vasti

              

VAITARANA VASTI

Etymology

Vaitarana is the name of river. This vasti is so powerful in a sense that it can bring back life of a person who is about to cross the vaitarana river.

The term Vaitarana has been made from the word “Vitaranam”, which literary means to donate, go across, to leave which help to expel out the Dosha. Thus, we can say that Vaitarana vasti help to expel out the morbid Dosha from the body and thereby giving relief in the disease.

                                  Vaitarana vasti formulation popular among the current generation of  Ayurveda.Kshara vasti and Vaitarana vasti were not common in the routine  clinical practice of Ashtavaidya tradition.Various formulations of vaitarana  vasti are mentioned in the texts of Ayurveda. The vasti in which chinch (tamarind), guda (jiggery), saindhav, gomutra (cow urine) and oil are used is known as vaitarana vasti. This vasti is described in cakradatta & vangaseva.  It is very useful in abdominal pains (vataja & kaphaja) , anaha(flatulence), amavata, all types of vataja pain like..katishoola.

INDICATION:-

       Cakradatta & vrndamadhava:- shoola, anaha, amavatahara       

                            

      Vangaseva:-  katiurupristha shotha, shoola, 

                                Vataroga, Urusthambha 

                               Gridhrasi, Janu samkocha,   

                               Visama jwara, Klaibya                 

Table 7. Vaitarana vasti formulation in vangasena  (vastikarmadhikara chapter 83/ 186-190)

INGREDIENTS	QUANTITY
Saindava	1 karsha
Guda	1/2 pala
Amlika	1 pala
Surabhi paya	1 kudaba
Taila	Little quantity

                              

                      In Saligramavaidyas hindi translation of Vangasena, he mentions gomutra instead of milk as a constituent.This may be due to the influence of references in the former treatises like Vrinda madhava and Cakradatha.The first reference regarding Vaitarana vasti is probably found in Sidhayoga or Vrindhamadhava.                                      

                 The placement of this vasti in the text of Vrindha madhava is also worth mentioning. The vaitarana vasti is explained as a separate section after niroohadhikara in the Anandasramas edition of Vrindhamadhava,as this formulation does not satisfy the common pattern of combination observed in the preparation of nirooha vasti ie makshika,lavana,sneha,kalka, and kwatha and it is also lesser in quantity.

Table 8 Vaitarana vasti formulation in Vrinda madhava ( niruha vasti chapter 76/43, 44)

INGREDIENTS	QUANTITY
Saindava	1 karsha
Guda	1 sukti
Amlika	1 pala
Gomutra	1 kudaba
Taila	Specific quantity not mentioned

The indications of the vasti formulations are shoola,anaha and amavatha.The critical edition of Vrinda madhava by Dr.P.V Thivari and Dr.Ashakumari reports a variant reading where guda is replaced by Hingu.Cakrapani datha also accepts the same formula of Vrinda.The commentators furnish certain important clues regarding the

combination of this vasti. Srikanta datha and Sivadas sena explain that even though in the case of vasti the measurement is taken as explained in the formula, here double the quantity of gomutra is taken as per the paribhasha of drava yogana. Chandrata explains that the doubling of the quantity of liquid ingredient is applicable for drava or liquid mentioned which are of the quantity kudaba or more.Niscalakara and Sivadas sena stipulates the quantity of taila as 1  pala.Tatwa chandrika teeka presents the practise of adding one madanaphala to vaitarana vasti which is usually added to every nirooha vasti.This tradition seems to a conscious effort to grant the status of nirooha vasti to vaitarana vasti. Adamalla who closely follow vangasena, refers to the vasti preparation as kshira vaitarana.

Table No 9. References of vaitarana vasti in Chakradutta- Niruha-adhikara (73/32)

INGREDIENTS	QUANTITY
Saindavam	1 karsha
Guda	1 sukti
Amlika	1 pala
Taila	specific quantity not mentioned
Gomutra	1 kudaba

We can stipulate the quantity of taila as one pala on the basis of Nischalakara and Sivadasa.Regarding the quantity of gomutra Nischalakara is silent but both Srikanta datha and Sivadasa take it as ashtapala 8 palas by sticking to the paribhasha of drava yogana.

DHANYAMALA As per A.H.Su.(5/79-80) & C .Si (10/14-16)

INGREDIENTS	QUANTITY
Saindavam	15 gm
Guda	30 gm
Chinch kalka	60 gm
Tila Taila	120 ml
Dhanyamla	240 ml

 There is no direct reference of Vaitarana vasti using dhanyamla in Ayurvedic Classics. This Dhanyamala Yukta Vaitarana Vasti is prepared by replacing gomutra by dhanyamla from the reference of Chakradutta- Niruha-adhikara (73/32) and Vangasena -Vashtikarmadhikara (83/186-190)

Idea behind selection:

Ø  It is very popular amoung Ayurveda practitioners of Kerala.

Ø  Taking into consideration wide range of use of this yoga.

Ø  Its popularity and efficiency.

Ø  There a great need of proper research in this sector.

This vasti is mentioned in niruhadhikara and having teekshana and shodhana properties should be administered continuously 5 days. .

METHOD OF ADMINISTRATION OF VASTI

Vasti is praised by all the Acharya for its significant results. In order to achieve these results, to its maximum extent care must be taken at all the steps starting from selection of the patient till the completion of the Vasti therapy. Vasti Karma can be classified into three phases viz. Purva karma, Pradhana karma and Paschata Karma. They can be explained as follows:

1) Purva Karma:

It includes the selection of the patients, selection of the drugs for the Vasti Karma, its Dosage, duration and schedule. In order to decide these things, consideration of several factors in minute details is essential those factors are – Dosha, Aushadha, Desha, Kala, Satmya, Agni, Satva, Oka, Vaya & Bala. Charaka says that the Vasti prepared and administered after considering all these factors critically, is certainly capable of providing the significant results, the benefits of all the Karma and ultimately success (Ch.Si.3/6). After that preparation of the Patient and preparation of the Vasti dravya is coming.

a) Preparation of the Patient: - patient should be administered before deepana & pachana by give vaishavana churna & gandharvashtadi kashayam.

b) Preparation of vasti dravya :

1.      Prepare the paste of chinch and guda separately added hot water and material should be removed.

              

Method of Preparation:

Vaitarana Vasti was prepared as per the classical method used for the preparation for the preparation of Niruha Vasti.

 Step 1: Initially 30 gm (1 Shukti) of Jaggary (Guda) was mixed uniformly with equal quantity of lukewarm water.

 Step 2:   15gm (1 Karsha) of Saindhava was added to the above.

 Step 3: as per required (120ml) Tila Taila was added till the mixture become homogenous.

 Step 4:    60 gm (1 Pala) of Chincha Kalka was taken and added to above mixture    carefully.

 Step 5: Lastly 240 ml (1 Kudava) of Gomutra or dhanyamla was added slowly and mixing is continued so as to have uniform Vasti Dravya.

 Step 6: Finally after filtering, Vasti Dravya is made lukewarm by keeping it into hot water.

Snehana:

 Bahya Snehana is to be performed by Sarvadaihika Abhyanga.

Swedana:

Preferably Bashpa Sweda is advised.

Per-rectal examination:

All patients should be examined per rectally before administration of Vasti drava.

v  Characteristics of a well prepared Vasti Dravya:

A well prepared Vasti dravya should not run quickly out of the hand nor should it stick/coat or remain steady on the hand. It should be uniform mixture without separation (Samhata) of its contents (Chakradutta -73/8). After preparing the Vasti Dravya, it is to be filled in the clean Vasti Putaka then the Vasti Netra which is clean and devoid of Dosha is to be tied with the Vasti Putaka in such a way that air will not be present in the Putaka, then a cotton piece is to be kept in the hole of the Vasti Netra.

2) Pradhana Karma:

It includes advice to the Patient, Vasti Pranidhana, Vasti Pratyagamana and observing the Samyaka Yoga, Ayoga and Atiyoga Lakshana.

Advice to the patient:

Patient is to be asked to pass his natural urges before Vasti Pranidhana and not to laugh, cough, sneeze and take the yawning while administering Vasti.

v Vasti Pranidhana:

Vasti is to be administered when the patient is having the symptoms of Jirnahara and is not very much hungry. After performing Abhyanga and Bashpa Sweda, the patient is asked to lie down in the left lateral position on the Vasti table which should be cleaned and covered with the bed sheet, then is asked to keep his left hand below the head as a pillow, to extend the left leg completely and to flex the right leg at the Knee Joint keeping on the left leg by flexing the hip Joint. Then Sukhoshna Sneha is to be applied in the anal region and on the Vastinetra, remove the cotton piece and the air bubble if any and keep the thumb on the Netra till introducing it. Then introduce the Vastinetra gradually in the parallel direction to that of the vertebral column up to 1/4 part of the Netra i.e. till the nearer Karnika fixes over the anus. Then hold the Vasti Putaka in the left hand and keep the right hand on the Putaka and press it gradually with the constant pressure neither too fast nor to slow without tremoring the hand. By asking the patient to breath in push the Vasti dravya into the rectum till a little quantity remains in the Putaka otherwise Vayu enters into the Pakvashaya after that withdraw the Netra gradually. Then the patient is asked to lie down in the supine position gradually and Sphikatadana is to be done slowly and softly 3-4 times and the foot end of the table or the legs of the patient are to be lifted slowly. The patient is then asked to lie in a comfortable position with a pillow below the hips till he gets the urge for defecation and when he/she gets the urge ask him/her to sit in Utkatasana and pass the urge.

v  Vasti Pratyagamana:

One Muhurta (48 mins.) is the maximum period of time with in which the Pratyagamana of Vasti should occur. If it does not occur then it causes untoward consequences like Vata Pratilomata, Vistabdhata, Shula, Arati, Jvara and even death. Hence if it does not comes out within the stipulated time period certain measures are to be undertaken for the Vasti Pratyagamana like administration of the Tikshna Vasti, Phalavarti, Swedana over the pelvic region, Utrasana (Showing fear) and administration of Virechana Aushadhi. Till the Pratyagamana takes place, the physician should observe the patient. However Kashyapa opines that Yapana Vasti owing to its Mrudu in nature retains for longer time, and Tikshna Vasti comes out in 100 Matra Kala, hence Atitikshna Vasti should not be administered.

Table no. 1.18: Showing the Samyaka, Ayoga & Atiyoga lakshana of Niruha Vasti

Samyaka lakshana	Ayoga lakshana	Atiyoga lakshana
Passing stool,  Urine, flatus usually	Headache	Same as that of virechana Atiyoga
Lightness in the body	Pain in the heart, umbilicus, bladder, anus, penis or vagina	Dullness in the body
Feeling tasty		Body ache
Increased digestive power	Oedema	Tiredness
	Coryza	Tremors
	Cutting pain	Sleep
	Anuria	Weakness
	Dyspnoea	Drowsiness
	Anorexia	Insanity
	Heaviness	Hiccup

In Atiyoga, Grahi, Dipana and Pachana Aushadhi are to be administered and according to symptoms it is to be managed.

3)  Paschata Karma:

              If patient gets natural urge with in 10 to 15 minutes ask him to go for latrine, he may get 3-4 motions.

v  Pathya Ahara-Vihara :-

After observing the Samyaka Niruha Lakshana, the patient is advised to take hot water bath and light diet in accordance with the dominance of Dosha i.e. Yusha, Kshira & Mamsarasa in Kapha, Pitta and Vata dominant conditions respectively or in general, Mamsarasa with rice is to be taken. The hot water bath and food taken prevents the occurrence of diseases produced by agitated and moving Mala caused by Vasti (A. Hr. Su.19/50).The patient should also be advised for not doing heavy laborious work, day sleep, sexual intercourse etc.

v  Pariharya Vishaya:-

 Certain things are strictly prohibited, both during the Vasti course and even after the Vasti course for a time period twice the Vasti course period (Parihara Kala). The things to be avoided are as follows: loud speech, jolting movement, long wayfaring, constant sitting, and indigestion, intake of unwholesome food, day sleeping and sexual intercourse

  

Time of administration

Vrindamadhava and vangasena explains vaitarana vasti can be administered to all types patients.It can be given even after the consumption of food, which deviates from the general norm of administering nirooha vasti.It can be given at evening times.though all the authorities favour the administration of vaitarana vasti after taking food it should be understood as an exceptional rule and should be administered in special cases where the patient is too weak to withstand the strength of the vasti

Mode of Action of Vaitarana Vasti :

Vaitarana Vasti works by the virtue of action of ingredients present in it. The ingredients present are Saindhava, Guda, Chincha, Gomutra and Tila Taila. The action of each ingredient can be described as follows.

Saindhava :

Ø  Due to its Sukshma and Tikshna properties, it helps to pass the drug molecule in systemic circulation through mucosa. Thus, it helps the Vasti Dravya to reach up to the molecular level.  It is also helpful for the elimination of waste due to its irritant property. It is capable of liquefying the viscid matter and breaking it into minute particles.

Guda (Jaggary) :

Ø  In this Vasti instead of honey (Madhu) jaggary is used. It along with Saindhava makes homogenous mixture, to form a solution having properties to permeable the water easily. The retention of the irritative substances may be favoured by making its solution as nearly isotonic as possible by using colloidal fluids. Here, Purana Guda should be taken as it is Laghu, Pathya, Anabhishyandi, Agnivardhaka, Vatapittaghna. It also helps in carrying the drug up to micro-cellular level.

Tila Taila :

Ø  In this Vasti, Tila Taila mixed with the solution of jaggary and Saindhava help in forming the uniform mixture. Again it counterparts some of the irritating properties of both Saindhava and Guda.

Chincha :

Ø  Chincha is having Vata-kaphashamaka, Ruksha and Ushna properties. These properties of the Chincha make it useful for the disease katishoola. Guna helps in counteracting the relief of pain. which is chief pathogenic factor of the disease.

Gomutra :

Ø  In Vaitarna Vasti, the Gomutra is chief content, which owing to its Katu Rasa, Katu Vipaka, Ushna Virya, Laghu, Ruksha, Tikshna Guna pacify the Kapha. The Ruksha Guna of Gomutra is very much helpful in the diseased condition like katishoola, Amavata. It is considered as useful for Kshara Vasti owing to its Tridoshahara, Agnideepana, Pachana, Srotovishodhana and Vatanulomaka properties.

Dhanyamla:

Ø  As indicating the name, Dhanyamla is amla. So the associated qualities of amlarasa as stated in classics viz. laghu, snigdha, deepana, Vatanulomana, etc. can be safely attributed to it. . It is sristha vina-mutra in nature, vasthi sodhana and vibhandhaghna. The properties of dhanya like brumhana, tarpana, balya, and vatahara are also supplemented.  In brief dhanyamla may possess the following properties. it can be used in amavata. It is srotoshodhana and shoolahara

Thus, Vasti Dravya when administered reaches up to the micro and macro level due to its Virya (potency) helps first to disrupt the pathogenic process and carries out the morbid matter toward Pakvashaya for the elimination. Thus it works as curative as well purificative measure.

            Vasti is not merely the enema, one which exerts local cleansing effect; rather it is a highly complex, sophisticated and systemic therapy having wider range of therapeutic actions and indication. It excretes its action by endocolonic (action inside the colon), endocolonic (action on tissues of colon) and diacolonic (for systemic action) ways.