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.
Panchakarma Management in Pratishyaya

Beware of Pratishyaya –
it spreads !

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.
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.
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,

Classification of
Pratishyaya
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

SAMPRAPTI
GHATAKA

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.
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

Panchakarma in Pratishyaya
• Mukha Abhyanga (Panchlavana
Ghrita, Panchamula Ghrita,
Dashmula Ghrita)
• Swedana
• Nasya (Anu Taila, Shadabindu
Taila)
• Dhoompana (Vidangadi Dhuma,
Ghrtasaktu Dhuma)
• Kawalagraha

Nasya
according
to Charaka

Nasya
according
to Susruta

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

Trayodashanaga Kwatha (A) Prathamana nasya (B) Combined therapy (C)
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%).
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.
Dharmedrasinh BV et.al, Effect of Vyoshadi Vati &
Rajanyadi taila on Pratishyaya – Rhinitis, Ayu -2008 vol-
29 (3), pp149-53

Anutaila Nasya in Pratishyaya
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

Haridra khanda (Gr-A) & Pippalyadi
Taila Nasya (Gr-B) in Pratishyaya
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
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,
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
Avoid –
Snana, Krodha
Vegadharana (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 Abhyanga
2. Swedana (pipe steam /
cloth fomentation)
3. Nasya
4. Kavalagraha
5. Dhoomapana

Steps for Mukha
Abhyanga
• Step -1:
• Apply Medicinal oil
/Ghee gently all over
face

Steps for Mukha
Abhyanga
• 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

Steps for Mukha
Abhyanga
• 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

Steps for
Mukha Abhyanga
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

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

Steps for
Mukha Abhyanga
Step -6:
• Run the fingers on
either side of face
below the earlobes
to chin to cover
mandible from up
and down

Steps for
Mukha Abhyanga
Step -7:
• Massage the
mandible with the
fingers and maxillary
with thumb – from
central line to outer
line and in reverse

Steps for
Mukha Abhyanga
Step -9:
• Gently Massage the
cheeks with the flat
palm

Steps for
Mukha Abhyanga
Step -10:
• Gently Massage the
neck with fingers in
upward direction

Steps for
Mukha Abhyanga
Step -11:
• Give admissible
pressure on temples,
sinuses, and earlobes &
pins

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

Nasya Karma
step-2
• Take “Gokarna” – the
instrument of Nasya
karma
• Pour the medicinal
drops according to
the need (4 to 8
drops)

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

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

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

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

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

THANK YOU
31/08/2013
technoayurveda@gmail.com
It’s
Technoayurveda
Presentation
By 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

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