Pratishyaya -Nasya ksr

Prof. KSR Prasad, Head, Panchakarma, MGACH&RC, Wardha

Panchakarma Management in

Pratishyaya

Dr. K. Shiva Rama

Prasad, at http://www.technoayurveda.com/

CME on Management of Allergic Rhinitis in Ayurveda on 31/8/2013 @ MGACH&RC, Salod (H), Wardha, MS

Pratishyaya is defined as – common cold, develops because of allergy or a mild viral infection involving the nose and

respiratory passages (but not the lungs).

• Pratishyaya can be successfully treated by physician in 7 days –– If not it cures by it self with

in a weak.

Dr. K. Shiva Rama


Panchakarma Management in Pratishyaya

Beware of Pratishyaya – it spreads !

Dr. K. Shiva Rama



Cold Stories • Hand kerchief

– Is a square scarf that is folded into a triangle and worn over the head or about the neck

– King Richard II of England, who reigned from 1377 to 1399, is widely believed to have invented the cloth handkerchief, as surviving documents written by his courtiers describe his use of square pieces of cloth to wipe his nose.

Dr. K. Shiva Rama



http://en.wikipedia.org/wiki/Handkerchief

http://en.wikipedia.org/wiki/Handkerchief

Cold Stories • Necktie

– Neckwear consisting of a long narrow piece of material worn (mostly by men) under a collar and tied in knot at the front

– “Trajanuscollony” in Rome, about 200 years after Christ mentions that a Roman legionnaire bearing a cloth around his neck. It was probably used both as a protection against the cold and as a handkerchief.

Dr. K. Shiva Rama



http://www.tieroom.com/necktie-history

http://www.tieroom.com/necktie-history

Prevalence of Pratishyaya

• Pratishyaya prevalence is about 10-40% among all age- groups in United States and other western countries.

• Prevalence is reported to range from 10-13% in Delhi state of North India.

• Symptoms of rhinitis are reported in 75% of children and 80% of asthmatic adults in India,

Dr. K. Shiva Rama



Classification of Pratishyaya

Dr. K. Shiva Rama



Authors Vataja Pittaja Kaphaja Raktaja Sannipataja

Charaka + + + - +

Sushruta + + + + +

Kasyapa + + + - +

zClinical Manifestations

of Pratishyaya• Rhinitis• Nasal irritation• Paroxysmal sneezing• Watery copious

rhinorrhea• Nasal obstruction• Watery eyes• Headache & Fatigue

Dr. K. Shiva Rama



SAMPRAPTI GHATAKA

Dr. K. Shiva Rama



Dr. K. Shiva Rama



Painful Sinuses

Middle Ear block

Throat irritation

Headache

Eye irritation / Watering eyes

Nasal Obstruction

Management Of Allergic Rhinitis

• If Pratishyaya is not treated properly or neglected, it causes complications of ENT and Head, such as -– Dushta Pratishyaya, Puti nasa, Nasa paka,

arbuda, Netra roga, Khalitya, Arjuna, Shwasa, Kasa, Jwara, Andhatwa, Badhirya, etc.

• Rasayana therapy is proved to have a good immunomodulatory effect thereby showing good results in management of Pratishyaya and allergic disorders.

Dr. K. Shiva Rama



Priyanka et.al., An Ayurvedic Approach Towards The Management Of Allergic Rhinitis, E-JIAAP, January 2013 :Volume 01: Number 01, pp62-66

Nasahi shiraso dwaram• Start the treatment

where the disease is –• The nose is the entry to

the brain (head) even.• The nasal diseases are

best treated with –– Nasya– Dhoomapana

Dr. K. Shiva Rama



Panchakarma in Pratishyaya

• Mukha Abhyanga (Panchlavana Ghrita, Panchamula Ghrita, Dashmula Ghrita)

• Swedana• Nasya (Anu Taila, Shadabindu

Taila)• Dhoompana (Vidangadi Dhuma,

Ghrtasaktu Dhuma)• Kawalagraha

Dr. K. Shiva Rama



Nasya according

to Charaka

Dr. K. Shiva Rama



Nasya according to Susruta

Dr. K. Shiva Rama



Dr. K. Shiva Rama



Nasya according to Vagbhata

What drugs are used commonly for Nasya

• Anutaila Nasya• Triphala & Trikatu churna

Prathamana Nasya• Sunthi Taila Nasya• Rajanyadi Taila Nasya• Pippalyadi Taila Nasya• Patadi taila pratimarsha Nasya

Dr. K. Shiva Rama



Trayodashanaga Kwatha (A) Prathamana nasya (B) Combined therapy (C)

Dr. K. Shiva Rama



Varsha C. et.al., Role of Pradhamana nasya and Trayodashanga Kwatha in the management of Dusta Pratishyaya w.s.r. to Chronic sinusitis, Ayu 2010, Jul-Sep; (31) 3, 325-331, available url – www.ncbi.nlm.nih.gov/pmc/articles/PMC3321066/

Sunthi Taila Nasya

• Suddha Haridra internally made a common drug in 3 groups. Nasya with Sunthi taila is compared with Katphaladi churna for 21 days

• Haridra (int) + Sunthi taila Nasya show the results of 78.94% against Katphala + Haridra (int) (91.3%) and Haridra (int) (76.19%).

Dr. K. Shiva Rama



Neha JM et.al, Clinical study of Anurjata janitaPratishyaya (Allergic Rhinitis) & comparative assessment of nasya karma, Ayu-Vol30- (1) Jan- Mar 2009, p47-54

Vyoshadi Vati & Rajanyadi Taila Nasya in Pratishyaya

• The results are highly significant.

Dr. K. Shiva Rama



Dharmedrasinh BV et.al, Effect of Vyoshadi Vati & Rajanyadi taila on Pratishyaya – Rhinitis, Ayu -2008 vol- 29 (3), pp149-53

Anutaila Nasya in Pratishyaya

Dr. K. Shiva Rama



Sreekumar, Role of Anutaila Nasya and Varunadi Ghrita in the management of Dusta Pratishyaya w.s.r. to Chronic Sinusitis, 2005, Department of Shalakya, I.P.G.T. & R.A. Gujarat Ayurved University, Jamnagar

Probable Mode of action of

Anutaila

Dr. K. Shiva Rama



Haridra khanda (Gr-A) & Pippalyadi Taila Nasya (Gr-B) in Pratishyaya

Dr. K. Shiva Rama



Bhakti Chhaya, CLINICAL EVALUATION OF HARIDRA KHANDA & PIPPALYADI TAILA NASYA ON PRATISHYAYA – ALLERGIC RHINITIS, 2008, Department of Shalakya, I.P.G.T. & R.A. Gujarat Ayurved University, Jamnagar

Patadi taila pratimarsha nasya in Pratishyaya

Dr. K. Shiva Rama



Jigaloor SH, Comparative study of Amrutha guggulu and Patadi taila pratimarsha nasya in the management of pratishyaya, 2007, Dept of KC, PGSRC, DGMAMC, (RGUHS) Gadag.

Jala Neti (Yogic Nasal Cleansing) in Pratishyaya• Among shatkarmas, neti is the best technique to purify

the nasal passage, sinuses, etc. • Jala neti is one of the simplest forms of neti and devoid of

side effects and is easy to perform. • Technique - Jala neti can be performed over a sink, a

bowl on a table, in the shower or outside. The neti pot should be filled with lukewarm saline water; it should be neither too hot nor cold before administration.

• Action: – Jala neti rinses out the dirt and bacteria – Jala neti helps to drain “dead end” passages like the

sinuses– The eustachian tubes receive exactly the same effects as

the sinuses,

Dr. K. Shiva Rama



Mangalagowri V. Rao et.al., Role of Jala Neti (Yogic Nasal Cleansing) in the Management of Pratishyaya vis-a-vis Allergic Rhinitis, STM Journals 2012. Volume 1, Issue 2, August 2012, Pages 63-72

Diet in Pratishyaya• Katu,Amla, lavana rasa• Snigdha,ushna, Laghu bhojana• Purana yava & Shali• Kulatha & Mudga yusha• Gramya & Jangala mamsa rasa• Vartaka, Kulaka, Shigru,

Karkota, Lashuna• Dadhi• Taptambu, Varuni jala• Trikatu

Dr. K. Shiva Rama



Avoid –Snana, KrodhaVegadharana (mala, mutra, adhovata)Ati drava ahara & Bhumi shayya Yoga Ratnakara, nasarogadikara 85/88

How to do it?The steps for Good Nasya

administration steps are as follows -

1. Mukha Abhyanga2. Swedana (pipe steam /

cloth fomentation) 3. Nasya4. Kavalagraha5. Dhoomapana

Dr. K. Shiva Rama



Steps for Mukha Abhyanga

• Step -1:• Apply Medicinal oil

/Ghee gently all over face

Dr. K. Shiva Rama




• Step -2:• Start massaging with

fingers on fore head– Keep the fingers on

central line – gently rub toward the temporal region as shown with arrow marks

Dr. K. Shiva Rama




• Step -3:• Massage with fingers

on eye brows from medial canthus to lateral– Keep the fingers firm

and gently drag towards the lateral canthus as shown with arrow marks

Dr. K. Shiva Rama




Step -4:

• Keep the thumbs on either side of nose and gently massage down on maxillary area (maxillary sinuses) dropped towards lateral side of the face

Dr. K. Shiva Rama



Steps for Mukha

Abhyanga Step -5:

• Keep the thumbs on either side of nose and on maxillary area and gently massage towards lateral side of the face

Dr. K. Shiva Rama




Step -6:

• Run the fingers on either side of face below the earlobes to chin to cover mandible from up and down

Dr. K. Shiva Rama




Step -7:• Massage the

mandible with the fingers and maxillary with thumb – from central line to outer line and in reverse

Dr. K. Shiva Rama




Step -9:• Gently Massage the

cheeks with the flat palm

Dr. K. Shiva Rama




Step -10:• Gently Massage the

neck with fingers in upward direction

Dr. K. Shiva Rama




Step -11:

• Give admissible pressure on temples, sinuses, and earlobes & pins

Dr. K. Shiva Rama



Nasya Karma step-1

• Let the patient lie down in supine position

• Keep patient neck straight and raised chin

• It facilitates the easy administration of the Nasya Medicine

Dr. K. Shiva Rama



Nasya Karma step-2

• Take “Gokarna” – the instrument of Nasya karma

• Pour the medicinal drops according to the need (4 to 8 drops)

Dr. K. Shiva Rama



Nasya Karma step-3

• Close one nostril and pour the medicine in the other

• Ask the patient to take a deep breath

• The medicine passes in to the throat

• When the patient feels the medicine - administer in the other nostril also

Dr. K. Shiva Rama



Nasya Karma Step-4

• Let the patient feel the medicine in throat from both nostrils and accumulates phlegm

• Ask the patient to spit it from side in to a tray

• Let patient inhale from each nostril separately

• When the phlegm is reduced – patient asked to have “Kavalagraha” – the Gargling with Luke warm water to clean the throat

Dr. K. Shiva Rama



Dr. K. Shiva Rama



Kavalagraha• Kavalagraha is taking the

medicinal liquid or lukewarm water in to mouth and gargling to remove the Kapha from mouth

• It offers the freshness to mouth and avoids the bad breath and infection in the oral cavity

Dr. K. Shiva Rama



Dhoomapana• Dhoomapana is a mandatory procedure after the Nasya karma

• The dhooma varthi is lighten to get smoke and inhaled from each nostril

• The smoke is inhaled from nostril and let out from mouth

Dr. K. Shiva Rama



Conclusion • Pratishyaya is small

disease with big discomfort

• It hampers the daily routine and makes the mind clumsy

• When it becomes chronic – reflects with raised eosionophylia

• The best management from Ayurveda is Nasya karma

• Many medicines are used selectively according to the sensitivity and utility

Dr. K. Shiva Rama



THANK YOU31/08/2013

[email protected]

It’sTechnoayurveda

PresentationBy Dr. KSR Prasad, Prof. & Head,

Panchakarma, MGACH&RC, Wardha (MS) . . http://www.technoayurveda.com/

Dr. K. Shiva Rama

Prasad, at http://technoayurveda.wordpress.com

Pratishyaya -Nasya ksr

Health & Medicine

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