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3.7 Nasya Karma

Nasyakarma is one among the Panchakarma in which the medicated drugs are

administered through the Nasal route which is meant for the Shirogataroga and

specially Nasagataroga which is mentioned by most of Ayurvedic scholars and in

ancient literature. Urdhvanga chikitsa is one of the important branches of Ashtanga

Ayurveda and Nasyakarma is the main therapeutic measure of Urdhvajatrugata roga.

All sense organs, which are above the clavicle, are considered as Urdhvanga e.g.

Nasa, Mukha, Netra and Shiras.

Historical Background

Eradication of diseases from the routes of Nasa (Nostrils), Chibuka (Chin), Shira

(Head), Karna (ear) and Jiwha (tongue) are mentioned in Rigveda (Ri.V. 10-16-4).

Etymology

The word Nasya is derived from „Nasa‟ Dhatu. In Ayurvedic texts, Nasa

Dhatu is used in sense of Nose (Nasa Nasikayam)68

. The literal meaning of the word

Nasya is the thing beneficial to the Nose.

Definition

Transnasal drug administration is called as Nasya, which are in the form of

Kwatha, Swarasa, Kalka, Sneha etc69, 70, 71

Synonyms

1. Shirovirechana72

2. Nastapraschardhana

3. Navana

4. Nastahkarma

5. Shirovireka

6. Murdhavirechana

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Amongst the various synonyms of Nasya karma Shirovirechana, Shirovireka and

Murdhavirechana are suggestive of elimination of Doshas from the Shiras or parts

situated above the clavicle i.e. Prachchardana, whereas the terms Nastaha and Navana

indicates site of administration.

Benefits of Nasya:

Patient who regularly undergoes Nasyakarma does not become victim of

diseases of eyes, ears and nose. His hair and beard does not turn gray. His hair doesn‟t

falls but instead grows faster. The joints, sinus, tendons and bones of his cranium

acquire great strength. His face becomes cheerful and plump and his voice becomes

mallow, firm and stentorian. He gets clarity of senses, good smell of mouth etc. He

never suffers from the premature appearance of wrinkles and Vyanga. There will be

no sudden invasion of disease above the clavicle (Urdhvajatrugata) of the body.

Diseases like Migraine, Rhinitis, headache, facial paralysis, etc. can be alleviated with

the practice of nasya karma73

.

Classification of Nasya

Classification of Nasya is done in various manners depending upon various

factors like form of drug, mode of action etc. as shown in the table

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Table No1 of Classification of Nasya

Sl.No Athours Types Names

1. Charaka 3types Mode of action:

Rechana, Tarpana, Shamana

5types Method of administration :

Navana, Avapidana, Dhmapana, Dhuma, Pratimarsha

7types According to various parts of drugs utilized:

Phala, Patra, Mula, Kanda, Pushpa, Niryasa,

Twaka74,75

2. Sushruta 5types

Shirovirechana, Pradhamana, Avapida, Nasya,

Pratimarsha76

3. Vagbhata 3types Virechana, Brimhana, Shamana77

4. Kashyapa 2types Shodhana, Poorana78

5. Sharangadhara 2types Rechana, Snehana79

Acharya Charaka‟s classification of all the above mentioned types of Nasya

can be interpreted as follows.

1. Navana Nasya :

Method : Transnasal administration of Sneha dravya is considered as Navana Nasya.

Classification – i.Snehana Nasya ii. Shodhana Nasya.

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Snehana Nasya :

The Nasya which gives strength to all the Dhatus and is used as

Dhatuposhaka.

Dose : (i) Hina Matra – 8 drops in each nostril.

(ii) Madhyamamatra – Shukti Pramana - 16 dropsin each nostril.

(iii) Uttama Matra- Panishukti Pramana–32 drops in each nostril80

.

Indications: Vatika Shirahshula, Keshapata,Dantapata, Shmashrupata,

Tivrakarnashula, Timira, Nasaroga, Mukhashosha, Avabahuka, Akalaja

Valita,Akalaja Palita, Darunaprabodha and Vatapittaja Mukharoga 81

.

Shodhana Nasya :

Sushruta‟s Shirovirechana type is included in Shodhana type of Navana

Nasya. It eliminates the vitiated Doshas.

Drugs: In this type of Nasya, oil prepared by Shirovirechana Dravyas like Pippali,

Shigru etc. can be selected.

Dose: It can be given in following dosage schedule 82

(i) Uttama - 8 drops

(ii) Madhyama - 6 drops

(i) Hina - 4 drops.

Indications: Kaphapurna Talu & Shira, Aruchi, Shirogaurava, Shula, Pinasa,

Ardhavabhedaka, Krimi, Pratishyaya, Apasmara, Gandhagyananasha and

Urdhvajatrugata Kapharogas83

.

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In healthy persons Navana Nasya given according to the following seasonal

schedule.

Season Nasya kala

(i) Shita Kala :Noon

(ii) Sharada and Vasanta :Morning

(iii) Grishma Rutu :Evening

(iv) Varsha Rutu :Only when the sun is visible.

Time Schedule84

:

I. In Kaphaja Roga :Fore noon

II. In Pittaja Roga :Noon

III. In Vataja Roga :After Noon

2. Avapida Nasya :

Definition:It is the extracted juice of leaves or paste (kalka) of required medicine.

Method85,86

: Transnasal administration of the liquid media (other than Sneha) by

means of either squeezing the kalkawhich is taken in a clean cloth or by dipping the

cotton swab into the Shrita (decoction) or Sheeta (cold infusion), Swarasa (juice)87

of

the required drug to get the proper quantity of the Nasya dravya.

Types: (i) Stambhana Nasya (ii) Shodhana Nasya88

.

Drugs :

Kalka of Tikshna and Stambhana Dravyas have been mentioned as Avapida

Nasya for Shodhana and Stambhana purpose.

Dose: Like Shirovirechana, Avapida Nasya should be given in the following dose89

.

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Hina Matra - 4 drops

Madhyama Matra - 6 drops

Uttama Matra - 8 drops

Indications – Manasaroga, Moha, Krodha, Bhiru, Sukumara, Chitta, vyakulavastha,

Bhaya Krisharogi, Murchha, Sanyasa, Apasmara, Shirovedana, Mada, Raktapitta,

Vishabhighata, Apatantrka90

Galaroga,Vishamajwara, Manovikaraand, Krimi91

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3. Dhmapana Nasya :

Dhmapana or Pradhamana is a specific Shodhana Nasya.

Definition: This type of Nasya is instilled with churna (powder) specifically for

Shirovirechana. Sushruta has used the term Pradhamana instead of Dhmapana92

.

Method: The required medicated Churna is taken and kept at one end of the Nadi

yantra and air is blown from the other end, so that the medicine may enter into the

nostrils93

.

Dose: According to Videha the dose of Dhmapana Nasya is three Muchuti.

Drug: The generally used drugs for Pradhamana Nasya are Saindhava, Pippali,

Maricha, Vidanga, etc which are Tikshna in nature. Hence care should be taken in a

proper way94

.

Indications: Shiro Roga (Disease of the head), Nasa Roga (Disease of the nose),

Akshi Roga (Disease of Eye)95

4. Dhuma Nasya :

Definition: Dhuma Nasya is defined as a process in which the medicated fumes are

taken by nasal route and eliminated by oral route.

Types : i Prayogika ii Snaihika iii.Vairechanika

Instrument: A special instrument is for the Dhuma Nasya which is known as

Dhumanadi (smoking pipe). It should be of 24 angulas length and breadth of

measuring one‟s own angula for Virechana type of Dhumanasya. 32 Angula length

for Sneihika Dhuma and 36 Angula length of Prayogika Dhuma is advocated96

.

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Dose: During the prescribed time, a wise person should smoke twice for habitual

variety of smoking, Once for Sneihika Dhuma (Unctuous variety) and three to four

times for the Vairechanic Dhuma (eliminative variety of smoking).

Drugs: For Prayogika Dhuma drugs like Priyangu, Ushira etc. should be used. For

Sneihika Dhuma Vasa, Ghrita etc. and for Vairechanic Dhuma, drugs like Aparajita,

Apamarga etc. should be used97

.

Indication.: Dhuma Nasya is indicated in Shiroroga, Nasaroga and Akshiroga

98.

5. Marsha/ Pratimarsha Nasya :

Definition:

Marsha and Pratimarsha both consists of transnasal administration of Sneha. It

is well tolerated and is a very much convenient procedure.

Pratimarsha and Marsha are same in principle, but the main difference

between them is of dose. In Pratimarsha Nasya 1-2 drops are given while in Marsha

Nasya the dose is 6 to 10 drops.

Pratimarsha Nasya:

Pratimarsha Nasya can be given daily and even in all the seasons at morning

and evening99

.

Method –It is given by dipping the finger in the required Sneha and then dropping it

in the nostrils. The patient should be advised not to sniff the Sneha given in the form

of Nasya.

Dose – 2 drops morning and evening. The Sneha should at least reach from nose to

gullet, but it should not be too much that could produce secretion in gullet.

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Indications: Bala, Vridhdha Bhiru Sukumara, Kshata, Kshama Trishna Pidita

Valita, Palita, Mukhashosha100

.

Contraindications: Dushta Pratishyaya, Krimija Shiroroga, Badhirya (deafness)

Bahudosha, Utklishta Doshas, Madhyapi101

.

Timings for Pratimarsha Nasya application

The most commonly mentioned time of Pratimarsha nasya as are After

leaving the bed in morning , After exercise , After sexual intercourse, After walking,

After kavala, After anjana, After sleeping in the noon, and in the evening. Alongwith

the above, the specific time mentioned by Sushruta are- After passing apanavayu,

after sneezing, by Vagbhata are-After shiroabhyanga and After laughing. and by both

Sharangadhara and Vagbhata are- After vomiting and after defecation. Sushruta and

Sharangadhara have added an extra timing- Before going outside102,103,104

.

Marsha:

Transnasal administration of Sneha in the nostrils from 6 to 10 drops is known

as Marsha. Marsha Nasya gives more side effects (Vyapad) but it gives quick result and

is more effective than Pratimarsha Nasya105

.

Classification ofNasya according to Pharmacological action.

(i) Rechana (Virechana) means purificatory,

(ii) Tarpana (Brimhana) means nourishing and

(iii) Shamana106

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1. Rechana Nasya (Virechana Nasya)

Definition:

Elimination of vitiated Doshas from Urdhvajatrugata part of the body by

means of transnasal administration of medicated drugs is known as Rechana Nasya.

Drugs: Apamarga, Pippali, Maricha etc. may be used for Rechana Nasya. It may also

be given with Tikshna Sneha, Kwatha or Swarasa of Shirovirechana drugs or by

dissolving these drugs in Madya, Madhu, Saindhava, Asava, Pitta and Mutra or mixed

with the drugs according to the diseases107,108

.

Indications: It is indicated specifically in Kapha dominant Shiroroga like Stambha,

Supti and Guruta of Shira109

.

Sushruta and Vagbhata have indicated Rechana Nasya in Shleshma

Abhivyapta in Talukantha and Shirokrimi, Arochaka, Shula, Shirogaurava, Pinasa,

Pratishyaya, Urdhvajatrugata Kaphaja Vikara110

.Urdhvajatrugata Shopha, Praseka,

Vairasya, Arbuda, Dadru and Kotha111

. Rechana Nasya by using Sneha is best

indicated to the afraid, women, weak and delicate patients. Shirovirechana Nasya with

Kalka, Churna or Swarasa are indicated in Patients of Galaroga, Sannipataja Jwara,

Atinidra, Manovikara, Abhishyanda Sarpadansha and Murchha112

.

2. Tarpana Nasya:

Tarpana Nasya of Charaka can be considered as synonym for Snehana Nasya

and Brimhana Nasya described by Sushruta, Sharangadhara and Vagbhata

respectively.

Drugs: The Sneha prepared with Vatapittahara drugs should be used and the drugs of

Madhura Skandha113

are also useful114

Sneha prepared with Snigdha and Madhura

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drugs or with the drugs described useful for that particular disease and Exudations of

certain trees, meat soup and blood may also be administered115

.

Indications: Vatapittaja Rogas like Dantapata, Keshapata, Darunaka, Vatika

Shiroroga116

.

3. Shamana Nasya:

Definition: The type of Nasya which does the alleviation of Dosha situated in Shirah

(head) is known as Shamana Nasya.

Indications: It is used to stop bleeding in Raktapitta. It is also indicated in Akala

Valita, Palita and Khalitya, Darunaka, Raktaraji, Vyanga and Nilika117

.

Indications of Nasya

Charaka has explained the following general indications Shirasthamba, Griva

Roga, Manyasthamba, Skandharoga, Dantastamba, Mukharoga, Danta Shula, Karna

Shula, Hanu Graham, Nasa Shula, Pinasa, Akshi Shula, Gala Shundika, Shirashula,

Gala Shaluka, Ardita, Sukla Mandala Gataroga, Apatantraka, Timira, Galaganda,

Vartmaroga, Danta Harsha Vyanga,Netraraji , Upajihvika, Arbuda, Ardhavabhedaka,

Swarabheda, Suryavarta, Gadgatatwa, Apabahuka, Kesadosha, Apasmara.

Contra Indications of Nasya118,119,120

:

Nasya should not be given on Durdina (Rainy day) or in Anrutu (Viparita

Kala). Charaka, Sushruta and Vagbhata commonly contraindicated conditions are

during bhuktabhakta, pita sneha, pita madhya, pita toya, snatu kamah, garbhini and

anuvastita (Sushruta and Vagbhata-databasti). Charaka and Sushruta commonly

contraindicated conditions are during shramarta, vyayamaklanta, trishnarta and ajirna,

virikta. Acharya Charaka and Vagbhata have contraindicated in commonly like during

snehadi patukamah, snatah shirah and kshudharta. As per Sushruta & Vagbhata,

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during gararta, vegavarodhitah and pitadravah, apatarpita have been contraindicated

commonly. Acharya Charaka, during Navapratishyayarta, matta, murcchita,

shastradandahrita, vyavayaklanta, panaklanta, navajwara pidita and shokabhitapta are

the exclusive conditions of contraindication. As per Sushruta, during kruddha, bala

and vriddha are the exclusive conditions of contraindication. As per Vagbhata, during

raktasravita, sutika, shvasapidita and kasapidita are the exclusive conditions of

contraindication.

Suitable Time for Nasya:

a) Time schedule in different seasons

In Grishma Rutu, Shita Rutu and Varsha Rutu Before noon (morning), Noon

and when the sky is clear are considered as the ideal time for administration of Nasya

respectively121

.

b) Time schedule in Doshaja Vikara122

• Kaphaja Vikara - Morning

• Pittaja Vikara - Noon

• Vataja Vikara - Evening

Suitable Age for Nasyakarma123

:

Above 7 years upto 80 years of the age is considered as the suitable age for

Nasyakarma.

Duration of Nasya Karma:

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Table No: 2 Showing the Duration of Nasyakarma

S.No. Name of authors Duration

1. Sushruta124

. 1,2,7, 21 days

2. Bhoja125

9 days

3. Vagbhata126

. 3, 5,7,8 days

Dose of Nasya Karma127

:

Sushruta and 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 index finger in any Dravadravya.

Table No: 3 Showing the Dosage of Nasya Karma

No. Type of Nasya

Drops in each Nostril

Hrasva

Matra

Madhyama

Matra

Uttam

Matra

1 Shamana Nasya 8 16 32

2 Shodhana Nasya 8 12 16

3 Marsha Nasya 6 8 10

4 Avapida Nasya (Kalka Nasya) 4 6 8

5. Pratimarsha Nasya 2 2 2

Nasya Karma Procedure

The procedure of Nasya karma may be classified under following headings:

i) Poorvakarma ii) Pradhana Karma and iii) Pashchat Karma

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i) Poorvakarma:

For Nasya karma, Special room should be prepared which should be free from

atmospheric effects like direct blow of air or dust and it should be ventilated and

lighted properly.

Nasya asana: To perform Nasya for sitting and lying purpose two asanas are essential

1. A chair for sitting purpose

2. A cot for lying purpose this helps for proper administration of Nasya dravya and to

reach the dravya to its target area.

Medicine for Nasya: Drug required for Nasya karma in the form of Kalka, Churna,

Kwatha, Ksheera, Udaka, Taila, Ghrita etc. should be collected in sufficient quantity

and with necessary utensil, for paschat karma Kavala, Gandusha yoga.

Nasya Yantra: Dropper or Pichu or Gokarnayantra- For Snehana, Avapeeda, Marsha

and Pratimarsha Nasya. Shadangula nadi for Pradhmana Nasya.Dhuma Yantra for

Dhuma Nasya Besides it is also necessary that a heater, bowl, napkins, spitting pits

and an efficient assistant are kept ready.

Selection of the Patient: Yogya patient should be selected accordingly.

Preparation of the Patient: Patient should pass his/her natural urges like urine and

stool. He should have completed his routine activities. Vital examinations like BP,

Pulse, Respiration rate and Heart rate are checked. After preparation of patient by

above said regimens, snehana and swedana should be done. Here, Snehana means,

Mridu Abhyanga. It should be done on scalp, forehead and neck for 3 to 5 minutes by

medicated oil according to requirement. After Abhyanga, Mridu Swedana should be

done on Shira, Mukha, Nasa, Manya, Greeva and Kantha. Though according to

Ayurvedic texts, Swedana should not be done on the head, but for the purpose of

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elimination and liquification of dosha,Mrudu Swedanacan be done as Purva karmaof

Nasya128

.

Pradhana Karma:

Patient should lie down in supine position on Nasya table. The head of the

patient should be lowered. The position of head should not be excessively extended.

After covering of eyes with cotton gauze, the tip of patient‟s nose should be drawn

upward by the left thumb (angushta) of the Vaidya. At the same time with the right

hand Vaidya should instill lukewarm medicine in the nostrils, alternately, with the

help of proper instrument. The drug should be installed into nostril in required

dose129,130,131

. The patient‟s should be counseled to remain relaxed at the time of

administration of Nasya and he should avoid speech, anger, sneezing, laughing and

shaking his head132

.

Paschatkarma:

After the administration of nasya. Patient should be in lying position and

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

should be done on forehead, cheeks and neck for pacifying Vatadosha. The patient

should be asked to expel out the medicine which comes in oropharynx. Care should

be taken that no portion of medicated oil is left inside. Medicated Dhumapana and

Gandusha are advocated to expel out the residue mucous lodged in Kantha. Patient

should be advised to stay in warm place. A light meal and lukewarm water are

advised133

.

Post Nasya instructions: avoid dust, day sleep, and should not use cold water for

any purpose like pana, snana, atapa sevana, abhishyandi ahara, Madhya, Vyavaya,

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Vyayama, avoid smoke, sunshine, anger, riding, excessive intake of fat and liquid

diet134

.

Samyaka Yoga, Ayoga and Atiyoga of Nasya Karma135,136,137,138

:

After Nasya karma the symptoms of its Samyaka yoga, Ayoga and Atiyoga

should be observed, which are being described here under.

Table No: 4 Showing the Samayak Yoga Lakshana

Sl.No Athours Samyak lakshanas

1. Charaka Indriyaachchta prasada,Urah Laghuta,Shiro Laghuta,

Srotovishuddhi

2. Sushruta Shiro Laghuta, Srotovishuddhi,Indriyaachchta-prasada,

Chitta Prasada, Vikaropashama, Sukhachchvasa,Sukha

Svapna Prabodha

3. Vagbhata Netra Laghuta, Vaktravishuddhi, Netrateja Vriddhi, Sukha

Svapna Prabodha

4. Kashyapa Netra Laghuta, Srotovishuddhi,Indriyaachchta-prasada,

Netrateja Vriddhi, Chitta Prasada

5. Sharangadhara Netra Laghuta, Srotovishuddhi, Indriyaachchta-prasada,

Chitta Prasada, Vikaropashama

Table No: 5 Showing the Ayoga Lakshana

Sl.No Authours Ayoga lakshanas

1. Charaka Shirogaurava & Dehagaurava, Galopalepa, Nishthivana,

Upadeha, Rukshata, Vata Vaigunya, Srotasamkaphasrava

2. Sushruta Kandu, Nasashosha, Asyashosha, Akshistabdhata

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Shiroshunyata

3. Vagbhata Upadeha, Kandu

4. Kashyapa Shirogaurava & Dehagaurava , Rukshata,

Srotasamkaphasrava

5. Sharangadhara Shirogaurava & Dehagaurava , Rukshata,

Srotasamkaphasrava, Kandu, Upadeha

Table No: 6 Showing the Atiyoga Lakshana

Sl.No Authours Atiyoga lakshanas

1. Charaka Shirovedana, Netra Vedana, Shankhavedana,

Suchitodavata Pida, Vata Vriddhi

2. Sushruta Shirogaurava, Shiroshunyata, Indriya Vibhrama

Mastulungagama, Kandu, Praseka, Pinasa

3. Vagbhata Shirogaurava, Praseka, Aruchi

4. Kashyapa Shirogaurava & Dehagaurava , Rukshata,

Srotasamkaphasrava

5. Sharangadhara Shirogaurava, Shiroshunyata, Indriya Vibhrama

Praseka

Mode of Action of Nasyakarma:

The drug which is administered, acts upon the particular systems of the

body. For this drug has to be absorbed into the system. Absorption is very essential to

obtain any action and this is based on the following.

Routes of Administration

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Physical state of Drug

Solubility and absorbing surface

Anatomical and Physiological considerations

Role of Kala, Position, Poorvakarma and Paschatkarma

Routes of Administration:

The routes of drug administration play an important role. Some important

routes of drug administration‟s are Nose, Mouth, Rectal, Skin, etc.

Transnasal route:

Through this route it may reach the brain along with lymphatic channels.

Physical state of Drug:

For the better absorption and for good results the physical state of drug plays an

important role. The drugs such as Ghrita, Taila are used in Nasyakarma.

The Sneha which was used for the Nasya possesses gunas like

Dravamsukshmam etc. Because of these gunas it has quick spreading in nature,

produces softness, unctouness and penetrate into minute channels, does counter

irritation or stimulation to the nerves and produce wide spead effect. While explaining

the types of drug action it has been explained that by stimulation it increases the

activity of specialized cells. Liquids are better absorbed than solids.

Solubility and Absorbing surface

Absorption of the drugs depends upon the solubility of the drugs. The drugs

which are water soluble will be quick in action and the duration of the action is short,

but the lipid soluble drugs have delayed.

Water-soluble- Quick action and duration of action is short.

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Lipid soluble - Delayed action and duration of action is long.

Pharmacology

The drugs which are used in Nasyakarma will be volatile, water soluble and

highly lipid soluble. Mucous membrane in the body is a good absorbing surface. The

shleshmika kala of the nose, nasopharynx, conjunctiva, vagina, and rectum are more

accessible. The mode of action of nasopharynx can be accessed from the path through

which it is absorbed. Any drug, which is installed in the nose, will have its effect on

the local region as well as general action. That‟s why nasa is considered as dwara for

shiras.The Nasya dravyas reaches to Shringataka marma spreads there and shows its

action after having reached the Siramukhas of moordha, netra, karna, etc and cures the

urdhwajathrugata vikaras by eliminting the vitiated kapha dosha which is located in

Shiras shringataka marma. By Shirovirechana the shuddhi of the karna, Jiwha, Nasa,

rasavahini dhamanis and the mukha is taking place139

.

Anatomical and Physiological Considerations:

The cribriform plate of ethmoide bone: It lies between the two orbital parts of the

frontal bone. It separates the fossa from the nasal cavity, the roof of which it helps to

form 1) foramen ceacum 2) foramina in cribriform 3) anterior and posterior ethmoidal

foramens. Through this anterior and posterior ethmoidal foramen the nerves and blood

vessels are passed and forms connection from nasal cavity to cranial cavity. This is

the passage between nose and cranium.

The nasal mucosa which comes into direct contact with these drugs directly

involved in Nasyakarma is supplied by both Opthalmic as well as maxillary branch of

trigeminal nerve. Direct counter irritation or stimulation to these nerves is done

through nasya.

Apart from these small veins entering cavernous sinus of brain, a pair of venous

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branch emerging from Ala nasi drain into facial vein. Just in the opposite direction

inferior ophthalmic veins enter the facial vein. These ophthalmic also drains

cavernous sinuses of meanings and in addition neither the facial vein nor the

ophthalmic veins have any venial valves. So the facial veins drain into the "cavernous

sinus" in the lowered head position. The drug being carried veins of Ala nasi has got a

chance to enter into the meninges.

The Nasal cavity directly opens with the frontal maxillary and sphenoidal air

sinuses epithelial layer is also continuous throughout them. The momentary retention

of drug is Naso pharynx and secretion, cause oozing of drug material into the air

sinuses. These sites are rich with blood vessels entering the brain meninges through

the existing foramens in the bones.

The Shringataka marma has been explained as "middle cephalic fossa" shiraso-

antarmadhya of the skull consisting of paranasal sinuses and meningel vessels and

nerves. The drug administered enteres paranasal sinuses where the ophthalmic vein

and other veins spread out.

Due to vascularity, the drug is mainly absorbed through the capillaries

(raktavahinis). The capillaries of shleshmika kala joins venules which anastamose

with each other to form plexus. Some of these venules open into the spheno palantine

veins. Other join facial vein, some end in ophtalmic vein few communicate with siras.

Thus drain blood into systemic circulation.

The shleshmika kala of the Nasa is continuous with frontal sinus, maxillary

sphenoidal and ethymoid. Any drugs, which are administered through the nose, will

certainly penetrate through the shleshmika kala and will have its action on these

sinuses.

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Role of Kala and Position: Time factor which plays important role that is after

completion of Nasya patient should lie down in uthana position upto 100 deerga

akshara ucchara kala like.

Role of Poorvakarma and Paschatkarma: Snehana and Swedana to Shiras, Lalata

and Mukha regions, Comfortable smooth massage on forehead, temporal region,

earbase, mastoid lateral side of neck, soles and palms. Dhoomapana and kavala-

gandusha also plays an important role. The procedures like lowering of head,

elevation of the lower extremities and giving mild fomentation seems to have an

impact on blood circulation to the head, receives stimulation and increases blood flow

to the brain.

Stimulation Theory: Drugs present in Nasyakalpa when come into contact with nasal

mucosa irritate and stimulate the olfactory nerve cells lying in superior turbinate

which send efferent fibres to olfactory area in floor of cerebral cortex. The impulse

from lateral olfactory strania terminates at primary olfactory cortex, anygdaloid

complex and many other areas. Efferent fibres from anygaloid complex go to the

hypothalamus and stimulate it, which inturn gives feed back to pitutary. Nasya

probably acts by increasing the immunity of the nasal sinus mucosa and reduces its

hypersensitivity to external inhalable irritants.

Effect on Neuro-vascular Junction: Specific posture during Nasya karma, like the

lowering of the head, fomentation of face seems to have an impact on blood

circulation of the head and face. The efferent vasodilator nerves are spread out on the

superficial surface of face. They receive stimulation by fomentation and this may

increase the blood flow to the brain i.e. momentary hyperemia. According to

Chatterjee, approximately 22% of total dilatation of cerebral capillaries, caused by

facial efferent stimulation will lead to 150% blood in flow (Chatterjee 1980). It is also

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possible that the fall of arterial pressure due to vasodilatation may induce the

Cushing‟s reaction. Due to this reaction “Slush” is created in intra-cranial space,

which probably forces more transfusion of fluid in brain tissue which may lead to

make possible the drug action in the brain. This can be explained by the example of

drug like benzyl penicillin. The drug does not attain therapeutic level in the brain in

normal conditions. But it is found to be effective during the meningitis (the

inflammatory condition of meninges) (Gillman and Goodman 1980).

Absorption of drug: The drug may be absorbed initially by „passive processes across

the cell wall. Any lipid soluble substance has greater chance for passive absorption

directly through the lining of cell membrane. Then the later transversion may be

carried through capillaries and veins. Usually the Nasya implies usage of Sneha

dravya. Modern science states that the greater the lipid water coefficient, the

concentration of drug in the membrane and the faster is its diffusion. The partion

coefficient is also dependent upon the temperature of the moment of administration.

Hence, the raised temperature due to hot fomentation may help in this active process.

In the conclusion it may be stated that, the nose is the doorway to the brain and

it is also path to consciousness. Prana of life energy enters the body through the breath

taken in, through the nose; Nasal administration helps to correct the disorders of prana

affecting the higher cerebral, sensory and motor functions. The brief study of

mechanism of Nasyakarma can be summed up in a single statement made in the

Ayurvedic classics „Nasahi Shirasodwaram‟. i.e, nose is the pharmacological passage

into the head.

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Nasal pathway: Keeping the head in lowering position and retention of medicine in

nasopharynx help in providing sufficient time for local drug absorption. Any liquid

soluble substance has greater chance for passive absorption through the cell of lining

membrane. The drug absorption can also be enhanced by massage and local

fomentation Fingl 1980. The absorption of drug, promoted by massage and local

fomentation can occur in two ways. By systemic circulation Direct pooling into the

intra-cranial region the second way is of more interest. It can occur by two ways 1)

vascular path and 2) lymphatic path.

Transportation by Vascular Path: Pooling of the blood of nasal vein and of

ophthalmic vein occurs in facial vein naturally. It is interesting that both facial and

ophthalmic veins have no veinal valve in between. As a result the blood may drain on

either side. It means blood from facial vein can enter in cavernous venous sinus of the

brain in reverse direction. Such a pooling of blood in the brain is more possible in

head lowered position due to gravity. Thus the absorption of drug in meninges and

related intra-cranial organ is considerable point. In the support of this hypothesis it is

described in modern medicine also that the infective thrombosis of facial vein may

lead to infection of meninges easily, through this path. William et al. 1971 Pooling of

the blood from paranasal sinuses is also possible in the same manner. Shringataka

marma being a sira marma can also be explained by above description.

Drug Transportation by Lymphatic Path: Through this pathway drug can reach

directly into the C.S.F. Along with olfactory nerve, the arachnoid matter sleeve is

extended to sub-mucosal area of the nose. Correlation between them is understood by

the fact that dye injected to arachnoid matter causes colouration of nasal mucosa

within seconds and vice versa also. Here it is important to remind the statement of

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Sushruta that the excessive administration of Virechana Nasya (eliminative errhine)

may cause oozing of mastulunga (C.S.F.) into the nose.

Importance of Post Nasya Massage: Post Nasya massage on the mukha and manya

region may help to subside the irritation of the somatic constriction due to heat

stimulation. It may also help in removing the slush created in these regions. Manya is

a marma existing in neck on either side of trachea. This likely corresponds to the

carotid sinus of neck on the bifurcation of common carotid artery. The receptors

called baroreceptors are situated here and manipulation on it may have a buffering

action on cerebral arterial pressure. Pressure applied on the baroreceptors is also

found to normalize the deranged cerebral arterial pressure (Hejmadi S. 1985)

On the basis of this fact, we can understand that procedures, postures and conducts

explained for Nasya karma have a great importance in drug absorption and

transportation. Thus it can be stated that there is a definite effect of Nasya karma on

the multi system diseases as well as in a preventive aspect also.

How does the drugs enter into the brain can be discussed below. The absorption of the

drugs is carried out in three media. They are:

1. By general blood circulation, after absorption through mucous membrane.

2. The direct pooling into venous sinuses of brain via inferior ophthalmic veins.

3. Absorption directly into the cerebrospinal fluid.