Pradhan Karma

Vamana(Emesis):

Vamana(Emesis) is the unique procedure of eliminating the dosha from the body through the oral route by way of inducing vomiting. Kapha dosha, the third among the three doshas is best eliminated by this procedure. The forcible expulsion of undigested pitta and kapha through the upper root is known as vamana by definition. To begin with the client is treated with snehana and swedana procedures and is followed by the induction of vomiting. The client is then subjected to samsarjana karma to complete the procedure. The whole procedure including the preliminary procedure as well as follow up procedure is called Vamana karma.

Virechana(Therapeutic Purgation):

Evacuation of the fecal matter and other accumulation of dosha in the lower gastrointestinal tract through the anal route are known as Virechana Karma. Though this word refers to expulsion of dosha from any route in general, particular elimination of dosha by way of including purgation is referred by name of virechana.

Basti (Therapeutic enema):-

The administration of the liquid medicine through the rectal, urethral or vaginal route is collectively referred by the name Basti. Literally this term basti refers the urinary bladder. In general the basti refers to the administration of medicine through any of the above said routes, but more particularly it refers to the therapeutic enema using the decoction through rectal route.
The administration of the medicine done through the urethral or vaginal route is specifically known by the name uttarbasti. More over the procedure is also practiced to administer the medicine into a sinus wound, where it is referred by the name vrana basti.

Types of basti:-

Retaining the warm oil over the painful knee joint for certain period is known by the name Janu Basti. This is a form of snigdha sveda and is achieved by pouring warm oil into a frame prepared on the surface of the knee joint. Janu Basti is proved effective in conditions like osteoarthritis, rheumatoid arthritis, and other painful conditions of the knee.

Asthapana basti:- In the composition of medicines used for the administration of basti when predominantly contains the decoctions of herbs then the basti is known by the name Asthapana basti.

Anuvasana basti:- The drug administered in the basti when predominantly contains the sneha or oil, is then known as Anuvasana basti.

Raktmokshana(Blood Letting):-

The surgical procedure of allowing the blood to bleed for therapeutic purposes is known by the name Raktamokshana. According to Ayurveda, certain diseases are caused by vitiation of the blood. These can be treated effectively by letting out the vitiated blood. Susruta and his disciples devised a form of surgical venesection called Raktamokshana to effect this.

Bloodletting is used to treat certain types of health issues headaches, skin diseases like eczema and leukoderma, hydrocele and abscesses.

Nasya:-

Administration of the medicine through nasal route is known as nasya. As this is the nearest route, the diseases related to head is best treated by this procedure. Depending upon the composition of the herbs used in the pharmacological action the nasya is classified into different types.

Purvakarma(Pre-purification Measures)

Prior to nasya karma, sneha and sweda should be done to the patients Face, Forehead, Head, Ears and Neck. This prior snehana (oleation) and swedana (sudation or sweating) will help to loosen the adhesive doshas, thereby facilitating the subsequent elimination.

Pradhan karma (Main Procedure of Nasyakarma)

After the Purvakarma the patient is asked to lie down in a bed with his hand and legs kept straight. His head is maintained at a lower position by keeping the pillow below the neck. This position will facilitate the direct passage of the drug. Placing the medicine above hot water gently warms it and then it is made to flow in to one nostril, while the other is kept closed the same process is carried out in the other nostril also. For the administration of the drug a pichu (Cotton swab) or nadi(tube) may be used (dropper can be used). The sole, shoulder, neck, ear and palm are gently massaged after the administration of the drug. He must pit out all the impurities and medicine that reach his mouth. The spitting is repeatedly carried out turning to both sides while the patient is lying. Swedakarma (sudation) should be repeated after the nasya treatment. The process of nasya can be repeated twice or thrice if necessary. This process should be repeated for 7 days.

Mechanism of Nasyakarma

The nasya dravya (medicine) acts by reaching 'Sringataka marma'(a main vital point situated on the surface of the brain corresponding to the nerve centres, which consisting of nerve cells and fibres responsible for the function of speech-Broca's Centre, vision, hearing, taste and smell).
From where it spreads into various strotasas (vessels and nerves) and brings out vitiated doshas from the bread.
Sringataka is a composite structure consisting of four siras (arteries) in connection with four sense organs-viz, nose, ear, eye and tongue. The composite structure formed by the union of these four arteries is called sringata. As per the ayurveda school of thought for the evolution of a disease the vitiated doshas should be brought to the site from its original seat. This movement will be made through the srotasas (channels) and if there is any disturbance in the integrity of the srotasas it will result in the development of disease.
With regards to the Urdhwangarogas (diseases of head) there should be some disturbance in the normal functions of urdwanga srotasas (arteries, veins, nerves in the head). Sringadaka are the most important group of srotasas in the urdhwanga (head) and drugs acting through these srotasas are certain to bring about srotosuddhi (cleaning) in urdhwanga.
Action of drugs used in Nasyakarma
* By general blood circulation, after absorption through mucous membrane.
* Direct pooling into venous sinuses of brain via, inferior ophthalmic veins.
* Absorption directly into the cerebrospinal fluid.

Many nerve endings which are arranged in the peripheral surface of mucous membrance, olfactory, trigeminal etc will be stimulated by Nasyadravya (the medicine used to give nasya) and impulses are transmitted to the central nervous system. This results in better circulation and nourishment of the organs and the diseases will subside. Most of the drugs described for nasya therapy have got katu (bitter), ushna (hot) and theekshna (sharpness) properties. These drugs produce draveekaranam (liquifaction) and chhedanam (expulsion) of vitiated doshas. The kashaya rasa (astringent taste) drugs produce astringent effect while madhura rasa (sweat) drugs produce cooling and nourishing effect.

In conclusion it may be stated that The nose is the doorway to the brain and it is also the doorway to consciousness.Prana or life energy enters the body through breath taken in through the nose. Nasal administration of medication helps to correct the disorders of prana affecting the higher cerebral, sensory and motor functions.the brief study of the mechanism of nasya can be summed up in a single statement made in the ayurvedic classics, "Nasahi Shirasodwaram" ie., nose is a pharmacological passage into the head.

Types of Nasya

There are six main types of nasya, as listed below.
1. Pradhamana (virechan) Nasya (cleansing nasya) uses dry powders (rather than oils) that are blown into the nose with a tube. Pradhamana nasya is mainly used for kapha types of diseases involving headaches, heaviness in the head, cold, nasal congestion, sticky eyes, hoarseness of voice due to sticky kapha, sinusitis, cervical lymph adenitis, tumors, worms, some skin diseases, epilepsy, drowsiness, Parkinsonism, inflammation of the nasal mucosa, attachment, greed and lust. Traditionally, powders such as brahmi are used.

2. Bruhana Nasya (nutrition nasya) uses ghee, oils, salt, shatavari ghee, ashwagandha ghee and medicated milk and is used mainly for vata disorders. It is said to benefit conditions resulting from vata imbalances such as vata-type headaches, migraine headache, dryness of voice, dry nose, nervousness, anxiety, fear, dizziness, emptiness, negativity, heaviness of eyelids, bursitis, stiffness in the neck, dry sinuses and loss of sense of smell.

3. Shaman Nasya (sedative nasya) is used according to which dosha is aggravated but mainly for pitta-type disorders such as thinning of hair, conjunctivitis and ringing in the ears. Generally certain herbal medicated decoctions, teas and medicated oils are used.

4. Navana Nasya (decoction nasya) is used in vata-pitta or kapha-pitta disorders and is made from decoctions and oils together.

5. Marshya Nasya (ghee or oil nasya)

6. Pratimarshya (daily oil nasya) is performed by dipping the clean little finger in the ghee or oil and inserting into each nostril, lubricating the nasal passage with gentle massage as described above. This helps to open deep tissues and can be done every day and at any time to release stress.

Indications for Nasyakarma:-

• Trigeminal Neuralgia
• Bel's Palsy
• To improve memory & eye sight
• Insomnia
• Elimination of excess Mucus
• Hyper pigmentation in the face
• Pre-mature graying of hair
• To bring clarity to voice
• Headaches of various origin
• Hemiplegia
• Loss of smell and taste
• Frozen Shoulder
• Migraine
• Stiffness of the neck
• Nasal Allergies
• Nasal Polyp
• Neurological dysfunctions
• Sinusitis
• To relive stress and emotional imbalances
• Stiffness in the neck & shoulders
• Dryness of the nose
• Hoarseness of voice
• Convulsions

Contra-Indications for Nasya:-

Nasal medication should not be administered after a bath, food, sex, drinking alcohol, during pregnancy or menstruation.It should not be used below 7 years or over 80 years of age.
Substances Used in Nasya: brahmi, ginger, ghee, oils, decoctions, Piper longum, black pepper, curry pepper, rose, jasmine, henna etc.