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Nasya karma

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Nasya karma

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A brief introduction to "Nasya Karma", one among the Panchakarma therapies, and it's probable mode of action

A brief introduction to "Nasya Karma", one among the Panchakarma therapies, and it's probable mode of action

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Nasya karma

  1. 1. Definition नस्तःकर्म च कु र्वीद शिरोरोगेषु िास्रवर्वद द्र्वारर् ् हि शिरसोनासा तेन तद््याप्य िन्तत तान II (च.शस. ९-२५) औिधर् ् औिधशसद्धर् ् स्नेिोर्वा नाशसकाभयाां दीयते इतत नस्यां (सु.चच. ४०) ऊर्धर्वमजरु वर्वकारेषु वर्वषेिातनस्यशर्ष्यथेय नासहि शिरसो द्र्वारर् ् तेनातद्यावि िन्तत तान II (अि. सु. २०)
  2. 2. Introduction – Nasya karma basically means instilling the medicated oils, liquids, powders into the nose, to achieve a desired therapeutic effect – It need not be always an therapeutic procedure, but can also refer to one among the daily activities of a svasthya – Nasya has been mentioned as a part of dinacharya, and it’s daily practice has been in use for several years
  3. 3. Types of Nasya – According to:- – Charaka- Navana, Avapida, Dhmapana, Dhuma, Pratimarsha – Susrutha- Nasya, Sirovirechana, Pratimarsha, Avapida, Pradhamana – Vagbhata- Virechana, Brumhana, Shamana – Sarangadhara Samhita- Rechana, Snehana – According to ashraya bheda शिरोविरेचनं सप्तविधं फलपत्रमूलकन्दपुष्पननर्यासत्िगयर्थः भेधयत्
  4. 4. Acharya No. Of Types Reference Classification Charaka 3 Cha. Si.9/92 Rechana, tarpana, shaman 5 Cha. Si. 9/89 Navana, avapida, dhmapana, dhuma, pratimarsha 7 Cha. Vi. 8/151 Yoni/ ashraya bheda Susrutha 5 Su. Chi. 40/21 Sirovirechana, pradhamana, avapida, nasya, pratimarsha Vagbhata 3 Ah. Su. 20/2 Virechana, brumhana, shaman Sarangadhara 2 Sa. Ut. 8/2-11-24 Rechana, snehana Kashyapa 2 Brumhana, karshana
  5. 5. नार्वनां चार्विीदश्च र्धर्ािनां धूर् एर्व च प्रततर्षमश्च वर्वज्ञेय नस्तःकर्मःतु िञ्चधा II Types of Nasya Nasya navana avapida dhmaapanadhumana pratimarsa
  6. 6. स्नेिनां िोधनां चैर्व द्वर्ववर्वधां नार्वनां स्र्ृतां नयिनं स्नेहनं िोधनं िोधनां स्तांभनश्च स्यादर्विीदो द्वर्वधा र्तः अिपीड िोधन स्तंभन Types of avapeeda nasya Types of naavana nasya
  7. 7. चुर्ास्र्यध्मयपनं तद्विददेह स्रोतो वििोधनम् प्रनतमर्षो भिेत् स्नेहो ननदोर्षः भभर्यथाकत त Dhmapana i.e insufflation of drugs in powder form is srotovishodhana i.e cleanses the channels ofbody Pratimarsha serves both the purposes i.e oleation and elimination
  8. 8. – As a whole, the Nasya karma can be categorised into three varieties, based on their pharmacological action:- – Rechana- which eliminates the doshas वर्वरेचनां शिरःिूल अतगस्यातदगलार्ये िोफगतद कृ शर्ग्रन्तथ कु ष्टािस्र्ारिीनसे – Tarpana- it provides nourishment to the organs of head बृांिणां र्वातजेिूले सूयाम्र्वते स्र्वरक्षये नासिोषे र्वाक्सङ्गे कृ च्छबोदार्वबािुके – Shamana- Which pacifies alleviated doshas in head िर्नां नीशलका्यतगा के िदोिाक्षक्षरान्जषु यथास्यां योचगकौ स्नेिौ यथास्र्वां च प्रसाचधतौ
  9. 9. What For What? स्तंभसुप्प्त गुरुत्ियद्र् श्लैप्ष्मकयर्य शसरोगदः र्े च ियतयत्मकयरोगः शिरःकं पयर्दातस्र् च रक्तवपत्तर्दरोगेर्षु िमनं नस्र्शमष्र्ते Rechana nasya Tarpana nasya Shamana nasya
  10. 10. In a Gist…. – Navana Nasya: instilling medicated oil or ghrita – Avapida Nasya: nasya with juice extracted from the drug – Dhmapana Nasya: blowing fine powder of drug into nostrils – Dhuma Nasya: medicated smoke inhaled through nose and exhaled through mouth – Marsha Nasya: Instilling oils in higher dose to achieve instant result – Pratimarsha Nasya: Instilling oils in lower dose, has no complications, advised for all.
  11. 11. Drugs Used In Nasya फलयर्दभेिजं प्रोक्तं शिरसोर्द्विरेचनं तच्चूर्ं कल्पेर्ेत्तेन पचेत् स्नेहं विरेचनं – In Charaka Vimana Sthana Chapter 8, seven categories of plant parts viz., fruits, leaves, roots, rhizomes, bark, flowers, exudates are mentioned. They can be used in powder form or can be processed in oil form and used to achieve siro virechana (Cha.Vi.8/151) र्दुक्तं मधुरस्कन्धे भेर्षजं तेन तपानं – Oils may be processed by the drugs of madhura skandha (Cha. Vi-8/139), and can be used for tarpana type of nasyam
  12. 12. – Acharya Charaka metioned few drugs in apamargatanduliyadhyaya of Sutrasthana. Few on them include:- – Apamarga – Pippali – Vidanga – Shigru – Maricha – Sarshapa – Sirishs – Haridra – Lavana – Nagara – Jyotishmati गौरि शिरसःिूले पीनसयथयािभेधके कत शमव्र्ध्र्यिपस्मयरे घ्रयननयिे प्रमोहके
  13. 13. General Indications of Nasya Sirostambha Ardhavabhedaka Vakgraha Shirahshula Grivaroga Akshishula Svarabheda Shuklaroga Netraroga Galashundika Tundikeri Galashaluka Timira Galaganda Vartmaroga Nasashula Upajihwaka Pinasa Manyastamba Ardita Dantastamba Apatantraka Dantaharsha Karnashula Chaladanta Arbuda Hanugraha Skandaroga Mukharoga Amshashula Khalitya Palitya
  14. 14. General Contra- Indications of Nasya Bhuktabhakta (just after meals) Ajeerna Pita sneha Pita madya Pita toya Snata shirah Snatukama Kshudartha Sramartha Matta Murchita Shastraghata Vyayava klanta Vyayama klanta Pana klanta Navajvara Shokabhitapa Virikta Anuvasita Garbhini Nava pratishyaya Apatarpita Pitadrava Trushna Garatha Kruddha Bala Vruddha
  15. 15. Indications Depending on the Type of Nasya Snehana Sodhana Avapida Pradhamana Vatika sirahshula Kaphapurna talu/ shiras Manasa roga Mano vikara Keshapaata Praseka Apasmara Ati Uttklishta Dosha Danta pata Aruchi Sirovedhana Krumi Smashru pata Shirogourava Moha/ Murcha Visha Tivra karna shula Urdhva jatrugata sopha Apatantraka Sangna nasha Timira Pinasa Chitta vyakulavastha Nasa roga Arthavabhedaka Krisha/ Visha Mukha sosha Krimi, Kotha Sanyasa Avabahuka Pratisyaya Bhaya/ Bhiru Vali-palita Apasmara Krodha Mukha roga Gandhajnana nasha Stri/ Krisha
  16. 16. General Dose of Nasya Karma Type of Nasya Hrasva Madhyama Uttama Snehana Nasya 8 16 32 Sodhana Nasya 4 6 8 Marsha Nasya 6 8 10 Avapida Nasya 4 6 8 Pratimarsha Nasya 2 2 2 Dose of Nasya Karma according to Sarangadhara • Tikshna aushadi churna- 24 ratti • Hingu- 1 yava • Saindhava- 1 masha • Dugdha- 8 sana • Jala- 3 karsha • Madhura dravya- 1 karsha
  17. 17. Nasya Kala Rtu Time of Nasya Grishma Morning Sisira Afternoon Varsha In clear morning Sarat+ Vasanta In morning Sisira+ Hemanta Afternoon Grishma+ Varsha Evening Doshic Predominance Time of Nasya Kaphaja Vikara Morning Pittaja Vikara Afternoon Vataja Vikara Evening
  18. 18. Duration Of Nasya Karma Name of Acharya No of Days Charaka Depending on the severity Susrutha 1, 2, 7, 21 Vagbhata 3, 5, 7, 8
  19. 19. • Sambara sangraha • Examination of patient • Preparation of Patient Purvakarma • Administration of Nasya Oushadi • Immediate measures after nasya Pradhana Karma • Observing the samyak yoga, atiyoga, ayoga • Dhuma and Gandusha • Parihara • Vyapad and Chikitsa Paschat Karma
  20. 20. Samyak Yoga, Atiyoga and Ayoga Lakshana – Samyak Yoga Lakshana:- उरन्शिरोइन्तिय लाघर्वश्च स्रोतोवर्वषुद्चधश्च भर्वेन्वर्वषुद्धै – Ayoga Lakshana:- गलोिलेिः शिरसोगुरुवर्वा तनष्तीर्वनां चाप्यदुर्वीररक्ते – Atiyoga Lakshana:- शिरोक्षक्षिङ्का स्रर्वनाततमतोद अवयथमषुद्धे ततशर्रां च िश्चेत
  21. 21. Nasya Karmukhata नयसयर्ह शिरसो द्ियरम ् तत्रयिसेचचतं और्षधंस्रोतः स्रुन्गयतकं प्रयप्र्ं व्र्यप्र् मूधयानं नेत्रस्रोत्रकन्तयर्द शिरयमुखयनन च, ऊध्ियात्रुगतय िैकयररकी अिेर्षं आिु दोर्ष संहनत भत्तमयङ्गं गदयपकर्षानत II (अ. हृ. सू. २९/३) – The drug administered reaches the srungataka marma, then spreads in murdha, netra, karna, kantha, siramukha, then scratches the morbidly attached doshas, and expels them out
  22. 22. Mode of Action of Nasya – As such there is no direct relation between the nasal cavity and the brain. But the drug transport can be occurring in three different pathways – By simple Diffusion across the nasal mucosal epithelium – Vascular pathway – Lymphatic pathway – Olfactory Pathway
  23. 23. Vascular Pathway – The facial vein has no valves and is directly related to Intracranial Circulation. Also the supra-orbital veins and the ophthalmic vein drain into facial vein, which directly pools into the cavernous venous sinus – The drug which is held in the posterior nasal cavity, that too in head lowered position due to gravity enters the blood pool, and thus it’s absorption into the meninges and the intracranium can be considered.
  24. 24. The Olfactory Pathway – The major part of the nasal cavity is covered with respiratory epithelium, where drug absorption can be easily achieved – The olfactory epithelium is present in the upper posterior part and is supplied by the olfactory nerves, which connect to the olfactory bulb of brain – However the transfer of drugs is hindered by BBB, but it has an affinity towards lipophilic molecules
  25. 25. Olfactory Pathway – The olfactory nerves are connected to higher centres of brain such as amygdalus, limbic system, hypothalamus.. Etc – As we know the Limbic System controls the behavioural pattern and emotions, and the Hypothalamus controlling the ANS and co-ordinating between the Endocrine and Nervous Systems. – Hereby, the medicated oils given through nasal passage may stimulate the olfactory nerve endings and also may transport across the olfactory tract to reach the higher centres of brain.
  26. 26. Olfactory Pathway
  27. 27. Factors affecting the Nasal Absorption – Nasal ph – Particle Size of the drug administered – Local Capillary drainage – Gravity – Affinity of the drug to the nasal epithelium
  28. 28. What possibly is Happening? – Navana Nasya:- – The Nasya Oushadhi having oil base is easily absorbed across the mucosa, as it is highly lipophilic in nature. – It could either stimulate the nerve endings, thereby stimulating the higher centres of brain, or reach there via Trans-Neuronal Pathway – Taila being sukshma, tikshna and ushna in nature penetrates deep into the tissues, and may transport the drug across the tract
  29. 29. – Avapida Nasya:- – As the drug is squeezed directly into the nasal cavity, by virtue of its pungent action, it may instantly stimulate the the nerve endings and the nasal mucosa – As mentioned earlier, the olfactory tract is directly connected to the higher centres of brain such as the Limbic System which controls the emotions – And already it has been discussed that avapida nasya is effective in psycho- somatic conditions, this gives a hint of what’s happening
  30. 30. – Pradhamana Nasya:- – As powders of the drug are blowed into the nose, it creates an immediate reflex action, and irritates the nasal mucosa – It increases the nasal secretion, and thereby clears the congestion and drains the accumulated phlegm in the region – As it is highly irritant in nature, it is helpful in gaining back the consciousness in patients suffering from apasmara, unmada, moha, murcha…etc
  31. 31. Conclusion – On a whole, the nasya karmukhata mentioned in Ayurveda and the mode of action of nasal administration are identical – However the effect of Nasya Karma in Musculo-skeletal cases such as Torticollis, Cervical Spondylosis… Etc have to be understood, taking into consideration the REFLEX ARC Mechanism – The Exact Mechanism has to be studied en-masse, taking into consideration the detailed analysis of the nasya oushadi using HPTLC, Particle Size Assessment – RCCT and Double Blind Placebo Study helps to establish the efficacy of Nasya Karma

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