Score Grades

Asnigdha < 3 1

Avara 4-5 2

Madhyama 6-7 3

Pravara 8 - 10 4

Serum Cholesterol, Triglycerides and Total Proteins were checked as a

supportive criteria. These tests were done on the 1st day when the

patient was examined and on the last day of treatment when Samyak

Snigdhatā Lakṣaṇa appeared.

III. OBSERVATIONS AND RESULTS

In the present study, Samyak Snigdhatā Lakṣaṇas were observed after

administration of Anuvāsana Basti prior to Vamana and Virecana.

Vātānulomana, Angalāghava, Asaṃhata Varca, Klama and Twak

Snigdhatā were observed as they are Samyak Snigdhatā Lakṣaṇas.

These symptoms were observed within Prakṛti, Agni and Koṣṭha.

Scores were given to each symptom and grades of Snigdhatā were

drawn.

To examine the association between Samyak Snigdhatā Lakṣaṇa and

Treatment groups Chi-square test was used.

Paired t test was used to find significance of Twak Snigdhatā in each

group before and after the treatment.

Inter group Twak Snigdhatā was assessed by using unpaired t test.

To find significance association of Samyak Snigdhatā Lakṣaṇa,

unpaired t test and Z test for proportion were used.

Student‟s t test was applied for two independent groups for Dhāraṇa

Kāla of Anuvāsana Basti.

Paired t test was used to find significance of values of Sr. Cholesterol,

Triglycerides and Total Proteins in each group before and after the

treatment.

Scoring pattern is as follows:

Score VL AL KL ST AV

0 Improper Evacuation

of flatus, faeces, urine

and absence of Udgār

Usual

light

ness

As

usual

Softness of

skin

Soft

stool

1 Urdhwāvatpravrutti,

Ādhmana,

Udgārbahulya

Heavi

ness

Enthu

siastic

Dryness of

skin

Hard

stool

2 Proper Evacuation of

flatus, faeces and

urine

Light

ness

Klama Oiliness of

skin

Loose

stool

Accordingly grades were given as follows:

Snigdhatā Lakṣaṇa Score Grades

Asnigdha < 3 1

Avara 4-5 2

Madhyam 6-7 3

Pravara 8-10 4

Table 1: Number and percentagewise distribution of patients

according to gender and age.

Gr. Age Sex Total

Male Female

Gr. A 20 – 30 yrs 22 6 28

44% 12% 56%

30 – 40 yrs 8 8 16

16% 16% 32%

40 -50 yrs 1 2 3

2% 4% 6%

50 – 60 yrs 1 2 3

2% 4% 6%

Total 32 18 50

64% 36% 100%

Gr. B 20 – 30 yrs 13 4 17

26% 8% 34%

30 – 40 yrs 13 4 17

26% 8% 34%

40 -50 yrs 5 4 9

10% 8% 18%

50 – 60 yrs 5 2 7

10% 4% 14%

Total 36 14 50

72% 28% 100%

Fig. 1: showing percentagewise distribution of patients according

to gender and age.

In Gr. A, 44% male patients and 12% female were noted, in the age

group of 20 – 30 yrs. 16% male 16% male and female were in the age

group of 30 to 40 yrs. 2% male patients and 2% female patients were

recorded in the age group of 40 to 50 yrs. 2% male and 4% female

were above 50 yrs.

In Gr. B, In the age group pf 20 – 30 yrs 26% male and 8% female

were noted. 26% male and 8% female were in the age group of 30 to 40

yrs. 10% male patients and 8% female patients were recorded in the

age group of 40 to 50 yrs. 10% male and 4% female were above 50 yrs.

Table 2: Number and percentagewise distribution of patients

according to Prakṛti.

Gp. Prakṛti Total

VP VK PV PK KV KP

Gr.A 6 3 9 16 9 7 50

12% 6% 18% 32% 18% 14% 100%

Gr.B 9 10 5 8 8 10 50

18% 20% 10% 16% 16% 20% 100%

0

10

20

30

40

50

60

70

20-3

0yrs

30-4

0yrs

40-5

0yrs

50-6

0yrs

20-3

0yrs

30-4

0yrs

40-5

0yrs

50-6

0yrs

Male Female

increasing dose

constant dose

Fig.2: showing distribution of patients according to Prakṛti.

VP= Vāta Pitta Prakṛti, VK= Vāta Kapha Prakṛti,

PV= Pitta Vāta Prakṛti, PK=Pitta Kapha Prakṛti,

KV= KaphaVāta Prakṛti, KP= Kapha Pitta Prakṛti

In Gr. A; maximum i.e. 32% patients were of PK Prakṛti followed by PV

and KV with 18% patients each. 14% patients were of KP, 12%

patients were of VP. Least i.e. 6% patients were noted having VK

Prakṛti.

In Gr. B; maximum patients i.e. 20% were noted of two Prakṛti; VK and

KP followed by VP with 18% patients. 16% patients were recorded

having PK and KV Prakṛti. 10% patients were found having PV Prakṛti.

Table 3: Number and percentagewise distribution of patients

according to Agni.

Gp. Agni Total

Manda Tīkṣṇa Viṣama

Gr.A 18 18 13 50

36% 38% 26% 100%

Gr.B 18 20 12 50

36% 40% 24% 100%

0

5

10

15

20

25

30

35

VP VK PV PK KV KP

constant dose

increasing dose

Fig.3: showing percentagewise distribution of patients according

to Agni.

In Gp. A 36% patients were having Mandāgni. 38% and 26% were

found having Tikṣṇāgni and Viṣamāgni respectively.

In Gp. B, 36% patients were found with Mandāgni where as 40%

patients with Tikṣṇāgni and 24% having Viṣamāgni.

Table 4: Number and percentagewise distribution of patients

according to Koṣṭha.

Gp. Koṣṭha Total

Mṛdu Madhyam Krura

Gp.A 11 23 16 50

22% 46% 32% 100%

Gp. B 07 25 18 50

14% 50% 36% 100%

Fig.4: showing percentagewise distribution of patients according

to Koṣṭha.

0

5

10

15

20

25

30

35

40

45

Manda Tīkṣṇa Viṣama

constant dose

increasing dose

0

10

20

30

40

50

60

Mṛdu Madhyama Krura

constant dose

increasing dose

In Gp. A, maximum i.e. 46% patients were noted Madhyam Koṣṭha.

32% with Krura Koṣṭha and 22% with Mṛdu Koṣṭha.

In Gp. B, again patients having Madhyam Koṣṭha were maximum i.e.

50%. 14% patients were of Mṛdu Koṣṭha and 36% were of Krura

Koṣṭha.

Table 5: Number and percentagewise distribution of patients

according to grades of Samyak Snigdhatā Lakṣaṇa.

Gp. Grades of Samyak Snigdhatā lakṣaṇa Total

Asnigdha Avara Madhyam Pravara

Gp .A 7

20

16

7

50

14% 40% 32% 14% 100%

Gp. B 0 5

16

29

50

0 10% 32% 58% 100%

Total 7 25 32 36 100

100% 100% 100% 100% 100%

Chi-square = 29.444, P = 0.000 Significant association.

Fig.5: showing percentagewise distribution of patients according

to grades of Samyak Snigdhatā Lakṣaṇa.

0

10

20

30

40

50

60

70

Asnigdha Avara Madhyam Pravara

% p

atie

nts

Constant Dose

Increasing Dose

As per the scoring pattern described in methodology; Asnigdha, Avara,

Madhyama and Pravara grades of Snigdhatā were made.

In Gp. A; 40% patients showed Avara Snigdhatā, 32% patients had

Madhyam Snigdhatā, 14% patients were having Pravara Snigdhatā

grade. But there were 14% patients who showed few or no symptom of

Snigdhatā and were recorded as Asnigdha category.

In Gp. B; no one showed Asnigdha Lakṣaṇa. 58% patients were

recorded having Pravara Snigdhatā which is quite significant. 32%

patients showed Madhyama, 10% showed Avara Snigdha Lakṣaṇa.

It clearly indicates that, in increasing dose of Anuvāsana Basti,

maximum patients can achieve Pravara Snigdhatā. Where as in

constant dose of Anuvāsana Basti, there are chances of getting

Asnigdhatā.

Table 6: Number and percentagewise distribution of patients

according to duration required for getting Samyak Snigdha

Lakśaṇa after administration of Anuvāsana Basti.

Duration

of AB

4th day 5th day 6th day 7th day Total

Gr.A 0 0 3 47 50

0 0 6% 94% 100%

Gr. B 1 4 5 40 50

2% 8% 10% 80% 100%

Fig. 6: showing percentagewise distribution of patients according

to duration required for getting Samyak Snigdha Lakśaṇa.

0

20

40

60

80

100

4th day 5th day 6th day 7th day

% p

atie

nts

Constant Dose

Increasing Dose

In Gp. A only 6% patients showed Samyak Snigdha Lakśaṇa on 6th day

and rest of the 94% patients required 7 days for getting Snigdha

Lakśaṇa.

In Gp. B, Samyak Snigdhatā Lakṣaṇas were observed starting from 4th

day in 2% patient. 8% patients showed on 4th day, 10% patients

showed Samyak Snigdhatā Lakṣaṇa on 6th day and maximum patients

i.e. 80% had Samyak Snigdhatā Lakṣaṇa on 7th day.

It means that; in increasing dose of Anuvāsana Basti, Snigdhatā can

be achieved earlier than the constant dose of Anuvāsana Basti.

Table 7: Number and percentagewise distribution of patients

according to score of the symptom Vatānulomana.

Group Score of VL Total

0 1 2

Gr. A 2 0 48 50

4% 0 96% 100%

Gr. B 0 1 49 50

0 2% 98% 100%

Chi-squre=3.01 P=0.22 Not Significant association

In Gp.A, 4% patients showed Vatānulomana score 0 and 96% patients

showed score 2.

In Gp. B, 2% patients were in score 1 and 98% were in score 2 i.e.

proper Vatānulomana took place.

It indicates that in both groups Vatānulomana was very good. In Gp. B

i.e. in increasing dose of Anuvāsana Basti, only 2% patient showed

Urdhva Vātapravṛtti.

Table 8: Number and percentagewise distribution of patients

according to score of the symptom Angalāghava.

Group Score of AL Total

0 1 2

Gr. A 28 3 19 50

56% 6% 38% 100%

Gr. B 15 20 15 50

30% 40% 30% 100%

Chi-squre=16.97 P=0.000 Significant association

In Gp. A, 56% patients showed no change in Angalāghava i.e. score 0

where as 6% patients showed Angagaurava and 38% patients were

noted Angalāghava.

In Gp. B, 30% patients feels as usual i.e. score 0, 40% patients

recorded Angagaurava and 30% patients had Angalāghava.

It means in Gp. B may be due to the larger quantity, patients felt

Angagaurava.

Table 9: Number and percentagewise distribution of patients

according to score of the symptom Asaṃhata Varca.

Group Score of AV Total

0 1 2

Gr. A 20 0 30 50

40 0 60% 100%

Gr. B 3 1 46 50

6% 2% 92% 100%

Chi-square=16.93 P=0.000 Significant association

In Gr. A, 40% patients showed score 0 i.e. no change in their

consistency of faecal matter and 60% patients had Asaṃhata Varca.

No patient was recorded having hard stool after administration of

Anuvāsana Basti.

In Gr. B, 6% patients had score 0, 2% had hard stool and 92%

patients showed Asaṃhata Varca.

This clearly indicates that, increasing quantity of Taila through

Anuvāsana Basti can do Snehana to Pakwāśaya and hence the

symptom Asaṃhata Varca can be seen.

Table 10: Number and percentagewise distribution of patients

according to score of the symptom Klama.

Group Score of KL Total

0 1 2

Gr. A 37 6 7 50

74% 12% 14% 100%

Gr. B 11 11 28 50

22% 22% 56% 100%

Chi-square=28.154 P=0.000 Significant association

In Gp. A, 74% patients neither had Klama nor enthusiasms. They

were recorded in score 0. 12% patients had grade 1 and 14% patients

showed score 2 i.e. Klama.

In Gp. B, 22% patients showed score 0, 22% patients showed score

1i.e. feeling enthusiastic and 56% were recorded score 2 i.e. Klama.

It means that, when Anuvāsana Basti is given in increasing dose,

Klama can be seen.

Table 11: Number and percentagewise distribution of patients

according to score of the symptom Snigdha Twak.

Group Score of ST Total

0 1 2

Gr. A 27 5 18 50

54% 10% 36% 100%

Gr. B 12 4 34 50

24% 8% 68% 100%

Chi-squre=10.80 P=0.005 Significant association

In Gr. A, 54% patients showed score 0 i.e. softness of skin, 10%

showed score 1, i.e. dry skin and 36% showed score 2, i.e. oiliness of

skin.

In Gr. B, 24% patients showed score 0, 8% patients showed score 1

and 68% patients had score 2.

This shows skin gets oiliness in both groups but more in the group of

increasing dose of Anuvāsana Basti.

Fig. 7: Showing percentagewise distribution of patients according

to scores of Samyak Snigdhatā Lakṣaṇa:

0102030405060708090

100

0 1 2 0 1 2 0 1 2 0 1 2 0 1 2

VL AL AV KL ST

% p

atie

nts

Constant Dose

Increasing Dose

Table 12: Comparative effect of Anuvāsana Basti in both groups

on Snigdha Twak before and after the treatment measured by Pin

Test.

Twak Snigdhatā of each patient was measured in seconds by Pin Test

before and after completion of the course of administration of

Anuvāsana Basti. Following table shows the significance of Twak

Snigdhatā of each group by using paired t test.

Gr Mean ± SD Std.

Error

t value P value

Gr. A BT 143.98 82.81 11.71 2.26 0.02

AT 162.90 105.53 14.92

Gr. B BT 146.40 82.61 11.68 7.4 0.00

AT 293.08 186.02 26.30

Gr. A: t = 2.26, p = 0.02, significant association

Gr. B: t = 7.4, p = 0.00, significant association

It clearly indicates that, in both groups Snigdhatā of Twaca increases

but in Gr. B i.e. in increasing dose of Anuvāsana Basti; it increases

more.

Table 13: showing inter group association of scores of Snigdha

Twak by using Unpaired t test.

Gr Mean ± SD Std.

Error

t value P value

Gr. A 162.90 105.53 14.92 4.3 0.00

Gr. B 293.08 186.02 26.30

P = 0.00, significant association

Table 14: Comparative effect of Anuvāsana Basti in both groups

according Samyak Snigdhatā Lakṣaṇa, (n= 50)

SSL Gr. A Gr. B Unpaired

t test

Z test

for

propor

tion

Coun

t

with

%

Mea

n

± SD Cou

nt

with

%

Mea

n

± SD

VL 48

96%

1.92 0.4 49

98%

1.98 0.14 -1.0

NS

1.0

NS

AL 19

38%

0.82 0.92 15

30%

1.0 0.78 -1.03

NS

1.0

NS

AV 30

60%

1.2 0.99 46

92%

1.86 0.49 -4.22

S

0.00

S

KL 7

14%

0.4 0.73 28

56%

1.34 0.82 -6.05

S

0.00

S

ST 18

36%

0.82 0.9 34

68%

1.44 0.86 -3.52

S

0.0006

S

VL : Vatānulomana, AL : Angalāghava, AV : Asaṃhata Varca,

KL : Klama, ST: Snigdha Twak

In Gr.A, 96% patients and in Gr. B 98% patients showed

Vatānulomana with SD 0.4 and 0.14 respectively. By using paired t

test (p= -0.1) and Z test for proportion, it is not significant.

In Gr. A 38% and in Gr. B 30% patients were having Angalāghava,

with mean 0.82 and 1.0, and SD± 0.96 and 0.78 respectively which is

statistically not significant by using unpaired t test (p= -1.03) and Z

test for proportion.

In Gr.A and Gr.B, 60% and 92% patients were having Asaṃhata Varca

with p= -4.22 which is statistically significant.

In Gr. A 14% patients had Klama with mean 0.4 and SD± 0.73. In Gr.

B 56% patients were observed having Klama with mean 1.34 and SD±

0.82 with p= -6.05 which is statistically significant.

In Gr. A, 36% patients were found with Snigdha Twak with mean 0.82

and SD± 0.9. In Gr. B, 68% patients had Snigdha Twak with mean

1.44 and SD± 0.86 with p= -3.52 which is statistically significant.

Table 15: Distribution of patients according to Samyak Snigdhatā

Lakṣaṇa found on every day during the study.

Group Samyak

Snigdhatā

Lakṣaṇa

in %

Days

1 2 3 4 5 6 7

Gr. A VL 12.0 16.0 42.0 56.0 78.0 88.0 95.7

AL 2.0 4.0 8.0 10.0 20.0 36.0 40.4

AV 0.0 0.0 0.0 0.0 6.0 32.0 59.6

KL 0.0 0.0 0.0 0.0 0.0 10.0 12.8

ST 0.0 0.0 0.0 0.0 0.0 6.0 36.2

Gr. B VL 14.0 22.0 46.0 76.0 93.9 97.8 97.5

AL 0.0 2.0 4.0 12.0 20.4 26.7 27.5

AV 0.0 0.0 10.0 24.0 61.2 86.7 90.0

KL 0.0 0.0 0.0 6.0 26.5 46.7 52.5

ST 0.0 0.0 0.0 0.0 8.2 11.1 60.0

Fig.8: showing percentagewise distribution of the appearanceof Snigdhatā Lakṣaṇa according to days.

0

10

20

30

40

50

60

70

80

90

100

1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7

VL AL AV KL ST

% p

atie

nts

Constant Dose

Increasing Dose

In Gr. A, the pattern of Samyak Snigdhatā Lakṣaṇa found with respect

of duration of Anuvāsana Basti as follows Vatānulomana was seen in

12% of subjects on 1st day.16%, 42%, 56%, 78%, 88% and 95.7% on

subsequent days.

Angalāghava was noted 2%, 4%, 8%, 10%, 20%, 36% and 40.4% on

1st to 7th day respectively.

Asaṃhata Varca was observed from 5th day of administration of

Anuvāsana Basti. 6% patients were found on 5th day followed by 32%

and 59.6% on subsequent days.

10% patients showed Klama on 6th day and 12.8% patients on 7th day

of Anuvāsana Basti.

Twak Snigdhatā was found 6% on 6th day and 36.2% on 7th day of

administration of Anuvāsana Basti.

In Gr. B, the pattern of Samyak Snigdhatā Lakṣaṇa found with respect

of duration of Anuvāsana Basti as follows Vatānulomanā was seen in

14% of subjects on 1st day.22%, 46%, 76%, 93%, 97.8% and 97.5% on

subsequent days.

Angalāghava was noted 2%, 4%, 12%, 20.4%, 26.7% and 27.5% on

2nd to 7th day respectively.

Asaṃhata Varca was observed from 3rd day of administration of

Anuvāsana Basti. 10%, 24%,61.2%, 86.7% and 90% patients were

found on 3rd to 7th day respectively.

6% patients showed Klama on 4th day,26.5% patients on 5th day,

46.7% on 6th day and 52.5% on 7th day of Anuvāsana Basti.

Twak Snigdhatā was found 8.2%% on 5th day. 11.1% and 60.0% on

6th and 7th day of administration of Anuvāsana Basti respectively.

It means symptoms of Samyak Snigdhatā do not appear on the same

day but as Snehana process goes on through Anuvāsana Basti, the

symptoms appear one by one. Vatānulomanā was observed in initial

days followed by Angalāghava, Asaṃhata Varca, Klama and Twak

Snigdhatā.

Table 16: Number and percentagewise distribution of patients

with score of symptom Vatānulomana according to Prakṛti

Gr. Score

VL

prakṛti Total

VP VK PV PK KV KP

Gr. A 0 1 0 0 0 0 1 2

16.7% 0 0 0 0 14.3% 4%

1 0 0 0 0 0 0 0

0 0 0 0 0 0 0

2 5 3 9 16 9 6 48

83.3% 100% 100% 100% 100% 85.7% 96%

Total 6 3 9 16 9 7 50

100% 100% 100% 100% 100% 100% 100%

Gr. B 0 1 0 0 0 0 0 1

11.1% 0 0 0 0 0 2%

1 0 0 0 0 0 0 0

0 0 0 0 0 0 0

2 8 10 5 8 8 10 49

88.9% 100% 100% 100% 100% 100% 98%

Total 9 10 5 8 8 10 50

100% 100% 100% 100% 100% 100% 100%

Fig.9: showing the percentagewise distribution of patients with

score of symptom Vatānulomana according to Prakṛti.

In Gp. A, 16.7% and 14.3% of VP and KP respectively showed the

score of Vatānulomana 0. Whereas 83.3% patients having VP Prakṛti

0102030405060708090

100

0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2

VP VK PV PK KV KP

% p

ati

en

ts

Constant Dose

Increasing Dose

and 85.7% patients having KP Prakṛti showed score 2. All other

patients having VK, PV, PK, KV Prakṛti had score 2.

In Gp. B, 11.2% and 88.9% of VP Prakṛti showed score 0 and 2

respectively. Score 2 was obtained by remaining five Prakṛti.

It shows that irrespective of Prkṛti and dose of Anuvāsana Basti,

Vatānulomana can be obtained.

Table 17: Distribution of patients with score of symptom

Angalāghava within Prakṛti

Gp. Score

AL

Prakṛti Total

Gr. A

VP VK PV PK KV KP

0 5 3 6 7 4 3 28

83.3% 100% 66.7% 43.8% 44.4% 42.9% 56%

1 0 0 1 1 0 1 3

0 0 11.1% 6.3% 0 14.3% 6%

2 1 0 2 8 5 3 19

16.7% 0 22.2% 50% 55.6% 42.9% 38%

Total 6 3 9 16 9 7 50

100% 100% 100% 100% 100% 100% 100%

Gp.

B

0 2 3 2 4 2 2 15

22.2% 30% 40% 50% 25% 20% 30%

1 4 7 0 3 2 4 20

44.4% 70% 0 37.5% 25% 40% 40%

2 3 0 3 1 4 4 15

33.3% 0 60% 12.5% 50% 40% 30%

Total 9 10 5 8 8 10 50

100% 100% 100% 100% 100% 100% 100%

Fig.10: showing percentagewise distribution of patients with

score of symptom Angalāghava within Prakṛti.

0102030405060708090

100

0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2

VP VK PV PK KV KP

% p

ati

en

ts

Constant Dose

Increasing Dose

In Gp. A, 83.3%, 100%, 66.7%, 43.8%,44.4%, 42.9% patients of VP,

VK, PV, PK, KV, KP Prakṛti showed score of Angalāghava 0. No one of

VP, VK and KV showed score 1. 11.1%, 6.3%, 14.3% 0f PV, PK, KP

showed score 1 respectively. 16.7%, 0%, 22.2%, 50%, 55.6%, 49.9%

patients of VP, VK, PV, PK, KV and KP Prakṛti showed score 2

respectively.

It shows that in Gr. A, maximum patients of KP Prakṛti and in Gr. B

maximum patients of, PV Prakṛti had the symptom Angalāghava.

Table 18: Distribution of patients with score of symptom

Asaṃhata Varca within Prakṛti.

Gr. Scor

e of AV

Prakṛti Total

VP VK PV PK KV KP

Gr.

A

0 3 2 3 6 2 4 20

50% 66.7% 33.3% 37.5% 22.2% 57.1% 40%

1 0 0 0 0 0 0 0

0 0 0 0 0 0 0

2 3 1 6 10 7 3 30

50% 33.3% 66.7% 62.5% 77.8% 42.9% 60%

Total 6 3 9 16 9 7 50

100% 100% 100% 100% 100% 100% 100%

Gr.

B

0 0 0 1 1 1 0 3

0 0 20% 12.5% 12.5% 0 6%

1 0 1 0 0 0 0 1

0 10% 0 0 0 0 2%

2 9 9 4 7 7 10 46

100% 90% 80% 87.5% 87.5% 100% 92%

Total 9 10 5 8 8 10 50

100% 100% 100% 100% 100% 100% 100%

Fig. 11: showing the percentagewise distribution of patients with

score of symptom Asaṃhata Varca within Prakṛti.

In Gr. A, maximum i.e. 66.7% patients of VK Prakṛti and minimum

i.e. 22.2% patients of KV had score of Asaṃhata Varca 0. 50%, 33.3%,

37.5%, 57.1% patients of VP, PV, PK and KP respectively scored

Asaṃhata Varca score 0. In score 2; there were 50%, 33.3%, 66.7%,

62.5%, 77.8% and 42.9% patients of VP, VK, PV, PK, KV and KP

Prakṛti respectively.

In Gr. B, 20% patients of PV Prakṛti showed score 0 of Asaṃhata

Varca. 12.5% each of PK and KV showed score 0 and 6% of KP scored

0. Only 10% patients of VK Prakṛti had 1 score of Asaṃhata Varca.

Whereas 100% patients of VP and KP Prakṛti and 87.5% patients of

KP and KV Prakṛti showed the score 2. 90% of PK and 80% of PV

Prakṛti had score 2.

It indicates that, in Gr. A, maximum patients of KV Prakṛti, and in Gr.

B, maximum patients of VP and KP Prakṛti showed Asaṃhata Varca.

But in Gr.B, maximum patients from all Prakṛti had Asaṃhata Varca.

0

20

40

60

80

100

0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2

VP VK PV PK KV KP

% p

ati

en

ts

Constant Dose

Increasing Dose

Table 19: Number and percentagewise distribution of patients

with symptom Klama within Prakṛti

Gr. Score

of KL

Prakṛti Total

VP VK PV PK KV KP

Gr.

A

0 6 2 8 10 7 4 37

100% 66.7% 88.9% 62.5% 77.8% 57.1% 74%

1 0 0 1 3 1 1 6

0 0 11.1% 18.8% 11.1% 14.3% 12%

2 0 1 0 3 1 2 7

0 33.3% 0 18.8% 11.1% 28.6% 14%

Total 6 3 9 16 9 7 50

100% 100% 100% 100% 100% 100% 100%

Gr. B

0 0 2 2 2 2 3 11

0% 20% 40% 25% 25% 30% 22%

1 3 1 3 1 0 3 11

33.3% 10% 60% 12.5% 0 30% 22%

2 6 7 0 5 6 4 28

66.7% 70% 0 62.5% 75% 40% 56%

Total 9 10 5 8 8 10 50

100% 100% 100% 100% 100% 100% 100%

Fig. 12: showing percentagewise distribution of patients with

score of symptom Klama within Prakṛti.

In Gr. A, 100% patients of VP Prakṛti showed score 0 where as 66.7%,

88.9%, 62.5%, 77.8%, 57.1% patients of VK, PV, PK, KV, KP scored 0

respectively.

0102030405060708090

100

0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2

VP VK PV PK KV KP

% p

ati

en

ts

Constant Dose

Increasing Dose

No patient of VP was found in score 1 and 2. 33.3% patients of VK

were there in score 2. 11.1% patients of PV were recorded having score

1. 18.8% patients of PK Prakṛti got 1 and 2 score. 11.1% patients of

score 1 and 2 were found of KV Prakṛti. 14.3% and 28.6% patients had

score 1 and 2 respectively.

In Gr. B, no one from VP Prakṛti showed Klama score 0 whereas 33.3%

and 66.7% patients of VP Prakṛti were having score 1 and 2

respectively. 20%, 10% and 70% patients of VK showed score 0, 1 and

2. no one from PV Prakṛti showed Klama score 2 whereas 40% and

60% patients of VP Prakṛti were having score 0 and 1 respectively.

25% patients of PK Prakṛti were in score 0, 12.5% in score 1 and

62.5% in score 2. 25% and 75% patients of KV were recorded having

score 0 and 2 respectively. No patient of KV was found having score 1.

In the group of KP Prakṛti, 30% were found in score 0 and 1. 40%

patients of KP showed score 2. It shows that more patients of Gr. B i.e.

with increasing dose of Anuvāsana Basti had Klama than Gr. A i.e.

constant dose.

Table 20: Number and percentagewise distribution of patients

with symptom Snigdha Twak within Prakṛti.

Gr. Score of ST

Prakṛti Total

VP VK PV PK KV KP

Gr.

A

0 4 1 6 9 2 5 27

66.7% 33.3% 66.7% 56.3% 22.2% 71.4% 54%

1 1 1 1 0 2 0 5

16.7% 33.3% 11.1% 0 22.2% 0 10%

2 1 1 2 7 5 2 18

16.7% 33.3% 22.2% 43.8% 55.6% 28.6% 36%

Total 6 3 9 16 9 7 50

100% 100% 100% 100% 100% 100% 100%

Gp. B

0 2 1 3 2 3 1 12

22.2% 10% 60% 25% 37.5% 10% 24%

1 0 3 0 1 0 0 4

0 30% 0 12.5% 0 0 8%

2 7 6 2 5 5 9 34

77.8% 60% 40% 62.5% 62.5% 90% 68%

Total 9 10 5 8 8 10 50

100% 100% 100% 100% 100% 100% 100%

Fig. 13: showing percentagewise distribution of patients with

score of symptom Twak Snigdhatā within Prakṛti.

In Gr. A; 66.7% patients of VP Prakṛti showed score 0 whereas 16.7%

showed score 1 and 2. In VK Prakṛti 33.3% were found in each group

of score 0, 1 and 2. In PV Prakṛti, 66.7% patients were having score 0,

11.1% patients were having score 1 and 22.2% patients had score 2.

No one from PK Prakṛti showed Snigdha Twak score 1 whereas 56.3%

and 43.8% patients of PK Prakṛti were having score 0 and 2

respectively. In KV Prakṛti 22.2% were found in each group of score 0

and 1. 55.6% patients of KV had score 2. . No one from KP Prakṛti

showed Snigdha Twak score 1 whereas 71.4% and 28.6% patients of

KP Prakṛti were having score 0 and 2 respectively.

In Gr. B, 22.2% and 77.8% patients of VP Prakṛti had score 0 and 2

respectively. No one was recorded in score 1. 10% patients of VK

Prakṛti showed score 0, 30% showed score 1 and 60% showed score 2.

60% and 40% patients of PV Prakṛti had score 0 and 2 respectively. No

one was recorded in score 1. 25% patients of PK were recorded score

1, 12.5% were recorded score 1 and 62.5% ere recorded score 2. No

one had score 1 in KV and KP Prakṛti. In score 0, 37.5% and 10%

patients of KV and KP were recorded respectively. 10% and 90%

patients of KV and KP had score 0 and 2 respectively.

It indicates that; even though patients from both groups obtain Twak

Snigdhatā, Gr. B had more Twak Snigdhtā than group B.

0102030405060708090

100

0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2

VP VK PV PK KV KP

% p

ati

en

ts

Constant Dose

Increasing Dose

Table 21: Distribution of patients according to days required for

getting Samyak Snigdhatā Lakṣaṇa according to Prakriti

Group Prakriti Duration of AB Total

4th day 5th day 6th day 7th day

Gp. A VP 0 0 0 6 6

VK 0 0 0 3 3

PV 0 0 2 7 9

PK 0 0 1 15 16

KV 0 0 0 9 9

KP 0 0 0 7 7

Total 0 0 3 47 50

Gp. B VP 0 1 1 7 9

VK 0 1 1 8 10

PV 0 0 0 5 5

PK 0 0 1 7 8

KV 0 1 1 6 8

KP 1 1 1 7 10

Total 1 4 5 40 50

In Gr. A, 6 patients of VP Prakṛti, 3 patients of VK, 9 patients of KV

and 7 patients of KV Prakṛti required 7 days for getting Snigdha

Lakśaṇa. 2 patients of PV and 1patient of PK showed Snigdha Lakśaṇa

on 6th day of AB.

In Gr. B, Lakśaṇa of Snigdhatā were noted on 4th day in the patient

having KP Prakṛti.1 – 1 patient of VP, VK, KV and KP Prakṛti were

noted Snigdhatā on 5th day. Total 5 patients of VP, VK, PK, KV and KP

with 1 patient each showed Lakśaṇa of Snigdhatā on 6th day.

Maximum patients i.e. 40 were recorded Lakśaṇa of Snigdhatā on 7th

day.10 patients of VK and KP patients showed Snigdha Lakśaṇa on 7th

day. 9 patients having VP Prakṛti showed Snigdhatā on 7th day. 8

patients of PK and KV, 5 patients of PV Prakṛti showed Snigdha

Lakśaṇa on 7th day.

This indicates that in both groups almost every Prakṛti needs 7 days

for achieving Samyak Snigdhatā Lakṣaṇa. As these symptoms depends

upon Koṣṭha and Agni also.

Table 22: Distribution of patients according to grades of Samyak

Snigdhatā Lakṣaṇa within Prakṛti

G

r.

SSL Prakṛti Total

VP VK PV PK KV KP

G

r.

A

Asnig

dha

2 1 2 0 0 2 7

33.3% 33.3% 22.2% 0% 0% 28.6% 14%

Avara 3 1 4 8 2 2 20

50.0% 33.3% 44.4% 50% 22.2% 28.6% 40%

Madh

yam

1 1 3 4 5 2 16

16.7% 33.3% 33.3% 25% 55.6% 28.6% 32%

Prava

ra

0 0 0 4 2 1 7

0 0 0 25% 22.2% 14.3% 14%

Total 6 3 9 16 9 7 50

100% 100% 100% 100% 100% 100% 100%

G

r.

B

Asnig

dha

0 0 0 0 0 0 0

0 0 0 0 0 0 0

Avara 0 0 2 2 1 0 5

0 0 40% 25% 12.5% 0% 10%

Madh

yam

2 4 2 1 3 4 16

22.2% 40% 40% 12.5% 37.5% 40% 32%

Prava

ra

7 6 1 5 4 6 29

77.8% 60.0% 20.0% 62.5% 50.0% 60.0% 58.0%

Total 9 10 5 8 8 10 50

100% 100% 100% 100% 100% 100% 100%

Fig. 14: showing percentagewise distribution of patients with

grades of Samyak Snigdhatā Lakṣṇas within Prakṛti.

In Gr. A, 33.3%, 33.3%, 22.2%, 28.6% patients of VP, VK, PV and KP

Prakṛti were found Asnigdha.

Avara Snigdhatā was found in 50% of VP, 33.3% of VK, 44.4% of PV,

50% of PK, 22.2% of KV and 28.6% Prakṛti of KP.

16.7% of VP, 33.3% of VK, 33.3% of PV, 25% of PK, 55.6% of KV and

28.6% of KP Prakṛti had Madhyama Snigdhatā.

No patient from VP, VK and PV Prakṛti had Pravara Snigdhatā. 25%,

22.2% and 14.3% patients of PK, KV and KP Prakṛti respectively were

found having Pravara Snigdhatā.

In Gr. B, no patient was found having Asnigdha grade.

40%, 25% and 12.5% patients of PV, PK and KV Prakṛti respectively

were found having Avara Snigdhatā. Remaining Prakṛti didn‟t show

Avara Snigdhatā.

22.2% of VP, 40% of VK, 40% of PV, 12.5% of PK, 37.5% of KV and

40% of KP Prakṛti had Madhyama Snigdhatā.

Pravara Snigdhatā was found in 77.7% of Vp, 60% of VK, 20% of PV,

62.5% of PK, 50% of KV and 60% of KP Prakṛti.

0102030405060708090

100

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Asn

igdh

a

Avara

Madh

yam

Pra

vara

VP VK PV PK KV KP

% p

ati

en

ts

Constant Dose

Increasing Dose

It indicates that Avara Snigdhatā was not found in any of the Prakṛti

in the group of increasing dose of Anuvāsana Basti and comparatively

more patients had Pravara Snigdhatā than the group of constant dose

of Anuvāsana Basti.

Table 23: Number and percentagewise distribution of patients

with symptom Vatānulomana within Agni.

Gr Score of

Vatānulomana

Agni Total

Manda Tīkṣṇa Viṣama

Gr.

A

0 1 1 0 2

5.6% 5.3% 0% 4%

1 0 0 0 0

0 0 0 0

2 17 18 13 48

94.4% 94.7% 100% 96%

Total 18 19 13 50

100% 100% 100% 100%

Gr.

B

0 0 0 0 0

0 0 0 0

1 0 0 1 1

0 0 8.3% 2%

2 18 20 11 49

100% 100% 91.7% 98%

Total 18 20 12 50

100% 100% 100% 100%

Fig. 15: showing percentagewise distribution of patients with

symptom Vatānulomana within Agni.

0102030405060708090

100

0 1 2 0 1 2 0 1 2

Manda Tīkṣṇa Viṣama

% p

atie

nts

Constant Dose

Increasing Dose

In Gr. A, 5.6% patients of Mandāgni were recorded score 0 and 94.4%

recorded score 2. 5.3% patients with Tikṣnāgni had score 0, and

94.7% had score 2. 100% patients having Viṣama agni were having

score 2.No one from Mandāgni , Tikṣnāgni or Viṣamagni showed score

1.

In Gr. B, 0% patients were noted score 0 from either Agni.100%

patients of Mandāgni and Tikṣnāgni had score 2. 8.3% and 91.7%

patients with Viṣamāgni were having score 1 and 2 respectively.

It indicates that, Vatānulomana takes place after administration of

Anuvāsana Basti irrespective of dose and Agni.

Table 24: Number and percentagewise distribution of patients

with symptom Angalāghava within Agni.

Gr. Score of

Angalāghava

Agni Total

Manda Tīkṣṇa Viṣama

Gr. A

0 9 11 8 28

50% 57.9% 61.5% 56%

1 1 2 0 3

5.6% 10.5% 0 6%

2 8 6 5 19

44.4% 31.6% 38.5% 38%

Total 18 19 13 50

100% 100% 100% 100%

Gr.

B

0 7 5 3 15

38.9% 25% 25% 30%

1 3 11 6 20

16.7% 55% 50% 40%

2 8 4 3 15

44.4% 20% 25% 30%

Total 18 20 12 50

100% 100% 100% 100%

Fig.16 : showing percentagewise distribution of patients with

grades of symptom Angalāghava within Agni.

In Gr. A, 50%, 5.6%, 44.4% patients of Madagni were noted having

score of Angalāghavaa 0,1,2 respectively. 57.9%, 10.5%, 31.6%

patients having Tikṣnāgni showed score 0, 1, 2 respectively whereas

61.5%, and 38.5% patients of Viṣama agni scored 0 and 2 respectively.

No one was noted in score 1.

In Gr.B, 38.9% patients of Mandāgni showed score 0, 16.7% showed

score 1 and 44.4% showed score 2. In Tikṣnāgni group; 25%, 55% and

20% patients were noted score 0, 1 and 2 respectively. 25%, 50% and

25% patients of Viṣamāgni score 0, 1 and 2 respectively.

It indicates that, patients from constant dose i.e. Gr. A had more

Angalāghava than patients from Gr. B except from Mandāgni.

0

20

40

60

80

100

0 1 2 0 1 2 0 1 2

Manda Tīkṣṇa Viṣama

% p

ati

ents

Constant Dose

Increasing Dose

Table 25: Distribution of patients with symptom Asaṃhata Varca

within Agni

Gr. Score of AV Agni Total

Manda Tīkṣṇa Viṣama

Gr. A

0 8 7 5 20

44.4% 36.8% 38.5% 40%

1 0 0 0 0

0 0 0 0

2 10 12 8 30

55.6% 63.2% 61.5% 60%

Total 18 19 13 50

100% 100% 100% 100%

Gr. B 0 2 1 0 3

11.1% 5% 0% 6%

1 1 0 0 1

5.6% 0 0 2%

2 15 19 12 46

83.3% 95% 100% 92%

Total 18 20 12 50

100% 100% 100% 100%

Fig. 17: showing percentagewise distribution of patients with

symptom Asaṃhata Varca within Agni.

In Gr. A, 44.4% patients of Mandāgni showed 0 score i.e. softness of

faecal matter without much strain. No one showed Rukṣa

0

20

40

60

80

100

0 1 2 0 1 2 0 1 2

Manda Tīkṣṇa Viṣama

% p

atie

nts

Constant Dose

Increasing Dose

Malapravartana and 55.6% patients had score 2 i.e. Asaṃhata Varca.

36.8% and 63.2% patients of Tikṣnāgni had score 0 and 2 respectively.

38.5% patients of Tikṣnāgni had score 0 and 61.5% patients were

having score 2.

In Gr. B, 11.1% patients of Mandāgni had score of Asaṃhata Varca 0,

5.6% were in score 1 and 83.3% were noted score 2.

5% and 95% patients of Tikṣnāgni showed score 0 and 2 respectively.

Whereas 100% patients of Viṣamāgni showed score 2 i.e. Asaṃhata

Varca.

It indicates that, in escalating dose Asaṃhata Varca can be seen

irrespective of type of Agni. But all patients having Viṣamāgni had

Asaṃhata Varca.

Table 26: Number and percentagewise distribution of patients

with symptom Klama within Agni.

Gr. Score of

KL

Agni Total

Manda Tīkṣṇa Viṣama

Gr. A 0 11 14 12 37

61.1% 73.7% 92.3% 74%

1 4 2 0 6

22.2% 10.5% 0 12%

2 3 3 1 7

16.7% 15.8% 7.7% 14%

Total 18 19 13 50

100% 100% 100% 100%

Gr.B 0 4 5 2 11

22.2% 25.0% 16.7% 22%

1 4 4 3 11

22.2% 20% 25% 22%

2 10 11 7 28

55.6% 55% 58.3% 56%

Total 18 20 12 50

100% 100% 100% 100%

Fig. 18: showing percentagewise distribution of patients with

grades of symptom Klama within Agni.

In Gr. A, 61.1% patients of Mandāgni had neither Klama nor

enthusiasm, 22.2% patients felt enthusiastic and 16.7% were having

Klama.

73.7% patients of Tikṣnāgni showed score 0, 10.5% were noted score 1

and 15.8% were having score 2.

92.3% and 7.7% patients of Viṣama agni showed score 0 and 2

respectively. No one was scored 1.

In Gr. B, 22.2% patients of Mandāgni had score of Klama 0, 22.2%

patients had score 1 and 55.6% were having score 2.

25% patients of Tikṣnāgni showed score 0, 20% were noted score 1

and 55% were having score 2.

16.7%, 25% and 58.3% patients of Viṣamāgni showed score 0, 1 and 2

respectively.

It was found that most of the patients from constant dose of

Anuvāsana Basti felt as usual. And more patients from escalating dose

had Klama than constant dose.

0

20

40

60

80

100

0 1 2 0 1 2 0 1 2

Manda Tīkṣṇa Viṣama

% p

ati

ents

Constant Dose

Increasing Dose

Table 27: Distribution of patients with symptom Snigdha Twak

within Agni

Gr. Score of

ST

Agni Total

Manda Tīkṣṇa Viṣama

Gr. A

0 9 11 7 27

50% 57.9% 53.8% 54%

1 3 0 2 5

16.7% 0 15.4% 10%

2 6 8 4 18

33.3% 42.1% 30.8% 36%

Total 18 19 13 50

100% 100% 100% 100%

Gr. B 0 3 6 3 12

16.7% 30% 25% 24%

1 0 2 2 4

0 10% 16.7% 8%

2 15 12 7 34

83.3% 60% 58.3% 68%

Total 18 20 12 50

100% 100% 100% 100%

Fig. 19: showing percentagewise distribution of patients with

symptom Snigdha Twak within Agni.

In Gr. A, 50% patients of Mandāgni had score of Twak Snigdhatā 0,

16.7% patients showed score 1 and 33.3% were in score 2.

57.9% and 42.1% patients of Tikṣnāgni were having score 0 and 2

respectively.

0

10

20

30

40

50

60

70

80

90

100

0 1 2 0 1 2 0 1 2

Manda Tīkṣṇa Viṣama

% p

ati

en

ts

Constant Dose

Increasing Dose

53.8% patients of Viṣama agni noted score 0,15.4% showed score 1

and 30.8% patients showed score 2.

In Gr. B, 16.7% and 83.3% patients of Mandāgni were having score 0

and 2 respectively.

30% patients of Tikṣnāgni had score of Twak Snigdhatā 0, 10%

patients showed score 1 and 60% were in score 2.

25% patients of Viṣamāgni noted score 0, 16.7% showed score 1 and

58.3% patients showed score 2.

It indicates that, there is more Twak Snigdhatā in escalating dose

group than in constant dose.

Table 28: Distribution of patients according to days required for

getting Samyak Snigdhatā Lakṣaṇa according to Agni

Gr. Agni Duration of AB Total

4th day 5th day 6th day 7th day

Gr. A Manda 0 0 0 18 18

Tīkṣṇa 0 0 3 16 19

Viṣama 0 0 0 13 13

Total 0 0 3 47 50

Gr.

B

Manda 1 2 3 12 18

Tīkṣṇa 0 1 0 19 20

Viṣama 0 1 2 9 12

Total 1 4 5 40 50

In Gr. A, 18 and 13 patients with Mandāgni and Viṣama agni

respectively required 7 days for getting Samyak Snigdhatā Lakṣaṇa. 3

patients having Tikṣnāgni showed Samyak Snigdhatā Lakṣaṇa on 3rd

day and remaining 13 patients showed Samyak Snigdhatā Lakṣaṇa on

7th day.

In Gr. B, 1patient of Mandāgni showed Samyak Snigdhatā Lakṣaṇa on

4th day, 2 patients on 5th day, 3 patients on 6th day and 12 patients

on 7th day. 1 patient of Tikṣnāgni was noted Samyak Snigdhatā

Lakṣaṇa on 5th day, 19 patients on 7th day. 1,2 and 9 patients of

Viṣama agni showed Samyak Snigdhatā Lakṣaṇa on 5th ,6th, 7th day

respectively.

In the group of increasing dose of AB, Samyak Snigdhatā Lakṣaṇa

started on 4th day in a patient of Mandāgni .

Table 29: Distribution of patients according to grades of Samyak

Snigdhatā Lakṣaṇa within Agni.

Gr. SSL Agni Total

Manda Tīkṣṇa Viṣama

Gr. A Asnigdha 3 3 1 7

16.7% 15.8% 7.7% 14%

Avara 6 8 6 20

33.3% 42.1% 46.2% 40%

Madhyam 7 3 6 16

38.9% 15.8% 46.2% 32%

Pravara 2 5 0 7

11.1% 26.3% 0% 14%

Total 18 19 13 50

100% 100% 100% 100%

Gp. B Asnigdha 0 0 0 0

0 0 0 0

Avara 1 3 1 5

5.6% 15% 8.3% 10%

Madhyam 7 6 3 16

38.9% 30% 25% 32%

Pravara 10 11 8 29

55.6% 55% 66.7% 58%

Total 18 20 12 50

100% 100% 100% 100%

Fig. 20: showing percentagewise distribution of patients with

grades of Samyk Snigdhatā Lakṣaṇas within Agni.

In Gr. A, 16.7% patients of Mandāgni were Asnigdha, 33.3% patients

were noted as Avara Snigdha, 38.9% patients had grade Madhyama

Snigdha and 11.1% patients were Pravara Snigdha.

15.8% patients of Tikṣnāgni were of Asnigdha grade. 42.1% patients

were Avara Snigdha, 15.8% patients were Madhyama Snigdha and

26.3% patients were noted Pravara Snigdha.

7.7% patients of Tikṣnāgni showed Asnigdha grade and 46.2% each

showed Avara and Madhyama Snigdhatā. No one was recorded in

Pravara Snigdhatā grade.

In Gr. B, not a single patient was found in Asnigdha grade from

Manda, Tīkṣṇa or Viṣama agni.

5.6% patients of Mandāgni were of Avara Snigdha grade,38.9%

patients with Madhyama Snigdhatā and 55.6% patients were of

Pravara Snigdhatā.

15% patients of Tikṣnāgni were having Avara Snigdhatā, 30% patients

had Madhyama and 55% patients had Pravara Snigdhatā grade.

0102030405060708090

100

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Manda Tīkṣṇa Viṣama

% p

ati

en

ts

Constant Dose

Increasing Dose

8.3%, 25%, 66.7% patients of Viṣama agni showed Avara , Madhyama

and Pravara Snigdha Lakśaṇas.

This indicates that maximum patients showed Pravara Snigdhatā in

Gr. B i.e. in escalating dose of Anuvāsana Basti irrespective type of

Agni.

Table 30: Number and percentagewise distribution of patients

according to the symptom Vatanuloaman within Koṣṭha

Gr Score of VL Koṣṭha Total

Mṛdu Madhyam Krura

Gr. A

0 0 1 1 2

0 4.3% 6.3% 4%

1 0 0 0 0

0 0 0 0

2 11 22 15 48

100% 95.7% 93.8% 96%

Total 11 23 16 50

100% 100% 100% 100%

Gr.B 0 0 0 0 0

0 0 0 0

1 0 0 1 1

0 0 5.6% 2%

2 7 25 17 49

100% 100% 94.4% 98%

Total 7 25 18 50

100% 100% 100% 100%

Fig. 21: showing percentagewise distribution of patients with

symptom Vatanuloaman within Koṣṭha.

0

10

20

30

40

50

60

70

80

90

100

0 1 2 0 1 2 0 1 2

Mṛdu Madhyam Krura

% p

ati

en

ts

Constant Dose

Increasing Dose

In Gr. A, 100% patients of Mṛdu Koṣṭha showed score 2, i.e. proper

Vatānulomanaa.

4.3% and 95.7% patients of Madhyama Koṣṭha had 0 and 2 score

respectively.

6.3%, 96% patients of Krura Koṣṭha recorded score 0 and 2

respectively.

In Gr. B, 100% patients of Mṛdu Koṣṭha and Madhyama Koṣṭha had

score 2.

5.6% patients of Krura Koṣṭha showed score 1 and 94.4% patients

showed score 2.

It clearly indicates that, Vatānulomanaa takes place after

administration of Anuvāsana Basti irrespective of dose, but in Mṛdu

Koṣṭha it is predomonent.

Table 31: Number and percentagewise distribution of patients

according to the symptom Angalāghava within Koṣṭha

Gr. Score of

Angalāghava

Koṣṭha Total

Mṛdu Madhyam Krura

Gr. A

0 4 16 8 28

36.4% 69.6% 50% 56%

1 2 1 0 3

18.2% 4.3% 0 6%

2 5 6 8 19

45.5% 26.1% 50% 38%

Total 11 23 16 50

100% 100% 100% 100%

Gr.B 0 2 8 5 15

28.6% 32% 27.8% 30%

1 2 10 8 20

28.6% 40% 44.4% 40%

2 3 7 5 15

42.9% 28% 27.8% 30%

Total 7 25 18 50

100% 100% 100% 100%

Fig. 22: showing percentagewise distribution of patients with

symptom Angalāghava within Koṣṭha.

In Gr. A, 36.4% patients of Mṛdu Koṣṭha showed score of Angalāghava

0, 18.2% patients had 1 score and 45.5% patients noted score 2.

69.6% patients of Madhyama Koṣṭha showed score 0, 4.3% patients

showed 1 score and 26.1% patients had score 2.

50 - 50% patients of Krura Koṣṭha recorded score 0 and 2 respectively.

In Gr. B, 28.6% patients of Mṛdu Koṣṭha showed score of Angalāghavaa

0, 28.6% patients had 1 score and 42.9% patients noted score 2.

32% patients of Madhyama Koṣṭha showed score 0, 40% patients

showed 1 score and 28% patients had score 2.

27.8%, 44.4%, 27.8% patients of Krura Koṣṭha recorded score 0, 1 and

2 respectively.

In Gr. A, patients of Krura Koṣṭha showed Angalāghava maximum and

in Gr. B, patients of Mrudu Koṣṭha showed Angalāghava maximum

than other two types of Koṣṭha.

0

10

20

30

40

50

60

70

80

90

100

0 1 2 0 1 2 0 1 2

Mṛdu Madhyam Krura

% p

ati

en

ts

Constant Dose

Increasing Dose

Table 32: Number and percentagewise distribution of patients

according to the symptom Asaṃhata Varca within Koṣṭha

Gr Score of

AV

Koṣṭha Total

Mṛdu Madhyam Krura

Gr. A

0 6 7 7 20

54.5% 30.4% 43.8% 40%

1 0 0 0 0

0 0 0 0

2 5 16 9 30

45.5% 69.6% 56.3% 60%

Total 11 23 16 50

100% 100% 100% 100%

Gr. B 0 0 2 1 3

0 8% 5.6% 6%

1 0 1 0 1

0 4% 0 2%

2 7 22 17 46

100% 88% 94.4% 92%

Total 7 25 18 50

100% 100% 100% 100%

Fig. 23: showing percentagewise distribution of patients with

symptom Asaṃhata Varca within Koṣṭha.

In Gr. A, 54.5% and 45.5% patients of Mṛdu Koṣṭha showed score 0

and 2 respectively.

0

10

20

30

40

50

60

70

80

90

100

0 1 2 0 1 2 0 1 2

Mṛdu Madhyam Krura

% p

ati

en

ts

Constant Dose

Increasing Dose

30.4% patients of Madhyama Koṣṭha had score 0 and 69.6% patients

showed score 2. 43.8% patients and 56.3% patients noted score 0 and

2 respectively.

In this group no one was recorded having score 1 i.e. Rukṣa Varca.

In Gr. B, 100% patients of Mṛdu Koṣṭha showed score 2.

8% patients of Madhyama Koṣṭha had score 0, 4% patients recorded

score 1 and 88% patients showed score 2.

5.6% patients and 94.4% patients of Krura Koṣṭha noted score 0 and 2

respectively.

In this group maximum patients were recorded having score 2 i.e.

Asaṃhata Varca especially patients of Mṛdu Koṣṭha.

Table 33: Number and percentagewise distribution of patients

according to the symptom Klama within Koṣṭha.

Gr. Score of KL

Koṣṭha Total

Mṛdu Madhyam Krura

Gr. A 0 8 16 13 37

72.7% 69.6% 81.3% 74%

1 1 2 3 6

9.1% 8.7% 18.8% 12%

2 2 5 0 7

18.2% 21.7% 0 14%

Total 11 23 16 50

100% 100% 100% 100%

Gr. B 0 1 6 4 11

14.3% 24% 22.2% 22%

1 2 6 3 11

28.6% 24% 16.7% 22%

2 4 13 11 28

57.1% 52% 61.1% 56%

Total 7 25 18 50

100% 100% 100% 100%

Fig. 24: showing percentagewise distribution of patients with

symptom Klama within Koṣṭha.

In Gr. A, 72.7% patients of Mṛdu Koṣṭha recorded score 0, 9.1% were

recorded score 1 and 18.2% had score 2.

69.6% patients of Madhyama Koṣṭha were in score 0, 8.7% noted score

1 and 21.7% patients had 2 score.

81.3% patients of Krura Koṣṭha were having score 0 and 18.8%

patients had score 1. No one had score 2.

In Gr. B, 14.3% patients of Mṛdu Koṣṭha recorded score 0, 28.6% were

recorded score 1 and 57.1% had score 2.

24% patients of Madhyama Koṣṭha were in score 0, 24% noted score 1

and 52% patients had 2 score.

22.2% patients of Krura Koṣṭha were having score 0 16.7% patients

had score 1. And 61.1% had score 2.

More patients of escalating dose showed Klama than of constant dose.

0

10

20

30

40

50

60

70

80

90

100

0 1 2 0 1 2 0 1 2

Mṛdu Madhyam Krura

% p

ati

en

ts

Constant Dose

Increasing Dose

Table 34: Number and percentagewise distribution of patients

according to the symptom Snigdha Twak within Koṣṭha

Gr. Score of

ST

Koṣṭha Total

Mṛdu Madhyam Krura

Gr. A

0 8 12 7 27

72.7% 52.2% 43.8% 54%

1 1 3 1 5

9.1% 13% 6.3% 10%

2 2 8 8 18

18.2% 34.8% 50% 36%

Total 11 23 16 50

100% 100% 100% 100%

Gr. B 0 0 6 6 12

0 24% 33.3% 24%

1 0 2 2 4

0 8% 11.1% 8%

2 7 17 10 34

100% 68% 55.6% 68%

Total 7 25 18 50

100% 100% 100% 100%

Fig. 25: showing percentagewise distribution of patients with

symptom Snigdha Twak within Koṣṭha.

In Gr. A, 72.7% patients of Mṛdu Koṣṭha showed score 0, 9.1% patients

had score 1 and 18.2% patients had score2.

0

10

20

30

40

50

60

70

80

90

100

0 1 2 0 1 2 0 1 2

Mṛdu Madhyam Krura

% p

ati

en

ts

Constant Dose

Increasing Dose

52.2%, 13%, 34.8% patients of Madhyama Koṣṭha showed score 0, 1

and 2 respectively.

54% patients of Krura Koṣṭha noted score 0, 6.3% had score 1 and

50% patients had score 2.

In Gr. B, all patients of Mṛdu Koṣṭha showed score 2 i.e. Twak

Snigdhatā.

24%, 8%, 68% patients of Madhyama Koṣṭha showed score 0, 1 and 2

respectively.

33.3% patients of Krura Koṣṭha noted score 0, 11.1% had score 1 and

55.6% patients had score 2.

In Gr. A, more patients are recorded with soft skin where as in Gr. B

more patients are recorded with oily skin irrespective of Koṣṭha.

Table 35: Distribution of patients according to days required for

getting Samyak Snigdhatā Lakṣaṇa according to Koṣṭha

Gr. Koṣṭha Duration of AB Total

4th day 5th day 6th day 7th day

Gr.

A

Mṛdu 3 8 11

27.27% 72.72% 100%

Madhyam 0 23 23

100% 100%

Krura 0 16 16

100% 100%

Total 3 47 50

6% 94% 100%

Gr.

B

Mṛdu 1 3 2 1 7

14% 42.85% 28% 14% 100%

Madhyam 0 1 1 23 25

4% 4% 92% 100%

Krura 0 0 2 16 18

11.11% 88.88% 100%

Total 1 4 5 40 50

2% 8% 10% 80% 100%

In Gp. A, 8, 23 and 16 patients of Mṛdu, Madhyam and Krura Koṣṭha

respectively showed Samyak Snigdhatā Lakṣaṇa on 7th day. Only 1

patient of Mṛdu Koṣṭha showed Samyak Snigdhatā Lakṣaṇa on 6th day.

In Gp. B, 1 patient showed Samyak Snigdhatā Lakṣaṇa on 4th day, 3

patients on 5th day, 2 patients on 6th day and 1 patient on 7th day. In

Mṛdu Koṣṭha Samyak Snigdhatā Lakṣaṇa were started appearing on 3rd

day, for Madhyam Koashtha on 5th day and Krura Koṣṭha on 6th day.

Table 36: Distribution of patients according to Samyak Snigdhatā

Lakṣaṇa within Koṣṭha

Gr. SSL Koṣṭha Total

Mṛdu Madhyam Krura

Gr. A Asnigdha 2 4 1 7

18.2% 17.4% 6.3% 14%

Avara 6 7 7 20

54.5% 30.4% 43.8% 40%

Madhyam 1 9 6 16

9.1% 39.1% 37.5% 32%

Pravara 2 3 2 7

18.2% 13% 12.5% 14%

Total 11 23 16 50

100% 100% 100% 100%

Gr.

B

Asnigdha 0 0 0 0

0 0 0 0

Avara 0 3 2 5

0 12% 11.1% 10%

Madhyam 1 8 7 16

14.3% 32% 38.9% 32%

Pravara 6 14 9 29

85.7% 56% 50% 58%

Total 7 25 18 50

100% 100% 100% 100%

Fig. 26: showing percentagewise distribution of patients with

grades of Samyak Snigdhatā Lakṣana within Koṣṭha.

In Gr. A, 18.2% patients of Mṛdu Koṣṭha, 17.4% patients of Madhyam

Koṣṭha, 6.3% patients of Krura Koṣṭha showed grade Asnigdha. 54.5%,

30.4%, 43.8% patients of Mṛdu, Madhyam and Krura Koṣṭha showed

grade Avara Snigdha respectively. 9.1% patient of Mṛdu Koṣṭha, 39.1%

patients of Madhyam Koṣṭha and 37.5% patients of Krura Koṣṭha had

grade Madhyam Snigdha where as 18.2% patients of Mṛdu Koṣṭha 13%

patients of Madhyam Koṣṭha and 12.5% patients of Krura Koṣṭha

showed grade Pravara Snigdha.

In Gr. B, no one showed grade Asnigdha. 12% patients of Madhyama

Koṣṭha and 11.1% patients of Krura Koṣṭha were in grade of Avara

Snigdha. 14.3%, 32% and 38.9% patients of Mṛdu, Madhyam and

Krira Koṣṭha showed Madhyam Snigdha grade respectively. 85.7%

patients of Mṛdu Koṣṭha, 56% patients of Madhyam Koṣṭha and 50%

patients of Krura Koṣṭha were noted in grade Pravara Snigdha.

It indicates that patient of Mṛdu Koṣṭha, with escalating dose of

Anuvāsana Basti had Pravara Snigdhatā.

0102030405060708090

100

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Asn

igdh

a

Avara

Madh

yam

Pra

vara

Mṛdu Madhyam Krura

% p

ati

en

ts

Constant Dose

Increasing Dose

Table 37: Distribution of patients according to duration and

quantity required for getting Samyak Snigdhatā Lakṣaṇa within

Koṣṭha

Gr. Mṛdu Madyama Krura

Min Maxi Min Maxi Min Maxi

Duration

in days

A 6 7 7 7 7 7

B 4 7 5 7 6 7

Total

dose in

ml

A 720 840 840 840 840 840

B 630 1365 850 1365 1095 1365

In Gr. A, only patients of Mṛdu Koṣṭha required minimum 6 days for

getting Samyak Snigdhatā Lakṣaṇas, where as patients of Madhyama

and Krura Koṣṭha required 7 days for getting Samyak Snigdhatā

Lakṣaṇas. Minimum dose required for getting Samyak Snigdhatā

Lakṣaṇas for Mṛdu Koṣṭha was 720 ml. and other two Koṣṭha was 840

ml.

In Gr. B, patients of Mṛdu Koṣṭha required minimum 4 days for getting

Samyak Snigdhatā Lakṣaṇas with the minimum dose of 630 ml where

as patients of Madhyama and Krura Koṣṭha required 5 and 6 days

respectively for getting Samyak Snigdhatā Lakṣaṇas with minimum

dose of 850 ml and 1095 ml respectively.

This shows that Mṛdu Koṣṭha requires less period and dose for getting

Samyak Snigdhatā Lakṣaṇas than Madhyama and Krura Koṣṭha.

Table 38: Distribution of patients according to Samyak Snigdhatā

Lakṣaṇa within Agni and Koṣṭha

Gr. Grade of

SSL

Koṣṭha Agni Total

Manda Tīkṣṇa Viṣama

Gr. A Asnigdha Mṛdu 0 1 1 2

Madhyam 3 1 0 4

krura 0 1 0 1

Total 3 3 1 7

Avara Mṛdu 2 4 0 6

Madhyam 2 0 5 7

Krura 2 4 1 7

Total 6 8 6 20

Madhyam Mṛdu 0 0 1 1

Madhyam 7 1 1 9

Krura 0 2 4 6

Total 7 3 6 16

Pravara Mṛdu 0 2 0 2

Madhyam 2 1 0 3

Krura 0 2 0 2

Total 2 5 0 5

Gr. B Avara Mṛdu 0 0 0 0

Madhyam 1 1 1 3

Krura 0 2 0 2

Total 1 3 1 5

Madhyam Mṛdu 0 0 1 1

Madhyam 4 3 1 8

Krura 3 3 1 7

Total 7 6 3 16

Pravara Mṛdu 4 1 1 6

Madhyam 4 8 2 14

Krura 2 2 5 9

Total 10 11 8 29

In Gr. A,

In Asnigdha grade:- 1- 1 patient of Mṛdu Koṣṭha with Tīkṣṇa and

Viṣama Agni each were found.

3 patients of Mandāgni and 1 of Tikṣnāgni with Madhyama Koṣṭha

were noted.

Only 1 patient of Tikṣnāgni with Krura Koṣṭha was recorded.

In Avara Snigdhatā grade:- 2 patient of Mṛdu Koṣṭha with Tīkṣṇa and

4 patients of Viṣama Agni were found.

2 patients of Mandāgni and 5 of Viṣama agni with Madhyama Koṣṭha

were noted.

2,4 and 1 patient of Mandāgni , Tikṣnāgni and Viṣama agni with Krura

Koṣṭha were recorded.

In Madhyama Snigdhatā grade:- only 1 patient of Mṛdu Koṣṭha with

Viṣama a Agni was found.

7, 1 and 1 patient of Mandāgni , Tikṣnāgni and Viṣama agni with

Madhyama Koṣṭha were recorded respectively.

2 patients of Tikṣnāgni and 4 of Viṣama agni with Krura Koṣṭha were

noted.

In Pravara Snigdhatā Grade :- only 2 patients of Mṛdu Koṣṭha with

Mandāgni was found.

2 and 1 patient of Manda and Tīkṣṇa Agni respectively with

Madhyama Koṣṭha were recorded.

2 patients of Tikṣṇāgni with Krura Koṣṭha was noted.

In Gr. B,

In Asnigdha grade:- no patient of Mṛdu Koṣṭha with Manda, Tīkṣṇa

and Viṣama Agni was found.

1,1,1 patient of Madhyama Koṣṭha with Manda, Tīkṣṇa and Viṣama

Agni were noted.

Only 2 patients of Tikṣnāgni with Krura Koṣṭha was recorded.

In Madhyama Snigdhatā grade:- only 1 patient of Mṛdu Koṣṭha with

Viṣama Agni was recorded.

4, 3 and 1 patient of Madhyama Koṣṭha with Manda, Tīkṣṇa and

Viṣamāgni respectively were found.

3 patients of Mandāgni , 3 patients of Tikṣnāgni and 1 patient of

Viṣamāgni with Krura Koṣṭha were found.

In Pravara Snigdhatā grade :- 4, 1 and 1 patient of Mṛdu Koṣṭha with

Manda, Tīkṣṇa and Viṣamāni respectively were found.

4 patients of Mandāgni , 8 patients of Tikṣnāgni and 2 patients of

Viṣamāgni with Madhyama Koṣṭha were recorded.

2, 2 and 5 patients of Krura Koṣṭha with Manda, Tīkṣṇa and Viṣama

Agni were noted.

Table 39: Distribution of patients according to grades of Samyak

Snigdhatā Lakṣaṇa within Dhāraṇa Kāla of Anuvāsana Basti

Gp

Grades of SSL Mean N

Std. Deviation

S1Gp. A Asnigdha 2.0486 7 .95702

Avara 3.6256 20 1.42639

Madhyam 4.1250 16 1.91352

Pravara 4.7279 7 1.39510

Significance

using

ANOVA

Between

groups

.0120

Linearity .0020

Gp. B Avara 3.6429 5 1.81968

Madhyam 4.8384 16 1.99637

Pravara 6.2998 29 3.16437

Significance using

ANOVA

Between groups

.0690

Linearity .0220

Applying Student‟s T test for two independent groups, differences in

average Dhāraṇa Kala in Gr.A (4.72, ± 1.39) and Gr. B (6.30 ± 3.16)

were found to be highly significant.(P < 0.05)

Fig. 27 : distribution of patients according to grades of Samyak

Snigdhatā Lakṣaṇa within Dhāraṇa Kāla of Anuvāsana Basti.

It shows that Dhāraṇa Kāla is increased in both groups but it is more

in group B and so as Pravara Snigdhatā.

Table 40: Distribution of Nidāna according to Doṣavastha

Bahu

Doṣāvasthā Utkliṣta

Doṣāvasthā

Madhyama

Doṣāvasthā

Swāsthya

Rakṣaṇārtha

Gr. A Gr. B Gr. A Gr. B Gr. A Gr. B Gr. A Gr. B

23 26 5 14 16 7 6 3

46% 52% 10% 28% 32% 14% 12% 6%

Fig. 28: showing percentagewise distribution of Nidānas according

to Doṣāvasthā.

0

1

2

3

4

5

6

7

Asnigdha Avara Madhyam Pravara

Mea

n H

rs o

f D

hār

aṇa

Kāl

a

Constant Dose

Increasing Dose

0

10

20

30

40

50

60

constant dose

increasing dose

Bahu Doṣāvasthā :- 46% patients of Gr. A and 26% of Gr. B were

found.

Utkliṣṭa Doṣāvasthā:- 10% and 28% patients of Gr. A and Gr. B

respectively.

Madhyama Doṣāvasthā:- 32% of Gr. A and 14% of Gr. B were noted.

Swāsthya Rakṣaṇārtha :- 12% patients of Gr. A and 6% patients of Gr.

B were registered.

Table 41: Effect of Anuvāsana Basti on Sr. Cholesterol,

Triglycerides and Total Proteins before and after treatment:

Gr. Tests SD t P Significance

Gr. A

(N=40)

Cholesterol 2.186 0.36 0.71 NS

Triglycerides 1.81 1.04 0.30 NS

Total Proteins 0.133 0.47 0.63 NS

Gr. B

(N=40)

Cholesterol 2.76 0.34 0.73 NS

Triglycerides 2.27 1.11 0.02 NS

Total Proteins 0.15 1.66 0.15 NS

By applying paired t test, P value > 0.05 which shows non significant

association for both groups in the levels of Cholesterol, Triglycerides

and Total Proteins before and after administration of Anuvāsana Basti.

Table 42: Distribution of patients according to Āntikī and Vaigikī

Śuddhī of Virecana.

Gr.A (N=41) Gr.B (N=31)

Āntikī Śuddhī Vaigikī Śuddhī Āntikī Śuddhī Vaigikī Śuddhī

D P K 1-10

HS

11-20

MS

21-30

US

D P K 1-10

HS

11-20

MS

21-30

US

16 15 10 32 8 1 2 12 17 10 19 2

39. 02%

36. 58%

24. 39%

78. 04%

19. 51%

2.4 %

6.4 %

38. 7%

54. 83%

32. 25%

61. 29%

6.4 %

D= Dravānta, P= Pittānta, K= Kaphānta

HS= Hīna Śuddhī, MS= Madhyama Śuddhī, US= Uttama Śuddhī

Fig.29: showing percentagewise distribution of patients according

to Āntikī and Vaigikī Śuddhī of Virecana.

Āntikī Śuddhī: In Gr.A, 39.02% patients had Dravānta, 36.58%

patients had Pittānta and 6.4%patients had Kaphānta Virecana.

In Gr. B, 6.4% patients showed Dravānta, 36.7% patients had Pittanta

and 54.83% patients had Kaphānta Virecana.

Vaigiki Śuddhi: In Gr.A, 78.04% patients had Hīna Śuddhi i.e. Vegas

between 1-10, 19.51% patients had Madhyama i.e. 11-20 Vegas and

2.4%patients had Uttama Śuddhi of Virecana i.e. 21-30 Vegas.

In Gr.B, 32.25% patients showed Hīna i.e. Vegas between 1-10,

61.29% patients had Madhyama Śuddhī i.e. 11-20 Vegas and 6.4%

patients had Uttama Śuddhī of Virecana i.e. 21-30 Vegas.

Kaphānta Virecana and Madhyama Vega were observed more in Gr.B

than Gr.A. It indicates that in escalating dose of Anuvāsana Basti;

more Śodhana of Doṣa takes place.

0

10

20

30

40

50

60

70

80

90

constant dose

incrasing dose

Table 43: Distribution of patients according to Āntikī and Vaigikī

Śuddhī of Vamana.

Gr. A (N=9) Gr. B (N=19)

Āntikī Śuddhī

Vaigikī Śuddhī Āntikī Śuddhī

Vaigikī Śuddhī

P K 1-3

H

4-6

M

7-8

U

P K 1-3

H

4-6

M

7-8

U

3 6 0 5 4 16 3 0 1 18

33.33

%

66.6

6%

0 55.5

5%

44.44

%

84.

21

%

15.7

8%

0 5.2% 94.7

3%

P= Pittānta, K= Kaphānta

HS= Hīna Śuddhī, MS= Madhyama Śuddhī, US= Uttama Śuddhī

Fig.30: showing percentagewise distribution of patients according

to Āntikī and Vaigikī Śuddhī of Vamana.

Āntikī Śuddhī: In Gr.A, 33.33% patients had Pittānta and

66.66%patients had Kaphānta Vamana.

In Gr. B, 84.21% patients had Pittanta and 15.78% patients had

Kaphānta Vamana.

0

10

20

30

40

50

60

70

80

90

100

constant dose

increasing dose

Vaigikī Śuddhī: In Gr.A, no one was found having Hīna Śuddhi,

55.5% patients had Madhyama i.e. 4-6 Vegas and 44.4%patients had

Uttama Śuddhī of Vamana i.e. 7-8 Vegas.

In Gr.B, no one showed Hīna Śuddhī, i.e. Vegas between 1-3, 5.2%

patients had Madhyama Śuddhī i.e. 4-6 Vegas and 94.73% patients

had Uttama Śuddhī of Vamana i.e.7-8 Vegas.

Pittānta Vamana and Uttama Vega were observed more in Gr.B than

Gr.A. It indicates that in escalating dose of Anuvāsana Basti; more

Śodhana of Doṣa takes place.

I. DISCUSSION

Snehapāna as a preparatory procedure is extremely necessary prior to

Vamana and Virecana.(1) The purpose of Snehapāna prior to Śodhana

Karma is Snehana, Viṣyandana, Mārdava and Kledan of Doṣa.(2) Sneha

spreads all over the body through various Srotas and brings the Doṣa

from Śakhā to Koṣṭha so that they can be expelled out easily. This is

achieved by Vṛddhi and Abhiṣyanda of morbid Doṣas.(3) Caraka gives

simily that, as from a smooth container, contents easily separate

without any effort, similarly Kaphādi Doṣas are expelled out easily

from the Snigdha body.(4) As morbid Malas of any cloth is easily

washed by water, if we loosen them from its site, in the similar way

Malas are expelled out by Śodhana if we make them Utkliṣṭa by

Snehana and Swedana.(5) In the present study, efforts have been

made to observe the symptoms of Samyak Snigdhatā through

administration of Anuvāsana Basti.

As Basti is described as an internal route of drug administration by

Dalhaṇa [6], here anal route is considered as an alternative to oral

route so as Anuvāsana Basti to Snehapāna.

In this study, we observed symptoms of Samyak Snehana by

administration of Anuvāsana Basti in constant and escalating doses

instead of Snehapāna. Symptoms like Vātānulomana, Angalāghava,

Asaṃhata Varca, Klama and Snigdha Twak were observed.(7) Other

symptoms of Utkleśa of Doṣa were also noted.

By scrutinizing the symptoms of Snigdhatā carefully; it is clear that

they are obtained from following:-

1) Changes in the movement of Vāyu in Koṣṭha.

2) Changes produced in physical orientation like Angalāghava.

3) Changes occurred in consistency and Snigdhatā of Puriṣa.

4) Mental orientation like Glāni, Sāda, Klama.

5) Changes related to lustre and texture of skin.

6) Changes pertaining to Agni.

(1) Changes in the movement of Vāyu in Koṣṭha:-

Vātānulomana i.e. proper evacuation of flatus, faeces and urine.

Vātapratilomatā i.e. Urdhwavātapravṛtti, Udgāra Bāhulya and

Ādhmāna.

Improper evacuation of flatus, faeces and urine.

These symptoms are the result of movements in Koṣṭha. Sneha present

in Anuvāsana Basti; have the cardinal property of Snigdhatā which

acts on the exactly opposite property of Vāta i.e. Rukṣatā.

Vātānulomana is very first symptom quoted by Ācaryas in the list of

Samyak Snigdhatā . Practically also this symptom appeared on very

first day of Anuvāsana Basti in both groups. (Table No.15 ) It was

observed that on 3rd, 4th and 5th day; Vātānulomana was higher in Gr.

B. On 6th and 7th day both groups achieved Vātānulomana. It was

seen that, total 96% in gr. A and 98% patients in gr. B achieved

Vātānulomana ( Table No.7 ) As Vātānulomana is the main symptom

of proper administration of Anuvāsana Basti irrespective of it‟s dose;

in both groups Vātānulomana had been seen predoninently.(8)

Snigdha and Sara Guṇa of Tila Taila help in bringing Vātānulomana.

Tila Taila along with Saindhava lubricates and oliates Puriṣavaha

Srotas so as Pakwāśaya. It helps the fecal matter, urine and flatulance

to pass through with ease. As we know due to Rukṣatā, faecal matter

becomes hard and obstructs Vāta Gati, which in turn produces

Pratiloma Gati of Vāta. If the quantity of Sneha in Anuvāsana Basti is

not sufficient and Rukṣatā remains as it is, Vāta Pratilomatā takes

place with Udgāra, Ādhmāna or improper evacuation. These symptoms

are listed under Asnigdha Lakṣaṇas.(9)

Vātānulomana not only indicates the proper Gati of Vāyu but it

indicates Vāta Nigraha in Koṣṭha which helps Doṣa to move towards

Koṣṭha from Śakha.(3)

(2) Changes produced in physical orientation like Angalāghava:-

Following factors were considered to study this symptom.

Feeling of lightness in the body.

Feeling as usual.

Heaviness in body.

Angalāghava was seen in Gr. A on the 1st day which was observed

increasing on the following days. In Gr. B it was observed from 2nd

day. (Table No.15) Over all in Gr. A, 38% patients and in Gr. B, 30%

patients showed Angalāghava. On the contrary, 40% patients from Gr.

B had Angagaurava may be due to Guru property and large quantity of

Tila Taila administered through Anuvāsana Basti. (Table No.8)

(3) Changes occured in consistency and Snigdhatā to Puriṣa:

Following criterias were considered to check the consistency of Puriṣa.

Asaṃhata Varca.

Mṛdu Varca (Soft stool) without much straining.

Rukṣa Varca with straining.

Due to Snigdha property of Tila Taila; Pakwāśaya and Puriṣa becomes

Snigdha where as due to Sara and Drava properties, Puriṣa gets

loosened.

Asaṃhata Varca is a state of saturation of Sneha in faeces.

Eventhough in both groups Asaṃhata Varca was oberved; in Gr. B it

was seen earlier than Gr. A, i.e. on 3rd day. (Table No15 ) In Gr. A,

total 60% patients and in Gr. B total 92% patients showed the

symptom Asaṃhata Varca.(Table No.9) It indicates that, the saturation

of Sneha in the Puriṣa is more in escalating dose of Anuvāsana Basti.

When Sneha is administered in larger quantity through Anuvāsana

Basti, Śoṣyamaṇa Vanhī present in Pakwāśaya fails to absorb it

completly, hence Asaṃhata Varca and excretion of Sneha through anal

route can be observed. In Gr. A, 40% patients didn‟t show any change

in consistancy and frequency of faeces, but proper defication without

any strain was seen in these patients. It is again the Samyak Lakṣaṇas

of Anuvāsana Basti as the dose given was 120ml constantly.(8)

Vīrya of Anuvāsana Basti is absorbed by Apāna and immediately

taken up by Samāna Vāyu which in tern starts oliating Annavaha

Srotas.(10) Asaṃhata Varca indicates Snehana of Annavaha and

Purishavaha Srotas i.e. Snigdhatā of Koṣṭha in general.

The Rukṣa, Grathita, Śuṣka and Kṛcchra Varcapravāhaṇa is enlisted

under Asnigdha Lakṣaṇas, which denotes the quantity of Sneha given

is too less to overcome the Rukṣatā of Koṣṭha.(9)

In this study, we came across one limitation of observing the symptom

Snigdha Varca. In the process of Snehapāna, after certain period, stool

becomes oily due to saturation of Sneha in Koṣṭha. Whenever

defecation takes place after administration of Anuvāsana Basti of Tila

Taila, patient could not differentiate between oiliness of stool and stool

along with oil.

(4) Changes produced in mental orientation like Klama:-

Tiredness or exhaustion without much exertion.

Reasonably active as usual.

Enthusiastic

These factors were considered to assess Klama.

In Gr. B, Klama was seen on 4th day onwards. Whereas in Gr. A, it was

observed on 6th day. (Table No.15 )

Tiredness or exhaustion without much exertion may occur due to

obstruction in the way of perception of sense organs. This lassitude

develops due to Guru and Manda properties with large quantity of

Sneha and may be observed during digestion of Sneha. Over all 14%

and 56%patients from Gr. A and Gr. B respectively showed the

symptom Klama. Whereas 74% patients in gr. A were enthusiastic

after administration of Anuvāsana Basti in the dose of 120 ml

constantly. (Table No.10) This may happened due to proper excretion

of fecal matter, urine and flatulance and can be considered as Samyak

Anuvāsana Lakṣaṇa.(8a,8b,8c,8d)

(5) Changes related to lustre and texture of skin:-

Following symptoms were studied in this factor.

Proper oiliness of Skin.

Softness of skin.

Dryness of skin.

Interesting observation in the study was that, oiliness of skin was seen

in 68% patients of gr. B and 36% patients of gr. A. (Table No11) In the

present study, Snigdhatā of skin was measured before starting and

after completion the Anuvāsana Basti by Pin Test. The logic behind

that is; as oiliness of skin increases the absorption time of oil will also

increase. Interestingly we observed increased duration of absorption of

oil through skin in both groups. (Table No.12) In Gr. B, may be due to

gradually increasing dose of Tila Taila in Anuvāsana Basti, Twak

Snigdhatā was found significant. (Table No.13) Suśruta supports this

phenomenon by stating that as tree irrigated in its root level attains

branches with leaves, flowers and fruits. [11] In the same way;

Anuvāsana Basti administered into the rectum spreads and performs

significant results up to head to toe in human body. Vīrya (potency) of

Basti spreads all over the body even though it is administered in

rectum. [12] Suśruta further quotes day wise spreading of Basti. On 4th

day Basti reaches up to Rasa Dhātu and on 5th day up to Maṃsa

Dhātu. It indicates that Sneha can reach up to skin within 5 days as

skin is Upadhātu of Maṃsa and Vyaktīsthāna (site of manifestation)

of Rasa.(13) Vīrya of Anuvāsana Basti spreads all over the body through

Apāna, Samāna, Vyāna, Prāṇa and Udāna.(10) Hence Twak Snigdhatā

can be observed after administration of Anuvāsana Basti.

According to Sāmānya- Viśeṣa Siddhānta, Snigdha, Picchila and Mṛdu

properties of Tila Taila, enhances the same qualities in the body hence

Twak Snigdhatā and Mārdava can be seen.(14) Twak Prasadakara is a

quality of Tila Taila which is again one of the cause of Twak

Snigdhatā.(15)

In this study, Twak Snigdhatā was observed from 6th day in Gr. A

(Table No.15) and from 5th day in Gr. B. In Gr. A, 54% patients had

Rukṣa Twak which were observed unchanged after administration of

Anuvāsana Basti in constant dose of 120ml. It indicates the

significance of dose of Anuvāsana Basti in attaining Twak Snigdhatā .

(Table No.11)

(6) Changes pertaining to Agni:-

Agnidiptī is the symptom enlisted in the symptoms of Samyak

Snigdhatā . After proper Anulomana of Apāna Vāyu and Samāna Vāyu

Pacaka Pitta works properly. Even though Sneha is Āpa Mahābhuta

Pradhāna; it works as a fuel especially when the dose is low. But when

it is administerd in a larger quantity as a preparatory procedure for

Śodhana; Kṣudhāmandya is observed upto digestion of Sneha. In this

study we face some difficulties in assessing Agnidiptī; as Snehapāna is

done in empty stomach and Anuvāsana has to be given after having

food. In Snehapāna process Agni digests the Sneha only but in this

study Agni has to digest not only Sneha but food also. Hence

observation of Agnidīpti was the limitation of our study. Some

patients showed the symtom Kṣudhāmāndya from 4th – 5th day of

Anuvāsana Basti in Gr. B as dose of Anuvāsana increased. But no one

complaind Avipāka, Bhaktadweṣa or Aruci which can be considered as

symptoms of Asnigdha.

(7) Symptoms of Utkleśa:

In Gr. B, few patients showed Urdhvaga Utkleśa with symptoms like

Hṛllās, Kanthopalepa, Śirogaurava. To our surprise, two patients were

observed with Netra Mala Vṛddhi. This shows that effect of Basti is not

restricted to ano-rectal region locally. In this context, Chakrapāṇi

states that Basti reaches up to duodenum. (16) This statement is

supported by Best and Taylor who states “materials introduced by

enema, may in some instances pass through the valve into the ileum.

Such incompetence may permit the enema fluid to reach the

duodenum.”[17] However, considering the symptoms observed in our

study, we may infer that the effect of Basti can be seen even beyond

duodenum. It should be however noted that the extent of vitiated

Doṣa, season and other elements in the body also play the major role

in the process of Utkleśa. According to Caraka, Utkleśa of Doṣa and

Agnivadha are manifested if Anuvāsana Basti is administered

continuously.(18) Here Anuvāsana Basti was administered not only for

many days but also in escalating dose. Due to administration of oil in

large quantity, Utkleśa of Doṣa may take place. But in this study, both

groups were administered Anuvāsana Basti maximum for seven days

which is indicated as the limit of Ābhyantara Snehapāna.(19) Hence the

symptom Agnivadha may not be observed in this study.

Role of Agni in Snehana Karma through Anuvāsana Basti:

Even though Basti is administered in rectum, the Jāṭharāgni must be

in it‟s normal state. Absorption of Basti in Pakwāśaya is possible only

when Jāṭharāgni is in it‟s normal state and so as Dhātvāgni and

Bhutāgni. Digestion, absorption and assimilation of Sneha present in

Anuvāsana Basti is possible when these Agnis are in their proper

working capacity.

As observed in this study, in Gr. A, where the dose of Anuvāsana Basti

was constant, days required to achieve Samyak Snigdhatā are more

for Mandāgni and Viṣamāgni than Tikṣṇāgni. It underlines the

importance of pattern of Agni in absorption of Basti.(Table No.28) But

in gr. B, where the dose was escalating; 1 patient of Mandāgni showed

symptom of Snigdhatā earlier than other two Agni. This may

happened due to other factors like Koṣṭha and Prakṛti.

Agni plays major roll in absorption of Sneha in Anuvāsana Basti. As

Śoṣyamaṇa Karma is expected in Pakwāśaya, the proper working

capacity of Jāṭharāgni should be present.(20) Hence discrimination of

all symptoms of Samyak Snigdhatā were present in both groups

irrespective of their type. As in Gr. B, dose was escalating, Śoṣaṇa of

Sneha decreases and hence the symptom Asaṃhata Varca was

observed more in all types of Agni than in Gr. A.(Table No. 25) No

specific observations were found according to the grades of symptoms

of Samyak Snigdhatā. (Table No.29)

Roll of Koṣṭha in Snehana Karma through Anuvāsana Basti:

Types of Koṣṭha are dependent upon the dominance of properties of

Doṣa present in the Koṣṭha which are responsible for the tendency of a

person to pass stool.

The data shows that, in Gr.A, i.e. in constant dose, Snigdhatā

Lakṣaṇas appeared on 6th day of Anuvāsana in the patients of Mṛdu

Koṣṭha where as for Madhyama and Krura Koṣṭha, symptoms appeared

on 7th day. (Table No. 35)

In Gr. B, i.e. in escalating dose, 14% patients with Mṛdu Koṣṭha

showed symptoms of Snigdhatā on 4th day, 42.85% on 5th day, 28% on

6th day and 14% on last day. Patients having Madhyama Koṣṭha also

started showing symptoms of Snigdhatā earlier i.e. on 5th and 6th

day. Patients of Krura Koṣṭha showed Snigdhatā on 6th day

onwards.(Table No. 35) Surprisingly the data shows that the duration

required for achieving symptoms of proper Snehana after

administration of Anuvāsana Basti was similar to the textual reference

of Snehapāna. [21]

Even Pravara grade of Snigdhatā was achieved maximum i.e. in 85%

of patients with Mṛdu Koṣṭha in Gr. B and 18% in Gr. A (Table No.36)

Mṛdu Koṣṭha has a dominance of Pitta with Sara and Snigdha

properties. It may be the cause that Vātānulomana, Asaṃhata Varca

appeared earlier in the patients of Mrudu Koṣṭha. (Tabla No. 15) While

describing indications of Vicaraṇā Sneha, Caraka has maintioned

patients having Mṛdu Koṣṭha.(22) In this study the same results were

obtained.

Roll of Prakṛti in Snehana Karma through Anuvāsana Basti:

As Agni and Koṣṭha are two major components in defining Prakṛti, no

specific relationship was found between Prakṛti and symptoms of

Samyak Snigdhatā. (Table No. 16-22) Discrimination of all three Doṣas

is present in each, but dominating Doṣas are considered to define the

Prakṛti. This may be the cause that we could not relate Prakṛti with

symptoms of Samyak Snigdhatā.

Roll of Dhāraṇa Kāla in Snehana Karma through Anuvāsana Basti:

Dhāraṇa Kāla of Anuvāsana Basti and symptoms of Samyak Snigdhatā

were correlated. In both groups it was observed that as Dāraṇa Kāla

increases, grades of Samyak Snigdhatā also get increased. (TableNo.

39) Suśruta clearly mentions that, if Anuvāsana Basti doesn‟t retain

inside the rectum; then it is unable to provide proper Snigdhatā to

Pakwāśaya and may not avail expected results.(23) In Gr.B, Dhāraṇa

Kāla of Anuvāsana Basti was found more than that of Gr.A. This may

be the reason that, Pravara Snigdhatā was found more in that group.

Śuddhi of Virecana and Vamana after administration of

Anuvāsana Basti as an alternative for Snehapāna prior to Virecana

and Vamana:

In both groups Kaphānta Virecanas were observed. But more patients

were found in Gr.B having Kaphānta Virecana. In group A, patients

had Dravānta Virecana more than Kaphānta or Pittānta. In Gr. B more

patients were found having Virecana Vega between 11-20 i.e.

Madhyama Śuddhī. Hence by considering Āntikī and Vaigikī Śuddhī, it

is clear that, Asnigdha or Avara Snigdhatā cause improper Śuddhī of

Virecana.(24,25) (Table No.42)

For Vamana also same phenomenon was observed. (Table No.43)

Āntikī and Vaigikī Śuddhī were seen more in Gr. B may be due to

achievement of Samyak Snigdhatā. Proper Snigdhatā of the body,

cause Koṣṭhagati of Doṣa which in turn causes proper expulsion of

Doṣa without having Vātaprakopa.

In the present study also; very positive results were obtained in terms

of Vaigikī, Mānikī and Laingikī Śuddhi especially in Gr. B. Laingikī

Śuddhī was observed in both groups with relief obtained immediate

after Śodhana procedure and relief obtained in the symtoms of the

disease. Śarīra Lāghava, Indriya-Mana Prasannatā, Kṣudha Vṛddhī etc.

were found as immediate symptoms of Samyak Śodhana in both

groups. Maximum relief was found more in the diseases with

Bahudoṣāvasthā and Utklīṣṭa Doṣāvasthā for eg. In Vicarcikā; Kandu

and Srāva were discreased. Patients with Sthaulya, lost their weight

from 1 to 4 kg. Patients having Samprāpti related to Apāna Kṣetra, eg.

Vibandha, Urdhvaga Āmlapitta due to Vibandha, PCOD, Aniyamīta

Rajapravartana, Kaṣtārtava etc. had very good results irrespective of

way of Śodhana i.e. Vamana or Virecana and dose of Anuvāsana Basti.

As in the present study all diseases indicated for Vamana or Virecana

were included and allocated randomly in both groups; no significant

comparison was done in terms of results.

Biochemical Parameters like Serum Cholesterol, Serum Triglycerides

and Serum total Protein were observed. No significant changes in

these parameters were found in both groups. (Table No.41) As Basti

gets absorbs directly in systemic circulation and has portal bypass;

observations of these parameters were very important.

In the present study, a concept of Snehana Karma through Anuvāsana

Basti is put forth on the basis of Yuktī Pramāṇa. Even though

digestion of Sneha taken orally and through anal route is different,

Samyak Snigdhatā Lakṣanas were assessed here after administration

of Anuvāsana Basti. Surprisingly 58% patients who were administered

Anuvāsana Basti in increasing dose showed Pravara Snigdhatā. It

indicates the absorption of Sneha through anus. On the basis of

clinical study, the concept of Anuvāsana Basti as an alternative to

Snehapāna is seemed to be proved.

Even though all Ācaryas affirm the importance of Acchapāna; this

attempt has been made for those patients who may deprive the

benefits of Śodhana procedures; only because of aversion of

Snehapana. Hence considering some limitations and further scope

regarding this alternative; we have tried utmost.

II. FURTHER SCOPE OF THE STUDY

Study can be done with various Siddha Taila or Ghṛta according

to Vyādhīs.

Various doses of Anuvāsana Basti can be studied.

Study can be carried out with specific variable like Koṣṭha.

Study can be done according to proper Kāla for Śodhana, i.e. in

Vasanta Rṛtu- Vamana.

Study can be done with specific Siddha Sneha in specific

disease by keeping the variables identical like Ṛtu, Koṣṭha, Agni

etc.

Study can be done with bio- markers.

III. REFERENCES

1. snaohsvaodpcailata rsaO : isnagQaO$dIirta : I

daoYaa : kaoYzgata jantao : sauKa ht-uM ivaSaaoQanaO : I I sau.ica. 33/47

2. snaohnaM snaoh ivaYyandM maad-vaM @laodkarkma\ I ca.saU. 22/11

isnagQaat\ pa~ayaqaa taoyamaya%naona pNaudyato I

3. vaRdQyaa ivaYyaMdnaat\ pakat\ sa`aotaomauKivaSaaoQanaat\

SaaKaM %ya@%vaa malaa : kaoYzM yaaint vaayaaoSca inagahat\ I vaa.saU. 13/11

4. isnagQaat\ pa~aVqaataoyamaya%naona p`NauVto I

kfadya : pNaudyanto isnagQaa_oha<aqaaOYaQaO : I I ca.isa. 6/11

5.Aad`-M kaYzM yaqaa vai*naiva-Yyandyait sava-t : I

yaqaa isnagQasya vaO daoYaana\ svaodao ivaYyandyaot\ isqarana\ I I

i@laYTM vaasaao yaqaao%@laoSya mala : saMSaaoQyato | mBasaa I

snaohsvaodOstqaao%@laoSya SaaoQyato SaaoQanaOma-la : I I ca.isa. 6/12 – 13

6.t~ baa*ya : snaohsvaodaBya=gapirYaokaopnaahiSaraobaistnasyaaid : AaByantrstu

snaohpanaanauvaasanaina$haid : l sau. ].26/2,3 DlhNa

7. vaatanaulaaomyaM idPtao|ignava-ca-O: isnagQamasaMhtma\ l

maad-vaM isnagQata caaMgao isnagQaanaamaupjaayato l l ca.saU.13 / 57

8a.p`%yao%yasa@tM saSakRcca tOlaM

r@taidbauwIind`ya saMp`saad: l

svaPnaanauvaRi<ala-Gauta balaM ca

saRYTaSca vaogaa: svanauvaaisato syau: l l ca.isa.1/44

8b. saainala: sapuirYaSca snaoh: p`%yaoit yasya tu l

AaoYacaaoYaaO ivanaa SaIGa`M sa samyaganauvaaisat: I I sau.ica. 37/67

8c.ikMica%kalaM isqatao yaSca sapurIYaao inavat-to l

saa|naulaaomaa|inala: snaohsti%sawmanauvaasanama\ I I A.).saU. 19/42

8d.AignadIiPtva-ya: sqaanaM puiYTvaNaao- QaRitba-lama\

vaatanaulaaomata Saaint : svanauvaaisatlaxaNama\ I I ka.saM. 2

9. puirYaM gaiqatM $xaM vaayaurp`gauNaao maRdu: l

p@ta Kr%vaM raOxyaM ca gaa~syaaisnagQa laxaNama\ l l ca.saU.13 / 59

10. ya<a~aOYaQa vaIya-M ih tdpanaona vaayaunaa l

Payaa-Ptmaicaradova samaana : pitpVto l l

samaanaadU<arM caOvaM vyaanaaVa : pvanaakmaat\ l

to tRPta : pkRitM yaaint SarIranaugaho isqata : l l A.).isa. 5

11. p@vaaSayaad\baistvaIya-M KOdo-hmanausaip-it l

vaRxamaUlao inaiYa@tanaamapaM vaIya-imava dumama\ l l sau.ica. 35/25

12. naaiBapdoSaM kiTpaSva-kuixaM l

ga%vaa SakRd\daoYacayaM ivalaaoDya l

saMsnao( kayaM sapuirYadaoYa: l

samyak\ sauKonaOit ca ya: sa baist: l ca.isa. 1/40

13. d<astu p`qamaao baist: snaohyaod\baistva=xaNaaO

samyagdtaO iWtIyastu maUQa-sqamainalaM jayaot\

janayaod\balavaNaaO- ca tRtIyastu p`yaaoijat:

rsaM catuqaao- r@tM tu pMcama: snaohyao<aqaa

YaYzstu snaohyaonmaaMsaM maod: saPtma eva ca

AYTmaao navamaScaaisqa majjaanaM ca yaqaak`mama\

evaM Sauk`gatana\ daoYaana\ iWgauNa: saaQau saaQayaot\ l l sau.ica. 37 /71-74

14. vaRiw : samaanaO : savao-YaaM ivaprItOiva-pya-ya : l l A.).sau. 1/13

15. maa$tGnaM na ca SlaoYmavaw-naM balavaQa-nama\ I

%vacyamauYNaM isqarkrM tOlaM yaaoinaivaSaaoQanama\ I I ca.saU. 13 /15

16. vaamaaEayao ih ga`hNaIgaudo ca

tt\ paSva-saMsqasya sau#aaoplaibQa : l l

laIyant evaM valayaSca tsmaat\

savyaM Sayaanaao |h-it baistdanama\ l ca.isa.3 /24

17. Aayauvao-idya pMcakma- iva&ana ksturo hirdasa EaI baOd\yanaaqa Aayauvao-d Bavana p`ayavaoT

ila. saPtma saMskrNa pRYz k`. 469

18. snaohbaistM ina$hM vaa naOkmaovaaitSaIlayaot\ l

snaohadignavaQaa%@laoSaaO ina$hat\ pvanaad\Bayama\ l l sau.ica. 37/77

19. snaohsya p`kYaaO- tu saPtra~ai~ra~kaO

ekamuau<amaa poyaa Hyahmaova tu maQyamaa l l ca.saU.13 / 51

20. p@vaaSayaM tu p`aPtsya SaaoYyamaaNasya vainhnaa l ca.ica.15 /11

p@vaaSayaM tu p`aPtsyaoit mala$ptyaa p@vaaSayaM gatsya l SaaoYyamaaNasya vainhnaoit

yaVPyaUQva-dahxamaao vai*na : , tqaa | PyasyaaQaaogatsya vai*nana SaaoYyamaaNa%vaM

p@vaaSayagatsyaaPyauppnnama\ l yatScaaQaaogamanao samyagvai*navyaaparao naaist At :

‘ pcyamaanasya ’ [it pdM pir%yajya ‘ SaaoYyamaaNasya ’ [it kRtma\ l ca.ica.15 /11

21. maRdukaoYzis~ra~oNa isna*ya%yacCaopsaovayaa l

isna*yait kUrkaoYzstu saPtra~oNa maanava : l l ca.saU.13 / 65

22. snaohiWYa: snaohina%yaa maRdukaoYzaSca yao nara: l

@laoYaasaha maVina%yaastoYaaimaYTa ivacaarNaa l l ca.saU. 13 /82

23. yasyaoh yaamaananauvat-to ~Ina\

snaohao nar: syaat\ sa ivaSauw doh: l

AaSvaagato|nyaostu punaiva-Qaoya:

snaohao na saMsnaoh yait *yaitYzna\ l l ca.isa.1/46

24. AisnagQa isvanna dohsya$xasyaanavamaaOYaQama\ daoYaanaui%@laSya inah-tu-M ASa@tM

janayaoMdgadana\ l l ca.isa.6/38

25. AisnagQaisvannaonaalpgauNaM vaa BaoYajamaupyau@tM Alpana\ daoYaana\ hint l sau.ica. 34/7

CONCLUSION

Symptoms of Samyak Snigdhatā can be achieved after

administration of Anuvāsana Basti.

They can be developed better especially after administration of

escalating dose of Anuvāsana Basti.

Anuvāsana Basti in escalating dose can definitely be used as an

alternative for Snehapāna prior to Śodhana, i.e. Vamana and

Virecana.

Patients with Mṛdu Koṣṭha required minimum dose and duration for

getting symptoms of Samyak Snigdhatā, Madhyama Koṣṭha required

medium dose and duration, where as Krura Koṣṭha required

maximum dose and duration for getting Samyak Snigdhatā if dose

of Anuvāsana Basti is kept increasing.

Śuddhi Lakṣaṇas of Vamana and Virecana in terms of Vaigiki, Āntiki

and Laingiki were very promising. Madhyama to Uttama Śuddhi of

Vamana and Virecana can be observed, if Anuvāsana Basti is

administered in escalating dose.

SUMMARY

Anuvāsana Basti, Snehapāna and Rectal drug delivery described in

moderm medicine were studied at the length.

On the basis of the study; hypothetically it was confirmed that,

Anuvāsana Basti can be administered as an alternative for

Snehapāna in Vamana and Virecana as it is considered as internal

route of drug administration.

As Anuvāsana Basti was compaired with Snehapāna; maximum

duration for administration of Anuvāsana Basti was kept 7 days.

As no references were found regarding the concern topic; two groups

were made on the basis of dosage form: A group with constant dose

of Anuvāsana Basti of Mūrcchita Tila Taila (120ml) and Saindhava

(500mg) considered as control grop. B group with escalating dose.

Concept of escalating dose of Anuvāsana Basti was adopted as the

dose of Snehapāna used for Śodhana also gets increased. Hrasīyasī

Mātrā of Snehapāna is 25 to 30ml. By considering the same dose,

we decided to increase the dose of Anuvāsana Basti by 25ml daily.

As the dose of Saindhava is not mentioned in texts, 500mg dose was

decided on the 1st day with increase of 100mg daily for minimum 3

and maximum 7 days.

Symtoms of Samyak Snigdhatā except Agnidīpti and Snigdha Varca

were observed and statistically analysed. 58% patients of Gr. B had

Pravara Snigdhatā.

Samyak Śuddhi Lakṣaṇas of Vamana and Virecana were also

observed. These observations were discussed in detailed.

On the basis of conceptual study, observations, results and

discussion; conclusions were drawn.

The hypothesis which was drawn from a conceptual study i.e.

Anuvāsana Basti with Murcchita Tila Taila and Saindhava can be

used as an alternative for Snehapāna in Vamana and Virecana is

seemed to be proved as said by Dalhaṇa, especially in escalating

dose of Anuvāsana Basti.

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B.V.M.F.‟s BHARATI AYURVED HOSPITAL

PUNE 43

Case paper for the research project

“Study of Anuvāsana Basti as an alternative Purvakarm for

Snehapan in Vaman and Virechan.”

Scholar: Dr. Priyadarshani Kadus. Guide: Dr. S.M. Vedpathak

Name:- Date:-

Age:- Gender:-M/F.

Address:- Wt.:-

Occupation:- Religion:-

OPD No:- IPD No:-

Vedana Vishesh:-

Purvavrutta:-

Kulavrutta:-

Samanya Parikshana:-

Nadi:-

Mala Pravrutti:-

Mutra Pravrutti:-

Jivha:-

Shabda:-

Sparsha:-

Druk:-

Akruti:-

B.P.

Menstrual History:-

Obstetrical History :-

Pakruti Parikshan:-

Sara:-

Samhanana:-

Satva:-

Satmya:-

Bala:-

Koshtha Parikshan:-

Agni Parikshan:-

Vikrut Srotas Parikshan:-

Dosh:-

Dushya:-

Srotas:-

Vyadhimarga:-

Vyadhi Avastha:-

Nidan:-

Chikitsa:- Vaman / Virechan

Purvakama:- Anuvāsana Basti. Gp.A / Gp.B

Assessment Criteria:-

Criteria 1st

day

2nd

day

3rd

day

4th

day

5th

day

6th

day

7th

Day

Vata nuloman

Angalagha

v

Asamhat varcha

Klama

Snigdha

tvak

Overall

assessmen

t

Other symptoms

Other Assessment Criteria:

Blood Test B.T. A.T.

Sr. Cholesterol

Triglycerides

Total Proteins

Signature of Student:

Dr. Priyadarshani Kadus

Signature of Guide:

Dr. S.M. Vedpathak

MD, Ph.D, MBA (HR)

Prakṛti, Koṣṭha and Agni were assessed by asking following

questionnaire.

Prakṛti Parīkśana:

No. Test Vata Pitta Kapha

1 Body figure Short stature,

Thin

Medium

features like child

Large,

properly nourished

2 Skin colour Blackish

dry

cracked/rough

Moles more,

Raised body

temp. Reddish colour early

wrinkling.

Oily, fair, low

body temp.

thick skin

3 Sweating Scanty Profuse foul odour

Moderate

4 Hair Dry

split ends

lustreless less in quantity:

ash/ blackish

Soft

less in

quantity. brownish early

graying early

balding

Thick, black,

oily, strong

5 Eyes Unstable

dull &

lusterless round in

shape

dry, blackish/

ash, small half open

during sleep,

scanty eyelashes

Small

brownish

reddish sclera liking for cold

get red in

anger/sun/

alcohol. Less eye lashes

Large size

moist eyes

clearly defined white/black

more and long

eyelashes

6 Appetite/Thirst

Uncertain frequency of

meals is more

irregular

digestion

Excessive/ intolerable

eats more

drinks more

water frequently

good digestion

Less hunger tolerable

less thirst

strong even

without eating slow digestion

7 Liking/ Sweet

sour

salty and oily hot

Sweet

bitter

astringent taste

cold

Spicy

bitter

astringent hot, dry

8 Disliking/ Cold Hot Cold

Intolerance dryness

cold related illness

humid

frequent mouth ulcers

humid

ill occasionally

9 Sleep Disturbed

less

Good sleep

moderate (6-8

hrs.)

Deep sleep

more than 8

hrs.

10 Speech Talkative

irrelevant

Well thought

speech

impressive good at

argument

Reserved but

well thought

11 Movements Quick and

unsteady movement

Fast and

steady movement

Slow and

steady movement

12 Nature Unstable

tends to dislike things

likes

wondering,

quarrelling, art and

culture loving,

extravagant

Fearless

less, tolerance,

praise loving,

arrogant,

liking for fragrance,

new jewellery,

clothes clever and

cunning

adventure loving

Brave but not

adventurous, forgiving,

philosophical,

more

tolerance, calm and

stable,

thoughtful, liking for

indoor games,

money saving

13 Anger Quick,

unstable

Fast and

stable

Less anger

14 Decision

making

Indecisive

unpredictable

Fast and

calculated

Slow and

measured

15 Intelligence Quick grasping

weak memory

Quick grasping,

moderate

memory,

moderate knowledge

Slow grasping, don‟t forget

easily,

strong memory

Koṣṭha Parikṣaṇa:-

Mṛdu Koṣṭha Madhyama Koṣṭha Krura Koṣṭha

Passes stools daily

once or twice

regularly

Passes stools daily

once

Doesn‟t pass stool

regularly

Semi formed or

formed stools

Formed stools Kathiṇa or Śuṣka

Mala Pravṛtti/ tight

stools

Easy defecation Requires minimum

stress

Requires straining

Less time required

for defecation

Little long time for

defecation

Requires long time

for defecation

Previous encounters

shows often Drava

Mala Pravṛtti due to

hot drinks, tea, milk,

Uṣṇa, Guru Dravyas

Doesn‟t often

encounter diarrhoea

or constipation.

Unsatisfactory bowel

clearance

Minor laxatives often

encounter diarrhoea

Requires medium

dose of purgatives

and laxatives. Doesn‟t

purgatives by not milk

or minor laxatives.

Seldom encounters

diarrhoea and more

frequently

constipation.

Gandharva Harītakī

in the dose of 5 gms

before bed time: 2-3

semisolid Malavegas

Gandharva Harītakī

in the dose of 5 gms

before bed time: 1-2

soft and clear

Malavegas

Gandharva Harītakī

in the dose of 5 gms

before bed time: no

change in Malavegas

Assessment of Agni:

As Agni is assessed by evaluating Jaraṇa Śaktī, Abhyavaharaṇa Śaktī

and Ruci; questions were asked to the patients and pattern of Agni

was decided.

To evaluation of Jaraṇa Śaktī (capacity to digest) questions were asked

to the patient regarding Jīrṇa Āhar Lakṣaṇa like 1.Utsāha 2. Laghutā

3. Udgāra Śuddhi 4. Kṣudha Tṛṣṇā Pravṛtti 5. Yathocita Malotsarga

To assess Abhyavaharaṇa Śakti (capacity to eat) quantity and

frequency of intake of food per day were asked to the patient.

B.V.M.F.‟s BHARATI AYURVED HOSPITAL

PUNE 43

INFORMED CONSENT

I, Mr./ Mrs./ Miss ………………………………………………age……..yrs.

hereby give my consent to undergo examination and subsequent

treatment in the project “Study of Anuvāsana Basti as an

alternative Purvakarm for Snehapan in Vaman and Virechan.”

Undertaken by Dr. Priyadarshani Kadus.

The project has been explained to me and I have fully understood it. I

give my consent to participate in the project as volunteer in complete

consciousness and without being under any pressure.

Date: sign/ thumb

saMmatIp~

maI KalaIla sahI krNaar EaI. / saaO

........…………………………………………………………..................vaya………

vaYao- ilahUna doto dotao kI, Da. ip`yadSa-naI kDUsa yaaMcyaa Aayauvao -d vaairQaI AByaasak`maaMtga-t

AnausaMQaana p`baMQaamaQyao ‚Anauvaasana baistcaa vamana ivarocanaacyaa pUva -kmaa-maQyao snaohpanaaeovajaI

]pyaaoga‛ yaa AByaasaasaazI icaik%saa krNaosa maaJaI puNa - tyaarI Aaho. yaa saMSaaoQana

p`klpamaQyao svat:hUna sahBaagaI haot AsaUna maaJaI tpasaNaI AaiNa ]pcaar krNyaasa

prvaanagaI dot Aaho.

Anauvaasana baist dotovaoLI ikMvaa kolyaanaMtr haoNaayaa pirNaamaaMcaI malaa Da@TraMnaI pUNa-

klpnaa idlaI Aaho AaiNa %yaasaaZI maaJaI tyaarI Aaho. kaoNa%yaahI AimaYaalaa ikMvaa

dDpNaalaa baLI na pDta malaa saMSaaoQana p`klpat saaimala k$na GaoNyaasa prvaanagaI dot

Aaho.

idnaaMk : sahI / AMgaza