Abstract
Amavata is the most crippling of the joint disease. It occurs throughout world in the all climate and all ethical groups. Ama associated with aggravated vat play dominant role. The clinical features of Amavata such as pain, swelling, stiffness, fever, general debility are most identical mentioned in classical texts. In classics treatment mentioned in Amavata is Dipan, Pachan, Shodhan, Shaman, Asthapan basti, Vaitaran basti. Among them Vaitaran basti is very effective in Bahudosh and Lindosh avastha. It used in new and old Amavata as well because it brings Doshas from Shakha to Kostha and remove it from Gudmarg and gives relief.
Keywords- Amavata, Vaitaran basti, Shakha and Kostha.

Introduction
Amavata is first mentioned as separate disease by madhav nidan,where it is stated that mandagni plays key role in the menefestation of the disease. Acharya madhav described most characterstics features of the disease, severe pain similar to a scorpion bite. Asthi and sandhi are chief sites of presentation of cardinal symptoms, such as sandhi shool,sandhi grah,sandhi sotha etc.this symptoms are resembles the cardinal symptoms of rhumatoid arthritis i.e. pain, swelling, stiffness, fever, general debility etc. Amavat chikitsa described by chakradatta is dipan,tiktakatu ras, kshar basti, vaitaran basti, saindhavadi anuvasan and many yogas.

Basti
Nirukti - The word basti is derived from the root “bas+chit”.
“Bastina diyate aneniti basti” (A.H.Su.19/11 Arundatt)

The term basti means bladder. The bladder of animals were used as the device for basti karma in olden days. It is also said that medicine administered through the basti yantra, first reaches the lower abdomen area of the patient which contains organ basti(bladder).

Basti is mainly indicated in vata predominant diseases.The two type of abnormalities of vata namely, avaran and dhatukshayjanya can be treated by basti karma. Direct application of this type of treatment to colon helps not only in regulating and co-ordinating and vata dosha in its site,but also controls the other doshas involved in the pathogenesis of the disease (S.S.Chi.35/6). Basti is used in sakhagat, tiyarkgami dosha, kosthagat rogas. Among them vaitaran bastis lekhan or utkleshan basti used in those diseases in which dosha reached at deeper dhatu ex - Amavata, urustambh.

Vaitaran basti
Vaitaran is the name of a river,which a person is supported to cross during death in his astral realm. This basti is so powerful in a sense that it can bring back life of a preson who is about to cross the vaitaran river.

It can be administerated even after the meal. The word Go payah can be interpreted as the milk or cow’s urine. Based on the need ,either of these can be selected. Jaggery is added with water,melted,filtered and mixed like honey,then other drugs are added in the order mentioned.Tamarind is the kalkam here. Now a days seedless tamarind paste is available in the market.It can be directly used. If we want to add milk,it should not be very hot and we have to mix very slowly by adding little by little. So that spoiling of the milk will be prevented. Mixing takes double the time than the other bastis.

Some vaidhyas seriously considere adding milk and tamarind as samyog virudhdha(incompatable combination) and prefer to use gomutra.This is an understable logic. Some vaidhya advise to give anuvasan on the same day whenever lekhan basti or gomutra basti is given.

Indications:
Vangsen indicates this basti in kati pristha shotham,sulam,severe vata disorders,chronic Urustambh,Gridhrasi and janu sankoch. It is used in visham jwaram and klaibya. It can be given after food in the evening,but if the patient is strong then it can be given in morning empty stomuch also. Vaitaran basti brings doshas in sakha to kostha.

Action of vaitaran basti in amavta
Chakradatta and vangsen has mentioned vaitaran basti is useful in the amavata. It brings doshas shakha to kostha by utkleshan or lekhan action and it eliminated by gudmarg.

Srotomukh vishodhanat - Gomutra cleans the channels
Vridhdhi - Amlika increase the doshas
Abhishyandanat – Saindhav lavan increases the abhishyandi quality.
Paka – Gudam used for dosha paka
Vayosch nigrahat – Oil controls over the vayu

Conclusion
Amavata is first mentioned in madhav nidan as separate disease, and a complete picture of its nidan, samprapti and samanya as well as pravridhdh rupa is given. Its mostly disease of madhyam rogmarg with chirkari swabhav. Ama and vata being contraindicatory in nature make it difficult to plan the line of treatment ,in chronic stage doshas become lin dosha and reaches to the sakha. Here vaitaran basti is utkleshkar basti which increase the doshas so it comes out from the shakha to kostha and expel out from the body from gudmarg ,hense basti is best treatment for vatarog, so vaitaran basti plan key role in amavat lin doshavastha.