Nasya is the Ayurvedic procedure in which medication is applied to the nostrils to nourish the organs above the clavicle.
Dr. Vasant Lad argues that without nasya, Panchakarma, an Ayurvedic detoxification protocol, is an incomplete purification.
Herbal medicine is directly administered via the nasal passages.
Ayurveda suggests that any excess doshas (ailments) accumulated in the sinuses, throat, nose or head areas can be eliminated by means of the nearest opening – the nose.
It is suggested that nasya can bring coordination between sensory and motor functions and will cleanse nadis (channels) related to brain and spinal cord. Therefore, nasya is indicated for sinus congestion, migraine headaches, seizures and eye and ear disorders.
Ayurvedic medicines are often considered effective for treating chronic and lifestyle-related diseases. This blog covers benefits of daily application of medicated oil in the nasal passages as well as use of Ancient practice nasya in the modern Clinical Practice under supervision of the Ayurvedic Doctor or an Ayurvedic Practitioner.
This blog references primary sources – ancient classical texts such as Caraka-Samhita and Sushruta Samhita where benefits and contraindications of nasal instillation of various medications is described by Acharyas.
These classical slokas or Sanskrit verses where translated into English, published and made easier to understand by Modern Ayurvedic Doctors.
For Ayurvedic Practitioners primary texts are the true guidance and protocol of management of diseases.
However, in the modern day, environment, socio-economic circumstances are very different to that of thousands of years ago, therefore a lot of Ayurvedic protocols should be adopted to suit ever changing population concerns.
Modern Ayurvedic Scientific community understands benefits of the nasya treatment, hence multiple trials and studies were completed on small groups of patients for short duration of time for various ailments to show efficacy of Nasya.
However, we should be aware that these studies, even though they demonstrate decrease in chief complaints, are conducted on a small number of patients for a short period of time, therefore the studies have limitations and cannot be treated as a definitive treatment protocol but rather a guidance for the Ayurvedic practitioners.
Ayurvedic practitioners must also advise their clients that even though these studies showed positive and encouraging results in the treatment of certain ailments, they cannot guarantee the absolute success of the treatment protocol.
In one of the main classical texts, Caraka-Samhita, importance of inhalation therapy is described.
Instilling medicated oils, liquids, powders into the nose is prescribed for the treatment of the diseases of the head and neck (Sharma RK, Charaka Samhita (Eng. Translation) Vol. VI (Siddhi Sthana Chp. IX verse 88), pg.355, 2018).
Caraka-Samhita mentions five varieties of inhalation therapy:
· Navana – inhalation of drugs in the form of nasal drops. Navana can be of two types – for the purpose of oleation and nourishment and for the purpose of detox of morbid materials from the head;
· Avapida – insufflation of drugs in thin paste form through the nasal passage. Avapida can be of two types - detox of morbid matter and stoppage of excessive secretion;
· Dhmapana – insufflation of drugs in powder form through the nasal passage. It cleanses the channels of the body;
· Dhuma – ingalation of drugs in the form of smoke. It is used for alleviation of imbalances, oleation of different parts of the head and elimination of morbid material from the head;
· Pratimarsa – application of medicated oil in the nostrils. It is considered harmless and serves both purposes of oleation and elimination of morbid matter from the head (Sharma RK, Charaka Samhita (Eng. Translation) Vol. VI (Siddhi Sthana Chp. IX verse 88), pg.355, 2018).
In Volume I of Charaka Samhita, where some of the daily rituals are described, instillation of special herbal formulation of Nasal drops is recommended every year, during the three seasons, when the sky is free from cloud.
Further the author of Charak Samhita has narrated that if Anu Taila Nasya is taken as per recommendation, the outcomes are very positive. In particular, a person never gets degenerative changes in the visua, olfactory and auditory sense.
Nasia helps in conditions of cervical spondylosis, headache, Facial Palsy, Lock jaw etc. Further the Nasya with Anu Taila offers the strengthening of vascular system, nervous system and musculoskeletal system of head and also offers deep and stable voice, fresh and well-built face, freshness and active sense organs and prevent the degenerative changes in the brain (Sharma RK, Charaka Samhita (Eng. Translation) Vol. I (Sutra Sthana Chp. V verse 57-62), pgs.119-120, 2018).
As it is seen in the ancient texts, nasya can be used as a highly therapeutic procedure during
Panchakarma (detox) regimen as well as a
health promoting daily activity as part of daily routine
It can be argued in the modern world that nasya is an outdated, complicated treatment that is cumbersome and can’t be adopted in our society.
However, the Pratimarsa variety of nasya is so simple and efficient that it can be easily promoted within the modern society.
For Pratimarsa, the finger is dipped into the medicated oil and then applied in the inner wall of the nostrils. As simple as that, it can be done in the morning or night for a healthy person to promote good function of the organs in the head (Charaka Samhita (Eng. Translation) Vol. VI (Siddhi Sthana Chp. IX verse 88), pg.355, 2018).
There is various modern research indicating that lipophilic compounds, which is what most nasya medications are, can easily cross biological membranes through the transcellular route.
Nose is the nearest root for the drug administration which can deliver the drug efficiently and provide nourishment to brain cells thus balance the functions of central nervous system (Prabhjot Kaur, 2016).
The authors of the article in the International Journal of Ayurveda and Pharma Research argue the need to have more community based studies to prove high potential of daily practice of Nasya due to the wide spread of such diseases as the Allergic Rhinitis, Chronic Sinusitis, Migraine, facial Palsy, frozen shoulder, Cervical spondylosis, Ophthalmic diseases, Alopecia, graying of hair and mental disorders (Bansal Charu, 2019).
There have been multiple studies conducted to show efficacy of Nasya for treatment of various ailments.
Nasya for Allergic Rhinitis
There have been some studies done to date to investigate the Ayurvedic management of Allergic Rhinitis by nasya.
Anutaila (specific herbal nasal drops) were applied daily for a period of 60 days and found significant effect on the chief complaints (Arun GR, 2014).
Nasya for Insomnia
In a different clinical study, Jatamansi oil nasya was prescribed for Insomia patients for 7 days where improvements were shown on the Sleep Quality Index (Yadav Kapil, 2019).
Nasya for Cervical Spondylosis
A randomnized controlled clinical trial was conducted to assess efficacy of Nasya for the patients of cervical spondylosis. Along with other Ayurvedic treatments, Nasya was administered to the controlled group for 7 days with Dhanwantaram Tailam which is one of the most versatile Ayurvedic classical oil. The trial proved that conventional management along with Nasya was more efficacious than conventional management alone in reducing the signs and symptoms of cervical spondylosis (C Radhika, 2012).
Nasya for Myopia
A short study was conducted on 30 patients with myopia (short-sightedness) to evaluate efficacy of Tarpana therapy only and Tarpana therapy followed with Nasya therapy. Tarpana therapy is rehydration of eyes with the medicated ghee where ghee is retained over the eyes for a specific amount of time. In the control group Tarpana therapy was followed by Nasya with Abhijit Taila. Abhijit taila is black sesame oil medicated with such herbs as Amalaki (Emblica officinalis) and Yashtimadhu (Glycyrrhiza glabra) along with cow’s milk. The total duration of application of Abhijit taila was 65 days at 8-10 drops to each nostril per day. The assessment was done on the basis of such symptoms as indistinct distance vision, blurred vision, diplopia, headache, eye strain, burning sensation, watering eye and other scores.
As a result of the study, Nasya followed by Tarpana in control group provided better results in chief complaints. In reduction of the dioptric power, Nasya followed by Tarpana has shown better results than only Tarpana (Durgesh Prasad Gupta, 2010).
Implementation in Clinical Practice
Along with Caraka Samhita, nasya has been described in other ancient texts, such as Sushruta Samhita and Ashtanga Sangraha. There are various indications of nasya that can be practiced in a daily modern life, such as:
· After getting up in the morning - causes cleansing the stagnated nasal discharge, makes headlight and pleases the mind;
· After tooth brushing - provides strength to denture and keeps the mouth fresh;
· Before going out of house - moistens Nasal cavity and upper respiratory tract;
· After exercise, after strenuous work/long travelling - removes fatigue, exertion, sweating and stiffness in body;
· Post meal - removes excessive secretion, make head light and pleases the mind;
· In the evening - Cleansing of respiratory tract, sound sleep at night and fresh awaking in morning;
· And many other indications (AK, 2001)
Nasya as part of daily routine
Ayurvedic Practitioners should be recommending nasya as part of the daily routine for the promotion of good health and longevity.
There are multiple nasya oils and formulations sold on the market which can be easily prescribed to the patients. Furthermore, nasya oil or nasya ghee can be prepared at home and used as a daily practice. Kate O’Donnell in her book “The everyday Ayurveda Guide to self-care” provides easy DIY recipes for preparation of brahmi oil, brahmi ghee, shatavari ghee, all of which can be used for daily practice of nasya (O'Donnell, 2020).
The classical preparation for nasya is called Anu taila, and the recipe is given in Charaka Samhita. Anu taila contains multiple herbs such as sandalwood, licorice, bala, vidanga, sariva and many more. These herbs are boiled in water to make a decoction and then boiled further with oil until all the water is evaporated. The classical recipe calls for the goat milk to be added as well. The prescribed dosage is 24 ml total within 24 hours (Sharma RK, Charaka Samhita (Eng. Translation) Vol. I (Sutra Sthana Chp. V verse 57-62), pgs.119-120, 2018).
The preventative use of Nasya in a daily life is an easy way to raise awareness of the modern population about benefits of not just this Ayurvedic practice but also many other Ayurvedic treatment protocols.
Vasant Lad describes the daily routine that should be followed for longevity and good health which includes daily application of oil. He suggests putting 3 to 5 drops of warm ghee or oil into each nostril in the morning helps to lubricate the nose, clean the sinuses, and improve voice, vision, and mental clarity. Our nose is the door to the brain, so nose drops nourish prana and bring intelligence.
Various oils and ghee types are indicated for various doshas – body types, such as sesame oil, ghee or vacha (calamus) oil is recommended for vata types; brahmi ghee, coconut oil is recommended for pitta types and vacha oil is recommended for kapha types (Vasant Lad, n.d.).
Nasya as part of Ayurvedic detox (Panchakarma)
Panchakarma is a profound Ayurvedic program directed to remove ama (toxins) from the body. A qualified Ayurvedic practitioner will prescribe a necessary protocol, whereas nasya might be required to remove accumulation of doshas (imbalances) in the head, sinus and throat areas, and to clear up breathing.
As part of the Panchakarma, nasya must be conducted under supervision of the Ayurvedic Doctor or practitioner as drugs, method and quantity of administration will differ.
Nasya for treatment of acute conditions
Ayurvedic medicine is often looked at as a slow acting treatment which is not applicable to the acute or emergency conditions. A case study published in the Ancient Science of Life magazine argued efficacy of Nasya in coma.
Classical literature has many references regarding management of acute conditions like syncope, coma, episodic conditions of bronchial asthma, epilepsy, etc. In the present study, a 61 year old female patient had a two year history of hypertension and was suffering with coma. She was treated with an Ayurvedic treatment modality. Nasya (nasal medication) of Trikaṭu cūrṇa (powder) for seven days, followed by dhūmapāna (fumigation) with saṅkhyāsthāpana (consciousness restorative) drugs for seven days was administered. The outcome of this management was appreciable, as it resulted in positive changes in Glasgow Coma Scale (GSCS) from 3 to 11 (Rajkala S. Ramteke, 2016).
The preventive potential of Nasya therapy is vast and has a wide scope in preventing various diseases prevalent among children, men, women and in geriatric age group.
Nasya treatment has very minimal side effects, inexpensive and can be done in both clinical setting as well by the patient on the daily basis. Nasya herbal medications require minimal dosages and provide maximum bioavailability of drug administered by means of Nasya. This opens up a new era in the management of various systemic diseases.
Generally, all the clinical trials and case studies conducted to date are short, hence for reaching any definite conclusion further long duration studies are needed. These studies have very encouraging results, hence it is recommended in the modern Ayurvedic scientific literature that the studies be carried out in a large number of patients, with longer duration, to evaluate and analyse the results.
AK, S. (2001). SushrutaSamhita of Maharshi Sushruta. Vol. II (Chikitsastana Chp. XXXX verse 51-52).
Arun GR, K. S. (2014). Clinical investigations on the Ayurvedic management of Allergic Rhinitis (Vataja Pratishyaya) by Pratimarsha Nasya as nasal drug delivery system. Exploratory Animal and Medical Research.
Bansal Charu, S. U. (2019). Preventive Nasya Scope and Challenges: Review. International Journal of Ayurveda and Pharma Research.
C Radhika, G. V. (2012). A randomized controlled clinical trial to assess the efficacy of Nasya in reducing the signs and symptoms of cervical spondylosis. An International Quaterly Journal of Research in Ayurveda.
Durgesh Prasad Gupta, 1. M. (2010). A clinical study on Akshitarpana and combination of Akshitarpana with Nasya therapy in Timira with special reference to myopia. An International Quaterly Journal of Research in Ayurveda.
Lad, V. (2012). Textobook of Ayurveda, General Principles of management and treatment, Volume 3. Albuquerque, New Mexico, USA.
O'Donnell, K. (2020). The Everyday Ayurveda Guide to Self-Care.
Prabhjot Kaur, T. G. (2016). In situ nasal gel drug delivery: A novel approach for brain targeting through the mucosal membrane. Artificial Cells, Nanomedicine, and Biotechnology.
Rajkala S. Ramteke, P. D. (2016). Efficacy of Nasya (nasal medication) in coma: A case study. Ancient Science of Life.
Sharma RK, B. D. (2018). Charaka Samhita (Eng. Translation) Vol. I (Sutra Sthana Chp. V verse 57-62), pgs.119-120.
Sharma RK, B. D. (2018). Charaka Samhita (Eng. Translation) Vol. VI (Siddhi Sthana Chp. IX verse 88), pg.355.
Vasant Lad, B. M. (n.d.). https://www.ayurveda.com/resources/articles/the-daily-routine. Retrieved from https://www.ayurveda.com.
Yadav Kapil, K. S. (2019). The Positive Effects of Pratimarsha Nasya W.S.R. To Sleep. Ayushdhara.