Nasya 1-ksr

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 http://www.technoayurveda.com/


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.



Introduction

• “Nasya” with a synonym “Navana” – is defined as “Nasa Graahya Aushadham” i.e. ythe 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



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.



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 yisotonic solutions or nano to micro fined power dustings as medicines to pacify thepower dustings as medicines to pacify the pathologic conditions



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







Surface AnatomyP 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 ycavity

• 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.





Surface AnatomyP th ti i ti i S t t• Parasympathetic innervation – i.e. Secretomotorinnervation of glands in themucosa 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 submandibularnodes

• Lymph from posterior regions of the nasal cavity y p p g yand the paranasal sinuses drains into upper deep cervical nodes.



Applied PhysiologyS 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.



Applied PhysiologyTh 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.



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.



Applied Physiologyh 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.


Olfactory cortexFundamentals of Nasya Karma

Olfactory cortex• In humans, sniffing activates the piriform cortex, g pbut smells with or without sniffing activate the lateral and anterior orbitofrontal gyri of the frontal lobe.

• The orbitofrontal activation is generally greater g y gon 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 pto olfactory stimuli, and to the entorhinal cortex, which is concerned with olfactory memories. y



Dose determination of Sneha Nasya

• Snehana Nasya (Sushruta) – Pradhama Matra (Avara) = 8 Bindu (Drops)( ) ( p )– Dwiteeya Matra (Madhyama) = 1 Shukti = 32 BinduTruteeya 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)



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



Dose determination

A d N (S h t )• Avapeedana Nasya (Sushruta)– Heena Matra = 4 BinduMadhyama 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)



Vagbhata Marsha Nasya doseH 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



i l d i iFinal Dose determinationNasya Type Heena Madhyama UttamaSnehana 8 32 64Rechana 4 6 8

Avapeedana (Kalka)

4 6 8( )

Pratimarsha 2 2 2Marsha 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



Timing & seasons for Nasya



Olfactory Thresholds & DiscriminationOlf 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.



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.



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 qthe odorant. The mitral cells with their glomeruliproject to different parts of the olfactory cortex.

• This sharpens and focuses olfactory signals. In addition, the extracellular field potential in each glomerulusoscillates, 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.



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 bulband from there primarily to areas in the amygdalaand from there primarily to areas in the amygdalaand hypothalamus that are concerned with reproduction and ingestive behaviorreproduction and ingestive behavior.



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.



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 slowed.is knocked out, adaptation is slowed.



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 pdiffusion 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.


Concl sion


…. 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.



Thank You

• Nasahi shiraso dwaram and Nasya is multiracial management of Ayurvedag y


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