Nasya (नस्यम्)

Nasya karma meaning Errhine therapy is one of the standard panchakarma therapy. It is one essential therapy in the treatment of urdvajatrugata vikara which means diseases pertaining to neck and above organs. There is instillation of medicated oil, churna(powder) etc in nostrils through a controlled procedure which expels the doshas through nasal pathway. Even though it is a prime treatment modality in diseases pertaining to neck and above organs and kapha doshas mainly, there are broad spectrum advantages of this therapy including preventive. Nasya karma is one of the important routines in dinacharya (daily regimen).

निरुक्तिः ॥ Nirukti

नासिकायै हितं तत्र भवो वा यत् नसादेशः । १

नासिकाभवे २ तद्धिते च ३ सुश्रुतोक्ते नासिकाहिते क्रियाभेदे ॥ (Vach.)

परिभाषा ॥ Definition

औषधमौषधसिद्धो वा स्नेहो नासिकाभ्यां दीयत इति नस्यम् | (sush.chik.40.21)

A therapy wherein medicated oil is instilled through nostrils is nasya karma.

नासायां प्रणीयमानमोउषधं नस्यम्| (Asht.sang.29.3)

Administration of medicated oil through nasal pathway is nasya karma.

This process eliminated the morbid doshas through nasal route.

नस्यभेदाः ॥ Classification

Nasya karma being a part of shodhana(purification) type of chikitsa karma, also does shamana(pacification) of doshas. There are few types of nasya karma which are classified based on their action modality, form of the medicine administered etc.

1.   Navana nasya – it is Sneha nasya meaning, oil is used as medicine for nasya instillation. (su. chik.40.23)

2.   Shodhana nasya – the dravya or drugs are chosen differently for shodhana(purification) nasya.

3.   Avapeedana nasya – the juice of herbs is extracted and instilled according to doshas in avapeedana nasya. (shar.utt.8/12)

4.   Pradhamana nasya - a very fine churna or powder of drugs is used as nasya medication n pradhamana nasya. (sush. chik.40.46)

5.   Dhuma nasya – dhumapana as a separate type of nasya has been described as well, where in medicated smoke is inhaled through nose. (char.sutr.5.46-49)

6.   Marsha-pratimarsha nasya –in marsha and pratimarsha nasya medicated oil is instilled as nasya medicine, the only difference stands is the dosage of the oil. (asht.hr.sutr.20.35) (char.sidd.9.116)

नस्यकर्म अर्हाः तथा अनर्हाः ॥ General indications and contraindications of nasya karma

Following are the conditions wherein nasya can be done under the proper guidance of a Vaidya.

नस्यकर्म अर्हाः ॥ Who are Fit for Nasya karma?

Those who are suffering from,

1. Shirosthamba (stiffness of head)
2. Dantasthamba (stiffnes in teeth)
3. Manyasthamba (neck stiffness)
4. Hanugraha (lockjaw/ jaw stiffness)
5. Peenasa (rhinitis/ common cold)
6. Galashundika (tonsilitis)
7. Timira (eye condition)
8. Vartma roga (disorders of eyelid)
9. Akshi roga(eye diseases)
10. Nasa roga (diseases pertaining with nose)
11. Ardhavabhedaka (migraine)
12. Ardita (facial palsy)
13. Shiro roga (diseases of head regien/ neurological conditions)
14. Apatanaka (convulsions)
15. Vak graha (speech disorders)
16. Swara bheda (hoarseness of voice)
17. Arbuda (tumours) Etc

(char. sidd.2.22)

नस्यकर्म अनर्हाः ॥ Who are Unfit for Nasya karma?

1. Ajeerna (indigestion)
2. Bhuktabhakta (just intaken food)
3. Peetasneha (intaken heavy amount of Sneha or fat)
4. Madyapana (alcoholic)
5. Snaatshira (taken head bath)
6. Trishnaarta (thirsty)
7. Shramarta (exhausted)
8. Murchhita (unconscious)
9. Garbhini (pregnant lady)
10. Anuvasita (who has taken anuvasana basti)
11. Anrutu (unseasonal)
12. Durdine (cloudy weather) etc

(char. sidd.2.21)

नस्य कर्मम् ॥ Procedure

The therapy of Nasya karma is divided in three sections

PURVA KARMA (PRE-PROCEDURE)

PRADHANA KARMA (MAIN PROCEDURE)

PASCHAT KARMA (AFTER PROCEDURE)

पुर्व कर्मम् ॥ Purva karma (Pre-procedure)

Every purva karma or pre procedure although being very basic plays an important role in the pradhana and paschat karma of nasya therapy.

Collection of materials – before nasya karma equipments and materials like nasya yantra, dhupana yantra etc required for the therapy is kept ready. Nasya oil or churna etc, medicines for complications etc are kept ready beforehand.

A special is assigned for patient which is devoid of dust direct air and AC, with good amount of light arrangement. (sush. chik.40.25)

Examination of patient – a Vaidya decides whether the patient is fit or unfit for nasya karma.

Abhyanga and swedana – patient is made to lie down on nasya table comfortably and mild abhyanga is done to face and neck region for about 15 min with medicated oil. (sush. chik.40.25). this is followed by swedana or steam therapy which is very mild and limited to face and neck only. Few times a towel is dipped in hot water and patted mildly over face in patients who are not indicated for swedana (steam therapy).

Snehapapana – oral administration of Sneha or ghee is not done in nasya.

Assessment of patient – Patient or individual is assessed based on various parameters like, Dashavidha pareeksha or 10-fold examination which includes assessment of prakrti of patient, aggrvated doshas, balam (strength), Kala (time of the year and climate), age and many other aspects. Ashtavidha pareeksha or 8-fold examination which includes nadi (pulse), bowel, bladder movements etc.Few biochemical tests would be conducted if and how necessary.

Patient is well informed about the procedure in advance and is expected to have a good night’s sleep, clear bowel movements. Patient or individual must be in a positive and calm mood for ease of the overall procedure.

प्रधान कर्मम् ॥ Pradhana Karma (Nasya procedure)

(char. sidd.9.92-102) (asht. sang. sutr.29/16) (sush. chik.40.26)

Patient is advised to lie down in supine position comfortably. Head of patient is elevated mildly.

Patient or individual’s eyes are covered with soft cotton cloth or cotton only.

Tip of the patient’s nose is raised a little and medicated oil is inserted drop by drop in both nostrils as instructed by Vaidya. A nasya yantra (equipment to instil nasya medicine) is used for oil instillation or a dropper.

Oil is not be too hot or cold, it is of lukewarm temperature.

Patient is advised to remain relaxed during the whole procedure. Also, talking, getting angry, laughing are to be avoided during nasya drops instillation.

After the whole procedure patient is kept under observation. This is mandatory for assessment of samyak yog(appropriate), ayoga(incomplete) and atiyoga (excess) evacuation of doshas.

Time for nasya administration- nasya therapy is indicated only in pravrut(early ran), sharad and vasant rutu in classics, but nasya can be administered at certain timings considering the requirements of patient. In summer season, it should be instilled in morning, in winter during noon time and in rainy season nasya is administered when sky is devoid of clouds.(char.sidd.2.23)

पश्चात कर्मम् ॥ Pashchat Karma

After nasya karma, patient is advised to rest. Feet, palms, shoulders of patient are gently massaged. (asht. sutr.20.20)

Patient is advised to spittle excessive medicine that might have come into throat and avoid swallowing the same.

Dhumapana and Gandusha – Dhumapana meaning medicated smoke is given to patient after nasya karma to eliminate any excess kapha dosha lodged locally. Gandusha meaning gargle with medicated decoction is given for cleansing of mouth and throat, and to remove any remnant morbid doshas locally.

Restrictions – patient should avoid getting exposed to heavy winds, excess dust, sunlight. Any contact with cold water should be avoided, sleep during daytime is contraindicated. (char. sidd.9.106-108) (sush. chik.40.31)

Diet – Excessive fatty or liquid diet is to be avoided; light meal is advised after nasya karma. Drinking warm water is advised. Cold, refrigerated water must be avoided. (char. sidd.9.106-108) (sush. chik.40.31)

Any kind of complication if may occur are treated with apt medicines.

नस्य कार्मुकता ॥ Mode of action

According to ayurvedic classics

नासा हि शिरसो द्वारम्|

तत्रावसेचितमोउषधं स्रोतः शृङ्गाटकं प्राप्य व्याप्य च मूर्धानं नेत्रश्रोत्रकण्ठादि-

सिरामुख़ानि च मुञ्जादिषीकामविसक्तामूर्ध्वजत्रुगतां

वैकारिकीमशेषामाशु दोषसंहतिमुत्तमाङ्गादपकर्षति||३||

Nasa or nostrils are the pathway to shiras(brain). Thus, when medicine is administered through nostrils it reaches shrungataka marma (a point in brain where energies are concentrated). From here on the medicine gets distributed further by opening of channels which are blood vessels of eye, throat and ears. Thus, due to presence of active ingredients in the medicines the morbid doshas get eliminated just like removing grass from its roots. Precisely, when the medicated oil or churna etc enters nose, the active compounds eradicate the morbid doshas completely from the system.

From modern point of view there is no direct pharmacodynamic corelation between nose and cranial organs. Moreover, there is a strong security system of blood brain barrier system present in the body. But the fact cannot be denied that whenever there is any irritation in the body, there is increased circulation and permeability of the blood vessels. When it comes to absorption of drug, the position of head helps retention of medicine in nasopharynx, on the other hand, local massage and fomentation will enhance the drug absorption. (Dr. Vasant c patil, Principles and practice of panchakarma, (chaukhamba publications, fifth edition 2015, chap-14, page no. 562-564)