“A COMPARATIVE CLINICAL STUDY ON THE EFFECT OF NASYA WITH KARPASASTHYADI TAILA AND NAGARA TAILA IN THE MANAGEMENT OF AVABAHUKA”

Avabahuka is a common condition which badly affects the routine domestic activities of patients like combing; bathing etc. interference in occupation by the illness is equally true both in patients with sedentary office work as well as heavy field work. Ayurveda has a great role to manage this disease successfully. Nasya is one among the treatments told by Acharyas for the management of this disease. A comparative clinical study on Nasya with Karpasasthyadi Taila and Nagara Taila had been taken to assess the effect of Nasya Karma and the drug in managing Avabahuka. The comparative effect in managing the same disease is also assessed.
OBJECTIVE OF THE STUDY
1. To evaluate the efficacy of Karpasasthyadi Taila Nasya in Avabahuka.
2. To evaluate the efficacy of Nagara Taila Nasya in Avabahuka.
3. To compare efficacy of Karpasasthyadi Taila Nasya and Nagara Taila Nasya in Avabahuka.
Two groups were made and the results obtained in both the individual groups were compared. The study design selected for the present study was prospective comparative clinical trial. The sample size for the present study was 30 patients suffering from Avabahuka as per the selection criteria. Patients were randomly distributed to both the groups of equal size.
Group A - 15 patients received Nasya with Karpasasthyadi Taila.
Group B – 15 patients received Nasya with Nagara Taila.
In group A 15 patients (100%) had got Prayika Shamana(61-99%) , and no patient (00%) had got no response to the treatment ie Guna Alabha. In group B 13 patients (81%) had got Prayika Shamana(61-99%),02 patients(19%) had got Amshika Shamana (31-60%), and no patient (00%) had got no response to the treatment ie Guna Alabha.
In Group A Shoola B T -53% and after follow up 91%, and in Sthabthatha i.e. Unnamana - B T- 42% and after follow up 66%, Avannamana B T- 43% and after follow up 84%,Akunchana B T-39 % and after follow up 81% and Prasarana B T- 61% and after follow up 87%, Triyakgamana BT-60% and after follow up 77%.
In Group B Shoola B T -51% and after follow up 81%, and in Sthabthatha ie Unnamana - B T- 34% and after follow up 63%, Avannamana B T- 30% and after follow up 76%,Akunchana B T-31 % and after follow up 69% and Prasarana B T- 43% and after follow up 80%, Triyakgamana BT-35% and after follow up 65%.
Group A had got good results while comparing with Group B.That means Nasya with Karpasasthyadi Taila had got good effect than Nasya with Nagara Taila in Avabahuka for the present study.
Key words; Nasya, Avabahuka, Karpasasthyadi Taila, Nagara Taila,

1. Introdution
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
1. INTRODUCTION
Ayurveda is the rich storehouse of time-tested and effective recipes for the
treatment of several obstinate and otherwise incurable diseases. More important than
these recipes are the specialised therapies, which while curing such diseases
strengthen the immune system in the body and help in the preservation of positive
health. These specialised therapies in Ayurveda are called as Panchakarmas. It is no
wonder that the scientists and physicians in India and abroad are evincing deep
interest in the classical form of Ayurvedic treatment. Panchakarma therapy primarily
aims at cleansing the body of its accumulated impurities and nourishing the tissues.
Once this is achieved, it becomes very easy to rejuvenate the tissues and prevent the
process of ageing. This helps the individual to lead a disease free old age and
becomes capable of serving the society with accumulated experience without any
mental disability and physical decay.
It is necessary at this state to make it clear that these Panchakarmas do not
imply simple administration of emesis, purgation, enema or nasal drops as is
conventionally understood. Elaborate methods are described for the preparation of
these therapies, their administration, preparation of the individual prior to the
administration of these and the management of the patient after the therapy is
administered.
Nasya is an important therapeutic procedure as many of the courses of
Ayurvedic treatment. It comes under the Panchashodhanakarmas. Nasya Karma is
one of the important Panchakarma mainly for Urdhwajatrugata Vikaras . It is
more or less essential in all Urdhwajathru Vikaras. Nasya is effective not only for
inducing immediate results but also serves as a permanent cure.

2. Introdution
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
The present day, world is full of stress and strain due to change in life style,
sedentary work, increasing competitions in all walks of life. This has lead to many
diseases which though does not kill a person, but hamper his day-to-day life. Vata
among three humors is considered to be superior most in all aspects, for every action
or movement, strongest in its ability to produce diseases and worst mortality. Vata
which is motivating factor of other two doshas gets easily aggravated in this fast
paced life. Contradictory approaches to pacify this vitiated state have to be resorted to
maintain the equilibrium.
Economy of country relies on its work force. Avabahuka is one of such
disease which hampers the day to day activity of an individual. In classics two disease
have been mentioned ie Bahushosha and Avabahuka. Bahushosha is due to
Kevalavataja and Avabahuka due to Vata and Kaphaja involvement (Avarana).In
Avabahuka Shoola during movement and Bahupraspanda Hara (Stabdhatha) are
manifested.
Considering these facts an attempt is made to study the disease Avabahuka in
detail and to counter act the disease process by adopting suitable therapies.
Avabahuka can be relieved by therapies like Nasya , Sneha Paana,Abhyanga,Swedana
etc according to the classics. In the present study Nasya is selected because this
procedure is more effective in different Vyadhyavasthaas of Avabahuka.
Karpasasthyadi Taila described in Vatavyadhi Adhikara of Sahasrayoga is
generally practiced in the treatment of Avabahuka. By considering the Samprapti of
Avabahuka, the Taila Yoga which is processed with the property of the drugs which
are having Vata Kaphahara nature would be affective. Nagara is a drug having Vata
Kaphahara property which is easily available and economical compared to
Karpasasthyadi Taila. Hence an attempt is made to compare the effect of
Karpasasthyadi Taila Nasya and Nagara Taila Nasya in the management of
Avabahuka, this study is undertaken.

3. Introdution
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
This dissertation is a sincere effort to study the Nidana Pancaka as well as
Chikitsa of Avabahuka with special reference to the therapeutic efficacy of Nasya
with Karpasasthyadi Taila and Nagara Taila. This dissertation consists of:
Conceptual Study.
Clinical Study.
Discussion.
Conclusion and Summary.
Conceptual study begins with the historical review and description of
Avabahuka, definition, etymological derivation, anatomical understanding of shoulder
joint in Ayurvedic and modern perspective, Nidana Panchankas, modern perpetuation
of the disease Avabahuka, Chikitsa and Pathyapathya. There after historical review
and description of Nasya Karma is decribed, followed by description of
Karpasasthyadi Taila and Nagara Taila in the drug review.
Clinical study starts with the materials and methods of the present work with
complete description of the assessment criteria and descriptive statistical analysis of
the sample taken for the study is methodically elaborated. Finally observations, results
and their statistical analysis are presented in order along with tables and graphs.
Discussion includes the critical conceptual analysis, observation and results
obtained in the present study.
The whole thesis work is summarized with conclusive points under the
headings of Conclusion and Summary.

4. Objectives
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
2. OBJECTIVES
Avabahuka occurs in Urdhwajatru Pradesha. Nasyakarma is one of the
important procedures in Panchakarma and it is the treatment of choice for
Urdwajatrugata vikara “Nasahi shiraso dwaram” i.e Nose is the gate way to head.
The ingredients of Karpasasthyadi Taila and Nagara Taila are having Ushna
Veerya, Snigdha Guna, Madhura Vipaka, Vatakapha Hara properties and having
Karmukata as ,Snehana and Brumhana .
In modern science, Adhesive Capsulitis or Frozen shoulder is a disease
having similar clinical features as Avabahuka. Frozen shoulder is a condition that
causes restricted range of active and passive glenohumeral motion in the shoulder
joint.
Adhesive Capsulitis or Frozen shoulder is not having much effective medicine
or therapy in contemporary system of medicine. Anti-inflammatory, analgesics are the
drugs of choice in contemporary system of medicine. Surgery occasionally is
performed. Unfortunately all the analgesics are prone to many side effects particularly
in prolonged usage. Ayurvedic approach to the Avabahuka is to retard the
degeneration process and strengthening the dhatus pacifying the Vata Dosha has
special importance in the management of any degenerative phenomenon. As
Avabahuka is one of the Urdhwajatrugata Vikara and especially Dhatukshayajanya
Vataroga Brumhana Nasya and Snehana, Swedana are more beneficial.
Ayurvedic scientists at various centers with an aim to study Avabahuka and to
evolve safer and economical medicaments for it have carried out several experimental
and clinical studies. The works are successful to some extent to relieve common

5. Objectives
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
complaints like pain and stiffness of this condition.
George P.J: Classical management of Avabahuka, 1981 Kerala University,
Thiruvananthapuram.
Philomina P.J: Avabahuka and its management, 1988 Government Ayurveda
Medical College, Mysore.
Shukla Niranjan: Effect of Nasya and Abhyanga on Avabahuka w.s.r to Masha
Taila, 1997 Gopabandhu Ayurveda Mahavidyalaya, Puri.
Naveen C.J: A study on Avabahuka and its management through Nasya
Karma and Vatagajankusha Rasa, 2004 Dr B.N.M Rural Ayurvedic Medical College,
Bijapur.
Only few works were carried out related to the present topic. In the
degenerative diseases, Brumhana Nasya and Vatashamaka Chikitsa are more effective
(A.S.Su. 29/16).
In the classics the line of treatament described as Nasya and Snehapana
(A.H.Chi. 21/44). No studies seem to have been conducted to evaluate the effect of
Karpasasthyadi Taila Nasya and Nagara Taila Nasya in Avabahuka. Hence it is
intended to evaluate the efficacy of these procedures in case of Avabahuka. So the
present study, “A comparative clinical study on the effect of Nasya with
Karpasasthyadi Taila and Nagara Taila in the management of Avabahuka” is under
taken.
Objectives of the study are -
1. To evaluate the efficacy of Karpasasthyadi Taila Nasya in Avabahuka.
2. To evaluate the efficacy of Nagara Taila Nasya in Avabahuka.
3. To compare efficacy of Karpasasthyadi Taila Nasya and Nagara Taila
Nasya in Avabahuka.

6. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
3. REVIEW OF LITRATURE
DISEASE REVIEW
AVABAHUKA
HISTORICAL REVIEW
History is a part of description of any object. In this way before going in detail
about the Avabahuka, an attempt has been made to trace the reference regarding
Avabahuka in particular and Vatavyadhi in general available till now beginning right
from Vedic period. For the total coverage of historical aspect, it has been divided into
four sections viz.
• Vedic Period and Pauranika period
• Samhita Period
• Sangraha Period
VEDIC PERIOD AND PAURANIKA PERIOD
The Vedas are considered as the oldest recorded knowledge in our culture.
Avabahuka is not mentioned in any form of Vedas. However, in the Atharvaveda, the
word ‘Vatikrita’ is mentioned. Here, ‘Vatikrita’ word denotes Vata Vyadhi. In same
Pippali (Ath. 6/109/3) and Visanika (Ath. 6/44/3) have been claimed as ‘Vatikritasya’
Bhesaja and Vatikritanashini respectively.
Many Vatika disorders pertaining to voluntary movement of limbs are told in
Vedic Literature under the terms Viskanda, though clear description of Avabahuka is
not found. Though the term Vishkanda mainly used in Atharva Veda (Atha-2/4; 3/9)
and Taitireeya Samhita (TS-7/3; 2/1). Viskanda was mentioned along with Visra

7. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
which means crushing the limbs and Abhisochana (burning sensation) (Atha-2/4/2).
Vyamsa was mentioned in Rig Veda which indicates the disorders which hamper the
movement or Gati.
In Yajur Veda , Thaittireeya Yajur Brahmana,second Ashtaka,6th chapter,4rth
Anuvaka,Vata and Vata Vyadhi is told.
On the basis of above Vedic descriptions it appears that many types of Vata
disorders were prevalent during Vedic period which impair the movement of the
limbs resulted due to description of muscles and joints leading to disability and appear
to be considered under the name Vishkanda and Vyamsa.
More attention was paid on Vata in Upanishads normal functions, etiological
factors of its disorders, its alleviations etc., have been described in Upanishads in
detail. Upanishads are the books which treat of spiritual matters apart from
ceremonials or belongs to the Jnaana-Kaanda. Their dates cannot be fixed with
certainty, only it is certain that they are older than the Buddhist movement. Puraanas
are the next literatures which deals more on Bhakti though it deals history and
cosmology, dates unknown. There are elaborate description of the functions and types
of Vata, its locations, qualities etc.

Kenopanishads have given the meaning of Vayu as one, which is always in
motion and continued efforts (Keno.3/10)

Ishopanishad (Ishavaasyopanishad) also described it in a similar fashion.
Chandogyopanishad has highlighted the Cala property of Vayu and described its
association with body and movements. (Cando.4/16/1 & 4/3/1).

8. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Bhrahmasutra has given importance of Vyana Vata as the one that resides in
the joints and it is responsible for the movements of the joint. The circulation is
considered as the function of Samaana. (B.S.1/5/3). In Garuda Puraana, Ayurveda
related subjects are described in details. In this treatise a separate chapter available as
Vaatavyaadhi Nidana.

Paanini has mentioned Vata Kopa as well as Vaaa Shamana. He has given the
term Vatiki for disorders of Vata.

SAMHITA PERIOD
Detailed description regarding Avabahuka is available in different Samhitas.
• Charaka Samhita (200 –300 B.C.): Charaka Samhita is one among the
Brihatrayees and has not mentioned directly about Avabahuka. But Charaka
explains regarding Bahushosha
1
a condition resembling Avabahuka.
• Sushruta Samhita (600 BC to 400 BC): has discussed the Samprapti Lakshanas
of Avabahuka in Nidana Sthana 1
st
Chapter and Chikitsa in 4
th
Chapter of Chikitsa
Sthana.
2

• Astanga Hridaya (5
th
Century): explains about Avabahuka in Nidana Sthana 15
th

Chapter and its Chikitsa is discussed in 21
st
chapter of Chikitsa Sthana.
3

• Astanga Sangraha

(5
th
Century): explains about Avabahuka, its Samprapti in
Nidana Sthana 15
th
Chapter and its Chikilsa in Chikilsa Sthana.
4

• Transitional Period: Many commentators of this period like Dalhana, Arundatta,
and Hemadri etc. have tried to Analyse Avabahuka.
SANGRAHA KALA :
Sangraha Kala - (100 A.D.-800AD): Different texts of Sangraha Kala contain

9. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
description regarding the disease Avabahuka.
• Madhava Nidan (7
th
Century A.D.): In Madhava Nidan in Acharaya
Madhavakara has explained the Lakshana of Avabahuka. Madhavakara is the first
to differentiate Avabahuka from Bahu Shosha.
5

• Chakradatta (12
th
Century): In Chakradatta Acharya Chakrapanidatta
explained the treatment of Avabahuka.
6

• Sharangdhara Samhita (13
th
Century): In Sharangadhara Samhita Acharaya
Sharagadhara explained Avabahuka under one of the Nanatmaja Vata vyadhi.
7

• Gada Nigraha (12
th
Century): In Gad Nigraha Acharya Shodhya mentioned the
Lakshanas and Chikitsa elaborately.
8

• Vangasena Samhita (12
th
Century): In Vangasena Samhita, Lakshanas and
Chikitsa is mentioned.
9

• Yogratnakara (17
th
Century): In Yogratnakara Lakshanas and Chikitsa of
AVabahuka is been mentioned.
10

• Bhaishajya Ratnavali (18
th
Century): Treatment of Avabahuka is mentioned in
Vata Vyadhi Chikitsa Adhikar.
11

• Sahasrayogam: It is complied by unknown author or authors containing
description of numerous preparations particularly used traditionally in Kerala.
While explaining the efficacy of Yogas he included Avabahuka.
12

NIRUKTI AND PARIBHASHA
Before proceeding to Avabahuka it is better to deal with the Nirukti and
Paribhasha of Vata Vyadhi as it is one of the Vata Vyadhi -

10. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
“Vikrita vata janito asadharana vyadhi vata vyadhi”
Extra- ordinary disease resulting from Vikrita Vata is known as Vata Vyadhi.
The word Avabahuka is formed by two components of words namely, Ava
and Bahuka.
Ava means:
• As per Sanskrit English dictionary edited by Vamana Shivaram Apte, Denotes
the meaning of Ava as away off or down.
• Ava as prefix to verbs and verbal nouns off, away down.
13

Apa is used as alternate for ‘Ava’ in some like Astanga Sangraha and
Sharangdhar Samhita etc., which gives following meaning.
• Viyoga, Vikratau
:14
Viyogou means Dysfunction.
15

• Stiffness in the arm joint.
16

The usage of ‘Ava’ or ‘Apa’ change according to different regional
pronunciation. Thus in the present condition, the ‘Ava’ or ‘Apa’ can be taken as
Deterioration as Dysfunction.
Bahuka usually occurs at the end of a compound and is studied as follows:
a) Bahu – The shoulder.
b) Bahu – “Bahu Prabahu cha Koorparasyaurdhwadha bhagou iti” (Vishnupuran)
c) Bahu – Muscular Gender.
d) “Bahu (Pum) Badha Ku Dhashaha Bhuje Kakshyanguli Paryanthe avayave.
Bahu is structure from kaksha to anguli.”
Acharaya Sushruta has considered Bahu is a part between Amsa and Karpoora
Sandhi.

11. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
“Amsa Koorparantharam Prathyangamekam.”
Thus Avabahuka can be defined as Bahu Stambha Avabahuka.
Under Avabahuka Monires writes the meaning as spasm in the arm and refers
to Sushrutha Samhita with due respects to the Scholar, it may be said that “Spasm in
the arm” is not to be taken literally but to mean it something like “stiffness in the
arm” in the words.
To summarize the above discussion and considering the relevant clinical
features, the term Avabahuka and Avabahuka would mean dysfunction of the arm,
stiffness in the arm joint, disability of shoulder joint.
Paryayas: As such there are no Paryaya of Avabahuka mentioned in classics but
different words like Avabahuka and Apabahuka are used in different context. These
words may be considered as Paryaya of Avabahuka.
Paribhasha of Avabahuka:
17

Avabahuka is a disease characterized by aggravated Vata at Amsa Pradesa
,after constriction of Sira (Akuncana) causes the restricted movement(Bahupraspanda
Hara).
AMSA SANDHI RACHANA SHAREERA VIVEVACHANA:
This is a major joint of upper limb. This is one type of Chala
18
and Ulookhala
Sandhi.
19
This is formed by the combination of Pragandasthi, Akshakasthi and
Amsaphalakasthi.
Pratanavat types of snayus cover this Sandhi
20

12. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Shleshmadhara Kala is presents in this joint and secretes Shleshaka kapha.
21

This acts as lubricant and helps in protection and movement of the Sandhi.
22,23

Amsamarma is present near this Sandhi. A brief explanation of it can be done as
follows.
Acharaya Sushruta has described that the Rachana of Sandhi as like a wheel
having an axis. When the axis is lubricated by putting oil on it, the wheel can move
freely and friction does not occur. In the same way the bones or joints can move
freely in the presence of Shleshama.
24
The word Amsa denotes a specific area of the shoulder. The Amsa Marma is
situated within the line of the area joining head (Murdha), neck (Greeva) and the arm
(Bahu). This is a Snayu Marma measuring to a length of half finger's width (1 cm)
25

This Marma is located on the Amsa that is formed by the union of Amsa
Peetha (glenoid) and the Skanda (acromio clavicular joint).
The physical matrix that are present in Amsa Marma are Mamsa, Sira, Snayu,
Sandhi and Asthi.
26
But it is a Snayu Marma.
27

As it is one of Vaikalyakara Marma, any trauma to this will produce disability
or deformity of the shoulder joint.
28
NIDANA PANCHAKA OF AVABAHUKA
To understand the entire process of manifestation of disease, Acharyas have
explained the five means through which one can diagnose a disease correctly. These
five individually or collectively helps to diagnose the diseases. These five means are
called as Nidana Panchak.

13. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Nidana of Avabahuka:
The knowledge of Nidana is important for the proper understanding of the
disease, for deciding the line of treatment to be adopted. It is also helpful in deciding
the Sadyaasadyata of the disease.
29

One of the Nidana that has been mentioned for the causation of the Vatavyadhi is
Marmabhighata. Charaka and Sushrutha have identified 107 Marma in the body,
where Sushrutha has elaborated all the types. While going through the Lakshana
mentioned for the Marmabhighata, it is said that the Amsa Marmabhighata, where the
Bahu lose its function and becomes stiff which mimics the Rupa of the disease
Avabahuka.

Hence it can be considered as one of the specific Nidana for this illness.
The following are considered as the Vishista Nidana as these are directly or
indirectly cause detrimental effect on Amsapradesha.
Abhighata: Any direct or indirect trauma that causes injury to the Amsapradesha or
Amsamarma will change the structural integrity and can cause Kriyahani of Bahu.
Vyayama: Those exercises which directly or indirectly influence the shoulder joint
are to be considered here.Vyayama in excess or violent exercises related with Bahu
provocates Vata, producing Shoshana and Sankocha of the Sira and ultimately causes
dysfunction of the joint.
Plavana: This if done in excess will be a cause of over exertion to the Sandhi causing
Vataprakopa and then manifesting the disease Avabahuka.
Bharavahana: Carrying heavy loads over shoulder will cause deformity in the joint
capsule which further leads to disease.

14. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Balatwat Vigraha: Wrestling with a person who is stronger will cause Aghata to
Amsapradesha and Vataprakopa can takes place.
Dhukka Shayya: An improper posture that gives more pressure over the Amsasandhi
will disturb the muscular integrity and can vitiate Vata. This leads to the disease.
Even though a specific Nidana have not been mentioned for Avabahuka,
however the general factors told for Vata prakopa have to be analyzed and elicited.

According to Madhukosha Nidana may be classified into two groups;
1) Bahya Nidana – Bahya Nidana includes Ahara,Achara,kala etc, which include
the Manasika Bavas also.
2) Abhyantara Nidana – Doshas and Dushyas (Dhathus, Mala, Upadhathu,
Srotas) coming under Abhyanthara Nidana. Indulging in Vata Prakopaka
Nidanas leading to vitiation of Vata in that region.
30

In regard to Nidanas Vatavyadhi only Acharya Charaka
31
and Bhavprakasha
have explained in detail. While in Sushruta Samhita
, 32, 33
Astanga Sangraha
34
and
Astanga Hridaya
35
etc, generally have been mentioned.
Nidanas of Vata Vyadhi and Vata Prakopa vis a vis Avabahuka
Aharaja: The Nidana in the form of Aharaja or faulty diet is included under this
group and this can be divided into 8 subgroups as follows:
i. Dravyataha: All the food articles responsible for Vata Prakopa have been
included under this group.

15. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
ii. Gunataha: The quality of food articles like Ruksha, Shita etc. that lead to the
Prakopa of Vata have been included under this group.
iii. Rasataha: Excessive use of certain Rasa which leads to the prakopa of Vata has
been included in this group.
iv. Karmataha: Vata Prakopa can occur due to excessive use of Vishthambhi food
article and those are included under this heading.
v. Viryataha: Shita Virya Yukta Ahara may cause the Prakopa of Vata.
vi. Matrataha: Taking food in Alpamatra, Atimatra etc. comes under this heading.
vii. Kalataha: The Vata Prakopa occurs at the end of Ahara Jeerna Kala and in
Varsha Ritu which is included here.
viii. Mithyopayogatah: Violating the rules of Ahara Sevana can lead to Vata Prakopa.
B) Viharaja: The Nidana in the form of Vihara or factors related to the habit and
behavior of the patient is considered here.
Any of the following two can cause Vataprakopa and leads to disease.
(1) Mithyaprayogataha: The faulty habits or the improper use of Sharira that may lead
to the Prakopa of Vayu is included under this heading.
(2) Atiyogataha: The excessive use of the Karmendriya can cause vata prakopa.
C) Agantuja: Vata prakopa which occurs due to external factors like trauma, etc. is
included under this heading.

16. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
D) Manasika: The Manasika Nidana like Chinta, Bhaya, Shoka etc. are also
responsible for Vata Prakopa.
E) Anya Heuja: All the other Nidanas except above are included under this heading.
Table no.1 Showing Nidanas of Vata Vyadhi and Vata Prakopa vis a vis Avabauka
Nidana C.S.
37,38,39
Su.S
40,41
A.H
42,43
A.S.
44
M.N
45

Aharaja
Rasa
Katu
Tikta
Kashaya
+
+
+
+
+
+
+
+
+
+
+
+

Gunas Ruksha
Laghu
Sheet
Vishad
Khara
Vaistambya
Darunak
+
+
+
+
+
-
+
+
+
+
+
-
+
-
+
+
+
-
+
-
-
+
+
-
+
+
-
-
+
+
+
-
-
-
-
Veerya Sheeta + - - - -
Dravya Adhaki
Chanaka
Kalaya
Masura
Mudga
Nispava
Shushkashaka
Tinduka
-
-
-
-
-
-
-
-
+
-
+
+
+
+
+
-
+
-
+
+
+
+
-
-
+
+
-
+
+
+
-
+
-
-
-
-
-
-
-
-
Matra Heen Abhojana
Alpabhojana
Vishamashan
+
-
-
+
+
+
-
+
-
-
-
+
+
-
-
Viharaj Ati Maithuna
Ati Jagaran
Ati Plavan
Ati vyayam
Ati Vichestam
Bhaya
+
+
+
+
+
+
-
-
+
+
-
-
-
-
-
+
-
+
-
-
-
+
-
+
+
+
+
+
-

17. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Cinta
Krodha
Mada
Soka
Utkantha

+
+
-
+
-
-
-
-
-
-

-
-
+
-
+
+
-
-
+
+
Mityayoga Dukhshaya
Asanat
Vegadharan
Balvat Nigraha
Bhar Haron
+
+
-
-
-
+
+
+
-
+
-
+
-
+
+
+
-
-
-
-
Kalaj Aparatra - - + + -
Agantuj Abhighataj
Marmaghata
+
+
-
-
-
-
-
-
-
-

Bhavprakasha
46
,Yogaratnakara etc is also having the same opinion regarding
Vatavyadhi.To summarize, the above said Nidanas mentioned under Vihara specially
involving Amasa Sandhi and Marmabhighata to Amsa leads to the development of
Avabahuka.
POORVA ROOPA OF AVABAHUKA
Poorva Roopa are indicators of impending diseases. They occur prior to
complete manifestation of disease to suggest the forthcoming illness. In parlance with
the Shadkriyakala this stage denotes the Sthanasamshraya Avastha.
47

“Poorva roopameva Sthana samshraya lingam (Chakradatta)”
In this stage the provocated Doshas having extended to the other parts of the
body become localized and it marks the beginning of specific symptoms pertaining to
those structures.

18. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
In the present context Poorva Roopa of Avabahuka have not been mentioned
anywhere in the text. So for that reason we have to take Poorva Roopa of the Vata
Vyadhi which are told as
“Avyaktam lakshanam tesham Poorvaroopamiti Smrutham”.
48

In case of Vata Vyadhi the face of Poorva Roopa will be in latent form. So the
patient will not appreciate them.
Chakrapanidatta commenting on the word “Avyakta” mentions that few mild
symptoms are to be taken as Poorva roopa.
49

But Vijayrakshita the commentator of Madhava Nidana has given the clear
meaning of the term Avyakta.
50
ie unclear symptoms.
It is clear from the above reference that Avyakta is Alpa Vyakta or less
manifested. So in Avabahuka also Poorva Roopa can be taken as minor symptom like
Alpa Shoola and Sthabdhatha produced before the actual manifestation of disease.
ROOPA:
Next to the Poorvaroopa in pathological conditions will be Roopa. Roopa
appears in the Vyakta Avastha. This is the unique stage of the illness, where in, it is
clearly recognizable as all its characteristics signs and symptoms manifest.
51
Based on
these Lakshanas a particular disease can be diagnosed.
The features of Avabahuka are as follows.
• Bahupraspandanahara
52
(Stabdatha)
• Shoola5
53.54

Thus practically speaking Stabdata ( Sthambha= Graha) and Shoola are the
Pradhan Lakshana that occurs in Avabahuka. The intensity and nature of the pain is
recommended only on the basis of patient’s description. Apart from these
Lakshanas, Sparshaasahatva is also one of the features observed.

19. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
UPASHAYA AND ANUPASHAYA
Upashaya are the medicines, diets and regimens which are similar to the
causative factors of disease or are dissimilar/opposite to the causative factors of
disease which gives relief to the patient
55
.
Upashaya for Avabahuka has not been mentioned in the text. But we have seen
some factors which aggravate the disease and some factors which give relief to the
patient. For example, Physical excretion , lifting heavy weights, exercises
etc.Increases pain in patient. These are Anupashaya.
Taking rest , application of oil , not indulging in physical excertions, there is
relief in pain in patient . These are Upashaya.
In the same way, in Shaithya (cold climate), and in rainy season patient feels
discomfort. These are Anupashaya.
On the other hand, in summer season, Ushnata or exposing to hot gives a feeling of
relief in patient, called as Upashaya in Apvabahuka.
SAMPRAPTI:
The manner of Doshic vitiation and the course they follow, culminating in the
development of specific clinical manifestation is known by the name Samprapti. In
other words, it briefly reflects the state of affairs brought about by the factors vitiated
by different source of etiological factors and afflicting different parts of the body,
resulting in either structural on functional changes in the part, finally developing a
series of signs and symptoms.
The knowledge of Samprapti helps in the comprehension of the features of a
disease like Dosha, Dushya, Sroto Dusti etc. A proper understanding of Samprapti is
Vital in planning of the treatment of any disease, since Chikitsa enunciated in
Ayurvedic text is nothing but Samprapti Vighatana.

20. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
This chapter discusses about Samprapti of Avabahuka. In the classics, the
Samprpati of Avabahuka is told as follows.
1 ) Samanya Samprapti
It is due to the Snayugata Vata.In this condition the Vyana Vata vitiates the
Snayu and produce Sthabdhatha in the Amsa Predesha and produce Avabahuka.
56

2)Vishesha Samprapthi
The Morbid Vata, which gets lodged in Amsa Moola, will cause the
Sirasankochana (constriction of the Sira) locally and produces Bahupraspandanahara
(restricted movement), manifesting Avabahuka.
3)Avaranajenya (Kaphaavrtha vyana)
In this condition Vyanavata combines with Sleshakakapha and leads to
Gatisanga (restricted movement) and produces Avabahuka
57
.
The Samprapti Ghatakas of Avabahuka can be taken as:
Dosha - Vata Vyana Vata
Dushya - Sira, Snayu.
Rogamarga - Madhyam
Udbavasthan - Pakwashaya
Vyaktasthan - Bahu (Amsa)
Adhisthana - Amsa Pradesh

21. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Illustration No. 1 Showing the Schematic Representation of Samprapti of
Avabahuka
Nidana
(Bharavahana ,Vyayama etc)




SADHYA ASADHAYATH
Acharya Charaka, in Chikitsa Sthana, has explained that if Vata vyadhi more
than 1 year or chronic is difficult to cure or considered as incurable for treatment
(Asadhya)

He further explains that, Vata vyadhi should be treated if they are in strong
patient, newly originated or less than 1 year and also free from complications
(upadrava). They are Sadhya for treatment
58
.
According to Acharya Charaka, if Vatavyadhi is connected with Sandhichuti,
Kunjanam, Kubjata, Ardita, Pakshaghata, Angasamshosha, Pangutva and those which
are Majja and Asthigata are usually cured with difficulty or even incurable for
treatment.
Provocation of
Vyana Vata
Vyaktasthana
(Amsa pradaesha Sira,Snayu)
Avabahuka
Sthana Samsharya,Vyaktha
Sanchaya, Prakopa,Prasara

22. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
UPADRAVA:
The occurrence of another disorder on the wake of primary disease is termed
as Upadrava
59
. Acharya Sushruta says that if the patient of Vatavyadhi develops the
complications like Sunam (edema/inflammation), Suptatvacha (tactile senselessness),
Bhagna (Fracture), Kampa (tremors), Adhamana (distention of abdomen with
tenderness) and pain in internal organs, then he doesn’t survive
60
.
SAPKESHA NIDANA:

Sapeksha Nidana is the comparison of similar features, which are found in
many diseases. Once the Samprapti of a disease has been established, that diseased
condition should be differentiated from taking consideration of similar other
disorders. Vyavachedaka Nidana or differential diagnosis is the determination and
establishment of a diseased condition taking consideration of the various disorders.
The disorders are differentiated from one another on certain cardinal features.
Avabahuka should be differentiated with the following diseased conditions that affect
the upper limb.
1. Amsashosha
61

2. Amavata
62

3. Vata Raktha
63

Table No.2 Showing Sapeksha / Vyavachedaka, Nidana of Avabahuka
Nidana
Panchaka
Avabahuka Amsashosha Amavata Vatarakta
Nidana Vatavridhikara
ahara-vihara
Vatavridhikara
ahara-vihara
Viruddha ahara,
Cheshta,
Mandagni,
Amla Lavana,
Madhura,Teeks
hna, Ushna,
Snigdha,
Viruddha,
Raktha

23. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Prakopakara
Ahara, Vihara
Purvarupa Avyakta Lakshna Avyakta Lakshna Swedaatyartha
Karshnya,
Sparshgnatva,
Kshateatiruk,
Sandhi
Shitilyata
Gurutva
Vaivarnya,
Peedakodhbava
Rupa Bahuspraspandhar
a
vadana
Bahuspraspandhara
Shosha, Vadana
Rujam,
Shotham,Daurb
alya, Agni
mandhya,
Prasaka,
Aruchi,
Gauravam,Daha
m Vrischika
damshavat
Peeda.etc
Toda, Beda,
Shosha,Kandu,
Daha,
Spurana,Paka,
Teevra ruk,
Grathita-paki
Shvayathu
Spreads like
mooshikavisha
Starting from
Smaller joints
Samprapthi
1.Adhistana

Amsasandhi Amsasandhi Hasta,Pada,
Janu Gulpha,
Trika, etc
Padhamoola,
Hasthamoola

2.Agni Dusti Samagni Samagni Mandagni Samagni
3.Rogamarg
a
Madyama Madyama Trividha roga
marga
Bahya,
Madyama
4.Dushya Sandhi, Snayu Sandhi, Snayu All Datus exep t
shukra
All Datus exept
shukra
5.Dosha Vata Kapha Vata Vata, Kapha Vata, Rakta
Upashaya Ushna-Snigdha Ushna-Snigdha Ushna-rooksha Sheeta

24. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
In Vata Raktha specific feature like Ahara, Vihara etc are indicated as Nidana
but specific Nidana is not told for Avabahuka. With this we can differentiate
Avabahuka from Vata Raktha. Guru Ahara, Agnimandhya are major Nidana for
Amavata, these are not told in Avabahuka Nidana. Agnimandya in Amavata is a
major Nidana which differentiate Amavata and Avabahuka.
In Vata Raktha specific features are mentioned under the headings of
Purvarupa, whith these we can differentiate it from Avabahuka as there is no
Purvarupa told in Avabahuka, Amavata, Amsashosha.
Bahuspraspandhara and Shosha, are the Lakshanas seen in Amsashosha. In
Avabahuka Shosha is not seen. In Amavata and Vata Raktha many features can be
seen as Rupa with which we can differentiate them from Avabahuka.
In Samprapthi of AmaVata and Vataraktha the Dushyas involved are all
Dathus exept Shukra. In Avabahuka Sandhi and Snayu Affected. In Amsashosha
Sandhi and Mamsa are affected. In the Roga Marga of AmaVata, Trividha Rogamarga
can be seen. In Vataraktha, Bahya and Madhyama Rogamarga is affected. In
Avabahuka and Amsashosha the Rogamarga is Madyama. In the Samprapti Of
Amavata Mandagni Plays a major role. Apart from these the Adisthana of the Roga
that is Amsa Sandhi is clearly mentioned in Avabahuka. With these we can
Differentiate Avabahuka from other diseases.
The Upashaya in Vataraktha is Sheeta. In Amavata it is Usna Rooksha in Ama
condition and Sneha and Usna in Nirama condition. In Avabahuka the Upasaya is
Usna, Snigdha which differentiates it from Vata Raktha and AmaVata

25. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
CHIKITSA:
After the Diagnosis of a Disease, the Next will be its Management. In the
Present chapter, the management of Avabahuka is discussed.
The general line of treatment mentioned for Vata Vyadhi in Ayurvedic
classics include Snehana (Both external and internal), Swedena, Mrdusamshodhana,
Basti, Sirobasti etc.
64
. Ayurvedic classics explain the chikitsa of Avabahuka as follows:
1. Nasya Karma has been mentioned by Vagbhata in Jatroordhava Vata Vikaras
65

2. Astanga hrudhaya explains Nasya and Uttara Bhaktika Snehapana are useful
in the management of Avabahuka
66
.
3. Sushruta Acharaya advice to follow Vata Vyadhi Chikitsa for Avabahuka
except Siravedh
67
.
4. Astanga Sangraha explains Nasya for Avabahuka. It also explains
Uttarbhaktika Snehapana
68
.
5. Vangasena advices Nasya Uttarabhaktika Snehapana and Sweda for the
treatment of Avabahuka
69

By considering the above references, this can be concluded as line of
treatment of Avabahuka.
• Abhyanga
• Swedana
• Uttarabhaktika Snehapana
• Nasya Karma
• Shamanaoushadi
• Pathya Apathya

26. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
1) Abyanga: .



The Veerya of the drug used for Abhyanga gets digested with the help of
Sthanika Bhrajaka Pitta and enters into the Srotas and start its action.
Taila used for
Abhyanga after entering into the body nourishes the body tissues, gives strength
70
.

2) Swedana:
“Stambha Gourava SheetaGunam Swedanum Swedakarakam”
71
.
The process which reduces stiffness, heaviness, reduces the Shetatha and
produce sweating is called Swedana. It does the dilation of the vessels thus by
improving blood circulation. Hence it is very much beneficial in conditions where
Shoola, Stambha and Sankocha are present.
In the context of Vatavyadhi Swedana Karma like Pinda Sweda, Nadi Sweda,
Avagaha Sweda are mentioned which alleviate Vata Dosha. It also helps in relieving
Stambha (stiffness), Gourava (Heaviness) and Sheeta (cold).
3) Uttarbhaktika Snehpana:
In classics Abhyantara Snehapana is divided into 2 types.
1) Shamana
2) Shodhana
Shamana and Shodana are used in case, when we need palliation and allivation
of the morbid Doshas from the body respectively. Brumhana Snehapana comes under
the Shamana Snehapana.
Brumhana is the one, which is done or used for the nourishment. In the
present context of Avabahuka the vitiated vata due to its Rookshadi qualities does the
Shoshana of Shleshaka Kapha that is present in the amsa Sandhi. To subside this
Rooksha quality and to normalize the Shleshaka kapha qualities, Brumhana

27. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Snehapana is advisable, Bruhmana type of Snehapana is advised prior, middle and
after the intake of food, as explained by Hemadri
72
Uttarbhaktika Snehapana i.e. Snehapana done after the intake of food is useful
in the disorders of Udana vata
73
.


Uttarabhaktika Snehapana indicated in Avabahuka fulfills the need of
treatment required in case of Udana Vata disorder and also act as Brumhana. Here
Alpa Matra Snehapana should be used. Sneha used here should be Taila, because
Taila is best amongst Snehas in Vata Vyadhi
74
.
4) Nasya Karma

The administration of either medicine (drug) on medicated oil through the
nose is known as Nasya Karma
75
. Navan, Nastakarma are the words used for Nasya
Karma. It gives strength to neck shoulders chest and increase vision
76
, thus Nasya is
useful in Avabahuka.
5) Shamanoushadi: Vata Vyadhis are very difficult to manage, in case of Shoola
Pradhan and Stambha Pradhana Vikaras. In such conditions along with Sthanika
procedures internal administration of Shamanaoushadi are essential.
6) Pathya – Apathya:


Pathya are the Ahara and Vihara that is congenial to the health both
in healthy and diseased where as the Ahara and Vihara that is quite opposite to the
above are named as Apathya.Specific Pathya and Apathya in regards to
Avabahuka is not mentioned in classics, so Pathya and Apathya told for the
Vatavyadhi in general are considered as Pathya and Apathya of Avabahuka.

28. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Table No.3 Pathyaapathyas in Vatavyadhi
77,78
Factors Pathyas Apathyas
Sneha Sarpi, Vasa, Taila, Majja,
-
Shaka and Phala Vargas

Kulatha, Masha, Godhuma,
Raktashali,Patola,Vartaka,
Dadima,Parushaka,Badara,
Lashuna and Draksha.

Chanaka, Kalaya, Shyamaka,

Kuravinda, Mudga,
Rajamasha, Guda, Jambuka,
Kramuka, Mrinala, Nishpava,
Taalaphala, Shimbi, Shaka,

Mamsa varga

Chataka, Kukkuta, Tittira,
Shilindhra, Nakra, Gargars,
Khudisha, Bileshaya

All Jangala Mamsa Varga.

Rasa Pradhana Madhura, Amla, Lavana Kashaya, Katu, Tikta
Manasika Sukha Chinta, Prajagara
Vihara

Snehana, Swedana, Snehapana,
Snana, Abhyanga, Rechana,
Mardana, Basti,Avagahana,
Samvahana, Agni Karma,
Upanaha, Tailadroni,
Shirobasti, Nasya, Santarpana

Vyavaya, Ativyayama, Basti,

Ashva Yana, Chankramana,
Vegadharana, Chardhi,
Shrama,

29. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
MODERN REWIEW
Figure 1.Anatomy of the Shoulder Joint:
79,80








This is a synovial joint of ball and socket variety.
Articular Surface: The joint is formed by articulation of scapula and head of the
humerus. Therefore, it is also known as Gleno Humeral articulation.
Structurally it is a weak joint; because Glenoid cavity is too small and shallow to hold
the head of the humorous in the place (the head is four times larger than the size of the
glenoid cavity). However this arrangement permits great mobility, stability of the
joint is maintained by the following factors.
1) The coracoacromial arch or secondary socket for the head of the humorous.
2) The musculotendinous cuff of the shoulder
3) The Glenoid labrum helps in deepening the Glenoid fossa. Stability is also
provided by the muscle attaching the humorous to the pectoral girdle, the long
head of the biceps, the long head of the triceps and atmospheric pressure.

30. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Ligaments of the Joint:
The capsular ligament: It is very loose and permits free movements. It is least
supported inferiorly where dislocation may damage the closely related axillary nerve.
The Coracohurmeral Ligament: It extends from the root of the coracoid process to
the neck of the humerus opposite to the greater tubercle. It gives strength to the
capsule.
Transverse humeral ligament: It bridges the upper part of the bicipital groove of the
humerus (between the greater and lesser tubercle). The tendon of the long head of the
biceps brachi, passes deep to the ligament.
The Glenoidal Labrum: It is a fibro cartilaginous rim, which covers the margins of
the glenoid cavity, thus increasing the depth of the cavity.
Figure 2.Bursae Related to the Shoulder Joint:




1) The sub acromial (sub deltoid) bursa.
2) The Sub Scapularis bursa, communicates with the joint cavity.
3) The infraspinatus bursa, may communicate with joint cavity.
4) Several other bursae related to the coroco brachialis, teres major, long head of
the triceps, latissimus dorsi, and the coracoid process are present.

31. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Relations:
Superiorly: Coracoarcomial arch, sub acromial bursa, supraspinatus and deltoid.
Inferiorly: Long head of the triceps.
Anteriorly: Sub Scapularis, corcao brachialis, short head of biceps and deltoid.
Posteriorly: Infraspinatus, teres minor and deltoid within the joint tendon of the
long head of biceps brachii.
Blood Supply:
Anterior circumflex humeral artery
Posterior circumflex humeral artery
Subscapular artery
Suprascapular artery.
Nerve Supply:
Axillary Nerve
Musculocutaneous Nerve
Suprascapular Nerve
Movements at the Shoulder Joint:
The shoulder joint enjoys great freedom of mobility at the cost of stability.
There is no other joint in the body which is more mobile than the shoulder. This wide
range of mobility is due to laxity of its fibrous capsule, and large size of the head of
the humorous as compared with the shallow glenoid cavity. The range of movements
is further increased by concurrent movements of the shoulder girdle.
Movements of shoulder joint are analyzed as follows.

32. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
1. Flexion and Extension: During flexion the arm moves forwards and medially and
during extension the arm moves backwards and laterally. The flexion and
extension take place in a plane parallel to the surface of the Glenoid cavity.
2. Abduction and Adduction: This takes place at right angles to the plane of flexion
and extension (i.e.-approximately midway between the saggital and coronal
plane). In Abduction, the arm moves antero-laterally away from the trunk. This
movement is in the same plane as that of the body of scapula.
3. Medial and lateral Rotation are best demonstrated with mid-flexed elbow. In this
position the hand is moved laterally in lateral rotation of the shoulder joint. And
hand moved medially is medial rotation.
4. Circumduction is the combination of different movements as a result of which the
hand moves along the circle.
5. Elevation: Elevation is an upward movement of a part of the body. Here arm is
taken upwards.
The Range of any movement depends on the availability of an area of free
articular surface on the head of the humorous. It may be noted that the articular area
on the head of the humorous is four times larger than that of the Glenoid cavity.
Table No.4 Muscles acting on Shoulder Girdle.
Muscles Origin Insertion Actio n on Shoulder
Pectoralis major Clavicle medial
2/3, sternum and
costal cartilages 1-
6.
Humorous, crest of
greater tubercle
Flexion and medial
rotation. Adduction
and medial rotation.
Lattisimus dorsi Lower ribs, iliac
crest.
Humorous inter
tubercular groove.
Adduction, medial
rotation, extension if
flexed.

33. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Deltoid Clavicle lat.1/3,
acromion spine of
scapula.
Deltoid tuberosity of
humerous.
Abduction, extension,
and lat. Rotation.
Biceps brachii
Short head
Long head
Coracoid process
Supraglenoid
tubercle
Radius
Radius
Flexion
Stabilization
Coracobrachialis Coracoid process Humerous middle
body
Flexion
Teres major Inf. 1/3 margin of
scapula
Crest of lesser
tubercle humerous
Adduction, medial
rotation.
Teres minor


Scapula, superior
2/3 lat. Margin
Humerous greater
tubercle post.
Surface
Lateral rotation,
stabilization
Supraspinatus

Scapula, supra
spinous fossa
Humerous greater
tubercle sup. Surface
Abduction,
stabilization
Infraspinatus

Scapula, infra
spinous fossa
Humerous greater
tubercle post.surface
Lat.rotation,
stabilization
Subscapularis Scapula,
subscapularis fossa
Humerous lesser
tubercle.
Med.rotation,
stabilization

Analysis of abduction at the shoulder occurs through 90 degrees. The
movement takes place partly at the shoulder joint and partly at the shoulder girdle
(forward rotation of scapula round the chest wall). The humorous and scapula move
in the ratio 2:1 throughout abduction, for every 15 degree of elevation, 10 degrees
occur at the shoulder joint and 5 degrees are due to movement of the scapula is
facilitated by movements at the sterno-clavicular and acromio-clavicular joint.
The articular surface of the head of the humorous permits abduction of the arm
only up to 90 degrees. At the limit of this movement there is lateral rotation of the
humorous and the head of the bone comes to lie deep to the coraco-acroial arch.

34. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Abduction is initiated by the supraspinatus, but the deltoid is the main abductor. The
scapula is rotated by combined action of the trapezium and serratus anterior.
MODERN REVIEW OF DISEASE:
In modern science, Avabahuka can be compared with
Periarthritis or Adhesive Capsulitis or Frozen shoulder
81,82
:
Frozen shoulder is a condition that causes restricted range of active and
passive glenohumeral motion in the shoulder joint. The cause of the frozen shoulder is
not well understood, but it often occurs for no known reason. Frozen shoulder causes
the capsule surrounding the shoulder joint to contract and form scar tissue called
adhesions. The contraction of the capsule and the formation of the adhesions cause the
frozen shoulder to become stiff and cause movements, more painful. There is also
lack of synovial fluid, which normally lubricates the gab between arm bone and
socket to help shoulder joint move.
In this condition pain and stiffness of the shoulder joint are the cardinal
symptom leading to inability of affected upper limb.
Painful / Freezing stage
Frozen stage
Thawing stage
a) Painful / Freezing Stage: This is the most painful stage of the frozen shoulder
motion is restricted, but the shoulder is not as stiff as the frozen stage. This
painful stage typically lasts 6-12 weeks.
b) Frozen Stage: During frozen stage, the pain usually eases up, but the stiffness
worsens. The frozen stage can last for 4-6 months.

35. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
c) Thawing Stage: The Thawing stage is gradual and motion steadily improves
over a lengthy period of time. The thawing stage can last more than a year.
The patient gives the history of having noticed a catch in the region of the
shoulder joint and upper arm with dull aging pain since several months. Gradually
becoming aware of the inability to perform certain tasks because of stiffness of the
arm, night pain, often awakening him after he has fallen asleep, is a common
complaint.
Figure 3.Exercises for frozen shoulder.


PROCEDURE REVIEW
NASYA KARMA
Nasa is considered to be that Indriya, whose functions are not only limited to
respiration but is also considered as a pathway for drug administration. In Ayurveda,
special procedure called Nasya has been mentioned.

36. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
HISTORICAL REVIEW
VEDA KLA: (PRE-SAMHITA PERIOD, 10,000 B.C. TO 500 B.C.)
In Puranas Nastam Kurut sentence meaning treat Nasagata roga is available,
the same sentence is not available in the Samhita Granthas but the very nearest
term Nasyakarma with the similar meaning treating the diseases of Nose is available.
Reference from Buddhist and Jaina traditions says that Jeevaka
administered Nasya karma. Buddha with a purgative drug sprinkled on lotus which
exerted its effect on smelling and 30 Vegas were observed.
83
In Buddha period
procedure like Dantadhavana, Paadaprakshalana, Nasyakarma, Abhyanga, Vyayama,
Snana are mentioned. In Koushika sutra of Vedic times application of Jalauka and
administration of Nasyakarma is mentioned
84
.
The reference regarding usage of Panchakarma is available in Jaina
period indicating the usage of Nasya karma.
In the same context while mentioning the different Chikitsa sutras, it is said
that Ghrita for Paana and Nasya Karma should be done to treat Dhanurvata, Anga
Kampa, Shareera Bhaga, etc. Vata Rogas
85
In Ramayana
86
, Lakshmana was given Nasyakarma by Vaidya Sushena
using Sanjeevini brought by Hanuman from Himalaya after which he regained
consciousness.
Reference about Pumsavana Karma where in medicated drops were instilled
into right nostril of a pregnant woman is explained widely by Charaka
87
,
Sushruta
88
and Vagbhata
89
.

37. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
These are some of the scattered references available in different periods
indicating the usage of Nasyakarma for different purposes.
SAMHITA PERIOD
Charaka Samhita: (200 –300 B.C):
In Samhitas Nasyakarma has been described in detail. Charaka in Sutrasthana
first chapter has given the synonyms of Nasyakarma, in Siddhisthana has
classified Nasyakarma depending on the medicines used and on the pharamacological
action and also has stated indications and contraindications for Nasyakarma.
90
He has
explained the procedure along with complications and Samyak and Asamyak
Yoga features. In Vimanasthana he mentions different types of Nasyakarma
depending on the parts of a plant used.
91
Sushruta Samhita: (600 BC to 400 BC):
Sushruta has defined Nasyakarma as instillation of medicine through
Nose in Chikitsasthana. He has given the classification of Nasyakarma, even
the timing of administration based on rutu and doshas. He has also given the
indications and contraindications, procedure, Samyak, Heena and Atiyoga features,
complications and the things to be followed after Nasyakarma is being stated by
him.
92
Astanga Hridaya:
(5
th
century):
Vagbhata mentioned Nasya Karma elaborately in Sutra Sthana
93
and advised
in various diseases like Jwara, Raktapitta, Swasa, Hikka and Vata Vyadhi Chikitsa
etc.

38. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Astanga Sangraha

(5
th
century)
Sangrahakara has also given extensive explanations regarding Nasyakarma,
the drugs to be used, indications and contraindications, procedure of Nasyakarma. He
has explained the Nasyakarma karmukata by using the terms shrungataka marma and
nasa as Shirodwara.Thus, Nasyakarma is being explained by all authors by
giving special importance to it.
94
Sharangdhara Samhita (13
th
century):

In Sharangadhara Samhita Acharaya Sharagadhara explained Nasya Vidhi in
Uttara Khanda.
95

Adunika period
Recent text like Vangasena Samhitha, Yogaratnakara, Sahasrayaogam etc
mentioned the Nasya treatment in different diseases.
Etymology of Nasya Karma
In Sanskrit language each word is derived from a specific Dhatu and each
Dhatu bears an inherent meaning which is the crux of the word. The derivation of the
word Nasya is from “Nasa” Dhatu. It conveys the sense of Gati – motion. Vyapti
bears the meaning pervasion. Here, the Nasa Dhatu is inferred in sense of nose.
According to Vachaspatyam word “Nasata” means beneficial for nose.
Nasya is the term applied generally to medicines or medicated oil
administered through the nasal passage
96
. Arunadatta states Nasayam Bhavam
Nasyam. According to Bhavaprakasha medicines administered through nose is termed
as Nasya
97
.

39. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Nasya karma is considered to be the most specific procedure for diseases of
the head or the diseases of Urdhwajatrugata region.Because, as stated by Vagbhata

the nasal passage is considered as the gateway of shirus (head) and the drugs
introduced through the nose spread throughout the head and its constituent
parts, accordingly influencing the dosha and the diseases situated in those parts.
98
Shiras in brief:
In a living being, the head is the place where Prana of all sense faculties reside
and hence rightly called as Uttamanga
99
.
Sushruta while enumerating Snayu has totally mentioned 900 out of which 70
are present in Greeva and Shiras
100
. Among the types of Snayu, Prutula Snayu is
present in Shirus, Uras, Parshwa and Prusta
101
. Out of 500 Peshis, 34 are present in
Shirus and Greeva
102
.
Among the different Marmas present in Shirus, Shringataka Marma is
explained in direct relation to Nasya Karma. This Marma is the place of collection of
Siras of Shrotra, Netra, Kanta-adi. Ghrana or Nasa, being a Jnanedriya does Gandha
Grahana and is said to be the door of Shirus. Nasya instilled through Nose enters
Shrungataka Marma and gets distributed all over, through the siras
103
.
Synonyms of Nasya :
• Navana
• Nastah karma
• Shirovirechana
• Shirovireka

40. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
• Murdha virechana , are the terms used synonymously.
Charaka has used the term Nastah Pracchardanam. Literally Pracchardanam is
a synonym of Vamana. Thus the term Nasya being used in relevance to terms
Virechana (Shirovirechana) and Vamana (Pracchardana) clearly appears to be a type
of Shodhana Karma administered through Nose. However, it comprises different
types and the purpose of all the procedures is one and the same.
Classification of Nasya karma
Nasya is classified in various ways by different Acharya. Each classification
has its own silent features and each is done with different angles. Classification
according to various Acharya is described in a tabular form as below
Table No 5 Showing Classification of Nasya according to Various Acharya
Sl No Name of
Acharya
Classification
1 Charaka According to mode of action - Rechana, Tarpana, Shamana
According to the methodof administration —
Navana, Avapeeda, Dhmapana, Dhooma, Pratimarsha
According to various parts of drugs utilized - Phala, Patra,
Moola, Kanda, Pushpa, Niryasa, and Twak Phala, Patra,
Moola, Kanda, Pushpa, Niryasa, Twak
2 Sushruta Shirovirechana, Pradhamana, Avapeeda, Na sya, Pratimarsha
3 Vagbhata Virechana, Brumhana, Shamana
4 Kashyapa Brumhana, Karshana
5 Sharangadhara Rechana, Snehana
6 Bhoja Prayogika, Snaihika
7 Videha Sanjya Prabodhaka, Stambhana,

41. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Charaka’s classification of Nasya:
According to Charaka the Nasya is of five type’s viz. Navana,
Avapeeda, Dhmapana, Dhooma and Pratimarsha
104
.
Navana is further divided in to Snehana and Shodhana, Avapeeda into
Shodhana and Stambhana, Dhooma into Prayogika, Vairechanika and Snaihika. While
Pratimarsha is divided into Snehana and Virechana.
The above-mentioned five types of Nasya are regrouped according to
their pharmacological action into three groups viz. — Rechana, Tarpana and
Shamana
105
.
Charaka has also mentioned 7 types of Nasya according to parts of the drugs
to be used in Nasya karma viz. — Phala, Patra, Moola, Kanda, Pushpa, Niryasa, and
Twak
106
.
Illustration No 2 Nasya according to
Charaka
NASYA

42. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka

!
Illustration No.3 Nasya According to the action
NASYA



Illustration No.4 According to various parts of the drugs utilized in Nasya therapy
NASYA



Classification of Nasya according to Sushruta :
According to Sushruta, Nasya is of 5 types viz. Nasya, Avapeeda,
Pradhamana, Shirovirechana and Pratimarsha. These 5 types of Nasya are further
classified according to their functions into two groups viz. Shirovirechana and
Snehana
107
.
Shirovirechana, Avapeeda and Pradhamana are used for Shirovirechana
purpose, i.e. for the elemination of morbid Dosha from Shirus while Pratimarsha and
Nasya may be used for Snehana.

43. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka






"











Illustration No.5 Classification of Nasya according to Sushruta




Vagbhata’s Classification of Nasya
108
Ashtanga Sangraha has mainly classified Nasya according to its effect
viz. Virechana, Brumhana and Shamana. Snehana and Brumhana Nasya have been
further subdevided according to the doses into two groups i.e. Marsha and
Pratimarsha
109
.
Avapeeda Nasya may be given for both Virechana and Shamana while
Pradhamana Nasya is given only for Shirovirechana.
Ashtanga Hrudaya has mainly classified Nasya in 3 types viz. Rechana,
Brumhana and Shamana.
Illustration No.6 Classification of Nasya according to
Vagbhata

44. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Kashyapa’s Classification of Nasya
110
According to Kashyapa Samhita, Nasya has been classified into two groups
i.e. Brumhana and Karshana. These two types are also known as Shodhana and
Purana Nasya.
Illustration No.7 Classification of Nasya according to
Kashyapa



Sharangadhara’s Classification of Nasya
Sharangadhara has also classified Nasya according to their functions into
twogroups viz. Rechana and Snehana. Rechana Nasya is further subdevied into
Avapeeda and Pradhamana while Snehana Nasya is subdevided into Marsha and
Pratimarsha
111abc
.
Illustration No.8 Classification of Nasya according to
Sharangadhara






"
# $

#$

!

45. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka

Videha’s Classification of Nasya
Videha has stated two types i.e. Samnja prabodhaka and Stamabhana
Illustration No.9 Classification of Nasya according to
Videha



It is clear from the above discription that two types of classification of Nasya
Karma are available in Ayurvedic literature. One is based on the pharmacological
actions viz. Rechana, Tarpana etc. Other is based on the preparation of drug and the
method of its application e.g. Dhmapana (Powder is blowed) Avapeeda (Extracted
Juice is used) Dhooma (Smoking through nose).
Navana Nasya:
This is one of the important types of Nasya. It is further classified into
Snehana and Shodhana. Navana is instillation of the drops of medicated oil into the
Nose. Navana is generally a Sneha Nasya and is synonymously used for Nasyakarma
in general.
Avapeeda Nasya:
Avapeeda Nasya is the Nasya consisting of the Swarasa of a drug administered
through nasal passage. It is of two types-Stambhana Nasya and Shodhana Nasya
Dhmapana or Pradhamana Nasya:


%

46. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
In Pradhamana Nasya, powder of drugs is blown or inhaled through nasal
passage. Its dose as mentioned by Videha as 3 munchuti (3 pinches).
Dhooma Nasya:
Dhooma Nasya is inhalation of medicated fumes through nasal route and
exhalation by oral route. It is of 3 types-
1. Prayogika
2. Snaihika
3. Vairechanika
Marsha-Pratimarsha Nasya:
Both consist of introduction of sneha through the nostrils. Marsha-Pratimarsha
is in the same principles but they have following distinctions-
Table No 6 Marsha-Pratimarsha Nasya
PRATIMARSHA MARSHA
*Never disturbs dosha
*Dose- 2drops morning and
evening




*Indicated in all seasons
*No complications
*Slow acting and less potent
*To all persons including
Swastha
*May disturb dosha
*Dose-
10 drops - uttama matra
8 drops - madhyam matra
6 drops - heena matra
*Seasons and age are to be considered
*May produce complications
*Quick effective and highly potent in action

47. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Indication for Nasyakarma
Shirastambha, Manyastambha, Dantastambha, Dantashoola, Hanugraha,
Peenasa, Galashaluka, Galashundika, Shukraghataroga, Timira, Vartma roga, Vyanga,
Upajihwika, Ardhavabhedaka, Greevaroga, Skandaroga, Amsashoola, Mukharoga,
Nasashoola, Karna shoola, Akshishoola, Shirashoola, Ardita, Apatantraka,
Apatanaka, Galaganda, Danta shoola, Danta harsha, Arbuda, Swarabheda, Vakgraha,
Gadgadatwa.
Table No 7 Showing the indications of Shodhana Nasya
Si.
No
Vyadhi C. S.
112
S.S .
113
A.H.
114
A.S
115

1 Shirogourava + + - +
2 Stambha + - - +
3 Supti + - - +
4 Shirah sheeta - + + -
5 Jadya - - + -
6 Soudnyaheena - - + -
7 Amaya - - + -
8 Shopha - - + +
9 Ganda - - + -
10 Krimi - + + +
11 Ghranti - - + +
12 Kushta - - + -
13 Apasmara - + + +
14 Peenasa - + + +
15 Upadeha - - - +
16 Kandu - - - +
17 Abhishyanda - - - +
18 Paka - - - +
19 Praseka - - - +

48. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
20 Asyavairasya - - - +
21 Arochaka - + - +
22 Svarabheda - - - +
23 Gandalaji - + - +
24 Arbhuda - - - +
25 Dadru - - - +
26 Kotha - - - +
27 Ardhavabhedak - + - -

Table No 8 showing the indications for Brumhana Nasya:
Si.
No
Vyadhi C. S.
116
S.S.
117
A.H
118
A.S
119
.
1 Shirakampa + - - -
2 Ardhita + - - -
3 Shirashool (vataja) - + + +
4 Suryavarta - - + +
5 Swarakshaya - + + +
6 Nasa shosha - + + +
7 Asya shosha - + + +
8 Vaksanga - - + +
9 Krichrabhoda - + + +
10 Avabahuka - + + +
11 Ardhavbhedak - - - +
12 Krimi shiroroga - - - +
13 Akshi sankocha - - - +
14 Spanda - - - +

49. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
15 Timira - + - +
16 Dantashoola - - - +
17 Karna shoola - + - +
18 Karnanada - + - +
19 Manya roga + + - +
20 Apatanaka - - - +
21 Valipalitya - + - -

Contraindications of Nasya:
In Bruhatrayi some special conditions have been mentioned where Nasya
should not be administered, otherwise various complications may occur. In general,
in all patients Nasya should not be given on Durdina (Rainy day) or in Anritu
(Viparita Kala).
Table No 9 Contraindication of Nasya
Nasya Anarha Ch
120
Su
121
Va
122

1.Bhuktabhakta + + +
2.Ajeerna + + -
3.Peeta Sneha + + +
4.Peeta Madhya + + +
5.Peetatoya + + +
6.Snehadi Patukamah + - +
7.Snatah Shirah + - +
8.Snatukamah + + +
9.Kshudharta + - +
10. Shramarta + + -
11.Matta + - -

50. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
12.Murchita + - -
13.Shastradandahrita + - -
14.Vyavayaklanta + - -
15.Vyayamaklanta Shranta) + + -
16.Panaklanta + - -
17.Navajwara Pidita + - -
18.Shokabhitapta + - -
19.Virikta + - +
20.Anuvasita + + +
21.Garbhini + + +
22.Navapratishyayarta + - -
23.Apatarpita - + +
24.Peetadravah - + +
25.Trishnarta + + -
26.Gararta - + +
27.Kruddha - + -
28.Bala - + -
29.Vruddha - + -
30.Vegavarodhitah (Vegarta) - + +
31.Raktasravita - - +
32.Sootika - - +
33.Shvasapidita - - +
34.Kasapidita - - +

Suitable time for giving Nasya:
According to Charaka generally Nasya should be given in Pravrit, Sharad and
Vasant Rutu. However in emergency it can be given in any season by
providing artificial conditions of the above mentioned seasons, for example in
summer Nasya can be given in cold places and in cold season it can be given in hot
places.

51. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Nasya karma according to Rutus
123

Grishma Rutu - ----- Before noon (morning)
Sheeta Rutu ---------- Noon
Varsha Rutu - ------- Day should be clear
Sharad + Vasanta - In the morning (Vagbhata) Shishira + Hemanta - Noon
Grishma + Varsha — Evening
According to Sushruta in normal conditions Nasya should be given in empty
stomach, at the time when the person usually takes his meal.
Nasya karma according to Doshas
124

Kaphaja Vikara — Poorvahna
Pittaja Vikara - Madhyahna
Vataja Vikara - Aparahna
Vagbhata has prescribed same timing as Sushruta has mentioned. According
to Doshaja Vikara it has suggested some more important points also. Nasya should be
given daily in morning and evening in Vataja Shiroroga, Hikka, Apatanaka,
Manyastambha and Swarabhramsha. Sharangadhara has described same time
schedule for different seasons as Sushruta has mentioned. He further states that —
Nasya can be given in night, if the patient is suffering from Lalasrava, Supti,
Pralapa, Putimukha, Ardita, Karnanada, Trushna, Shiroroga and such conditions
like excessive vitiated Doshas (Sha. Ut. 8I3)
125

52. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Table No 10 Course of Nasya Karma:
No. Name of Acharaya Days
1 Sushruta 1,2,7,21
2 Bhoja 9
3 Vagbhata 3,5,7,8

Nasya Karma may be given for seven consecutive days. In conditions like
Vata Dosha in head, Hikka, Manyastambha, Swarabheda. it may be done twice a day
(in morning and evening). (As. H. Su. 20I16).
Nasya should be given for 3 days, 5 days, 7 days & 8 days or till the patient
shows the symptoms of Samyak Nasya as stated in Ashtanga Samgraha
126
.
Bhoja says that if Nasya is given continuously beyond nine days then it
becomes Satmya (adaptable) to patients and if given further, it neither benefits nor
harms the patients.
According to Sushruta
127
, Nasya may be given repeatedly at the interval of 1,
2, 7 and 21 days depending upon the condition of the patient and the diseases he
suffers.
Charaka has not mentioned specific duration of the Nasya therapy, but
suggested to give according to the severity of disease.
Dose of Nasya:
The dose of Nasya drug depends upon the drugs utilized for it and the variety
of the therapy. Charaka has not prescribed the dose of the Nasya. Sushruta and

53. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Vagbhata have mentioned the dose in the form of Bindus (drops), here one Bindu
means the drop which is formed after dipping the two phalanges of Pradeshini (index)
finger
128
.
Table No 11 showing the dosage of Nasya Karma:
Drops in each Nostrii Si
No.

Type of Nasya Hrasva Matra Madhyama
Matra
Uttama Matra
1 Shamana Nasya 8 16 32
2 Shodhana Nasya 4 6 8
3 Marsha Nasya 6 8 10
4 Avapeeda Nasya (Kalka Nasya) 2 2 2
5 Pratimarsha Nasya 2 2 2

According to Videha:
The common dose for Pradhamana Nasya is 3 Munchuti (here one Munchuti =
the quantity of Churna which may come in between Index finger and thumb = 2.4
Ratti.) Sharangadhara (Sha. Ut. 8I9, 10) has described the following dosage schedule
for Nasya Karma according to the variety of material used.
• Tikshnaushadhi Churna - 1 Shana (4 Masha) (24 Ratti)
• Hingu — 1 Yava (S Ratti)

54. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
• Saindhava — 1 Masha (6 Ratti)
• Dugdha — 8 Shana (64 Drops)
• Jala (Aushadha Siddha) — 3 Karsha (3 Tola)
• Madhura Dravya — 1 Karsha (1 Tola)
If the Nasya is given less than the prescribed dose then it does not eliminate
the Doshas completely and cause heaviness, loss of appetite, cough, salivation,
coryza, vomiting and disorders of the throat etc. If the Snehana Nasya is
administered in the excessive dose it may produce the symptoms of Atiyoga (As. San.
Su. 29/6) Danta Chala, Arbuda, Hanugraha, Skandharoga, Mukharoga, Amsashula.
According to Ashtanga Sangraha if the Nasya is to be given as the part
of performing the complete Panchakarma then, it should be given after Bastikarma.
Procedure of Nasya Karma:
The whole procedure is divided into three stages-
* Poorva karma
* Pradhana karma
* Paschat karma
Poorva karma:
This includes all the preparations and events that are to be done up to
instillation of medicine. This stage is further divided into three steps
• Collection of materials

55. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
• Deciding the exact time for the procedure
• Preparation of the patient
Collection of materiais:
A separate well ventilated room with adequate light is to be sellected
131
. It
should flourish following needy things-Nasya Peeta or Nasya Shayya, Nasya
medicine, Nasya Yantra i.e. Gokarna Yantra, cotton or dropper for instillation,
spittoon, cloth, attainders, etc.
Ideal Time:
After considering the prevailing season and Dosha Pradhanyata, the time of
administration should be decided. In general Pravrut, Sharat,Vasanta Rutu are good.
In Varsha Rutu un-cloudy day, in Greeshma Rutu before Madhyanha and in Sheeta
Rutu during Madhyanha Nasya should be performed.
Preparation of patient:
Person to be administered with Nasya karma has to stay in Nirvata Pradesha,
light food is given, after resting for a short duration Dantadhavana and Dhoomapana
should be done and he should comfortably lie down relaxed on a cot in supine
position, hands and legs stretched straight. Snehana and Swedana to face is done.
Swedana is contraindicated to Shiras as it is a Marma. Even then for liquifaction of
Dosha and to facilitate easy expulsion of them Mrudu Swedana is performed over
Shira, Manya, Nasa, Greeva. Eyes are covered with a cloth to avoid any spilling of
medicine
129
.

56. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Pradhana karma
130

Head is slightly bent backwards by keeping a pillow below the shoulder
this facilitates easy instillation of Nasya medicine. Oil is warmed, nose tip is raised
with index finger of left hand and one nostril is closed with another finger, using right
hand medicine is instilled. Exact measured quantity of medicine is taken in a Gokarna
or even administered using a pad of cotton or cloth or a dropper and dropped in a
continues flow into each nostril one after the other.
Precautions to be taken before instiiiation:
Quantity of medicine should be exact neither more nor less, it should not be
poured all of a sudden, it should not be too warm or too cold, patients head should
neither be stretched down too much nor elevated and should lie relaxed.
Very little quantity of medicine will only excite the doshas but will not expel
them out and causes feeling of heaviness, loss of taste, cough, excessive salivation,
rhinitis, vomiting and diseases of kantha. More quantity of medicine will give
rise to complications i.e. atiyoga features. Pouring the entire quantity at once will
force the medicine to enter into the wrong routes causing diseases of head,
Pratishyaya, Ghrana Kleda, obstruction to expiration. If the medicine is too warm it
causes burning sensation, formation of ulcers, fever, bleeding through nose, headache,
blurring of vision. If it is very cold it will cause Ayoga features.
Medicine instilled in an improperly stretched position of the head too gives
Ayoga features as the medicine fails to spread all over the head uniformly. If the
head is stretched too much, the medicine traversing a long route causes Moorcha,
Jaadya, Kandu, Daha, Jwara. Nasya administered in an un-relaxed person causes

57. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
increase in Doshas as it is unable to spread all over, along with pain or stiffness
131
. If
the head is not stretched then medicine fails to enter inside Shirus and if stretched too
much then the entered medicine fails to come back. Patient should be observed for
any complications, if present then necessary steps are to be taken accordingly.
Paschat karma :
This has following steps-
• Snehana and swedana
• Dhoomapana and Gandusha
• Assessing the yoga Ayoga lakshanas
• Complications if any and measures to be adopted
• Ahaara and Vihara
Mrudu Abhyanga and Swedana over Gala, Kapola, Lalata, Mardana over
shoulder, feet and hands done. Patient is instructed not to swallow but to spit the
expectoration as it contains doshas
134
. Patient should lie still in same position for 100
Matra Kala
133
, should not shake his head, talk, laugh, sneeze, yawn as these prevent
the medicine reaching the expected place and even Kasa, Pratishyaya, Shiro Akshi
rogas may occur especially if the medicine doesn’t reach Shrungataka Marma
134
.
Dhoomapana and ushna jala gandusha should be done for kantha shuddi
135
.
Dhoomapana
136

Inhalation of Dhooma is indicated in the disorders of shiras, in general and in
particular Prayogika dhooma is indicated after Nasya karma
137
.
Two to three puffs are to be taken through mouth and exhaled through mouth
only
138
. By this lightness of head, sense organs, heart, Dosha Shamana takes place and

58. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
throat becomes clear
139
.
Snehana and Swedana are Poorva Karma of Nasya, by these the Srotas
becomes soft and Doshas in them gets loosened. Administration of Nasya easily
expels them out but the Nasya dravya being a Sneha and Sneha by nature increases
Kapha due to its Sheeta Guna.
This retains a portion of Kapha, which was liquefied due to Snehana and
Swedana. And so retained Kapha can’t be expelled out by Nasya Dravya and gets
collected in Karna, Manya and causes different diseases. To remove this, dhoomapana
is administered
140
. Dhooma by virtue of its ushna and teekshna Guna clears the dosha.
Gandusha:
After dhoomapana, Ushna jala gandusha is to be done. This removes the
Kapha present in the oral cavity and also increases the taste.
141
Samyak Yoga, Ayoga and Atiyoga of Nasya Karma:
After Nasya Karma the symptoms of its Samyakyoga , Ayoga, Atiyoga should
be observed.
Samyak yoga:
Samyak yoga mentioned according to different Acharyas.
Table No 12 Showing Samyak Yoga Lakshana
Si. No Symptoms C. S
142
a S. S
142
b A. H
142
c Sh. S
142
d
1. Uraha Laghuta + - - +
2. Shiro Laghuta + + - +

59. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
3. Netra Laghuta - - + -
4. Shareera Laghuta - + - +
5. Srotovishuddhi + + - +
6. Swaravishuddhi - - + -
7. Urdwajatrugata Vikaropashaman - - - +
8. Prakruta Indriyaschesta + + - +
9. Netrateja Vruddhi - - + -
10. Chitta Prasada - + - +
11. Vikaropashamana - + - +
12. Sukha Svapna Prabodha - + + -
Ayoga:
Ayoga is mentioned according to different acharya as follows.
Table No 13 Showing Ayoga Lakshana
Si. No Symptoms C. S
143
a S. S
143
b A. H
143
c Sh. S
143
d
1. Shirogaurava, Dehagaurava + + - +
2. Galopalepa + - - -
3. Nishtheevana + - - -
4. Kandu - + - +
5. Kaphapraseka - + - -
6. Upadeha + - + +
7. Rukshata + - - +
8. Vata Vaigunya + - - -
9. Srotoriktata - + - -
10. Srotasamkaphasrava + - - +
11. Nasashosha - + + -

60. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
12. Asyashosha - + - -
13. Akshistabdhata - + - -
14. Shiroshunyata - + + -
15. Vyadhi Vrudhdhi - - + -
Table no 14 showing Atiyoga lakshana
Si. No Symptoms C. S
144
a S. S
144
b A. H
144
c Sh. S
144
d
1. Shirogourava - + + +
2. Shiroshunyata - + - +
3. Shirovedana + - - -
4. Netra Vedana + - - -
5. Shankhavedana + - - -
6. Suchitodavat Peeda + - - -
7. Indriya Vibhrama - + - +
8. Mastulungagama - + - -
9. Snehapurna Srotasa - - - +
10. Karna Talu Upadeha - - + -
11. Vata Vruddhi + - - -
12. Kandu - + + -
13. Praseka - + + +
14. Peenasa - + - -
15. Aruchi - - + -
16. Deha Daurbalya - - + -

Complications of Nasya
145

Complications occur due to 2 reasons

61. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
a. Administration in a contraindicated state b. Improper technique of
administration These two give rise to Dosha Utklesha or Dosha Kshaya features
respectively. Dosha Utklesha is to be managed by Shodhana and Dosha Kshaya by
Brumhana Chikitsa.
Table No 15 Complications of Nasya Karma and their management
Si.No

Conditions where nasya
is contraindicated
Manifestations
occuring due to Nasya
Management
01. Ajeerna, bhukta bhakta
peeta toya, durdina
Kapha roga, shwasa,
peenasa, agnimandya
Kapha hara, teekshna,
ushna drugs
02. Krusha, virikta,
vyayaama
klanta, trushnarta, garbini
Vataja sula, angamarda,
mukashosha,garbastamba
Vatahara,snehana,
brumhana, in garbhini
milk and ghee is to be
given
03. Jwara,shokatapta,
Madyapeeta
Timira roga Rooksha, sheetala
anjana, lepa, putapaaka

Regimen to be followed after Nasya Karma-
After finishing Paschat Karma warm water is given to drink and light food is
given. One should avoid Abhishyandi Ahara, Sneha, Madya, Drava Pana, exposure to
Raja, Dhooma, Aatapa, Shira Snana, Atiyana, Krodha and should stay in Nirvata
Pradesha68. Cold water should not be used for drinking or for bathing only warm
water is to be used.
146
The procedure may be conducted on alternative days or once in 3 days for
about 7 to 21 days or even until results are got. In Vata Vyadhi daily 2 times Nasya
can be given. But Vagbhata says that Nasya should not be conducted for more than 7
days
147
.

62. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Benefits of Nasya Karma:

Who regularly follows Nasya Karma will be free from diseases of eyes, Ears
and Nose. His hair and beard does not turn grey. His hair doesn’t falls but instead
grows fast. Diseases like common cold, migraine, headache, facial paralysis, etc. can
be alleviated. The joints, sinus, tendons and bones of his cranium acquires great
strength. His face becomes cheerful and plump and his voice becomes mallow, firm
and stentorian. Strength of all sense organs increases greatly. There will be no
sudden invasion of disease in the upper parts (Urdhvajatrugata) of the body. He
experiences the symptoms of old age later.
Disease of the supra clavicular region are cured in the person who practices
Nasya. He gets clarity of senses, good smell of mouth and the strength of jaw, teeth,
arms, chest, etc. He never suffers from the premature appearance of wrinkles,
premature hair falling and Vyanga.
Importance of Post Nasya Massage:
The texts have recommended light massage on the frontal, temporal,
maxillary, mastoid & on Manya region.
A comfortable massage on the above regions may help to subside the irritation of
somatic construction due to heat stimulation. It may also help in removing the slush
created in these regions
Pressure applied on the barroreceptors may bring the deranged cerebral arterial
pressure to normalcy (hejmadi s. 1985).
Guards against attack of baldness, Vyanga, premature appearance of wrinkles
or furrows.

63. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Mode of action of Nasya Karma
The clear description regarding the mode of action of the Nasya karma is not
available in Ayurvedic classics. According to Charaka Nasa is the gate way of
Shirah.The drug administered through nose as Nasya reaches the brain & eliminates
only the morbidDoshas responsible for producing the disease.
Nasa being the gateway to Shiras, the drug administered through nostrils,
reaches Shringataka (a Sira Marma by Nasa Srota), spreads in the Murdha (brain)
taking Marma of Netra (eye), Shrotra (ear), Kantha (throat), Shiramukhas (opening of
the vessels, etc.) and scratches morbid Doshas in supra clavicular region and expels
them from Uttamanga (As.San.). Sushruta
153
has clarified Shringataka Marma as a
Sira Marma formed by the union of Siras (blood vessels) supplying to nose, ear, eye
& tongue. He further points out that injury to this Marma will be immediately
fatal (Su. Sha. ). Indu in his commentary on Ashstanga Sangraha has opined
Shringhataka as the inner side of middle part of the head i.e. Siraso Antarmadhyam.
Under the complications of Nasya karma
Sushruta noted that the excessive eliminative errhine may cause Mastulunga
(cerebro spinal fluid) to flow out of the nose (Su. Ch. ).In Sushruta, Astanga Hridaya,
Bhavaprakasha, etc detailed descriptions are not found about the mode of action of
Nasya Karma. According to all prominent Acharyas Nasa is said to be the gateway of
Shirah. It does not mean that any channel connects directly to the brain but
they might be connected through blood vessels or through nervous system (olfactory
nerve, etc.).
It is an experimentally proved fact that wherever any type of irritation takes
place in any part of body, the local blood circulation is always increased. This is the

64. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
result of natural protective function of the body. When provocation of Doshas takes
place in Shirah due to irritating effect of administered drug resulting increase of the
blood circulation of brain. So extra accumulated morbid Doshas are expelled out
from small blood vessels.
Ultimately these morbid Doshas are thrown out as nasal discharge, tear and
salivation
NASA SHAREERA
In Ayurvedic literature there is no detailed description of Nasa Sharira is
available at a single context like the anatomical description of eye (Netra).By an
overall analysis of Ayurvedic classics we can see that a lot of terms are used by
different Acharyas which clearly indicate the anatomical parts of Nasa while
explaining the pathophysiology of Nasal diseases.Dalhana while commenting that the
Samyoga Sthala of Ghranendriya is called as Shringataka, injury to this causes death.
Nasa is one among the seat of Sukshma Jnane ndriyas which is
dominant in Pruthwi Mahabhoota. Nasa is made up of Tarunasthi
149
. The pramana of
Nasa puta is 4 anguli, Dalhana comments that it is pramana of one Nasaputa, others
opines that the pramana of one Nasaputa is 2I3 anguli, it is Bahirmukha Srotus and it
has two peshis.
According to Sushruta, Nasa has 24 siras they are 6 Vatavahini, 6 Pittavahini,
6 Kaphavahini and 6 Raktavahini siras
150
. Nasa has 2 dhamanis.
Utpatti of Ghranendriya:
Acharya Charaka expained that development of Nasa occurs during the third
month of gestation.
151
In the third month of pregnancy at that time Indriyas involves.

65. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Nasa is the opening of Shiras, Hence in Urdwajatrugata Vikara mainly Nasya
Karma
152
is advised. Ayurvedic classics explained Nasa as the only route to the head.
So any medicine which is applying through the Nose can influence the head directly.
A lot of medicaments are advised to introduce through nose in
unconsciousness conditions as well as in fatal conditions like Sanyasa, Murcha, and
Sarpadamsha etc. We can conclude the structure of the Nasa as follows:
It is composed of
• 3 Asthis
• 2 Peshi
• 2 Dhamani
• 3 Marmas and
• 24 Siras.
Indria Panchapanchaka
153
:
Indriya — Ghranendriya
Indriya Dravya — Pruthvi
Indriya Adhisthana — Nasa
Indriya Artha — Gandha
Indriya Buddhi — Ghrana Buddhi
These faculties are responsible for the perception of smell.
Anatomy
154
: External Nose:
It is having the shape of a triangular pyramid; the supporting frame work
consists of bony part and cartilaginous parts.

66. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Bony parts:
Forms the upper part of external Nose it consists of anterior part of body of the
maxilla with its frontal process.
Cartilaginous part:
Area around the nose, vestibule and upper lip is dangerous as infection. From
these areas may drain into cavernous sinus, anterior facial and cellulites of the area
may be spreading of infection cavernous sinus.
Figure 4 showing anatomy of Nose

The Nasal cavity:
The nasal cavity is divided into right and left halves by the median septum and
extends from anterior nasal to the posterior nasal apertures where it communicates
with the nasopharynx.
Floor:
Floor is formed by the palatine process of the maxilla and palatine bone .
Roof:
Roof has anterior sloping and is formed by nasal bones, central part is
horizontal and is formed by cribriform plate of the ethmoid bone. The posterior

67. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
sloping part is formed by under surface of body of the sphenoid.
Medial wall: It is formed by the septum.
Lateral wall: It is formed by maxilla and ethmoid bone.
Olfactory area:
It is the upper part of the nasal cavity from the level of superior conchae. It is
bounded above by the cribriform plate. Laterally by lateral wall of the nasal cavity
above the level of the superior turbinate, medially by corresponding part of the nasal
septum. Nasal septum; -
Medial wall is the portion which divides the nasal cavity and lies in or near the
mid line; it consists of perpendicular plate of the ethmoid bone above and behind.
Vomer below and behind.Septal cartilage anterio- inferiorly.
Minor contribution by anterior nasal spine of the maxilla septal crest of
the maxillary and palatine bones, nasal spine of the frontal bone the sphenoidal crest.
DRUG REVIEW –
INTRODUCTION.
Dravya has a vital role in curing the diseases, so it is considered as one among
four in the Chiikitsa Chatushpada Without its knowledge, a physician cannot cure a
disease.
The main objective of the present clinical study is to evaluate the effect of
Nasya with Karpasasthyadi Taila and Nagara Taila respectively in the management
of Avabahuka. The properties of these drugs are summarized below.

68. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
PROPERTIES OF INGREDIENTS OF NAGARA TAILA.
Nagara ( Zingiber officinale Rosc) belonging to the family Zingiberaceae is a
herb. It is extensively grown in India, widely available, cheaper and non controversial
drug and is used as a household remedy. Besides a common drug and spice condiment
including vegetable or edible household item, the drug is used in wide range of
therapeutics, pharmaceuticals and also in dietetics.
Nagara is one among the drugs told in”Vatagana Gana” in Vata Vyadhi
Chikitsa Adhyaya of different classics
155
. In all most 70% of yogas told in Vata
Vyadhi Chikitsa in classics Nagara is present. Charaka describe Nagara in
Shoolaprashamana Gana, and Deepaneeya Gana
156
. Susruta and Vagbhatta have
described Nagara in Pipalyadi Gana.(SU.SU 38/22)
157
. This drug is also used in case
of Vatavyadhi, Shoola
158
, Shopha
159
and it is one of the ingredient in Masha taila,
Maharasnadi Kwatha which is used in Vatavyadhi (Avabahuka)
160
.In Bhavaprakasha
it is mentioned in Haritakyadi varga
161
it is also mentioned in Panchakola,
Sadusana
162
. In Shodala Nigandu it is mentioned in Shatapuspadi Varga
163
. Raja
Nighantu mentions Nagara in Pipalyadi Varga
164
.
SYNONYMS.

Ardraka, Ardrika, Sunthi, Usna, Nagara, Visvabhesaja, Srngavera,
Mahousadha, Gulmamoola, Moolaja, Kandala, Varam, Anupaja, Apakshakaa,
Saiktastha, Ardrakya, Rahuchatra shaka, Ardra shaka, Schaaka.(danwantari nigantu
pipalyadi varga).

69. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
BINOMIAL NOMENCLATURE
165

NOMENCLATURE
Kingdom : Plantae
Division : Angiosperma
Class : Monocotyledoneae.
Order : Sciataminaea
Family : Zingiberaceae
Subfamily : Zingiberoideae
Genus : Zingiber
Species : Officinale
Botanical Name : Zingiber officinale.
REGIONAL NAMES
Hindi: Adarak, Malayalam: Inchi, Tamil: Ardrakamu, Kanada: Hasisunti
DESCRIPTION OF THE DRUG
A slender, perennial rhizomatous herb, leaves are linear, sessile, glabrous,
flowers yellowish green in oblong, cylindrical spikes, ensheathed in few scarious,
glabrous bracts, fruits oblong capsules. The rhizomes are white to yellowish brown in
colour, irregularly branched, somewhat annulated and laterally flattened. The growing
tips are covered over by scales. The surface of the rhizome is smooth and if broken a
few fibrous elements of vascular bundles project out from the cut ends.

70. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
HABITAT OF THE DRUG
Cultivated throughout India, run wild in some places in the Western ghats
THERAPEUTICALLY USED PART
Rhizomes (raw as well as dry)
Table No.16 Properties of Nagara


ACTION OF DRUG
166
Doshaghna Karma – Kaphavatasamaka
Vyadhighna Karma –
Triptighna-Rochana-Dipana-Pachana, Vatanulomana-
Sulaprasamanam, Arsoghna, Pittasamaka, Rakthasodhaka, Hridya, Shothahara,
Kaphaghana, Swasahara, Kasaghna, Svarya, Vrsya, Uttejaka. Jwaraghna,
Sitaprasamna, Balya, Vedanasthapana, Nadyuttejaka.
INDICATIONS
Abyantara
Vatavyadhi, Aruchi,Hrllasa, Chardhi, Mukhavairasya, Agnimandya, Ajirna,
Adhmananaha, Udararoga, Sula, Kosthabaddhata, Arsa, Pandu, Kamala,
DRUG LATIN NAME RASA GUNA VEERYA VIPAKA DOSHAKARMA
Nagara Zingiber officinale
Rosc
Katu Laghu,
Snigdha
Tikshna
Usna Madhura Kaphavatasamaka

71. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Hrddourbalya, Hrcchula, Sotha, AmaVata, Slipada, Sitapitta, Kasa, Swasa, Hikka,
Pratisaya, Jwara.
Bahya
Amavata, Sandhisotha, Karnashoola, Shirasjoola
CHEMICAL COMPOSITION
Rhizome contain volatile oil 1-5%, gingerol, gingerin (oily resinous substance
main active principle), gingerenone, ginger glycolipids A, B, & C, citronellol,
geraniol, starch and other contents.
TILA TAILA:
167
The base of Nagara Taila is Tila taila. The properties of Tila

are
Table No 17: Showing Guna-Karma of Tila:
S.No Tila
01 Latin name Sesamum indicum Linn.
02 Family Sesamum
03 Sanskrit Tila
04 Rasa Madhura
05 Anurasa Kashaya-Tikta
06 Guna Guru, Snigda
07 Veerya Ushna
08 Vipaka Madhura
09 Doshakarma Tridosha Shamaka
10 Composition
(Beeja)
Moisture – 4.1-6.5%
Oil – 43-56.8%
Protein – 16.6-26.4%

72. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Fibers – 2.9-8.6%
Carbohydrate – 9.1-25.2%
Minerals – 4.1-7.4%
Calcium – 1.06-1.45%
Phosphorus – 0.47-0.62%
11 Parts used Beeja, Taila

Tila Taila Murchana:
Moorchita tila taila was prepared in the department of Rasashastra and
Bhaishajya kalpana, K V G A M C, Sullia. And taila paka was done according to
Sharngdhara Samhita
14
.
Tila taila Murchana procedure
168
:
For the taila Murchana 1/16
th
part of Manjistha, 1/64
th
part of Haritaki
,Vibhitaki, Amalaki, Mustha, Haridra, Lodra, Vatankura, Hrivera, Nalika,
Ketakipushpa,1 part of Tila taila, and 4 parts of jala was taken and done paka in
mandagni till Taila paka siddhi lakshana
NAGARA TAILA PREPARATION
Ingredients of Nagara Taila
(1) Kalka & Swarasa prepared out Nagara (Zingiber officinale Rosc)
(2) Tila Taila.
Taila will be prepared according to Mrdu Taila Paaka Vidhi mentioned in
ayurvedic classics
169
.

73. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Drugs were taken in the following proportion,
Nagara Swarasa- 8 litres (16 parts)
Nagara Kalka –250 gms(1/8 parts)
Tila Taila – 2 litres (4 parts)
Rhizomes (fresh) of Nagara was collected (30 kg) from surrounding areas
(locally) and cleaned properly. Then it was chopped into small pieces and taken in a
vessel. It was grinded and made into paste. The paste was squeezed through a cloth to
take the Swarasa. This Swarasa (8 litters) was added to 2 liters of Tila Taila and kept
over mild flame. Nagara Kalaka (250 gms) was also added to it and was kept over
mild flame till it attained Mrdu Paka Lakshana.
The Taila paka Lakshanas are
170

Phenotgama in Taila, Vartivat shape Kalka will be got, when a small quantity
of Kalka is taken from the boiling Taila and is rolled in between the fingers., Shabdha
Heena, when it is thrown on fire.
Then it is cooled, measured and stored in a dry, air tight container.
PROPERTIES OF INGREDIENTS OF KARPASASTHYAD TAILA.
Karpasasthyadi Taila described in Tailayoga Adhikara of Sahasrayoga is
generally practiced in the treatment of Avabahuka
171
. The ingredients of
Karpasasthyadi Taila are.
Table 18: Kasaya Dravyas of Karpasasthyadi Taila
172,173.
.
DRUG LATIN NAME RASA GUNA VEERYA VIPAKA DOSHA
KARMA
Karpasa Gossypium
Herbaceum

Madhura (Seed)

Laghu,
Teekshna

Anushna

Katu Vata Pitta
Shamaka

74. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Rasna Sida
Rhombifolia

Madhura Guru,
Snigdha,
Pichila

Sheeta

Madhura Vata
Pitta
Shamaka.

Masha Vigna Mungo Madhura
Guru,
Snigdha

Ushna
Madhura
Vata
Shamaka,
Pitta
Kapha
Kara

Kulattha Macrotyloma
Uniflorum


Kashaya,
Madhura


Laghu,
Teekshna,
Ushna

Ushna


Katu Vata
Kapha
Hara


Table 19: Kalka Dravyas of Karpasasthyadi Taila.
DRUG LATIN
NAME
RASA GUNA VEERYA VIPAKA DOSHAKA
RMA
Devadaru Cedrus
Deodara


Tikta,
Katu

Laghu,
Snigdha

Ushna

Katu

Kapha
Vatahara
Bala Sida
cordifolia
Madhura Guru,Snigd
ha, Picchila Sita Madhura Vata Pitta
Shamaka
Rasna Alpinia
Galanga

Tikta

Guru Ushna Katu Kapha Vata
Shamaka

Kustha Sausseria
Lappa


Tikta,
Katu,
Madhura

Laghu,
Rooksha,
Teekshna

Ushna
Katu

Kapha.
Vata
Shamaka

Sarshapa Brassica
Juncea

Katu,
Tikta

Teekshna,
Ruksha,
Snigdha

Ushna

Kapha Vata
Nashaka,
Pitta
Vardhaka

75. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka


Nagara Zingiber
Officinale

Katu
Tikta

Laghu
Snigdha

Ushna Madhura Kapha Vata
Shamaka

Shatapus
hpa

Anethum
Graveolens

Katu,
Tikta


Laghu,
Ruksha,
Teekshna

Ushna
Katu
Kapha Vata
Shamaka

Pippali
Moola

Piper
Longum

Katu Laghu,
Rooksha

Ushna Katu Vata Kapha
Shamaka,
Pitta
Vardhaka

Chavya Piper
Brachystachy
cum
Katu Laghu,
Rooksha
Ushna Katu Kapha Vata
Shamaka
Shigru Moringa
Olifera
Katu,
Tikta
Laghu,
Rooksha,
Teekshna
Ushna Katu Kapha Vata
Shamaka
Punarnav
a
Boerhaavia
Diffusa
MadhuraT
ikta,
Kashaya
Laghu,
Rooksha
Ushna Madhura Tridoshahar
a
Aja
Ksheera
- Madhura Drava,
Pichila,
Sara,
Manta,
Sukshma,
Teekshna
Ushna Madhura Vata
Pittagna
Tila Taila Seasamum
indicum Linn
Madhura Guru,
Drava,
Pichila,
Sara,
Manta,
Sukshma,
Teekshna
Ushna Madhura Vata
Pittagna

76. Review of Literature
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Method of preparation of Karpasasthyadi Taila:
Drugs for Kasaya – Karpasa Beeja – 500 mg
Bala - 500 mg
Masha - 500 mg
Kulattha - 500 mg
Quantity of Kasaya – 8 ltrs
Kalka Dravyas - Devadaru – 5 grms
Bala - 5 grms
Rasna - 5 grms
Kusta - 5 grms
Sarshapa - 5 grms
Nagara - 5 grms
Shatapushpa- 5 grms
Pippalimoola- 5 grms
Chavya - 5 grms
Shigru - 5 grms
Punarnava - 5 grms
Taila for preparation – Tila Taila - 2 ltrs
Ksheera - 2 ltrs
Kasaya was prepared by adding 3.2ltrs of water reduced to 800 ml after adding
the Kasaya Dravyas. Moorchita Tila Taila was prepared.To this, Kasaya was added
and boiled over mild fire.The Kalka Dravyas are prepared by making a paste and
added to the oil. Ksheera is added to the boiling oil and stirred thoroughly over mild
fire till the Paaka Siddhi Lakshanas are obtained. Then cooled and filtered into air
tight container and stored.

77. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
4. MATERIALS AND METHODOLOGY
CLINICAL STUDY
Methodological approach is the backbone of research. Utmost care is taken in
designing a methodology for conducting a research. Clinical research involves the
experimentation of a drug/therapy on a population and recording the feedback based
on which postulations are made regarding the usefulness of the drug/therapy in the
disease. Hence, in this section, the researchers put forward the systemic procedures,
which are followed by the researcher’s right from the identification of the problem to
the final conclusion.
Research Approach
In this clinical study, the objective was to. The “A comparative clinical study
on the effect of Nasya with Karpasasthyadi Taila and Nagara Taila in the management
of Avabahuka ”. Efficacy of this was determined by finding of base line data of the
parameters before and after the treatment of Nasya Karma with Karpasasthyadi Taila
and Nagara Taila.
Materials and Methods
Study Design
It is a comparative clinical study. Total patients were made in to two Groups
A and B. Group A had received Nasya with Karpasasthyadi Taila and Group B
received Nasya with Nagara Taila.

78. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
a). Source of Data
Patients:- Patients with classical features of Avabahuka had been
selected from OPD/IPD dept in KVG Ayurvedic Medical College &
Hospital, Sullia.
b). Literary ;-literary aspect of the study had been collected from
classical Ayurvedic texts, recent medical journals and internet
c). Therapy:
Nasya Karma –with Karpasasthyadi Taila
Nasya Karma –with Nagara Taila.
d). “Selection of drug”- the trial drug collected from the surrounding
area and local market after being properly identified.
e). Preparation of medicine:-according to Sneha Paka mentioned in
classics. Medicine was prepared in K.V.G Ayurveda pharmacy,
Sullia
1. Karpasasthyadi Taila
Karpasasthyadi Taila is used for Nasya in group A.
Contents of Karpasasthyadi Taila.
Drugs for Kasaya - Karpasa Beeja, Bala, Masha, Kulattha.
Kalka Dravyas - Devadaru, Bala, Rasna, Kusta, Sarshapa, Nagara,Shatapushpa,
Chavya, Shigru, Punarnava. Ksheera.
Tila Taila

79. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Ksheera
Taila was prepared according to Mrdu Paka Vidhi mentioned by Ayurvedic
classics.(Sharangathara Samhiha)

.
Method of preparation of Karpasasthyadi Taila
Kasaya was prepared by adding 3.2ltrs of water reduced to 800 ml after adding
the Kasaya Dravyas. Moorchita Tila Taila was prepared. To this, Kasaya was added
and boiled over mild fire. The Kalka Dravyas are prepared by making a paste and
added to the oil. Ksheera is added to the boiling oil and stirred thoroughly over mild
fire till the Paaka Siddhi Lakshanas are obtained. Then cooled and filtered into air
tight container and stored.
2. Nagara Taila
Nagara Taila is used for Nasya in group B.
Contents of Nagara Taila.
(1) Kalka & Swarasa prepared out Nagara (Zingiber officinale Rosc)
(2) Tila Taila.
Method of preparation of Nagara Taila.
Rhizomes (fresh) of Nagara was collected (30 kg) from surrounding areas
(locally) and cleaned properly. Then it was chopped into small pieces and taken in a
vessel. It was grinded and made into paste. The paste was squeezed through a cloth to
take the Swarasa. This Swarasa (8 litters) was added to 2 liters of Tila Taila and kept
over mild flame. Nagara Kalaka (250 gms) was also added to it and was kept over
mild flame till it attained Mrdu Paka Lakshana. Then it is cooled, measured and stored
in a dry, air tight container.

80. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Sample Size & Grouping
30 Patients equally distributed in each groups.
Group A - Nasya with Karpasasthyadi Taila
Group B – Nasya with Nagara Taila.
Selection criteria
The cases were selected strictly as per the pre-set inclusion and exclusion of
criteria.
Inclusion Criteria
• Patients having the classical Lakshanas of Avabahuka which is mentioned in
diagnostic criteria was selected.
• Patients of both genders who were Nasya Yogya according to Ayurveda
classics irrespective of chronicity, occupation and socio-economic status were
selected
• Patients in between 20 years and 70 years of age was selected.
Exclusion Criteria:
1. Patients with the history of fracture and dislocation of affected
shoulder joint were Excluded..
2. Patients who were Nasya Ayogya according to Ayurveda classics.
3. Patients with the association of other systemic disorders.
4. Patients below the age 20 and above 70 were excluded in this study.
Duration of the study
• Totally the course of treatment along with placebo intake for late
assessment (follow up ) was 22 days

81. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Observation Period
1. Initially on the first day before treatment.
2. On the 7
th
day after treatment.
3. On the 14
th
day.
4. 22
nd
day for the last assessment.
Posology ( for a single use )
Nasya– 6 Bindhus in each nostrils.
Placebo:
Placebo in the form of rice flour tablets will be given twice a day from 8
th
day for a
period of 15 days till 22
nd
day for late assessment.
Data Collection
Patients were thoroughly examined both subjectively and objectively. Detailed
history pertaining to the mode of onset, previous ailment, previous treatment history,
family history, habits, Astavidhapareeksha and Dashavidhapareeksha and physical
examination findings were noted.
Assessment criteria
Assessment of the condition was done based on the detailed Proforma
adopting standard method of scoring of subjective and objective parameters which
will be analysed statistically.

82. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Procedure
Nasya Karma
Preparation of Patient
• Patient was selected after fulfilling the criteria's. The patient were briefed
about the intended procedure.
• Room for Nasya was prepared which was free from atmospheric effects like
direct blow of air or dust and it was lighted properly. The patient for the Nasya
karma ,should have passed his natural urges like urine and stool. Light
breakfast prior (1 hour) to Nasya karma was advised.
• After preparation of patient by above said regimens, Snehana and Swedana
were done. Here, Snehana means, Mridu Abhyanga. It should be done on
scalp, forehead and neck for 3 to 5 minutes . After Abhyanga, Mrudu Swedana
was done on Shira, Mukha, Nasa, Manya, Greeva and Kantha.
Pradhana Karma
Posture of The Patient :
Patient was made to lye down in supine position on Nasya table. The head of
the patient was lowered (Pravilambita). Eyes were covered with a clean cloth.The tip
of patients nose was drawn upward by the left thumb , at the same time with the right
hand 6 drops of lukewarm oil (Karpasasthyadi Taila or Nagara Taila) was installed
in both the nostrils, alternately, with the help of proper instrument like Pichu, dropper,
The drug should be proper in dose and temperature. The patients was advised
to remain relaxed at the time of administration of Nasya and asked to avoid speech,
anger, sneezing, laughing and shaking his head.

83. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Pashchat Karma
Patient in lying position is asked to count up to 100 matra i.e. approximately 2
minutes. After administration of Nasya feet, shoulders, palms and ears should be
massaged. Again mild fomentation was done on forehead, cheeks and neck. The
patient was asked to expel out the drug which comes in oropharynx. Care was taken
that no portion of medicated oil is left behind. Medicated Dhumpana two puffs were
advocated to expel out the residue mucous lodged in Kanta.
Pathya during treatment period & Pariharakala
Patient was advised to stay in a windless place. A light meal and lukewarm
water were advised. Patients were also advised to avoid dust, smoke, sunshine, hot
bath, anger, riding vehicles, excessive intake fat and liquid diet, day sleeping and
should not use cold water for any purpose like Pana, Snana, etc. The Pathyacharana is
an important factor which was followed for 14 days including the treatment period &
Pathyacharana.
Photograph No 1.Showing Procedure of Nasya Karma

84. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Methods of Assessment of clinical response.
SUBJECTIVE CRITERIA
Shoola:
This was evaluated by subjective parameters mainly based on critical
observation and by giving grading as follows.
1.SHOOLA.
1) Pravara - Grade 3 – (100 – 60 %) Severe and persistent pain with disturbing
sleep. Here normal routine activities will be completely hampered.
2) Madhyama - Grade 2 – (60 -30%) Pain increases on little work involving joint
movement. But get relived by rest. Normal activities will be slightly hampered.
3) Avara - Grade 1 – (30 – 1 % )Pain on excessive work with joint involvement.
Normal routine activities will not be hampered.
4) Absent - Grade 0 – No Shoola
OBJECTIVE CRITERIA
It can be considered as restricted movement of shoulder joint. This can be
observed in Unnamana, Avannamana, Akunchana, Prasarana and Triyakgamana of
shoulder joint. The degree of movement was considered for assessment criteria.
Using goniometry, the degree was measured and recorded. Here different
grading were given depending upon the degree of individual patients, before and after
the treatment.
Abduction (Unnamana).
160
0
-180
0
………0
80
0
-160
0
………1
10
0
- 80
0
............2
Cannot abduct ………3

85. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Adduction (Avannamana).
20
0
- 30
0
………0
10
0
- 20
0
………1
0
0
- 10
0
………2
Cannot adduct ………3
Flexion (Akunchana).
160
0
-180
0
………0
80
0
-160
0
………1
10
0
- 80
0
............2
Cannot flex ………3
Extension (Prasarana).
40
0
- 60
0
………0
20
0
- 40
0
………1
0
0
- 20
0
………2
Cannot extend ………3
Circumduction (Triyakgamana).
Normal .………0
Pain on Circumduction .………1
Circumduction not possible due to stiffness ...……..2
Overall Assessment Of Clinical Response.
Clinical improvement of patients was made based on improvement in the
clinical findings and reduction in the severity of the symptoms of the disease, grading
for the clinical improvement for individual variables. Grading for the clinical
improvement for individual variables.
1. – 100% relief in signs and symptoms considered.
2. -60 - 99% relief in signs and symptoms were considered.
3. – 30-60% relief in signs and symptoms were considered.

86. Materials and Methodology
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
4. – 1-30% reduction in signs and symptoms.
5. – .
Stastical analysis:
Data were colleted from sample before, after and post follows up treatment.
Statically analyzed by using students “t” test in consultation with Bio-statistician.

87. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
5. OBSERVATION AND RESULTS
Statistical analysis
Statistical results of Karpasasthyadi Taila Nasya
in Group A and Group B
patients witn
Nagara Taila Nasya before and after treatment were analyzed
statistically.

Total 30 patients were registered in this study. Out of that all 30 patients were
studied in this project. 15 patients were in group A while 15 were in B group. Each
patient was observed thoroughly and noted neatly. The observations are recorded and
necessary charts and graphs were made.
DISTRIBUTION OF PATIENTS BASED ON SEX
Table No.20 Distribution of Patients Based on Sex
No. of Patients and Percentage
Sex
Group A Group B Total
Male 09 60% 08 53.33 % 17 56.67%
Female 06 40% 07 46.67% 13 43.33%

Sex wise: Out of 30 patients in group A and Group B, 17 patients were male while 13
patients were female. It means total 56.67% were male as compared to 43.33% were
female.
Group wise division: Group A has 60% male while 40% females respectively. In
Group B male were 53.33% and female were 46.67%.

88. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Figure 5 showing Incidence of sex

DISTRIBUTION OF PATIENTS BASED ON AGE:
Table No. - 21 Distribution of Patients Based on Age
No. of Patients and Percentage
Age in years
Group A Group B Total
21-30 3 20% 5 33.33% 8 26.67%
31-40 3 20% 1 6.67% 4 13.33%
41-50 4 26.67% 4 26.67% 8 26.67%
51-60 4 26.67% 3 20% 7 23.33%
61-70 1 6.67% 2 13.33% 3 10%

Age wise: Out of total 30 patients in group A and group B, maximum patients were in
age Group 41-50 and 21-30 years followed by age 51-60 years. They were 26.67%,

89. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
26.67% and 23.33% respectively. Group wise division: They were 26.67%, 20% and
26.67%, 33.33% respectively in A and B Group.
Figure 6 showing Incidence of age

DISTRIBUTION OF PATIENTS BASED ON OCCUPATION:
Table No.22 Distribution of Patients Based on Occupation:
No. of Patients and Percentage
Occupation
Group A Group B Total
BUSINESS 2 13.33% 1 6.67% 3 10%
AGRICULTURIST 3 20% 2 13.33% 5 16.67%
ELECTRICIAN 1 6.67% 0 0% 1 3.33%
HOUSEWIFE 5 33.33% 5 33.33% 10 33.33%
DRIVER 1 6.67% 0 0% 1 3.33%
DOCTOR 3 20% 0 0% 3 10%

90. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
COOLIE 0 0% 2 13.33% 2 6.67%
THERAPIST 0 0% 1 6.67% 1 3.33%
STUDENT 0 0% 3 20% 3 10%
TEACHER 0 0% 1 6.67% 1 3.33%

Occupation wise: Out of total 30 patients in Group A and Group B, maximum patients
were found in Housewife followed by Agriculturist. They were 10 (33.33%) and 05
(16.67%) Respectively.
Group wise division: In, Group A, they were 33.33% and 20% respectively. In, Group
B they were 33.33% and 13.33% respectively.
Figure 7 showing Occupation incidences

91. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED ON RELIGION INVOLVED :
Table No.23 Distribution of Patients Based on Religion Involved:
No. of Patients and Percentage
RELIGION
Group A Group B Total
CHRISTIAN 02 13.33% 04 26.67% 06 20%
HINDU 11 73.33% 11 73.33% 22 73.33%
MUSLIM 02 13.33% 0 0 02 6.67%

Out of total 30 patients in group A and Group B, maximum patients were of
Hindu religion (73.33%).
Group wise division: In, Group A they were 73.33% of Hindus, 13.33% of Muslims
and 13.33% Christians, while in Group B they were 73.33% of Hindus and 26.67%
Christians.
Figure 8 showing Incidence according to the religion

92. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED ON SOCIO ECONOMIC
STATUS INVOLVED:
Table No.24 Distribution of Patients Based on Socio Economic Status.
Out of thirty patients 01 (3.3%) was poor, 14 (46.6%) were of lower middle
class, 13 (43.3%) were of upper middle class and 02 (2.8%) were rich class.
Group wise division: In, Group A, upper middle class class are 46.67% and lower
middleclass are 46.67%. In, Group B , Upper middleclass are 40% and lower class are
46.67%.
No. of Patients and Percentage
Socio Economic Status
Group A Group B Total
RICH 0 0 1 6.67 1 3.33%
UPPER 7 46.67 6 40 13 43.33
LOWER 7 46.67 7 46.67 14 46.67%
POOR 1 6.67 1 6.66 2 3.33%
Figure 9 showing distribution of patients by socio economic status.

93. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED BY EDUCATION
Table No 25 Showing distribution of patients by Education:

In the study as a total 30 patients, 12 patients had Graduation (40%), 01
patient had Secondary education (3.33%), 11 patients had Primary education
(36.67%), 06 patients were uneducated (20%).
Among the 15 patients in group A, 05 patients had Graduation (33.33%), 01
patient had Secondary education (6.67%), 05 patients had Primary education
(33.33%), 04 patients were uneducated (26.67%). Among the 15 patients in group B,
7 patients had Graduation (46.67%), 06 patients had Primary education (40%), 02
patients were uneducated (13.33%).
Figure 10 showing distribution of patients by Education

No. of Patients and Percentage EDUCATION
Group A Group B Total
GRADUATION 05 33.33% 07 46.67% 12 40%
SECONDARY 01 6.67% 0 0% 01 3.33%
PRIMARY 05 33.33% 06 40% 11 36.67%
UNEDUCATED 04 26.67% 02 13.33% 06 20%

94. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED BY MARITAL STATUS
Table No 26 Showing distribution of patients by Marital Status :
No. of Patients and Percentage
MARITAL
STATUS
Group A Group B Total
Married 13 86.67% 12 80% 25 83.33%
Unmarried 02 13.33% 03 20% 05 16.67%

In the study as a whole 30 patients, 25 patients were married (83.33%), 05 patients
were unmarried (16.67%). Among the 15 Patients in group A, 13 patients were married
(86.67%), 02 patients were unmarried (13.33%). Among the 15 Patients in group B, 12
patients were married (80%), 03 patients were unmarried (20%).
Figure11 showing distribution of patients by Marital Status

95. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka


DISTRIBUTION OF PATIENTS BASED ON DIETRY HABIT:
Table No.27 Distribution of Patients Based on Dietary Habit:
No. of Patients and Percentage
Dietary Habit
Group A Group B Total
VEGETARIAN 04 26.67% 06 40% 10 33.33%
MIXED 11 73.33% 09 60% 20 66.67%

Out of total 30 patients in Group A and Group B, maximum patients’ dietary
habits were mixed ie: 20 (66.67%).
Group wise: In, Group A, maximum patients dietary habits were mixed 73.33% and
Vegetarian were 26.67%. In, Group B, maximum patients habits were Mixed 60% and
Vegetarian were 40%.
Figure 12 showing Incidence of Dietary habits

96. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED BY AGNI:
Table No.28 Distribution of Patients Based on Agni:

In the study as a total 30 patients, 12 patients were having Samagni (33.33%),
8 patients were having Teekshnagni (26.67%), 8 patients were having Manthagni
(26.67%) and 4 were having Vishamagni(13.33%).
Among the 15 patients in group A, 04 patients were having Samagni
(26.67%), 2 patients were having Teekshnagni (13.33%), 5 patients were having
Manthagni (33.33%) and 4 were having Vishamagni(26.67%). Among the 15 patients
in group B, 6 patients were having Samagni (40%), 6 patients were having
Teekshnagni (40%) and 3 patients were having Manthagni (20%).
Figure13 showing Incidence of Agni

No. of Patients and Percentage
Agni
Group A Group B Total
TEEKSHNAGNI 2 13.33% 6 40% 8 26.67%
MANTHAGNI 5 33.33% 3 20% 8 26.67%
SAMAGNI 4 26.67% 6 40% 10 33.33%
VISHAMAGNI 4 26.67% 0 0% 4 13.33%

97. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED BY KOSHTA
Table No. 29 Distribution of Patients Based on Koshta:
No. of Patients and Percentage
KOSHTA
Group A Group B Total
KRURA 4 26.67% 05 33.33% 09 30%
MADYAMA 10 66.67% 10 66.67% 20 66.67%
MRUDU 1 6.67% 0 0% 1 3.33%

In the study as a total 30 patient, 20 patients were having Madhyama
koshta (66.67%), 9 patients were having Krura koshta (30%), and 1 patients were
having Mrudu koshta (3.33%). Among the 15 patients in group A, 10 patients were
having Madhyama koshta (66.67%), 4 patients were having Krura koshta (26.67%),
and 1 patients were having Mrudu koshta (6.67%). Among the 15 patients in group B,
10 patients were having Madhyama koshta (66.67%) and 5 patients were having
Krura koshta (33.33%).
Figure 14 showing Incidence of Koshta

98. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED BY PRAKRUTI
Table No. 30 Showing distribution of patients by Prakruti :
No. of Patients and Percentage
Prakruti
Group A Group B Total
VATAPITTA 9 60% 12 80% 21 70%
VATAKAPHA 6 40% 3 20% 9 30%

Out of total 30 patients in Group A and Group B, maximum patients were
found Vatapitta prakruthi followed by vatakapha prakruthi. They were 21 (70%) and
09 (30%) Respectively.
Group wise division: In, Group A, they were 60% and 40% respectively. In,
Group B they were 80% and 20% respectively.
Figure 15 showing distribution of patients by Prakruti

99. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED BY DURATION OF ILLNE SS
Table No. 31 Showing distribution of patients by Duration of illness:
No. of Patients and Percentage
Duration of
illness
Group A Group B Total BELOW 1 YEAR 09 60% 11 73.33% 20 66.67%
1 YEAR ABOVE 06 40% 04 26.67% 10 33.33%

In the study as a whole (30 patients) 20 patients fall under below 1 year
(66.67%) and 10 patients fall under 1yrs-and above (33.33%).
Among 15 patients in group A, 09 patients fall under below I year (60%), and
6 patients fall under 1 yrs-and above (40%). Among 15 patients in group B, 11
patients fall under below 1 year (73.33%) and 04 patients fall under 1 yrs-and above
(26.67%).
Figure 16 showing distribution of patients by Duration of illness:

100. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED BY VYSANA
Table No.32 showing distribution of patients by Vysana:
No. of Patients and Percentage
VYSANA
Group A Group B Total
ALCOHOL 02 13.33% 03 20% 05 16.67%
TOBACCO 05 33.33% 01 6.67% 06 20%
SMOKING 0 0% 01 6.67% 01 3.33%
NONE 08 53.33% 10 66.67% 18 60

Out of total 30 patients in Group A and Group B, maximum patients Vyasana
were none followed by Tobacco. They were 18(60%) and 06 (20%) respectively.
Group wise division: In, Group A, they were 53.33% and 33.33% respectively.
In, Group B they were 66.67% and 6.67% respectively.
Figure 17 showing distribution of patients by Vysana

101. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka


DISTRIBUTION OF PATIENTS BASED OF RASA:
Table No. – 33 Distribution of Patients Based on Rasa
No. of Patients and Percentage
RASA
Group A Group B Total
KATU 07 46.67% 08 53.33% 15 50%
TIKTA 06 40% 05 33.33% 11 36.67%
KASHAYA 02 13.33% 02 13.33% 04 13.33%

Out of total 30 patients in group A and Group B, maximum patients Rasa are
Katu and Tikta. They were 15(50%) and 11 (36.67%) respectively.
Group wise division: In, Group A, they were 46.67% and 40% respectively. In,
Group B, they were 53.33% and 33.33% respectively.
Figure 18 showing showing distribution of patients by Rasa

102. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED ON ONSET:
Table No.34 Distribution of Patients Based on Onset
No. of Patients and Percentage
Onset
Group A Group B Total
SUDDEN 01 6.67% 02 13.33% 03 10%
GRADUAL 08 53.33% 08 53.33% 16 53.33%
INCIDIOUS 06 40% 05 33.33% 11 36.67%

Out of total 30 patients in group A and Group B, maximum patients are in
gradual 16 (53.33%).
Group wise division: In, Group A out of 15 patients gradual is 53.33%, Insidious is
40% and Sudden is 6.67%. In, Group B, out of 15 patients gradual is 53.33%
Insidious is 33.33% and Sudden is 13.33%.
Figure 19 showing showing distribution of patients by Onset

103. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED ON VIHARA:
Table No.35 Distribution of Patients Based on Vihara
No. of Patients and Percentage
VIHARA
Group A Group B Total
HARD 04 26.67% 02 13.33% 06 20%
MODERATE 09 60% 13 86.67% 22 73.33%
SEDENTARY 02 13.33% 0 13.33% 02 6.67%

Out of total 30 patients in group A and Group B Hard Vihara patients are 20%,
Moderate Vihara patients are 73.33% and Sedentary Vihara patients are 6.67%.
Group wise division: In, Group A, Hard Vihara patients are 26.67%, Moderate Vihara
patients are 60% and Sedentary Vihara patients are 13.33%. In, Group B, Hard Vihara
patients are 20%, Moderate Vihara patients are 73.33% and Sedentary Vihara patients
are 6.67%.
Figure 20 showing distribution of patients by Vihara

104. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED ON SATVA:
Table No.36 Distribution of Patients Based on Satva
No. of Patients and Percentage
SATVA
Group A Group B Total
AVARA 5 33.33% 6 40% 11 36.67%
PRAVARA 2 13.33% 9 60% 11 36.67%
MADHYAMA 8 53.33% 0 0% 8 26.67%

Out of total 30 patients in group A and Group B, Maximum patients were in
Avara and Pravara ie, 36.67% and 36.67% respectively.
Group wise division: In, Group A, Maximum patients were in Madhyama 53.33%
followed by Avara 33.33%. In, Group B, Maximum patients were in Pravara 60%
followed by Avara 40%.
Figure 21 showing distribution of patients by Satva

105. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
DISTRIBUTION OF PATIENTS BASED ON VYADHI BALA:
Table No.37 Distribution of Patients Based on Vyadhi Bala
No. of Patients and Percentage
Vyadhi Bala
Group A Group B Total
MADHYAMA 15 100% 15 100% 30 100%

Out of total 30 patients in group A and Group B, All patients Vyadhi Bala
were Madhyama.
Figure 22 showing distribution of patients by Vyadhi Bala

DISTRIBUTION OF PATIENTS BASED ON HABITAT:
Table No. 38 Distribution of Patients Based on Habitat
No. of Patients and Percentage
Habitat
Group A Group B Total
URBAN 06 40% 06 40% 12 40%
RURAL 09 60% 09 60% 18 60%

106. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka

Out of total 30 patients in group A and Group B, maximum patients habitat is
Rural 18(60%) followed by Urban Habitat 12(40%).
Group wise division: In, Group A, maximum patients Habitat is Rural
09(60%) followed by Urban Habitat 06(40%). In, Group B, maximum patients
Habitat is Rural 09(60%) followed by Urban Habitat 06(40%).
Figure 23 showing distribution of patients by Habitat

DISTRIBUTION OF PATIENTS BASED ON NIDRA:
Table No.39 Distribution of Patients Based on Nidra
No. of Patients and Percentage
NIDRA
Group A Group B Total
DISTURBED 10 66.67% 10 66.67% 20 66.67%
NOT DISTURBED 05 33.33% 05 33.33% 10 33.33%

107. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Out of total 30 patients in group A and Group B, maximum patients Nidra is
Disturbed 20(66.67%) followed by Not Disturbed 10(33.33%).
Group wise division: In, Group A, Maximum patients Nidra is Disturbed
10(66.67%) followed by Not Disturbed 5(33.33%). In, Group B, Maximum patients
Nidra is Disturbed 10(66.67%) followed by Not Disturbed 5(33.33%).
Figure 24 showing distribution of patients by Nidra

DISTRIBUTION OF PATIENTS BASED ON JOINT:
Table No.40 Distribution of Patients Based on Joint
No. of Patients and Percentage
JOINT
Group A Group B Total
RIGHT 07 46.67% 09 60% 16 53.33%
LEFT 08 53.33% 06 40% 14 46.67%

Out of total 30 patients in group A and Group B, maximum patients Joint is
Right 16(53.33%) followed by Left Joint 14(46.67%).

108. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Group wise division: In, Group A, Maximum patients Joint is Right
07(46.67%) followed by Left Joint 18(53.33%). In, Group B, Maximum patients Joint
is Right 09(60%) followed by Left Joint 06(40%).
Figure 25 showing distribution of patients by Joint

RESULTS
Effects of Karpasasthyadi Taila (Group-A)
Table No.41 Effect of Group-A on Shoola of Avabahuka

Effect on Shoola
In this work of 15 patients studied in Avabahuka with Group-A Shoola
revealed are given in detail in Table No.41. Statistical analysis showed that the mean
score which was 2.87 before the treatment was reduced to 1.47 (49%) after the
Mean score
SYMPTOM
BT
BT-
AT
%
S.D
(±)
S.E
(±)
t value p value
AT 1.47 1.40 49 0.736 0.190 7.35 <0.001
SHOOLA
2.87
FU 0.27 2.60 91 0.507 0.131 19.85 <0.001

109. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
treatment and after follow up it became .27 with 91% improvement and there is a
statistically highly significant. (P<0.001) results are graphically represented in figure
no 26:
Table No.42, Effect of Group-B on Shoola of Avabahuka

Effect on Shoola
In this work of 15 patients studied in Avabahuka with Group-B on Shoola
revealed are given in detail in Table No.42. Statistical analysis showed that the mean
score which was 2.47 before the treatment was reduced to 1.20 after the treatment and
after follow up it became .47 with 81% improvement and there is a statistically
significant change. (P<0.001) results are graphically represented in figure:
Figure 26 showing Effect ofGroup A and Group-B on Shoola

Mean score
SYMPTOM
BT BT-AT
%
S.D
(±)
S.E
(±)
t value p value
AT 1.20 1.27 51 0.799 0.206 6.14 <0.001
SHOOLA
2.47
FU 0.47 2.00 81 0.925 0.239 8.36 <0.001

110. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka

Table No 43 Effect of Group-A Unnamana of Avabahuka
Mean score
SYMPTOM
BT BT-AT
%
S.D
(±)
S.E (±) T value
p
value
AT 1.47 1.06 42 0.258 0.066 16.00 <0.001
UNNAMANA 2.53
FU 0.87 1.66 66 0.617 0.159 10.45 <0.001

Effect on Unnamana
An assessment of Unnamana in patients of Avabahuka before and after the
treatment with Group-A showed reduction in the mean score from 2.53 to 1.47 after
the treatment and after follow up it became 0.87 with 66% improvement. It is found to
be statistically highly significant (P<0.001). The details are shown with statistical data
in Table No.43 and graphically represented in figure:
Table No.44 Effect of Group-B on Unnamana of Avabahuka
Mean score
SYMPTOM
BT BT-AT
%
S.D
(±)
S.E (±) T value
p
value
AT 1.67 0.86 34 0.516 0.133 6.50 <0.001
UNNAMANA 2.53
FU 0.93 1.60 63 0.632 0.163 9.79 <0.001

Effect on Unnamana
An assessment of Unnamana in patients of Avabahuka before and after the
treatment with Group-B showed reduction in the mean score from 2.53 to 1.67 after

111. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
the treatment and after follow up it became 0.93 with 63% improvement. It is found to
be statistically significant (P<0.001). The details are shown with statistical data in
Table No.44 and graphically represented in figure:
Figure 27 showing Effect ofGroup A and Group-B on Unnamana

Table No 45, Effect of Group-A
Avannamana of Avabahuka
Mean score
SYMPTOM
BT BT-AT
% S.D (±) S.E(±) t value p value
AT 1.40 1.07 43 0.258 0.067 16.00 <0.001
AVANNAMANA 2.47
FU 0.40 2.07 84 0.258 0.067 8.67 <0.001

Effect on
Avannamana of Avabahuka
Magnitude of Avannamana in patients of Avabahuka before and after the
treatment was assessed and analyzed statistically. In patients registered in GROUP-A
group showed highly significant improvement (P<0.001). The mean score which was
2.47 before treatment reduced to 1.40 after the treatment and after follow up it
become 0.40 with 84% improvement. Further the particulars are tabled below in Table
No.46 and graphically represented in figure :

112. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka

Table No.46, Effect of Group-B on
Avannamana of Avabahuka
Mean score
SYMPTOM
BT BT-AT
% S.D (±) S.E(±) t value p value
AT 1.73 0.74 30 0.593 0.153 4.78 <0.001
AVANNAMANA 2.47
FU 0.60 1.87 76 0.516 0.133 14.00 <0.001

Effect on
Avannamana of Avabahuka
Magnitude of Avannamana in patients of Avabahuka before and after the
treatment was assessed and analyzed statistically. In patients registered in GROUP-B
group showed statistically significant improvement (P<0.001). The mean score which
was 2.47 before treatment reduced to 1.73 after the treatment and after follow up it
become 0.60 with 76% improvement.
Figure 28 showing Effect ofGroup A and Group-B on Avannamana

113. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka

Table No. 47 Effect of Group-A on Akunchana
Mean score
SYMPTOM
BT BT-AT
%
S.D
(±)
S.E
(±)
t
value
p
value
AT 1.47 0.93 39 0.258 0.067 14.00 <0.001
AKUNCHANA 2.40
FU 0.47 1.93 81 0.258 0.067 29.00 <0.001
Effect on Akunchana
By the treatment, in GROUP-A Akunchana was observed with a mean
reduction of score from 2.40 to 1.47 after treatment and after follow up it again
reduced to 0.47 with 81% improvement. Analysis of this data shows statistically
significant improvement (P<0.001).
Table No.48, Effect of Group-B on Akunchana
Mean score
SYMPTOM
BT BT-AT
% S.D (±)
S.E
(±)
t
value
p
value
AT 1.60 0.73 31 0.593 0.153 4.78 <0.001
AKUNCHANA 2.33
FU 0.73 1.60 69 0.507 0.131 12.22 <0.001

Effect on Akunchana
By the treatment, in GROUP-B Akunchana was observed with a mean
reduction of score from 2.33 to 1.60 after treatment and after follow up it again
reduced to 0.73 with 69% improvement. Analysis of this data shows statistically
significant improvement (P<0.001).

114. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka

Figure 29 showing Effect of Group A and Group-B on Akunchana

Table No 49, Effect of Prasarana on Group-A
Mean score
SYMPTOM
BT BT-AT
%
S.D
(±)
S.E
(±)
t
value
p
value
AT 0.80 1.27 61 0.458 0.118 10.71 <0.001
PRASARANA 2.07
FU 0.27 0.80 87 0.414 0.107 16.83 <0.001
By the treatment, in GROUP-A Prasarana was observed with a mean reduction
of score from 2.07 to 0.80 after treatment and after follow up it again reduced to 0.27
with 87% improvement. Analysis of this data shows statistically significant
improvement (P<0.001).
Table No 50, Effect of Prasarana on Group-B
Mean score
SYMPTOM
BT BT-AT
%
S.D
(±)
S.E (±) t value p value
AT 1.13 0.87 43 0.834 0.215 4.02 <0.001
PRASARANA 2.00
FU 0.40 1.60 80 0.828 0.214 7.48 <0.001

115. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
By the treatment, in GROUP-B Prasarana was observed with a mean
reduction of score from 2.00 to 1.13 after treatment and after follow up it again
reduced to 0.40 with 80% improvement. Analysis of this data shows statistically
significant improvement (P<0.001).
Figure 30 showing Effect of Group A and Group-B on Prasarana

Table No.51 Effect of Triyakgamana on Group-A
Mean score
SYMPTOM
BT
BT-
AT
% S.D(±) S.E (±) t value p value
AT 0.80 1.20 60 0.560 0.145 8.29 <0.001
TRIYAKGAMANA 2.00
FU 0.47 1.53 77 0.640 0.165 9.27 <0.001

By the treatment, in GROUP-A Triyakgamana was observed with a mean
reduction of score from 2.00 to 0.80 after treatment and after follow up it again
reduced to 0.47 with 77% improvement. Analysis of this data shows statistically
significant improvement (P<0.001).

116. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Table No 52 Effect of Triyakgamana on Group-B
Mean score
SYMPTOM
BT
BT-
AT
%
S.D
(±)
S.E (±) t value p value
AT 1.33 0.73 35 0.703 0.182 4.03 <0.001
TRIYAKGAMANA 2.07
FU 0.73 1.34 65 0.723 0.187 7.03 <0.001

By the treatment, in GROUP-B Triyakgamana was observed with a mean
reduction of score from 2.07 to 1.33 after treatment and after follow up it again
reduced to 0.73 with 65% improvement. Analysis of this data shows statistically
significant improvement (P<0.001).
Figure 31 showing Effect of Group A and Group-B on Triyakgamana.

117. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
ASSESSMENT OF TOTAL EFFECT OF THERAPY
Table No 53. Overall effect of
Karpasasthyadi Taila Group-A
EFFECT OF TREATMENT IN GROUP - A
Class Grading No of patients
100

0
61-99

15
31-60

0
1-30

0
0

0

Figure 32 showing Result on Group A

118. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Effects of Nagara Taila (Group-B)
ASSESSMENT OF TOTAL EFFECT OF THERAPY
Table No.54 Overall effect of Group-B
EFFECT OF TREATMENT IN GROUP - B
Class Grading No of patients
100

0
61-99

13
31-60

2
1-30

0
0

0

Figure 33 showing Result on Group B

119. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka


Table No.55 Comparative results of Group-A and Group-B

Result of group A
The percentage of improvement in Group A on Shoola is 91%, Unnamana is
66%., Avannamana is 84%, Akunchana is 81%, Prasarana is 87%, and Triyakgamana
is 77%.


Characteristics Group-A Group-B
Mean score Mean score
Signs and Symptoms
BT FU
Percentage of
relief
BT FU
Percentage of
relief
SHOOLA 2.87 0.27 91 2.47 0.47 81
UNNAMANA 2.53 0.87 66 2.53 0.93 63
AVANNAMANA 2.47 0.40 84 2.47 0.60 76
AKUNCHANA 2.40 0.47 81 2.33 0.73 69
PRASARANA 2.07 0.27 87 2.00 0.40 80
TRIYAKGAMANA 2.00 0.47 77 2.07 0.73 65

120. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Result of group B
The percentage of improvement in Group B on Shoola is 81%, Unnamana is 63%.,
Avannamana is 76%, Akunchana is 69%, Prasarana is 80%, and Triyakgamana is
65%.
Comparative results of Group-A and Group-B –
In case of Avabahuka, Group A overall result is 81% and Group B overall
result is 73%
Figure 34 showing Comparative results of Group-A and Group-B

Table No 56 Comparative Results of Group A and Group B
Group A Group B Mean
Difference
SE (±) T value P value
81.16 72.77 8.39 5.44 1.54 >0.001

121. Observation and Results
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Comparison of total effect of two groups had analyased statistically through Paired t
test. The test revealed that Group A Nasya with Karpasasthyadi Taila had got highly
significant result than Group B Nasya with Nagara Taila. Details are given in the
table above.
Table No 57 Overall results of the Patients
Srl No. Group A Group B
1 87.50 73.33
2 80.00 84.62
3 72.22 86.67
4 91.67 84.62
5 81.25 25.00
6 81.25 53.85
7 81.25 91.67
8 92.31 80.00
9 92.31 81.25
10 92.31 62.50
11 78.57 90.91
12 76.92 45.45
13 69.23 62.50
14 69.23 84.62
15 71.43 84.62
Statistical analysis proved that the group-A is more effective than group-B.

122. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
6. DISCUSSION

Avabahuka has been described as one among the Nanatmaja Vyadhi caused by
Vata Dosha. The Morbid Vata, which gets lodged in Amsa Moola, will cause the
Sirasankochana (constriction of the Sira) locally and produces Bahupraspandahara
(restricted movement), manifesting Avabahuka. Also in this condition Vyanavata
combines with Sleshakakapha and leads to Gatisanga (restricted movement) and
produces Avabahuka.
There are many clinical conditions described in the medical texts, which
involves the shoulder joint, from which the most common condition is Adhesive
Capsulitis or Frozen shoulder. Frozen shoulder is a condition that causes restricted
range of active and passive glenohumeral motion in the shoulder joint.
The capsule surrounding the shoulder joint contract and form scar tissue called
adhesions. Contraction of the capsule surrounding Shoulder joint and the formation
of the adhesions cause the shoulder to become stiff and cause movements, more
painful. There is also lack of synovial fluid, which normally lubricates the gap
between arm bone and socket to help shoulder joint move. In this condition pain and
stiffness of the shoulder joint are the cardinal symptom leading to inability of affected
upper limb.
In contemporary medical science potent Analgesics, Anti-inflammatory drugs
and also Corticosteroids are prescribed for this type of condition. These drugs do
posses increased risk of gastric erosion, hepatic and nephron-toxicity type of adverse
effects.
The treatment modalities told in Ayurveda for the management of Avabahuka
has got a greater role to play in the treatment and prophylactic care

123. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Discussion about conceptual study:
The clinical trial is a comparative study between Nasya with Karpasasthyadi
Taila and Nagara Taila in management of Avabahuka. Diagnostic criteria of
Avabahuka are based on the Prathyatma Lakshanas which are explained in texts as
Bahupraspanda Hara and Shoola. In the present clinical study total number of 30
patients was selected randomly and irrespective of their sex, cast or creed and
chronicity of the diseases, from the out patient and in patient department of K.V.G
College of Ayurveda Hospital, Sullia. The first group named Group-A Nasya with
Karpasasthyadi taila included 15 patients and the second group named Group-B
Nasya with Nagara Taila consisted of 15 patients were studied.
The History taking, Examination and Investigations were done according to
the specially prepared proforma. The patients with Fractures and Dislocations of the
joint are excluded where the line of treatment is different form the present line of
treatment.
Discussion on Nasyakarma:
Route of administration always has its own importance in management
of any disease. Nasya is a term to be applied generally for medicines or medicated
oils administered through the nasal passage as stated by Acharya Sushruta.
According to Ayurvedic classics in Urdhwajatrugata Vikara Nasya therapy is
most favorable. Avabahuka is one among them.
Mode of action of Nasya karma
In Ayurvedic classics, the mode of action of Nasya Karma is explained indirectly.
According to Charaka Samhita, the drug administered through the nose enters
in the Uttamanga and eliminates the morbid Doshas residing there.

124. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
According to Vrudda Vagbhata :
Drug administered through nose -the doorway to Shira

Reaches the Shringataka Marma of Head (Shira), which is a Sira Marma and
formed by the Siras of nose, eyes, Kantha and Shrotra

The drug spreads by the same route

Scratches the morbid Doshas of Urdhwajatru and extracts them from the
Uttamanga

Indu, the commentator of Ashtanga Sangraha, opined that Shringataka is the
inner side of middle part of head i.e. “Shiraso Antar Madhyam”.
In this context Sushruta has clarified that Shringataka Marma is a Siramarma
formed by the union of Siras (blood vessels) supplying to nose, ear, eye and tongue.
Thus we can say that drug administered through Nasya may enter the above Sira and
purifies them. Under the complications of Nasya Karma, Sushruta has mentioned that
excessive eliminative errhine may cause Mastulunga Strava (flow of cerebrospinal
fluid out to the nose). Which suggest the direct relation of Nasal pathway to brain.
All ancient Acharyas have said considered Nasa as the gate way of Sheera. It
does not mean that any channel directly connects brain and nose, but it may be
suggestive of any connection through blood vessels, lymphatics and nerve.
Drug absorption and Transportation :
Keeping the head in lowered position and retention of medicine in
nasopharynx help in providing sufficient time for local drug absorption. Any liquid

125. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
soluble substance has greater chance for passive absorption directly through the cell
of lining membrane. On other hand, massage and local fomentation also enhances the
drug absorption. The later course of drug transversion can occur in two ways.
(i) By systemic circulation (ii) Direct pooling into the intracranial region.. This
direct transportaion can be assumed again in two paths, viz. (a) By vascular path, (b)
Lymphatic path. Vascular path transportation is possible through the pooling of nasal
veinal blood to the facial vein, which naturally occurs. Just of the opposite entrance
the inferior ophthalmic veins also pool into the facial vein. Interestingly, both facial
and ophthalmic veins have no veinal valves in between. So that, blood may drain on
either side, that is to say the blood from facial vein can enter cavernous venous sinus
of the brain in reverse direction. Thus, such a pooling of blood from nasal veins to
venous sinuses of the brain is more likely in the head lowered position due to gravity.
On this lines, the absorption of drug materials into meninges and related parts of
intracranial organs, is a worth considering point. Moreover the modern scholars have
noted that the infective thrombosis of the facial vein may lead to infection of the
meninges easily through this path Pooling of blood from paranasal sinuses also
possible in the same manner. Vaghbhatta;s notation of Shringataka Srotas (anterior
cranial fossa) seems to relation with the above explanation.
The lowering of the head, elevation of lower extremities and fomentation of
face, seem to have an impact on blood circulation of the head and face. As the efferent
vasodilator nerves are spread out on the superficial surface of the face, receive
stimulation by fomentation and it may engender the increased blood flow to the brain.
Discussion on Dose of Nasya
The amount of liquid that flow, down after immersing two digits of index
finger in any liquid and taking the finger out is (forms) one Bindu (drop).Acharya

126. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Vaghbhata, had told that ten, eight, six Bindus are the maximum, medium, minimum
doses, respectively of Marsha Nasya. Since the taila used is Theekshna Avara Matra
have been considered i.e. 6 Bindhus is taken for Nasya.
Discussion Mode of action of Karpasasthyadi Tail
Karpasasthyadi Taila comprises mainly Karpasa, Masha, Kulattha, Bala,
Pippalimoola, Sigru, Nagara etc.and Taila having the properties like Snigdha Guna,
Ushna Veerya and Vata-Kapha Shamaka and acts as Vedana Shamaka, Shothahara
and Brumhana. Thus provides significant effect on symptoms of Avabahuka.
Avabahuka is Vata predominated disease. Karpasasthyadi Taila is having
Vatahara property. Most of the contents of Karpasasthyadi Taila has Katu Rasa, this
Katu Rasa even though aggravates Vata Vyadhi, but with the influence of Snigdha,
Guru Guna of Taila, Usna Guna and Veerya of the ingredients it subsides the
aggravated Vata in Avabahuka .The Usna Guna of the ingredients of Karpasasthyadi
Taila subsides the Sheeta Guna of Vata to subside the Shoola and Sthabthatha in
Avabahuka.
Discussion Mode of action of Nagara Taila
Nagara
Avabahuka is Vata predominated disease .The Ushna Guna of Nagara
subsides Sheeta Guna of Vata to subside the Shoola and Sthabthatha in Avabahuka.
Taila
Taila is having Ushna, Teekshna, Guna etc . Avabahuka is Vata predominant
disease. Due to the Vata Hara properties and Usna Guna we are getting a good
result.

127. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Taila is having Mrudhukara Bhavas (softening property) .In Avabahuka
Akunchana (constriction) is there. This Akunchana is relieved by the Mrudhukara
Bhavas of the Taila.
Mode of action of Nagara taila in Shoola and Sthabdhatha
Shoolahara Dashemani Drayas is having Ushna Verya. Nagara is having Usna
Guna. Shoola and Sheeta are inter related. All painful Vatavyadhi get aggravated by
cold (Shayithyatha).If we give hot fomentation i.e. Usna the pain subsides. This part
suggests that Nagara due to it Usna Guna subsides the Shoola of Avabahuka.
Sthabdhatha is produced due to Sheeta as well as Rooksha Guna. Nagara taila
is having Usna and Snigdha Guna.Usna Guna of Nagara subsides the Sheetha
(Sthabthatha) of Avabahuka.
Snigtha Guna of taila subsides the Rookshatha (Sthabthatha) of Avabahuka.
Nagara is having Madhura Vipaka. Due to the Madhura Vipaka it does the
Bruhmana effect. Brumhana is the one, which is done or used for the nourishment.
In the present context of Avabahuka the vitiated Vata due to its Rookshadi qualities
reduces the Snigdhata of Amsa Pradesha (Snayu, Sandhi). To subside this Rookstha
and to strengthen the amsa Pradesha Nasya with Nagara Taila is advised.
Discussion on observations of the clinical study & Results
Age
Incidence of 30 patients suffering from Avabahuka showed more number of
patients between the age group of 41-50 (26.67%) and 21-30 (26.67%) years followed
by age 51-60 years (23.33%) i.e. more number of patients is between the age group of
20-50. This suggests that disease is more common in middle age group. Maximum
number of patients belonged to the age group of 41-50 (26.67%) and 21-30 (26.67%)
and less in 61-70years (10%). The reason behind this may be because this group of

128. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
adults are under strong working pressure in today’s modern lifestyle which leads to
irregular exercise, abnormal postures and working for long time without taking proper
rest.
The age group of 41-50 (26.67%),, 4
th
and 5
th
decade of life, According to
modern science, there is progressive decrease in the degree of hydration of joint
space, with age that leads to the cycle of degeneration.
Sex
In the sample taken for the study, 56.67% of males were registered in
comparison to 43.33% of females. This suggests incidence of disease is come more
common in male. Strenuous work schedule like carrying heavy loads, working with
upper limb to perform different agricultural works driving ,etc, may be a causative
factor in the predominance. All the females in the study were housewives having
excessive work in house like washing cloths, dishes, sweeping , etc, this reflects that
their habit of work is having a direct influence in aetiopathogenesis of Avabahuka.
Among males most of them were in Agriculture and Labour Work which is having
direct impact on this disease.
Marital status
83.33% patients registered in the study were married and 16.67 % were
unmarried. As this disease more common in age group of above 20 years & most of
people get married.
Education:
In the study as a total 30 patients, 12 patients had Graduation (40%), , 11
patients had Primary education (36.67%), 06 patients were uneducated (20%) and 01
patient had Secondary education (3.33%). This data reflects that physical strain

129. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
activities and inadequate health care due to busy lifestyle , may contribute in the
manifestation of the disease Avabahuka.
Socio-economic status
Out of thirty patients 01 (3.3%) was poor, 14 (46.6%) were of lower middle
class, 13 (43.3%) were of upper middle class and 02 (2.8%) were rich class. About
socio-economic status of patients, maximum number of patients was of Lower middle
class, followed by upper middle class and Rich class indicates that this disease
incidence is common in lower middle classes
According to Acharya Vagbhata consuming insufficient quantity of food does
not help in improvement of strength, growth and vigour, it becomes a cause for all
diseases of Vata orgin.(AH.Su.8/3).
The lower middle classes, who depend on hard work for their daily expenses
and have a under nourished diet indicates that the diseases has a direct relation with
the Socio-economic status of the patient.
Occupation
Out of total 30 patients in Group A and Group B, maximum patients were
Housewife followed by Agriculturist. They were 10 (33.33%) and 05 (16.67%)
Respectively. Group wise division: In, Group A, they were 33.33% and 20%
respectively. In, Group B they were 33.33% and 13.33% respectively.
Strenuous work schedule may be a causative factor in the predominance. All
the females in the study were housewives having excessive work in house and this
reflects that their habit of work is having a direct influence in aetiopathogenesis of

130. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Apabahuka. Among males most of them were in Agriculture and Labour Work which
is having direct impact on this disease.
Habitat
Out of total 30 patients in group A and Group B, maximum patients habitat is
Rural 18(60%) followed by Urban Habitat 12(40%). This once again suggests
Avabahuka is more common in peoples of rural area as they come from low socio
economic status.
Dietary Habit
Patients in this group does not exhibit much preponderance of either
vegetarian or mixed food habits in the causation of this illness. As this study showed
66.67 % of patients had the habit of mixed diet, in comparison to 33.33 % of patients
restricted only to vegetarian dietary habits. The study exhibited that 66.67% of the
patients were non-vegetarians (mixed) consumption of more spicy food, this may
cause further vitiation of Vata causing Avabahuka.
Intake of Dominent Rasa:
Majority of patients had a diet of consuming Katu Rasa Pradana Ahara 50%.
Katurasa is one of Nidana for Vata Prakopa.36.67 % prefers Tiktha Rasa Pradhana
Ahara and 13.33% consuming Kashayarasa Pradhana Ahara. These are the some
factors explained in the Samanya Vatavyadhi Nidana. This supports and validates the
presumption that made earlier that Vatavyadhi Samanya Nidana can be taken as
Nidana for Avabahuka.

131. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Agni
Majority of the patients 33.33 % were having Samag ni followed by
Teekshnagni in 26..67 % and Mandagni is found to be in 26.67 % and Vishamagni in
13.33 % of the patients and Vishamagni. The Roga Marga in Avabahuka is
Madhyama, so herethere is no role of Agni in the maniefestation of the diseases.
Nidra
It is quite obvious that, a disease, dominant with pain will disturbs the sleep
pattern. In the present study , out of thirty patients 20(66.67 %) complained that, they
had disturbed sleep and 10 (33.33 %) sleep was not disturbed. In the present study
maximum number of patients i.e. 33.33 % had a Normal sleep where as 66.67 % of
people had a disturbed sleep. It indicates that more number of patients had the Anidra
as an aetiological factor for the Prokopana of Vata.
Vyasana
Out of total 30 patients in Group A and Group B, maximum patients 18 (60 %)
Vyasana were none followed by Tobacco 06 (20%) respectively. The Study reveals
that Tobacco Smoking, Chewing and alcoholism may not have effect on this disease
as 40 % of patients were having addiction and 60 % were not having any addiction. It
shows the present trend of life.
Satvabala
Out of thirty patients, 11 (36.67%) had Avara Satvabala and Pravara
Satvabala. 8 (26.67 %) patients had Madyama Satvabala.

132. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Prakruthi:
Majority of patients were belong Vatapitta Prakruthi ie 70 %.Vatakapha
Prakruthi persons are 30 %. Avabahuka is a disease in which Vata have a
predominant role ie Vatika Purushas were more afflicted by Vataja disorders. That
may be the reason for longstanding nature of the disease.
Chronicity (Duration of illness):
In the study as a whole (30 patients) 20 patients fall under below 1 year
(66.67%) and 10 patients fall under 1yrs-and above (33.33%).In Yogaratnakara it is
clearly mentioned that Kaalathikranmethethu kashtam bhavathi durjaram. So
Avabahuka is a chronic disease if it is > 1 years. From this it is also clear that patients
consults for this disease in early stages.
Vyadhibala:
Vyadhibala had assessed considering Nidana Panchaka,Chronicity and
Severity of the disease. Out of total 30 patients in group A and Group B, All patients
Vyadhi Bala were Madhyama.
Mode of Onset
Out of total 30 patients in group A and Group B, maximum patients are in
gradual 16 (53.33%), 11 (36.67 %) were had incidious onset and 03 (10%) had
sudden onset.

133. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Joint involvement
Out of total 30 patients in group A and Group B, maximum patients Joint is
Right 16(53.33%) followed by Left Joint 14(46.67%). This may be because most of
the patients were right handed.
Effect of therapy on signs and symptoms:
Based on the feature’s of Avabahuka as explained in the classics, which are
Shoola and Bahupraspanda Hara (Sthabthatha) , it was observed in the study that all
the patients were presented with the same feature. All the patients complained with
decreased strength in the affected shoulder joint
All the 30 patients complained about difficult in Throwing , Pulling any
heavy things, Carrying weight, Keeping up the objects in shelf, scratching the back
during bath and finally by doing these the pain get aggravates which leads to
disturbed sleep. Also the 30 patients noticed that the pain aggravates in night hours,
relieves in day hours, with rest and by giving support to the affected shoulder joint.
This shows the relation between the etiological factors and symptoms. Symptoms also
show the effect of Kala on the disease which supports that Avabahuka is of Vataja
and Kaphaja variety.
The effect of therapy was assessed on each signs and symptoms of Avabahuka
by standard questionnaires. The functional ability score before and after treatment
were assessed statistically to see the significance. The details are as follows:

134. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Group A-Karpasasthyadi Taila
Effect on Shoola:
a) After completion of Nasya :
The intensity of the pain was markedly decreased just after the Nasya Karma.
Statistical analysis showed that the mean score which was 2.87 before the treatment
was reduced to 1.47 with 49 % improvement. This means the Nasya i.e.
Karpasasthyadi Taila reduces the intensity of the Shoola, in the patients of
Avabahuka.
b) After Follow up of Treatment:
A highly significant change in the severity of Shoola was observed after
follow up of up of treatment. Mean score which was 2.87 before the treatment was
reduced to 1.47 after the treatment. and after follow up it became 0.27 with 91%
improvement and there is a statistically highly significant
This means the Nasya with Karpasasthyadi Taila is effective in reducing the
intensity of the pain.
Effect on Bahupraspandahara (Unnamana -Abduction):
a) After completion of Nasya:
In group, after Nasya highly significant changes were observed. The
Abduction initial value of Goniometric reading was 2.53 and reduced to 1.47 with
improvement of 42%. After treatment the mean score reduced to 1.47 which was

135. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
statistically significant. This shows improvement in degree of movement by,
statistically significant as assessed by paired ‘t’ test.
After follow up of Treatment:
The difference in mean score of abduction after follow up of treatment showed
improvement in degree of movement to 0.87 with 66% improvement, as compared to
before treatment. On statistical analysis by paired‘t’ test the difference was highly
statistically significant.
The improvement may be because of the drugs used, which help in pacifying
Vyanavata.
Effect on Bahupraspandahara (Avannamana -Adduction):
a) After completion of Nasya:
In the group, after Nasya highly significant changes were observed. The
Adduction initial value was 2.47 and reduced to 1.40 with improvement 43%. After
treatment the mean score reduced to 1.40 which was statistically significant. This
shows improvement in degree of movement , statistically significant as assessed by
paired ‘t’ test.
After follow up of Treatment:
The difference in mean score of adduction after follow up of treatment showed
improvement in degree of movement to 0.40 with 84% improvement as compared to
before treatment. On statistical analysis by paired‘t’ test the difference was
statistically highly significant.

136. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Effect on Bahupraspandahara (Akunchana -flexion):
a) After completion of Nasya:
In group, after Nasya highly significant changes were observed. The flexion
initial value was 2.40 and reduced to 1.47 with 39% improvement. After treatment the
mean score reduced to 1.150 which was statistically significant. This shows
improvement in degree of movement by 39%, statistically significant as assessed by
paired ‘t’ test.
After follow up of Treatment:
The difference in mean score of flexion after follow up of treatment showed
improvement in degree of movement to 0.47 ie 81 % as compared to before treatment.
On statistical analysis by paired‘t’ test the difference was statistically highly
significant.
Effect on Bahupraspandahara (Prasarana - extension):
a) After completion of Nasya:
In group, after Nasya highly significant changes were observed. The extension
initial value was 2.07 and reduced to 1.27 with 61 % improvement. After treatment
the mean score reduced to 0.80 which was statistically significant. This shows
improvement in degree of movement by 61%, statistically significant as assessed by
paired‘t’ test.

137. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
After follow up of Treatment:
The difference in mean score of extension after follow up of treatment showed
improvement in degree of movement to 0.80 ie 87 % as compared to before treatment.
On statistical analysis by paired‘t’ test the difference was statistically highly
significant.
Effect on Bahupraspandahara (Circumduction-Triyakgamana):
In group, after Nasya highly significant changes were observed. The
Circumduction initial value was 2.00 and reduced to 0.80 with 60 % improvement.
After treatment the mean score reduced to 0.80 which was statistically highly
significant. This shows improvement in degree of movement by 60 %, statistically
significant as assessed by paired‘t’ test.
After follow up of Treatment:
The difference in mean score of Circumduction after follow up of treatment
showed improvement in degree of movement to 0.47 ie 77 % as compared to before
treatment. On statistical analysis by paired‘t’ test the difference was statistically
highly significant.
Overall Assessment: Analysis of over all effect of the treatment in the patients of
Avabahuka showed good improvement.
The treatment was given with seven days of Nasya with Karpasasthyadi taila
which was highly significant. None of the patients develop any complications, or any
untoward symptom or any side effects during the course of treatment in the study
group and therefore the treatment modalities is safe and is of therapeutic value. Here

138. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
when we compare with Nasya with Nagara Taila group B, group A got very good
improvement after the follow up than after treatment.
The above said observations indicate that patients have shown improvement in
all the criteria of assessment of Avabahuka. The therapeutic effects like Vedana
Sthapak, Stambha hara etc. are achieved, by relieving shoola and improvement in the
movement of Bahu. The ultimate effect will be in reducing the intensity of the shoola
and controlling the vitiated vata as the basic management of Avabahuka. Along with
this therapeutic effect, Balya and Rasayana are achieved in these modalities.
Group B-Nagara Taila
Effect on Shoola:
c) After completion of Nasya :
The intensity of the pain was markedly decreased just after the Nasya Karma.
Mean score of Shoola was 2.47 before treatment which was reduced significantly to
1.20 after treatment with 51 % improvement. After treatment the mean score reduced
to 1.20 which was statistically significant. This means the Nasya with Nagara Taila is
very effective in reducing the intensity of the shoola, in the patients of Avabahuka.
d) After Follow up of Treatment:
A highly significant change in the severity of Shoola was observed after
follow up of up of treatment. Mean score of Shoola was 2.47 before treatment, which
was reduced highly significantly to 0.47 after follow up with 81 % improvement.
After post follow up the mean score reduced to 0.47 which is statistically highly
significant.

139. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
This means the Nasya with Nagara Taila is effective in reducing the intensity
of the pain.
Effect on Bahupraspandahara (Unnamana-Abduction):
a) After completion of Nasya:
In group, after Nasya significant changes were observed. The Abduction
initial value of reading was 2.53 and reduced to 1.67 with 34 % improvement. After
treatment the mean score reduced to 1.67 which was statistically significant. This
shows improvement in degree of movement by 34 %, statistically significant as
assessed by paired ‘t’ test.
After follow up of Treatment:
The difference in mean score of abduction after follow up of treatment showed
improvement in degree of movement to 0.93 ie 63 % as compared to before treatment.
On statistical analysis by paired ‘t’ test the difference was statistically significant.
The improvement may be because of the drug used, which help in pacifying
Vyanavata.
Effect on Bahupraspandahara (Avannamana-Adduction):
a) After completion of Nasya:
In group, after Nasya significant changes were observed. The Adduction initial
value was 2.47 and reduced to 1.73 with 30% improvement. After treatment the mean
score reduced to 01.73 which was statistically significant. This shows improvement in
degree of movement by 30%, statistically significant as assessed by paired ‘t’ test.

140. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
After follow up of Treatment:
The difference in mean score of adduction after follow up of treatment showed
improvement in degree of movement to 0.60 i.e. 76 % as compared to before
treatment. On statistical analysis by paired‘t’ test the difference was statistically
significant.
Effect on Bahupraspandahara (Akunchana-flexion):
a) After completion of Nasya:
In group, after Nasya significant changes were observed. The flexion initial
value was 2.33 and reduced to 1.60 with 31% improvement. After treatment the mean
score reduced to 1.60 which was statistically significant. This shows improvement in
degree of movement by 31%, statistically significant as assessed by paired ‘t’ test.
After follow up of Treatment:
The difference in mean score of flexion after follow up of treatment showed
improvement in degree of movement to 0.73 i.e. 69 % as compared to before
treatment. On statistical analysis by paired ‘t’ test the difference was statistically
significant.
Effect on Bahupraspandahara (Prasarana-extension):
a) After completion of Nasya:
In group, after Nasya highly significant changes were observed. The extension
initial value was 2.00 and reduced to 1.13 with 43 % improvement. After treatment
the mean score reduced to 1.13 which was statistically significant. This shows

141. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
improvement in degree of movement by 43%, statistically significant as assessed by
paired ‘t’ test.
After follow up of Treatment:
The difference in mean score of extension after follow up of treatment showed
improvement in degree of movement to 1.60 i.e. 80 % as compared to before
treatment. On statistical analysis by paired ‘t’ test the difference was statistically
highly significant.
Effect on Bahupraspandahara (Circumduction-Triyakgamana):
In group, after Nasya significant changes were observed. The Circumduction
initial value was 2.07 and reduced to 1.33 with 35% improvement. After treatment
the mean score reduced to 1.33 which was statistically significant. This shows
improvement in degree of movement by 35 %, statistically significant as assessed by
paired ‘t’ test.
After follow up of Treatment:
The difference in mean score of Circumduction after follow up of treatment
showed improvement in degree of movement to 0.73 i.e. 65 % as compared to before
treatment. On statistical analysis by paired ‘t’ test the difference was statistically
significant.
Overall Assessment: Analysis of over all effect of the treatment in the patients of
Avabahuka showed good improvement.

142. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
The treatment was given with seven days of Nasya with Nagara Taila which
was significant. None of the patients develop any complications, or any untoward
symptom or any side effects during the course of treatment in the study group and
therefore the treatment modalities is safe and is of therapeutic value. But the patients
of group B shows more improvement after treatment when comparing with the group
A .This may be due the fast action of Nagara Taila. On the same time Nasya with
Nagara Taila has less improvement after follow up when comparing with the Nasya
with Karpasasthyadi Taila.
The above said observations indicate that patients have shown improvement in
all the criteria of assessment of Avabahuka. The therapeutic effects like Vedana
Sthapak, Stambha hara etc. are achieved, by relieving Shoola and improvement in the
movement of Bahu. The ultimate effect will be in reducing the intensity of the Shoola
and controlling the vitiated Vata as the basic management of Avabahuka. Along with
this therapeutic effect, Balya and Rasayana are achieved in these modalities.
Discussion on Efficacy of Thaila and Procedure:
Present study shows good results in the Avabahuka. But in Chronic condition
it is not getting much result. It may be due to the long standing nature of the disease.
Karpasasthyadi Taila Nasya and Nagara Taila Nasya given for the seven days gives
good changes in Avabahuka. So we can say that both are effective in different stages
of Avabahuka. This may be due to the action of Nasya in the Jathrupredesa.
Avabahuka is a disease of Jathrupredesa. If the study has done for more duration of
treatment then we can achieve a better result.

143. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Nasya with Karpasasthyadi Taila had got more result compared to Nasya with
Nagara Taila. This may be because Karpasasthyadi Taila is processed with more
Vatakaphahara drugs and the Taila is having more Usna Veerya, and Brihmana nature
compared to Nagara taila.
Table No.58 Comparative results of Group-A and Group-B
Characteristics GROUP-A GROUP-B
Mean score
Mean score
Signs and
Symptoms BT FU
% of
relief BT FU
% of
relief

Shoola 2.87 0.27 91% 2.47 0.47 81%
Unnamana 2.53 0.87 66% 2.53 0.93 63%
Avannamana 2.47 0.40 84% 2.47 0.60 76%
Akunchana 2.40 0.47 81% 2.33 0.73 69%
Prasarana 2.07 0.27 87% 2.00 0.40 80%
Triyakgamana 2.00 0.47 77% 2.07 0.73 65%

Table No 59 Comparative Results of Group A and Group B.
Group A Group B Mean
Difference
SE (±) T value P value
85.71 73.93 11.78 5.45 2.15 >0.001

144. Discussion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Comparison of total effect of two groups had analyased statistically through
Unpaired t test. The test revealed that Group A Nasya with Karpasasthyadi Taila had
got highly significant result than Group B Nasya with Nagara Taila. Details are
given in the table above.
Statitical conclusion
Statistical analysis proved that the group-A is more effective than group-B.
Table No 60 Overall results of the Patients
Srl No. Group A Group B
1 87.6 73.2
2 80.2 84.6
3 72.3 86.7
4 100 85.2
5 81.2 25.4
6 80.6 54.3
7 80.7 100
8 91.7 80.2
9 92.2 80.1
10 91.7 63.2
11 86.2 100
12 84.7 45.3
13 85.1 63.2
14 84.1 85.2
15 85.3 84.7

145. Conclusion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
7. CONCULSION
The following conclusions may be drawn based on the analysis of the
conceptual part and observations made in the clinical study.
1. The disease is named after the site of illness as well as leading clinical
presentation.
2. Present study revealed that the Bharavahana, Dukshashaya, Rooksha, Alpa
Ahara are the most occurring causes for the manifestation of disease
Avabahuka.
3. Nasya Karma is considered as very effective and easy procedure adopted in
treatment in Avabahuka.
4. Karpasasthyadi Taila and Nagara Taila Nasya can be practiced safely without
any adverse effect.
5. The present study shown highly significant results which indicate that
therapeutic effects like Shoolahara and Sthambhara, i.e. improvement in degree
of shoulder joint movement without pain which is achieved to great extend by
Nasya karma.
6. Karpasasthyadi Taila is more beneficial in the form of Nasya karma in the
management of Avabahuka due to its Vatahara properties.
7. Nasya with Nagara Taila showed more Shoola Hara property after the treatment.
But after follow up the percentage of improvement was less as compared to
Karpasasthyadi Taila.
8. In chronic stage giving Karpasasthyadi Taila is more beneficial compared to
Nagara Taila, but treatment for seven days is not enough.

146. Conclusion
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
9. We can give treatment in O P D level itself. So that it is convenient for the
patient.
10. The medicine and Procedure are cheaper and cost-effective.
11. Overall the group A is more effective clinically and statistically than group B in
almost all the parameters.
Suggestions for the future study :
1) Study on large sample is required.
2) In the present study, Patients with Fractures, dislocation and injury to
the shoulder joint were excluded. Evaluation of the effect of the
therapy should be done in these conditions also.
3) Studying on repeated application of these treatment procedures and
interchanging the samples from one group to the other may be
conducted to evaluate further.

147. Summary
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
8. SUMMARY
“A comparative clinical study on the effect of Nasya with Karpasasthyadi taila
and Nagara taila in the management of Avabahuka”. is the title of the present
dissertation work. It consists of Introduction, Objectives, Review of Literature,
Material and Methodology, Observations and Results, Discussion and Conclusion.
Introduction briefs selection of Upakarma i.e. Nasya Karma and its utility in
the diseases Avabahuka.
The study is presented in two parts, first part of the work deals with the
disease Avabahuka review presented from Paribasha, Shareera Vivechana, Nidana
Panchaka, Sadhyasadhyata, Sapkesha Nidana, Updrava, Chikitsa Vivechana,
Pathyapthya and Drug Review. Then review of literature comprising of Nasya
Nirukti, Synonymous, Historical background, Classifications, Indications, and
Contraindications, Time duration, Dosage, Drug mentioned, Procedure, Samyaka,
Ayoga, Atiyoga, Vyapad.
The second part of the work is dedicated to clinical trial i.e. “A comparative
clinical study on the effect of Nasya with Karpasasthyadi taila and Nagara taila in the
management of Avabahuka”. It includes inclusion and exclusion criteria, diagnostic
and assessment criteria and treatment schedule. Data analysis, discussion on these
points and observations in different stages are dealt in detail.
The study was conducted by randomly selecting the patients into two groups.
The cases were assessed for all the signs and symptoms. Grading was given to all the
parameters like Shoola, Bahupraspanditahara (movements), was assessed by using
Goniometry.

148. Summary
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Response to the treatment was assessed based on the above said parameters
before, after and after follow up of the treatment. The effect of the treatment
statistically, variables were subjected for paired‘t’ test. At the end of the study, it was
concluded that Nasya with Karpasasthyadi provided better and more effective results
as highly significant result were obtained after follow up.
Conclusion was drawn on the basis of discussion on Avabahuka, Nasya
Karma, mode of action of the drug, Observation and Results.

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87. Shri Kashinatha Shastri edited., CharakaSamhita Shareerasthana chapter 8
shloka 19. Reprint 1994 Chaukambha Sanskrit Sansthanai Varanasi . P no 821
88. Kaviraj Dr.Ambikadatta Shastri edited, SushrutaSamhita Shareerasthana chapter
2 shloka 34. Reprint 2OO5. Chaukambha Sanskrit Sansthanai Varanasi p.no 15
89. Prof K R Shrikantha Murthy edited, Ashtangasanraha Shareerasthana chapter 1
shloka 31 Reprint 1996 Choukambha Orientalia ; Varanasi: P.no 13..
90. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Siddhi
Sthana, Chapter 9, Sloka No.88-92, Edition: Reprint 2008, Pub: Chaukhamba
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.722
91. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Vimana
Sthana, Chapter 7, Sloka No.151, Edition: Reprint 2008, Pub: Chaukhamba
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.286
92. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Chikitsa Sthana, Chapter 40, Shloka no.21, Edition
: Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116, Gopal
Mandir Lane, Varanasi, Page no. 554.

162. Bibliographic References
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
93. Pt. Hari Sadashiva shastri Paradakara Bishagacharya edited, Ashtanga Hrudaya,
Sutra Sthana, Chapter 20, Shloka No.1, Reprint, 2007, Pub:Chaukhamba
Surbharati Prakashan K.37/117, Gopal Mandir lane, post box No.1129, Varanasi
(UP), Page No.287
94. Dr. Shivprasad Sharma edited Astanga Sangraha, Sutra Sthana, Chapter 29,
Shloka No.2, Edition: First 2006, Pub:Chowkhamba Sanskrit Series Office,
K.37/99, Gopal Mandir lane, Post box No.1008, Varanasi (UP),Page No.223.
95. Pandit Parashurama Shastri Vidyasagar edited, Sharangadhara Samhita, Deepika
commentory by Adamalla on Uttara Khanda, Chapter 8, Shloka No.1-2, 3rd
edition 1983, Pub:Chawkambha Orientalia, P.B.32, K, 37/109, Gopal Mandir
lane, Varanasi (UP), Page No.215.
96. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Chikitsa Sthana, Chapter 40, Shloka no.21, Edition
: Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116, Gopal
Mandir Lane, Varanasi, Page no. 554.
97. Shree Brahmashankara Mishra edited, Bhava prakasha poorva khanda chapter-5
shloka-189,5th edition Reprint 1969 Choukambha Sanskrit series Varanasi p
no.882.
98. Pt. Hari Sadashiva shastri Paradakara Bishagacharya edited, Ashtanga Hrudaya,
Sutra Sthana, Chapter 20, Shloka No.1, Reprint, 2007, Pub:Chaukhamba
Surbharati Prakashan K.37/117, Gopal Mandir lane, post box No.1129, Varanasi
(UP), Page No.287
99. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Suthra
Sthana, Chapter 17, Sloka No.12, Edition: Reprint 2008, Pub: Chaukhamba

163. Bibliographic References
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.99.
100. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Shareera Sthana, Chapter 5, Shloka no.37, Edition :
Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116, Gopal Mandir
Lane, Varanasi, Page no. 367-368.
101. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Shareera Sthana, Chapter 5, Shloka no.40, Edition :
Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116, Gopal Mandir
Lane, Varanasi, Page no. 368.
102. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Shareera Sthana, Chapter 5, Shloka no.42, Edition :
Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116, Gopal Mandir
Lane, Varanasi, Page no.368.
103. Dr. Shivprasad Sharma edited Astanga Sangraha, Sutra Sthana, Chapter 29,
Shloka No.3, Edition: First 2006, Pub:Chowkhamba Sanskrit Series Office,
K.37/99, Gopal Mandir lane, Post box No.1008, Varanasi (UP),Page No.223.
104. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Siddhi
Sthana, Chapter 9, Sloka No.88-92, Edition: Reprint 2008, Pub: Chaukhamba
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.722
105. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Siddhi
Sthana, Chapter 9, Sloka No.92, Edition: Reprint 2008, Pub: Chaukhamba

164. Bibliographic References
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.722
106. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Vimana
Sthana, Chapter 7, Sloka No.151, Edition: Reprint 2008, Pub: Chaukhamba
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.286
107. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Chikitsa Sthana, Chapter 40, Shloka no.21, Edition
: Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116, Gopal
Mandir Lane, Varanasi, Page no. 554.
108. Dr. Shivprasad Sharma edited Astanga Sangraha, Sutra Sthana, Chapter 29,
Shloka No.4, Edition: First 2006, Pub:Chowkhamba Sanskrit Series Office,
K.37/99, Gopal Mandir lane, Post box No.1008, Varanasi (UP),Page No.223.
109. Pt. Hari Sadashiva shastri Paradakara Bishagacharya edited, Ashtanga Hrudaya,
Sutra Sthana, Chapter 20, Shloka No.2, Reprint, 2007, Pub:Chaukhamba
Surbharati Prakashan K.37/117, Gopal Mandir lane, post box No.1129, Varanasi
(UP), Page No.287
110. Pandit Hemaraj Sharma edited, Kashyapa Samhita Siddhisthana chapter 4
shloka 2 Reprint 1976, Choukambha Sanskrit Sansthanai Varanasi p no 159.
111. a) Pandit Parashuram Shastri edited, Sharangadhara Samhita Uttarakhanda
chapter 8 shloka 2 ,3rd edition Reprint 1983, Choukambha Orientalia
Varanasi p no 339.

165. Bibliographic References
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
b) Pandit Parashuram Shastri edited, Sharangadhara Samhita Uttarakhanda
chapter 8 shloka 11, 3rd edition Reprint 1983,Choukambha Orientalia
Varanasi p no 341.
c) Pandit Parashuram Shastri edited, Sharangadhara Samhita Uttarakhanda
chapter 8 shloka 24 , 3r edition Reprint 1983 ,Choukambha Orientalia
Varanasi p no 342.
112. Satyanarayana Shastri edited, Charaka Samhita Siddisthana chapter 9,shloka
15 Reprint 1995 Choukambha Bharati Academy Varanasi p no.1O71.
113. Kaviraj Dr.Ambikadatta Shastri edited, Sushruta Samhita Chikitsa sthana
chapter 40 shloka -23 Reprint 2OO5 Choukambha Sanskrit Sansthanai
Varanasi p no. 182.
114. Prof. Shrikantha Murthy edited, Ashtanga Hrudaya Sutra Sthana chapter 2O,
shloka .2 Reprint 1996, Choukambha Krishna das academy Varanasi ,p
no.255.
115. Dr. Govardhan Sharma edited, Ashtanga Sangraha Sutrasthana chapter
29.shloka 5 Reprint 2OO5 , , Choukambha Sanskrit Sa nsthanai
Varanasi p no.262.
116. Satyanarayana Shastri edited, Charaka Samhita Siddisthana chapter 9,shloka
15 Reprint 1995 Choukambha Bharati Academy Varanasi p no.1O71.
117. Kaviraj Dr.Ambikadatta Shastri edited, Sushruta Samhita Chikitsasthana
chapter 40 shloka -22, Reprint 2OO5 Choukambha Sanskrit Sansthanai
Varanasi p no.182.
118. Prof. Shrikantha Murthy edited, Ashtanga Hrudaya Sutra Sthana chapter
20,shloka no.3 , Reprint 1996 Choukambha Krishna das academy Varanasi
,p no.255.

166. Bibliographic References
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
119. Dr. Govardhan sharma edited, Ashtanga Sangraha Sutra Sthana chapter
29.shloka 6 ,Reprint 2OO5 , Choukambha Sanskrit Sansthana Varanasi p
no.263.
120. Satyanarayana Shastri edited, Charaka Samhita Siddhisthana chapter 2,shloka
20 Reprint 1995 Choukambha Bharati Academy Varanasi p no.9O2.
121. Kaviraj Dr.Ambikadatta Shastri edited, Sushruta Samhita Chikitsa Sthana
chapter 40 shloka -47 ,Reprint 2OO5 Choukambha Sanskrit Sansthana
Varanasi p no. 184.
122. Dr. Govardhan Sharma edited, Ashtanga Sangraha Sutrasthana chapter
29.shloka 11 Reprint 2OO5 , Choukambha Sanskrit Sansthana Varanasi p
no.264.
123. Satyanarayana Shastri edited, Charaka Samhita Siddisthana chapter 2,shloka
23 Reprint 1998 Choukambha Bharati Academy Varanasi p no.986.
124. Kaviraj Dr.Ambikadatta Shastri edited ,Sushruta Samhita Chikitsa Sthana
chapter 40 shloka -24 ,Reprint 2OO5 Choukambha Sanskrit Sansthana
Varanasi p no. 182.
125. Pandit Parashuram Shastri edited, Sharangadhara Samhita Uttarakhanda
chapter 8 shloka 3 , 3rd edition,Reprint 1983 Choukambha Orientalia
Varanasi , p no 339.
126. Dr. Govardhan Sharma edited, Ashtanga Sangraha Sutrasthana chapter
29.shloka 17 Reprint 2OO5, Choukambha Sanskrit Sansthana Varanasi p
no.267.
127. Kaviraj Dr.Ambikadatta Shastri edited, Sushruta Samhita Chikitsa Sthana
chapter 40 shloka -42 ,Reprint 2OO5 Choukambha Sanskrit Sansthanai

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128. Prof. Shrikantha Murthy edited, Ashtanga Hrudaya Sutrasthana chapter
20,shloka.9 Reprint 1996, Choukambha Krishna das academy Varanasi ,p
no.257.
129. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Chikitsa Sthana, Chapter 40, Shloka no 25,
Edition : Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116,
Gopal Mandir Lane, Varanasi, Page no.555
130. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Siddhi
Sthana, Chapter 9, Sloka No.98, Edition: Reprint 2008, Pub: Chaukhamba
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.723
131. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Siddhi
Sthana, Chapter 9, Sloka No.100, Edition: Reprint 2008, Pub: Chaukhamba
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.723
132. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Siddhi
Sthana, Chapter 9, Sloka No.106-110, Edition: Reprint 2008, Pub:
Chaukhamba Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box
No.1129, Varanasi (UP), Page no.723
133. Prof. Shrikantha Murthy edited, Ashtanga Hrudaya Sutrasthana chapter

168. Bibliographic References
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
2O,shloka 22 Reprint 1996 Choukambha Krishna das academy Varanasi p
no.259.
134. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Chikitsa Sthana, Chapter 40, Shloka no 29,
Edition : Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116,
Gopal Mandir Lane, Varanasi, Page no.556
135. Prof. Shrikantha Murthy edited, Ashtanga Hrudaya Sutrasthana chapter
2O,shloka 22 Reprint 1996 Choukambha Krishna das academy Varanasi p
no.259.
136. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Chikitsa Sthana, Chapter 40, Shloka no 31,
Edition : Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116,
Gopal Mandir Lane, Varanasi, Page no.556
137. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Siddhi
Sthana, Chapter 9, Sloka No.106-110, Edition: Reprint 2008, Pub:
Chaukhamba Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box
No.1129, Varanasi (UP), Page no.723
138. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Chikitsa Sthana, Chapter 40, Shloka no 7, Edition
: Reprint, 2009, Pub : Chaukhambha Sanskrit Sansthan, K.37/116, Gopal
Mandir Lane, Varanasi, Page no.553
139. Vaidya Jadvji Trikamji Acharya edited Susruta Samhita, Nibandhasangraha
Commentary by Dalhana on Chikitsa Sthana, Chapter 40, Shloka no 32,

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Gopal Mandir Lane, Varanasi, Page no.556
140. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Suthra
Sthana, Chapter 5, Sloka No.31-32, Edition: Reprint 2008, Pub: Chaukhamba
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.40.
141. Dr. Govardhan Sharma edited, Ashtanga Sangraha Sutrasthana chapter
29.shloka 18,Reprint 2OO5 , Choukambha Sanskrit Sansthana Varanasi p
no.262.
142. a) Satyanarayana Shastri edited, Charaka Samhita Siddhisthana chapter 1,
shloka 51, Reprint 1995 Choukambha Bharati Academy Varanasi p
no.974.
b) Kaviraj Dr.Ambikadatta Shastri edited, Sushruta Samhita Chikitsasthana
chapter 40 ,shloka -33,Reprint 2OO5 Choukambha Sanskrit Sansthana
Varanasi p no.183.
c) Prof. Shrikantha Murthy edited, Ashtanga Hrudaya Sutrasthana chapter 2O,
shloka.23, Reprint 1996, Krishna das academy Varanasi ,p no.259.
d) Pandit Parashuram Shastri edited, Sharangadhara Samhita Uttarakhanda
chapter 8 shloka 58, 3rd edition ,Reprint 1983 Choukambha orientalia
Varanasi , p no 345.
d) Pandit Parashuram Shastri edited, Sharangadhara Samhita Uttarakhanda
chapter 8 shloka 6O , 3rd edition, Reprint 1983 Choukambha Orientalia
Varanasi p no 345.

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The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
143. a) Satyanarayana Shastri edited, Charaka Samhita Siddhisthana chapter
1,shloka 52 Reprint 1995 Choukambha Bharati Academy Varanasi pg
no974.
b) Kaviraj Dr.Ambikadatta Shastri edited, Sushruta Samhita Chikitsasthana
chapter 40 ,Shloka -35, Reprint 2005 Choukambha Sanskrit Sansthana
Varanasi p no.183.
c) Prof. Shrikantha Murthy edited, Ashtanga Hrudaya
Sutrasthana chapter 20,shloka.23 Reprint 1996,,Krishna das academy
Varanasi ,p no.260.
d) Pa ndit Parashuram Shastri edited, Sharangadhara Samhita Uttarakhanda
chapter 8 Shloka 59 , 3rd edition,Reprint 1983 Choukambha orientalia
Varanasi p no 345.
144. a) Satyanarayana Shastri edited, Charaka Samhita Siddisthana chapter
1,shloka 52 Reprint 1995 Choukambha Bharati Academy Varanasi p
no974.
b) Kaviraj Dr.Ambikadatta Shastri edited, Sushruta Samhita Chikitsasthana
chapter 40,Shloka -34, ,Reprint 2005 Choukambha Sanskrit Sansthana
Varanasi p no. 183.
c) Prof. Shrikantha Murthy edited, Ashtanga Hrudaya Sutrasthana chapter
20,shloka.24, Reprint 1996 Krishna das academy Varanasi p no.260.
d) Pandit Parashuram Shastri edited, Sharangadhara Samhita Uttarakhanda
chapter 8 shloka 60 , 3rd edition, Reprint 1983 Choukambha Orientalia
Varanasi pg no 345.

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145. Vaidya Haridas Shridhar Kasturi 5th edition Reprint 1998 Shree
Baidyanath Ayurveda bhavana pg no.467.
146. Kaviraj Dr.Ambikadatta Shastri edited, Sushruta Samhita Chikitsasthana
chapter 40 Shloka -31 ,Reprint 2005 Choukambha Sanskrit Sansthana
Varanasi pg no. 183.
147. Pt. Hari Sadashiva shastri Paradakara Bishagacharya edited, Ashtanga
Hrudaya, Sutra Sthana, Chapter 20, Shloka No.16, Reprint, 2007,
Pub:Chaukhamba Surbharati Prakashan K.37/117, Gopal Mandir lane, post
box No.1129, Varanasi (UP), Page No.290.
148. Kaviraj Dr.Ambikadatta Shastri edited SushrutaSamhita Shareerasthana
chapter 5 shloka 22. Reprint 2005. Chaukambha Sanskrit Sansthanai
Varanasi pg. no 45
149. Shri Kashinatha Shastri edited., CharakaSamhita Vimanasthana chapter 8
Shloka 117. Reprint 1994 Chaukambha Sanskrit Sansthanai Varanasi . P no
668
150. Kaviraj Dr.Ambikadatta Shastri edited SushrutaSamhita Shareerasthana
chapter 7 shloka 25. Reprint 2005. Chaukambha Sanskrit Sansthanai Varanasi
p.no 62
151. Kaviraj Dr.Ambikadatta Shastri edited SushrutaSamhita Shareerasthana
chapter 7 shloka 25. Reprint 2005. Chaukambha Sanskrit Sansthanai Varanasi
p.no 62
152. Kashinath Shastri edited, CharakaSamhita Shareerasthana chapter 4 shloka 11.
4th ed. Reprint 1994 Varanasi: Chaukambha Sanskrit Sansthan; Varanasi.
p.no760 .

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153. Vaidya Jadavaji Trikamji Acharya edited Charaka Samhita, revised by Caraka
and Drdhabala, with Ayurvedic commentary by Chakrapanidatta on Suthra
Sthana, Chapter 11, Sloka No.43, Edition: Reprint 2008, Pub: Chaukhamba
Surbharati Prakashan, K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP), Page no.60.
154. B.D.Chaurasia, Human Anatomy Volume 3 , 6th Reprint 2OO2 p no 193
155. Vaidya Yadavji Trivikramji Acharya edited Charaka Samhitha with Ayurveda
Dipika commentary of Chakrapani Datta, Chikitsa Sthana chapter 28, Shloka
no 98, , 4th edition 1994,Pub: Chaukamba Sanskrit series office, Varanasi.
Page no 621
156. a)Vaidya Yadavji Trivikramji Acharya edited Charaka Samhitha with
Ayurveda Dipika commentary of Chakrapani Datta, Sutra Sthana chapter 4,
Shloka no 11,Page no 33, 4th edition 1994,Pub: Chaukamba Sanskrit series
office, Varanasi.
b)Vaidya Yadavji Trivikramji Acharya edited Charaka Samhitha with
Ayurveda Dipika commentary of Chakrapani Datta, Sutra Sthana chapter 4,
Shloka no 45,Page no 34, 4
th
edition 1994,Pub: Chaukamba Sanskrit series
office, Varanasi. (CH.SU 4/17)
157. Sushrutha kritha Sushrutha Samhitha with Sri Dalhanacharya and Sri
Gaydascharya, Commentory. Edited by Vaidya Jadavji Trikamji Acharya,
Pub. Chaukhambha Sanskrit Series, Varanasi, Reprint 2003, Sutra Sthana, 38
st

Chapter, 22
nd
Shloka pg 269.

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158. Vagbhat Virachita Astanga Hridayam,Edited by Dr.Brahmanand Tripathi
,Pub. Chaukhamba Sanskrit Pratisthan, Varanasi, Reprint 2003 Sutra Sthana
15
th
Chapter,33-34, Shloka pg.238.
159. Dhanwantari Nighantu with commentary and edited by Dr.S.D.Kamath;
Chaukhamba Surbharati Prakahan,Varanasi; 2nd Edition 1996, Satapuspadi
Varga 29 Shloka 85-87, Pg no-167
160. Bhavamishra ,’BhavapRakasha Nighantu”Commetary by K.c Chunekar,Edited
by Dr.G.S Pandey,Chaukambha bharathi academy.Varnasi,10th edition
1995,Haritakyadi Varga/105,Pp-984, Pg no-339
161. Bhavamishra ,’Bhavaprakasha Nighantu”Commetary by K.c Chunekar,Edited
by Dr.G.S Pandey,Chaukambha bharathi academy.Varnasi,10th edition
1995,Haritakyadi Varga/105,Pp-984, Pg no-339
162. Yoga ratnakara,with ‘Vidyotini ‘Hindi commentary By vaidya Lakshmi
Shastri,edited by Bhishagratna Brahmashankara Shastry,Chaukambha Sanskrit
sansthan,Fifth edition 1993, Dhanyadiphalakanda shaaka gunaha/40 ,Pp-504,
Pg no-28
163. Sodhala Nigandu. Dhanwantari with english commentary by Prof. (Dr)
Gyanendra Pandey and edited by Dr.R.R Dwivedi; Chaukhamba Krishnadas
Academy Varanasi; 1st Edition 2009, Satapuspadi Varga Shloka 309-310, Pg
no-243.
164. Pandit Narhari,Rajanighantu, Edited by Indradeva Tripati ,Chaukambha
Orientalia Varnasi,First edition 1982.Pipalyadi Varga,Pp-703 , Pg no-193,194
165. A).Indian medicinal plants-Vol 5 Dr P.K.Varrier,Published by Orient
Longman,Reprinting , 2002.Pg 431

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B). Priyavat Sharma,Dravyaguna Vijnana Vol-2, Chaukamba Bharathi Accademy
Varanasi, 1999.Pg 331
166. A)Bhavamishra ,’Bhavaprakasha Nighantu”Commetary by K.c
Chunekar,Edited by Dr.G.S Pandey,Chaukambha bharath i
academy.Varnasi,10th edition 1995,Haritakyadi Varga/105,Pp-984, Pg no-339
B) Acharya Sushruta, Sushruta Samhita. Edited by Dr.Shri Bhaskar Govindaji
Ghanekar, Motilal Banarasidas,Madras, Varanasi ,8th Edition
2005;Utt.18/100, Pp 812,Pg no- 641
C) Kaiya deva Nighantu ;Prof P.V.Sharrma,Chaukambha Orientalia,varanasi;First
editon 1979,Oushadhi varga Pp 696 ;Pg no 214-215.
167. Indian medicinal plants-Vol 1 Dr P.K.Varrier,Published by Orient
Longman,Reprinting 2002 ,page no 93
168. Pandit Parashurama Shastri Vidyasagar edited, Sharangadhara Samhita,
Madhyama Khanda, Chapter 9, Shloka No.1-2, 3rd edition 1983,
Pub:Chawkambha Orientalia, P.B.32, K, 37/109, Gopal Mandir lane, Varanasi
(UP), Page No.212.
169. Shri. Rajeshwardatta Shastri edited Bhaishajya Ratnavali, Chapter 5, Shloka
No. 1286-1287, Edition: Eighteenth Revised Edition 2005, Pub:
Chaukhambha Sanskrit Sansthan, varanasi, Page No. 185-186.
170. Shri. Brahmanath Tripathi edited Sharagdhara Samhitha with dipika hindi
commentary, madhyama khanda, Chapter 9, sloka no 1-18, Page no 217-220,
3
rd
edition 1998, Pub: Chaukamba Surbharthi Prakashan, Varanasi.

175. Bibliographic References
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
171. Shri. Brahmanath Tripathi edited Sharagdhara Samhitha with dipika hindi
commentary, madhyama khanda, Chapter 9, sloka no 12-15, Page no 217-220,
3
rd
edition 1998, Pub: Chaukamba Surbharthi Prakashan, Varanasi.
172. .Dr.Nishteswar & Dr.R.Vidyanath edited Sahasrayoga, Taila Prakarana Pg No:
118, Second edition, 2008, Pub: by Chaukhambha Sanskrit series Varanasi.
173. Indian medicinal plants-Vol 1-5 Dr P.K.Varrier,Published by Orient
Longman,Reprinting 2002.
174. Priyavat Sharma,Dravyaguna Vijnana Vol-2, Chaukamba Bharathi Accademy
Varanasi, 1999.

176. Annexure
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
10. ANNEXURE
DEPARTMENT OF P.G. STUDIES IN PANCHAKARMA
K.V.G. AYURVEDA COLLEGE AND HOSPITAL, SULLIA
CASE PROFORMA FOR AVABAHUKA
Title:
A COMPARATIVE CLINICAL STUDY ON THE EFFECT OF NASYA WITH
KARPASASTHYADI TAILA AND NAGARA TAILA IN THE
MANAGEMENT OF APABAHUKA
GUIDE : Dr. KRISHNA PRAKASH M. K. M.D. (AYU.)
CO-GUIDE : Dr. SANATH KUMAR D.G. M.D. (AYU.)
SCHOLAR : Dr. FEBIN. P.JOSE
Rugna nama : SR No. :
Vaya : OPD No. :
Linga : M /F IPD No. :
Jati : H /M /CH /O Bed No. :
Vyavasaya : Date :
Marital status : M / UM / W / D Group A / B :
Samajika avam arthik sthiti : P / LM / UM / R Date of Completion of trial:
Education : Un / Pr / Sec / Gr
Nivas : 1 Follow Up :
Consent: I here by agree that, I have been fully educated with the disease and
treatment, here by satisfied whole heartedly, and accept the medical trial over me.


Patient’s Signature

177. Annexure
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
1) ROGA PAREEKSHA

I) VEDANA (Complaints)

Kalavadhi Bahu (Dakshina/Vama) Shoola.

Sthabdatha.


II) TRIVIDHA PARIKSHA

A) Darsana :

• Sthabdatha:

B) Sparsana :


C) Prasana :

• Shoola:

178. Annexure
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
III) KULA VRUTTANTHA :

IV) PURVOTPANNA VYADHI VRUTTANTHA :

V) PURVA AUSHADHI VRUTTANTHA :

2) ROGI PAREEKSHA

VI) NIDANA PANCHAKA :

a) Nidana (Bahya Nidana)

AAHARA VIHAARAJA KALAJA
Katu Rasa Ativyaayaama Greeshma
Tikta Rasa Prajagara Varsha
Kashaya Rasa Asrksravana Sheetakaala
Alpa Ahara Abhighaata
Abhojana Dhatukshaya
Rooksha Bhojana Vishama Upachara
Mudga Yana
Nishpava Athibhaya
Shuskashaka Athishoka
Masura Athichintha

179. Annexure
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
b) Poorva Roopa:
c) Roopa:
Symptoms Pravara Madhyama Avara
Shoola
Sthabdatha
VYADHI BALA :- Pravara\Madhyama\Avara
d) Upashaya / Anupashaya :
Vyaayaama ( ) Seetha Kala ( )
Avyaayaama ( ) Ushna Kala ( ) Sneha Abhyanga ( )
e) SAMPRAPTI
!"#$%&
'()*"#+,
!"#$%&
#$%! -#+! &
'.)*"#+,
SAMPRAPTI GHATAKA
Dosha - Vata (vyana vata)
Kapha (sleshaka)
Dushya - Dhathu -Mamsa
Upadhathu - sira, sandhi.
Rogamarga - Madhyama
Adhisthana - Amsadesha
Vyaktasthana - Vama Bahu / Dekshina Bahu

180. Annexure
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
VI1) VYADHI VINISCHAYA :- APABAHUKA
VIII) PRAKRUTHI :-

VATA PITHA KAPHA VP VK PK SAMA


IX) SADHYA ASADYADHATHA

Sukhasadhya( ) / Kruchasadhya( ) / Yapya ( ) / Anupakrama ( )

X) Investigations
B.T. A.T.
1 Pulse /min /min
2 Resp. rate /min /min
3 Blood Pressure mm of Hg mm of Hg
4 Body Temp F F
5 Body weight Kgs. Kgs.
X1) LABORATORY INVESTIGATION: (if necessary )
1. Haematological Investigation :
Hb :
TC: DC: N __ %, L__ %, B__ %, E__ %, M__ %
ESR: __ mm after one hour Blood Sugar level: RBS ___gms /dl.
2. Routine Urine Investigation: Alb
Sugar
3. X-ray : Shoulder Joint. : AP, Lateral

181. Annexure
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
X1I) Examination of the Shoulder Joint :

Movements at Shoulder joint
Grade
DAKSHINA VAMA
Akunchana
Prasarana
Unnamana
Avannamana
Triyakgamana

XIII) CHIKITSA : TREATMENT PROTOCOL
Group A Group B

Group A :-– Nasya with Karpasasthyadi Taila.
Group B :- Nasya with Nagara taila.
Day Time Dose Observation Advise
1
2
3
4
5
6
7

182. Annexure
The Effect of Nasya with Karpasasthyadi Taila & Nagara Taila in The Management of Avabahuka
XIV) PATHYA / APATHYA :-
XV) RESULT :-


XVI) ASESSMENT CRITERIA:
Involved part:
Dakshina Bahu Vama Bahu




B.T A.T F.U 22
st
day
Shoola







Sthabdatha
B.T A.T F.U 22
st
day
Unnamana





Avannamana





Akunchana





Prasarana
Triyakgamana


Signature of the Scholar : Signature of the CO-GUIDE :
Dr. FEBIN.P.JOSE BAMS Dr. SANATH KUMAR.D.G. M.D (Ayu.)


Signature of the GUIDE : Signature of the HOD :
Dr.KRISHNAPRAKASH M.K M.D (Ayu.) Dr. N.S. SHETTAR. M.D (Ayu.)