Sus`hruta has mentioned a special type of Basti i.e. Utkles`hana Basti in Chikitsaa Sthaana but the exact condition in which it is useful is not specified. So for, Post Graduation study, the topic of Utkles`han Basti was selected. The main aim of the study was “To specify the exact conditions of Utkles`han`a Basti and to ascertain the mode of its action. The study revealed significant results.
The term Utkles`ha and Utkles`han`a
=iÉ + ÊKú¶É >øv´ÉÇiÉ& +ÉnüÔEúÉ®Eäú KäúnüEúÉ®Eäú * ´ÉÉSɺ{ÉiªÉ¨ÉÂ
To excite, to agitate
Utkles`ha – excitement, agitation
Utkles`haka – Causing disorder of Dosha.
- Ulkleshya-Prakopya (Dalhan`a S. Su. 20/20)
‘Utlkes`ha’ means provocation or accentuation of Dosha.
- Utklisht`ya Sthaanaat Chalitah (A.H.Su. 18/12 Hemaadri)
Dosha get agitated from the sites they usually occupy.
- Anuklisht`aan Svasthaanaat Achalitaana (A.H.Su13/28 Sarvaangasundera)
The word Anutklisht`a means Dosha are in their own site but are lurking and not separated from their site.
To Summarize:
- Utkles`ha is a very specific condition of Dosha.
- The prefix Ut indicates movements which is in upward direction.
- Upward movement or direction is with respect to specific site i.e. from the site.
- The verbal phrase Chalita indicates movement regarding Moorta Dosha.
- So the phenomenon of Utkles`han`a is possible in case of Moorta Dosha i.e. Kapha and Pitta.
- Vaata is an important force for the movement.
There are two phrases ‘Utkles`ha’ and ‘Upasthita’ seem to be similar:
- Utkles`ha – For S`haakhagata or Madhyama Maarga Gata Dosha Utkles`han`a means provocation or agitation of Dosha from their site in S`haakha or Madhyama Maarga. The movement of Dosha takes place from S`haakha or Madhyama Maarga towards Kosht`ha. This movement can be termed as ‘Utkles`ha’. Thus the separated Dosha leave their site in S`haakha or Madhyama Maarga and occupy the site in Kosht`a i.e. Upasthita Doshatva.
Here movement of Dosha from one organ in Kosht`a to other organ in Kosht`a can be considered.
- Some times Dosha present in the Kosht`a show excitement and tend to move outside the body or they show spontaneous elimination from Kosht`a to outside the body. E.g. छर्दि, Aamaatisaara. This movement is termed as Utkles`ha of Dosha in Kosht`a i.e. Upasthita Dosha.
‘Utkles`han`a’ can take place by:
- Utkles`haka Aahaara.
- Specific Kaala
- Different treatment procedures (Snehana, Svedana etc., Basti is one of them).
- Unpleasant subjects.
- Unsuccessful purification method.
The mode of Utkles`ha of Dosha in all above conditions does differ as per following parameters:
- Amount of Utklisht`a Dosha.
- Site of affliction.
- Direction of Utkles`han`a.
- Period of Utkles`ha.
Constituents of Utkles`han`a Basti: (Reference: S.Chi. 38/92) Eran`da Beeja, Yasht`ee, Pippali, Vachaa, Hapushaa
Prakshepa: Madhu, Saindhava, Madanaphala
Drugs and Bhoutika Constitution:
- Eran`da Beeja(Prithvi + Agni):
- Rasa: Madhura, Kat`u, Kashaaya
- Veerya: Ushn`a
- Vipaaka: Madhura
- Properties: Guru, Teekshn`a, Svedopaga, Sookshma
- Action: Svedopaga, Bhedana
- Prabhaava – Adhobhaagahara
- Pureeshadhara
- Pakvaas`haya
- Uttaraguda
- Adharaguda
- Sthoolaantra
- Yasht`ee(Prithvi + Aapa) :
- Rasa: Madhura
- Veerya: S`heeta
- Vipaaka: Madhura
- Properties: Guru, Snigdha
- Action: Vamanopaga, Kaphavilayana, Raktastambhana,Hridya(¾þt)
- Pippali(Agni + Vaayu):
- Rasa: Kat`u
- Veerya: Anushn`a- S`heeta (Ushn`a – According to Charak)
- Vipaaka: Madhura
- Properties: Laghu, Snigdha, Teekshn`a, Aas`hukaari, Yogavaahi
- Action: Rechana, Deepana, Chardana,Rasaayana
- Vachaa(Agni + Vayu):
- Rasa: Tikta,Kat`u
- Veerya: Ushn`a
- Vipaaka: Kat`u
- Properties: Laghu, Teekshn`a, Sara, Pramathi, Aashukaari
- Action: Emesis, Liquefying Kapha, Lekhana
- Hapushaa(Due to unavailability not used in Basti):
- Rasa: Tikta,Kat`u, Kashaaya
- Veerya: Ushn`a
- Vipaaka: Kat`u
- Properties: Guru, Mridu
- Action – Deepana, Anulomana, Bhedana
- Prakshepa:
- Madhu:
Rasa: Madhura, Kashaaya
Veerya: S`heeta
Vipaaka: Madhura
Properties: Sookshma, Rooksha, Yogavaahi
Action: Deepana, Srotomukhavis`hodhana, Lekhana - Saindhava(Agni + Jala):
Rasa: Lavan`a, Madhura
Veerya: Anushn`a
Vipaaka: Madhura
Properties: Sookshma, Laghu, Sara, Teekshn`a
Action: Deepana, Paachana, Chedana, Bhedana,Kledana, Sramsana - Madanaphala (Agni + Vayu) :
Rasa: Madhura,Tikta, Kashaaya
Veerya: : Ushn`a
Vipaaka: Kat`u
Properties: Laghu, Rooksha, Vikaasee, Vyavaayi, Aas`hukaari
Action: Lekhana, Vaamaka
Prabhaava – Vaamaka
Basti Kalpanaa: Sus`hruta has given Utkles`han`a Basti as Nirooha Basti Kalpana. He intended to use the three Basti – Utkles`han`a, Doshahara and Dosha S`hamana in sequence. (S.Chi.38/91). Thus it can be inferred that Utkles`han`a Nirooha according to Sus`hruta is expected to be used for Utkles`han`a of Kosht`hagata Dosha and it should be followed by Doshahara and Dosha S`hamana.
There is one opinion in the commentary made by Dalhan`a that the Basti does not cause Utkles`han`a of Dosha situated in Dhaatu (tissues) (Dalhan`a Su.Chi. 38)
But to observe the results in patients of Bahudosha Avasthaa and S`haakhagata Dosha, Basti was used as Nirooha and Anuvaasana Basti.
From above opinion of Dalhan`a, it can be inferred that, Sus`hruta has expected Kalka / Aavaapa of Dravya [Eran`dabeeja, Yasht`i, Pippali, Vacha, Madanphala] in hot water. Hence Kalka in hot water will not be used for Utkles`han`a at tissue level / Dhaatu level. It will act in Pakvaas`haya and will cause Utkles`han`a of Pakvaas`hayagata Dosha.
But for Gun`otkarsha, Karmotkarsha and to see the effect all over the body (i.e. Dosha, Dhaatu, Mala, Agni, Srotas), decoction and Siddha Taila (processed oil) was used. Here one thing should be noted that due to decoction and Siddha Sneha Utkles`han`a of Dhaatugata Dosha can be seen e.g. in आमवात, शोथ. These changes are mentioned in the thesis.
For the purpose of Gun`otkarsha and Karmotkarsha, decoction of the above drugs was used.
For Anuvaasana sesame oil processed with the above drugs (Siddha Sneha) was used according to Snehapaaka Vidhi as per S`haarangadhara Samhita.
Nirooha – Dose – Decoction 320 ml (Pippali, Eran`dabeeja, Vacha, Yasht`i, Kalka – 5 gm each drug in fine powder form, Oil 30 ml, Honey 30 ml, Saindhava 5 gm ).
Anuvaasana – Processed oil 60 ml was used.
Action of Utkles`han`a Basti:
- General Action
- Specific Action
- Collectively Utkles`han`a Basti has:
- Rasa – Kat`u , Tikta
- Veerya Ushn`a
- Vipaaka – Kat`u
- Gandha – Utkles`haka
- Properties Ushn`a, Sookshma, Teekshn`a, Laghu, Saandra, Pramathi, Snigdha, Vyavayi, Vikaasee
- Functions – According to the principle
- Utkles`han`a Basti will perform function like Langhana, Rookshan`a, Svedana and Snehana.
- Other function – Chedana, Bhedana, Lekhana.
- Action of Utkles`hana Basti – Action on Dosha and Dhatu :
- Dosha– Kaphavilayana, Pittavriddhi, Activation of Vaata.
- Dhatu – Final Action / Ultimate result.
Rasa: Increase in Fluidity and Subtleness.Decrease in Unctuousness.
Rakta: Increase in Fluidity and Saragun`a (spreading)
Maamsa: Decrease in Hardness and Heaviness.
Meda: Increase in Fluidity (S`haithilya).
Asthi: Increase in Dryness.
Majja: Decrease in Softness.
S`hukra: Increase in Fluidity. Decrease in Unctuousness.
- Upadhaatu :
- Raja – Fluidity, Hotness
- Tvak – Softness
- Srotas – Upalepa, Sanga, Vimaargagamana – Eliminated
- Kaala – Purification of Pureeshadhara, Maamasadhara, Asthidhara, Majjaadhara, Pittadhara kalaa
- Agni – Deepana
- Mala
- Purisha – Bhedana, Malakshaya
- Mootra – Increase in Fluidity, Hotness, Quantity
- Sveda Pravrutti
- Action:
- Utkles`han`a Basti with Vyavaayi and Vikaasee attributes
- In Pakvaas`haya
- Nipaata / Samparka with body constituents
- Properties responsible for rapid diffusion of drugs in body]
- Pakvaas`haya, ग्रहणी and Rasagaami – Rasa flows in Oordhva, Adha and Tiryak direction and three Maarga
- Veerya of Basti – is first taken by Apaana Vaayu, then Samaana and then Vyaana Vaayu and in whole body
- Through Rasa drug can reach Dusht`a Srotas (afflicted tissues)
- Due to Vikasee, Pramathi etc. properties, adhesion of Dosha are broken down (Until now function occurs irrespective of Jaat`haraagni)
- Other properties – (Sookshma, Ushn`a, Teekshn`a etc.) act with respect to Jaat`haraagni
- Pakvaas`hayastha Agni – activated by Jaat`haraagni
- Paachana of drug occurs
- Drug circulates through Rasa
- This requires time hence Dhaaran`a kaala is important
- Through ‘Rasa’ drug reaches Dusht`a Srotas
- From specific Dusht`a Srotas Lekhana, Bhedana of Dosha occurs
- Separated Dosha move along Rasa
- Reach Kosht`ha
- Show excitement in upward direction with respect to Kosht`ha or Show excitement in downward direction with respect to Kosht`ha
Here ‘Pramaathi’ property along with Vyavaayi, Vikaasee etc. is very important.
The drug is capable of converting and eliminating vitiated and strongly harbored Dosha from various body constituents (also deep body constituents) due to their potency. For this it does not require any assistance from Jaat`haraagni. S`harangadhara Samhita-Paribhaasha.
- Thus, Utkles`han`a Basti indications are:
- Dosha- Vruddha Dosha
- Bahub.
- Madhyama
- Avasthaa Anutklisht`a
Leena
Aama - Gati S`haakha to Kosht`ha
Kosht`ha to Kosht`ha
Madhyama – Maarga - Dooshya – Rasa, Maamsa, Meda, Asthi
- Srotas- Annavaha; Pureeshavaha
Mootravaha
Udakavaha
Rasavaha
Maamsavaha
Medavaha
Asthivaha - Events – Sanga
Sanga and Vimaargagamana - Vyaadhi Santarpan`ottha
- Selection of Patients:
Dosha Sanchaya is the common factor in the Vyaadhi like आमवात, शोथ, श्वास. So these were selected for the research.
But the Sampraapti Ghat`aka in these Vyaadhi are different.
e.g. Aamavaata – Upalepa
S`hotha Srotorodha
- Role of Utkles`hana Basti in आमवात :
आमवात is debilitating disease in view of its chronicity (Chirakaaritva) & complications (Upadrava).
There is variety of patients (one can classify like Bahudosha, Alpa Dosha, Puraan`a, Nava, Saamanyalakshan`a, Prakupita Aamavaata, Aamapradhaana Aamavaata , etc.) Various treatments have been given for आमवात which are to be used as per Avasthaa = stage of the disease.
The guiding principles of सौषधं are:
- Bahudoshaavasthaa
- Utkles`ha and Upasthita Doshatva.
Precipitation of Dosha from S`haakhaa to Kosht`ha and presence of Dosha in the Kosht`ha is necessary before purification. (C.VI. 3/44, C.S. 2/15)
In आमवात for Saama Dosha and S`haakhagata Dosha, different ways of precipitation of Dosha (Utkles`h a) are given in A.H.S. 13/18, 19, 30
But we cannot follow the same principle in all conditions.
E.g.:
- Patients with less vitality.
- Akaala – Kaala Mithyaayoga etc.
- Strong obstruction in channels (Balavan Srotorodha)
Here Utkles`han`a Basti plays important role for achieving Utkles`han`a and Upasthita Doshatva.
Twenty cases diagnosed as आमवात were studied during research.
- Classification of patients:
Bahudosha – 9 patients
Madhyamadosha – 8 patients
Alpadosha – 3 patients.
Saamanya Lakshan`a – 3 patients.
Prakupita Aamavaata – 17 patients.
- Method of using Basti:
Utkles`han`a Nirooha and Anuvaasana Basti were given alternately on the same day for 4 to 7 days.
- Sampraapti of आमवात :
Dosha- Vaata, Kapha
Dooshya – Agni, Rasa.
Sanchara – All S`hlesmasthaana – Aamashaya, Sandhi, Ura, Rasa etc.
Adhishthana – Sandhi
Samprapti Ghat`ana – Abhishyanda in Srotas (Upalepa).
- Results:
Oordhva Utkles`ha – 4 Vamana
Adha Utkles`ha – 15 Doshahara Basti.
NoUtkles`ha – 1
Four patients showed Oordhava Utkles`ha after administration of five Basti. Symptoms like Hrillasa, Praseka, Udara Gaurava, Kshudhaamaandya were seen. On examination, there was Aamaas`haya Gaurava.
Hence वमन with Panchatiktaka Kvaatha was given. This relieved 40% to 60% of Symptoms. For remaining Dosha, Doshahara and Doshas`hamana Basti were administered.
Twelve patients (Bahudosha – 6 patients, Madhyamadosha – 6 patients) showed aggravation of S`haakhagata Symptoms after administration of 5 to 6 Basti which signifies Doshavriddhi. After administration of next 4 to 6 Basti, there was relief of symptoms which signifies S`haakha to Kosht`a Gati of Dosha and elimination of Dosha.
- Chart:
Three patients after administration of seven Basti showed decrease in signs and symptoms upto 80%.
A short course of Doshahara and Doshas`hamana Basti was given after this.
When the Dosha move in upward direction, there is Oordhva Utkles`h a. When the Dosha move in downward direction, there is Adha Utkles`h a. Symptoms are Udara Gaurava, Malavriddhi and Sakapha Mala Pravrutti.
Utkles`hana Nirooha Basti causes purification of Dosha along with Doshahara Basti, thus –
- As Utkles`hana Basti is a Basti Kalpana, it has primary action of Vaata Dosha and on Vividhagati (movements of Vaata).
- Drugs in Basti bring about action primarily due to Veerya. Basti has fact action and is very effective (Aas`hukaa`ri).
- In आमवात there is vitiation of Vaata and Agni and Basti has direct action on Agni and Moolasthaana of Vaata, Rasavaha Srotas, Pureeshadhara Kalaa, Asthidhara Kalaa and Majjadhara Kalaa.
- Aama is Guru and naturally Adhogaami and its elimination by Basti is natural. Hence AdhaUtkles`ha was commonly found. As Nirooha Basti Kalpana is important in view of S`hodhana, Dosha are eliminated by Utkles`han`a Basti.
Thus Basti revealed good results in all stages of आमवात Patients were followed for one year. In most of the cases recurrence was hard to find.
- Role of Utkles`hana Basti in treatment of शोथ:
शोथ is one of the common diseases. Charaka has expounded a wide range of causative factors for Nija S`hotha (C-Chi-12/5, 6). The treatment principle of शोथ is given according to the cause and condition of S`hotha.
| Condition | Treatment |
| Aamaja S`hotha | Paachana |
| Snehabhava S`hotha | Virookshan`a C.Ch.12/8 |
| Bahudoshaja S`hotha | सौषधं |
| Santarpanajanya S`hotha | Apatarpan`a |
| Langhana | |
| Langhana, Paachana | |
| Doshaavasechana C.Su.23/8,9 |
We have already seen that Utkles`han`a Basti has attributes to do the above functions like Pachana, Rukshana, Shodhana, Lekhana etc. Hence Utkles`han`a Basti was tried in Nija S`hotha as Vyaadhi Pratyaneeka Chikitsaa.
- Method of using Basti:
It was same as आमवात .
- Classification of patients:
18 patients of Nija S`hotha were selected.
Bahudosha Avasthaa – 14 patients.
Madhyam Dosha Avasthaa – 4 patients.
Chirakaari S`hotha – 1 patient.
Nava S`hotha – 17 patients.
- Results:
Urdhva Utkles`ha – 5 patients.
Adha Utkles`ha – 13 patients.
Five patients of Bahudosha Avasthaa showed Urdhva Utkles`ha after administration of seven Basti. Out of these five patients, two patients showed symptoms like Hrullaasa, Praseka, Kshudhaamaandya, Arati, S`hiro Gaurava and छर्दि. In छर्दि contents were Pichhila Kapha and Pitta.
As there was no total elimination of Dosha, the patients were given Doshahara Basti and S`hamanaChikitsaa.
Another three patients also showed symptoms of Urdhava Utkles`ha. Hence Sadyo वमन was given with Panchatikta Kvaatha. After वमन the शोथ was reduced upto 60%.
One patient, after administration of six Utkles`hana Basti, showed Adhara Utkles`h a Prabhoota AdhoVaatasaran`a with 6 to 7 Dravamala Vega_s (loose motions). Then the शोथ was reduced.
Twelve patients showed specific S`haakha to Kosht`ha Gati of Dosha. After administration of 5 to 6 Basties, Shakha gata symptoms were aggravated which signifies Doshavriddhi and after administration of next 5 to 6 Basti there was relief of symptoms about 60% to 70%. This signified S`haakha to Kosht`hagati of Dosha and elimination of Dosha by Adha Marga.
- Conclusion:
In शोथ Doshaachayajanya Srotorodha is the main Sampraapti Ghat`ana. Basti Kalpana has main action on Vaata Dosha. It has fast action and is very effective. Utkles`han`a Basti eliminates Doshasanchaya from S`haakha and Kosht`ha by it’s Ushn`a (hot), Sookshma (Subtle) and Pramathi properties. Hence Srotorodha gets eliminated and Vaatanulomana occurs. Thus Sampraaptibheda of शोथ takes place.
Hence Utkles`han`a Basti is useful in Nija S`hotha – KaphaVaataja S`hotha, Vaatakaphaja, Kaphaja, Santarpan`ajanya, Snehabhaava and Aamaja S`hotha .
In this research Kaphaja and Santarpanajanya S`hotha were found and observed, But more work is to be done for Snehabhaava, Aamaja etc. types of शोथ . Patients were followed for one year. Three patients showed recurrence with less intensity.
The Basti was also tried in श्वास. It was used as a Poorvakarma of वमन along with Snehapaana. It revealed positive significant results. But more work has to be carried out.
The topic of Utkles`han`a Basti was selected by the author for post graduation study under the guidance of Vd.V. M. Nanal. This article is a part of the same thesis.
Vd. Mrs. Monica S Mulay
M.D.
Last updated on March 31st, 2021 at 06:08 am