Matra Basti in Vibandh – A Review Article
Vibandh is a very common gastrointestinal disorder of all age groups and occur commonly due to our sedentary life style and poor food habits. It is experienced by most of the people at some time during their whole life. Vibandha is the obstruction of Purisha /stool in the Purishavaha Srotas which can be called as Constipation. Apana Vayu is responsible for the expulsion of Mala from the Purishavaha Shrotas. When Apana Vayu is vitiated, it results in Vibandh. In modern aspect Vibandh is corelated with constipation. It refers to bowel movements that are infrequent or hard to pass and in general term used to indicate fewer bowel movements, solidified hard stools, painful defecation and feeling of bloating, abdominal discomfort or incomplete elimination. In Panchkarma, Basti Chikitsa is considered to be a prime treatment of vitiated Vata Dosha. It has not only curative aspects but also preventive and promotive aspects. Matra Basti is a type of Sneha Basti. In Matra Basti, least dose of oil/unctuous substance is used and administered in the body through anus preceded by Sthanik Abhyanga and Swedana. It normalizes the vitiated Apana Vayu and clears the obstruction of Purishavaha Shrotas. So Matra basti is found to be effective in the treatment of Vibandh.
Introduction
In this present competitive era, the people in an attempt to fulfil their fast-growing desires by following irregular life styles and erratic dietary habits because of which there is a strong impact on the Gastro-intestinal tract (GIT). That’s why, day by day, the incidence of diseases due to Gastro Intestinal derangement is increasing. Vibandh or Constipation is one of the outcomes of such problems. 22% of the adult Indian population is suffering from this condition, with 13% complaining of severe constipation, 6% of the Indian population suffer from constipation associated with certain comorbidities [1]. The worldwide prevalence of 1% to 80 % where the condition is characterized by a wide geographical variation [2]. Constipation is known as Vibandh or Malabadhta in Ayurveda. In which there is a passing of hard stool or inability to evacuate completely.
Hetu
Though, there is no independent mention of the causative factors of Vibandh available in the classical text, but according to all the Acharyas, Vata is the main responsible factors for this Disease. According to Acharya Charak, excessive intake of Katu, Tikta, Kashaya and Ruksha Aharas, suppressing of natural urges and excessive sexual indulgence leads to aggravation of Apana vayu in Pakvashaya and obstructs the Purishavaha and Mutravaha Srotas. This obstruction causes various symptoms like Avrita of Mala (Vibandha), Urdhva Gaman of Apana Vayu and Shuskta of Purisha. Other symptoms like Adhamana, Hrillasa, Shula of Basti, Parshva, Kukshi and Pristha which all are the symptoms of Udavarta [3]. So Vibandh is the obstruction of Purisha /stool in the Purishavaha Srotas which can be called as Constipation. It may be the end result of many gastrointestinal and other medical disorders According to Sushruta, Mandagni is the main cause of Vibandh [4] or constipation. Indigestion (Ajirna) and improper diet (Malinahar) also causes constipation. It is to be noted that Dusti of Apana Vayu and Pureesha causes Vibandha [5]. Both of them can create symptoms like pain in Abdomen, gas formation, pain in anus while passing stool, headache, acidity, palpitation and in chronic cases, Piles and Fistula [6]. सर्वेषामेव रोगाणां निदानं कुपिता मलााः [7]
As it is said that kupita Mala is the root cause of all the disease which means that mala gets kupita due to Vibandh or constipation.
Samprapti
Due to all above mentioned reason, the digestive power become sluggish which cause incomplete digestion of food, which is not expelled by the intestines and causes the formation of Ama. This Ama occult stool slowly and accumulate in the stomach and large intestine and impair Vata Dosha which results in obstruction of the digestive tract. When the digestive tract is not clear, the body will not be able to facilitate proper bowel movements, thereby leading to the condition of Vibandh.
Samprapti Ghatak
- Nidana : Aharaja, Viharaja, Manasika
- Dosha : Apana vayu
- Dushya : Purisha
- Agni : Mandagni, Vishamagni
- Srotasa : Purishvaha srotas
- Srotodusti : Sanga
- Udbhavasthan : Amashaya, Pakvashaya
- Rogamarga : madhayama
- Vyadiswabhava : Chirakari
- Adhisthana : Pakvashay
Chikitsa
The line of treatment for Vibandh may be followed as that is in Udarvata [8] as Apana Vayu is the main factor for the causing the disease and Vibandh itself is one of the important symptoms of Udaravata.
तं तैलशीतज्वरनाशनाक्तं स्वेदैर्यथोक्तैः प्रबिलीनदोषम् | उपाचरेद्तिॅनिरूहबस्तिस्नेहैविॅरेकैरनुलोमनान्नैः [9] || Matra Basti is a type of Sneha Basti i,e AnuvasanaBasti. It promotes strength and can be administered easily. It helps in early voiding (elimination) of stool. For Matra Basti, the dose of Sneha to be given is equal to the minimum quantity prescribed for Anuvasana Basti. This dose gets digested in half of the day (2 Yama i.e. 6 hours) is called as Harsva Matra but the dose required to get digested in 2 Yama is not mentioned [10].
While commenting upon Matra Basti, Chakrapani has described that Sneha Basti contains 6 Pala of Sneha, Anuvasana Basti contains 3 Pala of Sneha and Matra Basti contains 1½ Pala of Sneha. From above references it can be said that the dose of Matra Basti is 1½ Pala of Sneha i.e. approximately 60 ml. The normal time of Pratyagamana Kala of Sneha Basti is 3 Yama i.e. 9 hours [11]. Since, Matra Basti is the type of Sneha Basti, its Pratyagamana Kala is also 3 Yama i.e 9 hours. There is no harm if Matra Basti is retained in the body, because while describing Anuvasana Basti, Acharya has explained that it does not injure to body, even in the event of its being retained in the body for a whole day. Also the dose of Sneha in Matra Basti is very small which can get easily absorbed in the body without coming out. It is believed that Sneha Basti should retain in the body. If Basti returns much earlier, it cannot produce the described Sneha effect in the body. “Basti Vata Haranam Shrestham” is the quotation mentioned by Acharya Charaka in Agradravyas [12]. This type of medicated Basti immediately relieves the retention of urine, stool and flatus and promotes the normal functioning of the rectum as well as connected vessel.
Discussion
In recent years, there has been an unprecedented increase of incidences of gastrointestinal anomalies, due to changes in life style, diet habits, behavioral pattern etc, which very much disturb the normal physiology of digestion. Vibandha is a disease of Annavaha Srotasa, any disturbance of Agni due to irregular diet and behavioral pattern as well as the involvement of mental stress and strain, leads to the disease Vibandha. Basti administered through Guda (Rectal Route) reaches the Pakvashaya which is considered as the main site of Vata Dosha.After that it normalizes Apana Vayu leading to Vatanulomana and improves physiological functioning of Vata. As the Vata is pacified disease itself gets cured because it is a major causative factor in the disease. Basti administered in the Pakvashaya affects the whole body by its Virya.
Conclusion
Constipation is a major and common health concern. It put greater impact on the general health and quality of life of general population. If not treated or treated is delayed, it can lead to further problems such as piles, fissures, fistula, lack of appetite and indigestion. Matra Basti is one of the most important and useful treatments for a diseased and healthy person. Matra Basti helps to maintain the equilibrium of Vata Dosha in our body. More and more strategies should be conducted to have a better understanding for the prevention and treatment of constipation among general population.
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