Chapter 20: Nasya Vidhi Nasal

Medication This chapter explains in detail about types, methods, indications and contra indication of nasal instillation of medicine – Nasya therapy. It is the 20thchapter of Ashtanga Hrudaya Sutrasthana, written by Acharya Vagbhata, son of Vaidyapathi Simhagupta. उ वज ु वकारे षु वशेषा न य म यते

नासा ह शरसो

वारं तेन त

या य हि त तान ् १

Nasya- Nasal medication is especially described for the treatment of diseases of the parts above the shoulders; Nose is the gateway for the head, spreading through this, the nasal medication reaches all the parts of the head and neck and cures the diseases. 1 Trividha Nasya – three kinds of Nasal medication:वरे चनं बं ृहणं च शमनं च

धा अ प तत ्

Nasya treatment is of three kinds – 1. Virechana Nasya – purgatory 2. Brimhana Nasya – nourishing and 3. Shamana – Palliative,

Virechana Nasya – वरे चनं शरः शल ू जा य य दगलामये

शोफग डकृ म ि थकु ठाप मारपीनसे

It does purification. It expels the Doshas of head and neck out of the body. It is useful in Shirashoola – headache, Jadya – loss of movement of the head, heaviness, stiffness Syanda – eye diseases Galamaya – diseases of the throat, Shopha – swelling, Ganda – enlargement of glands, Krumi – worm infestation Granthi – tumour, fibroid Kushta – skin diseases Apasmara – Epilepsy and Peenasa – rhinitis

Shodhana nasya यथा वं यौ गकैः

ने हैयथा वं च

सा धतैः

क क वाथा द भ चा यं मधप ु वासवैर प Shodhana nasya is by the use of fats – (oils and ghee), suitable to the diseases and processed with appropriate drugs, in the form of Paste, decoction etc. and mixed with honey, salt and Asava (fermented infusion). 5

Brimhana Nasya – बं ृहणं वातजे शूले सुयावत

वर ये

नासा यशोषे वा स गे कृ

बोधे अवबाहुके

Nourishing type of Nasya treatment is required for Vataja Shula – headache of Vata origin, Suryavarta – Headache that increases by the day Svarakshaya – loss of voice, Nasa, Asya Shosha – emaciated – dryness of the nose and mouth, Vak Sangha – Difficulty to speak Krichra bodha – difficulty in opening of eyes and Apabahuka- difficulty of movement of the Arm. 3

Brimhana Nasya बं ृहणं ध वमांस ो थरसास ृ खपुरैर प Brimhana Nasya is by the use of juice of meat or blood of animals of desert- like lands, mixed with Khapura –plant extracts, resin, Gums etc.

Shamana Nasya – शमनं नी लका य गकेशदोषा

रािजषु

Palliative nasal medication is required in Neelika – blue patches on the skin, Vyanga – discolored patch on face diseases of the hair and of the eyes. 4 शमनं योजये पूवः

ीरे ण स ललेन वा

Shamana Nasya is by the use of juice of meat, blood milk or even water. 6

Anya Nasya Prakarah – other kinds of nasal medication :मश च

तमश च

वधा

नेहो अ

मा या

क का यैः अवपीड तु स ती णैः मध ू वरे चनैः ७ Marsha and Pratimarsha are the two subdivisions of sneha nasya- nasal medication with fat material based on the quantity –of fats used. Avapeeda is from paste (Kalka), fresh juice, decoction and it is a strong purgation to the head. 7 मानं वरे चन चूण यु

या तं मुखवायुन ा

Dhmana is in the form of powder- to be blown into the nose and is a purgative. षड गुल वमुखया ना या भेषजगभया

स ह भू रतरं दोषं चूण वादपकष त

It is administered by blowing it inside with the help of air from the mouth, the power held in a tube of six Angula in length, having opening at both its end. It pulls out the greatly imbalanced Doshas because it is in the form of powder. 8 Nasya Matra – quantity of nasal drops:दे श य गल ु पव वया म नसमु ृ तात ्

याव पत यसौ ब द ुदशा टौ ष

मेण ते

मश यो कृ टम योना मा ा ता एव च

मात ्

ब द ु वयोनाः क कादे ः

The amount of liquid that drops after immersing two digits of the index finger in any liquid and taking the finger out forms one bindu- 1 drop. 10, 8 and 6 such drops are the maximum, moderate and minimum doses, respectively of Marsha Nasya (oil / fat medication). In respect of Paste (Kalka), fresh juice, decoction the doses are less by two bindu. i.e. maximum, medium and minimum does of Avapidaka kind of nasya are 8,4 and 6 drops respectively. 9-10 Nasya Anarhah – persons unsuitable to nasal medication :योजये न तु नावनम ्

तोयम यगर नेहपीतानां पातु म छताम ्

भु तभ त शरः नात नातुकाम ुतास ृजाम ्

नवपीनसवेगातसू तका वासका सनाम ्

शु ानां द तब तीनां तथा अनातवद ु दने अ य ा य यका

याधेः

Nasal medication should not be administered to persons who have just then consumed water, wine, artificial poison (Garavisha – chronic poisoning) and fat (as part of Snehana therapy or who wish to consume them, soon, who have taken food just then, who have already taken bath or who desire to take bath-soon, who have had blood letting therapy- or severe bleeding due to other causes, who are having acute rhinitis, Who are getting natural urges of the body; the woman who has recently delivered, patients of dyspnoea, COPD, Asthma and cough, those who have undergone purification (Panchakarma) therapies (Vamana and Virechana) who have been given Basti treatment – just then, at unsuitable seasons and on Sunless cloudy days except in emergency during diseases. 11-12 ½ अथ न यं

योजयेत ्

ातः ले म ण, म या ने प ते, सायं नशो चले व थव ृ ते त ु पूवा ने शर कालवस तयोः १४

शीते म यं दने

ी मे सायं वषासु सातपे

वाता भभूते शर स ह मायामपतानके १५ म या त भे

वर ंशे सायं

ातः दने दने

Nasal medication should be administered in morning for Shleshma – increase of Kapha, during midday for pitta, in the evening or night for the healthy. During Sharath (Autumn) and Vasantha (Spring), it should be given in forenoon. During winter, it should be given in midday. Evenings in Grisma –summer, when there is sunlight during Varsha- rainy season. It should be done both in evening and morning daily in the following diseases. Vataja shiroroga – diseases of the head caused by Vata, Hikka – Hiccup, Ayama – tetanus, Apatanaka - Convulsive disorders, Manyasthambha – stiffness of the neck, and Svarakshaya – hoarseness of voice, 13-15 एकाहा तरं अ य

स ताहं च तदाचरे त ्

In other diseases, it should be done on every alternative days for a week. 16

Nasya Vidhi – procedure of medication :ि न धि व नो तमा ग य नवातशयन थ य ज ू व

अथो तानजुदे ह य पा णपादे

कृताव यक य च

वेदये त ् पन ु ः सा रते

कि चतु नतपाद य कि च मू न ना मते

नासापुटं पधायैकं पयायेण नषेचये त ् उ णा बुत तं भैष यं

णा या पचुना अथवा

द ते पादतल क धह तकणा द मदयेत ्

शनै ि छ य न ठ वे पा वयो भयो ततः आभेषज यादे वं

वि

वा न यमाचरे त ्

The head of the person who has attended to this essential activities – elimination of urine and faeces, washing of the teeth and mouth etc. earlier, should be massaged with oil and given fomentation (mild sweating). He should then be made to lie – on a cot in a room devoid of breeze, the parts above his shoulders should be given fomentation (mild sweating) once again, He is made to lie straight with his face upwards, extending his arms and legs, the medicine slightly warmed with the help of hot water, should be taken either in a tube or soaked in a piece of cloth, and instilled into each nostril alternately, keeping the other one closed. After instilling, his soles, neck, palms, ears etc. should be massaged- mildly, he should then turn to his sides and spit out till the entire medicine comes out. In this manner two or three nasal medications should be administered to him. मू छायां शीततोयेन स चे प रहरन ् शरः Ife goes unconscious, cold water should be sprinkled over the face, avoiding head. 21

Sneha Nasya- Nasal medication with fat materials:नेहं वरे चन या ते द या ोषा यपे या Nasal medication with fat material should be given at the end of purgative Nasal medications, in consideration of the Doshas etc. न या ते वा शतं त ठे द ु तानः धारये ततः धूमं पी वा कवो णा बुकवलान ् क ठशु ये

After medication is completed, the patient should lie with face upwards, for a period of uttering one hundred syllables (for 100 seconds), Then he should inhale smoke of medicated herbs and gargle the month with lukewarm water many times to cleanse the throat. 21-22 ½

Symptoms of good Sneha nasya (with oil or ghee) – स यि

न धे सुखो

वास

व नबोधा पाटवम ् २३

(remember that Marsha and Pratimarsha are the two types of Sneha nasya) Sukha Uchvasa – Expiration without difficulty, Sukha swapna – sleep Sukha bodha – easy awakening from sleep and Akshapatava – keenness of sense organs are the signs of lubricating nasal therapy properly done. 23

Symptoms of inadequate Sneha nasya (with oil or ghee) – े अ

त धता शोषो नासा ये मध ू शू यता

Akshi stabdhata – Loss of movement of the eyes, Shosha Nasa asye – emaciation, dryness of the nose and mouth Murdha shunyata – feeling of emptiness inside the head are the signs of dryness- or inadequate Lubrication.

Symptoms of excess Sneha nasya ि न धे अ त क डूगु ता से का चपीनसाः Kandu – Itching Guruta – feeling of heaviness of the head, Praseka – excess salivation, Aruchi – anorexia Peenasa – rhinitis are signs of excess of Lubrications therapy. 24

Symptoms of Good Virechana (Purgation) Nasya therapy सु व र ता अ

लघुताव

द ु व र ते गदो े कः,

वर वशु यः

ामता अ त वरे चते

akshikaghuta – lightness of the eyes, vaktra swara vishuddhi – clean mouth and clear voice; Inadequate Virechana Nasya (purgative therapy ) causes exacerbation of the diseases and excess therapy leads to emaciation. 25

Pratimarsha Nasya:तमशः

त ामबालव ृ सुखा मसु

यो यो अकालवष अ प न ि व टो द ु टपीनसे

म यपीते अबल ो े कृ मद ू षतमू न उि

ल टोि

ल टदोषे च, ह नमा तया ह सः

Pratimarsha Nasya is a type of oil / fat Nasya. Here the dose is very low. Hence, it is indicated in wide variety of diseases. It can be administered to Kshata – wounded, Kshaama – the emaciated, Baala – the children, Vruddha – the aged and Sukhaatma – those who lead a happy conservative life; it can be administered even during unsuitable time, season, day etc. It can also be administered during rainy season. Contra indication for Pratimarsha nasya – It is not suitable in Dushta Peenasa – infective Rhinitis, Madyapeeta – those who has have drunk wine, Abalashrota – People with low ears- low hearing capacity Krumidushita Murdha – head infested with worms, utklishta Dosha – in whom, in the Doshas are greatly imbalanced and moving from place to place; In these conditions, it is not suitable because it is of less quantity. 26-27

Pratimarsha Kala – time to administered Pratimarsha Nasya – नशाहभु

वा ताहः

व ना व मरे तसाम ्

शरो अ य जन ग डूष

ाव अ जन वचसाम ् ॥२८॥ द तका ट य हास य यो यो अ ते असौ

व ब द ुक: ।

After head massage After Gandusha (gargling) After Anjana – collyrium, After defecation, After tooth brushing, After bouts of laughing ; its dose is two Bindu- 2 drops. 28 प चसु

ोतसां शु ः , लमनाशि

बलं प चसु, ततो द तदा यं म

षु

मात ्

छमः

Pratimarsha cleanses, clears the channels, relieves fatigue, improves eye sight, bestows sturdiness to the teeth and mitigates the Vata.29

Kriya Nisiddha Vayas – unsuitable age for therapies – न न यमूनस ता दे नातीताशी तव सरे

न चोना टादशे धूमः, कवला नोनप चमे न शु

नदशमे न चाि त ा तस ततौ

Nasya should not be administered to those who are less seven years and more than 80 years of age; Dhuma- inhalation of smoke of drugs should not be administered for children below 18 years; Kavala- mouth gargling should not be administered for children below five years; Shodhana – purification (Panchakarma) therapies like Vamana, Virechana etc. should not be administered below 10 years and above 70 years of age. 30-31 आज ममरणं श तः

तमश तु बि तवत ्

मशाव च गण ु ान ् कुया स ह न योपसेवनात ्

न चा

य

णा ना प याप यो मशव यम ्

Pratimarsha – kind of nasal medication is good from birth to death just like basti treatment. It provides the benefits like Marsha Nasya (oil, high dose if used daily, it does not need any control – regarding food and activities nor it has any risks like Marsha Nasya. 32 तैलमेव च न याथ न या यासेन श यते ॥३३॥ शरस: ले मधाम वात ् नेहा:

व थ य नेतरे ।

Medicated oil only is ideal for daily use of Nasya (Pratimarsha), because the head is the dwelling place of kapha and no fat other than oil, can keep it healthy. 33 आशुकृि चरका र वं गुणो कषापकृ टता मश च

तमश च वशेषो न भवे या द

को मश सपर हारं सापदं च भजे ततः अ छपान वचारा यौ कुट वातातपि थती

अ वासामा ाब ती च त वदे व व न दशे त ् Immediate and delayed action, more and less benefits are the results of Marsha and Pratimarsa respectively. If there is no difference between then, who will resort to marsha which is associated with controls – regarding food and activities and risks? In the same way, Acchapana – drinking of pure fat alone and Vicharana- intake of fat mixed with foods etc. Similar is the case of Kuti Pravesika – one kind of rejuvenation therapy where the person needs to stay in a house for

weeks together, taking Chyawanprash etc. and Vatatapika- Rejuvenation treatment, wherein patient can do his routine work. Similar is the case of Anuvasana – fat enema and Matra basti – fat enema with very little oil 34-36

Anu taila जीव तीजलदे वदा जलद व से यगोपी हमं दाव व मधुक लवागु वर पु

ा व ब वो पलम ्

धाव यौ सरु भं ि थरे कृ महरं प ं

ु ट रे णक ु ां

कि ज कं कमला वलां शतगुणे द ये अ भ स

वाथयेत ् ३७

तैला सं दशगण ु ं प रशो य तेन तैलं पचेत ् स ललेन दशैव वारान ् पाके

पे चदशमे सममाजद ु धं न यं महागुणमुश यणुतैलमेतत ् ३८

Jivanti, Jala, Devadaru, Jalada, Twak, Sevya, Gopi (sariva), Hima, Darvi twak, Madhuka, Plava, Agaru, Shatavari, Pundrahva, Bilva, Utpala, the two Dhavani, surabhi, the two Sthira, Krmihara (Vidanga), Patram (Cinnamon leaf), Truti (Cardamom), Renuka, Kinjalka, Kamala (lotus) and Bala- are to be boiled in one hundred parts of rain water / pure water and decoction reduced to one tenth part; to this decoction, equal quantity of sesame oil is added and cooked for ten times. (the decoction is added to the oil, boiled till water evaporation. Again, equal quantity of decoction is added, evaporated. This process is repeated for 10 times. During the tenth cooking, equal quantity of goats milk (equal to the quantity of oil) is added – and cooking is completed. This oil known as Anutaila, used as nasal drops, bestows great benefits. 37-38

Nasya Phala- Benefits of Nasya treatment – घनो नत स न व ढे ि

क ध ीवा यव सः

या तप लता भवेयुन यशी लनः

The skin, shoulders, neck face and chest become thick, well developed and bright; The body parts and the sense organs become strong disappearance of grey hairs will be obtained by persons who becomes habituated to nasal medication. 39

Thus ends the chapter Nasya Vidhi- the twentieth in suthrasthana of Astangahrdaya Samhita.