अथातो नस्य विधिर्नामाध्यायं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ॥१॥
We will now expound the chapter called Nasyavidhi medication (errhines) : thus said Atreya and other great sages. (1) – procedure of nasal
Nasya Vyakhya – definition of nasya
नासायां प्रणीयमानमौषधं नस्यम् । नावनं नस्तः कर्मेति च संज्ञां लभते । नासा हि शिरसो द्वारम् । तत्रावसेचितमौषधं स्त्रोतः शृङ्गाटकं प्राप्य च मूर्धानं नेत्रश्रोत्रकण्ठादिसि रामुखानि च मुञ्जादिषीकामिवासक्तामृर्ध्वजत्रुगतां वैकारिकीमशेषामाशु दोषसंहतिमुत्तमाङ्गा दपकर्षति ॥२॥
Administration of medicines through the nose is known as Nasya. It is also called as Navana and Nasyakarma. Nose is the gateway for the head. The medicine that is put into it, moves up the channels upto the sringataka (a vital spot at the base of the brain), spreads to the whole of the (interior of) of head, the channels of the eyes, ears, throat and their veins and cures the diseases affecting the parts above the shoulders quickly, removing out the accumulation of doshas localised in the head, just as a piece of grass is removed out of the body by (using a tuft of) munja grass.
Nasya bheda – Types of Nasya
तत्तु त्रिविधं विरेचनं बृंहणं शमनं च । तेषां विरेचनं जत्रू र्ध्वगौरवशोफोपदेहकण्डूस्तम्भाभिष्य न्दपाकप्रसेकवैरस्यारोचकस्वरभेदनिमिप्रतिश्यायापस्मारगन्धाज्ञानग्रन्र्थ्यर्बुददद्रुकोठादिषु श्लेष्मजेषु तीक्ष्णेन स्नेहेन शिरोविरेचनद्रव्यैर्वा सिद्धेन तेषां वा क्काथचूर्णस्वरसैस्तैरेव वा यथार्हद्रवश्लक्ष्णकल्कितालोडितैर्मधुसैन्धवासवपित्तमूत्रैर्यथास्वंचोपदिष्टैर्योज्यम् ॥३॥
It is of three kinds ; Virechana ( purgative), Brimhana ( strengthening) and Shamana (palliative, mitigating the doshas).
Virechana nasya – purgative errhines)
Virechana Nasya (purgation of the head) is indicated in diseases affecting the parts of the body above the shoulders, such as, feeling of heaviness, swelling, mild burning sensation, itching, stiffness, obstruction of passages due to exudation, ulcerations, excessive salivation, bad taste in the mouth, loss of appetite, hoarseness of vioce, worms, nasal catarrh, epilepsy, loss of sense of smell, tumors, malignant tumors, ringworm, rashes on the skin and other diseases of kapha origin. The medicinal recipe should be an oil processed with strong drugs possessing the property of causing purgations of the head, or may be a decoction, powder, fresh juice or other suitable liquids, mixed with soft paste of such drugs, honey, saindhava, fermented liquids, bile or urine of animals whichever is indicated. (3)
तत्र भीतक्लीबकृशसुकुमारेषु स्नेहः । गलरोगसन्निपातज्वरातिनिद्रामनोविकारक्रिमिविषाभिप न्नाभिष्यण्णसर्पदष्टविसंज्ञेषु शेषाः । तेष्वेव भूयसि दोषे शीघ्रकारिणि च चूर्णः । स हि निहितो नासाग्रे आवेगकरतरो भवति ॥४॥
For persons who are fretful, impotent, emaciated and of tender constitution the recipe should be in the form of oil. For those who are suffering from diseases of the throat, toxic fevers (due to increase of all the three doshas together), excessive sleep, mental disorders, worms, affections of poisons and those unconscious due to bite of poisonous snakes, other kinds of recipes may be used. Even among them, if the doshas are profound and the condition is serious, the recipe should be in the form of powder which will be acting quick, placed even at the tip of the nostrils it produces powerful bouts quickly. (4)
Brimhana nasya – strengthening errhines
बृंहणं सूर्यावर्तार्धावभेदकक्रिमिशिरोरोगाक्षिसङ्कोचस्पन्दतिमिरकृच्छ्रावबोधदन्तकर्णशूलनाद नासा मुखशोषवाक्सङ्गस्वरोपघातमन्यारोगापतानकापबाहुकनिद्रानाशादिष्वनिलोत्थेषु स्त्रिग्धमधुरद्रव्यैस्तत्सिद्धैर्यथायथं चोपदिष्टैः स्नेहैर्निर्यासैर्धन्वमांसरक्तैश्च ॥५॥
Brimhana (strengthening) nasya is indicated in diseases such as migraine, hemicrania, diseases of the head due to worms (bacteria etc.), contractions of the eyes, pulsations, blindness, difficulty in opening of lids (or difficulty in getting awake); pain in the teeth and ears, noise in the ears, dryness of the nose and mouth, obstruction of speech, loss of voice, diseases of the neck, apatanaka (tetanus), apabahuka (pain and loss of movement of the arm), loss of sleep and such other diseases of vata origin. The recipe should be of fatty material (oil, ghee etc.) processed with drugs of sweet taste or processed with unctous sap of trees, or the soup of meat of animals of desert-like regions or their blood. (5)
Shamana nasya – palliative errhines
शमनमकालवलीपलितखलतिदारुणकरक्तराजीव्यङ्गनीलिकारक्तपित्तादिषु यथास्वमुपदिष्टैः स्त्रेहैर्भेषजस्वरसादिभिः क्षीरोदकाभ्यां वा समदोषे वाणुतैलेनेति ॥६॥
Shamana (palliative) nasya is indicated in diseases such as appearance of premature wrinkles, grey hair and bladness, dandruff, appearance of reddish straie, pigmentation, blue spots, haemorrhagic diseases, and such other diseases. The recipe should be in the form of oil processed with fresh juice of appropriate drugs, milk or water or with Anu taila in case of normalcy of the doshas (healthy persons). Marsa, partimarsa etc. (6)
तत्र स्नेहो मात्राभेदाद् द्विधा । मर्शः प्रतिमर्शश्च । विरेचनः शमनो वा नासया प्रणीयमानः कल्कोऽवपीडसंज्ञो विरेचनचूर्णस्तु प्रधमनाख्यः । परिशेषं नावनमवपीडकसंज्ञम् | कल्कीकृता दौषधादवपीडितः स्रुतो रसोऽवपीड इत्यपरेषाम् । तत्र पुनस्तीक्ष्णे वैषेषिकी शिरोविरेचनसंज्ञा। तथान्ये सर्वमेव विरेचनं नस्यमित्याहुः । सद्यः श्लेष्मविरेचन सामान्यात् ॥७॥
Based on the quantity of oil used (to be specified later) the therapy is of two kinds viz., Marsa and Pratimarsa.
That which is squeezed into the nose from a wet bolus (paste) is known as Avapidaka, be it virecana or samana types.
Powder used for causing purgations is known as Pradhamana.
Some other authorities say that the juice pressed out of bolus (paste) alone is to be called as Avapidaka. That recipe which is strong and causes purgations is be specially known as Sirovirechana. Some others say that all purgatives are to be called as Virechana nasya because of their common property of bringing out the kapha immediately. (7)
अथाणुतैलस्य विधानमुच्यते । अणुतैलविधानं तु मञ्जिष्ठामधुकप्रपौण्डरीक जीवकर्षभककाकोलीद्वयपयस्यासारिवानन्तानीलोत्पलाञ्जनरास्त्रविडङ्गगतण्डुलमधुपर्णीश्रावणीमेदाकाकनासासरलसालभद्रदारु चन्दनः सुपिष्टैरष्टगुणं षड्गुणेन पयसा तैलं पचेत् । घृतं वा पित्तोल्वणेषु दोषेषु ॥८॥
Method of preparing Anu taila is as follows – equal quantities of manjistha, madhuka prapoundarika, jivaka, rsabhaka, the two kakoli ( kakoli, and ksirakakoli), payasya, sariva ananta, nilotpala, anjana, rasna, vidanga tandula, madhuparni, sravani, meda, kakanasa, sarala, sala, bhadradaru, and candana are all made into a paste forming one part in total; it is mixed with eight parts of (sessamum) oil, six parts of milk and medicated oil prepared in the usual manner. For use in doshas (or diseases) having predominance of pitta, ghee may be used instead of oil. (8)
अथवा चन्दनागरुपत्रदार्वीत्वङ्मधुकबलाद्वयबिल्वोत्पलपद्मकेसरप्रपौण्डरीकविडङ्गोशीरहीबेरवन्य त्वङ्मुस्तासारिवाबृहतीद्वयांशुमतीद्वयजीवन्तीदेवदारुसुरभिशतावरी: शतगुणे दिव्येऽम्भसि दशभागा वशिष्ठं क्वाथयेत् । ततस्तस्य क्वाथस्थ दशमांशेन समांश तैलं साधयेत् । दशमे चात्र पाके तैलतुल्यमाजमपिपयो दद्यात् । एतदप्यणुतैलं पूर्वस्माद्विशेषेणेन्द्रिय दार्ढ्यकरं केश्यं त्वच्यं कण्ठ्यं प्रीणनं बृंहणं दोषत्रयघ्नं च ॥९॥
Another method of preparing Anu taila is as follows – equal quantities of candana, aguru, patra, darvitwak, madhuka, the two balas, bilwa, utpala, padmakesara, prapoundarika, vidanga, usira, hribera, vanya, twak, musta, sariva, the two brhati, the two amsumatis, jivanti, devadaru, surabhi satavari – all these are put in one hundred times of rain water, boiled and the decoction reduced to onetenth of the quantity. To this decoctions the oil (of sessamum) equal to one-tenth of its quantity is added and then boiled. When only one-tenth of it remains, (in other words when oil only remains) goat’s milk equal in quantity of the oil is added and medicated oil prepared in the usual manner.
This also known as Anutaila, is more efficacious than the previous one; it especially strengthens the sense organs, improves the health of the hairs, skin, and throat; is satiating, nourishing and mitigates all the three doshas. (9)
Nasya ayogya – persons ineligible for nasya karma
अनस्यार्हास्तु भुक्तभक्तस्त्रेहमद्यगरतोयपीतपातुकामशिरः स्नातस्नातुकामसिरादिव्यधस्स्रुत रक्त मूत्रितोच्चारिता भिहतकृतवमनविरेक बस्तिकर्म गर्भिणी सतिका नवप्रतिश्यायश्वासकासिनोऽ नार्तवदुर्दिनेष्वपि । तत्र भुक्तभक्तस्य नस्येरितो दोष ऊर्ध्वस्त्रोतांस्यावृत्य छर्दिश्वासकासप्रतिश्या : यान जनयेत् । स्नेहादिपीत पातुकामानामक्षिनासास्यस्यन्दोपहतितिमिरशिरोरोगान् । शिरः स्नातस्य शिरोऽक्षिकर्णशूलकण्ठरोगपीनसहनुमन्यास्तम्भार्दितशिरः कम्पान् । स्नातुकामस्य मूर्धस्तैमित्यजाड्यारुचिपीनसान् । स्स्रुतरक्तस्य क्षामता मरुचिमग्निसादं च । मूत्रितोच्चारितयोभृं शतरं वेगधारणजान् विकारान् । अभिहतस्य तीव्रतरां रुजम् । कृतवमनादीनां श्वासकासस्वरे न्द्रियहानिशिरोगौरवकण्डूकृमिदोषान् । गर्भिण्या भक्तद्वेषज्वरमूर्च्छार्धावभेदकाः स्युरपत्यं च व्यङ्गं विकलेन्द्रियमुन्मादापस्मारयुक्तं वा । सूतिकायाः स्रुतरक्तोक्तान् दोषान् । नवप्रतिश्यायस्य स्त्रोतोरोधादुष्टप्रतिश्यायकेशशातकृमिकण्डूविचर्चिकाः । श्वासकासिनोर्व्याधिवृद्धिः । अकाले दुर्दिने सहसैव शैत्याच्छिरोरुग्वमथुस्तौमित्यतालुनेत्रकण्डूपाकमन्यास्तम्भ कण्ठरोग प्रतिश्यायारूंषिका ॥१०॥
The following types of persons are not eligible for nasal medication – those who have taken food just then, those who have drunk oil (as part of oleation therapy), wine, homicidal poison and water or who desire to drink these immediately, who have taken bath over the head or wish to do so quickly, who have undergone venesection or having bleeding; who are compelled by the urge of urine and feces; who are injured, who have just undergone emesis, purgation, and enema therapies; women who are in their pregnancy, and purpureum; those suffering from common cold, dyspnoea and cough of recent onset; every one during an unsuitable season and on a day when the sky is full of thick clouds and no sunlight.
The doshas getting increased by the nasal drops administered to a person who has taken food will occupy all the upper channels and produce vomiting, dyspnoea, cough and nasal catarrh; in persons who have drunk oil etc., and who wish to drink soon, it (nasal drops) will produce excessive secretions in the eyes, nose and mouth, blindness and diseases of the head; in persons who have taken bath over the head, it produces pain in the head, eyes and ears, diseases of the throat, rhinitis, stiffness of the lower jaw and neck, facial paralysis and tremors of the head; in persons who desire to take bath immediately it will cause stiffness of the head, lassitude, loss of taste and rhinitis; in persons who are bleeding it produces emaciation, loss of taste and weakness of digestion;
in those who are having urges of urine and feces it will produce severe complications of such suppression; in those who are injured it causes severe pain, in those who have just undergone emesis and other therapies it will produce dyspnoea, cough, loss of voice and sensory functions, heaviness of the head, itching and growth of worms (bacteria); in the pregnant woman there will be aversion to food, fever, fainiting, hemicrania and the child in her womb will develop discoloured patches on the face, improper sense organs, insanity and epilepsy; in the woman in purpureum, it will produce all the diseases due to excessive bleeding;
in those suffering from nasal catarrh of recent onset it will produce obstruction of the channels giving rise to bad rhinities, falling of the hairs, appearance of worms, itching and psoriasis; in those suffering from dyspnoea and cough there will be exacerbation of these diseases; administered in a unsuitable season or on a day without sunlight, it will produce (due to sudden cold) headace, rigors, lassitude, irritation and ulcerations of the palate, and eyes, stiffness of the neck, diseases of the throat, nasal catarrh and ulcers on the scalp. (10)
तेषु यथास्वमायतनं दोषोद्रेकं चापेक्ष्य स्नेहस्वेद- शिरोवक्त्रलेपसेकतीक्ष्णावपीडधूमगण्डूषादीनाचरेत् । विशेषेण तु गर्भिणी रुक्षे नस्यकर्मणि वर्षाभूकाकोलीकपिकच्छुभिः शृतं पयः पिबेत् । बलाविदार्यं शुमतीमेदाभिर्वा । एभिरेव च शृतं हविः वातहरसिद्धश्च स्नेहः शिरोबस्तौ कर्णपूरणे च योज्यः । सर्वं च बृंहणमन्नपानम् । भुक्तभक्तादिष्वपि चात्ययिक व्याध्यातुरमपेक्षेत ॥११॥
In these diseases, taking into consideration, the causes, and the degree of increase of the doshas, appropriate therepies such as oleation, sudation, application of medicines on the head and face and fomentation, strong avapidda (juice of drugs etc., put into the nose), inhalation of smoke, mouth gargles and others should be done.
The pregnant woman who has been administered non-lubricating nasal drops should be given a drink of milk in which varsabhu, kakoli and kapikaccu have been boilde, or ghee prepared in this way.
Oil prepared with drugs which mitigate vata should be used for Sirobasti (soaking the head with oil) and Karnapurana (filling oil into the ears). Likewise the use of foods and drinks which are nutritive.
Even among those who have just taken food and all others” severity of the disease and (nature of) the diseased should be considered for planning appropriate therapy. (11)
Nasya matra – quantity of medicine
मर्शप्रमाणं तु प्रदेशिन्यङ्गुलीपर्वद्वयान्निमग्नोद्धृताद्यावत् पतति स बिन्दुः । अमी दशाष्टौ षड्बिन्दवो उत्तममध्यमकनीयस्यो मात्राः । क्वाथादीनामष्टौ षट् चत्वारः । प्रधमनस्य तु षडङ्गुलद्विमुखयाः नाड्या मुखानिलेरितस्याकण्ठगतेर्दोषानुरोधतश्चपुनःपुनर्योजनमिति ॥१२॥
The quantity of oil that dribbles down when the first two angulis (sections) of the index finger are dipped into the oil and taken out is called a bindu (drop) (This is the unit of measurement of the recipe of nasal medications). Ten, eight and six such drops shall be the maximum, moderate (medium) and minimum doses for Marsa nasya. For decoction and others it shall be eight, six and four bindus.
Pradhamana Nasya – instilling of fine powder into the nose
Pradhamana nasya is administered by the use of a hollow tube of six anguli in length, having openings at both ends, the powder being filled into it and blown into the nostrils of the patient by the air from the mouth (of the physician), till the powder reaches his throat. It should be repeated often depending upon the condition of the doshas. (12)
Nasya vidhi – procedure of administration
अथ नस्यार्हं नरमव्याहतवेगं धौतान्तर्बहिर्मुखं स्निग्धस्विन्नशिरसं नातिक्षुधितं प्रायोगिक धूमपानविशुद्धस्त्रोतसं स्वास्तीर्णनिवातशयनस्थुत्तानशीर्षमीषदुन्नतपादं प्रसारितकरचरणं जत्रूर्ध्वं पाणितापेन पुनः पुनः स्वेदयेत् । ततः कनकरजतताम्रान्यतम शुक्तिस्थितं प्रदेयमौषधत्रिभागमुष्णाम्बुप्रतप्तं किञ्चित् प्रलम्बितशिरसो वामहस्ताङ्गुष्ठकनिष्ठिकाभ्यामा क्रम्य नयनप्रच्छादनं चतुर्गुणं वासो मध्यमया नासाग्रमुन्नमय्य प्रदेशिन्यनामिकाभ्यां चैकैकं नासापुटं पर्यायेण पिधायेतरस्मिन् नासास्त्रोतसि दक्षिणहस्तेन प्रनाड्या पिचुना वानवच्छिन्नमा सिञ्चेत ॥१३॥
The patient who is to be administered nasal therapy should be relieved of the urges of the body, his face washed both inside and outside, head anointed with oil and fomented mildly; the head having been cleared by inhalation of Prayogika dhuma (inhalation of smoke); he should not be very hungry, he should be made to lie on a cot comfortably, inside a room devoid of heavy breeze, with the head stretched slightly upwards and his legs slightly raised; his legs and arms kept stretched (at his two sides).
The parts above the shoulders should be fomented often by warmed palms of the hands. The physician should stand behind the head of the patient, cover the patient’s eyes with a clean cloth folded in four layers, holding it firmly in position and also the head of the patient with his left hand. The medicine to be used, is taken in a small crucible made of gold, silver, copper or any other such metal, slightly warmed by placing in hot water. The nostrils of the patient are widened with the index and little fingers, his head slightly raised up and the medicine poured into each nostril in a continuous stream, by the right hand of the physician, or by using a tube or a wad of cottonwool. The medicine is to be poured into both the nostrils, one after the other, keeping one nostril closed while pouring the medicine to the other. (13)
वातपित्तकफामयेषु क्रमेणापराह्नमध्याह्नपूर्वाह्नेषु । लालास्त्रावसुप्तप्रलापदन्तकटकटायनक्रथन कृच्छ्रोन्मीलनपूतिमुखकर्णनाद तृष्णार्दितशिरोरोगश्वासकासोन्निद्रेषु रात्रौ । स्वस्थवृत्ते तु शीते मध्याह्ने शरद्वसन्तयोः प्राहेग्रीष्मेऽपराह्ने वर्षास्वादित्यदर्शने । पञ्चकर्माण्याचरतो बस्तिकर्मोत्तर कालमेव ॥१४॥
This therapy is to be done during the afternoon, noon and forenoon for the treatment of increased vata, pitta and kapha respectively. It should be done at nights in conditions such as excessive salivation, loss of tactile sensation, delerium, grinding of the teeth, sudden obstruction of breathing ( asphyxia), difficulty in opening of the eyelids, bad smell in mouth, ringing in the ears, thirst, facial paralysis, diseases of the head, dyspnoea, cough and loss of sleep. In case of healthy persons it should be done at midday in cold seasons; in the forenoon during sarat (autumn) and vasanta (spring) seasons; in the afternoons during grisma (summer) and when there is sunlight during varsa (rainy season). For persons undergoing panchakarmas (five purificatory therapies) – it should be done only after the enema therapy. (14)
न च हीनाधिकं सकृदेव सर्वमत्युष्णशीतमत्युन्नतावनतशिरसे सङ्कुचितगात्रावयवाय देयम् । तत्रहीनं दोषमुत्क्लेश्य न निर्हरेत् । गौरवारुचिकासप्रसेकपीनसच्छर्दिकण्ठरोगान् कुर्यात् । अधिकमतियोगदोषान् । सकृदेव सर्वं दत्तमुत्स्नेहनशिरोरोगप्रतिश्यायघ्राणक्लेदानुच्छ्वासोप रोधं च । अत्युष्णं दाहपाकज्वररक्तागमशिरोरुग्दृष्टिदौर्बल्यमूर्च्छाभ्रमान् । अतिशीतं हीनदोषान् । अत्युन्नतशिरसोऽपि सम्यशिरोऽप्रतिपद्यमानं तानेव । अत्यवनतशिरसोऽति दूरगमनान्मूर्छाजाड्यकण्डूदाहज्वरान् । सङ्कचितगात्रस्य सम्यग्धमनीरव्याप्नुवद्योषोत्क्लेशं वेदनां स्तम्भं वा । यदि च नस्ये दीयमाने भेषजवेगादसात्म्यतया वा मूर्च्छा स्यात् ततः शिरोवर्जं शीताम्भसा सिञ्चेत् । न च नस्ये निषिच्यमाने कोपहास्यव्याहारस्पन्दनोच्छिङ्खनान्याचरेत् । तथा हि शिरोरुक्प्रतिश्यायकासतिमिरखलतिपलितव्यङ्ग तिलकालकमुखदूषिकाणां सम्भवः ॥१५॥
Nasal drops should be neither very less nor very large in quantity; it should not be poured all of a sudden in full, it should neither be too hot nor too cold, the patient’s head should neither be to much stretched up nor bent down and the medicine should not be administered when the patient keeps his body parts contracted. Very little quantity of medicine will only excite the doshas but will not expel them out and so leads to feeling of heaviness, loss of taste, cough, excessive salivation, rhinitis, vomiting and diseases of the throat. Large quantity of medicine will give rise to complications of excessive therapy. Pouring the entire quantity suddenly, will cause the oil to come out in worng routes, diseases of the head, nasal catarrh, exudations from the nose and obstruction to expiration. If the medicine is very hot, feeling of burning sensation, formation of ulcers, fever, bleeding through the nose, headache, weakness of vision, fainting and giddiness will manifest; If it is very cold, it will cause diseases described under inadequate nasal therapy. The same disease will be produced by pouring medicine into the nose when the head is stretched high up greatly, because the medicine will not spread to all the parts of the head uniformly; if the head is bent down greatly the medicine traversing a long route will cause fainting, lassitude, itiching, burning sensation and fevers; administered when the person is having constricted body parts, the medicine being unable to spread to all the arteries, causes mild increase of the doshas, pain or stiffness.
When the nasal drops are being poured, if the patient faints (becomes unconscious) either by the power of the medicinal recipe or by being not accustomed to it, then cold water should be sprinkled over the face and body, avoiding the head.
During the period of pouring the medicine (into the nostrils) or even later he should avoid anger, laughter, too much of talk, shaking the head, sneezing and such other violent activities, because of the possibilities of developing headache, running in the nose, cough, blindness, baldness, greying of hairs, discoloured patches, black moles on the body and pimples on the face. (15)
दत्तमात्रे तु नस्ये कर्णललाटकेशभूमिगण्डमन्यास्कन्धपाणिपादतलान्यनुसुखं मर्दयेत् । शनैश्चाच्छिङ्खेत् । अनभ्यवहरंश्च वामदक्षिणपार्श्वयोरौषधं निष्ठीवेत् । सकफं हि तदभ्यवहृतमग्निमवसादयेत् । दोषं च संवर्धयेत् । एकपार्श्वनिष्ठीवनेन सर्वा: सिरा भेषजेन सम्यग्व्याप्यन्ते । पुनः पुनश्चैनं स्वेदयेदाभेषजदर्शनान्नोछिङ्खेन्निष्ठीवेच्च । ततश्चैवमेव द्वितीयमंशमनुषेचयेत्तथा तृतीयं दोषादिबलेन वा । विरचने त्ववपीडे दोषबलमपेक्ष्य पश्चात् स्नेहमनुषेचयेत् । निवृत्तनस्यं चैवमुन्नि द्रमुत्तानं वाक्शतमात्रं शाययेत् । ततः पुनरप्युत्क्लिष्टदोषशेषोपशान्तये वैरेचनिकं यथार्हं वा धूमं पाययित्वोष्णोदकगण्डूषान् धारयेत् । अथास्य स्नेहोक्तमाचारमादिशेत् । अतिद्रवपानं च वर्जयेत् । पुनश्च तृतीयेऽहनि नस्यमवसेचयेत् । हिध्मास्वरोपघातमन्यास्तम्भापतानकेषु सिरसि चानिलार्त्याद्य भिभूते प्रत्यहं सायंप्रातरु भयकालं वा । अनेन विधिना पञ्च सप्त नव वा दिनानि दद्यादाससम्यग्योगाद्वा ॥१६॥
After pouring the medicine, the region of the ears, forehead, skin of the scalp, cheeks, nape of the neck, shoulders, palms and soles should be massaged comfortably. the patient should be instructed to suck the medicine up into the head, and spit it out throgh the right and left sides and not allow it to get into the stomach. If allowed into the stomach it will cause weakenss of the digestive activity because it gets mixed with kapha and also cause increase of the doshas. By spitting the medicine by any one side all the channels inside will not become properly lubricated.
He should be given formentations again and again till all the medicine is brought out by repeated sucking and spitting.
Next, the second or third instilling of medicine may be done in the same manner depending upon the strength of the doshas etc. After the administration of virechana nasya (purgative snuff) or avapida (pouring decoction, fresh juice etc. into the nose), lubricating nasal drops (oils) should be administered considering the strength of the doshas.
After the administration of nasal medication, the patient should lie on the bed with face upwards and without sleeping, for a duration of one hundred matras (syllables). Next he should be given a vairechanika dhuma (purgative smoke) or other suitable therapy to bring out any residue of the medicines or of the increased doshas, and then gargle the mouth with hot water. He should then follow all the regimen described under oleation therapy, and avoid drinking large quantities of water.
Again on the third day, nasal medication can be administered. In diseases like hiccup, loss of voice, stiffness of the neck, tetanus and hemicrania due to profound increase of vata, nasal medication can be done daily both in the morning and evening.
In this manner nasal medication can be done for five, seven or nine days or till the patient gets (the benefits of) proper nasal medication therapy. (16)
तत्र सम्यक् स्निग्धे मूर्धनि विरिक्ते वा सुखोच्छ्वासनिश्वासक्षवथुस्वप्नप्रबोधशिरोवदनेन्द्रियविशुद्धयो भवन्ति । यथोक्तव्याध्युपशमश्च । अयोगातियोगयोस्तु यथास्वं वातकफविकारास्तान्यथा स्वमेव साधयेत् । अन्यांश्च पूर्वोक्तान् विकारान् ॥ १७॥
When the head becomes properly oleated (lubricated) and purged there will be easy respiration, sneezing, good sleep and easy awakening; cleansing of the head, face and sense organs, and also mitigation of the diseases enumerated above.
The complication arising from inadequate and excessive therapy should be treated in the same manner as treating the increase of vata, pitta and kapha. Similarly also the other diseases mentioned previously. (17)
Pratimarsa nasya vidhi – procedure of pratimarsa errhines
प्रतिमर्शस्तु क्षामक्षततृष्णामुखशोषवृद्धबालभीरुसुकुमारेष्वप्यकालवर्षदुर्दिनेष्वपि च योज्यः । न तु दुष्टप्रतिश्यायबहुदोषक्रिमिणशिरोमद्यपीतदुर्बलश्रोत्रेषु । एषां ह्युदीर्णदोषत्वात् तावता दोषोत्क्लेशो भवति । तस्य पञ्चदश कालास्तेषां च गुणाः । प्रातर्दत्ते भुक्तवतश्चान्ते स्त्रोतोविशुद्धिः शिरोलाघवं मनः प्रसादश्च भवति । विण्मूत्रशिरोभ्यङ्गाञ्जनकवलान्ते दृष्टिप्रसाद: । दन्तधावनान्ते दन्तदृढता सौगन्ध्यं च । अध्वव्यायामव्यवायान्ते श्रमक्लमस्वेदस्तम्भनाशः । दिवास्वप्रान्ते निद्राशेषगौरवप्रणाशो मनः प्रसादश्च । अतिहसितान्तेऽनिलप्रशमः। छर्दितान्ते स्त्रोतोलीनश्लेष्मव्यपोहः । दिनान्ते स्त्रोतोविशुद्धिः सुखनिद्राप्रबोधश्च भवति । भवति चात्र ॥१८॥
Pratimarsa nasya (mild type of nasal medication) is ideal for persons who are emaciated, injured, suffering from thirst, dryness of the mouth; the aged, the children the fearful and of tender constitution. It can be administered even at unsuitable, rainy season and on bad days (having no sunlight).
It should not be administered to persons suffering from bad rhinities, abundance of increased doshas, worms (bacteria) in the head, those who have taken alcoholic drinks and those having weak ears (hearing). There will be sudden increase of the doshas in such people as they will be having mild increase of doshas already in their body.
It (pratimarsa) can be administered at fifteen periods of time and benefits obtained; such as (1) in the morning and (2) after the midday meal it cleanses the channels, causes lightness of the head and pleasantness of the mind; (3) after the elimination of feces and (4) of urine (5) after oil bath to the head, (6) applying eyesalve and (7) mouth gargling it will improve the vision; used after (8) washing the teeth it will cause firmnes of the teeth and pleasant adour to the mouth; after the end of (9) long wak (10) excercise and (11) sexual intercourse it will relieve exertion, fatigue, sweating and stiffness of the body; after the (12) completion of day sleep. it will drive away stupor, dryness, feeling of heavyness and bestows pleasantness of the mind; it mitigates vata if taken (13) after too much of laughing; (14) at the end of vomitting it will expel all the kapha adhering inside the tissue pores; (15) taken at the end of the day it cleanses the channels (tissue pores), bestows good sleep and easy awakening. (18)
प्रमाणं प्रतिमार्शस्य बिन्दुद्वितयमिष्यते । बिन्दुर्वा येन चोत्क्लेशो नानुत्क्लिष्टस्य जायते ॥१९॥ निष्ठयूते यत्र वा स्नेहो न साक्षादुपलक्ष्यते । न नस्यमूनसप्ताब्दे नातीताशीतिवत्सरे ॥२०॥ न चोनाष्टादशे धूमः कवलो नोनपञ्चमे । न शुद्धिरूनदशमे न चातिक्रान्तसप्ततौ ॥ २१ ॥ आजन्ममरणं शस्तः प्रतिमर्शस्तु बस्तिवत् । मर्शवच्च गुणान् कुर्यात् स हि नित्योपसेवनात् ॥ २२ ॥ न चात्र यन्त्रणा नापि व्यापद्भ्यो मर्शवद्भयम् । तैलमेव च नस्यार्थे नित्याभ्यासेन शस्यते ॥ शिरसः श्लेष्मधामत्वात् स्नेहाः स्वस्थस्य नेतरे ॥२३॥
आशुकृच्चिरकारित्वं गुणोत्कृष्टावकृष्टता । मर्शे च प्रतिमार्शे च न विशेषो भवेद्यदि ॥ को मर्शं सपरीहारं सापदं च भजेत्ततः ॥२४॥
Further on: some verses more :
The dose of the medicine in pratimarsa is either two bindus (drops, as described earlier) or even one bindu; by which the doshas which are mildly increased, do not undergo further increase, or that much quantity which will not cause the actual presence of oil in the spittle.
Nasal medication is not to be given to children less than seven years of age nor to those who are aged more than eighty years.
Dhuma (inhalation of smoke) should not be given to those less than eighteen years of age, kavala (mouth gargles) to those less than five years, sodhana (purificatory therapies) (emesis, purgation, enemas, etc.) to those less than ten years and more than seventy of age.
Pratimarsa nasya just like basti (enema therapy) is suitable for all, from birth to death, it bestows the same benefits as those from Marsa, if taken daily. It does not need any control (or following of any rigid regimen) nor there is the fear of complications as described for marsa nasya.
Oil alone is ideal for nasal medication to be practiced daily because the head is the chief seat of kapha and even during health, none: better than oil to produce lubrication.
Quick action and slow action, greater benefits and lesser of benefits are found both in Marsa and Pratimarsa nasyas (comparatively). If there no difference between these two kinds, who will go in for Marsa which is troublesome and associated with complications? (24)
अच्छपानविचाराख्यौ कुटीवातातपस्थिती । अन्वासमात्राबस्ती च तद्वदेव च निर्दिशेत् ॥५५॥
Acchapana and Vicharana (the two kinds of oleation therapy), Kuti (pravesa) and Vatatapika (the two kinds of rejuvenation therapy), Anuvasana and Matrabasti (lubricating enema and decoction enema) are also to be considered in the same way. (25)
॥ इति एकोनत्रिंशोऽध्यायः ॥
Thus ends the twentyninth chapter.