Charaka Siddhisthana Chapter 5 - Netrabasti Vyapat Siddhi

This article explains the 5th chapter of siddhisthana of Charaka samhita called 'Netrabasti vyapat Siddhi Adhyaya'. In this chapter, complications arising out of defective nozzle (basti netra), receptacle (Basti Putaka) and administration method along with their treatments are explained.

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??? ? ????? ????????????||?||
athato netrabastivyapatsiddhim vyakhyasyamah||1||
iti ha smaha bhagavanatreyah||2||

We shall now explore the chapter on "Complications Arising out of the Use of a defective nozzle, and its receptacle (including the Technique of Administration) and their Successful Treatment". Thus said Lord Atreya [1-2]

Table of Contents

Topics discussed

?? ???????? ????????? ???? ????????? ??????| ????????????????????? ??????? ????????????||?||
atha netrani bastimsca srnu varjyani karmasu| netrasyajnapranitasya vyapadah sacikitsitah||3||

Now listen to the description of the following topics:
Types of nnozzles (Netras) and their receptacles (basti) which are not to be used for the administration of enem
Complications arising out of their use
Complications arising out of the mishandling of the nozzles (including enema receptacle) by an inexperienced physician; and
Treatment of these complications [3]
Read: Basti Chikitsa: Benefits, Routes, Types, Indications, Equipment

Inappropriate nozzles, their complications

??????? ?????? ??? ?????? ?????? ????????????| ??????????????? ??? ????????? ???????? ????????||?||
????????????????????????????????????| ??????? ??????????? ????? ???? ?????????||?||
hrasvam dirgham tanu sthulam jirnam sithilabandhanam| parsvacchidram tatha vakramastau netrani varjayet||4||
apraptyatigatiksobhakarsanaksananasravah| gudapida gatirjihma tesam dosa yathakramam||5||

The eight types of nozzles (Netras) which are not to be used for the administration of enema, and complications arising out of their use are as follows:

Characteristics of Nozzles, & Complications Arising out of their use:

Hrasva (smaller in size) Aprapti (enema-fluid not reaching its destination)
Dirgha (longer in size) Atigati (enema- fluid penetrating far above)
Tanu (thinner in shape) Ksobha (irritation caused by the instability of the nozzle in the rectum)
Sthula (thicker in shape) Karsana (burning the wall of the rectum)
Jirna (worn out) Ksanana (causing injury to the rectum)
Sithila bandhana (loose fixation) Srava (leaking out of the enema- fluid)
Parsva chidra (having holes in the side) Guda-Pida (causing pain in the rectum)
Vakra (curved) Jihma-gati (tortuous passage of the fluid) [4-5]
Inappropriate Bastis and Complications arising out of their Use

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visamamamsalacchinnasthulajalikavatalah|snigdhah klinnasca tanastau bastin karmasu varjayet||6||
gativaisamyavisratvasravadaurgrahyanisravah|phenilacyutyadharyatvam basteh syurbastidosatah||7||

The types of Bastis (bladders used as receptacles) which are not to be the administration of enema, and the complications arising out of their use are as follows:

Characteristic of Bladder Complications arising out of their use
Visama (irregular in shape) Gati- Vaisamya (irregular flow of enema-fluid)
Mamsala (fleshy)
Visratva (making the enema-fluid smell fleshy)
Chinna (torn)
Srava (leaking of the fluid)
Sthula (thick)
Daurgrahya (difficulty in handling)
Jalika (network of small perforations)
Nisrava (exudation of enema fluid from the receptacle)
Vatala (having air bubbles inside)
Phenila (frothiness of fluid)
Ati-snigdha (excessively unctuous)
Cyuti (slipping away off the receptacle)
Klinna (Putrefied)
Adharyatva (inability to hold the receptacle) [6-7]
Read: Niruha Basti (Kashaya Basti) Panchakarma Method, Uses, Side Effects

Defective Techniques Employed by Physicians

????????????????????????????????????????????| ???????????????????????? ?????????||?||
savatatidrutotksiptatiryagulluptakampitah| atibahyagamandativegadosah pranetrtah||8||

The defective techniques employed by the (ignorant) physician for administering Basti are as follows:

Sa-vata - pushing the enema fluid along with air
Ati druta - (pushing the enema-fluid too rapidly
Utksipta - injecting the enema-fluid too high
Tiryak - injecting the enema-fluid obliquely
Ullupta - pushing the enema-fluid again after interruption)
Kampita - shaking the nozzle while injecting the enema-fluid
Atiga - excessive insertion of the nozzle
Bahyaga - wrong pushing so that instead of entering the anal canal, the enema-fluid flows outside and
Manda vega - compressing the receptacle too slowly so that the enema-fluid does not reach the colon
Ati vega - compressing the receptacle too forcibly as a result of which the enema fluid rapidly enters and reaches the distant part of the alimentary canal [8]

Complications arising out of anucchvasa etc., their treatment

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???????????? ???? ?????? ??????????????? ?|??|
anucchvasya ca baddhe va datte nihsesa eva va| pravisya kupito vayuh sulatodakaro bhavet||9||
tatrabhyango gude svedo vataghnanyasanani ca|10|

If the enema receptacle is tied to the nozzle without taking out the air from the bladder, or if the entire amount of fluid is rushed into the rectum without leaving any residue in the bladder (basti), then the Vayu (air) entering into the rectum causes colic pain and piercing pain.

In such a condition, massage and fomentation should be given over the anus, and the patient should be given Vayu- alleviating food. [9 1/2 10]

Complications Arising out of Rapid insertion of Nozzle

?????? ??????? ?????????? ????????????? ?? ??||??|| ?????? ??????????????????????????????????? |
????? ???? ??????? ??????? ??????? ???????||??||
drutam pranite niskrste sahasotksipta eva va||10|| syat katigudajanghartibastistambhoruvedanah |
bhojanam tatra vataghnam snehah svedah sabastayah||11||

If the Basti Netra is inserted rapidly, if it is taken out hurriedly, and if it is pushed very high, then there will be pain in the lumbar region, anus and calf region; stiffness of the bladder, and pain in the thigh. In such cases, the patient should be given Vata alleviating food, oleation, fomentation and enema therapy. [1/ 2 10- 11]
Read: Anuvasana Basti: Method, Benefits, Mode Of Action, Contra Indications

Complications caused by oblique insertion of nozzle

????????????????????? ????? ????? ? ??????| ?????? ????? ????????? ??????? ? ??????????||??||
tiryagvalyavrtadvare baddhe va'pi na gacchati| netre tadrju niskrsya samsodhya ca pravesayet||12||

If the Basti Netra is inserted obliquely, if the passage is obstructed by the anal sphincters, and if there is blockage because of the (fibres in the) recipe itself, then the fluid will not flow into the rectum.

In this case, the Basti Netra should be taken out, (the passage of the nozzle should be) cleaned, and the nozzle should be inserted again straight. [12]

Complications arising from Interrupted administration of Basti

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?????? ?????????? ???????????????????????????|
pidyamane'ntara mukte gude pratihato'nilah| urahsirortimurvosca sadanam janayedbali||13||
bastih syattatra bilvadiphalasyamadimutravan|

If the enema receptacle is compressed again after an interruption, then the aggravated vayu being obstructed in the rectum causes pain in the chest, head, and prostration of the thighs.

In such conditions, the recipe prepared of Bilvadi (Dashamula), Phaladi and Shyamadi groups of drugs mixed with cow's urine should be given as enema. [13 - 1/2 14]
Read:

Complication caused by shaking of Nozzle

?????????? ????? ???? ??????????? ????||??|| ?????????? ????? ?????????? ???????|??|
syaddaho davathuh sophah kampanabhihate gude||14|| kasayamadhurah sitah sekastatra sabastayah|15|

If the anus gets injured because of the shaking of the nozzle, then there will be burning sensation, sneezing and oedema. In such conditions, the patient should be given astringent, sweet and cold effusion along with enema. [14 1/2 - 1/2 15]

Complications caused by excessive penetration of nozzle

???????????????? ??????? ????????????||??|| ?????? ?????? ????????????????????????????|
???? ?????? ????? ?????? ?????????????? ??????||??||
atimatrapranitena netrena ksananadvaleh||15|| syat sarti dahanistodagudavarcahpravartanam|
tatra sarpih picuh ksiram picchabastisca sasyate||16||

If the nozzle is excessively penetrated (or inserted repeatedly), then it causes injury to the anal sphincters leading to pain, burning sensation, pricking pain, prolapsed of the anus and discharge of faecal matter.

In such conditions, Sarpi-pichu (pack of ghee- soaked cotton- pad) should be applied over the anus. Milk and Piccha Basti (mucilaginous enema) are useful in this condition. [15 1/2 - 16]

Effects of slow enema

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na bhavayati mandastu bahyastvasu nivartate| snehastatra punah samyak praneyah siddhimicchata||17||

If the receptacle is inadequately compressed then the enema fluid does not reach its destination, and comes out quickly. In such a condition, Anuvasana- Basti should be administered appropriately again by the physician desirous of success of treatment. [17]
Read: Bala Varna Krit Basti: Enemas For Strength, Skin Glow, Weight

Effects of forceful administration of Basti, and their treatment

???????????? ?????? ????????????? ?? ????| ???? ??????????????? ???????? ???? ?||??||
atiprapiditah kosthe tisthatyayati va galam| tatra bastirvirekasca galapidadi karma ca||18||

If the enema-fluid is injected with excess force, then the fluid is either retained in the gastro-intestinal tract, or stomach goes up to reach the throat.

In such case, the patient should be given enema and purgation (if the fluid gets retained in the alimentary tract) or Gala-Pida (application of pressure on the throat) etc. (if the fluid tends to come up from the throat) [18]

???? ??????- ???????????????????? ?????????? ????????| ?????? ?????? ??????? ???????????? ???????||??||
tatra slokah- netrabastipranetrnam dosanetan sabhesajan| vetti yastena matiman bastikarmani karayet||19||

To sum up: - The physician, who is conversant with the defects of Netra (nozzle) and basti (receptacle of enema), the effects of wrongful techniques applied by the administrator, and treatment of the complications arising out of these factors, should administer basti therapy and only that person gains success.

??????????????? ??????? ????????????????????????? ?????????????? ???????????? ???????????????????????????? ?????????????||?||
ityagnivesakrte tantre carakapratisamskrte'prapte drdhabalasampurite siddhisthane netrabastivyapatsiddhirnama pancamo'dhyayah||5||

Thus, ends the fifth chapter of Siddhi-Sthana dealing with "The Success in treatment of Complications Caused by the Use of Improper Nozzle and Receptacle" of Agnivesha's work as redacted by Charaka, and Because of its non- availability, supplemented by Drdhabala.

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