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Nasya 1-ksr


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Fundamentals of Nasya Karma - By
Dr KSR Prasad in CME on Panchakarma for AYUSH Doctors
January 9th to 14th 2017 @ Alva’s Ayurveda Medical College, Moodbidri, Karnataka
Review of Nasya karma with definition, classification and advantages of Nasya by different acharyas
Knowledge of Anatomy of nose and para-nasal sinuses.
Pharmacological action of modern drugs administered through nose.
Standardization of the dose of various types of Nasyas.
Standardization of Bindu Pramana.

Published in: Health & Medicine

Nasya 1-ksr

  1. 1. Fundamentals of Nasya Karma Fundamentals of Nasya KarmaNasya Karma BBy  Dr KSR Prasad CME on Panchakarma for AYUSH Doctors  January 9th to 14th 2017 @  Alva’s Ayurveda Medical College, Moodbidri, Karnataka Dr. K. Shiva Rama Prasad, at
  2. 2. Fundamentals of Nasya Karma Learning Objectives  R i f N k ith d fi iti• Review of Nasya karma with definition,  classification and advantages of Nasya by  different acharyasdifferent acharyas • Knowledge of Anatomy of nose and para‐nasal  sinusessinuses.  • Pharmacological action of modern drugs  administered through nose.administered through nose.  • Standardization of the dose of various types of  Nasyas. y • Standardization of Bindu Pramana. Dr. K. Shiva Rama Prasad, at
  3. 3. Fundamentals of Nasya Karma Introduction • “Nasya” with a synonym “Navana” – is  defined as “Nasa Graahya Aushadham” i.e. y the medicine administered/ received through  nosenose  • For the medicine administration different  b h hroutes are used in Ayurveda but to reach the  “shiras”, the Head it is difficult with other  routes there by the “Nasya” is developed Dr. K. Shiva Rama Prasad, at
  4. 4. Fundamentals of Nasya Karma Nasal administration • Nasal administration is a route of administration inNasal administration is a route of administration in  which drugs are insufflated through the nose. It can  be a form of either topical administration orbe a form of either topical administration or  systemic administration, as the drugs thus locally  delivered can go on to have either purely local ordelivered can go on to have either purely local or  systemic effects. • The nasal cavity is covered by a well vascularised thin• The nasal cavity is covered by a well vascularised thin  mucosa,  therefore, a drug molecule can be  transferred quickly across the single epithelial celltransferred quickly across the single epithelial cell  layer directly within 5 min for smaller drug  moleculesmolecules. Dr. K. Shiva Rama Prasad, at
  5. 5. Fundamentals of Nasya Karma Routes of Medicine Administration  d d h l• Ayueveda used the most common route – Oral  and the alternative routes are – Rectal,  transurethral, trans‐dermal, Nasal, etc. • The mucosa of either external (Skin) or ( ) internal (GI tract) or even the nasal mucosa  are comfortably used with ionized bioactive y isotonic solutions or nano to micro fined  power dustings as medicines to pacify thepower dustings as medicines to pacify the  pathologic conditions  Dr. K. Shiva Rama Prasad, at
  6. 6. Fundamentals of Nasya Karma Synonyms of Nasya • Shiro Virechana • Shiro Vireka Virechana word is used as it  Shiro Vireka • Moordha Virechana is propelling out  Chardana ord is sed as it • Nasthah Prachhardhana • Navana Chardana word is used as it  is spurts out  Navana • Nastha Karma These terms are used as it is  administered per nasa • Nasya karma  p Dr. K. Shiva Rama Prasad, at
  7. 7. Fundamentals of Nasya Karma Dr. K. Shiva Rama Prasad, at
  8. 8. Fundamentals of Nasya Karma Dr. K. Shiva Rama Prasad, at
  9. 9. Fundamentals of Nasya Karma Surface Anatomy P t i i l t l l l th• Posterior superior lateral nasal nerves supply the  nasal cavity lateral wall • Posterior superior medial nasal nerves cross the roofPosterior superior medial nasal nerves cross the roof  to the nasal septum • Nasopalatine nerve, supply to medial wall of the nasal p pp y cavity • Posterior inferior nasal nerves innervate the lateral  wall of the nasal cavitywall of the nasal cavity • a small nasal nerve also originates from the anterior  superior alveolar branch of the infra‐orbital nerve andsuperior alveolar branch of the infra orbital nerve and  supply the lateral wall near the anterior end of the  inferior concha.  Dr. K. Shiva Rama Prasad, at
  10. 10. Fundamentals of Nasya Karma Dr. K. Shiva Rama Prasad, at
  11. 11. Fundamentals of Nasya Karma Surface Anatomy P th ti i ti i S t t• Parasympathetic innervation – i.e. Secretomotor innervation of glands in the mucosa of the nasal  cavitycavity • Sympathetic innervation (T1), mainly involved  with regulating blood flow in the nasal mucosawith regulating blood flow in the nasal mucosa • Lymph from anterior regions of the nasal cavities  drains and connect with the submandibulardrains and connect with the submandibular nodes • Lymph from posterior regions of the nasal cavity y p p g y and the paranasal sinuses drains into upper deep  cervical nodes.  Dr. K. Shiva Rama Prasad, at
  12. 12. Fundamentals of Nasya Karma Applied Physiology S ll d ll l ifi d i l• Smell and taste are generally classified as visceral  senses because of their close association with  t i t ti l f ti Ph i l i ll thgastrointestinal function. Physiologically, they are  related to each other. • Both taste and smell receptors are  chemoreceptors that are stimulated by  l l i l i i i h dmolecules in solution in mucus in the nose and  saliva in the mouth.  • However, these two senses are anatomically  quite different. Dr. K. Shiva Rama Prasad, at
  13. 13. Fundamentals of Nasya Karma Applied Physiology Th lf ll l d i i li d• The olfactory receptor cells are located in a specialized  portion of the nasal mucosa, the yellowish‐pigmented  olfactory mucous membraneolfactory mucous membrane • It covers an area of 5 cm2 in the roof of the nasal cavity  near the septum It contains supporting cells andnear the septum. It contains supporting cells and  progenitor cells for the olfactory receptors. • Interspersed between these cells are 10‐20 millionInterspersed between these cells are 10 20 million  receptor cells. Each olfactory receptor is a neuron, and  the olfactory mucous membrane is said to be the place  in the body where the nervous system is closest to the  external world. Dr. K. Shiva Rama Prasad, at
  14. 14. Fundamentals of Nasya Karma Applied Physiology • The olfactory neurons, like the taste receptor  cells (see below) but unlike most other ( ) neurons, are constantly being replaced with a  half‐time of a few weeks The olfactoryhalf time of a few weeks. The olfactory  renewal process is carefully regulated, and  there is evidence that in this situation a bonethere is evidence that in this situation, a bone  morphogenic protein (BMP) exerts an  inhibitory effect.  Dr. K. Shiva Rama Prasad, at
  15. 15. Fundamentals of Nasya Karma Applied Physiology h lf b i l• The olfactory mucous membrane is constantly  covered by mucus. This mucus is produced by  B ' l d hi h j t d th b lBowman's glands, which are just under the basal  lamina of the membrane.  • The axons of the mitral and tufted cells pass  posteriorly through the intermediate olfactory  i d h l l lf i hstria and the lateral olfactory stria to the  olfactory cortex. • The axons terminate on the apical dendrites of  pyramidal cells in the olfactory cortex.  Dr. K. Shiva Rama Prasad, at
  16. 16. Olfactory cortex Fundamentals of Nasya Karma Olfactory cortex • In humans, sniffing activates the piriform cortex, g p but smells with or without sniffing activate the  lateral and anterior orbitofrontal gyri of the  frontal lobe.  • The orbitofrontal activation is generally greater g y g on the right side than the left. Thus, the cortical  representation of olfaction is asymmetric.  • Other fibers project to the amygdala, which is  probably involved with the emotional responses p y p to olfactory stimuli, and to the entorhinal cortex,  which is concerned with olfactory memories. y Dr. K. Shiva Rama Prasad, at
  17. 17. Fundamentals of Nasya Karma Dose determination of Sneha Nasya • Snehana Nasya (Sushruta)  – Pradhama Matra (Avara) = 8 Bindu (Drops)( ) ( p ) – Dwiteeya Matra (Madhyama) = 1 Shukti = 32 Bindu Truteeya Matra (Uttama) 1 Pani 64 Bindu– Truteeya Matra (Uttama) = 1 Pani = 64 Bindu • Charaka Nasya (Sneha) ‐ Ardha Pala (2 tola) • Bhoja Nasya (Sneha) – 16 Bindu in progressive  till 64 drops (4 times)till 64 drops (4 times)  Dr. K. Shiva Rama Prasad, at
  18. 18. Fundamentals of Nasya Karma Dose determination of Virechanika Nasya h (f i di id l )• Sushruta (for individual nose)  – Heena Matra = 4 Bindu – Madhyama Matra = 6 Bindu – Uttama Matra = 8 Bindu • Duration of Virechana Nasya (Sushruta)  Alternative day or once in two days– Alternative day or once in two days  – 7 – 21 days of total duration or till required with in  F f l t d t i d il ( h h )– For  few selected twice daily (muhurmuhu)  – Restriction of duration 7 days by Arunadatta Dr. K. Shiva Rama Prasad, at
  19. 19. Fundamentals of Nasya Karma Dose determination A d N (S h t )• Avapeedana Nasya (Sushruta) – Heena Matra = 4 Bindu Madhyama Matra 6 Bindu– Madhyama Matra = 6 Bindu – Uttama Matra = 8 Bindu – Duration as like Virechana Nasya– Duration as like Virechana Nasya • Dhmapana (churna) Nasya – 1 kola (1/2 tola) = 5 gms– 1 kola (1/2 tola) = 5 gms – Time of usage = in emergency  • Pratimarsha nasya – No specific dose – veryPratimarsha nasya No specific dose  very  minimal of 2 drops (Vagbhata /Bhavamishra) Dr. K. Shiva Rama Prasad, at
  20. 20. Fundamentals of Nasya Karma Vagbhata Marsha Nasya dose H M 6 Bi d– Heena Matra =6 Bindu – Madhyama Matra = 8 Bindu – Uttama Matra =10 Bindu • Bhavamishra Tarpani Matra (high dose/nase)p ( g / ) – Heena Matra = 8 Bindu (1 sana) – Madhyama Matra = 32 Bindu (4 sana)Madhyama Matra = 32 Bindu (4 sana) – Uttama Matra =64 Bindu (8 Sana) 2 3 times /day or alternative day for 3 5 or 7– 2 – 3 times /day or alternative day for 3, 5 or 7  days  Dr. K. Shiva Rama Prasad, at
  21. 21. Fundamentals of Nasya Karma i l d i iFinal Dose determination Nasya Type Heena Madhyama Uttama Snehana 8 32 64 Rechana 4 6 8 Avapeedana  (Kalka) 4 6 8 ( ) Pratimarsha 2 2 2 Marsha 6 8 10Marsha  6 8 10 Dhmapana  (churna) 125mg (2 gunja) 3gms  (churna) (2 gunja) 1 bindu is defined as the oil collected by dipping the finger till first phalagi Dr. K. Shiva Rama Prasad, at
  22. 22. Fundamentals of Nasya Karma Timing & seasons for Nasya Dr. K. Shiva Rama Prasad, at
  23. 23. Fundamentals of Nasya Karma Olfactory Thresholds & Discrimination Olf d l b• Olfactory receptors respond only to substances  that are in contact with the olfactory epithelium  d di l d i th thi l f th tand are dissolved in the thin layer of mucus that  covers it.  • Eg: Methyl mercaptan, one of the substances in  garlic, can be smelled at a concentration of less  h 500 /L f ithan 500 pg/L of air. • Olfactory discrimination is remarkable;  • Humans can recognize more than 10,000  different odors.  Dr. K. Shiva Rama Prasad, at
  24. 24. Fundamentals of Nasya Karma Signal Transduction • Olfactory mucosa and its brain representation canOlfactory mucosa and its brain representation can  mediate discrimination of more than 10,000 different  odors.  • Question is how 10,000 different odors can be  detected lies in the neural organization of thedetected lies in the neural organization of the  olfactory pathway.  • 2 million olfactory sensory neurons and each• 2 million olfactory sensory neurons, and each  expresses only one of the thousand different odorant  receptorsreceptors. • In the olfactory glomeruli, there is lateral inhibition  mediated by periglomerular cells and granule cellsmediated by periglomerular cells and granule cells. Dr. K. Shiva Rama Prasad, at
  25. 25. Fundamentals of Nasya Karma Signal Transduction • Each neuron expressing a given receptor projects to twoEach neuron expressing a given receptor projects to two  of the 1800 glomeruli. This provides a distinct two‐ dimensional map in the olfactory bulb that is unique to p y q the odorant. The mitral cells with their glomeruli project to different parts of the olfactory cortex.  • This sharpens and focuses olfactory signals. In addition,  the extracellular field potential in each glomerulus oscillates, and the granule cells appear to regulate the  frequency of the oscillation. The exact function of the  oscillation is unknown, but it probably also helps to  focus the olfactory signals reaching the cortex.  Dr. K. Shiva Rama Prasad, at
  26. 26. Fundamentals of Nasya Karma Signal Transduction • In addition, lipophilic odor‐producing moleculesIn addition, lipophilic odor producing molecules  must traverse the hydrophilic mucus in the nose to  reach the receptors. These facts led to thereach the receptors. These facts led to the  suggestion that the olfactory mucus might contain  one or more odorant‐binding proteins (OBP) thatone or more odorant binding proteins (OBP) that  concentrate the odorants and transfer them to the  receptors.receptors.  • Its receptors project to the accessory olfactory bulb and from there primarily to areas in the amygdalaand from there primarily to areas in the amygdala and hypothalamus that are concerned with  reproduction and ingestive behaviorreproduction and ingestive behavior.  Dr. K. Shiva Rama Prasad, at
  27. 27. Fundamentals of Nasya Karma Signal Transduction • Vomeronasal input has major effects on theseVomeronasal input has major effects on these  functions. The vomeronasal organ has about  30 ti d t t th t diff30 serpentine odorant receptors that differ  quite markedly in structure from those in the  rest of the olfactory epithelium.  • The sense of smell is said to be more acute inThe sense of smell is said to be more acute in  women than in men, and in women it is most  acute at the time of ovulationacute at the time of ovulation.  Dr. K. Shiva Rama Prasad, at
  28. 28. Fundamentals of Nasya Karma Signal Transduction • It is common knowledge that when one isIt is common knowledge that when one is  continuously exposed to even the most disagreeable  odor, perception of the odor decreases andodor, perception of the odor decreases and  eventually ceases. This sometimes beneficent  phenomenon is due to the fairly rapid adaptation, orphenomenon is due to the fairly rapid adaptation, or  desensitization, that occurs in the olfactory system. It  is mediated by Ca2+ acting via calmodulin on cyclicis mediated by Ca acting via calmodulin on cyclic  nucleotide‐gated (CNG) ion channels. When CNG A4  is knocked out, adaptation is knocked out, adaptation is slowed.  Dr. K. Shiva Rama Prasad, at
  29. 29. Fundamentals of Nasya Karma Conclusion  Th ll f h lf i h li j i• The nerve cells of the olfactory epithelium project into  the olfactory bulb of the brain, which provides a direct  connection between the brain and the externalconnection between the brain and the external  environment.  • The transfer of drugs to the brain from the bloodThe transfer of drugs to the brain from the blood  circulation is normally hindered by the blood–brain  barrier (BBB), which is virtually impermeable to passive ( ) y p p diffusion of all but small, lipophilic substances.  • However, if drug substances can be transferred along  the olfactory nerve cells, they can bypass the BBB and  enter the brain directly. Dr. K. Shiva Rama Prasad, at
  30. 30. Concl sion Fundamentals of Nasya Karma …. Conclusion  • Olfactory and ophthalmic are inter connected • Thoracic (T1) is the lower limit of the Nasya Karma effect( ) y • Lateral, Frontal lobes (Shiras) are connected with nasya activity y • hydrophilic drugs comfortable pass through Nasal mucus • lipophilic drugs with odorant‐binding proteins (OBP) arelipophilic drugs with odorant binding proteins (OBP) are  required to pass through  • Another choice is with emotional responses to recover• Another choice is with emotional responses to recover  olfactory memories   • Ceasing or desensitization of olfactory is mediated by Ca2+• Ceasing or desensitization of olfactory is mediated by Ca acting via calmodulin on cyclic nucleotide‐gated (CNG) ion  channels (vata). Its pacification is through Brumhana Nasya.channels (vata).  Its pacification is through Brumhana Nasya.  Dr. K. Shiva Rama Prasad, at
  31. 31. Fundamentals of Nasya Karma Thank You • Nasahi shiraso dwaram and Nasya is  multiracial management of Ayurvedag y Dr. K. Shiva Rama Prasad, at