Charaka Siddhisthana Chapter 3 – Basti Sutriya Siddhi

This article explains the third chapter of siddhisthana of Charaka samhita called ‘Bastisutriya Siddhi Adhyaya’. In this chapter, indications, contra-indications and adverse effects of Basti are explained.

Prologue
अथातो बस्तिसूत्रीयां सिद्धिं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
athāto bastisūtrīyāṃ siddhiṃ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātreyaḥ||2||

We shall now explore the chapter – Basti Sutriya Siddhi. Thus said Lord Atreya [1-2]

Dialogue
कृतक्षणं शैलवरस्य रम्ये स्थितं धनेशायतनस्य पार्श्वे|महर्षिसङ्घैर्वृतमग्निवेशः पुनर्वसुं प्राञ्जलिरन्वपृच्छत्||३||
बस्तिर्नरेभ्यः किमपेक्ष्य दत्तः स्यात् सिद्धिमान् किम्मयमस्य नेत्रम्| कीदृक्प्रमाणाकृति किङ्गुणं च केभ्यश्च किंयोनिगुणश्च बस्तिः||४||
निरूहकल्पः प्रणिधानमात्रा स्नेहस्य का वा शयने विधिः कः| के बस्तयः केषु हिता इतीदं श्रुत्वोत्तरं प्राह वचो महर्षिः||५||
kṛtakṣaṇaṃ śailavarasya ramye sthitaṃ dhaneśāyatanasya pārśve|maharṣisaṅghairvṛtamagniveśaḥ punarvasuṃ prāñjaliranvapṛcchat||3||
bastirnarebhyaḥ kimapekṣya dattaḥ syāt siddhimān kimmayamasya netram| kīdṛkpramāṇākṛti kiṅguṇaṃ ca kebhyaśca kiṃyoniguṇaśca bastiḥ||4||
nirūhakalpaḥ praṇidhānamātrā snehasya kā vā śayane vidhiḥ kaḥ| ke bastayaḥ keṣu hitā itīdaṃ śrutvottaraṃ prāha vaco maharṣiḥ||5||

When Punarvasu, after completing his daily rituals, was leisurely sitting in the beautiful valley of the Himalayas, being surrounded by a group of saints, close to the abode of Kubera (the god of wealth), Agnivesha with folded hands enquired about the following topics:

Which factors should be kept in mind for the successful administration of basti therapy? [to be explained in the verse no.6]
Which material is used to prepare the nozzle (basti netra) for giving enema? [explained in verse no. 7]
What is the size, shape and quantities of basti putaka? [explained in the verse nos. 8-2/4 10]
What is the source material to be used in the preparation of the basti for different persons, and what are its attributes? [explained in verse nos. 10 2/4 -2/4 12]
What are the recipes of niruha Basti? [explained in the verse nos. 12 2/4 – 2/4 31]
What is the Dosage of Niruha basti? [explained in the verse nos. 31 2/4- 2/4 33]
What is the Dosage of Anuvasana Basti? [explained in the chapter no. IV]
In which position, the patient should lie down during the administration of Basti? [explained in the verse nos. 33 2/4- 2/4 34]
What are the recipes of Basti, and for which type of patients these are useful? [explained in the verse nos. 35 2/4- 70]
After hearing these queries, the Great Sage replied as follows. [3-5]
Read: Basti Chikitsa: Benefits, Routes, Types, Indications, Equipment

Factors for successful administration of Niruha Basti

समीक्ष्य दोषौषधदेशकालसात्म्याग्निसत्त्वादिवयोबलानि|
बस्तिः प्रयुक्तो नियतं गुणाय स्यात् सर्वकर्माणि च सिद्धिमन्ति||६||
samīkṣya doṣauṣadhadeśakālasātmyāgnisattvādivayobalāni|
bastiḥ prayukto niyataṃ guṇāya syāt sarvakarmāṇi ca siddhimanti||6||

To achieve success in the administration and to obtain the desired therapeutic effects, Basti is administered keeping in view the factors like nature of the Doshas, Medicines, desha (habitat), kala (season), satmya (homologation), Agni (power of digestion and metabolism), Sattva (psychic condition), age and strength of the patient etc. [6]

Material for Basti Netra

सुवर्णरूप्यत्रपुताम्ररीतिकांस्यास्थिशस्त्रद्रुमवेणुदन्तैः नलैर्विषाणैर्मणिभिश्च तैस्तैर्नेत्राणि कार्याणि सु(त्रि)कर्णिकानि ||७||
suvarṇarūpyatraputāmrarītikāṃsyāsthiśastradrumaveṇudantaiḥ nalairviṣāṇairmaṇibhiśca taistairnetrāṇi kāryāṇi su(tri)karṇikāni ||7||
The enema-nozzle is made of gold, silver, tin, copper, brass, bronze, bone, iron, wood, bamboo-reed, ivory, pipe, horn or gems. It is fitted with well-polished rings (karnika, which are three in number). [7]

Size, Shape of Bastinetra

षड्द्वादशाष्टाङ्गुलसम्मितानि षड्विंशतिद्वादशवर्षजानाम्|
स्युर्मुद्गकर्कन्धुसतीनवाहिच्छिद्राणि वर्त्याऽपिहितानि चैव||८||
यथावयोऽङ्गुष्ठकनिष्ठिकाभ्यां मूलाग्रयोः स्युः परिणाहवन्ति|
ऋजूनि गोपुच्छसमाकृतीनि श्लक्ष्णानि च स्युर्गुडिकामुखानि||९||
स्यात् कर्णिकैकाऽग्रचतुर्थभागे मूलाश्रिते बस्तिनिबन्धने द्वे|१०|
ṣaḍdvādaśāṣṭāṅgulasammitāni ṣaḍviṃśatidvādaśavarṣajānām| syurmudgakarkandhusatīnavāhicchidrāṇi vartyā’pihitāni caiva||8||
yathāvayo’ṅguṣṭhakaniṣṭhikābhyāṃ mūlāgrayoḥ syuḥ pariṇāhavanti| ṛjūni gopucchasamākṛtīni ślakṣṇāni ca syurguḍikāmukhāni||9||
syāt karṇikaikā’gracaturthabhāge mūlāśrite bastinibandhane dve|10|

For the patients of the six, twenty and twelve years, the length of the nozzle is six, twelve and eight Angulas (one angula or finger’s breadth = ¾th of an inch), respectively.
The calibre of the hole inside the nozzle is such as to allow the passage of a seed of Mudga (green Gram), Karkandhu (small variety of Jujube) and satina (pea) respectively. This hole is crooked with a Varti (elongated plug).
The circumference of the nozzle at the base and top is the same as that of the thumb and little finger respectively of the patient of that age (i.e., six, twenty and twelve years old).
It is straight and tapering like the tail of a cow. The mouth (opening at the top) of the nozzle is smooth and circular.
One ring (Karnika) is fixed at the level of one fourth from the top, and two other rings are fixed at the base in order to facilitate tying the mouth of the bladder (basti) around the nozzle. [8 – 2/4 10]

Source of Basti Putaka and its Attributes

जारद्गवो माहिषहारिणौ वा स्याच्छौकरो बस्तिरजस्य वाऽपि||१०|| दृढस्तनुर्नष्टसिरो विगन्धः कषायरक्तः सुमृदुः सुशुद्धः|
नृणां वयो वीक्ष्य यथानुरूपं नेत्रेषु योज्यस्तु सुबद्धसूत्रः||११||
jāradgavo māhiṣahāriṇau vā syācchaukaro bastirajasya vā’pi||10|| dṛḍhastanurnaṣṭasiro vigandhaḥ kaṣāyaraktaḥ sumṛduḥ suśuddhaḥ|
nṛṇāṃ vayo vīkṣya yathānurūpaṃ netreṣu yojyastu subaddhasūtraḥ||11||

Enema- receptacle :
The enema- receptacle is prepared on the bladder of old ox, buffalo, deer, pig or goat. It is firm, thin, and free from vessels and without any foul odour. It is tanned with astringent drugs by which it becomes red in odour. It is very soft and very clean. Keeping in view the age of the patient, the Basti putaka of appropriate capacity is selected, and it is tied securely to the nozzle of appropriate size with the help of strings. [10 2/4- 11]

In case of non-availability of bladder
बस्तेरलाभे प्लवजो गलो वा स्यादङ्कपादः सुघनः पटो वा|१२|
basteralābhe plavajo galo vā syādaṅkapādaḥ sughanaḥ paṭo vā|12|

If bladder is not available then the sac in the throat of a pelican (Plava) or a sac prepared of either the skin of a bat or a thick cloth is used as enema- receptacle. [2/4 12]

Auspicious Time for Administration of Basti

आस्थापनार्हं पुरुषं विधिज्ञः समीक्ष्य पुण्येऽहनि शुक्लपक्षे||१२||
प्रशस्तनक्षत्रमुहूर्तयोगे जीर्णान्नमेकाग्रमुपक्रमेत |१३|
āsthāpanārhaṃ puruṣaṃ vidhijñaḥ samīkṣya puṇye’hani śuklapakṣe||12||
praśastanakṣatramuhūrtayoge jīrṇānnamekāgramupakrameta |13|

The physician well-versed in the method of administering Basti (medicated enema) should give therapy to a suitable patient (for whom Basti therapy is indicated) after he has digested his meal, and has concentration of the mind. It is given on an auspicious day in the Sukla-Paksa (bright fortnight of lunar month) having a propitious Naksatra (constellation), Muhurta (period of the day) and Yoga (Planatory conjunction). [12 2/4 – 2/4 13]

Method of Administering Basti

बलां गुडूचीं त्रिफलां सरास्नां द्वे पञ्चमूले च पलोन्मितानि||१३||
अष्टौ फलान्यर्धतुलां च मांसाच्छागात् पचेदप्सु चतुर्थशेषम्|
पूतं यवानीफलबिल्वकुष्ठवचाशताह्वाघनपिप्पलीनाम्||१४||
कल्कैर्गुडक्षौद्रघृतैः सतैलैर्युतं सुखोष्णैस्तु पिचुप्रमाणैः|
गुडात् पलं द्विप्रसृतां तु मात्रां स्नेहस्य युक्त्या मधु सैन्धवं च||१५||
प्रक्षिप्य बस्तौ मथितं खजेन सुबद्धमुच्छ्वास्य च निर्वलीकम्|
अङ्गुष्ठमध्येन मुखं पिधाय नेत्राग्रसंस्थामपनीय वर्तिम्||१६||
तैलाक्तगात्रं कृतमूत्रविट्कं नातिक्षुधार्तं शयने मनुष्यम्|
समेऽथवेषन्नतशीर्षके वा नात्युच्छ्रिते स्वास्तरणोपपन्ने||१७||
सव्येन पार्श्वेन सुखं शयानं कृत्वर्जुदेहं स्वभुजोपधानम्|
सङ्कोच्य सव्येतरदस्य सक्थि वामं प्रसार्य प्रणयेत्ततस्तम्||१८||
स्निग्धे गुदे नेत्रचतुर्थभागं स्निग्धं शनैरृज्वन पृष्ठवंशम्|
अकम्पनावेपनलाघवादीन् पाण्योर्गुणांश्चापि विदर्शयंस्तम् ||१९||
प्रपीड्य चैकग्रहणेन दत्तं नेत्रं शनैरेव ततोऽपकर्षेत्|२०|
balāṃ guḍūcīṃ triphalāṃ sarāsnāṃ dve pañcamūle ca palonmitāni||13||
aṣṭau phalānyardhatulāṃ ca māṃsācchāgāt pacedapsu caturthaśeṣam|
pūtaṃ yavānīphalabilvakuṣṭhavacāśatāhvāghanapippalīnām||14||
kalkairguḍakṣaudraghṛtaiḥ satailairyutaṃ sukhoṣṇaistu picupramāṇaiḥ|
guḍāt palaṃ dviprasṛtāṃ tu mātrāṃ snehasya yuktyā madhu saindhavaṃ ca||15||
prakṣipya bastau mathitaṃ khajena subaddhamucchvāsya ca nirvalīkam|
aṅguṣṭhamadhyena mukhaṃ pidhāya netrāgrasaṃsthāmapanīya vartim||16||
tailāktagātraṃ kṛtamūtraviṭkaṃ nātikṣudhārtaṃ śayane manuṣyam|
same’thaveṣannataśīrṣake vā nātyucchrite svāstaraṇopapanne||17||
savyena pārśvena sukhaṃ śayānaṃ kṛtvarjudehaṃ svabhujopadhānam|
saṅkocya savyetaradasya sakthi vāmaṃ prasārya praṇayettatastam||18||
snigdhe gude netracaturthabhāgaṃ snigdhaṃ śanairṛjvana pṛṣṭhavaṃśam|
akampanāvepanalāghavādīn pāṇyorguṇāṃścāpi vidarśayaṃstam ||19||
prapīḍya caikagrahaṇena dattaṃ netraṃ śanaireva tato’pakarṣet|20|

One Pala each of Bala, Guduchi, Haritaki, Vibhitaka, Amalaki, Rasna, Bilva, Syonaka, Gambhari, Patala, Ganikarika, Salaparni, Prsniparni, Brhati, Kantakari and Goksura, eight fruits of madana and half Tula (200 Tolas) of Goat meat should be added with water, and boiled till one fourth of water remains.

Then the decoction is collected by filtration. To this decoction, one Picu (12 g) each of the paste of Yavani, Madana phala, Bilva, Kustha, Vaca, Satahva, Ghana and Pippali, one Pala of Jaggery, two Prastas each of ghee and oil, and appropriate quantities of honey and rock salt should be added. The recipe should then be stirred with a stirrer (Khaja), and kept inside the basti (enema receptacle) should then be tied to the base of the nozzle, the air inside the bladder is taken out, and the bladder is made free from wrinkles.

Thereafter, Varti (elongated plug) at the mouth (of the nozzle) is removed, and the opening (in the mouth) is covered with the middle part of the thumb.
The patient whose body is anointed with oil, who has passed urine and stool, and who is not very hungry is made to sleep over a well spread, and not very high bed which is uniform in level or which is slightly low in level at the head- side.
The patient should sleep comfortably on his left side. He should keep his body straight, and use his flooded left hand as a pillow. He should then flex his right leg, keeping the left leg straight (fully extended).
The anus of the patient is lubricated, and the lubricated nozzle is inserted into it up to one fourth part from the top slowly and straight following the position of the vertebral column.
The physician should not shake or tremble his hand, and quickly compress the bladder (enema – receptacle) so that the recipe goes inside at one stretch. Thereafter, he should remove the nozzle slowly. [13 2/4 – 2/4 20]
Read: Mode Of Action Of Basti Panchakarma Treatment

Improper Administration of Basti

तिर्यक् प्रणीते तु न याति धारा गुदे व्रणः स्याच्चलिते तु नेत्रे||२०||
दत्तः शनैर्नाशयमेति बस्तिः कण्ठं प्रधावत्यतिपीडितश्च|
शीतस्त्वतिस्तम्भकरो विदाहं मूर्च्छां च कुर्यादतिमात्रमुष्णः||२१||
स्निग्धोऽतिजाड्यं पवनं तु रूक्षस्तन्वल्पमात्रालवणस्त्वयोगम्|
करोति मात्राभ्यधिकोऽतियोगं क्षामं तु सान्द्रः सुचिरेण चैति||२२||
दाहातिसारौ लवणोऽति कुर्यात्तस्मात् सुयुक्तं सममेव दद्यात्|२३|
tiryak praṇīte tu na yāti dhārā gude vraṇaḥ syāccalite tu netre||20||
dattaḥ śanairnāśayameti bastiḥ kaṇṭhaṃ pradhāvatyatipīḍitaśca|
śītastvatistambhakaro vidāhaṃ mūrcchāṃ ca kuryādatimātramuṣṇaḥ||21||
snigdho’tijāḍyaṃ pavanaṃ tu rūkṣastanvalpamātrālavaṇastvayogam|
karoti mātrābhyadhiko’tiyogaṃ kṣāmaṃ tu sāndraḥ sucireṇa caiti||22||
dāhātisārau lavaṇo’ti kuryāttasmāt suyuktaṃ samameva dadyāt|23|

If the nozzle is obliquely inserted, then the fluid will not flow into the rectum. If the nozzle is shifted from one place to the other, then this may cause anal ulcer. If the bladder is compressed slowly, then the enema-fluid may not reach the colon. If the bladder (Basti) is strongly compressed, then the fluid may rush very fast [in the alimentary tract] even up to the throat.

Therefore, Basti should be properly and uniformly administered. [20 2/4 – 2/4 23]

Order of adding ingredients of different categories

पूर्वं हि दद्यान्मधु सैन्धवं तु स्नेहं विनिर्मथ्यं ततोऽनु कल्कम्||२३||
विमथ्य संयोज्य पुनर्द्रवैस्तं बस्तौ निदध्यान्मथितं खजेन|२४|
pūrvaṃ hi dadyānmadhu saindhavaṃ tu snehaṃ vinirmathyaṃ tato’nu kalkam||23||
vimathya saṃyojya punardravaistaṃ bastau nidadhyānmathitaṃ khajena|24|

In the beginning, honey and rock-salt is added to the fat (ghee and oil) and stirred. Thereafter, the paste of drugs is added and stirred again. To this, the liquid (decoction) is added and stirred further with the help of a stirrer. This recipe should thereafter, be placed in the Basti (enema – receptacle). [23 2/4- 2/4 24]

Posture of Body during Basti

वामाश्रये हि ग्रहणीगुदे च तत् पार्श्वसंस्थस्य सुखोपलब्धिः||२४||
लीयन्त एवं वलयश्च तस्मात् सव्यं शयानोऽर्हति बस्तिदानम्|२५|
vāmāśraye hi grahaṇīgude ca tat pārśvasaṃsthasya sukhopalabdhiḥ||24||
līyanta evaṃ valayaśca tasmāt savyaṃ śayāno’rhati bastidānam|25|

As the Grahani (organ of assimilation, i.e duodenum and upper part of the small intestine) and rectum are located in the left side of the body, administration of Basti (enema) while the patient is lying in his left side would bestow pleasant benefits. The patient laying in his left side keeps the sphincters (valayas) submerged [into the surrounding musculature]. Therefore, Basti is given when the patient is lying in his left side. [24 2/4 – 2/4 25]

Management of Complications

विड्वातवेगो यदि चार्धदत्ते निष्कृष्य मुक्ते प्रणयेदशेषम् ||२५||
उत्तानदेहश्च कृतोपधानः स्याद्वीर्यमाप्नोति तथाऽस्य देहम् |२६|
viḍvātavego yadi cārdhadatte niṣkṛṣya mukte praṇayedaśeṣam ||25||
uttānadehaśca kṛtopadhānaḥ syādvīryamāpnoti tathā’sya deham |26|

While administering enema, if in the middle, the patient gets an urge to void feces or flatus, then the nozzle is taken out, and after the patient has voided stool or flatus, the remaining enema- fluid is injected. The patient should thereafter, be made to lie down on his back with a pillow below his head. By doing so, his body gets invigorated with the effect of enema. [25 2/4 – 2/4 26]

Effect of Three Bastis

एकोऽपकर्षत्यनिलं स्वमार्गात् पित्तं द्वितीयस्तु कफं तृतीयः||२६||
eko’pakarṣatyanilaṃ svamārgāt pittaṃ dvitīyastu kaphaṃ tṛtīyaḥ||26||

The first enema helps in the elimination of Vata, the second enema helps in the elimination of pitta, and the third enema helps in the elimination of Kapha from their own channels. [26 2/4]

Post therapeutic measures

प्रत्यागते कोष्णजलावसिक्तः शाल्यन्नमद्यात्तनुना रसेन|
जीर्णे तु सायं लघु चाल्पमात्रं भुक्तोऽनुवास्यः परिबृंहणार्थम्||२७||
निरूहपादांशसमेन तैलेनाम्लानिलघ्नौषधसाधितेन|
दत्त्वा स्फिचौ पाणितलेन हन्यात् स्नेहस्य शीघ्रागमरक्षणार्थम्||२८||
ईषच्च पादाङ्गुलियुग्ममाञ्छेदुत्तानदेहस्य तलौ प्रमृज्यात्|
स्नेहेन पार्ष्ण्यङ्गुलिपिण्डिकाश्च ये चास्य गात्रावयवा रुगार्ताः||२९||
तांश्चावमद्गीत सुखं ततश्च निद्रामुपासीत कृतोपधानः|३०|
pratyāgate koṣṇajalāvasiktaḥ śālyannamadyāttanunā rasena|
jīrṇe tu sāyaṃ laghu cālpamātraṃ bhukto’nuvāsyaḥ paribṛṃhaṇārtham||27||
nirūhapādāṃśasamena tailenāmlānilaghnauṣadhasādhitena|
dattvā sphicau pāṇitalena hanyāt snehasya śīghrāgamarakṣaṇārtham||28||
īṣacca pādāṅguliyugmamāñcheduttānadehasya talau pramṛjyāt|
snehena pārṣṇyaṅgulipiṇḍikāśca ye cāsya gātrāvayavā rugārtāḥ||29||
tāṃścāvamadgīta sukhaṃ tataśca nidrāmupāsīta kṛtopadhānaḥ|30|

After the enema-fluid has returned, the patient is sprinkled with tepid water, and thereafter, given the diet containing Sali rice along with thin meat soup.
In the evening, after the previous meal is digested, the patient is given light food in small quantities.
Thereafter, Anuvasana Basti (unctuous enema) is given to the patient for all round nourishment of his body.
For anuvasana basti, medicated oil cooked by adding sour and vayu-alleviating drugs should be used. This oil is one-fourth in quantity of the fluid used for
Niruha Basti. After the administration of oil, the buttocks of the patient are tapped (pressed) with the palms to prevent early return of reciepe (medicated oil) from the anus.
The patient should lie on the bed in supine position, and the toe joints of both of his legs are pulled gently. The soles of his feet are massaged with oil. His heels, toes, calf regions and such other parts which are painful should also be massaged with oil. Thereafter, the patient should sleep comfortably by keeping his head over a pillow (and he should not do any other work) [27- 2/4 30]

Proportion of Ingredients in Basti dravya

भागाः कषायस्य तु पञ्च, पित्ते स्नेहस्य षष्ठः प्रकृतौ स्थिते च||३०||
वाते विवृद्धे तु चतुर्थभागो, मात्रा निरूहेषु कफेऽष्टभागः|३१|
bhāgāḥ kaṣāyasya tu pañca, pitte snehasya ṣaṣṭhaḥ prakṛtau sthite ca||30||
vāte vivṛddhe tu caturthabhāgo, mātrā nirūheṣu kaphe’ṣṭabhāgaḥ|31|

In the recipe of Niruha Basti (total quantity: twelve Prasrutas or 24 Palas) the decoction is five parts (five Prasritas or ten Palas). If this is intended to be given to a patient suffering from Paittika diseases or to a healthy person, then the quantity of Sneha (fat) is one sixth of the total quantity (i.e two Prasritas or four Palas). For Vaittika diseases, the quantity of Sneha (fat) is one-fourth of the total quantity (i.e., three Prasritas or six Palas). For Kaphaja diseases, the quantity of Sneha is 1/8 th of the total quantity (i.e 1 ½ Prastas or three palas). [30 2/4- 2/4 31]

Dose of Niruha Basti for Different Age groups

निरूहमात्रा प्रसृतार्धमाद्ये वर्षे ततोऽर्धप्रसृताभिवृद्धिः||३१||
आद्वादशात् स्यात् प्रसृताभिवृद्धिरष्टादशाद् द्वादशतः परं स्युः|
आसप्ततेस्तद्विहितं प्रमाणमतः परं षोडशवद्विधेयम्||३२||
निरूहमात्रा प्रसृतप्रमाणा बाले च वृद्धे च मृदुर्विशेषः|३३|
nirūhamātrā prasṛtārdhamādye varṣe tato’rdhaprasṛtābhivṛddhiḥ||31||
ādvādaśāt syāt prasṛtābhivṛddhiraṣṭādaśād dvādaśataḥ paraṃ syuḥ|
āsaptatestadvihitaṃ pramāṇamataḥ paraṃ ṣoḍaśavadvidheyam||32||
nirūhamātrā prasṛtapramāṇā bāle ca vṛddhe ca mṛdurviśeṣaḥ|33|

For the one-year-old, the dose of niruha recipe is half Prasrta (one Pala). Thereafter, for each year of age, the dose is increased by half Prasrta up to twelve years. [For the patient of twelve years old, the dose of Niruha recipe should, therefore, be six Prasritas].
After twelve years of age, the dose of Niruha is increased by one Prasrta for each (of age) till eighteenth year of age. [For the patient of eighteen years old the dose of Niruha should therefore be twelve Prasthas, which is the maximum dose]. This dose of Niruha is prescribed up to the age of seventy. After seventy years of age, the dose of Niruha should be similar to that of a patient of sixteen years old [i.e ten Prasritas]
Thus, the dose of Niruha is described for patients of different age groups in terms of Prasrta.
For infants and old people, the ingredients of enema recipe are specifically mild in nature. [31 2/4- 2/4 33]
Read: Niruha Basti (Kashaya Basti) Panchakarma Method, Uses, Side Effects

Bed after Basti

नात्युच्छ्रितं नाप्यतिनीचपादं सपादपीठं शयनं प्रशस्तम्||३३||
प्रधानमृद्वास्तरणोपपन्नं प्राक्शीर्षकं शुक्लपटोत्तरीयम्|३४|
nātyucchritaṃ nāpyatinīcapādaṃ sapādapīṭhaṃ śayanaṃ praśastam||33||
pradhānamṛdvāstaraṇopapannaṃ prākśīrṣakaṃ śuklapaṭottarīyam|34|

After the administration of the therapy is over, the patient should lie down on a bed which is neither too high nor with too low pedestal. This bed should have a foot-rest, and is spread with an adequately big and soft mattress. The patient should lie with his head towards the east, and cover himself with white linen. [33 2/4- 2/4 34]

Diet after Basti

भोज्यं पुनर्व्याधिमवेक्ष्य तद्वत् प्रकल्पयेद्यूषपयोरसाद्यैः||३४||
सर्वेषु विद्याद्विधिमेतमाद्यं वक्ष्यामि बस्तीनत उत्तरीयान्|३५|
bhojyaṃ punarvyādhimavekṣya tadvat prakalpayedyūṣapayorasādyaiḥ||34||
sarveṣu vidyādvidhimetamādyaṃ vakṣyāmi bastīnata uttarīyān|35|

The diet of the patient after the therapy is determined on the basis of the nature of his disease. It should consist of vegetable soup, milk, meat soup, etc. This is the primary and general principle to be followed in all the conditions. Hereafter, the recipes for the Niruha Basti will be described. [34 2/4- 2/4 35]
Read: Anuvasana Basti: Method, Benefits, Mode Of Action, Contra Indications

Recipe of Niruha (first Recipe)

द्विपञ्चमूलस्य रसोऽम्लयुक्तः सच्छागमांसस्य सपूर्वपेष्यः||३५||
त्रिस्नेहयुक्तः प्रवरो निरूहः सर्वानिलव्याधिहरः प्रदिष्टः|
dvipañcamūlasya raso’mlayuktaḥ sacchāgamāṃsasya sapūrvapeṣyaḥ||35||
trisnehayuktaḥ pravaro nirūhaḥ sarvānilavyādhiharaḥ pradiṣṭaḥ|

The recipe containing decoction of Dvi Panchamoola (Dashamoola) is added with sour juice, soup of goat-meat, the paste of drugs described earlier in the verse no. 13 (viz, Bala, Guduchi, Haritaki, Vibhitaka, Amalaki, Rasna, Bilva, Syonaka, Gambhari, Patala, Ganikarika, Salaparni, Prsniparni, Brhati, Kantakari and Goksura), and three types of fat (ghee, oil and muscle fat) is excellent for Niruha Basti to be given for curing all the diseases caused by aggravation of Vayu. [35 2/4 – 2/4 3]

Second Recipe of Niruha

स्थिरादिवर्गस्य बलापटोलत्रायन्तिकैरण्डयवैर्युतस्य||३६||
प्रस्थो रसाच्छागरसार्धयुक्तः साध्यः पुनः प्रस्थसमस्तु यावत्|
प्रियङ्गुकृष्णाघनकल्कयुक्तः सतैलसर्पिर्मधुसैन्धवश्च||३७||
स्याद्दीपनो मांसबलप्रदश्च चक्षुर्बलं चापि ददाति बस्तिः ||
sthirādivargasya balāpaṭolatrāyantikairaṇḍayavairyutasya||36||
prastho rasācchāgarasārdhayuktaḥ sādhyaḥ punaḥ prasthasamastu yāvat|
priyaṅgukṛṣṇāghanakalkayuktaḥ satailasarpirmadhusaindhavaśca||37||
syāddīpano māṃsabalapradaśca cakṣurbalaṃ cāpi dadāti bastiḥ |

One Prastha of the decoction of drugs belonging to Sthiradi – group (sthira or Vidarigandha, Prsniparni, Brhati, Kantakari, Eranda, Kakoli, Chandana, Usira, Ela and Madhuka- vide Sutra 4: 170 Bala, Patola, Trayantika, Eranda (it is a repetition) and Yava, and half a Prastha of the liquid remains. To this, the paste of Priyangu, Krsna and Ghana, oil, ghee, honey and rocksalt is added, and used for enema. It stimulates the power of digestion, provides strength to the muscle tissue and even promotes the strength of the eyes. [36 2/4 – 2/4 38]

Third Recipe of Niruha Eranda-Basti

एरण्डमूलं त्रिपलं पलाशा ह्रस्वानि मूलानि च यानि पञ्च||३८||
रास्नाश्वगन्धातिबलागुडूची पुनर्नवारग्वधदेवदारु|
भागाः पलांशा मदनाष्टयुक्ता जलद्विकंसे क्वथितेऽष्टशेषे||३९||
पेष्याः शताह्वा हपुषा प्रियङ्गुः सपिप्पलीकं मधुकं बला च|
रसाञ्जनं वत्सकबीजमुस्तं भागाक्षमात्रं लवणांशयुक्तम्||४०||
समाक्षिकस्तैलयुतः समूत्रो बस्तिर्नृणां दीपनलेखनीयः|
जङ्घोरुपादत्रिकपृष्ठशूलं कफावृतिं मारुतनिग्रहं च||४१||
विण्मूत्रवातग्रहणं सशूलमाध्मानतामश्मरिशर्करे च|
आनाहमर्शोग्रहणीप्रदोषानेरण्डबस्तिः शमयेत् प्रयुक्तः||४२||
eraṇḍamūlaṃ tripalaṃ palāśā hrasvāni mūlāni ca yāni pañca||38||
rāsnāśvagandhātibalāguḍūcī punarnavāragvadhadevadāru|
bhāgāḥ palāṃśā madanāṣṭayuktā jaladvikaṃse kvathite’ṣṭaśeṣe||39||
peṣyāḥ śatāhvā hapuṣā priyaṅguḥ sapippalīkaṃ madhukaṃ balā ca|
rasāñjanaṃ vatsakabījamustaṃ bhāgākṣamātraṃ lavaṇāṃśayuktam||40||
samākṣikastailayutaḥ samūtro bastirnṛṇāṃ dīpanalekhanīyaḥ|
jaṅghorupādatrikapṛṣṭhaśūlaṃ kaphāvṛtiṃ mārutanigrahaṃ ca||41||
viṇmūtravātagrahaṇaṃ saśūlamādhmānatāmaśmariśarkare ca|
ānāhamarśograhaṇīpradoṣāneraṇḍabastiḥ śamayet prayuktaḥ||42||

Three Palas of the root of Eranda, one Pala each of the Pastes of Palasha (Sati), Salaparni, Prsniparni, Brhati, Kantakari, Goksura, Rasna, Asvagandha, Atibala, Guduchi, Punarnava, Aragvadha and Devadaru and the paste of eight seeds of Madana is added with two Kamsas (512 Tolas) of water and boiled till one-eighth of the liquid remains.
To this decoction, the paste of one Aksa or Tola each of Sarahva, Hapusa, Priyangu, Pippali, Madhuka, Bala, Rasanjana, seeds of Vatsaka and Musta along with appropriate quantity of rock-salt, honey, oil and cow’s urine is added. Administration of this recipe as enema is dipaniya (stimulant of the power of digestion) and Lekhaniya (which scraps out the morbid matter from the body). Administration of the Eranda-Basti cures pain in the calf region, thighs, feet, lumbar region and back, Kaphavrti (occlusion of vayu by kapha), Maruta Nigraha (immobility of Vata), obstruction to the voiding of stool, urine and flatus associated with pain, Adhmanata (tymphanites), Asmari (stone in the urinary tract), Sarkara (Gravel in urine), Anaha (constipation), Arsas (piles) and Grahani Dosha (Sprue syndrome) . [38 2/4 – 42]

Fourth Recipe of Niruha

चतुष्पले तैलघृतस्य भृष्टाच्छागाच्छतार्धो दधिदाडिमाम्लः|
रसः सपेष्यो बलमांसवर्णरेतोग्निदश्चान्ध्यशिरोर्तिशस्तः ||४३||
catuṣpale tailaghṛtasya bhṛṣṭācchāgācchatārdho dadhidāḍimāmlaḥ|
rasaḥ sapeṣyo balamāṃsavarṇaretognidaścāndhyaśirortiśastaḥ ||43||

Fifty Palas of the soup of goat-meat should be sizzled with four Palas of ghee and oil, made sour by adding Dadhi (yogurt) and Dadima, and added with the paste (of bala, etc. described earlier in verse no. 13)
Use of this recipe for enema promotes strength, muscles, complexion, semen and agni (power of digestion as well as metabolism), and cures blindness as well as headache. [43]

Fifth recipe of Niruha

जलद्विकंसेऽष्टपलं पलाशात् पक्त्वा रसोऽर्धाढकमात्रशेषः|
कल्कैर्वचामागधिकापलाभ्यां युक्तः शताह्वाद्विपलेन चापि||४४||
ससैन्धवः क्षौद्रयुतः सतैलो देयो निरूहो बलवर्णकारी|
आनाहपार्श्वामययोनिदोषान् गुल्मानुदावर्तरुजं च हन्यात्||४५||
jaladvikaṃse’ṣṭapalaṃ palāśāt paktvā raso’rdhāḍhakamātraśeṣaḥ|
kalkairvacāmāgadhikāpalābhyāṃ yuktaḥ śatāhvādvipalena cāpi||44||
sasaindhavaḥ kṣaudrayutaḥ satailo deyo nirūho balavarṇakārī|
ānāhapārśvāmayayonidoṣān gulmānudāvartarujaṃ ca hanyāt||45||

Eight Palas of Palasha is added with two Kamsas (128 Palas) of water, and boiled till the liquid is reduced to half Adhaka (32 Palas). To this decoction, the paste of one Pala each of Vaca and magadhika, and two Palas of Satahva along with rock- salt, honey and oil are added. This recipe is used for Niruha.
It promotes strength and complex. It cures (Constipation), parsvamaya (pain in the sides of the chest), Yoni-Dosha (gynecic diseases), Gulma (phantom tumour) and Udavarta (upward movement of wind in the abdomen). [45]

Six Recipes of Niruha

यष्ट्याह्वयस्याष्टपलेन सिद्धं पयः शताह्वाफलपिप्पलीभिः|
युक्तं ससर्पिर्मधु वातरक्तवैस्वर्यवीसर्पहितो निरूहः||४६||
yaṣṭyāhvayasyāṣṭapalena siddhaṃ payaḥ śatāhvāphalapippalībhiḥ|
yuktaṃ sasarpirmadhu vātaraktavaisvaryavīsarpahito nirūhaḥ||46||

Milk boiled by adding eight palas of Yastimadhu is mixed with [the paste] of satahva, Phala (Madanaphala) and Pippali, ghee and honey. Administration of this recipe in the form of Niruha Basti cures Vatarakta (gout), vaisvarya (hoarseness of voice) and Visarpa (erysipelas). [46]

Seventh recipe of Niruha

यष्ट्याह्वलोध्राभयचन्दनैश्च शृतं पयोऽग्र्यं कमलोत्पलैश्च|
सशर्करं क्षौद्रयुतं सुशीतं पित्तामयान् हन्ति सजीवनीयम्||४७||
yaṣṭyāhvalodhrābhayacandanaiśca śṛtaṃ payo’gryaṃ kamalotpalaiśca|
saśarkaraṃ kṣaudrayutaṃ suśītaṃ pittāmayān hanti sajīvanīyam||47||

The milk boiled with Yastimadhu, Lodhra, Abhaya (Usira), Chandana, Kamala and Utpala is added with sugar as well as honey, and cooled. To this, the [paste] of drugs belonging to Jivaniya- group (Jivika, Rsabhaka, Meda, Maha-meda, Kakoli, Ksirakakoli, Mudgaparni, Masaparni, Jivanti and Madhuka: vide Sutra 4:9) is added.
Niruha –basti administered with this recipe cures diseases caused by aggravated Pitta. [47]

Eighth recipe of Niruha

द्विकार्षिकाश्चन्दनपद्मकर्धियष्ट्याह्वरास्नावृषसारिवाश्च|
सलोध्रमञ्जिष्ठमथाप्यनन्ताबलास्थिरादितृणपञ्चमूलम् ||४८||
तोये समुत्क्वाथ्य रसेन तेन शृतं पयोऽर्धाढकमम्बुहीनम्|
जीवन्तिमेदर्धिशतावरीभिर्वीराद्विकाकोलिकशेरुकाभिः||४९||
सितोपलाजीवकपद्मरेणु प्रपौण्डरीकैः कमलोत्पलैश्च|
लोध्रात्मगुप्तामधुकैर्विदारीमुञ्जातकैः केशरचन्दनैश्च||५०||
पिष्टैर्घृतक्षौद्रयुतैर्निरूहं ससैन्धवं शीतलमेव दद्यात्|
प्रत्यागते धन्वरसेन शालीन् क्षीरेण वाऽद्यात् परिषिक्तगात्रः||५१||
दाहातिसारप्रदरास्रपित्तहृत्पाण्डुरोगान् विषमज्वरं च|
सगुल्ममूत्रग्रहकामलादीन् सर्वामयान् पित्तकृतान्निहन्ति||५२||
dvikārṣikāścandanapadmakardhiyaṣṭyāhvarāsnāvṛṣasārivāśca|
salodhramañjiṣṭhamathāpyanantābalāsthirāditṛṇapañcamūlam ||48||
toye samutkvāthya rasena tena śṛtaṃ payo’rdhāḍhakamambuhīnam|
jīvantimedardhiśatāvarībhirvīrādvikākolikaśerukābhiḥ||49||
sitopalājīvakapadmareṇu prapauṇḍarīkaiḥ kamalotpalaiśca|
lodhrātmaguptāmadhukairvidārīmuñjātakaiḥ keśaracandanaiśca||50||
piṣṭairghṛtakṣaudrayutairnirūhaṃ sasaindhavaṃ śītalameva dadyāt|
pratyāgate dhanvarasena śālīn kṣīreṇa vā’dyāt pariṣiktagātraḥ||51||
dāhātisārapradarāsrapittahṛtpāṇḍurogān viṣamajvaraṃ ca|
sagulmamūtragrahakāmalādīn sarvāmayān pittakṛtānnihanti||52||

Two Karsas (tolas) each of Chandana, Padmaka, Rddhi, Yastimadhu, Rasna, Vrsa, Sariva, Lodhra, Manjistha, Ananta (Utpala-Sariva), Bala, Vidarigandha, Prsniparni, Brhati, Kantakarika, Eranda, Kakoli, Chandana, Usira, Ela, Madhuka (vide Sutra 4:17), Sali, Kasa, Darbha and Iksu (vide Cikista 1:1:44) is boiled by adding water.
To this decoction, half Adhaka (72 Palas) of milk is added and boiled till the moisture / water content of the liquid gets evaporated, i.e only 72 Palas of milk remains. Thereafter, to this milk, the paste of Jivanti, Meda, Rddhi, Satavari, Vira, Kakoli, Ksirakakoli, Kaseruka, Sitopala (crystal sugar), Jivaka, anthers of lotus, Prapanudarika, Kamala, Utpala, Lodhra, Atmagupta, Madhuka, Vidari, Munjataka, Kesara and Chandana along with ghee, honey and small quantity of rock-salt is added. This recipe, when cold, is given as Niruha basti.
After the return of enema fluid, the patient’s body is sprinkled with water, and he is given Sali type of rice either with meat of animals inhabiting arid zone (jangala-mamsa) or milk.
This type of enema cures Daha (burning sensation), Atisara (diarrhoea), Pradara (menorrhagia), Raktapitta (an ailment characterised by bleeding from different parts of the body), Hrdroga (heart- diseases), Pandu Roga (anemia), Visama-Jvara (irregular fever), Gulma (phantom tumour), Mutra-Graha (anuria), Kamala (jaundice) etc. and all the other diseases caused by aggravated Pitta. [48-52]

Ninth recipe of Niruha

द्राक्षादिकाश्मर्यमधूकसेव्यैः ससारिवाचन्दनशीतपाक्यैः|
पयः शृतं श्रावणिमुद्गपर्णीतुगात्मगुप्तामधुयष्टिकल्कैः||५३||
गोधूमचूर्णैश्च तथाऽक्षमात्रैः सक्षौद्रसर्पिर्मधुयष्टितैलैः|
पथ्याविदारीक्षुरसैर्गुडेन बस्तिं युतं पित्तहरं विदध्यात्||५४||
हृन्नाभिपार्श्वोत्तमदेहदाहे दाहेऽन्तरस्थे च सकृच्छ्रमूत्रे|
क्षीणे क्षते रेतसि चापि नष्टे पैत्तेऽतिसारे च नृणां प्रशस्तः||५५||
drākṣādikāśmaryamadhūkasevyaiḥ sasārivācandanaśītapākyaiḥ|
payaḥ śṛtaṃ śrāvaṇimudgaparṇītugātmaguptāmadhuyaṣṭikalkaiḥ||53||
godhūmacūrṇaiśca tathā’kṣamātraiḥ sakṣaudrasarpirmadhuyaṣṭitailaiḥ|
pathyāvidārīkṣurasairguḍena bastiṃ yutaṃ pittaharaṃ vidadhyāt||54||
hṛnnābhipārśvottamadehadāhe dāhe’ntarasthe ca sakṛcchramūtre|
kṣīṇe kṣate retasi cāpi naṣṭe paitte’tisāre ca nṛṇāṃ praśastaḥ||55||

Milk boiled with Draksa (and such other sweet ingredients), Kashmarya, Madhuka, Sevya, Sariva, Chandana and Sitapaki (Sitali) is added with the paste of one Karsa (tola) each of Sravani, Mudgaparni, Tugaksiri, Atmagupta and Madhuyasti as well as with one Aksa of wheat-flour. To this, honey, ghee, Madhuyasti, oil, haritaki, vidari, sugarcane juice and jaggery is added and given as Basti (medicated enema). This alleviates aggravated Pitta. It is an excellent remedy for the patients suffering from burning sensation in the cardiac region, umbilicus, sides of the chest, head and the interior part of the body, Mutra-Krcchra (Dysuria), Ksina (consumption), Ksata (phthisis), loss of semen and Paittika type of Diarrhoea. [53- 55]
Read: Effective Basti Treatments for Vata disorders

Tenth recipe of Niruha

कोषातकारग्वधदेवदारुशार्ङ्गेष्टमूर्वाकुटजार्कपाठाः |
पक्त्वा कुलत्थान् बृहतीं च तोये रसस्य तस्य प्रसृता दश स्युः||५६||
तान् सर्षपैलामदनैः सकुष्ठैरक्षप्रमाणैः प्रसृतैश्च युक्तान्|
फलाह्वतैलस्य समाक्षिकस्य क्षारस्य तैलस्य च सार्षपस्य||५७||
दद्यान्निरूहं कफरोगिणे ज्ञो मन्दाग्नये चाप्यशनद्विषे च|
koṣātakāragvadhadevadāruśārṅgeṣṭamūrvākuṭajārkapāṭhāḥ |
paktvā kulatthān bṛhatīṃ ca toye rasasya tasya prasṛtā daśa syuḥ||56||
tān sarṣapailāmadanaiḥ sakuṣṭhairakṣapramāṇaiḥ prasṛtaiśca yuktān|
phalāhvatailasya samākṣikasya kṣārasya tailasya ca sārṣapasya||57||
dadyānnirūhaṃ kapharogiṇe jño mandāgnaye cāpyaśanadviṣe ca|

Ten Prasritas (one Prasrta = two palas) of decoction is prepared by boiling kosataka, Aragvadha, devadaru, Sarngesta (Gunja), Murva, Kutaja, Arka, Patha, Kulattha and brhati with water. To this, the paste of one Aksa each of Sarsapa, Ela, Madana and Kustha, and one Prasta each of Madana-Phala, oil, honey, Ksara (Alkali preparation) and mustard oil, honey, Ksara (alkali preparation) and mustard oil is added. An expert physician should use this recipe as niruha basti for the patients suffering from diseases caused by aggravated kapha, Mandagni (suppression of the power of digestion) and asana Dvesa (aversion to food). [56- 2/4 58]
Read: Effective Basti Treatments For Pitta Disorders

Eleventh recipe of Niruha

पटोलपथ्यामरदारुभिर्वा सपिप्पलीकैः क्वथितैर्जलेऽग्नौ||५८||
paṭolapathyāmaradārubhirvā sapippalīkaiḥ kvathitairjale’gnau||58||

Alternatively, water is boiled over fire by adding Patola, Pathya, Devadaru and Pippali. [With this decoction, enema is given according to the procedure described for the tenth recipe.] [58 2/4]

Twelfth recipe of Niruha

द्विपञ्चमूले त्रिफलां सबिल्वां फलानि गोमूत्रयुतः कषायः|
कलिङ्गपाठाफलमुस्तकल्कः ससैन्धवः क्षारयुतः सतैलः||५९||
निरूहमुख्यः कफजान् विकारान् सपाण्डुरोगालसकामदोषान्|
हन्यात्तथा मारुतमूत्रसङ्गं बस्तेस्तथाऽऽटोपमथापि घोरम्||६०||
dvipañcamūle triphalāṃ sabilvāṃ phalāni gomūtrayutaḥ kaṣāyaḥ|
kaliṅgapāṭhāphalamustakalkaḥ sasaindhavaḥ kṣārayutaḥ satailaḥ||59||
nirūhamukhyaḥ kaphajān vikārān sapāṇḍurogālasakāmadoṣān|
hanyāttathā mārutamūtrasaṅgaṃ bastestathā”ṭopamathāpi ghoram||60||

To the decoction of Dvi Panchamula (Dashamoola), Triphala, Bilva (fruit) and Madana phala and Musta prepared by adding cow’s urine, the paste of Kalinga, Patha, Madana phala is added. This recipe is mixed with rock-salt, Ksara (Yava-Ksara: and alkali preparation) and oil, and used for Niruha basti. It is excellent for curing diseases caused by aggravated kapha, Pandu-roga (anaemia), Alasaka (intestinal topor), ailments caused by Ama (product of improper digestion and metabolism), obstruction to the improper digestion and metabolism), obstruction to the voiding of flatus as well as urine, and serious types of bladder distension. [59-60]
Read: Effective Basti Treatments For Kapha Disorders

Thirteenth recipe of Niruha

रास्नामृतैरण्डविडङ्गदार्वीसप्तच्छदोशीरसुराह्वनिम्बैः|
शम्पाकभूनिम्बपटोलपाठातिक्ताखुपर्णीदशमूलमुस्तैः||६१||
त्रायन्तिकाशिग्रुफलत्रिकैश्च क्वाथः सपिण्डीतकतोयमूत्रः|
यष्ट्याह्वकृष्णाफलिनीशताह्वारसाञ्जनश्वेतवचाविडङ्गैः||६२||
कलिङ्गपाठाम्बुदसैन्धवैश्च कल्कैः ससर्पिर्मधुतैलमिश्रः|
अयं निरूहः क्रिमिकुष्ठमेहब्रध्नोदराजीर्णकफातुरेभ्यः||६३||
रूक्षौषधैरप्यपतर्पितेभ्य एतेषु रोगेष्वपि सत्सु दत्तः|
निहत्य वातं ज्वलनं प्रदीप्य विजित्य रोगांश्च बलं करोति||६४||
rāsnāmṛtairaṇḍaviḍaṅgadārvīsaptacchadośīrasurāhvanimbaiḥ|
śampākabhūnimbapaṭolapāṭhātiktākhuparṇīdaśamūlamustaiḥ||61||
trāyantikāśigruphalatrikaiśca kvāthaḥ sapiṇḍītakatoyamūtraḥ|
yaṣṭyāhvakṛṣṇāphalinīśatāhvārasāñjanaśvetavacāviḍaṅgaiḥ||62||
kaliṅgapāṭhāmbudasaindhavaiśca kalkaiḥ sasarpirmadhutailamiśraḥ|
ayaṃ nirūhaḥ krimikuṣṭhamehabradhnodarājīrṇakaphāturebhyaḥ||63||
rūkṣauṣadhairapyapatarpitebhya eteṣu rogeṣvapi satsu dattaḥ|
nihatya vātaṃ jvalanaṃ pradīpya vijitya rogāṃśca balaṃ karoti||64||

To the decoction of Rasna, Amrta, Eranda, Vidanga, Daruharidra, Saptacchada, Usira, Surahva, Nimba, Sampaka, Bhunimba, Patola, Patha, Tikta, Akhuparni, Dashamoola, Musta, Trayantika, Sigru, Haritaki, Vibhitaka, Amalaki, the decoction of Pinditaka (madana phala) and Mutra (cow’s urine) is added. To this liquid, the paste of madhuyasti, krsna (pippali), Phalini, satahva, Rasanjana, Sveta vaca, Vidanga, Kalinga, Patha, Ambuda (musta) and rock-salt along with ghee, honey and oil is added.
Administration of this recipe for Niruha basti cures Krmi (intestinal parasites), Kustha (skin diseases), meha (obstinate urinary disorders including diabetes), bradhna (inguinal swelling), udara (obstinate abdominal diseases including ascites), Ajirna (indigestion) and diseases caused by Kapha. Administration of this Niruha Basti to the aforesaid patients, who are emaciated because of the use of un-unctuous medicines alleviates Vayu, stimulates Agni (power of digestion and metabolism), cures diseases and promotes strength. [61-64]

Recipe of niruha for combined Doshas

पुनर्नवैरण्डवृषाश्मभेदवृश्चीरभूतीकबलापलाशाः |
द्विपञ्चमूलं च पलांशिकानि क्षुण्णानि धौतानि फलानि चाष्टौ||६५||
बिल्वं यवान् कोलकुलत्थधान्यफलानि चैव प्रसृतोन्मितानि|
पयोजलद्व्याढकवच्छृतं तत् क्षीरावशेषं सितवस्त्रपूतम्||६६||
वचाशताह्वामरदारुकुष्ठयष्ट्याह्वसिद्धार्थकपिप्पलीनाम् |
कल्कैर्यवान्या मदनैश्च युक्तं नात्युष्णशीतं गुडसैन्धवाक्तम्||६७||
क्षौद्रस्य तैलस्य च सर्पिषश्च तथैव युक्तं प्रसृतैस्त्रिभिश्च |
दद्यान्निरूहं विधिना विविज्ञः स सर्वसंसर्गकृतामयघ्नः||६८||
punarnavairaṇḍavṛṣāśmabhedavṛścīrabhūtīkabalāpalāśāḥ |
dvipañcamūlaṃ ca palāṃśikāni kṣuṇṇāni dhautāni phalāni cāṣṭau||65||
bilvaṃ yavān kolakulatthadhānyaphalāni caiva prasṛtonmitāni|
payojaladvyāḍhakavacchṛtaṃ tat kṣīrāvaśeṣaṃ sitavastrapūtam||66||
vacāśatāhvāmaradārukuṣṭhayaṣṭyāhvasiddhārthakapippalīnām |
kalkairyavānyā madanaiśca yuktaṃ nātyuṣṇaśītaṃ guḍasaindhavāktam||67||
kṣaudrasya tailasya ca sarpiṣaśca tathaiva yuktaṃ prasṛtaistribhiśca |
dadyānnirūhaṃ vidhinā vivijñaḥ sa sarvasaṃsargakṛtāmayaghnaḥ||68||

One Pala each of Punarnava (red variety), eranda vrksa (Vasaka) Asmabheda (Pasana- Bheda), Vrscira (sveta or white variety of Punarnava), Bhutika, bala, Palasha, bilva, syonaka, gambhari, patala, Ganikarika, Salaparni, Prsniparni, Brhati, Kantakari and Goksura and eight fruits of madana-phala is cut into pieces and washed. To this, one Prashta (two Palas) each of Bilva, Yava, Kola, Kulattha, Dhanyaka and madana phala, and two adhakas each of milk and water is added and boiled till the milk i.e., two adhakas of the liquid remains. The milk should then be filtered out through a white cloth. To this milk, the paste of Vaca, satahva, Devadaru, Kustha, Yastimadhu, Siddharthaka, Pippali, yavani and Madana phala is added. When lukewarm, jaggery, rock-salt, one prasrta each of honey, oil and ghee is added to this recipe, and administered as Niruha basti appropriately by a physician well versed in this field. It cures all the diseases caused by samsarga (combination of aggravated Doshas). [65-68]

Number of Bastis for Different Doshas

स्निग्धोष्ण एकः पवने समांसो द्वौ स्वादुशीतौ पयसा च पित्ते|
त्रयः समूत्राः कटुकोष्णतीक्ष्णाः कफे निरूहा न परं विधेयाः||६९||
snigdhoṣṇa ekaḥ pavane samāṃso dvau svāduśītau payasā ca pitte|
trayaḥ samūtrāḥ kaṭukoṣṇatīkṣṇāḥ kaphe nirūhā na paraṃ vidheyāḥ||69||

Patients suffering from Vatika diseases are given one Niruha Basti which is unctuous and warm, and which contains meat-soup. For the patients suffering from Paittika diseases, two Niruha bastis which are sweet and cold, and which contain milk is given. Patients suffering from Kaphaja diseases are given three Niruha Bastis which contain cow’s urine and which are pungent, hot as well as sharp.
Niruha Basti should not be given in excess of these specified numbers. [69]

Regimen after Niruha basti

रसेन वाते प्रतिभोजनं स्यात् क्षीरेण पित्ते तु कफे च यूषैः|
तथाऽनुवास्येषु च बिल्वतैलं स्याज्जीवनीयं फलसाधितं च||७०||
rasena vāte pratibhojanaṃ syāt kṣīreṇa pitte tu kaphe ca yūṣaiḥ|
tathā’nuvāsyeṣu ca bilvatailaṃ syājjīvanīyaṃ phalasādhitaṃ ca||70||

After the administration of Niuha basti, the patient suffering from vatika diseases is given meat-soup; the patient suffering from Paittika diseases is given milk and the patient suffering from kaphaja diseases is given vegetable soup as a diet.
After the administration of niruha basti (evacuative type of medicated enema), those requiring Anuvasana basti (unctuous type of medicated enema) are given this enema containing Bilva Taila (if the diseases are caused by Vayu), Jivaniya taila (if the disease is caused by Pitta) or Madhu Phala Taila (if the disease is caused by Kapha). [70]

इतीदमुक्तं निखिलं यथावद्बस्तिप्रदानस्य विधानमग्र्यम्|
योऽधीत्य विद्वानिह बस्तिकर्म करोति लोके लभते स सिद्धिम्||७१||
itīdamuktaṃ nikhilaṃ yathāvadbastipradānasya vidhānamagryam|
yo’dhītya vidvāniha bastikarma karoti loke labhate sa siddhim||71||

Thus, the foremost methods of the administration of basti are fully described. The wise physician, who, after studying this, practises Basti (medicated enema) therapy, achieves success in this world. [71]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते सिद्धिस्थाने बस्तिसूत्रीयसिद्धिर्नाम तृतीयोऽध्यायः||३||
ityagniveśakṛte tantre carakapratisaṃskṛte’prāpte dṛḍhabalasampūrite siddhisthāne bastisūtrīyasiddhirnāma tṛtīyo’dhyāyaḥ||3||

Thus, ends the third chapter describing “thePrinciples of Basti” in the text composed by Agnivesha, redacted by Charaka, and because of its non- availability, Supplemented by Drdhabala.