Shirovirechana and nasya are terms that are used interchangeably. In Sanskrit, shiro means “head,” and virechana means “purging.” This procedure purges and rejuvenates the tissues and organs of the head and neck. It introduces medicated oils and powders into the nose, the nearest access and outlet to the organs of the head. It removes ama and toxins from the nose, larynx, pharynx, mouth, para-nasal sinuses, ears and eyes.
Ayurveda describes the nose as the doorway to the brain. Nasya cleanses and opens the channels of the head and improves oxygenation — the flow of prana — which has a direct and highly beneficial influence on brain functioning.
Nasya is indicated in diseases of the head and neck. It is used for dry nasal passages, as well as sinus congestion, common cold, chronic sinusitis, allergies and allergic rhinitis. It relieves chronic vascular headaches, migraine, epilepsy, and has-a positive effect on degenerative diseases of the brain and mental retardation. Nasya also helps with eye and ear problems, such as dry, itching and watery eyes, conjunctivitis, glaucoma, hearing loss and tinnitus, as well as loss of the sense of smell.
The only cases in which nasya is contraindicated are for infants who are dehydrated, or for those who are experiencing severe panic or anger. It should also not be administered immediately after bathing. Some caution is advised when giving this therapy to pregnant women. Otherwise, anyone from age eight to eighty can be treated by nasya
A classic example of the therapeutic benefits of nasya treatment was a man who had been suffering for twenty years with chronic migraine headaches and allergies. He said he had been taking pain medication daily in order to be able to work. During his examination, he mentioned that whenever he felt nauseous and vomited, he felt better. This immediately indicated to me that kapha-related ama had collected in the region of his head and stomach. I designed a cleansing program for him that began with seven days of nasya treatments as well as snehana and swedana. This had remarkable results. He enthusiastically told me that for the first time in ten or fifteen years, he was waking up in the morning feeling free from pain and heaviness in his head.
His condition improved with this therapy until I felt he was properly prepared for vamana, virechana and bastis. After these treatments, his symptoms were completely gone. The ama which blocked normal activity in the kapha zone had been dispelled. I have since treated countless patients suffering from long-term, chronic sinus congestion and migraines. In some cases, the conditions had progressed to the point that tinnitus, hearing loss and other complications had developed. The cleansing treatments have, in all cases, produced either a complete cure or a significant improvement.
Another example of nasya’s effectiveness is the case of a patient who came to me with clinical symptoms of chronic colds and allergies. He had been suffering from these problems for the last ten to fifteen years. With the onset of the fall or spring seasons, his problem would become aggravated, and make his life miserable. He tried all kinds of therapies, with little benefit. I administered a series of nasya treatments over a three week period immediately before the spring and autumn seasons. This cleaned the sinus zones and improved their resistance to infection and aller-get. This successfully eliminated his symptoms and dramatically reduced his episodes of colds and allergies.
Types of Nasyas
Traditionally, nasya uses two different classes of substances: medicated powders and medicated oils. According to Charaka, both classes can be utilized for three different purposes:
(i) to promote secretions which dislodge and carry toxins out of the body, called shodhana nasya;
(ii) to create a palliative or soothing effect, called shamana nasya;
(iii) to provide nourishment to the tissues in the region, called bruhan nasya.
According to the needs of the patient, each of these three effects can be increased by varying the substances which are introduced into the nose. Tikshna shirovirechana is a shodhana type of nasya which uses herbs in a sesame oil base. These strong herbs are hot, pungent, dry and quickly penetrating. They increase secretions which help remove ama from the nose and head. This treatment effectively eliminates headaches, heaviness in the head, nasal congestion and swollen lymph glands.
Shamana and bruhan are palliative and nourishing types of nasyas, and generally incorporate sweet materials like ghee, sweet herbs (e.g., licorice) or flowers into their formulas. Shamana, which means “palliative,” helps manage symptoms but does not heal the cause of a condition. For example, when nasal passages are blocked or congested, vacha in a sesame oil base rapidly clears the obstruction and returns the patient to easier breathing. This is particularly useful for people with bronchial asthma. Shamana nasya helps control sneezing and nose bleeds.
Bruhan, meaning “nutritive,” is more nourishing than cleansing. It improves sensory functioning and attention deficit disorders, and helps with degenerative brain conditions like Alzheimer’s, epilepsy and mental retardation. The dosage usually begins with eight drops in each nostril and can increase to fifteen drops. Panchendriya vardhan oil is commonly used for these conditions. For thousands of years, the herbs in this formula have been known to rejuvenate this area of the body. They include: Ashwagandha (Witharia Somniferra), Pippali (Piper Longum), Naga bala (Sida Cardifolia) and seven other rejuvenative herbs.
Administering Nasya
Charaka describes a number of ways to administer nasya. The first, avapidana, or “squeezing,” drips juices extracted from fresh herbs into the nasal passages. This cleanses and soothes the paranasal sinus area. The astringent juices of common grass, for example, can be used to stop a nose bleed. Ayurveda employs avapidana for insomnia, headache and anxiety.
The second method for administering nasya is pradhamana, which ttanslates as “forcefully pushing.” It has a strong cleansing action and gives immediate relief from diz’kiness, fainting, severe headaches and disorientation. In pradhamana, powdered herbs are blown into the patient’s nose through a tube while the patient inhales deeply.
Marsha nasya and prati marsha nasya, or “repeated application,” are milder procedures than the previous two nasyas because they utilize fewer and weaker herbs and are not propelled as deeply into the nasal passages. Most of the herbs are decocted and applied in a sesame oil base. Marsha nasya introduces two to four drops of medicated oil into the nostrils every two hours.
In prati marsha nasya, the patient himself applies the medicated oils frequently during the day. He inserts his little finger into warm oil and gently massages the inside of the nasal passages. In both cases, once the oil has been inserted, the head is tilted back and the patient gently sniffs. This treatment cleans, lubricates and strengthens the mucous membranes, keeps the nasal passages open, and increases resistance to foreign substances.
Preparing for Nasya TreatmentProper preparation is crucial to all of Panchakarma’s elimination procedures, including nasya. Before the medicated drops or powders are administered, warm herbalized oil is vigorously massaged into the face, focusing on the sinus areas. Fomentation, using a hot water bottle wrapped in a hot, moist cloth or towel, is then applied to the face and neck to dilate the passageways. Ayurveda generally prohibits applying heat to the head, but this process provides one of the few exceptions.
After this localized snehana and swedana, the patient has his head tilted back and receives either herbalized drops in each nostril or powders forcefully blown in. The patient inhales deeply through the nose to bring the herbalized oil up into the sinus passages. To draw the medications more deeply into the passageways, the patient pinches his nostrils closed on the inhale and releases suddenly. He does this quickly, five to ten times per each strong inhale.
If the treatment uses many hot and penetrating substances, we ell the patient that the nose drops may cause a temporary burning sensation. Talking at this time, however, should be kept to a minimum. After a while, the dislodged ama and kapha begin to flow back into the hollow channels of the mouth, throat and nose. The patient then expectorates or blows his nose to remove these accumulated secretions.
If the patient’s nasal passages are inflamed because of excess pitta, he may experience burning from the nasya treatment. This can be alleviated by placing two drops of ghee in each nostril or by placing a cool towel over the face. This eases the dilating and penetrating action of the herbs. After nasya the patient rests and avoids exposure to stress, strain or anger.
Treatments start with four drops of herbalized oil in each nostril. As little as one drop is used if the patient is sensitive or if the herbs are particularly strong. Generally, treatment is performed for seven days in a row. After a rest period of a few days, treatment can be repeated for fourteen days and then twenty-one days. A series of treatments of increasing duration may be necessary to treat certain conditions, such as migraine, epilepsy and allergies.
For kapha disorders, cleansing nasya, using hot penetrating substances in oil, should be applied during kapha-dosha periods of the early morning or early evening. Nasyas for pitta and vata conditions are soothing and nourishing. For pitta conditions, indicated by nose bleeds and burning sensations, ghee is often used and is generally administered at midday or midnight. For vata conditions, nasya is performed in the late afternoon. As part of the overall Panchakarma program, it is best to offer nasyas daily, right after snehana and swedana.
After completing nasya, the patient’s head will feel lighter and less congested; her mind clear and her senses more acute. She will also feel more comfortable and happy. However, if improper herbs or dosages are used, the patient may experience discomfort. Nasya works in the sensitive area of the body close to the brain, and it is vital that it be properly administered.
As we have said, the nose is the gateway to the brain, so it is important to keep the nasal passages and the para-nasal sinuses clear of excess mucus and toxins so that they can function properly. These channels bring prana or life-force to the brain and surrounding tissues and protect the body by faltering out potentially dangerous airborne substances or allergens.