Nasya karma

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

1. Dr. Shanthan Nasya Karma

2. Definition नस्तःकर्म च कुर्वीद शिरोरोगेषु शास्त्रविद द्वारम् हि शिरसोनासा तेन तद्व्याप्य हन्ति तान II (च.सि. ९-२५) औशधम् औशधसिद्धम् स्नेहोवा नासिकाभ्यां दीयते इति नस्यं (सु.चि. ४०) ऊर्ध्वजत्रु विकारेषु विषेशान्नस्यमिष्यथेय नासहि शिरसो द्वारम् तेनातद्यापि हन्ति तान II (अह. सु. २०)

3. Introduction Nasya karma basically means instilling the medicated oils, liquids, powders into the nose, to achieve a desired therapeutic effect It need not be always an therapeutic procedure, but can also refer to one among the daily activities of a svasthya Nasya has been mentioned as a part of dinacharya , and it’s daily practice has been in use for several years

4. Types of Nasya According to:- Charaka- Navana , Avapida , Dhmapana , Dhuma , Pratimarsha Susrutha- Nasya , Sirovirechana , Pratimarsha , Avapida , Pradhamana Vagbhata - Virechana , Brumhana , Shamana Sarangadhara Samhita- Rechana , Snehana According to ashraya bheda शिरोविरेचनं सप्तविधं फलपत्रमूलकन्दपुष्पनिर्यासत्वगायथः भेधात्

5. Acharya No. Of Types Reference Classification Charaka 3 Cha. S i.9/92 Rechana , tarpana , shaman 5 Cha. Si. 9/89 Navana , avapida , dhmapana , dhuma , pratimarsha 7 Cha. Vi. 8/151 Yoni/ ashraya bheda Susrutha 5 Su. Chi. 40/21 Sirovirechana , pradhamana , avapida , nasya , pratimarsha Vagbhata 3 Ah. Su. 20/2 Virechana , brumhana , shaman Sarangadhara 2 Sa. Ut. 8/2-11-24 Rechana , snehana Kashyapa 2 Brumhana , karshana

6. नावनं चावपीदश्च ध्मापनं धूम एव च प्रतिमर्षश्च विज्ञेय नस्तःकर्मःतु पञ्चधा II Types of Nasya

7. स्नेहनं शोधनं चैव द्विविधं नावनं स्मृतं शोधनं स्तंभनश्च स्यादवपीदो द्विधा मतः

8. Dhmapana i.e insufflation of drugs in powder form is srotovishodhana i.e cleanses the channels ofbody Pratimarsha serves both the purposes i.e oleation and elimination

9. As a whole, the Nasya karma can be categorised into three varieties, based on their pharmacological action:- Rechana - which eliminates the doshas विरेचनं शिरःशूल अन्गस्यान्दगलामये शोफगन्द कृमिग्रन्थि कुष्टापस्मारपीनसे Tarpana - it provides nourishment to the organs of head बृंहणं वातजेशूले सूर्याव्वर्ते स्वरक्षये नासशोषे वाक्सङ्गे कृच्छबोदावबाहुके Shamana - Which pacifies alleviated doshas in head शमनं नीलिकाव्यन्गा केशदोशाक्षिराजिषु यथास्यं योगिकौ स्नेहौ यथास्वं च प्रसाधितौ

10. What For What? Rechana nasya Tarpana nasya S hamana nasya

11. In a Gist…. Navana Nasya : instilling medicated oil or ghrita Avapida Nasya : nasya with juice extracted from the drug Dhmapana Nasya : blowing fine powder of drug into nostrils Dhuma Nasya : medicated smoke inhaled through nose and exhaled through mouth Marsha Nasya : Instilling oils in higher dose to achieve instant result Pratimarsha Nasya : Instilling oils in lower dose, has no complications, advised for all.

12. Drugs Used In Nasya फलादिभेशजं प्रोक्तं शिरसोयद्विरेचनं तच्चूर्णं कल्पेयेत्तेन पचेत् स्नेहं विरेचनं In Charaka Vimana Sthana Chapter 8, seven categories of plant parts viz., fruits, leaves, roots, rhizomes, bark, flowers, exudates are mentioned. They can be used in powder form or can be processed in oil form and used to achieve siro virechana (Cha.Vi.8/151) यदुक्तं मधुरस्कन्धे भेषजं तेन तर्पनं Oils may be processed by the drugs of madhura skandha (Cha. Vi-8/139), and can be used for tarpana type of nasyam

13. Acharya Charaka metioned few drugs in apamargatanduliyadhyaya of Sutrasthana . Few on them include:- Apamarga Pippali Vidanga Shigru Maricha Sarshapa Sirishs Haridra Lavana Nagara Jyotishmati गौरव शिरसःशूले पीनसार्थावभेधके कृमिव्यध्यावपस्मारे घ्राननाशे प्रमोहके

14. General Indications of Nasya Sirostambha Ardhavabhedaka Vakgraha Shirahshula Grivaroga Akshishula Svarabheda Shuklaroga Netraroga Galashundika Tundikeri Galashaluka Timira Galaganda Vartmaroga Nasashula Upajihwaka Pinasa Manyastamba Ardita Dantastamba Apatantraka Dantaharsha Karnashula Chaladanta Arbuda Hanugraha Skandaroga Mukharoga Amshashula Khalitya Palitya

15. General Contra- Indications of Nasya Bhuktabhakta (just after meals) Ajeerna Pita sneha Pita madya Pita toya Snata shirah Snatukama Kshudartha Sramartha Matta Murchita Shastraghata Vyayava klanta Vyayama klanta Pana klanta Navajvara Shokabhitapa Virikta Anuvasita Garbhini Nava pratishyaya Apatarpita Pitadrava Trushna Garatha Kruddha Bala Vruddha

16. Indications Depending on the Type of Nasya Snehana Sodhana Avapida Pradhamana Vatika sirahshula Kaphapurna talu / shiras Manasa roga Mano vikara Keshapaata Praseka Apasmara Ati Uttklishta Dosha Danta pata Aruchi Sirovedhana Krumi Smashru pata Shirogourava Moha / Murcha Visha Tivra karna shula Urdhva jatrugata sopha Apatantraka Sangna nasha Timira Pinasa Chitta vyakulavastha Nasa roga Arthavabhedaka Krisha / Visha Mukha sosha Krimi , Kotha Sanyasa Avabahuka Pratisyaya Bhaya / Bhiru Vali- palita Apasmara Krodha Mukha roga Gandhajnana nasha Stri / Krisha

17. General Dose of Nasya Karma Type of Nasya Hrasva Madhyama Uttama Snehana Nasya 8 16 32 Sodhana Nasya 4 6 8 Marsha Nasya 6 8 10 Avapida Nasya 4 6 8 Pratimarsha Nasya 2 2 2 Dose of Nasya Karma according to Sarangadhara Tikshna aushadi churna - 24 ratti Hingu - 1 yava Saindhava - 1 masha Dugdha - 8 sana Jala - 3 karsha Madhura dravya - 1 karsha

18. Nasya Kala Rtu Time of Nasya Grishma Morning Sisira Afternoon Varsha In clear morning Sarat + Vasanta In morning Sisira + Hemanta Afternoon Grishma + Varsha Evening Doshic Predominance Time of Nasya Kaphaja Vikara Morning Pittaja Vikara Afternoon Vataja Vikara Evening

19. Duration Of Nasya Karma Name of Acharya No of Days Charaka Depending on the severity Susrutha 1, 2, 7, 21 Vagbhata 3, 5, 7, 8

20. Samyak Yoga, Atiyoga and Ayoga Lakshana Samyak Yoga Lakshana :- उरह्शिरोइन्द्रिय लाघवश्च स्रोतोविषुद्धिश्च भवेत्विषुद्धै Ayoga Lakshana :- गलोपलेपः शिरसोगुरुत्वा निष्तीवनं चाप्यदुर्वीरिक्ते Atiyoga Lakshana :- शिरोक्षिशङ्का स्श्रवनार्तितोद अत्यर्थषुद्धे तिमिरं च पश्चेत

21. Nasya Karmukhata नासाहि शिरसो द्वारम् तत्रावसेचितं औषधंस्रोतः स्रुन्गातकं प्राप्यं व्याप्य मूर्धानं नेत्रस्रोत्रकन्तादि शिरामुखानि च, ऊर्ध्वात्रुगता वैकारिकी अशेषं आशु दोष संहति उत्तमाङ्गं गदापकर्षति II (अ. हृ. सू. २९/३) The drug administered reaches the srungataka marma , then spreads in murdha , netra , karna , kantha , siramukha , then scratches the morbidly attached doshas , and expels them out

22. Mode of Action of Nasya As such there is no direct relation between the nasal cavity and the brain. But the drug transport can be occurring in three different pathways By simple Diffusion across the nasal mucosal epithelium Vascular pathway Lymphatic pathway Olfactory Pathway

23. Vascular Pathway The facial vein has no valves and is directly related to Intracranial Circulation. Also the supra-orbital veins and the ophthalmic vein drain into facial vein, which directly pools into the cavernous venous sinus The drug which is held in the posterior nasal cavity, that too in head lowered position due to gravity enters the blood pool, and thus it’s absorption into the meninges and the intracranium can be considered.

24. The Olfactory Pathway The major part of the nasal cavity is covered with respiratory epithelium, where drug absorption can be easily achieved The olfactory epithelium is present in the upper posterior part and is supplied by the olfactory nerves, which connect to the olfactory bulb of brain However the transfer of drugs is hindered by BBB, but it has an affinity towards lipophilic molecules

25. Olfactory Pathway The olfactory nerves are connected to higher centres of brain such as amygdalus , limbic system, hypothalamus.. Etc As we know the Limbic System controls the behavioural pattern and emotions, and the Hypothalamus controlling the ANS and co-ordinating between the Endocrine and Nervous Systems. Hereby, the medicated oils given through nasal passage may stimulate the olfactory nerve endings and also may transport across the olfactory tract to reach the higher centres of brain.

26. Olfactory Pathway

27. Factors affecting the Nasal Absorption Nasal ph Particle Size of the drug administered Local Capillary drainage Gravity Affinity of the drug to the nasal epithelium

28. What possibly is Happening? Navana Nasya:- The Nasya Oushadhi having oil base is easily absorbed across the mucosa, as it is highly lipophilic in nature. It could either stimulate the nerve endings, thereby stimulating the higher centres of brain, or reach there via Trans-Neuronal Pathway Taila being sukshma , tikshna and ushna in nature penetrates deep into the tissues, and may transport the drug across the tract

29. Avapida Nasya:- As the drug is squeezed directly into the nasal cavity, by virtue of its pungent action, it may instantly stimulate the the nerve endings and the nasal mucosa As mentioned earlier, the olfactory tract is directly connected to the higher centres of brain such as the Limbic System which controls the emotions And already it has been discussed that avapida nasya is effective in psycho-somatic conditions, this gives a hint of what’s happening

30. Pradhamana Nasya:- As powders of the drug are blowed into the nose, it creates an immediate reflex action, and irritates the nasal mucosa It increases the nasal secretion, and thereby clears the congestion and drains the accumulated phlegm in the region As it is highly irritant in nature, it is helpful in gaining back the consciousness in patients suffering from apasmara , unmada , moha , murcha … etc

31. Conclusion On a whole, the nasya karmukhata mentioned in Ayurveda and the mode of action of nasal administration are identical However the effect of Nasya Karma in Musculo -skeletal cases such as Torticollis, Cervical Spondylosis… Etc have to be understood, taking into consideration the REFLEX ARC Mechanism The Exact Mechanism has to be studied en -masse, taking into consideration the detailed analysis of the nasya oushadi using HPTLC, Particle Size Assessment RCCT and Double Blind Placebo Study helps to establish the efficacy of Nasya Karma