A well-known shloka quotes “Naasa hi shiraso dwaram…” or the nose is the entrance to the head or the brain. The nostrils are the openings which connect the external environment with the internal environment. Since there is continuous inflow coupled with outflow of particles along with gases, the cleaning of nose remains an important portion of keeping away from infections. Medicine introduced through it goes into all channels of eye, ear, and throat and removes morbid doshas. After the cleansing of oral cavity and the eyes, the nasal cavity comes next in the dinacharya.
The nasal cavity is lined with delicate and highly sensory and absorptive membrane. It is also connected to the central nervous system (CNS) via blood brain barrier. Since only lipid soluble drugs pass through this barrier, a greater number of nasya dravya contain oils and ghee-bases. Thus, nasya is an important part of daily maintenance of health permeating to the level of CNS.
Nasya karma on a daily basis includes heating of the nasya dravya (indirect heat), administering 2-3 drops per nostril and inhaling slowly. The person should the spit out phlegm as and when he has the urge to. Once the nose and throat feel clear, he is advised to rinse his mouth through gargling or gandusha and cleaning his nose.
Dhumapana
After nasya, dhumapana is advised in dinacharya krama. Generally termed Ayurvedic smoking, it is far from the cancerous smoking which is the root cause of most systemic illnesses including cardiovascular diseases. Dhuma means smoke or fumes and paana refers to inhalation. The cardinal difference between smoking and dhumapana is that the fumes are to be exhaled immediately via mouth in dhumapana. Medicated fumes are created by burning wicks rolled in herbs and minerals or burning powders of these (generally used for fumigation).
Ayurveda perspective
Nasya
Nasya karma is an essential component of the panchakarma procedures. Such significant procedure being a part of dinacharya stands self-explanatory of its importance. Based on the nature of drugs used, time of procedure, number of sittings etc give rise to different types of nasya such as Pradhamana, Avapeedana, Snehana, Shamana, Virechana, Marsha, Pratimarsha nasya etc. For daily use, Anu taila is suggested for use. It confers strength to shoulders, head and neck as a whole. Benefits include common ones such as reducing hair-fall to complex ones such as cessation of migraine, reestablishment of olfactory senses etc.
Use of Anutaila strengthens the sense organs as the regulator of these, the shringataka marma, is reached via nasya karma. It also reduces hair breakage, improves hair growth with strong roots and is used in treating premature greying of hair. Apart from these, anu taila is also indicated in pains felt in jatrurdhwa or the parts above shoulder and to clear blocked sinuses. It enhances or helps in restoration of perception of smell and maintains the health of nasal membrane.
Nasya and hridaya: the disease causing factors of hridroga include the forceful controlling of sneezing, kaasa, forceful blowing of nose etc. All these point at viloma gati of udana and prana vata. In such conditions, local administration of dravyas such as sahacharadi taila, ksheerabala taila etc help in getting rid of accumulated doshas whilst aiding in anulomana too. nasya was found efficient in conditions such as palpitations, headaches, dizziness etc. This is a procedure to be inculcated in the daily routine to enrich the avalambaka kapha. In conditions of constant tinnitus (karna nada – vatavyadhi), blackouts, blurred vision etc Nasya is the choice of treatment. Nasya facilitates and redirects efficient blood circulation in the head and neck region. This can avoid stroke, clots and early degeneration of nerves.
Dhumapana
The person who wishes to take care of his health should inhale herbal smoke daily to treat or to prevent the onset of diseases of the parts above the shoulders, arising from – increase of Kapha and Vata. There are different types based on nature of drug, dosha targeted and expected action. These are Snigdha/ Prayogika, Shamana/ Madhyama and Vairechanika dhuma. Dhoomavati or a wick of about 12 angula in length, prepared by soaking and smearing paste of medicaments and sun drying, is to be used. The wick is lit and fumes are to be inhaled from one nostril (keeping the other nostril closed) and immediately exhaled through the mouth. The same is done through the other nostril too. The number of inhalations is based on the strength of the medicines, condition of the person, associated disorders etc.
Benefits of habitual inhalation of medicated dhuma include freedom from Kaasa (cough), Shwasa (dyspnoea), Peenasa (rhinitis), disorders of voice, Halutosis (foul smelling mouth), pallor of the face, hair issues, discharges from nose and ear, itching, pain and in activities – loss of function of the ears, mouth and eyes; stupor and hiccups.
Dhumapana and hridaya: This method is contraindicated in bleeding disorders (raktapitta), urdhwa gati (vilomatwa) of vata, pandu etc. These conditions are directly related to the hridaya. Vilomatwa leads to vikruti of prana, udana along with vyana vata (raktapitta conditions). It also reduces the strength of hridaya marma. Over or improper use of dhuma leads to mada, moha, murcha (loss of conciousness) etc, which are again linked to circulation and pumping of the heart. However, use of dhumapana and nasya is indicated to be made use of in cases of unresponsive patient and comatose conditions (to revive).
Western perspective
Nasal drug administration has been used as an alternative route for the systemic availability of drugs restricted to intravenous administration. This is due to the large surface area, porous endothelial membrane, high total blood flow, the avoidance of first-pass metabolism, and ready accessibility. Drugs are cleared rapidly from the nasal cavity after intranasal administration, resulting in rapid systemic drug absorption1. In line with Ayurveda concept of dhumapana, there are many medications which are inhaled in contemporary science such as gaseous anaesthesia, inhalers for respiratory conditions etc. Medications administered through inhalation are dispersed via an aerosol spray, mist, or powder that patients inhale into their airways. Although the primary effect of inhaled medications is respiratory, there are likely to be systemic effects as well2.
Heart conditions like hypertension (high blood pressure) and congestive heart failure can cause Epistaxis or simply nosebleeds, as can hypertensive crisis — a sudden, rapid increase in blood pressure that may be accompanied by a severe headache, shortness of breath, and anxiety3. Blood thinners (anticoagulants) commonly used in cardiac disorders are also seen to cause nosebleeds. The link between chronic inflammatory disease and cardiovascular disease (CVD) is recognized. Chronic rhino sinusitis is one of the most common chronic inflammatory diseases4. In some hereditary disorders such as haemorrhagic telangiectasia (arteriovenous malformations or telangiectasia in multiple organ), cardiac involvement through high-output cardiac failure significantly increases the nose bleed than in patients without the heart disease5.
Conclusion
The use of nasya and dhumpana daily is indirectly linked to hridaya. These procedures keep the respiratory tract clean; aid the sensory organs whilst maintaining the natural gati of vata. A clean nose and a clear conscience keep the hridaya healthy in the long term.
References:
- https://pubmed.ncbi.nlm.nih.gov/15230360/
- https://pressbooks.bccampus.ca/clinicalproceduresforsaferpatientcaretrubscn/chapter/6-6-administering-inhaled-medications/
- https://www.everydayhealth.com/heart-health/nose-bleed-for-no-reason-here-are-possible-causes-3856.aspx#:~:text=Heart%20conditions%20like%20hypertension%20(high,American%20Heart%20Association%20(AHA))
- https://www.zadehmd.com/articles/chronic-sinusitis-linked-to-heart-attack/
- https://pubmed.ncbi.nlm.nih.gov/19635281/
Author
Spoorthy S Naik
Ayurvedic Cardiac Consultant
Sriranga Ayurveda Chikitsa Mandira, Dattagalli, Mysore.