Topic 10.2.14 Kati Basti post-treatment. Paschat karma

Removal of oil and flour ring

At the end of fixed duration meant for completing a schedule (20 minutes roughly), the oil is slowly removed from the pool and stored in a container or bottle.

Whist it is ideal to use new oil every day, practically it becomes unaffordable from the patients and practitioners perspective. On the next day, the same oil will be reused after adding some more oil to replace the quantity consumed for treatment procedures on the previous day.

The entire oil needs to be replaced on the fourth day of the treatment.

The dough container (kati basti ring) is also removed thoroughly.

Abhyanga

– A light massage is given using the same oil for 10-15 minutes.

– Care should be taken not to apply too much pressure while massaging.

– The lower limbs and feet can also be massaged (optional).

Kati Basti is the best treatment which Ayurveda provides to heal your back pain. All you need to do is to meet an experienced Ayurvedic doctor and put forth your problems. The doctor will help you to get your sore back into its rhythm.

The beauty of Kati Basti is that it can even be administered on healthy individuals and health fanatics, thus also forming an important part of prophylactic back care, with a ‘prevention is better than cure’ philosophy.

If you have occasional back pain, understand that this is a platform for a more serious one. If your job and posture are bad enough to predispose for recurrent episodes of backache, you need to take preventive ‘Kati Basti’ sessions. In this your doctor may advise you to take Kati Basti and Patra Pinda Sweda once or twice a month, say on alternate Saturday’s or Sunday’s. This is really good news to all back pain sufferers.

Probable mode of action

Almost all pains are caused due to:

Aggravation of Vayu (mainly degenerative types of pain). This further leads to depletion and degeneration of tissues
Avarana of Vayu (enveloping of smooth functioning of Vayu by one or the other element of the body including Pitta, Kapha, Dhatus (tissues)
Ama. Sticky toxins produced as a result of low digestion (gut and cellular) which hamper the smooth functioning of Doshas and Dhatus and block the excretion of body wastes by blocking them.
High Pitta can cause inflammatory type of pain in the low back and also in lower limbs
High Pitta can cause stiffness and loss of movements in the low back.

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Practitioner Level. (Advanced Diploma Ayurveda)

Patra Pinda Sweda, Leaf bolus fomentation

The fresh leaves of the Vata alleviating / pain relieving herbs are collected and sliced.

Examples include leaves of:

– Eranda (Ricinus communis – castor plant)

– Nigundi (Vitex nigundo)

– Arka (Calotropis gigantean)

– Chincha (tamarind)

– Shigru (Moringa oleifera – Drum stick leaves)

– Dhattura (Datura stramonium)

– Agnimantha (Clerodendrum phlomidis),

The sliced leaves are fried in oil (appropriate for Kati Basti).

Together with the leaves,

– grated coconut

– sliced lemon

– Rasnadi Churna

– Haridra (Turmeric powder)

– Methika (fenugreek)

– Saindhava Lavana (rock salt)

– Eranda Taila (castor oil) are also added and fried.

The sliced leaves are tied in a bolus to form a Patra Pinda (Leaf bolus).

A couple of boluses are prepared

The leaf bolus is dipped in warm oil, any oil drooping from the bolus is mopped over the edge of the pan, and temperature of the bolus is tested and used for giving fomentation.

The bolus is rubbed on the affected part gently (as good as massaging with bolus).

Circular motions with gentle pressure is given over the joints and rubbed vertically from above downwards while giving fomentation over muscles (in the direction of muscles).

Once the bolus loses its temperature, it should be replaced with the other bolus which has been kept dipped in the oil in the heated pan. The fire beneath the pan should be constant (mild flame) until the treatment is completed.

The boluses are thus changed one after the other until the procedure is completed.

After the completion of treatment, the residual oil etc are cleansed with the help of a tissue paper or vata alleviateing leaves or with sterile cloth / cotton dipped in warm water.

Shashtika Shali Pinda Sweda

Fomentation with Shashtika Rice (rice grown in 60 days duration) processed with medicinal decoctions packed in boluses shall be preferred as a combined therapy for Kati Basti when there are signs of severe Vata vitiation and degeneration of tissues and when nourishment seems to be in demand as far as the low back is concerned.

Snana, Bath

The patient is allowed to rest for about 1 hour and later advised to take a hot water bath. The patient should be using green gram powder to rub their body. Alternatively, Siddhartha Snana churna (bathing powder) or any herbal powder can also be used.

If the patient is being treated as an outpatient, the patient is advised to take a bath at home after an hour or couple of hours.

Matra Basti

Basti (Vasti), medicated enema’s are the best to control morbid Vayu and hence the painful conditions caused by it, including low back pain.

Matra Basti is a subtype of the Basti procedure wherein a small quantity of enema using medicated oil or ghee or a combination of both is given daily. Usually 50-75 ml is given after food.

Medicines used for Matra Basti

Guggulutiktakam Ghritam, Mahanarayana Tailam, Sahacharadi Tailam, Dhanwantaram tailam / mezhupakam etc

Matra Basti is given on all days of Kati Basti

Nitya Virechana

Daily metered dose of purgation with purgative decoctions or oils such as Gandharvahastadi Kashayam, Gandharvahastadi Eranda tailam, Nimbamritadi Eranda Tailam etc can be administered if a small amount of detoxification is essential on a daily basis or if morbid Vata and Pitta need to be tackled (optional and strictly based on the decision of the doctor). This can be thought of when Virechana is needed during treatment. Nitya Virechana can also be a part of follow up treatment. Nitya Virechana should never be administered when Matra Basti is planned in the protocol of treatment. In such cases, Matra Basti can be given during the schedule of Kati Basti and Nitya Virechana, if needed can be brought in the follow up seeing the morbidity of Vata and Pitta.

Nitya Virechana and Matra Basti

These also cleanse the bowel and bladder, thus minimising the pressure of bowel and bladder on low back.

Discharge

The patient is discharged on daily basis as an out-patient, or after the course has been completed if they are an in-patient, after giving proper lifestyle and diet advices along with suitable oral medicines.

The patient is also advised to undergo the treatment twice or thrice in a year as a part of maintenance and to avoid recurrence.

Chronic diseases should be attended by prompt intake of treatment. Obesity is one of the main concerns and risk factor for lower back pain and arthritis. Correction of constipation and menstrual disorders in women also should be focussed upon. Regular, beneficial exercises should be added with a planned diet to reduce weight.

Some physicians like to tend the process after finishing Kati Basti without touching or extending it to Abhyanga, Patra pinda sweda and Basti. However, in our experience, there is no problem combining therapies with the aim of providing a better relief. Whenever we have combined Kati Basti with Patra Pinda Sweda or Matra Basti, the results have been outstanding. But again the nature of the disease, the predominance of the Dosha, and affordability to the patient should be considered. There are no fixed rules for carrying on the treatments, the only rule is that things should not be overdone or underdone and the relief of the patient is the most important motive. Ayurveda has given us the liberty to experiment.

Duration of the course

The number of days of treatment varies from 7-14 days depending upon the nature and intensity of the disease.

Treatment (only Kati Basti) is done for a period of 30-45 minutes per session (Please note, the duration of treatment will extend beyond this if it is combined with other treatments mentioned above).

External applications

The same herbal oils mentioned in Abhyanga etc. can be used for external application.

Summary

Probable mode of action

Almost all pains are caused due to:

Aggravation of Vayu (mainly degenerative types of pain). This further leads to depletion and degeneration of tissues
Avarana of Vayu (enveloping of smooth functioning of Vayu by one or the other element of the body including Pitta, Kapha, Dhatus (tissues)
Ama. Sticky toxins produced as a result of low digestion (gut and cellular) which hamper the smooth functioning of Doshas and Dhatus and block the excretion of body wastes by blocking them.
High Pitta can cause inflammatory type of pain in the low back and also in lower limbs
High Pitta can cause stiffness and loss of movements in the low back.

Udwarthana and or Churna Pinda Sweda done before Kati Basti would dry up ama and kapha, liquidity of pitta (sama pitta) and relieve stiffness and loss of movements. Kati Basti nourishes the joints of the low back, pacifies the dosha causing pain or discomfort (by using ideal oils), soothes the nerves, relieves degeneration, stiffness and inflammation and cures pain. Patra Pinda Sweda further rejuvenates the back by controlling Vayu. Shashtika shali pinda sweda strengthens and nourishes the low back and limbs. Virechana detoxifies the system and relieves inflammation and Basti drives the morbid Vayu out of the system and fortifies the cure. Basti and Virechana also help in removing the avarana of Vayu and also in preventing the recurrence of low back pain. Basti and Virechana also normalise the functions of Apana vayu, thus correcting all the functional aspects of the lower body under its governance.

It is not mandatory to combine all the treatments at a time but it is left to the wisdom of the Ayurvedic doctor attending your low back and the diagnosis he or she has done after examining you.