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Palitya shirobhyanga pk023-gdg

  2. 2. DECLARATION BY THE CANDITATE I hereby declare that this dissertation / thesis entitled “Evaluation of combinedeffect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in AkalaPalitya.” An observational clinical study is a bonafide and genuine research workcarried out by me under the guidance of Dr. Suresh Babu. S M.D. (Ayu), FRAV (GOI, Delhi)Professor and the co-guidance of Dr. Yasmeen A Phaniband M.D(Ayu), Post GraduateDepartment of Panchakarma, Shri D.G.M.Ayurvedic Medical College, Gadag.Date: Signature of the CandidatePlace: Gadag. (Sabareesh M) II
  3. 3. CERTIFICATE BY THE GUIDE This is to certify that the dissertation entitled “Evaluation of combined effectof Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya.” Anobservational clinical study is a bonafide research work done by Sabareesh M inpartial fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.(Panchakarma).Date: Signature of the GuidePlace: Gadag Dr. S. Suresh Babu M.D. M.D. (Ayu), FRAV (GOI, Delhi) Professor P.G. Dept of Panchakarma Shri.D.G.M. Ayurvedic Medical College, Gadag. III
  4. 4. CERTIFICATE BY THE CO-GUIDE This is to certify that the dissertation entitled “Evaluation of combined effectof Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya.” Anobservational clinical study is a bonafide research work done by Sabareesh M inpartial fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.(Panchakarma).Date: Signature of the Co-GuidePlace: Gadag Dr. Yasmeen A Phaniband M.D. (Ayu). IV
  5. 5. J.S.V.V. SAMSTHE’S SHRI D.G.M. AYURVEDIC MEDICAL COLLEGE, GADAG POST GRADUATE DEPARTMENT OF PANCHAKARMA ENDORSEMENT BY THE H.O.D AND PRINCIPAL OF THE INSTITUTION This is to certify that the dissertation entitled “Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya.” An observational clinical study is a bonafide research work done by Sabareesh M under the guidance of Dr. Suresh Babu S M.D. (Ayu), FRAV (GOI, Delhi) Professor, and co- guidance of Dr. Yasmeen A Phaniband M.D. (Ayu) , Post Graduate Department of Panchakarma, Shri D.G.M.A.M.C., Gadag and contributed good values to the Ayurvedic research. Dr. Sivaramudu M.D. (Ayu), M.A (San), M.A (Psy) Dr. G. B. Patil Prof. and H.O.D. Principal, P.G. Dept of Panchakarma Shri. D.G.M. Ayurvedic Medical College,Shri. D.G.M. Ayurvedic Medical College, Gadag Gadag.Date: Date:Place: Gadag Place: Gadag V
  6. 6. COPYRIGHT Declaration by the Candidate I here by declare that the Rajiv Gandhi University of Health Sciences,Karnataka shall have the rights to preserve, use and disseminate this dissertation /thesis in print or electronic format for academic / research purpose.Date: Signature of the CandidatePlace: Gadag. Sabareesh M © Rajiv Gandhi University of Health Sciences, Karnataka. VI
  7. 7. ACKNOWLEDGEMENT: There is hardly any task which is more pleasant than acknowledging mygratitude to all those who have helped in so many ways in preparing this work. At thisjuncture, first of all I would like to start expressing my gratitude by bowing my headon the feet of lord almighty. Without whose blessings i would have never been able tocomplete this work. I deserve my respectful greetings in the lotus feet of Jagadguru Shri.Abhinava Shivanandmahaswamiji to his holiness and divine blessings. It is beyond the words to express my gratitude towards my esteemed Parents,Shri. Unnikrishnan; Mother, Smt. Devayani; for their support, effort and never endinglove which are the driving forces behind my success and achievement. I also grab thisopportunity to express my feelings to my sisters, and all other members of my familyfor their constant inspiration and encouragement. I would like to avail the opportunity to express my profound and immensegratitude and whole hearted thanks to my respected guide Proff. Dr. Suresh Babu. S,M.D. (Ayu), FRAV (GOI,Delhi) for his excellent guidance, constant help, inspiration, valuablesuggestions, keen observation and logical interpretation rendered throughout mystudy. I express my thankfulness to my beloved principal Dr.G.B.Patil, for hisencouragement and support by providing all necessary facilities for this researchwork. I wish to express my deepest gratitude to Dr. P.Sivaramudu, M.D.(Ayu), HOD,Dept of Panchakarma for his timely advises and encouragement during this researchwork. I am extremely happy to express my deep sense of gratitude to my co-guideDr. Yasmeen .A. Phaniband, M.D.(Ayu), whose sympathetic, scholarly suggestionshave inspired me to accomplish this work in all aspects. I shall remain grateful to the affectionate guidance of my teachers Dr.Santosh N. Belavadi,M.D (Ayu) and Dr. Jairaj Basarigidad MD (Ayu), for their valuablesuggestions. Their invincible and radical thinking were very valuable in achieving thisresearch work. I am sincerely thankful to professor Dr.G.Purushothamacharyulu, M.D. (Ayu)who was former H.O.D. and Dr. Rajashekar C.V. MD (Ayu), who was former teacherin the department for their scholarly guidance. VII
  8. 8. I am grateful to all the PG teachers Dr. K. S. Prasad, Dr. M. C. Patil, Dr.Mulugund, Dr. G. S. Hiremath, Dr. R. V. Shettar, Dr. Girish Danappa Goudar, Dr.Jagadeesh Mitti, Dr. KuberSankh, Dr. Shashikanth Nidugundi, Dr. B. M. Mulkipatiland Dr. M D. Samudri, for their valuable inputs and suggestions. I extend my immense gratitude to Dr. V. M. Sajjan, Dr.Purad, Dr.Yarageri,Dr.Suvarna Nidugundi, Dr. Shakuntala and other teaching staff who helped during mystudy. My sincere thanks are extended to my beloved U.G.Teachers Dr. MuralidharPujar, Dr.B.S.Prasad, Dr.Prakash Mangalassery, Dr.Sajitha, Dr.G.V.Ramana,Dr.Ashwinkumar, Mr.Panduranga, and Dr. Tripati for their inspiration and valuablesuggestions. I express my sincere thanks to Sri. Nandakumar, for his help in statisticalanalysis of results. I take the privilege to thank Sri. Mundinamani, Librarian, whoprovided me all the necessary books and time for my literary work. I cannot move further before thanking to my intimate friends Mr. Shakthi(Local guardian), Dr.Sasisankar.MS, Dr.Sanathan sarma, Dr.Rahul, Dr.Sunil kumar,Dr.Sanand, Dr.Sajith kumar, Dr.Jibi, Dr.Sreekumar(Pappu), Dr.Sachin(Mangu),Dr.Sandeep Patil, Dr.Gautam alva, Dr.Hariprasad shetty, Dr.Pratap, Dr.Anatharamsarma who helped me in each and every circumstance and gave me a depth sense offriendship. I feel extremely thankful to seniors Dr. Ashok M.G, Dr. Prasanna V. Joshi, Dr.Devandrappa Budi, Dr. Prasanna Kumar, Dr. Siba Prasad, Dr. Payappa Gowdar, Dr.Madhushree, Dr. Nataraj, Dr. Sanjeev Chaudary, Dr. Udaya Ganesha, Dr. Adarsh, Dr.Shailej, Dr. Mukta Hiremath and others for valuable suggestions. I pay sincere regards to my fellow colleagues Dr. Sanath kumar, Dr. Rajesh,Dr. Jayasankar, Dr. Deepak, Dr. Ishwar Patil, Dr. Praveen Nayak, Dr. Bodke, Dr.Kanti, Dr. Shakunthala, Dr. Asha, Dr. C.C Hiremath, Dr. Rotti, Dr. Bupesh, Dr.Gorpade, Dr. Deepa, Dr. Jadav, Dr. Mahantesh Swami Hiremath and Dr. PraveenPalled for their truly help and co-operation. I thank my juniors Dr. Joshi Goerge, Dr. Bhaghyesh, Dr. Anish Joseph, Dr.Surej, Dr. Vijay raj, Dr. Raghavendrachar, Dr. Vishwajith, Dr. Renukaraj, Dr.Sangamesh, Dr. Vijay Mahanthesh, Dr. Jagadeesh, Dr.Maneesh, Dr. Paresh, Dr.Shilpa, and for their support. I also thank to my UG friends for their help and support. VIII
  9. 9. I am also very much thankful to Mr. Salimath, Smt. Lalithamma who mademy stay comfort through out my P.G. carrier. I extend my thanks to Sri Kulakarni, Sri Nabi, Smt. Sunanda and Smt Renukafor their timely help in Panchakarma theatre during the trail. Lastly I pay my deepest respect for those patients who took part in the studyand I share my success with them. “To err is Human” – certain names, who could be directly or indirectly helpedin this work, might have been missed unintentionally. Thanks are due, to all of them.Date : Signature of the scholarPlace : Gadag. (Dr. Sabareesh M) IX
  10. 10. LIST OF ABBREVIATIONS USED: A.H – Ashtanga Hrudaya A.S – Ashtanga Samgraha B.P – Bhavaprakasha B.S – Bhela Samhita C.S – Charaka Samhita M.N – Madhava Nidana S.S – Sushruta Samhita V.S – Vangasena Y.R – Yogaratnakara X
  11. 11. ABSTRACT: Hair has a tendency to lose its natural colour with advancing age. It istherefore natural for the hair to turn grey with age. But premature graying is a morbidcondition and it makes even the young looks older. This causes a great deal ofconcern to the effected persons. Akala Palitya is a burning problem as large numberof population especially young men and women in present times are suffering fromthis malady. Acharyas have mentioned Nimba taila Nasya is one of the best treatment forAkala Palitya along with Bringaraja taila Shiroabyanga as Bringaraja is one of thebest Kesharanjaka drug. Thus these drugs were considered for the study.Objectives of the study: • To evaluate the effect of Nimba taila Nasya and Bringaraja taila Shiroabyanga in Akala Palitya. • To evaluate the adverse effect of Nimba taila Nasya, if any.Materials and Methods: A total of 30 patients were selected from O.P.D and I.P.D. of D.G.M.A.M.C &H after fulfilling the inclusion and exclusion criteria randomly. All the 30 patientswere included in a single group and given 3 courses of Nasya karma andShiroabyanga, each course of 7 days and 3 days gap in between each course. Alongwith 30 days Pariharakala.Assessments results: Assessment of results was done by considering the base line data of subjectiveand objective parameters to pre and post medication was analyzed statistically for ‘p’value using ‘t’ test. XI
  12. 12. Overall response of patients: In the study, no patients had very good as well as good response. Among 30patients 13 Patients (43.33%) had satisfactory response to the treatment (25%-50%improvement in all the parameters), 17 Patients (56.66%) had poor response to thetreatment (<25% improvement in all the parameters).Key words: Akala Palitya, Premature graying of hair, Nimba taila Nasya, Bringarajataila Shiroabyanga. XII
  13. 13. TABLE OF CONTENTS:1. Introduction 1-22. Objectives 3-43. Literary review 5-1034. Materials and methods 104-1135. Observations and results 114-1386. Discussion 139-1537. Conclusion 1538. Summary 155-1569. Bibliography 157-16810. Annexure 169-177 XIII
  14. 14. LIST OF TABLES: SI Table and content PageNo. No.1 Nasya classification according to various Acharyas 92 Seasonal schedule of Nasya 153 Time schedule of Nasya acco. to dosha 154 Time schedule of Nasya 215 Contraindications of Nasya 256 Time schedule of Nasya in different seasons 267 Time schedule according to Dosha vitiation 268 Course of Nasya Karma 269 Dose of Nasya 2710 Samyaka Yoga Lakshanas of Nasya 3011 Ayoga Lakshanas of Nasya 30-3112 Atiyoga Lakshana of Nasya 3113 Seven layers of skin 4714 Stages of hair growth 5915 Aharaja nidana of Palitya 6916 Palita lakshanas of Palitya acc. to Vagbhata 7617 Palita lakshanas of Palitya acc. to Yogarathnakara 7618 food items which will be helpful to maintain the health of hair 8819 Properties of Nimba 9920 Properties Bringaraja 10121 Properties of Narikela 10322 Subjective parameters 10823 Parameter Area of scalp involved 11024 Parameter Random hair count 11025 Distribution of patient’s age group 11526 Distribution of patients according to sex 11527 Distribution of patients by Religion 11528 Distribution of patients by Occupation 11629 Distribution of patients by Economical status 11630 Distribution of Patients by Dietary habit 11731 Distribution of Patients by Agni 11732 Distribution of Patients by Koshta 11833 Distribution of Patients by Nidra 11834 Distribution of Patients by Vysana 11835 Distribution of Patients by Deha prakrithi 11936 Distribution of patients by Satmya 12037 Distribution of patients by color of hair 12038 Distribution of patients by nature of hair 12139 Distribution of patients by Anubandha vedana 12140 Distribution of patients by Mode of onset 12241 Distribution of patients by Site of onset 12242 Distribution of patients by Kula vrutantha 12343 Distribution of patients by head bath 12344 Distribution of patients by Type of water for head bath 124 XIV
  15. 15. 45 Distribution of patients by Materials used for hair wash 12446 Distribution of patients by Methods of hair drying 12547 Distribution of patients by using hair oil 12548 Distribution of patients by using hair dye 12649 Distribution of patients according to response 12650 Before treatment and after treatment values of all Parameters. 12751 Statistical analysis of parameter value 12852 Demographic data in patients 12953 Demographic data in patients 13054 Demographic data in patients 13155 Demographic data in patients 13256 Demographic data in patients 13357 Demographic data in patients 13458 Demographic data in patients 13559 Demographic data in patients 13660 Demographic data in patients 13761 Demographic data in patients 138 XV
  16. 16. LIST OF FIGURES: SI Figure PageNo. No.1 Cross section of scalp with hair and its parts 472 Structure of the shaft of hair 513 Structure of the hair root 534 Drug Nimba 985 Drug Bringaraja 1006 Drug Narikela 1027 Olsen/Canfield visual aid 1088 Shiroabhyanga 1139 Nasya 11310 Distribution of patient’s age group 11511 Distribution of patients according to sex 11512 Distribution of patients by Religion 11613 Distribution of patients by Occupation 11614 Distribution of patients by Economical status 11715 Distribution of Patients by Dietary habit 11716 Distribution of Patients by Agni 11717 Distribution of Patients by Koshta 11818 Distribution of Patients by Nidra 11819 Distribution of Patients by Vysana 11920 Distribution of Patients by Deha prakrithi 11921 Distribution of patients by Satmya 12022 Distribution of patients by color of hair 12023 Distribution of patients by nature of hair 12124 Distribution of patients by Anubandha vedana 12125 Distribution of patients by Mode of onset 12226 Distribution of patients by Site of onset 12227 Distribution of patients by Kula vrutantha 12328 Distribution of patients by head bath 12329 Distribution of patients by Type of water for head bath 12430 Distribution of patients by Materials used for hair wash 12431 Distribution of patients by Methods of hair drying 12532 Distribution of patients by using hair oil 12533 Distribution of patients by using hair dye 12634 Distribution of patients according to response 126 XVI
  17. 17. IntroductionIntroduction: The face of an individual is a personal identity in which hair plays asignificant role. Therefore a perfect head with hair is an attribute of personality andbeauty. Genetically Indians are black haired and a dark head is any time better andgoes well on any dress.1 This feeling makes one especially Palitya persons to havedark black hair, that’s why they undergo various therapies with hope of getting blackhair. Akala Palitya is a burning problem as large percent of population especiallyyoung men and women in present times are suffering from this malady. Because ofthis effected persons feel social embarrassment and stigma. In present days because of altered life style and stressful occupation signs ofaging are seen much earlier. Increasing urbanization and industrialization has posedgreater danger, due to pollution and contamination of water and air, with variableboth extrinsic and endogenous factors, there is definite increase in the incidence ofPremature Graying of Hairs, especially in tropical and developing countries.Incidence as per W.H.O is largely between the age group of 25-30 years.Accordingly ‘Akala Palitya’ is such condition, which is prevailing more andencountered more in day to day clinical practice. Unfortunately contemporary medical science also does not offer anysatisfactory treatment other than artificial coloring of hair (Dyeing). This regulardyeing will leads to many adverse effects like hair fall and other scalp diseases.Understanding hair and related problems, is not merely cosmetic claim, but itreflects the psychological and pathological conditions of whole body system. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in 1 Akala Palitya
  18. 18. Introduction In such grim clinical situations while referring various Ayurvedic texts, I cameacross a few formulations and procedures for this Akala Palitya (Premature grayingof hair). The one and only Panchakarma procedure explained for Palitya is Nasya.Sharangadara Samhita2, Yogarathnakara3, Baishajyarathnavali4 and Chakradatta5have mentioned Nimbabeeja taila as one of the best treatments for Palitya as it is anUrdwajatrugatha vyadhi where in Nasya is specially indicated6. Basing on thisNimba beeja taila Nasya has been selected for the present study. Along with thisShirobyanga with Bringaraja taila is also selected, as daily Shiroabyanga with Snehawill prevent Palitya7 and Bringaraja is one of the best Kesharanjaka drug8. This twofold therapy has been done on selected 30 patients strictly in accordance with theprocedure laid-down in the Ayurvedic classics and duly following the researchmethodology8(a). Finally the result/data obtained has been statistically evaluated. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in 2 Akala Palitya
  19. 19. ObjectivesObjectives: • To evaluate the effect of Nimba taila Nasya and Bringaraja taila Shiroabyanga in Akala Palitya. • To evaluate the adverse effect of Nimba taila Nasya, if any.Need for the study: In present days because of altered life style and stressful occupation signs ofaging are seen much earlier. ‘Akala Palitya’ is such condition, which is prevailingmore and encountered more in day to day clinical practice. The incidence ofpremature graying of hair as per W.H.O is between the age group of 25-30 years. Contemporary medical science does not offer any satisfactory treatment otherthan artificial coloring of hair (Dyeing). Hence this study has been undertaken with the title, “Evaluation of combinedeffect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in AkalaPalitya.” An observational clinical study.Previous researches on this topic: • Nalini C: A clinical study on akala palitya and its management, R.G.U.H.S, Bangalore, Dept.of Shalakya 1999. • Sunil Kumar S: Management of akala palitya with brungaraja taila nasya and internal use of kaseesa bhasma, A.P. university, Vijayavada. Dept.of Shalakya 1993. • Chawda Harsha: Role of nirgundi patra palitagna lepa and neeli taila in management of palitya, G.A.U., 2000. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 3 Shiroabhyanga in Akala Palitya
  20. 20. Objectives• Kamala Kumari L: Clinical management of akala palitya (grey hair) with triphaladi lepa with and with out nimba beeja taila, A.P. university, Vijayavada. Dept.of Shalakya 2005.• Kaushal Randhir: A comparative and clinical study in between shirovirechana- poorvaka mahaneela taila shirobasti and brungaraja rasayana in palitya roga,Rajastan university Jaipur, Dept.of Kayachikitsa. 2000.Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 4 Shiroabhyanga in Akala Palitya
  21. 21. Review of NasyaHistorical review: The meaning of historical review is to trace out a continuous chain ofknowledge and by that come to know that where at present. The history of medicine isas old as human civilization. Plenty of disorders have been found referred in theancient literatures of Vedic period, either directly naming the disease itself or byhinting the nature of the disorder.Historical Aspect of Nasya karma: Seeds of knowledge are implanted in Veda. Veda’s are ancient source ofknowledge. There is description of health and disease related topics in a variable formin all Vedas but proportion of such topics is significant in Atharvaveda. HenceAyurveda is considered as a subset of Atharvaveda. It is natural that growth ofknowledge of any topic occurs gradually and same is the case with Nasya karma,which has developed since Vedic era to Modern era. Before the historical review ofNasya that of Nasa through which it is given would be appropriate.Description of Nasa in ancient texts:Yajurveda: While describing the Indriyas, there is mention of two Netra, two Karna,two Nasika Chhidra and Jihva.Atharvaveda: Nasa is described among nine chhidras and Indriya.“A¹cÉ¢ü,lÉuɲÉU…….” (Atharvaveda, 10/2/32)Bhagvad Gita: While describing Indriyas, the Nasa is mentioned.“lÉuɲÉU mÉÔuÉÉïSåÌWû lÉåuÉÉ…….” (Bhagawat Gita 5/13) Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 5 Shiroabhyanga in Akala Palitya
  22. 22. Review of NasyaDescription of Nasya in ancient texts:Rigveda: Although it is very difficult to say that the procedure of Nasya karmatherapy was in practice during Vedic period. But the few Mantras of Rigavedaindirectly refer towards the Karmas which are included under Panchakarma measures.There is a Mantra of Rigveda, in which eradication of Roga from the routes of Nasa(Nostrils), Chibuka (Chin), Shira (Head), Karna (ear) and Rasana (tongue) arementioned (Ri.V. 10-16-4). Thus one can think that the references of eradication ofdisease from the above mentioned routes most probably refers towards Nasa (nose) orShirovirechana.Krishna Yajurveda, Shatpatha Brahmana, Upanishad: In these texts, the termNasya karma has been used frequently.Ramayana: In Valmiki Ramayana, when Laxman became unconscious by the blowof Meghanada, Vaidya Sushena administered the juice of Sanjivani through nasalroute bringing him to consciousness instantaneously.Bauddha Kala: “Jeevaka” the famous Vaidya of Bauddha period had utilized Nasyakarma in many cases such as 1) In Shirahshoola, he prescribed Nasya of medicated ghrita to the wife of Shreshthi of Saketa Nagar. 2) Once, when Jeevak wanted to give Virechana to Lord Buddha, he gave him aushadhi by nasya for Virechana.Vinaya Pitika: In this book, it is mentioned that one utpala hasta of Nasya haspotency to induce 10 vegas of Virechana.Samhita Kala: Literature written during this period is the heart of ayurvedicliterature. In all the Samhita, Nasya karma has been elaborately described especiallyin Charaka Samhita, Sushruta Samhita and Ashtanga Samgraha. The research Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 6 Shiroabhyanga in Akala Palitya
  23. 23. Review of Nasyaconducted on this therapy was at such a height that it was used to achieve desired sexof foetus. Nasya karma is utilized in treatment of many diseases in Brihattrayi such asin Charaka, in chikitsa of Jwara, Raktapitta, Kustha, Rajyakshama, Unmada,Apasmara, Shwayathu, Hikka, Shvasa, Kasa, Visha, Trimarmiya, Vata vyadhi,Trimarmiya siddhi etc,. In Sushruta Samhita, in Chiktisa of Dwivraniya, Sadyovrana,Bhagandar, Vata Vyadhi, Mahavata Vyadhi, Kustha, Udara, Granthi, Apachi, Arbudaganda, Vriddhi, Upadamsha, Shlipada, Kshudra Roga, Mukha Roga etc, . In AshtangaHridaya, in Chikitsa of Jwara, Raktapitta, Shvasa Hikka, Rajyakshama, Chhardi,Hridaroga, Trishna, Madatyaya, Shvitra, Krimi, Vata Vyadhi etc,.Etymology of Nasya Karma: In Sanskrit language each word is derived from a specific dhatu and eachdhatu bears an inherent meaning which is the crux of the word. The derivation of theword Nasya is from “Nasa” dhatu. It conveys the sense of Gati – motion. Vyapti bearsthe meaning pervasion. Here, the Nasa dhatu is inferred in sense of nose. Accordingto Vachaspatyam word “Nasata” means beneficial for nose. In Ayurveda, the word Nasya has been taken specifically to mention the nasalroute of administration of the drugs. According to Acharya Susruta medicines ormedicated oils administered through the nose is known as Nasya9. According toAruna Dutta and Bhava Prakasha all drugs and measures that are, administeredthrough the nasal passage are called Nasya10. Sharangdhara and Vaghbhata are also ofsame view11. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 7 Shiroabhyanga in Akala Palitya
  24. 24. Review of NasyaSynonyms: • Prachchardana. • Shirovirechana. • Shirovireka. • Murdhavirechana. • Navana. • Nastaha Karma. Sushruta specify the word Shirovirechana to describe a particular variety ofNasya karma12. The word Virechana means elimination of morbid Doshas from thebody. This Shirovirechana or Murdhavirechana indicates its main function eliminationof morbid Doshas particularly from the Shira or parts situated above the clavicle. Charaka has used the term “Nastah Pracchardana” for Nasya13. This denotesShodhana done by Nasya. The words Nastah and Navana denote the site of administration. Nasta karma& Navana karma means the measures which are beneficial to nose, or region of thenose. On this basis it may be said that Nasya karma is a therapeutic measure inwhich the drug (medicated oil or other) administered through Nasa mainly toeliminate the vitiated Doshas situated in Shirah and its constituent parts, reliving thediseases of those parts (Urdhvajatrugata Vikaras). Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 8 Shiroabhyanga in Akala Palitya
  25. 25. Review of NasyaClassification of Nasya: Nasya is classified in various ways by different Acharyas but ultimately all theprocedures are same. Mainly classified according to its mode of action i.e. Shodhana,Shamana, etc & on the basis of various forms of drug preparation utilized for theNasya karma e.g. Churna, Sneha, etc. The classifications according to variousAcharyas are shown in table.Table No. 01. Showing Nasya classification according to various Acharyas Name of Acharya ClassificationNo1 Charaka According to mode of action - Rechana, Tarpana, Shamana According to the method of administration – Navana, Avapidana, Dhmapana, Dhuma, Pratimarsha According to various parts of drugs utilized – Phala, Patra, Mula, Kanda, Pushpa, Niryasa, Twaka2 Sushruta Shirovirechana, Pradhamana, Avapida, Nasya, Pratimarsha3 Vagbhatta Virechana, Brimhana, Shamana4 Kashyapa Brimhana, Karshana5 Sharangadhara Rechana, Snehana6 Videha Sangya Prabodhaka, Stambhana,Charaka’s Classification of Nasya: According to Charaka the Nasya is of five types viz. Navana, Avapida,Dhmapana, Dhuma and Pratimarasa14. Navana is further divided in to Snehana andShodhana, Avapidana into Shodhana and Stambhana, Dhuma into Prayogika,Vairechanika and Sneihika while Pratimarsha is divided into Snehana and Virechana. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 9 Shiroabhyanga in Akala Palitya
  26. 26. Review of Nasya The above mentioned five types of Nasya are regrouped according to theirpharmacological action into three groups viz. – Rechana, Tarpana and Shamana15. Charaka has also mentioned 7 types of Nasya according to parts of the drugsto be used in Nasyakarma viz – Phala, Patra, Mula, Kanda, Pushpa, Niryasa andTwak16. Nasya Navana Avapidana Dhmapana Dhuma Pratimarsha Snehana Shodhana Prayogika Snaihika Vairechanika Shodhana Stambhana Snehana Virechana According to the action of Nasya therapy Rechana Tarpana Shamana According to various parts of the drugs utilized in Nasya therapy Phala Patra Mula Kanda Pushpa Niryasa TwakaClassification of Nasya according to Sushruta: According to Sushruta Nasya is also of 5 types Viz. Nasya, Avapida,Pradhamana, Shirovirechana and Pratimarsha. These 5 types of Nasya are furtherclassified according to their functions into two groups viz. Shirovirechana andSnehana. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 10 Shiroabhyanga in Akala Palitya
  27. 27. Review of Nasya Shirovirechana, Avapida and Pradhamana are used for Shirovirechana i.e. forthe elemination of morbid Dosha from Shira, Pratimarsha and Nasya type may beused for Snehana17. Nasya Shirovirechana Snehana Shirovirechana Pradhmana Avapida Nasya PratimarshaVagbhata’s Classification of Nasya: Ashtanga Sangraha has mainly classified Nasya according to the functions viz.Virechana, Brimhana and Shamana18. Snehana and Brimhana Nasya have been furthersubdivided according to the doses into two groups i.e. Marsha and Pratimarsha19. Avapidanasya may be given for both Virechana and Shamana whilePradhamana Nasya is given only for Shirovirechana. Ashtanga Hridaya has mainly classified Nasya in 3 types viz. Rechana,Brimhana and Shamana20. Nasya Virechana Brimhana Shamana Pradhamana Murdha Sneha Nasya Virechana According to Dose Pratimarsha Marsha Avapida Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 11 Shiroabhyanga in Akala Palitya
  28. 28. Review of NasyaKashyapa’s Classification of Nasya: According to Kashyapa Samhita Nasya has been classified into two groups i.e.Brimhana and Karshana. These two types are also known as Shodhana and PuranaNasya21. Nasya Brimhana Karshana (Purana) (Shodhana)Sharangdhara’s Classification of Nasya: Sharangdhara has also classified Nasya according to their functions into twogroups viz. Rechana and Snehana. Rechana Nasya is further subdivied into Avapidaand Pradhamana. Snehana Nasya is subdivided into Marsha and Pratimarsha22. Nasya Rechana Snehana Avapida Pradhmana Marsha PratimarshaVideha’s Classification of Nasya: Videha has stated two types i.e. Sangyaprabodhaka and Stmabhana23. Nasya Sangyaprabodhaka Stmabhana Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 12 Shiroabhyanga in Akala Palitya
  29. 29. Review of NasyaIt is clear from the above discription that two types of classification of Nasya Karmaare available in Ayurvedic literature. • Other is based on the preparation of drug and the method of its application e.g. Dhmapana (Powder is blowed) Avapida (Extracted Juice is used) Dhuma (smoking through nose) etc. • One is based on the pharmacological actions viz. Rechana, Tarpana etc. Classification of Nasya by Charaka into Navana, Avapida, Dhmapana, Dhumaand Pratimarsha while by Sushruta into Nasya, Shirovirechana, Pratimarsha , Avapidaand Pradhamana seems to be based on the type of preparation utilized or the way inwhich it is administered. For instance in Avapida Nasya as its name indicates generally expressed juiceis used. Pradhamana is so named because it requires blowing. Vagbhata has describedMarsha and Pratimarsha mainly on the basis of difference in the dose to be droppedinto the nostrils. Taking the Charaka’s classification as the basis, all the above mentioned typesof Nasya are being described here seperately.Navana Nasya:Definition: Navana is one of the important and well applicable therapies of Nasya Karma.Navana is administered by instilling the drops of a medicated oil or Ghrita in the nose.Instrument: Charaka has described Pranadi (pippet or dropper) for administration ofNasya24. Navana is generally the Sneha Nasya and is known as Nasya in general.Classification: It can be mainly classified into Snehana and Shodhana Nasya. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 13 Shiroabhyanga in Akala Palitya
  30. 30. Review of NasyaSnehana Nasya: As the word Sneha suggests, Snehana Nasya gives strength to all the Dhatusand is used as Dhatuposhaka.Dose: The following is the dosage schedule for Sneha Nasya25 • Hina Matra – 8 drops in each nostril. • Madhyamamatra – Shukti Pramana - 16 drops in each nostril. • Uttama Matra - Panishukti Pramana – 32 drops in each nostril. According to Bhoja, Matra of Prayogika sneha nasya is 8 drops, while matraof Snahika Nasya 16 drops. According to Doshabala quantity can be doubled ortripled.Benefits of Sneha Nasya: It is used for the Snehana in the complaint of feeling ofhead lightness. It gives strength to neck, shoulder and chest and improves eyesight.Indications of Sneha Nays: Vatika Shirahshula, Keshapata, Dantapata,Shmashrupata,Tivrakarnashula, Timira, Nasaroga, Mukhashosha, Avabahuka, AkalajaValita,Akalaja Palita, Darunaprabodha and Vatapittaja Mukharoga26.Shodhana Nasya:Definition: This Nasya which eliminates the vitiated Doshas. Sushruta’sShirovirechana type is included in Shodhana type of Navana Nasya.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 accoding to Sushruta27. • Uttama - 8 drops • Madhyama - 6 drops • Hina - 4 drops. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 14 Shiroabhyanga in Akala Palitya
  31. 31. Review of NasyaIndications: Kaphapurna Talu & Shira, Aruchi, Shirogaurava, Shula, Pinasa,Ardhavabhedaka, Krimi, Pratishyaya, Apasmara, Gandhagyana nasha andUrdhvajatrugata Kapharogas28; and Urdhvajatrugata Shopha, Praseka, Arbuda andKotha29. In healthy persons Navana Nasya should be given according to the followingseasonal schedule.Table No. 02. Showing the seasonal schedule of Nasya: Sl.No Season Nasya to be given at 1 Shita Kala Noon 2 Sharada and Vasanta Morning 3 Grishma Rutu Evening 4 Varsha Rutu Only when sun is visibleTime Schedule: Navana Nasya should be administered according to the followingtimeSchedule30, 31.Table No. 03. Showing the time schedule of Nasya acco. to dosha: Sl.No Roga Nasya to be given at 1 In Kaphaja Roga Fore noon 2 In Pittaja Roga Noon 3 In Vataja Roga After Noon Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 15 Shiroabhyanga in Akala Palitya
  32. 32. Review of NasyaAvapida Nasya:Definition: In Avapida Nasya, juice is expressed from paste or kalka of a drug. The wordAvapida means it is expressed juice of leaves or paste (kalka) of required medicine.(Chakrapani). This Nasya can be utilized for both Shodhana and Shamana purposedepending upon the drug utilized.Method: For this purpose first Kalka of the required medicine is prepared which isplaced in white & clean cloth & is squeezed to obtain the required quantity of juice,directly in the nostril of the patient. The administration of the drug in this way isknown as Avapida Nasya32. This type of Nasya may also be given with Kalka(paste)33. It may also be given by diping the swab (pichu) into the Shrita (decoction) orSheeta (cold infusion), Swarasa (juice) of the required drug34.Types: It is mainly of two types35. • Stambhana Nasya • Shodhana Nasya.According to Chakrapani, three types. • Shodhana • Stambhana • ShamanaAccording to Videha two types. • Sangya prabodhana • Stambhana Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 16 Shiroabhyanga in Akala Palitya
  33. 33. Review of NasyaDrugs: For Shodhana purpose Kalka of Tikshna dravyas like Saindhava, Pippali etc.have been mentioned as Avapida Nasya and for Stambhana purpose Stambhana drugshave been described.Dose: Avapida Nasya should be given in the following dose • Hina Matra - 4 drops • Madhyama Matra - 6 drops • Uttama Matra - 8 dropsIndications: Avapida Nasya is indicated in the following conditions36. Manasaroga,Apasmara, Shirovedana, Chitta- vyakulavastha, Moha, Mada, Murchha, Sanyasa,Bhaya, Krodha, Bhiru, Sukumara, Krisharogi, Stri, Raktapitta, Vishabhighata,Apatantraka. Sharangdhara recommends the Avapida Nasya for the patients suffering fromGalaroga, Vishamajwara Manovikara and Krimi37.Dhmapana Nasya:Definition: Dhmapana or Pradhamana is a specific Shodhana Nasya. This type ofNasya is instilled with churna (powder) specifically for Shirovirechana. Dhmapanamentioned in Charaka & Pradhamana described in Sushruta.Instrument: In this type, fine powder of drug is administered through nasal passage.For this purpose specific Nadi yantra, A tube like instrument with length of 6 angulasand with open ends is utilized.Method: In Pradhamana Nasya, Churna (powder of drugs) is administered (inhaled)by Nasal passage with the help of Nadi Yantra. The Churna (fine powder) of requireddrug is kept at one end, and air is blown from the other end, so that the medicine mayenter in to the nostrils38. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 17 Shiroabhyanga in Akala Palitya
  34. 34. Review of Nasya Videha has described another method for Pradhamana, in which fine powderof drug kept in a Pottali made of a thin cloth is used to inhale, so that smallestparticles of the medicine enter into the nostrils.Dose: According to Videha the dose of Dhmapana Nasya is three Muchuti (3 pinch).For the Pottali method Churna should be atleast 2 Tolas i.e. 20gms.Drug: Generally Tikshna drugs like Rock salt, Garlic, Guggulu, Maricha, Vidanga,etc are used for this type of Nasya. Hence cautions should be taken during itsadministration.Indications: Its indications are as follows39. Shiro Roga Nasa Roga Akshi RogaDhuma Nasya:Definition: Dhuma Nasya is defined as medicated fume taken by nasal route andeliminated by oral route. Acharya Sushruta has not described it as a type of Nasya.The smoking per mouth is known as Dhumapana and is not included in Nasya. It isharmful to eye sight.Types: Dhuma Nasya are of the following types • Prayogika • Vairechanika • SnaihikaInstrument: Acharya Charaka has mentioned special Dhuma Nadi for Dhuma Nasya.The length of the Nadi depends upon the type of the Dhuma Nasya, details of whichare as under40. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 18 Shiroabhyanga in Akala Palitya
  35. 35. Review of Nasya • Prayogika - 36 angula • Vairechanika - 24 angula • Snaihika - 32 angulaBreadth of the Nadi should be as per measurement of ones own angula.Dose: It should be given in the following dose • Two puffs are to be taken for Prayogika Dhuma. • 3 to 4 puffs are to be taken for Vairechanika Dhuma. • A single puff is advised for snaihika Dhuma.Drugs: For Prayogika Dhuma drugs like Priyangu, Ushira etc. should be used. ForSneihika Dhuma Vasa, Ghrita etc. and for Vairechanic Dhuma, drugs like Aparajita,Apamarga etc. should be used41.Indication: Dhuma Nasya is indicated in Shiroroga, Nasaroga and Akshiroga42.Marsha – Pratimarsha Nasya:Definition: Marsha and Pratimarsha both consists of introduction of oil through thenostrils. It is well tolerated and is very much convenient procedure. Pratimarsha and Marsha are same in principle, but the main differencebetween them is of dose. In Pratimarsha Nasya 1-2 drops are given while in MarshaNasya the dose is 6 to 10 drops.Pratimarsha Nasya: Pratimarsha Nasya can be given daily and even in all the seasons at morningand evening. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 19 Shiroabhyanga in Akala Palitya
  36. 36. Review of NasyaMethod: A finger is dipped in the appropriate sneha up to 2 phalanges and then oil isallowed to drop from it in both nostrils. Patient is advised to expel out the sneha,which comes in oral cavity.Dose: 2 drops morning and evening.The Sneha should atleast reach from nose to gullet, but it should not be too much thatcan produce secretion in gullet43.Indications: Pratimarsha can be given in44 • Any age. • Any season • Even in not suitable time and season i.e. in Varsha and • Durdina • Bala • Vridhdha • Bhiru • Sukumara • Weak patients • Kshtakshama • Trishna Pidita • Mukhashosha • Valita and PalitaContraindications: it is contraindicated in45 • Dushta Pratishyaya • Krimija Shiroroga • Madhyapi (habitual drunkers) • Badhirya (deafness) Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 20 Shiroabhyanga in Akala Palitya
  37. 37. Review of Nasya • Bahudosha • Utklishta Doshas It is contraindicated in such persons because the Sneha Matra is quiteinsufficient to eliminate Doshas or Kriminasha and already aggravated Doshas mayget vitiated further46. Sushruta and Sharangadhara have described 14 suitable times for PratimarshaNasya, while Vagbhatta has mentioned fifteen Kala.Table No. 04. Showing the time schedule of Nasya:No Time for Pratimarsha Nasya Su. As. H. Sha.1 After leaving the bed in morning + + +2 After cleaning the teeth (with Dantadhavana) + + +3 Before going outside + - +4 After exercise + + +5 After sexual intercourse + + +6 After walking + + +7 After urination + + +8 After passing Apanavayu + - -9 After Kavala + + +10 After Anjana + + +11 After meal + + +12 After sneezing + - -13 After sleeping in the noon + + +14 In the evening + + +15 After vomiting - + +16 After Shirobhyanga - + -17 After defaecation - + +18 After laughing - + - Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 21 Shiroabhyanga in Akala Palitya
  38. 38. Review of NasyaMarsha Nasya:The method of administration of Marsha Nasya resembles that of Pratimarsha but assaid earlier the dose varies.Dose: In Marsha Nasya, 6 to 10 drops of Sneha are administered.Drugs: Though all Sneha dravya like oil, ghee, etc. can be utilized but use of oil isadvisable because Shira is the place of Kapha and oil is inherently opposite to Kaphain properties. Marsha Nasya is quickly effective and more beneficial than pratimarsha47.Classification of Nasya according the Pharmacological action: Charaka and Vagbhata have classified Nasya into 3 groups according to theirpharmacological action48, 49. Nasya Rechana Brimhana Shaman Sangyaprabodhan Krimighna Stambhana Karshana a (Shodhana) Raktastambhan Doshastambhan The types Rechana, Tarpana and Shamana are described by Acharya Charakaand Vagbhatta. Sushruta has not described the Shamana Nasya. He has given onlytwo types viz. Shirovirechana and Snehana. Kashyapa has mentioned Brimhana and Karshana types of Nasya karma i.e.Sangya Prabodhana and Stambhana, according to their pharmacological action. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 22 Shiroabhyanga in Akala Palitya
  39. 39. Review of NasyaRechana Nasya: The Nasya, which eliminates vitiated Doshas of Shira through the nasal routeis also called Rechana Nasya. It is also termed as Karshana Nasya.Drugs: Apamarga, Pippali, Maricha etc. are drugs of choice that can be used forRechana Nasya. Kwatha, Swarasa or Tikshna sneha of above drugs may also beutilized for the same50, 51.Indications: It is indicated specifically in Kaphaja type of Shiroroga like Stambha,Supti and Guruta of Shira52. According to Susruta, Talukantha and Shirokrimi, Arochaka, Shula,Shirogaurava,Pinasa, Pratishyaya, Urdhvajatrugata Kaphaja Vikara53.Brimhana Nasya: Tarpana is that type of Nasya, which is specially indicated in a Dhatukshaya(degeneration). Tarpana Nasya resembles Snehana Nasya described by Sushruta andSharangadhara and Brimhana Nasya mentioned by Acharya Vagbhatta in itsproperties and actions.Drugs: Drugs of Madhura skandha and Sneha prepared with Vata-Pittahara drugs areused for above type54, 55. Exudation of certain trees, meat soups and blood may also beadministered56.Indications: Vatika Shiroroga, Dantapata, Keshapata, Darunaka and other Vata-Pittaja roga. Sushruta advises Sneha Nasya for increasing general strength and toimprove the vision power and its acquity. It is also used for curing the Shirah kampaand Ardita57.Shamana Nasya: Shamana Nasya is used for the alleviation of Dosha situated in Shirah (head).The Sneha prepared with the beneficial drugs may be used for Shamana Nasya. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 23 Shiroabhyanga in Akala Palitya
  40. 40. Review of NasyaIndication: It is used to stop bleeding in Raktapitta58. It is also indicated in AkalaValita, Palita and Khalitya, Darunaka, Raktaraji, Vyanga and Nilika.General indications of Nasya: Charaka has described the following general indications, where Nasya therapyshould be used. • Shirostambha Gadgadatva • Ardhavabhedaka Vaggraha • Shirahshula Grivaroga • Akshishula Swarabheda • Shukra Roga-Netragata Galashundika • Raji Galashaluka • Timira Galaganda • Vartmaroga Upajihvika • Pinasa Manyastambha • Nasa Shula Ardita • Danta Stambha Apatantraka • Danta Shula Apatanaka • Danta Harsha Karnashula • Danta Chala Arbuda • Hanugraha Skandharoga • Mukharoga Ansashula Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 24 Shiroabhyanga in Akala Palitya
  41. 41. Review of NasyaGeneral contra Indications of Nasya: In all patients Nasya should not be given on Durdina (Rainy day) or in Anrutu(Viparita Kala).Table No. 05. Showing the contraindications of NasyaNo. Anarhas Charaka Sushruta Vagbhatta1 Bhuktabhakta + + +2 Ajeerni + + -3 Pitta Sneha + + +4 Pitta Mad + + +5 Pitta Toya + + +6 Snehadi Patukamah + - +7 Snatah Shirah + - +8 Snatukamah + + +9 Kshudharta + - +10 Shramarta + + -11 Matha + - -12 Murcchita + - -13 Shastradandahrita + - -14 Vyavayaklanta + - -15 Vyayamaklanta + +(Shranta) -16 Panaklanta + - -17 Navajwara Pidita + - -18 Shokabhitapta + - -19 Virikta + - +(Shuddha)20 Anuvasita + +(DattaBasti) +(Datta Basti)21 Garbhini + + +22 Navapratishyayarta + - -23 Apatarpita - + +(Shuddha)24 Pittadravah - + +25 Trishnarta + + -26 Gararta - + +27 Kruddha - + -28 Bala - + - Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 25 Shiroabhyanga in Akala Palitya
  42. 42. Review of Nasya29 Vriddha - + -30 Vegavarodhitah - + + (Vegarta)31 Raktasravita - - +32 Sutika - - +33 Shvasapidita - - +34 Kasapidita - - +Suitable time for giving Nasya: According to Charaka generally Nasya should be given in Pravrita, Sharadaand Vasant Rutu. However in emergency it can be given in any season.Table No. 06. Showing the Time schedule in different seasons59:SL.No Rutu Nasya to be given at1 Grishma Rutu Morning2 Shita Rutu Noon3 Varsha Rutu When day is clear4 Sharada + Vasanta Morning5 Shishira + Hemanta Noon6 Grishma + Varsha EveningTable No. 07. Showing the Time schedule according to Dosha vitiation60:SL.No Doshaja Vikara Nasya to be given at1 Kaphaja Vikara Morning2 Pittaja Vikara Noon3 Vataja Vikara Evening Sharangdhara has described same time schedule for different seasons asSushruta has mentioned. He further states that – Nasya can be given in night, if thepatient is suffering from Lalasrava, Supti, Pralapa, Putimukha, Ardita, Karnanadi,Trishna, Shiroroga and such conditions like excessive vitiated Doshas61. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 26 Shiroabhyanga in Akala Palitya
  43. 43. Review of NasyaTable No. 08. Showing the Course of Nasya Karma62, 63, 64: No. Name of Acharaya Days 1 Sushruta 1,2,7,21 2 Bhoja 9 3 Vagbhatta 3,5,7,8 Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 27 Shiroabhyanga in Akala Palitya
  44. 44. Review of NasyaDose of Nasya Karma: The dose of Nasya drug depends upon the drug utilized for it and the varietyof the therapy. Charaka has not prescribed the dose of the Nasya. Sushruta andVagbhata have mentioned the dose in form of Bindus (drops), here one Bindu meansthe drop which is formed after dipping the two phalanges of Pradeshini (index)finger65.Table No. 09. Showing the dose of Nasya: TYPE OF NASYA DROPS IN EACH NOSTRILNo. Hrasva Madhyama Uttam Matra Matra Matra1 Shamana Nasya 8 16 322 Shodhana Nasya 4 6 83 Marsha Nasya 6 8 104 Avapida Nasya (Kalka Nasya) 4 6 85. Pratimarsha Nasya 2 2 2 The common dose for Pradhamana Nasya is 3 Muchuti (here one Muchuti =the quantity of Churna which may come in between index finger and thumb = 2.4Ratti.)66Dose According to Sharangadhara: Sharangadhara has described the following dosage schedule forNasya Karma depending upon the variety of material used67. • Tikshnaushadhi Churna - 1 Shana (4 Masha)/(24 Ratti) • Hingu – 1 Yava (½ Ratti) • Saindhava – 1 Masha (6 Ratti) • Dugdha – 8 Shana (64 Drops) • Jala (Aushadha Siddha) – 3 Karsha (3 Tola) • Madhura Dravya – 1 Karsha (1 Tola) Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 28 Shiroabhyanga in Akala Palitya
  45. 45. Review of NasyaNasyavidhi: The procedure of Nasya karma may be classified under following headings • Purva Karma (Pre-measures) • Pradhana Karma (Chief measure) • Pashchata Karma (Post-measures)Purva Karma (Pre-measure): It is advisable that all materials, drugs and equipmentslike napkin, utensils necessary for Nasya karma are collected in sufficient quantityprior to Nasya karma. Special room for Nasya should be prepared which should befree from atmospheric effects like direct blow of air or dust and it should be lightedproperly.Preparation of the Patient: Patient should have passed his natural urges like urineand stool. He should have completed his routine activities. Light breakfast prior (1hour) to Nasya karma is advised. After preparation of patient by above said regimens, snehana and swedanashould be done. Here, Snehana means, Mridu Abhyanga. It should be done on scalp,forehead and neck for 3 to 5 minutes by medicated oil68. After Abhyanga, Mridu Swedana should be done on Shira, Mukha, Nasa,Manya, Griva and Kantha. Though according to Ayurvedic texts, Swedana should notbe done on the head, but for the purpose of elimination and liquification of doshaMridu Swedana can be done as Purva karma of Nasya.Pradhana Karma: The procedure to be adopted for the Nasya karma is describedhere as per the statements of Charaka69, Vagbhata70 and susrutha71. Patient should lye down in supine position on Nasya table. The head of thepatient should be lowered (Pravilambita). The position of head should not beexcessively extended. After covering of eyes with a clean cloth, the tip of patient’s Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 29 Shiroabhyanga in Akala Palitya
  46. 46. Review of Nasyanose should be drawn upward by the left thumb of the Vaidya. At the same time withthe right hand Vaidya should instill lukewarm medicine in both the nostrils,alternately, with the help of proper instrument like pichu, dropper, shadangula nadietc. according the type of Nasya. The drug should be proper in dose and temperature.The patients should remain relaxed at the time of administration of nasya and heshould avoid speech, anger, sneezing, laughing and shaking his head.Paschat Karma72, 73, 74: According to Acharya Charaka, Acharya Sushruta, and Acharya Vagbhattafollowing regimen should be followed after administration of Nasya. Patient in lyingposition is asked to count up to 100 matra i.e. approximately 2 minutes. Afteradministration of Nasya feet, shoulders, palms and ears should be massaged. Againmild fomentation should be done on forehead, cheeks and neck. For pacifying Vatadosha, Rasna churna is rubbed on head. The patient is asked to expel out the drug which comes in oropharynx. Careshould be taken that no portion of medicated oil is left behind. Medicated Dhumapanaand Gandusha are advocated to expel out the residue mucous lodged in Kantha.Patient should be advised to stay in a windless place. A light meal and lukewarmwater are advised. One should avoid dust, smoke, sunshine, hot bath, anger, riding,excessive intake fat and liquid diet. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 30 Shiroabhyanga in Akala Palitya
  47. 47. Review of NasyaSamyaka Yoga, Ayoga and Atiyoga of Nasya karma75, 76, 77, 78: After Nasya karma the symptoms of its Samyaka yoga, Ayoga and Atiyogashould be observed, which are being described here as under.Table No. 10. Showing the Samyaka Yoga Lakshanas of Nasya: Symptoms Ch. Su. As. H. Sha. B. P. Ka.Urah Laghuta + - - - + -Shiro Laghuta + + - - - -Netra Laghuta - + + - +Laghuta - - - + -Srotovishuddhi + + - + + +Swaravishuddhi - + - - -Vaktravishuddhi - + - - -Indriyaachchta-prasada + + - + + +Netrateja Vriddhi - + - - +Chitta Prasada - + - + + +Vikaropashama - + - + + -Sukha Svapna Prabodha - + + - - -Sukhachchvasa - + - - - -Arati - - - - - -Medha - - - - - -Bala - - - - - -Table No. 11. Showing the Ayoga Lakshanas of Nasya:Sl.No As. Symptoms Ch. Su. Sha. B.P. Ka. H.1 Shirogaurava and Dehagaurava + - - + + +2 Galopalepa + - - - - -3 Nishthivana + - - - - -4 Kandu - + + + + -5 Kaphapraseka - - - - - -6 Upadeha + - + + - - Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 31 Shiroabhyanga in Akala Palitya
  48. 48. Review of Nasya7 Rukshata + - - + + +8 Vata Vaigunya + - - - - -9 Srotoriktata - - - - + -10 Srotasamkaphasrava + - - + + +11 Nasashosha - + - - - -12 Asyashosha - + - - - -13 Akshistabdhata - + - - - -14 Shiroshunyata - + - - - -15 Vyadhi Vridhdhi - - - - - +Table No. 12. Showing the Atiyoga Lakshana of Nasya: Symptoms Ch. Su. As. H. Sha. B.P. Ka.Shirogaurava - + + + + -Shiroshunyata - + - + + -Shirovedana + - - - - +Netra Vedana + - - - - -Shankhavedana + - - - - -Suchitodavata Pida + - - - - -Indriya Vibhrama - + - + + +Mastulungagama - + - - - -Snehapurna Srotasa - - - - + -Karna Talu Upadeha - - - - - -Vata Vriddhi + - - - - +Kandu - + - - - -Praseka - + + + - -Pinasa - + - - - -Aruchi - - + - - -Deha Daurbalya - - - - - +Unmada - - - - - -Pitta Vriddhi - - - - - -Hridaya Shula - - - - - -Suryavarta Roga - - - - - -Atripti - - - - - - Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 32 Shiroabhyanga in Akala Palitya
  49. 49. Review of NasyaVyapada: Vyapada (complication) after administration of nasya occurs in followingconditions79. • If patient breaches the protocol to be followed after Nasya karma. • On administration of Nasya in any contra-indicated condition. • Due to technical failure by any means.The complications occur through following two modes: Doshotklesha: This should be managed by Shodhana and Shamana chikitsa. Doshakshaya: This should be managed by Brimhana chikitsa80. If nasya is given in contraindicated conditions then many Vyapada can occursuch as: When Nasya is administered to the patient just after lunch or who is sufferingfrom indigestion than diseases like Kasa, Shvasa, Chhardi, Pratishyaya etc. may occurdue to obstruction of channels situated in upper part of body. If Nasya is given in season in which it is contra-indicated for e.g. cloudyatmosphere, then there is possibility of occurrence of Kapha roga like asthma.Treatment: In above-mentioned conditions treatment should be done with KaphaNashaka Upchara like use of Ushna, Tikshna Aushadha and Kapha Nashaka karma.If Nasya is given in Krisha, Kshina (emaciated), Virikta (patient who had takenvirechana} Aatura (anxious), Garbhini (pregnant lady), Vyayam klant (exhausted withexercise) and a thirsty person then vitiation of Vata dosha takes place which mayproduce vata-vikara.In this condition, Vatanashaka treatment like snehana, swedana, Brimhana should bespecially done, pregnant lady should be treated with ghrita and milk81. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 33 Shiroabhyanga in Akala Palitya
  50. 50. Review of ShiroabhyangaShiroabhyanga:82Definition: Application of medicated or non-medicated Taila, Ghrita to the head is said tobe Shiroabhyanga. This procedure is most ideal for routine practice especially inhealthy persons. Mere smearing the oil with no following massage, smearing the oilfollowed by simple massage and smearing the oil followed by placing specific strokeson the head, all these three methods are known as Shiroabyanga Shiroabhyanga is one of the Snehana procedure. Snehana is further classifiedinto Bahya and Abhyantara types, obviously Shiro-abhyanga coming under theMoordhini taila of Bahyasneha. Shiroabyanga and its effects is explained in Charaka samhita83, Susrutasamhita84, and Astanga sangraha85.Abhyanga:Etymology of Abhyanga: The word Abhyanga is derived from ‘Anga’ Dhatu which is used to indicatemotion or movement. ‘Abhi’ Upasarga to ‘Anga’ Dhatu makes the word Abhyangawhich means to induce specific movements. Thus Abhyanga (massage) indicatessome movement done on the body with use of Taila, Ghrita etc.Indications: • In disease of hairs like Palitya, Khalitya etc. • In daily routine to maintain the health of the body. • Acharya Vagbhatta has indicated Shiro-abhyanga in dryness and itching of the scalp and in accumulation of Mala on head86. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 33 Shiroabhyanga in Akala Palitya
  51. 51. Review of ShiroabhyangaBenefits of Shiroabhyanga:87 • A person who does Shiro-abhyanga daily is never affected with headache, hair falling or hair graying. • His hair becomes strong rooted, black and long. • All senses of that person become healthy. • His facial skin becomes soft, shiny and gets a good sleep.Shiroabhyanga in healthy persons: In healthy individuals the oil used for Shiroabhyanga may be prescribedaccording to the Prakruti of the person.Procedure of Shiroabhyanga:82 Shiroabhyanga may be performed at any time of the day before the bath. Eventhen early morning at the time of sunrise is the most ideal time for the procedure.Requirements: • Comfortable knee high chair. • Bowl of 100ml capacity to take oil. • Oil for application.Poorvakarma: Then the patient is made to sit on a knee high chair. The body of the patient iswrapped with a cloth bellow the neck. Procedure should be carried out by standingbehind the patient, which is the ideal position to carryout Shiroabhyanga.Pradhanakarma: The technique of Shiroabyanga includes smearing the oil to the portions of thescalp above the neck followed by placing specific strokes. The oil for the application is first heated on a water bath approximately up to40oC, to make lukewarm. Then the oil is pored in to the head of the patient and then Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 34 Shiroabhyanga in Akala Palitya
  52. 52. Review of Shiroabhyangaspread all over the head including the neck and ear pinna. Moving the palms frombefore backwards is enough to spread the oil on the head if the scalp has shorttrimmed hair. If the patient has long hair, fingers have to be poked between the hairsin an attempt to smear the oil to the scalp.Gharshana hasta (Massage from before backwards): After smearing the oil thetherapist then massage the whole head, moving the palmar surface of the hand frombefore backwards applying gentle as well as firm pressure. Thus the therapist shouldmassage the complete area of the scalp that includes vertex, temporal and occipitalportions of the head. The procedure is continued for a desired period.Mridvanguli Tadana (Picking strokes): Fingers of the both hands are moved as ifpicking up tuft of hair. For this the fingers are partially approximated, and then gentlyand firmly placed on the scalp. This is followed by withdrawing of fingers in anattempt to approximate the fingers, simultaneously effecting rubbing of the scalp.This maneuver should be gentle producing mild traction effect on the hair. Each areaof the head is similarly treated. Also this maneuver should effect a pleasant sensationto the patient and should not cause any sort of discomfort or pain.Dvihasta tadana (Flat palm strokes): Gentle strokes are placed with the palmarsurface on the scalp by both hands either simultaneously or alternatively. Strokes areplaced on the vertex, occipital and temporal region.Taranga hasta (Rocking strokes): Gentle strokes are placed on the patients head byrapid rocking movement of both the palms simultaneously. While placing the strokesonly the base of the little finger and thumb comes on contact with the patients head.Anguli kridana hasta (Finger strokes): Placing the gentle strokes on the patientshead by making rocking movements of both the palms with its fingers stretched. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 35 Shiroabhyanga in Akala Palitya
  53. 53. Review of ShiroabhyangaWhile stoking only the palmar aspect of the little finger and thumb will touch thescalp.Mridu mushti tadana (Fist stroke): In this maneuver gentle strokes are placed on allareas of the head with the closed fist through the ulnar border. Initially the strokes areplaced with both the hands simultaneously, followed by placing the strokesalternatively with right and left fist.Ghatita hasta (Pressing): Flat of the palm is placed on the patients head, and ismoulded in to the shape of the scalp so that every portion of the palmar aspect of thepalm and fingers comes in contact with the head. This is followed by exerting gentleand firm pressure on the head. Every part of the head is treated by the similar manner.Squeeze strokes: This refers to grasping tuft of hair with hands followed by gentlesqueeze, producing comfortable traction on the hair. Every part of the scalp is treatedin this way.Karna-abyanga (Ear massage): Ear pinna is grasped between the thumb anteriorlyand the other fingers posteriorly. And the pinna is rubbed between the fingers.Further, supporting the pinna with the fingers posteriorly, thumb is firmly movedabove downwards in the anterior of the ear pinna.Duration: Each form of stroke is continued for about 4 to 5 minutes, and thus the wholeprocess of head massage takes about 30 to 40 minutes.Paschathkarma: The patient is asked to rest on the chair for about 15min, and then advice thepatient to take head bath with hot water. Alternative to the soap, herbal products canbe used. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 36 Shiroabhyanga in Akala Palitya
  54. 54. Review of PalityaDisease review:Historical review: The history of medicine is as old as human civilization. Plenty of disordershave been found referred in the ancient literatures of Vedic period, either directlynaming the disease itself or by hinting the nature of disorder. Scattered information regarding the hair and its disorders are found indifferent texts. Historical study reveals, ancients have not neglected the cosmeticaspect of the life. They have mentioned important various formulations whichimprove growth of hair complex rather than etiology.The history can grossly be divided into: 1) Vedic period 3) Medieval period 2) Samhita period 4) Modern period.Vedic period: Atharva veda • A vegetable drug named Devatada was used in the management of Kesha Palitya and Khalitya by the physicians of that period. • Keshabramhani a herbal drug was widely used in treating Indralupta, Khalitya & also prescribed for the growth of hairSamhita period: No Acharyas had dedicated a separate chapter for Palitya or any other hairdisorders. But scattered references are available about diseases of hair in the differentchapters of Ayurvedic classics. • Etio-pathogenesis and treatment of Palitya are mentioned in Trimarmiya Chikitsa of Charaka Samhita88. • While explaining the Guna of LavanaRasa89. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 37 Shiroabhyanga in Akala Palitya
  55. 55. Review of Palitya • While explaining about Anutaila90. • While explaining Nasya91, Shiroabhyanga. • While explaining Garbhopaghatakara bhavas, references about Palita by excess Lavana rasa sevana by garbhini is mentioned92. • In Bhela Samhita types of Palitya has been mentioned93. • In Sushruta Samhita Palitya roga has been considered as Kshudra Roga94. • In 20th chapter of Chikitsasthana of Susruta samhita he has explained the treatment of Palitya95. • Astanga sangraha has given reference about Indralupta, Palitya & Khalitya in Uttara tantra, Shirorogavignaniya96 and Shirorogapratishedha adhyaya97. • Astanga Hridaya has given reference about hair and its management in Uttaratantra98. So in Samhita Kala Both Acharya Charaka and Vagbhata mentioned this diseaseunder Shirogata Vyadhi where as Acharya Sushruta considers it in Kshudrarogadhikaras.Medieval period: • Madhavakara99 and Bhavamishra100 both have mentioned palita under Kshudra rogadhikaras. • Yogaratnakara101 also mentioned about palita in Kshudraroga nidana and Chikitsa. • Sharangadhara Samhita102 mentions palita in Kapalagata roga. • Chakradatta103 and Bhaishajyaratnavali104 listed the number of effective yogas for the treatment of Palitya in the Kshudraroga chikitsa. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 38 Shiroabhyanga in Akala Palitya
  56. 56. Review of PalityaModern period: Recently modern science has developed a branch deal with pathophysiology,care and preservation of hair, known as Trichology. Earlier, hair and its disorderswere described under the heading of skin diseases. The hairs are elastic threads likestructure derived partly from undifferentiated cells of the foetal epidermis. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 39 Shiroabhyanga in Akala Palitya
  57. 57. Review of PalityaPalitya:Vyutpatti : • mÉsÉ aÉiÉÉæ-kÉÉiÉÑ & YsÉlÉç-mÉëirÉrÉ (AqÉUMüÉãvÉ) • lÉqÉç-mÉÉsÉç pÉuÉã£ü ( vÉoSxiÉÉãqÉqÉWûÌlÉÍkÉ) • mÉsÉ-pÉÉuÉã (uÉÉcÉxmÉirÉqÉç)Nirukti: • mÉsÉÌiÉ vÉÉæMsrÉãlÉ vÉÉãpÉiÉã CÌiÉ mÉÍsÉiÉqÉç || Palitya means – The hair turned to sukla varna. • mÉÍsÉiÉÇ MåüzÉzÉÉæYsÉrÉqÉç || (Ayurveda Shabdakosha) Sukla varna of the hair is Palitya. • mÉÉÍsÉirÉqÉç MãüvÉ mÉÉMü: || (Bavaprakasha)Paribhasha: • mÉÍsÉiÉqÉç eÉUxÉÉ vÉÉæMüsrÉqÉç MãüvÉÉSÉæ|| Palitya is one of the lakshana of Jaravasta. (Amarakosha). • mÉÍsÉiÉqÉç mÉÉhQÒûUÉ: MãüvÉÉ: CÌiÉ|| Panduravarna of kasha is called Palitya. • MãüvÉÉSÉæ eÉUrÉÉ eÉÉiÉÉrÉÉqÉç µÉãiÉ-iÉÉrÉÉqÉç mÉÍsÉiÉqÉç|| In old age hair turns to white colour. (Vachaspatyam)Definition of Akala-Palita:AÉMüÉsÉã AxÉqÉrÉã mÉÍsÉiÉæuÉÉïkÉïYrÉæurÉÉïmiÉ: ÌmɨÉxrÉ FwqÉaÉÑhÉiuÉÉiÉç|| Palita occurs at the stage of vardhakya, but due to increased ushma guna ofpitta early graying (untimely) of hairs is observed.AMüÉsÉã iÉÂhÉÉuÉxjÉÉrÉÉqÉç mÉÍsÉiÉæ; µÉãiÉæ|| Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 40 Shiroabhyanga in Akala Palitya
  58. 58. Review of Palitya Akala-palita means graying of hairs at the young age. (vÉÉ.xÉÇ.mÉë 7 (aÉÔ.SÏ.)MãüvÉÉlÉÉÇ vÉÑYsÉpÉÉuÉãlÉ mÉÍsÉiÉÍqÉirÉÑcrÉiÉã|| Palitya means Shukla bava of the hair. (vÉÉ.xÉÇ.mÉë 7 (aÉÔ.SÏ.)Thus Akala palita may be defined as untimely or early graying of hairs due to excessushnaguna of pitta. Here untimely means premature graying of hair. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 41 Shiroabhyanga in Akala Palitya
  59. 59. Review of PalityaKesha Shariram: Before dealing with the disease palitya, which affects hair of human beingbrief knowledge of hair is essential.Etymology: The word Kesha has been derived from the root ‘Shi’ with ‘Ach’ prefix and‘Kuluk’ conjugation that which grow on head.Definition: Kesha are the elements that grow on the scalp, Mastak or Shirah.Synonyms: There are many synonyms of hair as far as literary texts are concerned. They maybe enlisted as follows –1) Kesha 2) Bala 3) Kacha4) Chikura 5) Kuntals 6) Shirorooha7) Ashrahs 8) Moordhaja 9) Shirasija The hairs growing on the different parts of the body are known by different namessuch as the hair growing on the scalp are known as Kesha, Kantal, Chikru etc. that on thebody are known by Roma, Romaraji, Loma etc. that growing on the eyelids are known asPakshma, the facial hairs are known as Shmashru, the hair on the eyebrows are known asBhrikuti, whereas the hair growing around the genetalia and in the armpits are known byVyanjana or Vyanjanana.Prashashtha Kesha Laxana:Acco. to Vagbhata;105 • Susnigdha ( Smooth, Glistening) • Mruduta ( Soft) • Sukshmata ( Fine & Precise ) Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 42 Shiroabhyanga in Akala Palitya
  60. 60. Review of Palitya • Naikamulatwa / Prithanmulata • Sthiratwa/ DhridhataAcco. to Charaka;106 • Snigdha • Mrudu • Subaddha mula • Ekaikaja • KrishnaKesha Samkhya: In ancient classics, many controversies have been noticed on this topic. Thenumber of hair as per various texts may be summarized as under. Acharya Charaka has enumerated the total human hair to be 29956 and stated thatthe number of Kesha, Shmashru and Loma is equal107. Chakrapani, while commenting on this says that, this number of the mouths ofDhamani has been counted in macro-sense, whereas if minutely counted they are liable toincrease. According to Vidyotini Tika of Caraka Samhita the number of hair stated is72 crores108. • Acharya Sushruta believes that like the Dhamani Agras hairs are innumerable. • Ashtanga Samgrahakara holds same view as that of Charaka.Parts of Hair:Kesha can be divided into following parts: Keshaagra (Hair ends) Kesha Bhumi / Kesha Bhu (scalp / Skin) Roma Kupa / Kupaka / Loma Kupa (Follicle) Roma Meda (Roots of hairs) Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 43 Shiroabhyanga in Akala Palitya
  61. 61. Review of Palitya These are different parts of Kesha told in different contexts and can becombined as above. Roma Kupa / Romachidra is embedded in twacha where thekesha utpatti sthana is present.Keshotpatti: Ayurveda believes that the human body is built of main seven body elements asDhatus viz. Rasa, Rakta, Mamsa, Meda, Asthi, Majja and Shukra. A specific manner hasbeen thought of for the commencement of each and every Dhatu and their variousmanifestations by the learned Acharya. Inspite of some controversies the major part ofthem believe that the production of the latter Dhatus occur from the former by thefunctions of their respective Agni i.e. the Rasagni turns the Ahara Rasa into Rasa Dhatu,then the Raktagni converts the suitable Rasa Dhatu in Rakta and so on. It has been further explained that, from the Poshakamsha of former Dhatu there isnot only production of latter Dhatu but consequently there is side by side production of itsUpadhatu and its Mala. There is no detailed description found in Ayurvedic classicsregarding the production of hair in particular, but it has been stated in the process ofDhatu Nirmana that when Paka of Asthidhatu occurs by its own Agni, the Majja Dhatuemerges from the Sara Bhaga and at the same time hair of scalp and body and nailemerges as Mala (waste product). According to ancient classics the hair is one of the“Pitruja Bhava” means the structure, color and quantity of hair of a progeny aredependent on paternal side109, 110. Acharya have considered the hair as “Parthiva Dravya” because of its qualitieslike roughness, steadiness, heaviness etc. The hair is directly related with skin. So a person with healthy skin is also shouldhave deep rooted, soft, fine and shiny hair. Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 44 Shiroabhyanga in Akala Palitya