Madhava Nidana Chapter 58 Nasa Roga Nidanam

This article explains Madava nidana 58th chapter “Nasa Roga Nidanam”. Causes, pathology and symptoms of Nasa Roga are explained in this chapter. Nasa Roga means diseases of nose.
Read – Nasal Disorders Causes, Pathogenesis, Treatment In Ayurveda

Apinasa

The condition in which the nasal passage of the person is obstructed (being stuffed with kapha dried by vata), dried up or moist and feeling of raised warmth (feeling of smoke being eliminated from the nose) and the person not understand (appreciate) the smell or taste of materials shall be considered as suffering from the disease Apinasa. It will have symptoms similar to that of pratisyaya and is caused by the increase of vata and kapha together. (1)
Read – Nasarsha (Nasal Polyps) Causes, Symptoms, Treatment

Putinasya

Vāta getting associated with the other (pitta and kapha) morbid (severely increased, burnt and accumulated) doshas localized at the roots of the throat and palate gets eliminated producing foul smell from the mouth and nose. This disease is called as putinasya. (2)
Read – Putinasa (Pootinasa) – Causes, Symptoms, Treatment

Nasikapaka

The disease in which the pitta located in the nose undergoing abnormal increase produce ulcerations inside the nose or causes severe suppuration or produces moistness and putrefaction inside the nose is known as Nasikapaka. (3)

Puyarakta

A condition in which due to abnormal increase of doshas or different kinds of injuries occurring on the forehead, there is continuous discharge of blood mixed pus from the nose is known as Puyarakta. (4)
Read – Nasa Puyarakta Causes, Pathogenesis, Symptoms, Treatment

Ksavathu

The disease in which vata getting aggravated in the vital spots located inside the nose comes out of the nose frequently getting associated with kapha, with great force, making great (loud) sounds is named as Ksavathu by the learned people. (5)

Agantuja Ksavathu

Kşavathu (sneezing) may also arise from various other external causes like – the ingestion of pungent (deep penetrating) food substances or use of similar substances, smelling of spicy materials (irritants), looking up at the sun, or injury to the cartilage and vital spots inside the nose due to introduction of thread, grass etc things into the nose. (Such ksavathu is called as agantuja ksavathu.) (6)

Bramshathu

The thick, burnt (improperly formed) and salty kapha which had been previously accumulated inside the head melts and undergoes liquefaction by the heat of the sun and falls (comes) out of the nose. Such a condition is described as the disease Bhramsathu. (7)
Read – Bhramshathu – Meaning, Causes, Symptoms, Treatment

Dipta Roga

The disease of the nose in which the air comes out just like smoke (hot air) from the nose wherein severe burning sensation is already present and the person feels as if his nose is being burnt by the fire is known by the name Dipta Roga. (8)
Read – Deepti Roga Nasal Disorder – Causes, Symptoms, Ayurvedic Treatment

Pratinaha

Kapha along with Vata causes blockage of the passage of respiration. This condition is called Pratinaha.

Nasasrava

Discharge of thick or thin, yellow or white coloured dosha (kapha) from the nose is known as Nasasrava. (9)

Nasashosha, Nasa parishosha

The disease in which the nasal passages become dry by the action of vata and warm due to the action of pitta and the person experiences difficulty in inspiration and expiration (breathing) is known as Nasasosa or Nasaparisosa. (10)
Read – Nasa Shosha Nasa Putaka – Meaning, Causes, Symptoms, Treatment

Pinasa

Symptoms of Ama (unripe, early stage) Pinasa – include feeling of heaviness of the head, loss of taste / appetite, discharge of thin fluid from the nose, feeble voice and frequent expectoration of the sputum.
Symptoms of Pakva (ripened stage) Pinasa – include decrease of symptoms of ama pinasa, discharges becoming thick and adhering to the inside of nasal passages, restoration of normal voice (clarity of voice) and restoration of normal colour. (11-12)
Read – Pinasa – Meaning, Symptoms, Treatment

Pratisyaya

Causative factors of Pratisyaya include – suppression of the natural urges of the body, having indigestion (ingestion of uncooked foods), exposure to excessive dust (frequently), excessive talking, excessive anger, seasonal abnormalities, injury to head or exposure to etiological factors which cause headache (dust, fumes, smoke etc which enter the head through the nose and cause headache), habit of keeping awake at night, excessive sleep or excessive day-sleep, excessive consumption of cold water, excessive exposure to snowfall (thin rain, frost, mist, dew), excessive indulgence in sexual act and excessive exposure to steam (vapours) and smoke.
Pathogenesis of Pratisyaya – The above-mentioned etiological factors (and similar others) lead to aggravation of vata in the head in which kapha has already solidified which in turn causes the disease pratisyaya.
Vata and the other doshas i.e., pitta and kapha and rakta (blood) accumulate in the head, suddenly get excited (and aggravated) either individually or in combination by their respective exciting causes (etiological factors) and produce pratisyaya. (13-14)
Read – Allergic Rhinitis: Causes, Remedies, Ayurvedic treatment, Herbs

Pratisyaya Purvarupa

Premonitory Symptoms of Pratisyaya
The symptoms seen in the premonitory stage of pratisyaya include – frequent bouts of sneezing, feeling of fullness of the head, stiffness / inactivity, pain all over the body, horripilation and many other complications. (15)

Pratisyaya Symptoms

Symptoms of Vataja, Pittaja and Kaphaja Pratisyaya
Symptoms of Vataja Pratisyaya – In this condition there is obstruction or covering inside the nose (full or partial blockage of nose), dripping out of thin fluid from the nose, dryness of the throat, palate and lips, pricking pain in the temples, excessive sneezing, distaste in the mouth and destruction of voice (broken voice). (16-17)
Symptoms of Pittaja Pratisyaya – In this condition there will be feeling of warmth inside the nose, yellowish discharges from the nose, emaciation, severe pallor, raised temperature (worried, restless), and exhaustion by heat (of pittta). The person feels as if he is vomiting fire along with the smoke (excessive hot air is eliminated from the mouth). (18)
Symptoms of Kaphaja Pratisyaya – In this condition there will be excessive discharge of cold, pale (whitish yellow), thick mucus (phlegm) from the nose, the body and eyes would become (appear) white in colour. The person would also experience heaviness of the head, and excessive itching in the throat, palate, lips and head. (19-20)
Sannipataja Pratisyaya
Symptoms of Sannipataja Pratisyaya – Partisyaya appearing and disappearing frequently without any apparent reason and is either in ripened or unripe state should be understood as being caused by all the three doshas together i.e., sannipataja pratisyaya. (20)
Dushta Pratisyaya
In this condition, the inside of the nose will become too wet (due to too much fluid) or too dry alternatively (and repeatedly). Similarly, the nose gets blocked and gets cleared (of blockage) on its own accord (repeatedly). There will be foul smell in the breath and the person would not appreciate smell (loss of sense of smell). This condition is called Dusta Pratisyaya and is difficult to treat. (21-22)
Raktaja Pratisyaya
In pratishyaya caused due to increase of rakta (blood) there will be bleeding from the nose, coppery colour of the eyes, and severe pain in the chest, foul smell in the breath and mouth and the person will not appreciate smell (loss of sense of smell). (23-24)

Transformation of all Pratisyayas into Dusta Pratisyaya
If not treated properly at proper time, all kinds of pratisyaya would ultimately get converted into dusta pratisyaya and become incurable in due course of time. Following this, there will be the appearance of worms which are white, unctuous (oily) and minute and the patient will develop symptoms similar to those of krimija siroroga (headache caused due to worms, bacteria). (25-26)
Read – Sinusitis: Ayurvedic treatment, Remedies, Preventive tips

Pratishyaya Upadrava

Complications of Pratisyaya
All varieties of peenasa when become progressive (neglected) will, in due course of time, produce deafness, blindness, loss of sense of smell, severe kinds of eye diseases, swelling of the body, poor digestion and cough. (27)

Other diseases manifesting in the nose
The seven kinds of abruda, four kinds of sotha, four kinds of arsas and four kinds of raktapitta described previously might also manifest in the nose (or these may also develop as complications / sequelae of diseases of the nose).

Thus ends the chapter on Nasa Roga Nidanam in Madhava Nidana text written by Acharya Madhavakara.