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7/22/2016 1
By
Dr .Jadhav Bhagyashree P
2 nd year PG Scholar
Dept.of Panchakarma
2
7/22/2016
3
1. Introduction
2. Definition of Basti Karma
3. Importance of Basti Karma
4. Description of Majja dhatu
5. Diseases under Majja vikaras heading
6. Why Basti Karma in Majja vikaras
7. Different Basti formulations in different Majja vikaras
8. Mode of action
9. Discussion
10.Conclusion
7/22/2016
• Basti karma is one among the most important Panchakarma therapies
which is also considered as “ArdhaChikitsa ”.
• It is possessed with multidimensional action which makes it unique.
• Ayurveda considers Majja as the sixth Dhatu of the body. Charaka
enumerates the Asthi (bones) and Sandhis (joints) as the Moola of
Majjavaha Srotas.
• Majja contributes to the formation of and an increase in the
Shukra Dhatu; it fills in the internal cavities of bones and is the chief
source of body strength.
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• The nourishment to all dhatus is supplied through
Ahara Rasa. Imbalance in Asthi Dhatvagni and Majja
dhatwagni leads to improper formation of Sthayi
Majja dhatu.
• Basti karma has action on different levels of Dhatus,
considering this here an attempt is made to understand
the role of Basti karma in Majja dhatu vikaras.
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6
7/22/2016
तत्र स्नेहादिनाां कर्मणाां बस्स्तकर्म प्रधानतमार्ाहुराचार्ाम:।
कस्र्ात? अनेक कमम करत्वात् बस्ते:।
7
Basti
सांशोधन
सांशर्न
सांग्रहणा
नन
क्षीणशुक्रां
वाजीकरो
नत
कृ शां
बृम्हर्नत
स्थूलां
कशमर्नत
चक्षु:
प्रीणर्
नत
वललपली
तर्पह
स्तत
वर्:
स्थापर्
नत
7/22/2016
8
मूले निनिक्तो नि यथा द्रुम: स्यान्िील्छद: कोमलपल्लवाग्र्य:।
काले महान पुष्पफलप्रदश्च तथा िर: स्यादिुवानिेि
(च नन १/२७-३१)
शाखागता: कॊष्ठगताश्च रोगा: ममोर्धववनवाववयवाजगशाश्च।
ये ननन्ततेिाज िनि कनश्चदनन्यो वायो:परं जन्मनन हेतुरनतत
नवण्मूत्रनपत्तानद मलाशयािाज नवक्षेपनजाातकर: न यस्मात।
तस्यानतवृद्धस्य शमाय नान्यद्बनतत नवना ेेजजमनतत नकं न त
तस्यानचनकत्नार्वनमनत ब्रुवनन्त नवाव नचनकत्नामनप्नस्तमेके
च नन १/३८-४०
7/22/2016
Definition:
करोनत तत्र सौनजययमत्ां मध्ये समीरण:।
मेदस तानन पूरयन्ते तनेहो मज्जा तत: तमृत:॥( न १५)
मज्जनत अनत्ष्वनत। (शब्दकल्पद्रुम)
During formation of Asthi dhatu , vata creates spaces in the bones.
These spaces are filled with nourishing tissues of Medas or fat which
is known as Majja . The final essence of the Asthi dhatu which is a
semisolid substance becomes Majja in the process of metabolism .
The unctuous material is found inside bone is called as Majja.
97/22/2016
Kala of
formation
Mahab
huta
Location of
majja dhatu: Kala Quantity Upadhatu Mala
Parashar
- Majja
dhatu - on
seventh
day.
According
to
shushruta
25 th day
आप
महाभू
त
र्ज्जापूरणां
अस्थाांनाां च
करोनत|
स्थूलास्स्थषु
ववशेषेण
र्ज्जात्वभ्र्
ततराश्रित
तृतीर्
र्ेिो
धरा,र्ेिो
दह
सवमभूतानाां
र्ुिरस्थर्
अण्वस्स्थषु
च र्हत्सु
च र्ज्जा
भवनत॥
एको
अतजलल
र्ज्जार्ा:।
र्स्स्तष्क
स्र्
अधामतजलल
के श ववट स्नेह
अक्षक्ष स्नेह
त्वक् स्नेह
7/22/2016 10
• मज्जासार लक्षणा:
ततवांगा बलवतत: स्स्नग्धवणमस्वरा: स्थूलिीर्मवृत्त सांधर्श्च
र्ज्जासार:।
ते िीर्ामर्ुष बलवतत: िुतववञानअपत्र्सांर्ानभाजश्च भवस्तत॥
(च वव ८/११०)
अकृ शर् उत्तर्बलां स्स्नग्ध गम्भीरस्वर सौभाग्र्ोपतनां र्हानेत्र च
र्ज्जा।
(सु सु ३५१६)
• मज्जावह स्रोतस:
र्ज्जावहानाां स्रोतसाां अस्स्थननमूलं सन्धयश्च।( चवव ५८)
• मज्जावह स्रोतस दुस्टिकारण:
उत्पेषाित्र्लभष्र्तिािलभर्ातात्प्रपीडनात।
र्ज्जावादहनी िुष्र्स्तत ववरुदधाांनाच सेवनात॥ (च वव ५१८) 117/22/2016
12
मज्जा वृद्धध
लक्षणा:
र्ज्जा सवाांग
नेत्रगौरवां च।
( सु.सु १५)
र्ज्जा
नेत्राांगगौरवर् ्।
(अ ह सु १५)
मज्जाक्षय:
शीयमन्त इव चा अस्स्थनी दुर्मलानन लघुनन
च।
प्रततं वातरोधिणी क्षीणे मज्जनन देहहनाम॥
(च सु १७६८)
मज्जाक्षयेअल्प शुक्र ता पवमभेदोअस्स्थनी
तोदोअस्स्थ शून्यता च।( सु सु १५)
अस्स्थ सौषषयमननस्तोद दौर्मल्य
भ्रमतमोदशमनैमज्जा ।( अ सं)
अस्थां मज्जनन सौषषयम भ्रमस्स्तममर
दशमनम्॥(अ हृ सु ११/१९)
मज्जाप्रदोषज षवकार:
रुक पवमणाांभ्रर्ोर्ूर्च्ामिशमनां तर्स्तथा।
अरुषाां स्थूल र्ूलानाां पवमजानाां च िशमनर््॥
( च सु १८१६)
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Concept of Majja dhatu can be considered in
following ways:
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14
मज्जा व्यापजन्य रोि ( Vangasena)
वविाहश्च र्िां चैव्स् सोतर्ािां चापतानकर््।
तर्ोिशमन र्ू्ामन र्ज्जाव्र्पवत्तजास्तविु:।
अस्स्थमज्जाित वातज रोि: (Bhela samhita)
अस्स्थर्ज्जागतो भांग कम्पनां गात्रशोषणर्।
पक्षग्रह अपस्र्ारर्ुतर्ािर्वप चादिमतर््।।
हनुग्रहां कु णणां कु ब्जां पाांगुल्र् सस्तधववर्चर्ुनतर््।
करोनत र्ारुतेऽभ्र् च वातरोगा भवतर्वप॥
मज्जाहदवात लक्षणानन: (Basavarajiyam)
सवाांग शोफ कम्पश्च दहक्का वैर्च्िमनां तथा।
तीव्र भ्रर्णशूलां च र्ज्जावातव्र् लक्षणर््॥
7/22/2016
• अधोनाभ्र्स्स्थर्ज्जनौ वातस्थानां प्रचक्षते। का सु २७/१०
• तत्रास््र्ानन स्स्थतो वार्ु:। अ हृ शा ११
• अस््र्ािर्ाणाां व्र्ाश्रधनाां पांचकर्ामणण भेषजर््।
बस्तर्: क्षीरसवपमवष नतक्तकोपदहतानन च॥ च सु २८/२७
• प्रतते वातरोश्रगणण क्षीणे र्ज्जनन िेदहनार््। (च सु १७/
६७६८)
• श्र्लेष्मा शेिेिु-रनमाजनमेदोमज्शशुक्रमूत्रपुरीिनदिुनस्थत:। अ हृ ११/२६
• According to Kashyapa Adhonabhi,Asthi and Majja are
the seat of Vata dosha. 15
Why Basti Karma in Majja
vikaras????
7/22/2016
• Basti dravya reaches first to pakvasaya & then to the
Grahani. So from these we say that Basti Karma has direct
action on asthi & majja dhatu so we can adopt Basti karma in
Majja vikaras.
• Basti karma is the best choice of treatment for Vata dosha
and Vata associated with Kapha and Pitta.
16
Pakwashya
Purishdhadara
kala
Vatasthana
Asthi
dhatu
Grahani
Majja dhara
kala
MajjaPittadhara
kala
7/22/2016
• बल िोष काल् रोग प्रकृ नत: प्रववभज्र् र्ोस्जता: सम्र्क् स्वै: स्वैरौषधवगै:
स्वान् स्वान् रोगाननर्च्र्स्तत ॥
कर्ामतर्व्िस्स्तसर्ां न ववदर्ते शीघ्रसुखववशोधनर्त्वात्।
आश्र्वपतपमणतपमणर्ोगार्चच ननरत्र्र्त्वार्चच॥ च लस १०५
Basti should be administered keeping in view the bala of patient,
Doshas involved, nature of disease,prakruti of patient.basti
cleanses the body quickly and easily, does aptarpana and
santarpana and is free from adverse effect.
• सर्ीक्ष्र् िोषौषध िेश काल सात्म्र्ास्ग्नसत्वौकवर्ोबलानन।
बस्स्त: प्रर्ुक्तो ननर्तां गुणार्स्र्ात सवमकर्ामणण च लसदश्रध र्स्तत॥
च लस ३६
17
How to plan Basti?
7/22/2016
Basti
Ausha
dha
kala
Desha
Satmya
AgniSatwa
Vaya
Bala
Dosha
awastha
एवां कालां बलां िोषां ववकारां च ववकारववत्।
बस्स्तद्रव्र्बलां चैव वीक्ष्र् बस्तीन प्रर्ोजर्ेत्॥
सु श्रच ३८७१
7/22/2016 18
• Yoga Basti:
अल्पत्वात स्नेह बस्स्तनाां र्ुक्तेर्ोग: स लार्वर्।
प्रर्ोज्र्: कफ सांसृष्टॆ नानत तीव्रबले अननले॥(का.णख ८९-१०)
• Kala Basti:
तत् अधम कलनात् काल: स दह र्ध्र् बलातवर्े।
पवने वपत्त सांसृष्टे ववधातव्र्ो ववजानता॥(का.णख ८८-९)
According to Charaka:
According to Kashyapa:
19
1 2 3 4 5 6 7 8
A N A N A N A A
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A N A N A N A N A N A A N A A A
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A A A N A A A N A A A N A A A
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• Karma Basti:
गम्भीर अनुगता र्स्र् क्रर्ेण अपश्रचता र्ला:।
कु वपता वात भुनर्ष्टा बस्स्त साध्र्ा ववशेषत:॥
सम्पतनस्र् सदहष्णॊर्चि कर्म तस्र् परार्णर््।(का.णख ८२८-२९)
20
1 2 3 4 5 6 7 8 9 10
A N A N A N A N A N
11 12 13 14 15 16 17 18 19 20
A N A N A N A N A N
21 22 23 24 25 26 27 28 29 30
A N A N A A A A A A
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Sneha matra in Niruha :
• In Swastha :
According to Susruta 5 pala
According to Charaka 4 pala (1/6 th of niruha matra)
• Dosha Avastha:
Vata dominance: 6 pala (1/4 th of NB)
Pitta dominance: 4 pala(1/6 th of N.B)
Kapha dominance: 3 pala(1/8 th of N.B)
स्स्नग्ध अम्ल लवण मधुरं पानं र्स्स्तश्च मारुते कोटण ्:। च
मस ८/४३-४४
In Vata dosha Snigdha ,Amla ,Lavana, Madhura,Ushna
dravya and mamsa rasa to be used.
21
7/22/2016
Ingredients
of basti
Vata Pitta Kapha Swastha
Madhu 1 ½ prasrita 2prasrita 3 prasrita 2prasrita
Saindhava 1 tola 1 tola 1 tola 1 tola
Sneha 3 prasrita 2 prasrita 1 ½ prasrita 2prasrita
Kalka 1 prasrita 1 prasrita 1 prasrita 1prasrita
Kwatha 5 prasrita 5 prasrita 5 prasrita 5prasrita
Avapa dravya 1 ½ prasrita 2 prasrita 1 ½ prasrita 2prasrita
22
Basti kalpana according to Dosha:
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• Vrinda madhava described particular dose
pattern for sneha basti as follows (V.M
basti ahikara)
23
Type of
sneha basti
1 st
day
2 nd
day
3 rd
day
4 th
day
5 th
day
6 th
day
7 th
day
8 th
day
9 th
day
Uttama
matra (6 P)
2 P 2 ½ P 3P 3 ½ P 4 P 4 ½ P 5P 5 ½ P 6P
Madhyama
matra(3P)
4T 5T 6T 7T 8T 9 T 10 T 11 T 12 T
Avara matra
(1 ½ P)
24M 32M 40M 48M 56M 64M 72M - -
7/22/2016
24
• न तैलादानात् परमस्स्त ककं धचत द्रव्यं षवशेषेण समीरणाते।
( च मस १/२९)
There is no remedy more beneficial than the administration
of Taila, particularly in affliction of vata
• ित्तस्तु प्रथर्ो बस्स्त: स्नेहर्ेव्िबस्स्तवांक्षणौ।
सम्र्ग्ित्तो स्व्ितीर्स्तु र्ूधमस्थर्ननलां जर्ेत्॥
जनर्ेव्िलवणौ च तृतीर्स्तु प्रर्ोस्जत:॥
रसां चतुथो रक्तां तु पतचर्: स्नेहर्ेत्तथा।
षष्ठस्तु स्नेहर्ेतर्ाांसां र्ेि: सप्तर् एव च॥
अष्टर्ो नवर्र्चिास्स्थ र्ज्जानां च र्थाक्रर्र््।
एवां शुक्रगतान् िोषान् स्व्िगुण: साधु साधर्ेत॥(सु श्रच ३७७१)
7/22/2016
तिुरुरब्रवीदििां शरीरां ततत्रर्तेऽननल: सांर्ववर्ातात्।
के वल एव िोषसदहतो वा स्वाशर्ग: प्रकोपर्ुपर्नत॥
तां पवनां सवपत्तकफववटक्ां शुदश्रधकरऽनुलोर्र्नत बस्स्त:।
सवमशरीरगश्र्च गिसांर्स्तत्प्रशर्ात् प्रशास्ततर्ुपर्ानत॥(च
लस ११/१७-१८)
Vata controls the body by integration disintegration. Vata gets
aggravated alone or along with other dosha, at its own site. Basti
eliminates these dosha & does the anulomana of vata .by the
pacification of the vata ( Pakvasaya gata vata ), all the disease of
body caused by vata gets pacified. 25
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7/22/2016 26
Asthi soushirya: Osteoporosis
• Osteoporosis is defined as a systemic skeletal diseases characterized
by low bone mass and micro architectural deterioration of bone tissue
with a consequent increase in bone fragility and susceptibility to
fracture.
• There is no exact clinical entity mentioned in classics like
osteoporosis ,but there are two conditions mentioned in our science
which may discussed in this regard one is Asthikshaya and Asthi
soushirya.
• Asthi soushirya is not mentioned as a separate condition but as a
symptom of Majja kshaya, where as Asthi kshaya is mentioned as an
independent condition. 27
7/22/2016
• Asthi saushirya means “Porous bones”, Hemadri has commented on
the word Saushirya as “ Sarandhratvan” which means with Porous.
• Majja is the next dhatu of Asthi ,hence in the process of kshaya, Majja
kshaya also occurs, thus Majja kshaya may take place.
• There is decrease of bone tissue in both condition i.e Osteopinea &
Osteoporosis, it can be considered as Asthi majja kshya because of its
core of pathogenesis –
1) Degeneration of bone tissue
2) Vitiation of Vata, the classical aspect of Asthi Majjakshaya can be
implanted in the disease Osteoporosis.
287/22/2016
29
Nidana
Aharaja Viharaja Mansika Avasthajanya
Asthi santarpana Apatarpanjanya
Amotapatti Srotasam
khavaigunya
Mamsa medo
srotoavrodha
Asthimajja
poshan
decreases
Vata
increases
Asthi majja
poshana
decreses
Asthi majja kshaya
7/22/2016
Chikitsa?????
• Need to focus on
srotoshodhana,ruksha
guna of vata and
dhatuposhana
30
vata
Kha
vaigyny
a
Ruksha
guna
kashaya
Matra basti
Narayan taila
Moorchita taila
Sahacharadi taila
Dhanwantarm
taila
Majja basti
7/22/2016
31
7/22/2016
• Acharaya Charaka while explaining about treatment for Asthimajja
gata vata, emphasizes to consider both Asthi and Majja for treating
through Snehana in both Bahya (externally) and Abhyantara
(internally). While explaining about Asthi pradoshaja vikaara he
explains to adopt treatment of Panchakarma in which he gives
Importance to Basti, containing Ghritha and Ksheera as main Dravya.
eg :Anuvasan Basti: guduchi grita Mahatiktaka
ghrita Tiktaka ghrita Eranda mooladi niruha basti
32
7/22/2016
Case report:
A male patient of age 33yrs came to opd with pain in low back region which was radiationg
to left leg since 2 weeks.
X ray finiding : IVDP L2-L3,L3-L4
Anuvasna basti with sahacharadi taila 100 ml
Eranda moola niruha basti:
Honey:80 ml
Saindhva lavana:3 gm
Sneha : sahacharadi taila 80 ml
Kalka :45 gms triphala choorna
rasna choorna each 15 gm
ajmodadi choorna
Eranda moola qwath :200 ml 33
7/22/2016
Erandamooladi Niruha Basti
DRAVYA QUANTITY
MADHU 80 ML
SAINDHAVA 5 gms
SNEHA – DHANWANTARA TAILA 160ML
KALKA - ERANDAMOOLADI 30GM
KWATHA – ERANDAMOOLADI 300ML
GOMUTRA 100ML
TOTAL 670ML (7 prasruta)
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7/22/2016 35
• मस्तुलुंि:
र्स्स्तष्क लशरोगतस्नेह:। (चक्रपाणण च शा ७/१५)
र्स्स्तष्क अधामतजलल।
• अत्र्ावास्क्शरसो नस्र्ां र्स्तुलुांग अवनतष्ठते। च लस ९१०
• र्स्तुलुांगोअववलीनर्ृताकार र्स्तकर्ज्जा। सु शा१०४२
• र्स्तुलुांगलर्नत लशरसो बलाधानां स्थानर्ृताकार र्स्तुलुांग
उर्चचते॥(डलहण)
• र्ेि: र्स्तुलुत्वथानतर्ज्जव्तांर्नत॥(इतिुटीका)
• र्स्स्तष्कां लशरस्थर्ज्जा।( चक्रपाणण) 36
7/22/2016
• Majja Dhatu and Mastulunga (Brain): Indu teeka says it is
Medodhatu, which turns into Mastulunga and it is Medodhatu again
which gets turned into Majjadhatu. Mastulunga is a
Sadyahpranahara marma. Mastulunga is present inside the flat
bones of skull. Astanga Sangraha describes Mastulunga as a Majja
Dhatu and appearance of Mastulunga is like solid ghee (Avilina
Ghrta).
37
7/22/2016
Pakshaghata
• Pakshaghata is a disabling disease which is manifested as paralysis of
one side of the body caused by vitiation of vata dosha. Hemiplegia
also caused by a wide spectrum of disease processes like vascular
disorders, infective disorders of brain tissue, tumours, trauma etc.
हत्वैकां र्ारुतः पक्षां िक्षक्षणां वार्र्ेव वा॥
कु र्ामत् चेष्टाननवृवत्तां दह रुजां वाक्स्तम्भर्ेव च।
गृदहत्वाऽधां शरीरस्र् लसरा स्नार्ुववमशोष्र् च॥
पािां सांकोचर्त्र्ेकां हस्तां वा तोि शूलकृ त्।
एकाङ्गरोगां तां ववदर्ात् सवामङ्गां वमिेहजर््॥
च.श्रच२८/५३-५५
38
7/22/2016
•Samprapti ghataka:
Dosha : vata – prana . Udana, vyana
pitta –sadhaka
kapha – tarpaka
Dushya : dhatu- rasa, rakta, mamsa,meda, majja
updhatu: sira , snayu
Srotas : rasavaha. Raktavaha, medovaha, mamsavaha,
majjavaha
Srotodushti: sanga
Agni: jathragni,dhatwagi of rasa,rakta,mamsa,meda and majja
Adhisthana: mastishka
Udbhava sthana: pakwashaya
39
7/22/2016
Nidana sevana
Kapha pitta rakta
dushti
Formation of ama
Sthana samshraya in
dhamanies and siras
Reaches masthishka/
uttamanga
40
Causes
margavarodha
Leads to obstruction
of movement of vata
Karma khaya
Pakshagata
7/22/2016
Mastishka majja as majja dhara kala .
Majja dhara kala : pittadhara kala
Pittadhara kala grahani
Grahani- nabhi pakvashay kukshi
Basti reaches to this sthanas has an effect over pakvashaya which is vata
sthana so basti can be given in this condition.
Majjavaha sroto dushti takes place in pakwashaya.
Hence basti can ne given in such cases.
Eg :Mustadi yapana basti
Eranda muladi yapana basti
Baladi yapana basti 41
7/22/2016
Content Quantity
Madhu 80 ml
Saindhava lavana 5 gm
Sukumar ghrita 100ml
Shatapushpa kalka 20 gm
Erandamoola qwath 200 ml
Anuvasana basti
Moorchita taila 100 ml
42
Kala basti (practically)
7/22/2016
A patient by name chandramma aged about 52 years co
reduced strength of both lower limb since 1 year
Anuvasana basti Niruha basti
Brihat chaglyadi ghrita 110 ml Madhu 30 ml
Saindhava 5 gm
Brihat chagalyadi ghrita 100 ml
Rajayapana basti kalka 20 gms
Rajayapana basti qwatha 200 ml
Mamsa rasa 100ml
Total quantity 450ml ( 5 prasruta) 437/22/2016
• IT is chronic neurodegenerative disease. That is reflecting an
underlying cellular degeneration of neurons in the brain.
Symptoms:
 Impairment of higher mental function, memory loss, aphasia
indicate severe cortical dysfunction, alteration in moods and
behavior.
 In Alzheimer's disease, the vata is severely provoked in the
Majja dhatu , the tissue layer which includes the central
nervous system and all other tissues which are contained
within bone.
44
Alzheimer’s disease
7/22/2016
• The vata dries and thus degenerates the brain .
• In addition the vata passes from Majja dhatu to manovaha srotas ,or
mind carrying channels causing thought disorders such as paranoia and
delusions as well as memory loss and confusion.
• The causes of this severe vata provocation within Majja dhatu and
mano vaha srotas are both hereditary and acquired. Susceptible people
are those who have a hereditary weakness of the Majja dhatu.
As it is cause due to provocation of vata in Mastishka, vata pacifying
measures should be introduced as soon as the onset of symptoms
appears.
As basti is best in vata condition here basti can be adopted.
Yapana basti can be adopted in such conditions7/22/2016 45
46
Rajayapana basti
Honey 30 ml Anuvasana basti 100 ml with morchita
taila
Saindhava lavana 10 gm
Morchita taila 80 ml
Rajayapana basti kalka 40 gm
Rajayapana basti kashaya 300 ml
Mamsa rasa 100 ml
Madhutailika basti
Honey 60 ml Anuvasna basti with moorchita tila taila
80 ml
Saindhava lavana 5 gms
Moorchita taila 40 ml
Satapushpa kalka 20 gms
Erandamoola kwatha 200 ml7/22/2016
• It is a clinical syndrome dominated by a disorder of movement
consisting of tremor at rest, rigidity, elements of bradykinesia,
postural and gait abnormalities associated with a distinctive pathology
consisting of pigmented brainstem nuclei including the dopaminergic
substantia nigra, pars compacta with the presence of lewy bodies.
• The vata dosha is responsible form entire neurophysiologic
phenomena operating the body.
• When vata dosha loses its equilibrium due to wide range of etiological
factors, including dhatu kshaya and margavarana causes vata vyadhis
or neurological diseases.
47
Parkinson's disease = Kampavata
7/22/2016
48
Nidana
Increases
vata
prana
,vyana
udana
Avarana by
kapha cheshtanga
Excessive
kashay and
tikta rasa
Margavarna
vayu propagets
due to chala and
rukhsha guna
Reaches to
shirastha
majja
Causes kshaya in indriy
pranvaha srotas
Which is concerd with
vak, pani ,pada
Also leads
to rasa
kshaya
Uttorottar
dhstu kshaya
Sirstha majja also gets
defaced and creates
obstruction in gati of
vayu
Majjavrita vata kampavata
7/22/2016
• Symptoms
Kampavata are Karapadtal kampa (tremors in hands and legs),
dehabramana (postural instability), nidrabhagna (insomnia) and
Matiksheen (dementia).10 The symptom like Stambha (rigidity),
Cestahani (slowness of the movement), Vinaman (flexed
posture),Vakvikriti (speech disorders) have been mentioned in other
pathological conditions of Vata vyadhi which can also be grouped
under the feature of Kampavata.
7/22/2016 49
Example:
Niruha basti Anuvasan basti
Madhu 80 gm bala taila 100 ml
Saindhava 5 gm
Bala taila100 ml
Kapi kacchu kalka 40 gm
Kapikacchu qwatha 640 ml
50
Honey 30 ml Anuvasana basti
Saindhava lavana 5 gm Moorchita taila 80 ml
Moorchita taila 80 ml
Rajayapana kalka 20 gms
Rajatapna qwatha 300 ml
Mamsa rasa 200 ml
7/22/2016
7/22/2016 51
• Aplastic Anaemia is a rare disease in which the bone marrow and the
hematopoietic stem cells that reside there are damaged.
• This cause deficiency of all three blood cell types. i.e red blood
cells(anemia),white blood cells(lukopenia) and
platelets(thrombocytopenia).
• Aplastic refers to inability of stem cells to generate mature blood cells.
• Signs and symptoms:
Anemia may lead to malaise, pallor and associated symptoms such as
palpitations.
Low platelet count, low white blood cells counts
52
Aplastic anemia
7/22/2016
 Treating immune mediated aplastic anemia involes suppression of the
immune system.
 Blood and marrow stem cell transplants may cure aplastic anemia .
• In ayurveda we have the reference of rakta basti in case of low
heamoglobin.
• रक्ते रक्तेन...। च लस ८ /२६
• रक्ते रक्तेनेऽ नत सरक्तेऽनतसार्मर्ाणे रक्तबस्स्तिेर्:।
whenever there is excessive loss of blood from body raktabasti should
be administered.
53
7/22/2016
• तिेव िभमर्ॄदितां रक्तां बस्स्तां प्रिापर्ेत। च लस ८२६
Whenever there is need of blood for body the raktabasti should be given
mixed with darbha.
Blood of goat ,rabbit, deer ,cat, buffalo can be used.
• Majja basti also can be given using majja of goat.
7/22/2016 54
Case report of acute lymphoblastic
leukemia
A 4 yrs old male boy came to opd with complaints of severe pallor
(low hemoglobin level in blood),fatigue, delayed milestone and
recurrent respiratory infections, lymphadenopathy,
hepatospleenomegaly.
Hb % -5.8 g %
Lecocytosis 44000
Thrombocytopenia 80,000
ESR 58mm in 1 st hr.
55
7/22/2016
Treatment :
Majja basti : fresh goats marrow ( crushed yellowish red internal part of
bone) approximately 15 g every day. it was boiled with 50 ml of milk
to reduce to 20 ml + 5 ml of panchatikta ghrita = basti was given for
30 days.
After 4 th day: increase in HB % by 1 g% and leucocytes count was
reduced to 32,600/cumm
7/22/2016 56
मज्जावृते षवनाम: स्र्ाज्जृम्भणां पररवेष्टनर््।
शूलां तु पीड्र्र्ाने च पाणणभ्र्ाां लभते सुखर््॥ च श्रच २८/६७
धचककत्सा :
र्हास्नेहोऽस्स्थर्ज्जस्थे पूवमवद्रेतसाऽऽवृते। च श्रच २८/१९६
• मज्जाधातु ित ज्वर
दहक्का श्वासस्तथा कासस्तम्भश्च नतलर्रिशमनर््।
र्र्ामर्च्ेिो बदह: शैत्र्ां िाहोऽततश्चैव र्ज्जगे॥ च श्रच ३/७३
धचककत्सा
अस्स्थर्ज्जागते िेर्ा ननरुहा: अनुवासना:। च श्रच ३/३१६
7/22/2016 57
Mode of action
• आपादतलं मूधमस्थान् दोषान् पक्वाशये स्स्थत:।
वीयेणर्स्स्त: आदत्ते खस्थोऽको भूररसाननव॥ च मस ७/६४
oÉÎxiÉ dravya though situated in the pakvashaya draws up the dosha
from sole of feet to head by its veerya as the sun situated in sky takes
up the rasa of the earth.
• मूलं िुदं शरीरस्य मसरास्तत्र प्रनतस्टिता:।
सवमशरीरपुटणास्न्त मूधामनं यावदाधिता:॥ (पराशर)
Guda is the mula of the body where all sira are located.The sneha
administered through the guda reaches up to head and nourishes up to
head and nourishes the body .
• ववश्र्वक् स्स्थतां िोषचर्ां ननरस्र् सवामन ववकारन् शर्र्ेत ननरुह्। (च लस
१/२८)
Through the systemic action basti, is capable of removing the doshas
58
7/22/2016
7/22/2016 59
The veerya of the basti
dravya carried through
urdhwa, adho and tiryag
dhamanis
Churnes up the
doshas and malas
Nourishes rasa dhatu
Draws out the mala
and kupita doshas
Nourishes
uttarottara dhatus
Tridoshas attains
normalcy
Maintains homeostasis
of the body7/22/2016 60
Basti dravyas by reaching upto nabhi,
kati, parshva, kukshi pradesha
Churns up the fecal and doshas present there
at the same time by spreading its unctuous effect in
the whole body,
Draws out the fecal and vitiated doshas
with ease by first niruha basti
Second niruha basti act on pittadosha
dependent on vata in pakvashaya
Third niruha expels out
morbid kapha in pakvashaya
dependent on vata
Vayu attains
normalcy 617/22/2016
Veerya of basti drugs reaches the
apana vayu and nourishes it,
Then it acts on samana vayu, after it nourishes the
vyana vayu, there after it acts on udana vayu and
prana vayu and nourishes them
Veerya of basti drugs act on the pitta and
kapha to bring them into normalcy and
provide them nourishment
. The veerya of the basti drugs is carried to tiryak
pradesha by vyana vayu to adha pradesha by apana
vayu and to urdhwa pradesha by prana vayu.
The whole body gets nourishment by
the veerya of basti drugs carried by
five types of vata through srotas.
7/22/2016 62
Niruha Basti clears all the
passages and removes
doshas
Sneha of anuvasana basti spreads
in minute channels very smoothly
Promoting vitality of
life.
7/22/2016 63
MODERN VIEW
Basti dravya
Inserted through anal route
Reaches rectum
Active ingredients of basti dravya
absorbed through circulation
Carried to large
intestine
Causes gastro intestinal
movements
Carried to liver and
absorbed to millions of
liver sinusoids
Action Of myenteric plexus
And submucosal Plexus
64
7/22/2016
Stimulation of
sympathetic and
parasympathetic
nerve fibers
Causes irritation to the gut
mucosa
Peristaltic rush
Generates defecation reflex
Expels toxins through feces
Action of reticulo
endothelial cells
Removes bacteria
Through hepatic veins
empties into portal hepatic
venous circulation
Removes bacteria
Improves circulation
Maintains homeostasis of
the body7/22/2016 65
Stimulation of sympathetic and
parasympathetic nerve fibers
Activates enteric nervous system
Visceral afferent stimulation
Activates HPO axis
Activates neuro transmitters
Maintains hormonal secretion
Maintains homeostasis of the body
7/22/2016 66
67
7/22/2016
DISCUSSION
• Diseases of Majja are not elaborated in classics ,so has to be
viewed in point of different systems.
• Diseases of Majja refers to marma,asthi,sandhi vikaras,gambhira
dhatu vikaras where involvement of vata is seen.
• Basti karma is the treatment of choice in regulating the function of
vata .
• Kala basti and karma basti are the types of basti which are
beneficial in treating the Majja gata vikaras.
• Depending upon the diseases we can modulate the functions of
basti karma.
7/22/2016 68
• प्रत्येत्यनक्तज नशकृ्च तैलज रक्तानद्ुद्धीनन्द्रय नजप्रनाद:।
स्वप्िािुव्रृनत्तलवाुता ्लज च नृष्टाश्च वेगा: स्विुवाननते स्यु: च नन १/४४
• रक्ताद्यो र्ातव: । चक्रपानि
• While describing gunas of Basti Karma Aacharya tells that it is
Dadhyavaha, which means gives strength .
• Before performing Basti Karma sarvanga or sthanika abyanga to be
done for 900 matra kala to reach sneha to Majja dhatu which in turn
helps in promoting Basti Karma.
• When a cloth is immersed in water mixed with a dye, the cloth will
take the color of dye only from water; like that, the given Basti will
take out the vitiated Doshas from body.
7/22/2016 69
Conclusion
• Majja is the sixth Dhatu, and diseases affecting the Majja are
indicative of deep rootedness of diseases which requires blending of
different modalities of treatment in which Basti Karma occupies the
prime place.
• Though , limited explanation is found in classics pertaining to Majja
vikaras the understanding of the same can be viewed from the point of
Neurological,Skeletal,Heamatological,Immunological,Tricological
considerations.
7/22/2016 70
• The modus operandi of Basti Karma in Majja vikaras can be
understood from the point of anatomical ,physiological, pathological
and therapeutic description such as the site functions, Kala, action on
Vata.
• Samyak lakshana and time taken for Basti to exert its action at the
level of Majja.
• Different modification pertaining to formulation and course of Basti
can be made in treating Majja vikaras based on site of pathology,
severity & intensity of disease.
7/22/2016 71
7/22/2016 72

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importance of basti karma in majja vikara

  • 2. By Dr .Jadhav Bhagyashree P 2 nd year PG Scholar Dept.of Panchakarma 2 7/22/2016
  • 3. 3 1. Introduction 2. Definition of Basti Karma 3. Importance of Basti Karma 4. Description of Majja dhatu 5. Diseases under Majja vikaras heading 6. Why Basti Karma in Majja vikaras 7. Different Basti formulations in different Majja vikaras 8. Mode of action 9. Discussion 10.Conclusion 7/22/2016
  • 4. • Basti karma is one among the most important Panchakarma therapies which is also considered as “ArdhaChikitsa ”. • It is possessed with multidimensional action which makes it unique. • Ayurveda considers Majja as the sixth Dhatu of the body. Charaka enumerates the Asthi (bones) and Sandhis (joints) as the Moola of Majjavaha Srotas. • Majja contributes to the formation of and an increase in the Shukra Dhatu; it fills in the internal cavities of bones and is the chief source of body strength. 47/22/2016
  • 5. • The nourishment to all dhatus is supplied through Ahara Rasa. Imbalance in Asthi Dhatvagni and Majja dhatwagni leads to improper formation of Sthayi Majja dhatu. • Basti karma has action on different levels of Dhatus, considering this here an attempt is made to understand the role of Basti karma in Majja dhatu vikaras. 57/22/2016
  • 7. तत्र स्नेहादिनाां कर्मणाां बस्स्तकर्म प्रधानतमार्ाहुराचार्ाम:। कस्र्ात? अनेक कमम करत्वात् बस्ते:। 7 Basti सांशोधन सांशर्न सांग्रहणा नन क्षीणशुक्रां वाजीकरो नत कृ शां बृम्हर्नत स्थूलां कशमर्नत चक्षु: प्रीणर् नत वललपली तर्पह स्तत वर्: स्थापर् नत 7/22/2016
  • 8. 8 मूले निनिक्तो नि यथा द्रुम: स्यान्िील्छद: कोमलपल्लवाग्र्य:। काले महान पुष्पफलप्रदश्च तथा िर: स्यादिुवानिेि (च नन १/२७-३१) शाखागता: कॊष्ठगताश्च रोगा: ममोर्धववनवाववयवाजगशाश्च। ये ननन्ततेिाज िनि कनश्चदनन्यो वायो:परं जन्मनन हेतुरनतत नवण्मूत्रनपत्तानद मलाशयािाज नवक्षेपनजाातकर: न यस्मात। तस्यानतवृद्धस्य शमाय नान्यद्बनतत नवना ेेजजमनतत नकं न त तस्यानचनकत्नार्वनमनत ब्रुवनन्त नवाव नचनकत्नामनप्नस्तमेके च नन १/३८-४० 7/22/2016
  • 9. Definition: करोनत तत्र सौनजययमत्ां मध्ये समीरण:। मेदस तानन पूरयन्ते तनेहो मज्जा तत: तमृत:॥( न १५) मज्जनत अनत्ष्वनत। (शब्दकल्पद्रुम) During formation of Asthi dhatu , vata creates spaces in the bones. These spaces are filled with nourishing tissues of Medas or fat which is known as Majja . The final essence of the Asthi dhatu which is a semisolid substance becomes Majja in the process of metabolism . The unctuous material is found inside bone is called as Majja. 97/22/2016
  • 10. Kala of formation Mahab huta Location of majja dhatu: Kala Quantity Upadhatu Mala Parashar - Majja dhatu - on seventh day. According to shushruta 25 th day आप महाभू त र्ज्जापूरणां अस्थाांनाां च करोनत| स्थूलास्स्थषु ववशेषेण र्ज्जात्वभ्र् ततराश्रित तृतीर् र्ेिो धरा,र्ेिो दह सवमभूतानाां र्ुिरस्थर् अण्वस्स्थषु च र्हत्सु च र्ज्जा भवनत॥ एको अतजलल र्ज्जार्ा:। र्स्स्तष्क स्र् अधामतजलल के श ववट स्नेह अक्षक्ष स्नेह त्वक् स्नेह 7/22/2016 10
  • 11. • मज्जासार लक्षणा: ततवांगा बलवतत: स्स्नग्धवणमस्वरा: स्थूलिीर्मवृत्त सांधर्श्च र्ज्जासार:। ते िीर्ामर्ुष बलवतत: िुतववञानअपत्र्सांर्ानभाजश्च भवस्तत॥ (च वव ८/११०) अकृ शर् उत्तर्बलां स्स्नग्ध गम्भीरस्वर सौभाग्र्ोपतनां र्हानेत्र च र्ज्जा। (सु सु ३५१६) • मज्जावह स्रोतस: र्ज्जावहानाां स्रोतसाां अस्स्थननमूलं सन्धयश्च।( चवव ५८) • मज्जावह स्रोतस दुस्टिकारण: उत्पेषाित्र्लभष्र्तिािलभर्ातात्प्रपीडनात। र्ज्जावादहनी िुष्र्स्तत ववरुदधाांनाच सेवनात॥ (च वव ५१८) 117/22/2016
  • 12. 12 मज्जा वृद्धध लक्षणा: र्ज्जा सवाांग नेत्रगौरवां च। ( सु.सु १५) र्ज्जा नेत्राांगगौरवर् ्। (अ ह सु १५) मज्जाक्षय: शीयमन्त इव चा अस्स्थनी दुर्मलानन लघुनन च। प्रततं वातरोधिणी क्षीणे मज्जनन देहहनाम॥ (च सु १७६८) मज्जाक्षयेअल्प शुक्र ता पवमभेदोअस्स्थनी तोदोअस्स्थ शून्यता च।( सु सु १५) अस्स्थ सौषषयमननस्तोद दौर्मल्य भ्रमतमोदशमनैमज्जा ।( अ सं) अस्थां मज्जनन सौषषयम भ्रमस्स्तममर दशमनम्॥(अ हृ सु ११/१९) मज्जाप्रदोषज षवकार: रुक पवमणाांभ्रर्ोर्ूर्च्ामिशमनां तर्स्तथा। अरुषाां स्थूल र्ूलानाां पवमजानाां च िशमनर््॥ ( च सु १८१६) 7/22/2016
  • 13. Concept of Majja dhatu can be considered in following ways: 7/22/2016 13
  • 14. 14 मज्जा व्यापजन्य रोि ( Vangasena) वविाहश्च र्िां चैव्स् सोतर्ािां चापतानकर््। तर्ोिशमन र्ू्ामन र्ज्जाव्र्पवत्तजास्तविु:। अस्स्थमज्जाित वातज रोि: (Bhela samhita) अस्स्थर्ज्जागतो भांग कम्पनां गात्रशोषणर्। पक्षग्रह अपस्र्ारर्ुतर्ािर्वप चादिमतर््।। हनुग्रहां कु णणां कु ब्जां पाांगुल्र् सस्तधववर्चर्ुनतर््। करोनत र्ारुतेऽभ्र् च वातरोगा भवतर्वप॥ मज्जाहदवात लक्षणानन: (Basavarajiyam) सवाांग शोफ कम्पश्च दहक्का वैर्च्िमनां तथा। तीव्र भ्रर्णशूलां च र्ज्जावातव्र् लक्षणर््॥ 7/22/2016
  • 15. • अधोनाभ्र्स्स्थर्ज्जनौ वातस्थानां प्रचक्षते। का सु २७/१० • तत्रास््र्ानन स्स्थतो वार्ु:। अ हृ शा ११ • अस््र्ािर्ाणाां व्र्ाश्रधनाां पांचकर्ामणण भेषजर््। बस्तर्: क्षीरसवपमवष नतक्तकोपदहतानन च॥ च सु २८/२७ • प्रतते वातरोश्रगणण क्षीणे र्ज्जनन िेदहनार््। (च सु १७/ ६७६८) • श्र्लेष्मा शेिेिु-रनमाजनमेदोमज्शशुक्रमूत्रपुरीिनदिुनस्थत:। अ हृ ११/२६ • According to Kashyapa Adhonabhi,Asthi and Majja are the seat of Vata dosha. 15 Why Basti Karma in Majja vikaras???? 7/22/2016
  • 16. • Basti dravya reaches first to pakvasaya & then to the Grahani. So from these we say that Basti Karma has direct action on asthi & majja dhatu so we can adopt Basti karma in Majja vikaras. • Basti karma is the best choice of treatment for Vata dosha and Vata associated with Kapha and Pitta. 16 Pakwashya Purishdhadara kala Vatasthana Asthi dhatu Grahani Majja dhara kala MajjaPittadhara kala 7/22/2016
  • 17. • बल िोष काल् रोग प्रकृ नत: प्रववभज्र् र्ोस्जता: सम्र्क् स्वै: स्वैरौषधवगै: स्वान् स्वान् रोगाननर्च्र्स्तत ॥ कर्ामतर्व्िस्स्तसर्ां न ववदर्ते शीघ्रसुखववशोधनर्त्वात्। आश्र्वपतपमणतपमणर्ोगार्चच ननरत्र्र्त्वार्चच॥ च लस १०५ Basti should be administered keeping in view the bala of patient, Doshas involved, nature of disease,prakruti of patient.basti cleanses the body quickly and easily, does aptarpana and santarpana and is free from adverse effect. • सर्ीक्ष्र् िोषौषध िेश काल सात्म्र्ास्ग्नसत्वौकवर्ोबलानन। बस्स्त: प्रर्ुक्तो ननर्तां गुणार्स्र्ात सवमकर्ामणण च लसदश्रध र्स्तत॥ च लस ३६ 17 How to plan Basti? 7/22/2016
  • 18. Basti Ausha dha kala Desha Satmya AgniSatwa Vaya Bala Dosha awastha एवां कालां बलां िोषां ववकारां च ववकारववत्। बस्स्तद्रव्र्बलां चैव वीक्ष्र् बस्तीन प्रर्ोजर्ेत्॥ सु श्रच ३८७१ 7/22/2016 18
  • 19. • Yoga Basti: अल्पत्वात स्नेह बस्स्तनाां र्ुक्तेर्ोग: स लार्वर्। प्रर्ोज्र्: कफ सांसृष्टॆ नानत तीव्रबले अननले॥(का.णख ८९-१०) • Kala Basti: तत् अधम कलनात् काल: स दह र्ध्र् बलातवर्े। पवने वपत्त सांसृष्टे ववधातव्र्ो ववजानता॥(का.णख ८८-९) According to Charaka: According to Kashyapa: 19 1 2 3 4 5 6 7 8 A N A N A N A A 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 A N A N A N A N A N A A N A A A 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 A A A N A A A N A A A N A A A 7/22/2016
  • 20. • Karma Basti: गम्भीर अनुगता र्स्र् क्रर्ेण अपश्रचता र्ला:। कु वपता वात भुनर्ष्टा बस्स्त साध्र्ा ववशेषत:॥ सम्पतनस्र् सदहष्णॊर्चि कर्म तस्र् परार्णर््।(का.णख ८२८-२९) 20 1 2 3 4 5 6 7 8 9 10 A N A N A N A N A N 11 12 13 14 15 16 17 18 19 20 A N A N A N A N A N 21 22 23 24 25 26 27 28 29 30 A N A N A A A A A A 7/22/2016
  • 21. Sneha matra in Niruha : • In Swastha : According to Susruta 5 pala According to Charaka 4 pala (1/6 th of niruha matra) • Dosha Avastha: Vata dominance: 6 pala (1/4 th of NB) Pitta dominance: 4 pala(1/6 th of N.B) Kapha dominance: 3 pala(1/8 th of N.B) स्स्नग्ध अम्ल लवण मधुरं पानं र्स्स्तश्च मारुते कोटण ्:। च मस ८/४३-४४ In Vata dosha Snigdha ,Amla ,Lavana, Madhura,Ushna dravya and mamsa rasa to be used. 21 7/22/2016
  • 22. Ingredients of basti Vata Pitta Kapha Swastha Madhu 1 ½ prasrita 2prasrita 3 prasrita 2prasrita Saindhava 1 tola 1 tola 1 tola 1 tola Sneha 3 prasrita 2 prasrita 1 ½ prasrita 2prasrita Kalka 1 prasrita 1 prasrita 1 prasrita 1prasrita Kwatha 5 prasrita 5 prasrita 5 prasrita 5prasrita Avapa dravya 1 ½ prasrita 2 prasrita 1 ½ prasrita 2prasrita 22 Basti kalpana according to Dosha: 7/22/2016
  • 23. • Vrinda madhava described particular dose pattern for sneha basti as follows (V.M basti ahikara) 23 Type of sneha basti 1 st day 2 nd day 3 rd day 4 th day 5 th day 6 th day 7 th day 8 th day 9 th day Uttama matra (6 P) 2 P 2 ½ P 3P 3 ½ P 4 P 4 ½ P 5P 5 ½ P 6P Madhyama matra(3P) 4T 5T 6T 7T 8T 9 T 10 T 11 T 12 T Avara matra (1 ½ P) 24M 32M 40M 48M 56M 64M 72M - - 7/22/2016
  • 24. 24 • न तैलादानात् परमस्स्त ककं धचत द्रव्यं षवशेषेण समीरणाते। ( च मस १/२९) There is no remedy more beneficial than the administration of Taila, particularly in affliction of vata • ित्तस्तु प्रथर्ो बस्स्त: स्नेहर्ेव्िबस्स्तवांक्षणौ। सम्र्ग्ित्तो स्व्ितीर्स्तु र्ूधमस्थर्ननलां जर्ेत्॥ जनर्ेव्िलवणौ च तृतीर्स्तु प्रर्ोस्जत:॥ रसां चतुथो रक्तां तु पतचर्: स्नेहर्ेत्तथा। षष्ठस्तु स्नेहर्ेतर्ाांसां र्ेि: सप्तर् एव च॥ अष्टर्ो नवर्र्चिास्स्थ र्ज्जानां च र्थाक्रर्र््। एवां शुक्रगतान् िोषान् स्व्िगुण: साधु साधर्ेत॥(सु श्रच ३७७१) 7/22/2016
  • 25. तिुरुरब्रवीदििां शरीरां ततत्रर्तेऽननल: सांर्ववर्ातात्। के वल एव िोषसदहतो वा स्वाशर्ग: प्रकोपर्ुपर्नत॥ तां पवनां सवपत्तकफववटक्ां शुदश्रधकरऽनुलोर्र्नत बस्स्त:। सवमशरीरगश्र्च गिसांर्स्तत्प्रशर्ात् प्रशास्ततर्ुपर्ानत॥(च लस ११/१७-१८) Vata controls the body by integration disintegration. Vata gets aggravated alone or along with other dosha, at its own site. Basti eliminates these dosha & does the anulomana of vata .by the pacification of the vata ( Pakvasaya gata vata ), all the disease of body caused by vata gets pacified. 25 7/22/2016
  • 27. Asthi soushirya: Osteoporosis • Osteoporosis is defined as a systemic skeletal diseases characterized by low bone mass and micro architectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture. • There is no exact clinical entity mentioned in classics like osteoporosis ,but there are two conditions mentioned in our science which may discussed in this regard one is Asthikshaya and Asthi soushirya. • Asthi soushirya is not mentioned as a separate condition but as a symptom of Majja kshaya, where as Asthi kshaya is mentioned as an independent condition. 27 7/22/2016
  • 28. • Asthi saushirya means “Porous bones”, Hemadri has commented on the word Saushirya as “ Sarandhratvan” which means with Porous. • Majja is the next dhatu of Asthi ,hence in the process of kshaya, Majja kshaya also occurs, thus Majja kshaya may take place. • There is decrease of bone tissue in both condition i.e Osteopinea & Osteoporosis, it can be considered as Asthi majja kshya because of its core of pathogenesis – 1) Degeneration of bone tissue 2) Vitiation of Vata, the classical aspect of Asthi Majjakshaya can be implanted in the disease Osteoporosis. 287/22/2016
  • 29. 29 Nidana Aharaja Viharaja Mansika Avasthajanya Asthi santarpana Apatarpanjanya Amotapatti Srotasam khavaigunya Mamsa medo srotoavrodha Asthimajja poshan decreases Vata increases Asthi majja poshana decreses Asthi majja kshaya 7/22/2016
  • 30. Chikitsa????? • Need to focus on srotoshodhana,ruksha guna of vata and dhatuposhana 30 vata Kha vaigyny a Ruksha guna kashaya Matra basti Narayan taila Moorchita taila Sahacharadi taila Dhanwantarm taila Majja basti 7/22/2016
  • 32. • Acharaya Charaka while explaining about treatment for Asthimajja gata vata, emphasizes to consider both Asthi and Majja for treating through Snehana in both Bahya (externally) and Abhyantara (internally). While explaining about Asthi pradoshaja vikaara he explains to adopt treatment of Panchakarma in which he gives Importance to Basti, containing Ghritha and Ksheera as main Dravya. eg :Anuvasan Basti: guduchi grita Mahatiktaka ghrita Tiktaka ghrita Eranda mooladi niruha basti 32 7/22/2016
  • 33. Case report: A male patient of age 33yrs came to opd with pain in low back region which was radiationg to left leg since 2 weeks. X ray finiding : IVDP L2-L3,L3-L4 Anuvasna basti with sahacharadi taila 100 ml Eranda moola niruha basti: Honey:80 ml Saindhva lavana:3 gm Sneha : sahacharadi taila 80 ml Kalka :45 gms triphala choorna rasna choorna each 15 gm ajmodadi choorna Eranda moola qwath :200 ml 33 7/22/2016
  • 34. Erandamooladi Niruha Basti DRAVYA QUANTITY MADHU 80 ML SAINDHAVA 5 gms SNEHA – DHANWANTARA TAILA 160ML KALKA - ERANDAMOOLADI 30GM KWATHA – ERANDAMOOLADI 300ML GOMUTRA 100ML TOTAL 670ML (7 prasruta) 7/22/2016 34
  • 36. • मस्तुलुंि: र्स्स्तष्क लशरोगतस्नेह:। (चक्रपाणण च शा ७/१५) र्स्स्तष्क अधामतजलल। • अत्र्ावास्क्शरसो नस्र्ां र्स्तुलुांग अवनतष्ठते। च लस ९१० • र्स्तुलुांगोअववलीनर्ृताकार र्स्तकर्ज्जा। सु शा१०४२ • र्स्तुलुांगलर्नत लशरसो बलाधानां स्थानर्ृताकार र्स्तुलुांग उर्चचते॥(डलहण) • र्ेि: र्स्तुलुत्वथानतर्ज्जव्तांर्नत॥(इतिुटीका) • र्स्स्तष्कां लशरस्थर्ज्जा।( चक्रपाणण) 36 7/22/2016
  • 37. • Majja Dhatu and Mastulunga (Brain): Indu teeka says it is Medodhatu, which turns into Mastulunga and it is Medodhatu again which gets turned into Majjadhatu. Mastulunga is a Sadyahpranahara marma. Mastulunga is present inside the flat bones of skull. Astanga Sangraha describes Mastulunga as a Majja Dhatu and appearance of Mastulunga is like solid ghee (Avilina Ghrta). 37 7/22/2016
  • 38. Pakshaghata • Pakshaghata is a disabling disease which is manifested as paralysis of one side of the body caused by vitiation of vata dosha. Hemiplegia also caused by a wide spectrum of disease processes like vascular disorders, infective disorders of brain tissue, tumours, trauma etc. हत्वैकां र्ारुतः पक्षां िक्षक्षणां वार्र्ेव वा॥ कु र्ामत् चेष्टाननवृवत्तां दह रुजां वाक्स्तम्भर्ेव च। गृदहत्वाऽधां शरीरस्र् लसरा स्नार्ुववमशोष्र् च॥ पािां सांकोचर्त्र्ेकां हस्तां वा तोि शूलकृ त्। एकाङ्गरोगां तां ववदर्ात् सवामङ्गां वमिेहजर््॥ च.श्रच२८/५३-५५ 38 7/22/2016
  • 39. •Samprapti ghataka: Dosha : vata – prana . Udana, vyana pitta –sadhaka kapha – tarpaka Dushya : dhatu- rasa, rakta, mamsa,meda, majja updhatu: sira , snayu Srotas : rasavaha. Raktavaha, medovaha, mamsavaha, majjavaha Srotodushti: sanga Agni: jathragni,dhatwagi of rasa,rakta,mamsa,meda and majja Adhisthana: mastishka Udbhava sthana: pakwashaya 39 7/22/2016
  • 40. Nidana sevana Kapha pitta rakta dushti Formation of ama Sthana samshraya in dhamanies and siras Reaches masthishka/ uttamanga 40 Causes margavarodha Leads to obstruction of movement of vata Karma khaya Pakshagata 7/22/2016
  • 41. Mastishka majja as majja dhara kala . Majja dhara kala : pittadhara kala Pittadhara kala grahani Grahani- nabhi pakvashay kukshi Basti reaches to this sthanas has an effect over pakvashaya which is vata sthana so basti can be given in this condition. Majjavaha sroto dushti takes place in pakwashaya. Hence basti can ne given in such cases. Eg :Mustadi yapana basti Eranda muladi yapana basti Baladi yapana basti 41 7/22/2016
  • 42. Content Quantity Madhu 80 ml Saindhava lavana 5 gm Sukumar ghrita 100ml Shatapushpa kalka 20 gm Erandamoola qwath 200 ml Anuvasana basti Moorchita taila 100 ml 42 Kala basti (practically) 7/22/2016
  • 43. A patient by name chandramma aged about 52 years co reduced strength of both lower limb since 1 year Anuvasana basti Niruha basti Brihat chaglyadi ghrita 110 ml Madhu 30 ml Saindhava 5 gm Brihat chagalyadi ghrita 100 ml Rajayapana basti kalka 20 gms Rajayapana basti qwatha 200 ml Mamsa rasa 100ml Total quantity 450ml ( 5 prasruta) 437/22/2016
  • 44. • IT is chronic neurodegenerative disease. That is reflecting an underlying cellular degeneration of neurons in the brain. Symptoms:  Impairment of higher mental function, memory loss, aphasia indicate severe cortical dysfunction, alteration in moods and behavior.  In Alzheimer's disease, the vata is severely provoked in the Majja dhatu , the tissue layer which includes the central nervous system and all other tissues which are contained within bone. 44 Alzheimer’s disease 7/22/2016
  • 45. • The vata dries and thus degenerates the brain . • In addition the vata passes from Majja dhatu to manovaha srotas ,or mind carrying channels causing thought disorders such as paranoia and delusions as well as memory loss and confusion. • The causes of this severe vata provocation within Majja dhatu and mano vaha srotas are both hereditary and acquired. Susceptible people are those who have a hereditary weakness of the Majja dhatu. As it is cause due to provocation of vata in Mastishka, vata pacifying measures should be introduced as soon as the onset of symptoms appears. As basti is best in vata condition here basti can be adopted. Yapana basti can be adopted in such conditions7/22/2016 45
  • 46. 46 Rajayapana basti Honey 30 ml Anuvasana basti 100 ml with morchita taila Saindhava lavana 10 gm Morchita taila 80 ml Rajayapana basti kalka 40 gm Rajayapana basti kashaya 300 ml Mamsa rasa 100 ml Madhutailika basti Honey 60 ml Anuvasna basti with moorchita tila taila 80 ml Saindhava lavana 5 gms Moorchita taila 40 ml Satapushpa kalka 20 gms Erandamoola kwatha 200 ml7/22/2016
  • 47. • It is a clinical syndrome dominated by a disorder of movement consisting of tremor at rest, rigidity, elements of bradykinesia, postural and gait abnormalities associated with a distinctive pathology consisting of pigmented brainstem nuclei including the dopaminergic substantia nigra, pars compacta with the presence of lewy bodies. • The vata dosha is responsible form entire neurophysiologic phenomena operating the body. • When vata dosha loses its equilibrium due to wide range of etiological factors, including dhatu kshaya and margavarana causes vata vyadhis or neurological diseases. 47 Parkinson's disease = Kampavata 7/22/2016
  • 48. 48 Nidana Increases vata prana ,vyana udana Avarana by kapha cheshtanga Excessive kashay and tikta rasa Margavarna vayu propagets due to chala and rukhsha guna Reaches to shirastha majja Causes kshaya in indriy pranvaha srotas Which is concerd with vak, pani ,pada Also leads to rasa kshaya Uttorottar dhstu kshaya Sirstha majja also gets defaced and creates obstruction in gati of vayu Majjavrita vata kampavata 7/22/2016
  • 49. • Symptoms Kampavata are Karapadtal kampa (tremors in hands and legs), dehabramana (postural instability), nidrabhagna (insomnia) and Matiksheen (dementia).10 The symptom like Stambha (rigidity), Cestahani (slowness of the movement), Vinaman (flexed posture),Vakvikriti (speech disorders) have been mentioned in other pathological conditions of Vata vyadhi which can also be grouped under the feature of Kampavata. 7/22/2016 49
  • 50. Example: Niruha basti Anuvasan basti Madhu 80 gm bala taila 100 ml Saindhava 5 gm Bala taila100 ml Kapi kacchu kalka 40 gm Kapikacchu qwatha 640 ml 50 Honey 30 ml Anuvasana basti Saindhava lavana 5 gm Moorchita taila 80 ml Moorchita taila 80 ml Rajayapana kalka 20 gms Rajatapna qwatha 300 ml Mamsa rasa 200 ml 7/22/2016
  • 52. • Aplastic Anaemia is a rare disease in which the bone marrow and the hematopoietic stem cells that reside there are damaged. • This cause deficiency of all three blood cell types. i.e red blood cells(anemia),white blood cells(lukopenia) and platelets(thrombocytopenia). • Aplastic refers to inability of stem cells to generate mature blood cells. • Signs and symptoms: Anemia may lead to malaise, pallor and associated symptoms such as palpitations. Low platelet count, low white blood cells counts 52 Aplastic anemia 7/22/2016
  • 53.  Treating immune mediated aplastic anemia involes suppression of the immune system.  Blood and marrow stem cell transplants may cure aplastic anemia . • In ayurveda we have the reference of rakta basti in case of low heamoglobin. • रक्ते रक्तेन...। च लस ८ /२६ • रक्ते रक्तेनेऽ नत सरक्तेऽनतसार्मर्ाणे रक्तबस्स्तिेर्:। whenever there is excessive loss of blood from body raktabasti should be administered. 53 7/22/2016
  • 54. • तिेव िभमर्ॄदितां रक्तां बस्स्तां प्रिापर्ेत। च लस ८२६ Whenever there is need of blood for body the raktabasti should be given mixed with darbha. Blood of goat ,rabbit, deer ,cat, buffalo can be used. • Majja basti also can be given using majja of goat. 7/22/2016 54
  • 55. Case report of acute lymphoblastic leukemia A 4 yrs old male boy came to opd with complaints of severe pallor (low hemoglobin level in blood),fatigue, delayed milestone and recurrent respiratory infections, lymphadenopathy, hepatospleenomegaly. Hb % -5.8 g % Lecocytosis 44000 Thrombocytopenia 80,000 ESR 58mm in 1 st hr. 55 7/22/2016
  • 56. Treatment : Majja basti : fresh goats marrow ( crushed yellowish red internal part of bone) approximately 15 g every day. it was boiled with 50 ml of milk to reduce to 20 ml + 5 ml of panchatikta ghrita = basti was given for 30 days. After 4 th day: increase in HB % by 1 g% and leucocytes count was reduced to 32,600/cumm 7/22/2016 56
  • 57. मज्जावृते षवनाम: स्र्ाज्जृम्भणां पररवेष्टनर््। शूलां तु पीड्र्र्ाने च पाणणभ्र्ाां लभते सुखर््॥ च श्रच २८/६७ धचककत्सा : र्हास्नेहोऽस्स्थर्ज्जस्थे पूवमवद्रेतसाऽऽवृते। च श्रच २८/१९६ • मज्जाधातु ित ज्वर दहक्का श्वासस्तथा कासस्तम्भश्च नतलर्रिशमनर््। र्र्ामर्च्ेिो बदह: शैत्र्ां िाहोऽततश्चैव र्ज्जगे॥ च श्रच ३/७३ धचककत्सा अस्स्थर्ज्जागते िेर्ा ननरुहा: अनुवासना:। च श्रच ३/३१६ 7/22/2016 57
  • 58. Mode of action • आपादतलं मूधमस्थान् दोषान् पक्वाशये स्स्थत:। वीयेणर्स्स्त: आदत्ते खस्थोऽको भूररसाननव॥ च मस ७/६४ oÉÎxiÉ dravya though situated in the pakvashaya draws up the dosha from sole of feet to head by its veerya as the sun situated in sky takes up the rasa of the earth. • मूलं िुदं शरीरस्य मसरास्तत्र प्रनतस्टिता:। सवमशरीरपुटणास्न्त मूधामनं यावदाधिता:॥ (पराशर) Guda is the mula of the body where all sira are located.The sneha administered through the guda reaches up to head and nourishes up to head and nourishes the body . • ववश्र्वक् स्स्थतां िोषचर्ां ननरस्र् सवामन ववकारन् शर्र्ेत ननरुह्। (च लस १/२८) Through the systemic action basti, is capable of removing the doshas 58 7/22/2016
  • 60. The veerya of the basti dravya carried through urdhwa, adho and tiryag dhamanis Churnes up the doshas and malas Nourishes rasa dhatu Draws out the mala and kupita doshas Nourishes uttarottara dhatus Tridoshas attains normalcy Maintains homeostasis of the body7/22/2016 60
  • 61. Basti dravyas by reaching upto nabhi, kati, parshva, kukshi pradesha Churns up the fecal and doshas present there at the same time by spreading its unctuous effect in the whole body, Draws out the fecal and vitiated doshas with ease by first niruha basti Second niruha basti act on pittadosha dependent on vata in pakvashaya Third niruha expels out morbid kapha in pakvashaya dependent on vata Vayu attains normalcy 617/22/2016
  • 62. Veerya of basti drugs reaches the apana vayu and nourishes it, Then it acts on samana vayu, after it nourishes the vyana vayu, there after it acts on udana vayu and prana vayu and nourishes them Veerya of basti drugs act on the pitta and kapha to bring them into normalcy and provide them nourishment . The veerya of the basti drugs is carried to tiryak pradesha by vyana vayu to adha pradesha by apana vayu and to urdhwa pradesha by prana vayu. The whole body gets nourishment by the veerya of basti drugs carried by five types of vata through srotas. 7/22/2016 62
  • 63. Niruha Basti clears all the passages and removes doshas Sneha of anuvasana basti spreads in minute channels very smoothly Promoting vitality of life. 7/22/2016 63
  • 64. MODERN VIEW Basti dravya Inserted through anal route Reaches rectum Active ingredients of basti dravya absorbed through circulation Carried to large intestine Causes gastro intestinal movements Carried to liver and absorbed to millions of liver sinusoids Action Of myenteric plexus And submucosal Plexus 64 7/22/2016
  • 65. Stimulation of sympathetic and parasympathetic nerve fibers Causes irritation to the gut mucosa Peristaltic rush Generates defecation reflex Expels toxins through feces Action of reticulo endothelial cells Removes bacteria Through hepatic veins empties into portal hepatic venous circulation Removes bacteria Improves circulation Maintains homeostasis of the body7/22/2016 65
  • 66. Stimulation of sympathetic and parasympathetic nerve fibers Activates enteric nervous system Visceral afferent stimulation Activates HPO axis Activates neuro transmitters Maintains hormonal secretion Maintains homeostasis of the body 7/22/2016 66
  • 68. DISCUSSION • Diseases of Majja are not elaborated in classics ,so has to be viewed in point of different systems. • Diseases of Majja refers to marma,asthi,sandhi vikaras,gambhira dhatu vikaras where involvement of vata is seen. • Basti karma is the treatment of choice in regulating the function of vata . • Kala basti and karma basti are the types of basti which are beneficial in treating the Majja gata vikaras. • Depending upon the diseases we can modulate the functions of basti karma. 7/22/2016 68
  • 69. • प्रत्येत्यनक्तज नशकृ्च तैलज रक्तानद्ुद्धीनन्द्रय नजप्रनाद:। स्वप्िािुव्रृनत्तलवाुता ्लज च नृष्टाश्च वेगा: स्विुवाननते स्यु: च नन १/४४ • रक्ताद्यो र्ातव: । चक्रपानि • While describing gunas of Basti Karma Aacharya tells that it is Dadhyavaha, which means gives strength . • Before performing Basti Karma sarvanga or sthanika abyanga to be done for 900 matra kala to reach sneha to Majja dhatu which in turn helps in promoting Basti Karma. • When a cloth is immersed in water mixed with a dye, the cloth will take the color of dye only from water; like that, the given Basti will take out the vitiated Doshas from body. 7/22/2016 69
  • 70. Conclusion • Majja is the sixth Dhatu, and diseases affecting the Majja are indicative of deep rootedness of diseases which requires blending of different modalities of treatment in which Basti Karma occupies the prime place. • Though , limited explanation is found in classics pertaining to Majja vikaras the understanding of the same can be viewed from the point of Neurological,Skeletal,Heamatological,Immunological,Tricological considerations. 7/22/2016 70
  • 71. • The modus operandi of Basti Karma in Majja vikaras can be understood from the point of anatomical ,physiological, pathological and therapeutic description such as the site functions, Kala, action on Vata. • Samyak lakshana and time taken for Basti to exert its action at the level of Majja. • Different modification pertaining to formulation and course of Basti can be made in treating Majja vikaras based on site of pathology, severity & intensity of disease. 7/22/2016 71