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.

अथातो नेत्रबस्तिव्यापत्सिद्धिं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
athāto netrabastivyāpatsiddhiṃ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātreyaḥ||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]

Topics discussed

अथ नेत्राणि बस्तींश्च शृणु वर्ज्यानि कर्मसु| नेत्रस्याज्ञप्रणीतस्य व्यापदः सचिकित्सिताः||३||
atha netrāṇi bastīṃśca śṛṇu varjyāni karmasu| netrasyājñapraṇītasya vyāpadaḥ sacikitsitāḥ||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

ह्रस्वं दीर्घं तनु स्थूलं जीर्णं शिथिलबन्धनम्| पार्श्वच्छिद्रं तथा वक्रमष्टौ नेत्राणि वर्जयेत्||४||
अप्राप्त्यतिगतिक्षोभकर्षणक्षणनस्रवाः| गुदपीडा गतिर्जिह्मा तेषां दोषा यथाक्रमम्||५||
hrasvaṃ dīrghaṃ tanu sthūlaṃ jīrṇaṃ śithilabandhanam| pārśvacchidraṃ tathā vakramaṣṭau netrāṇi varjayet||4||
aprāptyatigatikṣobhakarṣaṇakṣaṇanasravāḥ| gudapīḍā gatirjihmā teṣāṃ doṣā yathākramam||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

विषममांसलच्छिन्नस्थूलजालिकवातलाः|स्निग्धः क्लिन्नश्च तानष्टौ बस्तीन् कर्मसु वर्जयेत्||६||गतिवैषम्यविस्रत्वस्रावदौर्ग्राह्यनिस्रवाः|फेनिलच्युत्यधार्यत्वं बस्तेः स्युर्बस्तिदोषतः||७||
viṣamamāṃsalacchinnasthūlajālikavātalāḥ|snigdhaḥ klinnaśca tānaṣṭau bastīn karmasu varjayet||6||
gativaiṣamyavisratvasrāvadaurgrāhyanisravāḥ|phenilacyutyadhāryatvaṃ basteḥ syurbastidoṣataḥ||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

सवातातिद्रुतोत्क्षिप्ततिर्यगुल्लुप्तकम्पिताः| अतिबाह्यगमन्दातिवेगदोषाः प्रणेतृतः||८||
savātātidrutotkṣiptatiryagulluptakampitāḥ| atibāhyagamandātivegadoṣāḥ praṇetṛtaḥ||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

अनुच्छ्वास्य च बद्धे वा दत्ते निःशेष एव वा| प्रविश्य कुपितो वायुः शूलतोदकरो भवेत्||९||
तत्राभ्यङ्गो गुदे स्वेदो वातघ्नान्यशनानि च|१०|
anucchvāsya ca baddhe vā datte niḥśeṣa eva vā| praviśya kupito vāyuḥ śūlatodakaro bhavet||9||
tatrābhyaṅgo gude svedo vātaghnānyaśanāni 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 ½ 10]

Complications Arising out of Rapid insertion of Nozzle

द्रुतं प्रणीते निष्कृष्टे सहसोत्क्षिप्त एव वा||१०|| स्यात् कटीगुदजङ्घार्तिबस्तिस्तम्भोरुवेदनाः |
भोजनं तत्र वातघ्नं स्नेहाः स्वेदाः सबस्तयः||११||
drutaṃ praṇīte niṣkṛṣṭe sahasotkṣipta eva vā||10|| syāt kaṭīgudajaṅghārtibastistambhoruvedanāḥ |
bhojanaṃ tatra vātaghnaṃ snehāḥ svedāḥ sabastayaḥ||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

तिर्यग्वल्यावृतद्वारे बद्धे वाऽपि न गच्छति| नेत्रे तदृजु निष्कृष्य संशोध्य च प्रवेशयेत्||१२||
tiryagvalyāvṛtadvāre baddhe vā’pi na gacchati| netre tadṛju niṣkṛṣya saṃśodhya ca praveśayet||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

पीड्यमानेऽन्तरा मुक्ते गुदे प्रतिहतोऽनिलः| उरःशिरोर्तिमूर्वोश्च सदनं जनयेद्बली||१३||
बस्तिः स्यात्तत्र बिल्वादिफलश्यामादिमूत्रवान्|
pīḍyamāne’ntarā mukte gude pratihato’nilaḥ| uraḥśirortimūrvośca sadanaṃ janayedbalī||13||
bastiḥ syāttatra bilvādiphalaśyāmādimūtravān|

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 – ½ 14]
Read: Basti treatment procedure, Benefits- Astangahrudayam Sutrasthana 19

Complication caused by shaking of Nozzle

स्याद्दाहो दवथुः शोफः कम्पनाभिहते गुदे||१४|| कषायमधुराः शीताः सेकास्तत्र सबस्तयः|१५|
syāddāho davathuḥ śophaḥ kampanābhihate gude||14|| kaṣāyamadhurāḥ śītāḥ sekāstatra sabastayaḥ|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 ½ – ½ 15]

Complications caused by excessive penetration of nozzle

अतिमात्रप्रणीतेन नेत्रेण क्षणनाद्वलेः||१५|| स्यात् सार्ति दाहनिस्तोदगुदवर्चःप्रवर्तनम्|
तत्र सर्पिः पिचुः क्षीरं पिच्छाबस्तिश्च शस्यते||१६||
atimātrapraṇītena netreṇa kṣaṇanādvaleḥ||15|| syāt sārti dāhanistodagudavarcaḥpravartanam|
tatra sarpiḥ picuḥ kṣīraṃ picchābastiśca śasyate||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 ½ – 16]

Effects of slow enema

न भावयति मन्दस्तु बाह्यस्त्वाशु निवर्तते| स्नेहस्तत्र पुनः सम्यक् प्रणेयः सिद्धिमिच्छता||१७||
na bhāvayati mandastu bāhyastvāśu nivartate| snehastatra punaḥ samyak praṇeyaḥ siddhimicchatā||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

अतिप्रपीडितः कोष्ठे तिष्ठत्यायाति वा गलम्| तत्र बस्तिर्विरेकश्च गलपीडादि कर्म च||१८||
atiprapīḍitaḥ koṣṭhe tiṣṭhatyāyāti vā galam| tatra bastirvirekaśca galapīḍādi 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]

तत्र श्लोकः- नेत्रबस्तिप्रणेतॄणां दोषानेतान् सभेषजान्| वेत्ति यस्तेन मतिमान् बस्तिकर्माणि कारयेत्||१९||
tatra ślokaḥ- netrabastipraṇetṝṇāṃ doṣānetān sabheṣajān| vetti yastena matimān bastikarmāṇi kārayet||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.

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते सिद्धिस्थाने नेत्रबस्तिव्यापत्सिद्धिर्नाम पञ्चमोऽध्यायः||५||
ityagniveśakṛte tantre carakapratisaṃskṛte’prāpte dṛḍhabalasampūrite siddhisthāne netrabastivyāpatsiddhirnāma pañcamo’dhyāyaḥ||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.