Dr. Shanthan

Nasya Karma

Definition

नस्तःकर्म� च कुर्वी�द शि�रोरोगेषु �ास्त्रविर्वीदद्वारर्म् वि� शि�रसोनासा तेन तद्व्याप्य �न्ति त तान II (च.सिस. ९-२५)

औ�धर्म् औ�धसिसद्धर्म् स्ने�ोर्वीा नासिसकाभ्यां दीयते इवित नस्यं (स.ुसिच. ४०)

ऊर्ध्वर्वी�जतु्र विर्वीकारेषु विर्वीषे�ान्नस्यमिर्मष्यथेयनासवि� शि�रसो द्वारर्म् तेनातद्यावि6 �न्ति त तान II (अ�. सु. २०)

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

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

शि�रोवि�रेचनं सप्तवि�धं फलपत्रमूलकन्दपुष्पविनर्या��सत्�ग�र्याथः भेध�त्

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

नार्वीनं चार्वी6ीदश्च र्ध्वर्मा6नं धरू्म एर्वी च प्रवितर्मष�श्च विर्वीजे्ञय नस्तःकर्म�ःतु 6ञ्चधा II

Types of Nasya

Nasya

navana

avapida

dhmaapanadhumana

pratimarsa

स्न�ेनं �ोधनं चैर्वी विद्वविर्वीधं नार्वीनं स्रृ्मतं

न��नं स्नेहनं �ोधनं

�ोधनं स्तंभनश्च स्यादर्वी6ीदो विद्वधा र्मतः

अ�पीड

�ोधन स्तंभनTypes of avapeeda nasya

Types of naavana nasya

चुर्ण�स्र्या�ध्म�पनं तवि+ददेह स्रोतो वि��ोधनम्

प्रवितमर्षो/ भ�ेत् स्नेहो विनद/र्षोः उभर्या�थ�कृत

Dhmapana i.e insufflation of drugs in powder form is srotovishodhana

i.e cleanses the channels ofbody

Pratimarsha serves both the purposesi.e oleation and elimination

– As a whole, the Nasya karma can be categorised into three varieties, based on their pharmacological action:-

– Rechana- which eliminates the doshas

विर्वीरेचनं शि�रः�ूल अ गस्या दगलार्मये�ोफग द कृमिर्मग्रन्थिF कुष्टा6स्र्मार6ीनसे

– Tarpana- it provides nourishment to the organs of head

बृं�णं र्वीातजे�ूले सूया�व्र्वीतK स्र्वीरक्षये नास�ोषे र्वीाक्सङे्ग कृच्छबोदार्वीबाहुके

– Shamana- Which pacifies alleviated doshas in head

�र्मनं नीसिलकाव्य गा के�दो�ाशिक्षराजिजषुयथास्यं योविगकौ स्ने�ौ यथास्र्वीं च प्रसासिधतौ

What For What?

स्तंभसुप्तिप्त गुरुत्��द्य श्लैष्मिष्मक�र्या� शिसरोगदः

र्याे च ��त�त्मक�रोगः शि�रःकंप�र्दिद9तस्र्या च

रक्तविपत्तदिदरोगेर्षोु �मनं नस्र्यामिमष्र्याते

Rechana nasya

Tarpana nasya

Shamana nasya

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.

Drugs Used In Nasyaफल�दिदभे�जं प्रोकं्त शि�रसोर्यावि+रेचनंतच्चूर्ण@ कल्पेरे्यात्तेन पचेत् स्नेहं वि�रेचनं

– 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)

र्यादुकं्त मधुरस्कन्धे भेर्षोजं तेन तप�नं

– Oils may be processed by the drugs of madhura skandha (Cha. Vi-8/139), and can be used for tarpana type of nasyam

– Acharya Charaka metioned few drugs in apamargatanduliyadhyaya of Sutrasthana. Few on them include:-

– Apamarga

– Pippali

– Vidanga

– Shigru

– Maricha

– Sarshapa

– Sirishs

– Haridra

– Lavana

– Nagara

– Jyotishmati

गौर� शि�रसः�ूले पीनस�थ���भेधके कृमिमव्यध्र्या��पस्म�रे घ्र�नन��े प्रमोहके

General Indications of NasyaSirostambha 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

General Contra- Indications of NasyaBhuktabhakta (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

Indications Depending on the Type of NasyaSnehana Sodhana Avapida PradhamanaVatika sirahshula Kaphapurna talu/

shirasManasa roga Mano vikara

Keshapaata Praseka Apasmara Ati Uttklishta Dosha

Danta pata Aruchi Sirovedhana KrumiSmashru pata Shirogourava Moha/ Murcha VishaTivra karna shula Urdhva jatrugata

sophaApatantraka Sangna nasha

Timira Pinasa Chitta vyakulavastha

Nasa roga Arthavabhedaka Krisha/ Visha

Mukha sosha Krimi, Kotha SanyasaAvabahuka Pratisyaya Bhaya/ BhiruVali-palita Apasmara KrodhaMukha roga Gandhajnana nasha Stri/ Krisha

General Dose of Nasya KarmaType 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

Nasya KalaRtu 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

Duration Of Nasya KarmaName of Acharya No of Days

Charaka Depending on the severity

Susrutha 1, 2, 7, 21

Vagbhata 3, 5, 7, 8

• 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

Samyak Yoga, Atiyoga and Ayoga Lakshana

– Samyak Yoga Lakshana:-

उरह्शिV�रोइजि Wय लाघर्वीश्च स्रोतोविर्वीषुशिद्धश्च भरे्वीत्वि[र्वीषुदै्ध

– Ayoga Lakshana:-

गलो6ले6ः शि�रसोगुरु[र्वीा विनष्तीर्वीनं चाप्यदुर्वी�रिरके्त

– Atiyoga Lakshana:-

शि�रोशिक्ष�ङ्का स्श्रर्वीनार्तितcतोद अ[यथ�षुदे्ध वितमिर्मरं च 6श्चेत

Nasya Karmukhata

न�स�विह शि�रसो +�रम् तत्र��सेशिचतं और्षोधंस्रोतः स्रुन्ग�तकं प्र�प्रं्या व्य�प्र्या मूध��नं नेत्रस्रोत्रकन्त�दिद शि�र�मुख�विन च, ऊध्���त्रुगत� �ैक�रिरकी अ�ेर्षों आ�ु दोर्षो संहवित उत्तम�ङं्ग गद�पकर्षो�वित 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

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

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.

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

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.

Olfactory Pathway

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

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

– 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

– 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

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