Nasya Karma: Procedure, Types, Benefits, Contra Indications

Nasya (nasya-karma) is a term to be applied generally for medicines administered through the nasal route. It is also known as nāvana and nasyakarma. The formulations used for the purpose of nasyakarma are called nāsika kalpana. 

Introduction: 
Nasta : karma cha kurvita shirorogeshu shāstravidha|
Dvāram hi shiraso nāsā tena tad vyāpya hanti taan || (Cha. Si.)
Aushadhamoushadasiddho vā sneho nāsikaabyām diiyate iti nasyam| (Su. Chi)
Nasyam tatkathyate dhiirairnāsagrāhyam yadoushadham
Nāvanam nasyakarmeti tasya nāmadvyam matam|| (Sha. U)

The learned physician should administered nasya karma in disease of head because nose is the gate way of head and as such drug administered by this route pervades the head and thus destroys the diseases of Shirovirechana, Shirovireka and Murdha virechana are the synonyms of Nasya karma.

Synonyms:
Nāvana, Nasta karma, Nasya Nasthana, Pracchardana, Shirovirecana, Murdha virechana, etc.
Nasya treatment - nasal drops

Classification Of Nasya:
Depending upon the pharmacological actions of drug used in nasya karma scholars of Ayurveda have mentioned different varieties of nasya karma.

Types of Nasya:
Charaka has classified nasya as follows:
Nāvanam cha avapidascha dhmapanam dhuuma yeva cha|
Prathimarshscha vijneyam nastha : karma tu pancyadha||
Snehanam shodanam chaiva dvividham nāvanam smritam|
Shodhana:sthambhanascha syad avapido dvidhāmata:
Choornasyadāhyamapan taddi dehasroto vishodanam
Vijneya: trividho dhuma: prāgukta shamanādhika:
Prathimarsho bhavetsneho nirdosha ubhayārtakrit
Yevam tadrechanam karma tarpanam shamanam tridhā || Cha.Si

Nāvana: Snehana and Shodhana
Avapida: Shodhana and Stambhana
Dhumapāna
Dhumra nasya: 
Prayogika; Virechaniya; Snehaniya
Pratimarsha: Snehana and Virechana

The above mentioned 5 types of nasyas are grouped according to their actions in the following three classes.
Rechana (Purification)
Tarpana (Nourishing)
Shamana (Retraining)

Charaka also described 7 types of nasyas on the basis of the usable parts of the nasya drugs:
Phala nasya – using fruits
Patra nasya – leaves
Moola nasya – roots
Kānda nasya – stem
Pushpa nasya – flowers
Twak nasya – bark
Niryāsa nasya – extract / exudate

All the above mentioned drugs can be used for nasya in the form of Churna, kalka, swarasa, ksira. Kwātha, sāra, udaka, dhuma, mamsarasa, siddha taila, Ghrita, Madya etc.

Acharya Sushrutha classified nasya as:
Tad dvividham-shirovirechanam snehanam cha|
Tad dvividham api panchadhā tadyathā – nasyam
Shirovirechanam, pratimarsho, avapida: pradhamana cha
Teshu nasyam pradhāna shirovirechanam cha| nasyavikalpa:
Pratimarsha shirovirechana vikalpoavapida: pradhamanam Cha
Tatho nasyashabda panchadhā niyamita:|| (Su.chi 40/21)

1. Shiro virechana
2. Snehana

Each type is further classified into
Nasya
Siro virechana
Pratimarsha
Avapida
Pradhamana

Vāgbhata has classified nasya having in views their actions into the following 3 types: 
Virechana nasya
Brmhana nasya
Shamana nasya

According to scholar Shārangadhara: 
Nasyabhedo dvidhā proktho rechana : snehanastathā|
Rechanam karshanam proktham snehanam brahmanam matam| (sha.sam.u.k 8/2)
Rechana nasya (karshana) – 2 sub types – Avapeeda and Pradhamana
Snehana (Brmhana) -2 sub types – Marsha and Pratimarsha

Nasika Kalpana

Nāvana nasya: 
It is an important type of Nasya, which can be used always.
It can be mainly classified into Snehana and Sodhana.
Scholar sushrutha called it as Snehana nasya.
Nāvana is administered by instilling the drops of a medicated oil in the nose. Anutaila is used for this type of nasya.

In this type of nasya the pichu of karpasa is made and dipped into Sneha, the drops, formed after taking the pichu out of the Sneha, are dropped into the nostrils. Nāvana is gererally a sneha nasya and is known as nasya in general.

The nāvana nasya is indicated in following conditions:

Vātaja Shiroroga – headache, disorders pertaining to head and brain  due to Vata Dosha imbalance
Danta pātha – loss of teeth
Kesha pātha – hair loss
Smasr pātha – moustache loss
Tivrakarna Shula – excess earache
Karnachweda – ear disorder
Timira – night blindness, eye disorder involving blindness
Swedopaghāta – side effects of Swedana
Nāsa roga – nasal disorders
Mukha Shosha –dry mouth
Avabāhuka – Frozen shoulder
Akālaja Valee – premature skin wrinkles
Akālaja palita – premature greying of hairs
Dāruna prabodha
Vata pittaja Mukharoga – oral disorders of Vata and Pitta Dosha.

Nāvana kala – Su. Ch. 40/241 and Dalhana:  Time for administration of Navana Nasya: 
In Kaphaja roga – Forenoon
In Pittaja roga – Noon
In Vataja roga – Afternoon

Seasonal administration of Nasya to a healthy person:
Sheeta kāla – Noon
Sharad and Vasanta – Morning
Grishma rutu – Evening
Varsha rutu – When the sun is Visible

Nāvana mātra – Su. Ci. 40/36: Dose of Navana Nasya: 
Uttana – 8 drops
Madhyama – 6 drops
Hina – 4 drops

Example:- Shad Bindu Taila
Read related: Shadbindu Tail – Benefits, How To Use, Ingredients, Side Effects

Avapeeda nasya: 
Avapeeda nasya is the nasya consisting of the extract (juice) of a drug, administered through nasal passage.
Four, six, eight drops of the Swarasa are recommended to be put in each nostril. Depending upon the pharmacological action of drugs used for Avapida nasya.

It is of two types.
Stambhana nasya.
Sodhana nasya.

Avapida nasya is indicated in the following conditions: 

Vishābhighāta – toxicity, poisoning
Sanyāsa – syncope
Muurcha – unconsciousness
Moha- delusion
Apatantraka – neurological disorders
Mada – intoxication
Apasmāra – epilepsy
Shirobhedana – headache
Krodha – anger
Bhaya – fear
Mānasa roga – mental disorders
Chittha Vyakulāwastha – anxiety
Krusha Roga – weak patient
Bhiiru – fearful
Sukamāra persons – soft people
Stri – women
Raktapitta  – bleeding disorders like nasal bleeding, Ulcerative colitis and menorrhagia   etc.

Dhmāpana or pradhamana nasya: 
Pradhamana is a specific sodhana nasya.
In pradhamana nasya, churna (powder of drugs) is administered ( inhaled ) by nasal passage with the help of nādi yantra. Its dose is described by scholar Videha as one mucyuti (a pinch).

The drugs generally used for Pradhamana Nasya – 
Saindhava lavana – rock salt
Lashuna – garlic
Guggulu – Commiphora mukul
Katphala,
Maricha – Black pepper
Vacha – sweet flag etc.
These are mixed in equal parts and powdered along with the gall stones of a fish and kept dry. The powder may be used as pradhamana nasya.

Pradhamana nasya is indicated in following conditions:
Mental diseases
Poisoning
Krimija Siroroga

Example :- Katphala nasya – Su.u. 26/22.
Fine powder of katphala twak (Myrica nagi Thumb) should be blown into the nostril through a pipe 6” long. Katphala nasya is indicated for kaphaja Shirorogas.

Dhuma nasya:
Dhuma nasya is defined as medicated fume taken by nasal route and eliminated by the oral route. If dhuma is taken by oral route is eliminated by the nasal route, is harmful for the eyes.

Dhuma nasya is of 3 types
Prayogika
Snehana
Vairechanika

Its indications are as follows: 
Shiroroga
Nāsa roga
Akshiroga

Length of Dhumra netra: 
For Vairechanika nasya – 24”
Snaihika nasya – 32”
Prayogika nasya – 36”

Marsha and Pratimarsha Nasya:
Both consist of introduction of Sneha (taila) through the nostrils. It is well tolerated and is a very much convenient procedure. Pratamarsha and marsha are in principles the same but they have the following distinctions:

Difference between pratimarsha and marsha: 
Pratimarsha                                                                                              Marsha
Preventive in nature                                                                                         Curative
Never produces complications                                                                       May produce complications
Dose: 2 drops                                                                                                     Dose: 10 drops, 8 drops, 4 drops as Uttama,
morning and evening                                                                                        Madhyama and Hina matras respectively
Can be performed on people of all                                                                  Needs consideration of Rutus and Vayas
ages and in all seasons
Slow acting and less potent                                                                              Quick acting and highly potent
Consists of less sneha dravyas                                                                          Consists of more sneha dravyas

Pratimarsha is indicated in the following conditions: 
Talpothita kāla
Traksālita danta kāla
Graha niragachata kāla
Vyāyāmottara kāla – after exercise
Vyavāyottara kāla – after sex
Adhva parisrānta kāla – after walking a long distance
Mala Mutra Visarjanottara kāla – after defecation and urination
Kavalottara kāla – After mouth gargle / oil pulling
Anjanottara kāla – After anjana treatment (collyrium)
Bhojanottara kāla – after food
Vamanottara kāla – after Vamana therapy
Divāswapnottara kāla – after getting up from day sleep
Sāyankala – Evening
Sirobhyangottara kāla – after head massage
Hāsyottara kāla – after excess laughter

Indications of Nasya karma: 
Shirasthambha
Manyasthambha
Pinasa
Dantasthambha
Hanusthambha
Galashāluka
Galashundika
Shukragata Roga
Timira
Vartma Roga
Vyanga
Amsashula
Upajihwika
Ardhāwabhedaka
Karnashula
Grewa Roga
Skandha Roga
Nasāshula
Mukha Roga
Aksishula
Sirahshula
Ardita
Apatantraka
Apatānaka
Galaganda
Dantashula
Raji
Dantaharsha
Arbuda
Vākgraha
Swarabheda
Gadagadatwa
Krathana

Contraindications of Nasya karma:
Bhukta Bhakta – soon after food
Ajirna – in a person having indigestion
Pitasneha – soon after intake of ghee or oil
Pitamada – in a person intoxicated with excess alcohol
Pita toya- who has consumed excess water
Ksudhārta – who is suffering with excess thirst
Snehādi pitukāma – who is desirous of taking oil / ghee
Snata Sira – who has just taken head bath
Sramārta – who is excessively tired
Matta – intoxicated
Snatu kāma – who is just about to take bath
Murcchita – unconsciousness
Sastradandhata – who is severely injured by sharp instruments
Vyāwaya klanta – tired
Virikta – soon after Virechana treatment
Vyāyāma Klanta – tired due to excessive exercise
PānaKlanta – tired due to excess alcohol
Garbhini – pregnant
Nawa Jwara – fever – fever of recent onset
Sokaistapta – grieving
Anuwasita – who has just undergone Anuvasana Basti
Nawa pratishyāya – rhinitis of recent onset
Apatarpita – who has just undergone weight loss treatment
Pitadrava – excess consumption of liquids
Trsnārta – with excessive thirst
Garārta – afflicted with Gara Visha – toxic conditions
Kruddha – excess anger
Bāla – in children
Sutika – during early lactation period
Vegāwarodhita – who has suppressed his natural urges
Rakta Srāvita – with excess bleeding
Shwāsa – dyspnoea

Nasya Ausadhi kalpana – commonly used: 
Churna – kalpana
Katphala Churna
Trikatu Churna
Katu tumbi Churna
Pippali Churna
Maricha Churna
Vidanga Churna

Sneha Kalpana
Anu taila
Sadbindu taila
Jatyādi taila
Padmakādi taila
Panchaguna taila
Kumkumadi taila
Vacha
Ghrta
Ghanasāra yoga

Some of the Nasya Kalpas indicated by Shārangadhara —
Gudādi nasya: – It is indicated in diseases of eyes, ears, nose, head, neck, lower jaw, throat, shoulders and back.
Madhuka sāradi nasya: It is indicated in apasmāra (epilepsy), unmade (insanity) sannipātha (severe fevers) and apatantraka (tetanus)

Saindavādi nasya: It relieves excessive drowsiness, tandrā.
Marichādi nasya: It forms a good pradhamana nasya.

Brahmana nasya kalpana: It is indicated in diseases of head, nose, eyes, suryāvarta, ardhavabheda, dantarogas, for debilitated persons. In those suffering from diseases of neck, shoulders and arms, Mukhashosha, Karnanāda, disorders of vāta and pitta, Premature greying and falling of hairs and moustaches.

Kukuma nasya: It is indicated in disorders arising from vāta and rakta, pain in the forehead, temples, head, ears, suryāvarta and ardhavabheda.
Māshādi nasyam: It relieves pakshaghata associated with kampa, ardita,
Manyāsthambha and apabāhuka.
Vibhitakādi nasya: It cures palita (greying of hairs)

Pathway and fate of Nasya dravya:
Drug pathway
Nasal cavity -> Olfactory epithelium -> Olfactory nerve -> Cibriform plate of ethmoid bone -> Anterior cranial fossa -> Medial and lateral olfactory area of cerebral cortex.

Fate of drug:
Chemical impulse
Electrical impulse
Neuronal impulse

Nasya Yantra: 
A suitable Nasya Yantra may be devised according to the need depending upon the following outlines described in the text for Dhuma Nasya.

Tikshna or Virechana Nasya                 24 angula
Snaihika Nasya                                        32 angula
Prayogika or Shamana Nasya                36 angula

Observation of Ātura – Vaya and Kāla: 
Rutu:- Nasya should be given in prāvrt, Sharad and Vasanta Rutus. Time schedules in different seasons should be as follows
Grishma Rutu                                      Before noon
Sheeta Rutu                                          Noon
Varsha Rutu                                         Day should be clear.

Age:- Nasya should not be given in persons below 7 years and after 80 years. Thus Nasya is indicated between 8 and 80 years of age.
However the following exceptions have also been admitted.
Pratimarsha may be administered at any age between birth to death while
Dhuma is indicated after 12 years of age. Sneha pāna should not be given immediately before Nasya karma

Procedure of Nasya karma: 
Ātura, Mala – Mutrādi Vega Nivrtta
Diet should be given
After sometime tooth brush
Adequate Dhumapāna
Patient should lie down on Nasya Saiya
Put oil on scalp for massage
Mrudu snehana on head. According to Ayurveda texts swedana should not be given on the head. But it is only done for elimination of Dosha and liquification of Doshas
Tāpa sweda should be given in following regions i.e. Shira, Mukha, Nāsa, Manyā, Griwa, Kanta
After Swedana smooth massage should be applied on following regions eg. Gala, Kapola and LalataPradesha
During Nasya the patient should close his one nostril and should inhale the drug through the other.

Determination of Dosage in Nasya karma: 
Scholar Sharangadhara describes the following dosage schedule for Nasya karma: 
Tiksnaushadhi Mātra
Churna                                     1 Shāna (24 Rattis)
Drava                                       8 Bindu (8 drops)
Hingu                                       1 Yava (1/2 Ratti)
Saindhava                               1 Māsha (6 Ratti)
Dugdha (milk)                       8 Shāna (64 drops)
Jala (Ausadhi Siddha)          3 Tolas
Sharkara and other
Madhura guna dravyas         1 Tola

According to Sushruta nasya should be given for 21 days or till the appearance of adequate effects on the other hand according to Vāgbhata, Nasya should be given for 7 days.

Instructions for the patients during Nasya: 
As described by Charaka, Vāgbhata and Sushrtha the following instructions should be observed by a patient while undergoing Nasya karma.
Swedana and Mardana on the Shira, Gātra and Manya
Shira (head) should not be excessive flexed or extended
Patient should lye Supine (Uttāna ) for a time interval consumble for counting members upto 100
Avoid speech (Naprabhāset)
Avoid anger (Nakupyeta)
Avoid laughing (Nahaset)
Avoid swallowing of Nasya Aushadhi
Eliminate Kapha by Gandusha and Stiivana ( Spitting)

Post Nasya Regimen: 
Dhumapāna
Kawalagraha and Gandusha Dhārana
Diet – Warm water (Sukhoshna jala)
Light diet (Laghu āhāra)

Following should be avoided: 
Shitala Jala (cold water)
Dosha prakopaka āhāra (abhishyandi)
Rajodhuma (dust and fume)
Sneha (oils and ghee)
Ātāpa (sun and heat)
Madya (alcohol)
Shira Snāna (bath by head)
Atiyāna (travelling)
Krodha (anger)
Nidra (sleep)

Features of adequate Nasya: 
Lāghawa (lightness in the body)
Nidra (good sleep)
Shira Laghutwa (lightness in the head)
Srotas Shuddhi (cleaning of channels)
Indriya prasanna (sensorial happiness)
Mana prasanna (mental happiness)

Features of inadequate Nasya: 
Indriya Rukshata (Dryness of senses)
Aprasama Roga (Non relief)
Kandu (Itching)
Anga gourawa (Heaviness in body)
Nāsa, Netra, Mukha Srāwa (Hyper secretion)

Features of excessive Nasya: 
Shirahshula (headache)
Indriya Bibhrama (confusion)
Kapha Srāwa (salivation)

Nasya Vyapada (complications): 
The complications Nasya karma are many and they occur due to administration of Nasya when it is contraindicated due to technical failure

These complications occur through following two modes:
Doshotklesa — which can be managed by Shodhana and Shamana Chikitsa
Dosha kshaya — which has to be managed by Bramhana Chikitsa

Conclusion:
When nasya karma is done adequately the following benefits can be gained
Prevention of eye disease
Prevention of ear disease
Prevention of nasal disease
Healthy hair
Prevention of pinasa, Ardhāwabhedaka, Shirahshula, Ardita, Hanugraha.
Provides strength to scalp
Provides happiness
Improves voice
Improves senses
Prevention of urdhwajatrugala Roga
Delayed aging
Pleasant oral smell
Give strength to head, danta, shira, trika, bāhu and uras
Prevention of vali, palita, khalitya and vyanga etc.

References
BOOKS                                                                                 AUTHORS
Charaka Samhita                                                                    Dr. Ramkaran Sharma and Vaidya Bhagwan Das
Sushrutha Samhita                                                                 Kaviraj Kunjalal, Bhishagratna
Sharangadhara Samhita                                                        Prof. K.R. Srikantamurthy
Bhaishajya kalpana Vijnanam                                              Dr. Ramachandra Reddy
Text book of Bhaishaja kalpana                                           Dr. Shobha G. Hiremath
Bhaishajya kalpana                                                                 Dr. Siddhinandan Mishra
Bhaishajya Ratnavali                                                              Govinda Das Sen


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