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Charaka Samhita, Siddhisthana 9.89
Nasam hi shirasodvaram — the nose is the gateway to the head. Through nasal administration, medicines reach the brain, the Pranavaha Srotas, and all channels of the head. Nasya is the primary Panchakarma for all conditions above the clavicle.

The five types of clinical Nasya

Navana Nasya (Sneha Nasya): Medicated oil or ghee. 4–8 drops per nostril. The standard Panchakarma Nasya for Vata and Kapha head conditions. Primary preparation: Anu Taila (27-herb classical preparation), Kshirabala Taila for neurological conditions, Brahmi Ghrita for cognitive conditions.

Avapeedana Nasya: Fresh herb juice. For Kapha conditions with thick secretions — sinusitis, chronic rhinitis. The juice's direct pharmacological properties act on the Kapha deposits in the nasal channels.

Dhamapana Nasya (Pradhamana): Dry herbal powder blown into the nostril through a tube. For acute Kapha conditions — acute sinusitis, Kapha-type mental conditions. The mechanical plus pharmacological action dislodges thick Kapha deposits.

Dhuma Nasya: Herbal smoke inhaled through the nose. For Kapha conditions of the head requiring the penetrating, drying, and channel-opening action of herbal smoke. Specific medicated cigars (Dhumpana Varti) are classical preparations.

Pratimarsha Nasya: The mild daily version — 2 drops per nostril — documented in Dinacharya for all healthy people. This is distinct from clinical Panchakarma Nasya.

Clinical Nasya protocol

Pre-procedure

Mukha Abhyanga — facial massage

Warm medicated oil applied to the face, forehead, neck, and sinuses with specific massage strokes. Charaka Samhita documents this as essential preparation — the massage opens the channels of the face and head, making the nasal channels more receptive to the administered preparation. Duration: 5–10 minutes.

Pre-procedure

Facial Swedana — steaming

After Mukha Abhyanga, mild steam applied to the face (using a steam tent or warm towel) for 3–5 minutes. This further opens the sinus channels and ensures the nasal passages are clear and warm. The preparation must be administered while the channels are still open from the steam — within 5 minutes of Swedana completion.

During procedure

Administration

Patient supine, head slightly tilted back and to one side. Medicated preparation warmed to body temperature, administered drop by drop into each nostril. Patient inhales gently as each drop is administered. After administration: patient remains supine for 5 minutes, then sits up and expectorate any material that has reached the throat.

Post-procedure

Recovery restrictions

Charaka Samhita documents post-Nasya restrictions: avoid cold air, cold water, cold food for the remainder of the day; avoid speaking loudly or singing; avoid vigorous activity; avoid emotional distress. The opened head channels remain sensitive for several hours post-procedure.

Primary indications for clinical Nasya
Headache (Shirashula), sinusitis (Pratishyaya), facial palsy (Ardita), cervical spondylosis (Manyastambha), Parkinson's-type conditions (Kampavata), cognitive decline, voice disorders, hair loss, premature greying, and specific eye conditions. Charaka Samhita documents the scope of Nasya as 'all conditions above the clavicle.'
Contraindications
Immediately after meals; after Snehapana (internal oleation — the channels are already saturated); during pregnancy; acute respiratory infection with fever; children under 7; immediately after bathing; in extreme fatigue or emotional distress; and in conditions of active bleeding in the head or nasal region.