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“EVALUATION OF COMBINED EFFECT OF NIMBA
TAILA NASYA AND BRINGARAJA TAILA SHIROABHYANGA IN AKALA PALITYA” AN
OBSERVATIONAL CLINICAL STUDY
BY
SSAABBAARREEEESSHH MM
Dissertation Submitted to the Rajiv Gandhi University of Health Sciences,
Bangalore, Karnataka.
In partial f ment oulfil f the degree of
AAYYUURR TTII
DM.D. (AYU), FRAV (GOI, Delhi)
P.G. Dept. of Panchakarma
And co-guidance of
Dr. YASMEEN A PHANIBAND M.D. (Ayu)
VVEEDDAA VVAACCHHAASSPPAA IN PANCHAKARMA Under the guidance of
R. SURESH BABU S
Professor
POST GRADUATE PANCHAKARMA D.G M.AYURVEDIC E AND RESEARCH
GADAG – 582103 2007-2010
DEPARTMENT OF MED LEGICAL COL
CENTER
I
DECLARATION BY THE CANDITATE
I hereby declare that this dissertation / thesis entitled “Evaluation of combined
effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala
Palitya.” An observational clinical study is a bonafide and genuine research work
carried out by me under the guidance of Dr. Suresh Babu. S M.D. (Ayu), FRAV (GOI, Delhi)
Professor and the co-guidance of Dr. Yasmeen A Phaniband M.D(Ayu), Post Graduate
Department of Panchakarma, Shri D.G.M.Ayurvedic Medical College, Gadag.
Date: Signature of the Candidate
Place: Gadag. (Sabareesh M)
II
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled “Evaluation of combined effect
of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya.” An
observational clinical study is a bonafide research work done by Sabareesh M in
partial fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.
(Panchakarma).
Date: Signature of the Guide
Place: Gadag
Dr. S. Suresh Babu M.D. M.D. (Ayu), FRAV (GOI, Delhi) Professor
P.G. Dept of Panchakarma Shri.D.G.M. Ayurvedic Medical College,
Gadag.
III
CERTIFICATE BY THE CO-GUIDE
This is to certify that the dissertation entitled “Evaluation of combined effect
of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya.” An
observational clinical study is a bonafide research work done by Sabareesh M in
partial fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.
(Panchakarma).
Date: Signature of the Co-Guide Place: Gadag
Dr. Yasmeen A Phaniband D. (Ayu).
M.
IV
J.S.V.V. SAMSTHE’S
SHRI D.G.M. AYURVEDIC MEDICAL COLLEGE, GADAG POST GRADUATE DEPARTMENT OF PANCHAKARMA
ENDORSEMENT BY THE H.O.D AND PRINCIPAL OF
THE INSTITUTION
This is to certify that the dissertation entitled “Evaluation of combined effect
of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya.” An
observational clinical study is a bonafide research work done by Sabareesh M
under the guidance of Dr. Suresh Babu S M.D. (Ayu), FRAV (GOI, Delhi) Professor, and co-
guidance of Dr. Yasmeen A Phaniband M.D. (Ayu), Post Graduate Department of
Panchakarma, Shri D.G.M.A.M.C., Gadag and contributed good values to the
Ayurvedic research.
Dr. G. B. Patil Principal,
Shri. D.G.M. Ayurvedic Medical College, Gadag
Date: Place: Gadag
Dr. Sivaramudu M.D. (Ayu), M.A (San), M.A (Psy) Prof. and H.O.D. P.G. Dept of Panchakarma Shri. D.G.M. Ayurvedic Medical College, Gadag. Date: Place: Gadag
V
COPYRIGHT
Declaration by the Candidate
I here by declare that the Rajiv Gandhi University of Health Sciences,
Karnataka shall have the rights to preserve, use and disseminate this dissertation /
thesis in print or electronic format for academic / research purpose.
Date: Signature of the Candidate
Place: Gadag. Sabareesh M
© Rajiv Gandhi University of Health Sciences, Karnataka.
VI
ACKNOWLEDGEMENT:
There is hardly any task which is more pleasant than acknowledging my
gratitude to all those who have helped in so many ways in preparing this work. At this
juncture, first of all I would like to start expressing my gratitude by bowing my head
on the feet of lord almighty. Without whose blessings i would have never been able to
complete this work.
I deserve my respectful greetings in the lotus feet of Jagadguru Shri.
Abhinava Shivanandmahaswamiji to his holiness and divine blessings.
It is beyond the words to express my gratitude towards my esteemed Parents,
Shri. Unnikrishnan; Mother, Smt. Devayani; for their support, effort and never ending
love which are the driving forces behind my success and achievement. I also grab this
opportunity to express my feelings to my sisters, and all other members of my family
for their constant inspiration and encouragement.
I would like to avail the opportunity to express my profound and immense
gratitude and whole hearted thanks to my respected guide Proff. Dr. Suresh Babu. S,
M.D. (Ayu), FRAV (GOI,Delhi) for his excellent guidance, constant help, inspiration, valuable
suggestions, keen observation and logical interpretation rendered throughout my
study. I express my thankfulness to my beloved principal Dr.G.B.Patil, for his
encouragement and support by providing all necessary facilities for this research
work.
I wish to express my deepest gratitude to Dr. P.Sivaramudu, M.D.(Ayu), HOD,
Dept of Panchakarma for his timely advises and encouragement during this research
work.
I am extremely happy to express my deep sense of gratitude to my co-guide
Dr. Yasmeen .A. Phaniband, M.D.(Ayu), whose sympathetic, scholarly suggestions
have inspired me to accomplish this work in all aspects.
I shall remain grateful to the affectionate guidance of my teachers Dr.
Santosh N. Belavadi,M.D (Ayu) and Dr. Jairaj Basarigidad MD (Ayu), for their valuable
suggestions. Their invincible and radical thinking were very valuable in achieving this
research work.
I am sincerely thankful to professor Dr.G.Purushothamacharyulu, M.D. (Ayu)
who was former H.O.D. and Dr. Rajashekar C.V. MD (Ayu), who was former teacher
in the department for their scholarly guidance.
VII
I am grateful to all the PG teachers Dr. K. S. Prasad, Dr. M. C. Patil, Dr.
Mulugund, Dr. G. S. Hiremath, Dr. R. V. Shettar, Dr. Girish Danappa Goudar, Dr.
Jagadeesh Mitti, Dr. KuberSankh, Dr. Shashikanth Nidugundi, Dr. B. M. Mulkipatil
and Dr. M D. Samudri, for their valuable inputs and suggestions.
I extend my immense gratitude to Dr. V. M. Sajjan, Dr.Purad, Dr.Yarageri,
Dr.Suvarna Nidugundi, Dr. Shakuntala and other teaching staff who helped during my
study.
My sincere thanks are extended to my beloved U.G.Teachers Dr. Muralidhar
Pujar, Dr.B.S.Prasad, Dr.Prakash Mangalassery, Dr.Sajitha, Dr.G.V.Ramana,
Dr.Ashwinkumar, Mr.Panduranga, and Dr. Tripati for their inspiration and valuable
suggestions.
I express my sincere thanks to Sri. Nandakumar, for his help in statistical
analysis of results. I take the privilege to thank Sri. Mundinamani, Librarian, who
provided me all the necessary books and time for my literary work.
I cannot move further before thanking to my intimate friends Mr. Shakthi
(Local guardian), Dr.Sasisankar.MS, Dr.Sanathan sarma, Dr.Rahul, Dr.Sunil kumar,
Dr.Sanand, Dr.Sajith kumar, Dr.Jibi, Dr.Sreekumar(Pappu), Dr.Sachin(Mangu),
Dr.Sandeep Patil, Dr.Gautam alva, Dr.Hariprasad shetty, Dr.Pratap, Dr.Anatharam
sarma who helped me in each and every circumstance and gave me a depth sense of
friendship.
I feel extremely thankful to seniors Dr. Ashok M.G, Dr. Prasanna V. Joshi, Dr.
Devandrappa Budi, Dr. Prasanna Kumar, Dr. Siba Prasad, Dr. Payappa Gowdar, Dr.
Madhushree, Dr. Nataraj, Dr. Sanjeev Chaudary, Dr. Udaya Ganesha, Dr. Adarsh, Dr.
Shailej, Dr. Mukta Hiremath and others for valuable suggestions.
I pay sincere regards to my fellow colleagues Dr. Sanath kumar, Dr. Rajesh,
Dr. Jayasankar, Dr. Deepak, Dr. Ishwar Patil, Dr. Praveen Nayak, Dr. Bodke, Dr.
Kanti, Dr. Shakunthala, Dr. Asha, Dr. C.C Hiremath, Dr. Rotti, Dr. Bupesh, Dr.
Gorpade, Dr. Deepa, Dr. Jadav, Dr. Mahantesh Swami Hiremath and Dr. Praveen
Palled for their truly help and co-operation.
I thank my juniors Dr. Joshi Goerge, Dr. Bhaghyesh, Dr. Anish Joseph, Dr.
Surej, Dr. Vijay raj, Dr. Raghavendrachar, Dr. Vishwajith, Dr. Renukaraj, Dr.
Sangamesh, Dr. Vijay Mahanthesh, Dr. Jagadeesh, Dr.Maneesh, Dr. Paresh, Dr.
Shilpa, and for their support. I also thank to my UG friends for their help and support.
VIII
I am also very much thankful to Mr. Salimath, Smt. Lalithamma who made
my stay comfort through out my P.G. carrier.
I extend my thanks to Sri Kulakarni, Sri Nabi, Smt. Sunanda and Smt Renuka
for their timely help in Panchakarma theatre during the trail.
Lastly I pay my deepest respect for those patients who took part in the study
and I share my success with them.
“To err is Human” – certain names, who could be directly or indirectly helped
in this work, might have been missed unintentionally. Thanks are due, to all of them.
Date : Signature of the scholar
Place : Gadag. (Dr. Sabareesh M)
IX
LIST OF ABBREVIATIONS USED:
A.H – Ashtanga Hrudaya
A.S – Ashtanga Samgraha
B.P – Bhavaprakasha
B.S – Bhela Samhita
C.S – Charaka Samhita
M.N – Madhava Nidana
S.S – Sushruta Samhita
V.S – Vangasena
Y.R – Yogaratnakara
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ABSTRACT:
Hair has a tendency to lose its natural colour with advancing age. It is
therefore natural for the hair to turn grey with age. But premature graying is a morbid
condition and it makes even the young looks older. This causes a great deal of
concern to the effected persons. Akala Palitya is a burning problem as large number
of population especially young men and women in present times are suffering from
this malady.
Acharyas have mentioned Nimba taila Nasya is one of the best treatment for
Akala Palitya along with Bringaraja taila Shiroabyanga as Bringaraja is one of the
best Kesharanjaka drug. Thus these drugs were considered for the study.
Objectives of the study:
• To evaluate the effect of Nimba taila Nasya and Bringaraja taila Shiroabyanga
in Akala Palitya.
• To evaluate the adverse effect of Nimba taila Nasya, if any.
Materials and Methods:
A total of 30 patients were selected from O.P.D and I.P.D. of D.G.M.A.M.C &
H after fulfilling the inclusion and exclusion criteria randomly. All the 30 patients
were included in a single group and given 3 courses of Nasya karma and
Shiroabyanga, each course of 7 days and 3 days gap in between each course. Along
with 30 days Pariharakala.
Assessments results:
Assessment of results was done by considering the base line data of subjective
and objective parameters to pre and post medication was analyzed statistically for ‘p’
value using ‘t’ test.
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Overall response of patients:
In the study, no patients had very good as well as good response. Among 30
patients 13 Patients (43.33%) had satisfactory response to the treatment (25%-50%
improvement in all the parameters), 17 Patients (56.66%) had poor response to the
treatment (<25% improvement in all the parameters).
Key words: Akala Palitya, Premature graying of hair, Nimba taila Nasya, Bringaraja
taila Shiroabyanga.
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TABLE OF CONTENTS:
1. Introduction 1-2
2. Objectives 3-4
3. Literary review 5-103
4. Materials and methods 104-113
5. Observations and results 114-138
6. Discussion 139-153
7. Conclusion 153
8. Summary 155-156
9. Bibliography 157-168
10. Annexure 169-177
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LIST OF TABLES:
SI No.
Table and content PageNo.
1 Nasya classification according to various Acharyas 9 2 Seasonal schedule of Nasya 15 3 Time schedule of Nasya acco. to dosha 15 4 Time schedule of Nasya 21 5 Contraindications of Nasya 25 6 Time schedule of Nasya in different seasons 26 7 Time schedule according to Dosha vitiation 26 8 Course of Nasya Karma 26 9 Dose of Nasya 27 10 Samyaka Yoga Lakshanas of Nasya 30 11 Ayoga Lakshanas of Nasya 30-31 12 Atiyoga Lakshana of Nasya 31 13 Seven layers of skin 47 14 Stages of hair growth 59 15 Aharaja nidana of Palitya 69 16 Palita lakshanas of Palitya acc. to Vagbhata 76 17 Palita lakshanas of Palitya acc. to Yogarathnakara 76 18 food items which will be helpful to maintain the health of hair 88 19 Properties of Nimba 99 20 Properties Bringaraja 101 21 Properties of Narikela 103 22 Subjective parameters 108 23 Parameter Area of scalp involved 110 24 Parameter Random hair count 110 25 Distribution of patient’s age group 115 26 Distribution of patients according to sex 115 27 Distribution of patients by Religion 115 28 Distribution of patients by Occupation 116 29 Distribution of patients by Economical status 116 30 Distribution of Patients by Dietary habit 117 31 Distribution of Patients by Agni 117 32 Distribution of Patients by Koshta 118 33 Distribution of Patients by Nidra 118 34 Distribution of Patients by Vysana 118 35 Distribution of Patients by Deha prakrithi 119 36 Distribution of patients by Satmya 120 37 Distribution of patients by color of hair 120 38 Distribution of patients by nature of hair 121 39 Distribution of patients by Anubandha vedana 121 40 Distribution of patients by Mode of onset 122 41 Distribution of patients by Site of onset 122 42 Distribution of patients by Kula vrutantha 123 43 Distribution of patients by head bath 123 44 Distribution of patients by Type of water for head bath 124
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45 Distribution of patients by Materials used for hair wash 124 46 Distribution of patients by Methods of hair drying 125 47 Distribution of patients by using hair oil 125 48 Distribution of patients by using hair dye 126 49 Distribution of patients according to response 126 50 Before treatment and after treatment values of all Parameters. 127 51 Statistical analysis of parameter value 128 52 Demographic data in patients 129 53 Demographic data in patients 130 54 Demographic data in patients 131 55 Demographic data in patients 132 56 Demographic data in patients 133 57 Demographic data in patients 134 58 Demographic data in patients 135 59 Demographic data in patients 136 60 Demographic data in patients 137 61 Demographic data in patients 138
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LIST OF FIGURES:
SI No.
Figure PageNo.
1 Cross section of scalp with hair and its parts 47 2 Structure of the shaft of hair 51 3 Structure of the hair root 53 4 Drug Nimba 98 5 Drug Bringaraja 100 6 Drug Narikela 102 7 Olsen/Canfield visual aid 108 8 Shiroabhyanga 113 9 Nasya 113 10 Distribution of patient’s age group 115 11 Distribution of patients according to sex 115 12 Distribution of patients by Religion 116 13 Distribution of patients by Occupation 116 14 Distribution of patients by Economical status 117 15 Distribution of Patients by Dietary habit 117 16 Distribution of Patients by Agni 117 17 Distribution of Patients by Koshta 118 18 Distribution of Patients by Nidra 118 19 Distribution of Patients by Vysana 119 20 Distribution of Patients by Deha prakrithi 119 21 Distribution of patients by Satmya 120 22 Distribution of patients by color of hair 120 23 Distribution of patients by nature of hair 121 24 Distribution of patients by Anubandha vedana 121 25 Distribution of patients by Mode of onset 122 26 Distribution of patients by Site of onset 122 27 Distribution of patients by Kula vrutantha 123 28 Distribution of patients by head bath 123 29 Distribution of patients by Type of water for head bath 124 30 Distribution of patients by Materials used for hair wash 124 31 Distribution of patients by Methods of hair drying 125 32 Distribution of patients by using hair oil 125 33 Distribution of patients by using hair dye 126 34 Distribution of patients according to response 126
XVI
Introduction
Introduction:
The face of an individual is a personal identity in which hair plays a
significant role. Therefore a perfect head with hair is an attribute of personality and
beauty. Genetically Indians are black haired and a dark head is any time better and
goes well on any dress.1 This feeling makes one especially Palitya persons to have
dark black hair, that’s why they undergo various therapies with hope of getting black
hair.
Akala Palitya is a burning problem as large percent of population especially
young men and women in present times are suffering from this malady. Because of
this effected persons feel social embarrassment and stigma.
In present days because of altered life style and stressful occupation signs of
aging are seen much earlier. Increasing urbanization and industrialization has posed
greater danger, due to pollution and contamination of water and air, with variable
both extrinsic and endogenous factors, there is definite increase in the incidence of
Premature Graying of Hairs, especially in tropical and developing countries.
Incidence as per W.H.O is largely between the age group of 25-30 years.
Accordingly ‘Akala Palitya’ is such condition, which is prevailing more and
encountered more in day to day clinical practice.
Unfortunately contemporary medical science also does not offer any
satisfactory treatment other than artificial coloring of hair (Dyeing). This regular
dyeing will leads to many adverse effects like hair fall and other scalp diseases.
Understanding hair and related problems, is not merely cosmetic claim, but it
reflects the psychological and pathological conditions of whole body system.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
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Introduction
In such grim clinical situations while referring various Ayurvedic texts, I came
across a few formulations and procedures for this Akala Palitya (Premature graying
of hair).
The one and only Panchakarma procedure explained for Palitya is Nasya.
Sharangadara Samhita2, Yogarathnakara3, Baishajyarathnavali4 and Chakradatta5
have mentioned Nimbabeeja taila as one of the best treatments for Palitya as it is an
Urdwajatrugatha vyadhi where in Nasya is specially indicated6. Basing on this
Nimba beeja taila Nasya has been selected for the present study. Along with this
Shirobyanga with Bringaraja taila is also selected, as daily Shiroabyanga with Sneha
will prevent Palitya7 and Bringaraja is one of the best Kesharanjaka drug8. This two
fold therapy has been done on selected 30 patients strictly in accordance with the
procedure laid-down in the Ayurvedic classics and duly following the research
methodology8(a). Finally the result/data obtained has been statistically evaluated.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
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Objectives
Objectives:
• To evaluate the effect of Nimba taila Nasya and Bringaraja taila Shiroabyanga
in Akala Palitya.
• To evaluate the adverse effect of Nimba taila Nasya, if any.
Need for the study:
In present days because of altered life style and stressful occupation signs of
aging are seen much earlier. ‘Akala Palitya’ is such condition, which is prevailing
more and encountered more in day to day clinical practice. The incidence of
premature graying of hair as per W.H.O is between the age group of 25-30 years.
Contemporary medical science does not offer any satisfactory treatment other
than artificial coloring of hair (Dyeing).
Hence this study has been undertaken with the title, “Evaluation of combined
effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala
Palitya.” An observational clinical study.
Previous researches on this topic:
• Nalini C: A clinical study on akala palitya and its management, R.G.U.H.S,
Bangalore, Dept.of Shalakya 1999.
• Sunil Kumar S: Management of akala palitya with brungaraja taila nasya and
internal use of kaseesa bhasma, A.P. university, Vijayavada. Dept.of
Shalakya 1993.
• Chawda Harsha: Role of nirgundi patra palitagna lepa and neeli taila in
management of palitya, G.A.U., 2000.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
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Objectives
• Kamala Kumari L: Clinical management of akala palitya (grey hair) with
triphaladi lepa with and with out nimba beeja taila, A.P. university,
Vijayavada. Dept.of Shalakya 2005.
• Kaushal Randhir: A comparative and clinical study in between
shirovirechana- poorvaka mahaneela taila shirobasti and brungaraja rasayana
in palitya roga,Rajastan university Jaipur, Dept.of Kayachikitsa. 2000.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
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Review of Nasya
Historical review:
The meaning of historical review is to trace out a continuous chain of
knowledge and by that come to know that where at present. The history of medicine is
as old as human civilization. Plenty of disorders have been found referred in the
ancient literatures of Vedic period, either directly naming the disease itself or by
hinting the nature of the disorder.
Historical Aspect of Nasya karma:
Seeds of knowledge are implanted in Veda. Veda’s are ancient source of
knowledge. There is description of health and disease related topics in a variable form
in all Vedas but proportion of such topics is significant in Atharvaveda. Hence
Ayurveda is considered as a subset of Atharvaveda. It is natural that growth of
knowledge of any topic occurs gradually and same is the case with Nasya karma,
which has developed since Vedic era to Modern era. Before the historical review of
Nasya that of Nasa through which it is given would be appropriate.
Description of Nasa in ancient texts:
Yajurveda: While describing the Indriyas, there is mention of two Netra, two Karna,
two Nasika Chhidra and Jihva.
Atharvaveda: Nasa is described among nine chhidras and Indriya.
“A¹cÉ¢ü,lÉuɲÉU…….” (Atharvaveda, 10/2/32)
Bhagvad Gita: While describing Indriyas, the Nasa is mentioned.
“lÉuɲÉU mÉÔuÉÉïSåÌWû lÉåuÉÉ…….” (Bhagawat Gita 5/13)
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
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Review of Nasya
Description of Nasya in ancient texts:
Rigveda: Although it is very difficult to say that the procedure of Nasya karma
therapy was in practice during Vedic period. But the few Mantras of Rigaveda
indirectly refer towards the Karmas which are included under Panchakarma measures.
There is a Mantra of Rigveda, in which eradication of Roga from the routes of Nasa
(Nostrils), Chibuka (Chin), Shira (Head), Karna (ear) and Rasana (tongue) are
mentioned (Ri.V. 10-16-4). Thus one can think that the references of eradication of
disease from the above mentioned routes most probably refers towards Nasa (nose) or
Shirovirechana.
Krishna Yajurveda, Shatpatha Brahmana, Upanishad: In these texts, the term
Nasya karma has been used frequently.
Ramayana: In Valmiki Ramayana, when Laxman became unconscious by the blow
of Meghanada, Vaidya Sushena administered the juice of Sanjivani through nasal
route bringing him to consciousness instantaneously.
Bauddha Kala: “Jeevaka” the famous Vaidya of Bauddha period had utilized Nasya
karma in many cases such as
1) In Shirahshoola, he prescribed Nasya of medicated ghrita to the wife of
Shreshthi of Saketa Nagar.
2) Once, when Jeevak wanted to give Virechana to Lord Buddha, he gave him
aushadhi by nasya for Virechana.
Vinaya Pitika: In this book, it is mentioned that one utpala hasta of Nasya has
potency to induce 10 vegas of Virechana.
Samhita Kala: Literature written during this period is the heart of ayurvedic
literature. In all the Samhita, Nasya karma has been elaborately described especially
in Charaka Samhita, Sushruta Samhita and Ashtanga Samgraha. The research
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
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Review of Nasya
conducted on this therapy was at such a height that it was used to achieve desired sex
of foetus. Nasya karma is utilized in treatment of many diseases in Brihattrayi such as
in Charaka, in chikitsa of Jwara, Raktapitta, Kustha, Rajyakshama, Unmada,
Apasmara, Shwayathu, Hikka, Shvasa, Kasa, Visha, Trimarmiya, Vata vyadhi,
Trimarmiya siddhi etc,. In Sushruta Samhita, in Chiktisa of Dwivraniya, Sadyovrana,
Bhagandar, Vata Vyadhi, Mahavata Vyadhi, Kustha, Udara, Granthi, Apachi, Arbuda
ganda, Vriddhi, Upadamsha, Shlipada, Kshudra Roga, Mukha Roga etc, . In Ashtanga
Hridaya, in Chikitsa of Jwara, Raktapitta, Shvasa Hikka, Rajyakshama, Chhardi,
Hridaroga, Trishna, Madatyaya, Shvitra, Krimi, Vata Vyadhi etc,.
Etymology of Nasya Karma:
In Sanskrit language each word is derived from a specific dhatu and each
dhatu bears an inherent meaning which is the crux of the word. The derivation of the
word Nasya is from “Nasa” dhatu. It conveys the sense of Gati – motion. Vyapti bears
the meaning pervasion. Here, the Nasa dhatu is inferred in sense of nose. According
to Vachaspatyam word “Nasata” means beneficial for nose.
In Ayurveda, the word Nasya has been taken specifically to mention the nasal
route of administration of the drugs. According to Acharya Susruta medicines or
medicated oils administered through the nose is known as Nasya9. According to
Aruna Dutta and Bhava Prakasha all drugs and measures that are, administered
through the nasal passage are called Nasya10. Sharangdhara and Vaghbhata are also of
same view11.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
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Review of Nasya
Synonyms:
• Prachchardana.
• Shirovirechana.
• Shirovireka.
• Murdhavirechana.
• Navana.
• Nastaha Karma.
Sushruta specify the word Shirovirechana to describe a particular variety of
Nasya karma12. The word Virechana means elimination of morbid Doshas from the
body. This Shirovirechana or Murdhavirechana indicates its main function elimination
of morbid Doshas particularly from the Shira or parts situated above the clavicle.
Charaka has used the term “Nastah Pracchardana” for Nasya13. This denotes
Shodhana done by Nasya.
The words Nastah and Navana denote the site of administration. Nasta karma
& Navana karma means the measures which are beneficial to nose, or region of the
nose.
On this basis it may be said that Nasya karma is a therapeutic measure in
which the drug (medicated oil or other) administered through Nasa mainly to
eliminate the vitiated Doshas situated in Shirah and its constituent parts, reliving the
diseases of those parts (Urdhvajatrugata Vikaras).
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
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Review of Nasya
Classification of Nasya:
Nasya is classified in various ways by different Acharyas but ultimately all the
procedures are same. Mainly classified according to its mode of action i.e. Shodhana,
Shamana, etc & on the basis of various forms of drug preparation utilized for the
Nasya karma e.g. Churna, Sneha, etc. The classifications according to various
Acharyas are shown in table.
Table No. 01. Showing Nasya classification according to various Acharyas
No Name of Acharya Classification
1 Charaka According to mode of action - Rechana, Tarpana, Shamana
According to the method of administration –
Navana, Avapidana, Dhmapana, Dhuma, Pratimarsha
According to various parts of drugs utilized –
Phala, Patra, Mula, Kanda, Pushpa, Niryasa, Twaka
2 Sushruta Shirovirechana, Pradhamana, Avapida, Nasya, Pratimarsha
3 Vagbhatta Virechana, Brimhana,
Shamana
4 Kashyapa Brimhana, Karshana
5 Sharangadhara Rechana, Snehana
6 Videha Sangya Prabodhaka, Stambhana,
Charaka’s Classification of Nasya:
According to Charaka the Nasya is of five types viz. Navana, Avapida,
Dhmapana, Dhuma and Pratimarasa14. Navana is further divided in to Snehana and
Shodhana, Avapidana into Shodhana and Stambhana, Dhuma into Prayogika,
Vairechanika and Sneihika while Pratimarsha is divided into Snehana and Virechana.
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Review of Nasya
The above mentioned five types of Nasya are regrouped according to their
pharmacological action into three groups viz. – Rechana, Tarpana and Shamana15.
Charaka has also mentioned 7 types of Nasya according to parts of the drugs
to be used in Nasyakarma viz – Phala, Patra, Mula, Kanda, Pushpa, Niryasa and
Twak16.
Nasya
Navana Avapidana Dhmapana Dhuma Pratimarsha
Snehana Shodhana Prayogika Snaihika Vairechanika
Shodhana Stambhana Snehana Virechana
According to the action of Nasya therapy
Rechana Tarpana Shamana
According to various parts of the drugs utilized in Nasya therapy
Phala Patra Mula Kanda Pushpa Niryasa Twaka
Classification of Nasya according to Sushruta:
According to Sushruta Nasya is also of 5 types Viz. Nasya, Avapida,
Pradhamana, Shirovirechana and Pratimarsha. These 5 types of Nasya are further
classified according to their functions into two groups viz. Shirovirechana and
Snehana.
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Shirovirechana, Avapida and Pradhamana are used for Shirovirechana i.e. for
the elemination of morbid Dosha from Shira, Pratimarsha and Nasya type may be
used for Snehana17.
Nasya
Shirovirechana Snehana
Shirovirechana Pradhmana Avapida Nasya Pratimarsha
Vagbhata’s Classification of Nasya:
Ashtanga Sangraha has mainly classified Nasya according to the functions viz.
Virechana, Brimhana and Shamana18. Snehana and Brimhana Nasya have been further
subdivided according to the doses into two groups i.e. Marsha and Pratimarsha19.
Avapidanasya may be given for both Virechana and Shamana while
Pradhamana Nasya is given only for Shirovirechana.
Ashtanga Hridaya has mainly classified Nasya in 3 types viz. Rechana,
Brimhana and Shamana20.
Nasya
Virechana Brimhana Shamana
Pradhamana Murdha Virechana
Sneha Nasya According to Dose
Avapida Marsha Pratimarsha
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Kashyapa’s Classification of Nasya:
According to Kashyapa Samhita Nasya has been classified into two groups i.e.
Brimhana and Karshana. These two types are also known as Shodhana and Purana
Nasya21.
Nasya
Karshana (Shodhana)
Brimhana (Purana)
Sharangdhara’s Classification of Nasya:
Sharangdhara has also classified Nasya according to their functions into two
groups viz. Rechana and Snehana. Rechana Nasya is further subdivied into Avapida
and Pradhamana. Snehana Nasya is subdivided into Marsha and Pratimarsha22.
Videha’s Classification of Nasya:
Videha has stated two types i.e. Sangyaprabodhaka and Stmabhana23.
Nasya
Rechana Snehana
Avapida Pradhmana Marsha Pratimarsha
Stmabhana Sangyaprabodhaka
Nasya
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It is clear from the above discription that two types of classification of Nasya Karma
are available in Ayurvedic literature.
• Other is based on the preparation of drug and the method of its application e.g.
Dhmapana (Powder is blowed)
Avapida (Extracted Juice is used)
Dhuma (smoking through nose) etc.
• One is based on the pharmacological actions viz. Rechana, Tarpana etc.
Classification of Nasya by Charaka into Navana, Avapida, Dhmapana, Dhuma
and Pratimarsha while by Sushruta into Nasya, Shirovirechana, Pratimarsha , Avapida
and Pradhamana seems to be based on the type of preparation utilized or the way in
which it is administered.
For instance in Avapida Nasya as its name indicates generally expressed juice
is used. Pradhamana is so named because it requires blowing. Vagbhata has described
Marsha and Pratimarsha mainly on the basis of difference in the dose to be dropped
into the nostrils.
Taking the Charaka’s classification as the basis, all the above mentioned types
of Nasya are being described here seperately.
Navana Nasya:
Definition:
Navana is one of the important and well applicable therapies of Nasya Karma.
Navana is administered by instilling the drops of a medicated oil or Ghrita in the nose.
Instrument: Charaka has described Pranadi (pippet or dropper) for administration of
Nasya24. Navana is generally the Sneha Nasya and is known as Nasya in general.
Classification: It can be mainly classified into Snehana and Shodhana Nasya.
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Snehana Nasya:
As the word Sneha suggests, Snehana Nasya gives strength to all the Dhatus
and is used as Dhatuposhaka.
Dose: The following is the dosage schedule for Sneha Nasya25
• Hina Matra – 8 drops in each nostril.
• Madhyamamatra – Shukti Pramana - 16 drops in each nostril.
• Uttama Matra - Panishukti Pramana – 32 drops in each nostril.
According to Bhoja, Matra of Prayogika sneha nasya is 8 drops, while matra
of Snahika Nasya 16 drops. According to Doshabala quantity can be doubled or
tripled.
Benefits of Sneha Nasya: It is used for the Snehana in the complaint of feeling of
head lightness. It gives strength to neck, shoulder and chest and improves eyesight.
Indications of Sneha Nays: Vatika Shirahshula, Keshapata, Dantapata,
Shmashrupata,
Tivrakarnashula, Timira, Nasaroga, Mukhashosha, Avabahuka, AkalajaValita,
Akalaja Palita, Darunaprabodha and Vatapittaja Mukharoga26.
Shodhana Nasya:
Definition: This Nasya which eliminates the vitiated Doshas. Sushruta’s
Shirovirechana type is included in Shodhana type of Navana Nasya.
Drugs: In this type of Nasya, oil prepared by Shirovirechana Dravyas like Pippali,
Shigru etc. can be selected.
Dose: It can be given in following dosage schedule accoding to Sushruta27.
• Uttama - 8 drops
• Madhyama - 6 drops
• Hina - 4 drops.
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Indications: Kaphapurna Talu & Shira, Aruchi, Shirogaurava, Shula, Pinasa,
Ardhavabhedaka, Krimi, Pratishyaya, Apasmara, Gandhagyana nasha and
Urdhvajatrugata Kapharogas28; and Urdhvajatrugata Shopha, Praseka, Arbuda and
Kotha29.
In healthy persons Navana Nasya should be given according to the following
seasonal schedule.
Table No. 02. Showing the seasonal schedule of Nasya:
Sl.No Season Nasya to be given at
1 Shita Kala Noon
2 Sharada and Vasanta Morning
3 Grishma Rutu Evening
4 Varsha Rutu Only when sun is visible
Time Schedule: Navana Nasya should be administered according to the following
time
Schedule30, 31.
Table No. 03. Showing the time schedule of Nasya acco. to dosha:
Sl.No Roga Nasya to be given at
1 In Kaphaja Roga Fore noon
2 In Pittaja Roga Noon
3 In Vataja Roga After Noon
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Avapida Nasya:
Definition:
In Avapida Nasya, juice is expressed from paste or kalka of a drug. The word
Avapida means it is expressed juice of leaves or paste (kalka) of required medicine.
(Chakrapani). This Nasya can be utilized for both Shodhana and Shamana purpose
depending upon the drug utilized.
Method: For this purpose first Kalka of the required medicine is prepared which is
placed in white & clean cloth & is squeezed to obtain the required quantity of juice,
directly in the nostril of the patient. The administration of the drug in this way is
known as Avapida Nasya32. This type of Nasya may also be given with Kalka
(paste)33.
It may also be given by diping the swab (pichu) into the Shrita (decoction) or
Sheeta (cold infusion), Swarasa (juice) of the required drug34.
Types: It is mainly of two types35.
• Stambhana Nasya
• Shodhana Nasya.
According to Chakrapani, three types.
• Shodhana
• Stambhana
• Shamana
According to Videha two types. • Sangya prabodhana
• Stambhana
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Drugs: For Shodhana purpose Kalka of Tikshna dravyas like Saindhava, Pippali etc.
have been mentioned as Avapida Nasya and for Stambhana purpose Stambhana drugs
have been described.
Dose: Avapida Nasya should be given in the following dose
• Hina Matra - 4 drops
• Madhyama Matra - 6 drops
• Uttama Matra - 8 drops
Indications: Avapida Nasya is indicated in the following conditions36. Manasaroga,
Apasmara, Shirovedana, Chitta- vyakulavastha, Moha, Mada, Murchha, Sanyasa,
Bhaya, Krodha, Bhiru, Sukumara, Krisharogi, Stri, Raktapitta, Vishabhighata,
Apatantraka.
Sharangdhara recommends the Avapida Nasya for the patients suffering from
Galaroga, Vishamajwara Manovikara and Krimi37.
Dhmapana Nasya:
Definition: Dhmapana or Pradhamana is a specific Shodhana Nasya. This type of
Nasya is instilled with churna (powder) specifically for Shirovirechana. Dhmapana
mentioned in Charaka & Pradhamana described in Sushruta.
Instrument: In this type, fine powder of drug is administered through nasal passage.
For this purpose specific Nadi yantra, A tube like instrument with length of 6 angulas
and with open ends is utilized.
Method: In Pradhamana Nasya, Churna (powder of drugs) is administered (inhaled)
by Nasal passage with the help of Nadi Yantra. The Churna (fine powder) of required
drug is kept at one end, and air is blown from the other end, so that the medicine may
enter in to the nostrils38.
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Videha has described another method for Pradhamana, in which fine powder
of drug kept in a Pottali made of a thin cloth is used to inhale, so that smallest
particles of the medicine enter into the nostrils.
Dose: According to Videha the dose of Dhmapana Nasya is three Muchuti (3 pinch).
For the Pottali method Churna should be atleast 2 Tolas i.e. 20gms.
Drug: Generally Tikshna drugs like Rock salt, Garlic, Guggulu, Maricha, Vidanga,
etc are used for this type of Nasya. Hence cautions should be taken during its
administration.
Indications: Its indications are as follows39.
Shiro Roga
Nasa Roga
Akshi Roga
Dhuma Nasya:
Definition: Dhuma Nasya is defined as medicated fume taken by nasal route and
eliminated by oral route. Acharya Sushruta has not described it as a type of Nasya.
The smoking per mouth is known as Dhumapana and is not included in Nasya. It is
harmful to eye sight.
Types: Dhuma Nasya are of the following types
• Prayogika
• Vairechanika
• Snaihika
Instrument: Acharya Charaka has mentioned special Dhuma Nadi for Dhuma Nasya.
The length of the Nadi depends upon the type of the Dhuma Nasya, details of which
are as under40.
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• Prayogika - 36 angula
• Vairechanika - 24 angula
• Snaihika - 32 angula
Breadth of the Nadi should be as per measurement of ones own angula.
Dose: It should be given in the following dose
• Two puffs are to be taken for Prayogika Dhuma.
• 3 to 4 puffs are to be taken for Vairechanika Dhuma.
• A single puff is advised for snaihika Dhuma.
Drugs: For Prayogika Dhuma drugs like Priyangu, Ushira etc. should be used. For
Sneihika Dhuma Vasa, Ghrita etc. and for Vairechanic Dhuma, drugs like Aparajita,
Apamarga etc. should be used41.
Indication: Dhuma Nasya is indicated in Shiroroga, Nasaroga and Akshiroga42.
Marsha – Pratimarsha Nasya:
Definition:
Marsha and Pratimarsha both consists of introduction of oil through the
nostrils. It is well tolerated and is very much convenient procedure.
Pratimarsha and Marsha are same in principle, but the main difference
between them is of dose. In Pratimarsha Nasya 1-2 drops are given while in Marsha
Nasya the dose is 6 to 10 drops.
Pratimarsha Nasya:
Pratimarsha Nasya can be given daily and even in all the seasons at morning
and evening.
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Method: A finger is dipped in the appropriate sneha up to 2 phalanges and then oil is
allowed to drop from it in both nostrils. Patient is advised to expel out the sneha,
which comes in oral cavity.
Dose: 2 drops morning and evening.
The Sneha should atleast reach from nose to gullet, but it should not be too much that
can produce secretion in gullet43.
Indications: Pratimarsha can be given in44
• Any age.
• Any season
• Even in not suitable time and season i.e. in Varsha and
• Durdina
• Bala
• Vridhdha
• Bhiru
• Sukumara
• Weak patients
• Kshtakshama
• Trishna Pidita
• Mukhashosha
• Valita and Palita
Contraindications: it is contraindicated in45
• Dushta Pratishyaya
• Krimija Shiroroga
• Madhyapi (habitual drunkers)
• Badhirya (deafness)
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• Bahudosha
• Utklishta Doshas
It is contraindicated in such persons because the Sneha Matra is quite
insufficient to eliminate Doshas or Kriminasha and already aggravated Doshas may
get vitiated further46.
Sushruta and Sharangadhara have described 14 suitable times for Pratimarsha
Nasya, while Vagbhatta has mentioned fifteen Kala.
Table No. 04. Showing the time schedule of Nasya:
No Time for Pratimarsha Nasya Su. As. H. Sha.
1 After leaving the bed in morning + + +
2 After cleaning the teeth (with Dantadhavana) + + +
3 Before going outside + - +
4 After exercise + + +
5 After sexual intercourse + + +
6 After walking + + +
7 After urination + + +
8 After passing Apanavayu + - -
9 After Kavala + + +
10 After Anjana + + +
11 After meal + + +
12 After sneezing + - -
13 After sleeping in the noon + + +
14 In the evening + + +
15 After vomiting - + +
16 After Shirobhyanga - + -
17 After defaecation - + +
18 After laughing - + -
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Marsha Nasya:
The method of administration of Marsha Nasya resembles that of Pratimarsha but as
said earlier the dose varies.
Dose: In Marsha Nasya, 6 to 10 drops of Sneha are administered.
Drugs: Though all Sneha dravya like oil, ghee, etc. can be utilized but use of oil is
advisable because Shira is the place of Kapha and oil is inherently opposite to Kapha
in properties.
Marsha Nasya is quickly effective and more beneficial than pratimarsha47.
Classification of Nasya according the Pharmacological action:
Charaka and Vagbhata have classified Nasya into 3 groups according to their
pharmacological action48, 49.
Nasya Rechana Brimhana Shaman
Sangyaprabodhana (Shodhana)
Krimighna Stambhana Karshana
Raktastambhan Doshastambhan
The types Rechana, Tarpana and Shamana are described by Acharya Charaka
and Vagbhatta. Sushruta has not described the Shamana Nasya. He has given only
two types viz. Shirovirechana and Snehana.
Kashyapa has mentioned Brimhana and Karshana types of Nasya karma i.e.
Sangya Prabodhana and Stambhana, according to their pharmacological action.
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Rechana Nasya:
The Nasya, which eliminates vitiated Doshas of Shira through the nasal route
is also called Rechana Nasya. It is also termed as Karshana Nasya.
Drugs: Apamarga, Pippali, Maricha etc. are drugs of choice that can be used for
Rechana Nasya. Kwatha, Swarasa or Tikshna sneha of above drugs may also be
utilized for the same50, 51.
Indications: It is indicated specifically in Kaphaja type of Shiroroga like Stambha,
Supti and Guruta of Shira52.
According to Susruta, Talukantha and Shirokrimi, Arochaka, Shula,
Shirogaurava,Pinasa, Pratishyaya, Urdhvajatrugata Kaphaja Vikara53.
Brimhana Nasya:
Tarpana is that type of Nasya, which is specially indicated in a Dhatukshaya
(degeneration). Tarpana Nasya resembles Snehana Nasya described by Sushruta and
Sharangadhara and Brimhana Nasya mentioned by Acharya Vagbhatta in its
properties and actions.
Drugs: Drugs of Madhura skandha and Sneha prepared with Vata-Pittahara drugs are
used for above type54, 55. Exudation of certain trees, meat soups and blood may also be
administered56.
Indications: Vatika Shiroroga, Dantapata, Keshapata, Darunaka and other Vata-
Pittaja roga. Sushruta advises Sneha Nasya for increasing general strength and to
improve the vision power and its acquity. It is also used for curing the Shirah kampa
and Ardita57.
Shamana Nasya:
Shamana Nasya is used for the alleviation of Dosha situated in Shirah (head).
The Sneha prepared with the beneficial drugs may be used for Shamana Nasya.
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Indication: It is used to stop bleeding in Raktapitta58. It is also indicated in Akala
Valita, Palita and Khalitya, Darunaka, Raktaraji, Vyanga and Nilika.
General indications of Nasya:
Charaka has described the following general indications, where Nasya therapy
should be used.
• Shirostambha Gadgadatva
• Ardhavabhedaka Vaggraha
• Shirahshula Grivaroga
• Akshishula Swarabheda
• Shukra Roga-Netragata Galashundika
• Raji Galashaluka
• Timira Galaganda
• Vartmaroga Upajihvika
• Pinasa Manyastambha
• Nasa Shula Ardita
• Danta Stambha Apatantraka
• Danta Shula Apatanaka
• Danta Harsha Karnashula
• Danta Chala Arbuda
• Hanugraha Skandharoga
• Mukharoga Ansashula
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General contra Indications of Nasya:
In all patients Nasya should not be given on Durdina (Rainy day) or in Anrutu
(Viparita Kala).
Table No. 05. Showing the contraindications of Nasya No. Anarhas Charaka Sushruta Vagbhatta
1 Bhuktabhakta + + +
2 Ajeerni + + -
3 Pitta Sneha + + +
4 Pitta Mad + + +
5 Pitta Toya + + +
6 Snehadi Patukamah + - +
7 Snatah Shirah + - +
8 Snatukamah + + +
9 Kshudharta + - +
10 Shramarta + + -
11 Matha + - -
12 Murcchita + - -
13 Shastradandahrita + - -
14 Vyavayaklanta + - -
15 Vyayamaklanta + +(Shranta) -
16 Panaklanta + - -
17 Navajwara Pidita + - -
18 Shokabhitapta + - -
19 Virikta + - +(Shuddha)
20 Anuvasita + +(DattaBasti) +(Datta Basti)
21 Garbhini + + +
22 Navapratishyayarta + - -
23 Apatarpita - + +(Shuddha)
24 Pittadravah - + +
25 Trishnarta + + -
26 Gararta - + +
27 Kruddha - + -
28 Bala - + -
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29 Vriddha - + -
30 Vegavarodhitah - + + (Vegarta)
31 Raktasravita - - +
32 Sutika - - +
33 Shvasapidita - - +
34 Kasapidita - - +
Suitable time for giving Nasya:
According to Charaka generally Nasya should be given in Pravrita, Sharada
and Vasant Rutu. However in emergency it can be given in any season.
Table No. 06. Showing the Time schedule in different seasons59:
SL.No Rutu Nasya to be given at 1 Grishma Rutu Morning
2 Shita Rutu Noon
3 Varsha Rutu When day is clear
4 Sharada + Vasanta Morning
5 Shishira + Hemanta Noon
6 Grishma + Varsha Evening
Table No. 07. Showing the Time schedule according to Dosha vitiation60:
SL.No Doshaja Vikara Nasya to be given at
1 Kaphaja Vikara Morning
2 Pittaja Vikara Noon
3 Vataja Vikara Evening Sharangdhara has described same time schedule for different seasons as
Sushruta has mentioned. He further states that – Nasya can be given in night, if the
patient is suffering from Lalasrava, Supti, Pralapa, Putimukha, Ardita, Karnanadi,
Trishna, Shiroroga and such conditions like excessive vitiated Doshas61.
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Table No. 08. Showing the Course of Nasya Karma62, 63, 64:
No. Name of Acharaya Days
1 Sushruta 1,2,7,21
2 Bhoja 9
3 Vagbhatta 3,5,7,8
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Dose of Nasya Karma:
The dose of Nasya drug depends upon the drug utilized for it and the variety
of the therapy. Charaka has not prescribed the dose of the Nasya. Sushruta and
Vagbhata have mentioned the dose in form of Bindus (drops), here one Bindu means
the drop which is formed after dipping the two phalanges of Pradeshini (index)
finger65.
Table No. 09. Showing the dose of Nasya: DROPS IN EACH NOSTRIL
No. TYPE OF NASYA
Hrasva Matra
Madhyama Matra
Uttam Matra
1 Shamana Nasya 8 16 32 2 Shodhana Nasya 4 6 8 3 Marsha Nasya 6 8 10 4 Avapida Nasya (Kalka Nasya) 4 6 8 5. Pratimarsha Nasya 2 2 2
The common dose for Pradhamana Nasya is 3 Muchuti (here one Muchuti =
the quantity of Churna which may come in between index finger and thumb = 2.4
Ratti.)66
Dose According to Sharangadhara: Sharangadhara has described the following dosage schedule for Nasya Karma depending upon the variety of material used67.
• Tikshnaushadhi Churna - 1 Shana (4 Masha)/(24 Ratti)
• Hingu – 1 Yava (½ Ratti)
• Saindhava – 1 Masha (6 Ratti)
• Dugdha – 8 Shana (64 Drops)
• Jala (Aushadha Siddha) – 3 Karsha (3 Tola)
• Madhura Dravya – 1 Karsha (1 Tola)
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Nasyavidhi:
The procedure of Nasya karma may be classified under following headings
• Purva Karma (Pre-measures)
• Pradhana Karma (Chief measure)
• Pashchata Karma (Post-measures)
Purva Karma (Pre-measure): It is advisable that all materials, drugs and equipments
like napkin, utensils necessary for Nasya karma are collected in sufficient quantity
prior to Nasya karma. Special room for Nasya should be prepared which should be
free from atmospheric effects like direct blow of air or dust and it should be lighted
properly.
Preparation of the Patient: Patient should have passed his natural urges like urine
and stool. He should have completed his routine activities. Light breakfast prior (1
hour) to Nasya karma is advised.
After preparation of patient by above said regimens, snehana and swedana
should be done. Here, Snehana means, Mridu Abhyanga. It should be done on scalp,
forehead and neck for 3 to 5 minutes by medicated oil68.
After Abhyanga, Mridu Swedana should be done on Shira, Mukha, Nasa,
Manya, Griva and Kantha. Though according to Ayurvedic texts, Swedana should not
be done on the head, but for the purpose of elimination and liquification of dosha
Mridu Swedana can be done as Purva karma of Nasya.
Pradhana Karma: The procedure to be adopted for the Nasya karma is described
here as per the statements of Charaka69, Vagbhata70 and susrutha71.
Patient should lye down in supine position on Nasya table. The head of the
patient should be lowered (Pravilambita). The position of head should not be
excessively extended. After covering of eyes with a clean cloth, the tip of patient’s
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nose should be drawn upward by the left thumb of the Vaidya. At the same time with
the right hand Vaidya should instill lukewarm medicine in both the nostrils,
alternately, with the help of proper instrument like pichu, dropper, shadangula nadi
etc. according the type of Nasya. The drug should be proper in dose and temperature.
The patients should remain relaxed at the time of administration of nasya and he
should avoid speech, anger, sneezing, laughing and shaking his head.
Paschat Karma72, 73, 74:
According to Acharya Charaka, Acharya Sushruta, and Acharya Vagbhatta
following regimen should be followed after administration of Nasya. Patient in lying
position is asked to count up to 100 matra i.e. approximately 2 minutes. After
administration of Nasya feet, shoulders, palms and ears should be massaged. Again
mild fomentation should be done on forehead, cheeks and neck. For pacifying Vata
dosha, Rasna churna is rubbed on head.
The patient is asked to expel out the drug which comes in oropharynx. Care
should be taken that no portion of medicated oil is left behind. Medicated Dhumapana
and Gandusha are advocated to expel out the residue mucous lodged in Kantha.
Patient should be advised to stay in a windless place. A light meal and lukewarm
water are advised. One should avoid dust, smoke, sunshine, hot bath, anger, riding,
excessive intake fat and liquid diet.
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Review of Nasya
Samyaka Yoga, Ayoga and Atiyoga of Nasya karma75, 76, 77, 78:
After Nasya karma the symptoms of its Samyaka yoga, Ayoga and Atiyoga
should be observed, which are being described here as under.
Table No. 10. Showing the Samyaka Yoga Lakshanas of Nasya:
Symptoms Ch. Su. As. H. Sha. B. P. Ka.
Urah Laghuta + - - - + -
Shiro Laghuta + + - - - -
Netra Laghuta - + + - +
Laghuta - - - + -
Srotovishuddhi + + - + + +
Swaravishuddhi - + - - -
Vaktravishuddhi - + - - -
Indriyaachchta-prasada + + - + + +
Netrateja Vriddhi - + - - +
Chitta Prasada - + - + + +
Vikaropashama - + - + + -
Sukha Svapna Prabodha - + + - - -
Sukhachchvasa - + - - - -
Arati - - - - - -
Medha - - - - - -
Bala - - - - - -
Table No. 11. Showing the Ayoga Lakshanas of Nasya:
Sl.No Symptoms Ch. Su.
As.
H. Sha. B.P. Ka.
1 Shirogaurava and Dehagaurava + - - + + +
2 Galopalepa + - - - - -
3 Nishthivana + - - - - -
4 Kandu - + + + + -
5 Kaphapraseka - - - - - -
6 Upadeha + - + + - -
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7 Rukshata + - - + + +
8 Vata Vaigunya + - - - - -
9 Srotoriktata - - - - + -
10 Srotasamkaphasrava + - - + + +
11 Nasashosha - + - - - -
12 Asyashosha - + - - - -
13 Akshistabdhata - + - - - -
14 Shiroshunyata - + - - - -
15 Vyadhi Vridhdhi - - - - - +
Table No. 12. Showing the Atiyoga Lakshana of Nasya:
Symptoms Ch. Su. As. H. Sha. B.P. Ka. Shirogaurava - + + + + - Shiroshunyata - + - + + - Shirovedana + - - - - + Netra Vedana + - - - - - Shankhavedana + - - - - - Suchitodavata Pida + - - - - - Indriya Vibhrama - + - + + + Mastulungagama - + - - - - Snehapurna Srotasa - - - - + - Karna Talu Upadeha - - - - - - Vata Vriddhi + - - - - + Kandu - + - - - - Praseka - + + + - - Pinasa - + - - - - Aruchi - - + - - - Deha Daurbalya - - - - - + Unmada - - - - - - Pitta Vriddhi - - - - - - Hridaya Shula - - - - - - Suryavarta Roga - - - - - - Atripti - - - - - -
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Review of Nasya
Vyapada:
Vyapada (complication) after administration of nasya occurs in following
conditions79.
• If patient breaches the protocol to be followed after Nasya karma.
• On administration of Nasya in any contra-indicated condition.
• Due to technical failure by any means.
The complications occur through following two modes:
Doshotklesha: This should be managed by Shodhana and Shamana chikitsa.
Doshakshaya: This should be managed by Brimhana chikitsa80.
If nasya is given in contraindicated conditions then many Vyapada can occur
such as: When Nasya is administered to the patient just after lunch or who is suffering
from indigestion than diseases like Kasa, Shvasa, Chhardi, Pratishyaya etc. may occur
due to obstruction of channels situated in upper part of body.
If Nasya is given in season in which it is contra-indicated for e.g. cloudy
atmosphere, then there is possibility of occurrence of Kapha roga like asthma.
Treatment: In above-mentioned conditions treatment should be done with Kapha
Nashaka Upchara like use of Ushna, Tikshna Aushadha and Kapha Nashaka karma.
If Nasya is given in Krisha, Kshina (emaciated), Virikta (patient who had taken
virechana} Aatura (anxious), Garbhini (pregnant lady), Vyayam klant (exhausted with
exercise) and a thirsty person then vitiation of Vata dosha takes place which may
produce vata-vikara.
In this condition, Vatanashaka treatment like snehana, swedana, Brimhana should be
specially done, pregnant lady should be treated with ghrita and milk81.
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Review of Shiroabhyanga
Shiroabhyanga:82
Definition:
Application of medicated or non-medicated Taila, Ghrita to the head is said to
be Shiroabhyanga. This procedure is most ideal for routine practice especially in
healthy persons. Mere smearing the oil with no following massage, smearing the oil
followed by simple massage and smearing the oil followed by placing specific strokes
on the head, all these three methods are known as Shiroabyanga
Shiroabhyanga is one of the Snehana procedure. Snehana is further classified
into Bahya and Abhyantara types, obviously Shiro-abhyanga coming under the
Moordhini taila of Bahyasneha.
Shiroabyanga and its effects is explained in Charaka samhita83, Susruta
samhita84, and Astanga sangraha85.
Abhyanga:
Etymology of Abhyanga:
The word Abhyanga is derived from ‘Anga’ Dhatu which is used to indicate
motion or movement. ‘Abhi’ Upasarga to ‘Anga’ Dhatu makes the word Abhyanga
which means to induce specific movements. Thus Abhyanga (massage) indicates
some movement done on the body with use of Taila, Ghrita etc.
Indications:
• In disease of hairs like Palitya, Khalitya etc.
• In daily routine to maintain the health of the body.
• Acharya Vagbhatta has indicated Shiro-abhyanga in dryness and itching of the
scalp and in accumulation of Mala on head86.
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Benefits of Shiroabhyanga:87
• A person who does Shiro-abhyanga daily is never affected with headache, hair
falling or hair graying.
• His hair becomes strong rooted, black and long.
• All senses of that person become healthy.
• His facial skin becomes soft, shiny and gets a good sleep.
Shiroabhyanga in healthy persons:
In healthy individuals the oil used for Shiroabhyanga may be prescribed
according to the Prakruti of the person.
Procedure of Shiroabhyanga:82
Shiroabhyanga may be performed at any time of the day before the bath. Even
then early morning at the time of sunrise is the most ideal time for the procedure.
Requirements:
• Comfortable knee high chair.
• Bowl of 100ml capacity to take oil.
• Oil for application.
Poorvakarma:
Then the patient is made to sit on a knee high chair. The body of the patient is
wrapped with a cloth bellow the neck. Procedure should be carried out by standing
behind the patient, which is the ideal position to carryout Shiroabhyanga.
Pradhanakarma:
The technique of Shiroabyanga includes smearing the oil to the portions of the
scalp above the neck followed by placing specific strokes.
The oil for the application is first heated on a water bath approximately up to
40oC, to make lukewarm. Then the oil is pored in to the head of the patient and then
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Review of Shiroabhyanga
spread all over the head including the neck and ear pinna. Moving the palms from
before backwards is enough to spread the oil on the head if the scalp has short
trimmed hair. If the patient has long hair, fingers have to be poked between the hairs
in an attempt to smear the oil to the scalp.
Gharshana hasta (Massage from before backwards): After smearing the oil the
therapist then massage the whole head, moving the palmar surface of the hand from
before backwards applying gentle as well as firm pressure. Thus the therapist should
massage the complete area of the scalp that includes vertex, temporal and occipital
portions of the head. The procedure is continued for a desired period.
Mridvanguli Tadana (Picking strokes): Fingers of the both hands are moved as if
picking up tuft of hair. For this the fingers are partially approximated, and then gently
and firmly placed on the scalp. This is followed by withdrawing of fingers in an
attempt to approximate the fingers, simultaneously effecting rubbing of the scalp.
This maneuver should be gentle producing mild traction effect on the hair. Each area
of the head is similarly treated. Also this maneuver should effect a pleasant sensation
to the patient and should not cause any sort of discomfort or pain.
Dvihasta tadana (Flat palm strokes): Gentle strokes are placed with the palmar
surface on the scalp by both hands either simultaneously or alternatively. Strokes are
placed on the vertex, occipital and temporal region.
Taranga hasta (Rocking strokes): Gentle strokes are placed on the patients head by
rapid rocking movement of both the palms simultaneously. While placing the strokes
only the base of the little finger and thumb comes on contact with the patients head.
Anguli kridana hasta (Finger strokes): Placing the gentle strokes on the patients
head by making rocking movements of both the palms with its fingers stretched.
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While stoking only the palmar aspect of the little finger and thumb will touch the
scalp.
Mridu mushti tadana (Fist stroke): In this maneuver gentle strokes are placed on all
areas of the head with the closed fist through the ulnar border. Initially the strokes are
placed with both the hands simultaneously, followed by placing the strokes
alternatively with right and left fist.
Ghatita hasta (Pressing): Flat of the palm is placed on the patients head, and is
moulded in to the shape of the scalp so that every portion of the palmar aspect of the
palm and fingers comes in contact with the head. This is followed by exerting gentle
and firm pressure on the head. Every part of the head is treated by the similar manner.
Squeeze strokes: This refers to grasping tuft of hair with hands followed by gentle
squeeze, producing comfortable traction on the hair. Every part of the scalp is treated
in this way.
Karna-abyanga (Ear massage): Ear pinna is grasped between the thumb anteriorly
and the other fingers posteriorly. And the pinna is rubbed between the fingers.
Further, supporting the pinna with the fingers posteriorly, thumb is firmly moved
above downwards in the anterior of the ear pinna.
Duration:
Each form of stroke is continued for about 4 to 5 minutes, and thus the whole
process of head massage takes about 30 to 40 minutes.
Paschathkarma:
The patient is asked to rest on the chair for about 15min, and then advice the
patient to take head bath with hot water. Alternative to the soap, herbal products can
be used.
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Review of Palitya
Disease review:
Historical review:
The history of medicine is as old as human civilization. Plenty of disorders
have been found referred in the ancient literature's of Vedic period, either directly
naming the disease itself or by hinting the nature of disorder.
Scattered information regarding the hair and its disorders are found in
different texts. Historical study reveals, ancients have not neglected the cosmetic
aspect of the life. They have mentioned important various formulations which
improve growth of hair complex rather than etiology.
The history can grossly be divided into:
1) Vedic period 3) Medieval period
2) Samhita period 4) Modern period.
Vedic period:
Atharva veda
• A vegetable drug named Devatada was used in the management of Kesha
Palitya and Khalitya by the physicians of that period.
• Keshabramhani a herbal drug was widely used in treating Indralupta, Khalitya
& also prescribed for the growth of hair
Samhita period:
No Acharyas had dedicated a separate chapter for Palitya or any other hair
disorders. But scattered references are available about diseases of hair in the different
chapters of Ayurvedic classics.
• Etio-pathogenesis and treatment of Palitya are mentioned in Trimarmiya
Chikitsa of Charaka Samhita88.
• While explaining the Guna of LavanaRasa89.
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• While explaining about Anutaila90.
• While explaining Nasya91, Shiroabhyanga.
• While explaining Garbhopaghatakara bhavas, references about Palita by
excess Lavana rasa sevana by garbhini is mentioned92.
• In Bhela Samhita types of Palitya has been mentioned93.
• In Sushruta Samhita Palitya roga has been considered as Kshudra Roga94.
• In 20th chapter of Chikitsasthana of Susruta samhita he has explained the
treatment of Palitya95.
• Astanga sangraha has given reference about Indralupta, Palitya & Khalitya in
Uttara tantra, Shirorogavignaniya96 and Shirorogapratishedha adhyaya97.
• Astanga Hridaya has given reference about hair and its management in
Uttaratantra98.
So in Samhita Kala Both Acharya Charaka and Vagbhata mentioned this disease
under Shirogata Vyadhi where as Acharya Sushruta considers it in Kshudra
rogadhikaras.
Medieval period:
• Madhavakara99 and Bhavamishra100 both have mentioned palita under Kshudra
rogadhikaras.
• Yogaratnakara101 also mentioned about palita in Kshudraroga nidana and
Chikitsa.
• Sharangadhara Samhita102 mentions palita in Kapalagata roga.
• Chakradatta103 and Bhaishajyaratnavali104 listed the number of effective yogas
for the treatment of Palitya in the Kshudraroga chikitsa.
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Modern period:
Recently modern science has developed a branch deal with pathophysiology,
care and preservation of hair, known as Trichology. Earlier, hair and its disorders
were described under the heading of skin diseases. The hairs are elastic threads like
structure derived partly from undifferentiated cells of the foetal epidermis.
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Palitya:
Vyutpatti :
• 'mÉsÉ aÉiÉÉæ'-kÉÉiÉÑ & YsÉlÉç-mÉëirÉrÉ (AqÉUMüÉãvÉ)
• lÉqÉç-mÉÉsÉç pÉuÉã£ü ( vÉoSxiÉÉãqÉqÉWûÌlÉÍkÉ)
• mÉsÉ-pÉÉuÉã (uÉÉcÉxmÉirÉqÉç)
Nirukti:
• mÉsÉÌiÉ vÉÉæMsrÉãlÉ vÉÉãpÉiÉã CÌiÉ mÉÍsÉiÉqÉç ||
Palitya means – The hair turned to sukla varna.
• mÉÍsÉiÉÇ MåüzÉzÉÉæYsÉrÉqÉç || (Ayurveda Shabdakosha)
Sukla varna of the hair is Palitya.
• mÉÉÍsÉirÉqÉç MãüvÉ mÉÉMü: || (Bavaprakasha)
Paribhasha:
• mÉÍsÉiÉqÉç eÉUxÉÉ vÉÉæMüsrÉqÉç MãüvÉÉSÉæ||
Palitya is one of the lakshana of Jaravasta. (Amarakosha).
• mÉÍsÉiÉqÉç mÉÉhQÒûUÉ: MãüvÉÉ: CÌiÉ||
Panduravarna of kasha is called Palitya.
• MãüvÉÉSÉæ eÉUrÉÉ eÉÉiÉÉrÉÉqÉç µÉãiÉ-iÉÉrÉÉqÉç mÉÍsÉiÉqÉç||
In old age hair turns to white colour. (Vachaspatyam)
Definition of Akala-Palita:
AÉMüÉsÉã AxÉqÉrÉã mÉÍsÉiÉæuÉÉïkÉïYrÉæurÉÉïmiÉ: ÌmɨÉxrÉ FwqÉ
aÉÑhÉiuÉÉiÉç||
Palita occurs at the stage of vardhakya, but due to increased ushma guna of
pitta early graying (untimely) of hairs is observed.
AMüÉsÉã iÉÂhÉÉuÉxjÉÉrÉÉqÉç mÉÍsÉiÉæ; µÉãiÉæ||
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Akala-palita means graying of hairs at the young age. (vÉÉ.xÉÇ.mÉë 7
(aÉÔ.SÏ.)
MãüvÉÉlÉÉÇ vÉÑYsÉpÉÉuÉãlÉ mÉÍsÉiÉÍqÉirÉÑcrÉiÉã||
Palitya means Shukla bava of the hair. (vÉÉ.xÉÇ.mÉë 7 (aÉÔ.SÏ.)
Thus Akala palita may be defined as untimely or early graying of hairs due to excess
ushnaguna of pitta. Here untimely means premature graying of hair.
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Review of Palitya
Kesha Shariram:
Before dealing with the disease palitya, which affects hair of human being
brief knowledge of hair is essential.
Etymology:
The word Kesha has been derived from the root ‘Shi’ with ‘Ach’ prefix and
‘Kuluk’ conjugation that which grow on head.
Definition:
Kesha are the elements that grow on the scalp, Mastak or Shirah.
Synonyms:
There are many synonyms of hair as far as literary texts are concerned. They may
be enlisted as follows –
1) Kesha 2) Bala 3) Kacha
4) Chikura 5) Kuntals 6) Shirorooha
7) Ashrahs 8) Moordhaja 9) Shirasija
The hairs growing on the different parts of the body are known by different names
such as the hair growing on the scalp are known as Kesha, Kantal, Chikru etc. that on the
body are known by Roma, Romaraji, Loma etc. that growing on the eyelids are known as
Pakshma, the facial hairs are known as Shmashru, the hair on the eyebrows are known as
Bhrikuti, whereas the hair growing around the genetalia and in the armpits are known by
Vyanjana or Vyanjanana.
Prashashtha Kesha Laxana:
Acco. to Vagbhata;105
• Susnigdha ( Smooth, Glistening)
• Mruduta ( Soft)
• Sukshmata ( Fine & Precise )
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• Naikamulatwa / Prithanmulata
• Sthiratwa/ Dhridhata
Acco. to Charaka;106
• Snigdha
• Mrudu
• Subaddha mula
• Ekaikaja
• Krishna
Kesha Samkhya:
In ancient classics, many controversies have been noticed on this topic. The
number of hair as per various texts may be summarized as under.
Acharya Charaka has enumerated the total human hair to be 29956 and stated that
the number of Kesha, Shmashru and Loma is equal107.
Chakrapani, while commenting on this says that, this number of the mouths of
Dhamani has been counted in macro-sense, whereas if minutely counted they are liable to
increase. According to Vidyotini Tika of Caraka Samhita the number of hair stated is
72 crores108.
• Acharya Sushruta believes that like the Dhamani Agras hairs are innumerable.
• Ashtanga Samgrahakara holds same view as that of Charaka.
Parts of Hair:
Kesha can be divided into following parts:
Keshaagra (Hair ends)
Kesha Bhumi / Kesha Bhu (scalp / Skin)
Roma Kupa / Kupaka / Loma Kupa (Follicle)
Roma Meda (Roots of hairs)
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These are different parts of Kesha told in different contexts and can be
combined as above. Roma Kupa / Romachidra is embedded in twacha where the
kesha utpatti sthana is present.
Keshotpatti:
Ayurveda believes that the human body is built of main seven body elements as
Dhatus viz. Rasa, Rakta, Mamsa, Meda, Asthi, Majja and Shukra. A specific manner has
been thought of for the commencement of each and every Dhatu and their various
manifestations by the learned Acharya. Inspite of some controversies the major part of
them believe that the production of the latter Dhatus occur from the former by the
functions of their respective Agni i.e. the Rasagni turns the Ahara Rasa into Rasa Dhatu,
then the Raktagni converts the suitable Rasa Dhatu in Rakta and so on.
It has been further explained that, from the Poshakamsha of former Dhatu there is
not only production of latter Dhatu but consequently there is side by side production of its
Upadhatu and its Mala. There is no detailed description found in Ayurvedic classics
regarding the production of hair in particular, but it has been stated in the process of
Dhatu Nirmana that when Paka of Asthidhatu occurs by its own Agni, the Majja Dhatu
emerges from the Sara Bhaga and at the same time hair of scalp and body and nail
emerges as Mala (waste product). According to ancient classics the hair is one of the
“Pitruja Bhava” means the structure, color and quantity of hair of a progeny are
dependent on paternal side109, 110.
Acharya have considered the hair as “Parthiva Dravya” because of its qualities
like roughness, steadiness, heaviness etc.
The hair is directly related with skin. So a person with healthy skin is also should
have deep rooted, soft, fine and shiny hair.
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Keshotpatti Kala:
According to Caraka the Keshotpatti kala in foetus is at seventh month111.
While according to Vagbhata it is six months112.
Keha Poshana:
According to Acharya Charaka, from the ingested food there form an assimilable
nutrition fluid (Ahara Rasa), which further divided into two parts, namely essential fluid
(Sarabhaga) and the excretory matter/waste matter (Kitta). The waste matter is
responsible for the production and nutrition of so many things like sweat, urine, hair etc,
and among them are the hair follicles the hairs of the head and beard, hairs of the body
etc113.
According to Maharshi Sushruta, Kesha get nutrition from the end part of the
Dhamanis which are attached to the Romakoopa114.
Kesha Varnotpatti:
The colour of hair differs in different Desha, Jati etc. An exotic range of color is
seen in hairs viz. black, brown, red, golden etc. Ayurveda has adored the black colour of
hair, while describing the beauty of hair, the colour of hair like that of dragon-fly
(Bhramara) has been much appreciated.
Regarding the production of the color of hair, Ayurveda says that Teja Mahabhuta
is responsible for the colouration of hair. Bhrajaka Pitta, one of the manifestations of Teja
Mahabhuta, combines with Prithvi and Vayu Mahabhutas and produces black colour115,
116.
Kesha In Relation to Prakriti:117
The colour and texture of hair varies from person to person and it is based on his
Prakriti. The Prakriti of a man is determined by the preponderance of the particular
Doshas at the time of the generation (combination of the semen and ovum) and is made
by that preponderant Dosha.
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Vata Prakriti:
• According to Charaka they have rough hair on the head, face and body.
• Acharya Sushruta states that persons of this Prakriti have often a rough and grisly
beard and mustache, finger nails and hairs in him.
• Vagbhatta and Sharangadhara mention that Vata Prakriti person have Sphutit,
grey (dust), colour and in small number of hair.
Pitta Prakriti:
• According to Charaka, Sushruta and Sharangadhara Pitta Prkriti person have early
wrenches, grey hair and baldness, and are possessed generally scanty, soft and
tawny hair on the head, face and body.
• Vagbhatta mention that colour of the Kesha is Pingala and in small number of
Roma in Pittaja Prakriti.
Kapha Prakriti:
• Sushruta, Vagbhatta and Sharangadhara mention that the Kapha Prakriti have
firm, fleshy, curly, Snigdha and dark black colour of the hair.
In brief -
Vata Prakriti person - Dry with low-density hair
Pitta Prakriti person - Yellowish hair
Kapha Prakriti person - Thick, black and curly hairs.
Twacha:118
For the better understanding of the disorders of hair, it is necessary to have the
basic knowledge Twacha, as skin/Twacha is the Adhishtana for Roma/kesha.
According to Ayurveda there are seven layers for the skin.
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Table No. 13. Showing the 7 layers of skin: Layers Pramaana
(vrihi dhanya) VyadhiAdhisthana
Avabhasini 1/18th part Sidma, Padmakantaka
Lohita 1/16th part Tilakalaka , Nyaccha, Vyanga
Shweta 1/12th part Charmadala, Ajagallika
Tamra 1/8th part Kilasa , Shwitra, Kushta
Vedini 1/5th part Kushta , Visarpa
Rohini 1 Vrihi Granthi, Apachi, Arbuda
Mamsadhara 2 Vrihi Bhagandara, Arsha , Vidradhi
The roots of the Romakoopas are considered to be in the third and fourth layer
of the skin, ie; Shweta and Tamra.
Scalp: The scalp extends from the top of the forehead in front to the superior nuchal
line behind. Laterally it projects down to the zygomatic arch and external acoustic
meatus. It consists of five layers: skin, subcutaneous tissue, occipitofrontalis
(epicranius) and its aponeurosis, subaponeurotic areolar tissue and pericranium.
Figure No. 01. Showing the cross section of scalp with hair and its parts
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The skin of the scalp contains the hair and associated glands. There are many
sebaceous glands, and the scalp is the commonest site for sebaceous cysts. The dense
subcutaneous connective tissue has the richest cutaneous blood supply in the body.
The third layer contains occipitofrontalis its anterior and posterior muscular
components are connected by a tough, fibrous, epicranial aponeurosis, and
consequently this layer is called the aponeurotic layer (galea aponeurotica). Beneath
the aponeurotic layer is a layer of loose connective tissue over which the upper three
layers of the scalp can easily slide. The deepest layer is the periosteum of the skull. It
is very easy to raise a scalp flap within the plane between the galea and the
pericranium without compromising the blood or nerve supply of the scalp, because all
of these structures lie in the superficial fascia. Scalp flaps are used in craniofacial
surgery - e.g. for the correction of congenital deformity, for the release of
craniosynostoses and for the treatment of craniofacial fractures - and also for repairing
scalp defects following the excision of skin tumours. An anteriorly based scalp flap
gives excellent access to the frontal bone and upper facial skeleton including the
orbits and the infratemporal fossa and temporomandibular joint. Similar flaps are seen
in traumatic scalp avulsions, which occur when the hair is trapped in moving
machinery, and are also used electively in surgery.
The arterial blood supply to the scalp is particularly rich, and there are free
anastomoses between branches of the occipital and superficial temporal vessels. scalp
lacerations continue to bleed profusely because the elastic fibres of the underlying
galea aponeurotica prevent initial vessel retraction: these wounds may be associated
with significant blood loss which can result in clinical shock. When suturing scalp
lacerations it is essential to control all the bleeding points before repairing the scalp
itself. Usually it is necessary to tie off any larger arterioles and use bipolar diathermy
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to control smaller arterioles and veins. Failure to control the bleeding as a separate
step can result in significant haematomas, often subgaleal, leading to breakdown of
the original wound and sometimes necessitating surgical drainage. Repair of scalp
lacerations usually requires full thickness tension sutures because the galea
aponeurotica will otherwise gape as the occipital and frontal muscle bellies contract.
However, a wound that does not involve epicranius or its aponeurosis does not gape.
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Anatomy of the Hair:119
Recently modern science has developed a branch deal with pathophysiology,
care and preservation of hair, known as Trichology. Earlier, hair and its disorders
were described under the heading of skin diseases. Hair, nails and sudoriferous and
sebaceous glands in particular situations grow in the skin in its process of
development and as such they are taken to be the integrated part of the skin and are
usually described as appendages of the skin. The hairs are elastic threads like
structure derived partly from undifferentiated cells of the foetal epidermis.
Hair is found on almost every part of the body surface except on the palms and
the soles. The dorsal surface of the terminal phalanges, the inner surface of the labia,
the inner surface of the prepuce and the glans penis. Hair differs in length (short or
long), thickness (thick or thin) and colour (black, brown or blonde) in different parts
of the body and in different races (curly or straight). There are three types of hair :
1. Long medullated pigmented hair seen on the scalp.
2. Short, fine, non-medullated and non-pigmented ‘lanugo’ hair seen in women,
children and on the faces & trunks of adults (vellus hair). Even in bald
persons vellus hair may be present.
3. Thick bristles seen in the nose and ears.
Structure of the hair:
Structurally, the hair is entirely made up of epithelial cells. Each hair consists
of a shaft which is above the skin surface, a root (deepest part is called hair bulb) lies
deep inside the skin underneath the root. The skin forms a socket like structure,
known as hair folide.
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Figure No. 02. Showing the structure of the shaft of hair:
Shaft:
The hair shaft is a dead cornified structure that extends from the follice to
above the surface of the skin. The shaft is the superficial portion of the hair, which
projects from the surface of the skin. The shaft of straight hair is round in cross
section, that of wavy hair is oval and that of wooly hair is elliptical or kidneys shaped.
It has 3 parts, medulla, cortex and cuticle.
Medulla:
The inner medulla is composed of 2 or 3 rows of polyhedral cells containing
pigment granules and air spaces. It varies in thickness from 16-22 and occupies in
central axis of the hair. The medulla is absent in lanugo and fine hair.
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Cortex:
The middle cortex from the major part of the shaft and consists of elongated
cells that contain pigment granules in dark hair but mostly air in white hair. It consists
of that flat, spindle shaped epithelial cells containing pigment and fusifrom nuclei.
Between these cells are air spaces and pigment granules.
Cuticle:
The cuticle of the hair, the outermost layer consists of single layer of thin, flat
cells that are the most heavily keratinified, cuticular cells are arranged like shingles on
the side of a house, with their free edges pointing towered the end of the hair. In the
lower part of the root of the hair, the cells are present where as in the upper part of the
root as well as in the shaft of the hair cuticular cells are scale like have to nucleus and
appear to be transparent or featureless. They overlap each other in such a way that
they appear as scales of fishes.
Hair root:
The portion that penetrates into the substance of the skin is known as the hair
root. The root of the hair at its lower end forms a bulbous enlargement, which is
called the root bulb. It consists of polygonal and colimnar cells which are in active
state of proliferation. Their growth and proliferation displace more mature cells
towards the rests on the summit of a vascular papilla on which it is dependent for its
nutrition.
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Figure No. 03. Showing the structure of the hair root:
Hair follicle:
The hair is contained in the skin in a series of invaginations called the hair
follicles. If the hair root is of considerable length, the follicle may extend even into
the hypodermis. The hair follicle extends inwards from the surface of the epidermis
where it is funnel shaped, either perpendicularly or in a curved fashion, the later in
curly hair. It is dilated its inner end is known here as the hair pit. Hair follicle and its
hair can be anatomically divided into three segments:
• Infundibulum: Extends from pillar orifice above to the entrance of sebaceous
gland below.
• Isthmus: The short midsection of the follicle bounded superiority by the
sebaceous duct and inferiority by the insertion of arrector pilorum muscle.
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• Inferior: This extends from the insertion of muscle to the base of the follicle.
The upper segments of the isthmus and infundibulum are permanent. The
entire follicle beneath the isthmus disappears during the involutionary stages
of the hair cycle and again reforms during the growth cycle.
The hair follicle consists of 2 coats.
The outer corium or dermis:
It consists of a hyaline basement membrane, external to which is a Compact
layer of connective tissue fibers & spindle cells, arranged circularly around the
follicles. It is highly vascular & is supplied by numerous minute nerves.
The inner epidermis:
The inner coat, which is intimately attached to the root of the hair, consists
further of an internal root sheath and an external root sheath.
The internal root sheath:
It is made up of 3 layers.
• A fine cuticle composed of a single layer of imbricate scales with indistinct or
no nuclei.
• Huxley’s layer consisting of one or two layers of horny and flattened
nucleated cells.
• Henle’s layer consisting of a single layer of cubical cells with flattened nuclei.
The external root sheath:
The external root sheath corresponds to be polyhedral cells of the structure
malpighi which lies just deep to the connective tissue layer and form the continuation
of the stratum germination. The outer cells are mere polygonal.
When the hair is of considerable length the follicle extends into the
subcutaneous tissue. The ducts of one or more sebaceous glands open into the follicle,
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near the skin surface. At the bottom of each hair follicle there is a small conical
vascular papilla similar in every respect to those found upon the surface of the skin. It
is continuous with the dermal layer of the follicle and is supplied with capillaries in
the papilla that the hair derives its nutrition.
At the bases of each hair follicle is an enlarged, layered structure the bulb.
This structure houses a nipple shaped indentation, the papilla of the hair which
contains areolar connective tissue. The papilla of the hair contains many blood vessels
and provides nourishment for the growing hair. The bulb also contains a ring cells
called the matrix, derive from the stratum. They are responsible for the growth of
existing hair and produce new hair by cell division when older hairs are shed. This
replacement that occurred within the same matrix cells also give rise to the cells of the
internal root sheath.
Muscles:
Sebaceous glands and a bundle of smooth muscle cells are also associated with
hair. The smooth muscle is called an arrector (arrector-to raise) pili (plured is arrector
pilorum). It extends from the superficial dermis of the skin to the side of the hair
follicle. The arrector pili muscle contracts under the strem of fright cold and emotion
and pulls the hair into a vertical portion. This response makes a bury animal look
larger and thus it may appear more threatening to an aggressor. In people, with little
body hair it serves in apparent purpose mostly causing goose bumbs or goose flesh
because the skin around the shaft turns slight eration.
Around each hair follicle are nerves ending called hair root plexus that are
sensitive to touch. They respond if a hair shaft is moved. The contraction of these
muscle fibers is also thought to squeeze all sebum from the duct of the sebaceous
gland.
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Hair physiology:120
Hair contributes significantly to the visual image of both males and females of
all ages. Every visible major body surface is covered with some type of hair,
providing the creation of endless opportunities for cosmetic adornment. Hair is
nonliving, yet is immersed in a cycle of constant renewal and shedding. Unlike vital
organs, such as the heart, liver, or kidneys, where limited cellular renewal can occur,
hair growth occurs at the amazing rate of 0.35mm/day allowing the removal of old,
damaged hair that is readily replaced with new regrowth.1 Hair is the only body
structure that is completely renewable without scarring, as long as the follicle remains
a functioning unit. For this reason, the hair can be subjected to insults that could not
be sustained by any other body organ. This constant renewal also means that induced
cosmetic alterations in shape, color, or texture are temporary until the chemically
altered hair is sloughed or trimmed.
The hair follicle number that is present at birth remains constant throughout
youth, slowly decreasing with age. Hair follicles are formed early in development of
the fetus with eyebrow, upper lip, and chin follicles present at week 9 and the full
complement of follicles present by week 22. At this time, the total body number of 5
million follicles is present with 1 million on the head, of which 100,000 are on the
scalp.9 No additional follicles are formed during life. As body size increases, the
number of hair follicles per unit area decreases.
The hair grows from follicles, which resemble stocking-like invaginations of
the epithelium enclosing an area of dermis, known as the dermal papillae. The area of
active cell division, the living area of the hair, is formed around the dermal papillae
and is known as the bulb where cell division occurs every 23–72 hours. The follicles
slope into the dermis at varying angles, depending on body location and individual
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variation, and reside at varying levels between the lower dermis and the subcutaneous
fat. In general, larger hairs have more deeply placed follicles than finer hairs. An
arrector pili muscle attaches to the midsection of the follicle wall and ends at the
junction between the epidermis and dermis. In some body areas, a sebaceous gland
and an apocrine gland attach above the muscle and open into the follicle. The point at
which the arrector pili muscle attaches is known as the hair ‘bulge’ and is considered
to be the site where new matrix cells are formed and the hair growth cycle is initiated.
It takes approximately 3 weeks for a newly formed hair to appear at the scalp surface.
The sebaceous gland is intimately associated with each and every hair shaft.
Sebum is important to the maintenance of the grown hair shaft, as it functions as a
natural conditioning agent removing static electricity and imparting shine to newly
grown hair. Approximately 400–900 sebaceous glands per square centimeter are
located on the scalp and represent the largest glands on the body. Sebum, composed
of free fatty acids and neutral fats, is produced in increased amounts after puberty in
males and females and abundantly coats the hair shaft in youth. With advancing age,
sebum production declines in the female with a less significant decrease in males.
This leads us to the next topic of discussion, which is the hair growth cycle.
Hair growth cycle:
Hair growth occurs on a cyclic basis with periods of growth, impending
dormancy, and total dormancy occurring with clock-like accuracy. Each hair grows to
a finite length depending upon predetermined genetic factors and age. The growth
phase, known as anagen, lasts approximately 1000 days and the transitional phase, or
catagen, about 2 weeks. The resting phase, or telogen, lasts approximately 100 days.
Scalp hair is characterized by a relatively long anagen and a relatively short telogen
with a ratio of anagen to telogen hairs of 90 to 1018. Only 1% or less of the follicles is
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in catagen at any given time. Thus, the healthy individual loses 100 hairs per day. It is
estimated that each follicle completes this cycle 10–20 times over a life-time, but the
activity of each follicle is independent.
Generations and types of the hair:
Hair begins to appear first in foetal life and they are constantly shed placed
since them and the process continues through the whole span of life. There generation
of hair known to exist such as:
1) Lanugo: At about the middle of the foetus like the whole body surface is seen
to be covered by fine hair, which are known as lanugo.
2) Vellus down hair: At birth most of the lanugo hairs are replaced by another
kind of fine known as vellus down or secondary hair, which persist during the
early months of post natal life.
3) Terminal hair: The secondary hair persists in most of the regions after early
fustanated life. But during puberty the hair of scalp and eyebrow axilla. Pubic
region and these in front of the chest and face in males are replaced by
terminal hair. The terminal hairs are courser and more pigmented.
Growth of the hair:
Hair grows about 1-2 cm. per month. The growth varies in different people,
race and also on the different parts of the body. Hair growth and development is under
endocrine control. Fine balance of estrogens, androgens and gonado trophins
determines the pattern in an individual.
1) Anagen phase : Growing phase
During growth stage, a hair is formed by cells of the matrix that differentiate
divide become keratinized and die. As new cell ferostiate as new cells that are
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added at the base of the hair root, the hair grows longer. In time, the growth of
the hair stops and resting stage begin.
2) Telogen phase : Resting phase
During the resting stage, the matrix is inactive and the hair follicle atrophies
somewhat. During telogen phase the hair melanocytes cease to synthesize
melanin. This function of melanin formation begins again with anagen phase.
There fine the root of the anagen hair is pigmented, whereas the tip of the
telogen hair is unpigmented.
3) Catagen phase : Involutionary phase
After the resting stage a new growth cycles begins in which a new hair
replaces. The old hair is pushed out of the hair follicle. In general scalp hair
grows for about 3 years rest for about 1-2 years.
Table No. 14. Showing the hair growth:
Hair growth phase Duration of growth phase
Anagen 1000 days
Catagen 14 days
Telogen 100 days
The mechanism signaling the progression from one phase to the next is
unknown, but the duration of anagen determines the maximum length to which the
hair can be grown. Hair growth can be affected by physical factors (severe illness,
surgery, weight change, pregnancy, hormonal alterations, thyroid anomalies,
dermatologic disease) and emotional factors, but is unaffected by physical alterations
limited to the hair shaft (shaving, curling, combing, dyeing, etc.). Plucking of the
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hairs from resting follicles can stimulate growth, but the composition of the hair shaft
remains the same, as discussed below.
Hair composition:
Hair is a nonliving structure basically formed of protein. Specifically, it is
composed of keratin, which is formed from insoluble cystine-containing helicoidal
protein complexes. The hair is made up of an amorphous matrix high in sulfur
proteins in which the keratin fibers are embedded. These protein complexes, which
form 65–95% of the hair by weight, are extraordinarily resistant to degradation and
are thus termed hard keratins, as opposed to the soft keratins that compose the skin.
Under x-ray crystallography, the hair fiber helix has an alpha diffraction pattern,
which changes to a beta diffraction pattern as the hair is stretched and the helix is
pulled into a straight chain.
Each hair shaft is composed of a variety of layers, which are formed from
closely attached keratinized fusiform cells arranged to form a cohesive fiber. The
greatest mass of the hair shaft is the central cortex, with some shafts also possessing a
medulla. The cortex consists of closely packed spindle-shaped cells with their
boundaries separated by a narrow gap, which contains a proteinaceous intercellular
lamella thought to cement the cells together. It is this structural organization of the
cortex that provides mechanical strength to the hair shaft.
The cortex in turn surrounds the medulla, which is formed from a protein
known as trichohyalin. The function of the medulla remains unknown; however, it
contains glycogen and melanosomes. In older individuals, the medulla cells appear to
dehydrate and air-filled spaces are left behind in place of a functional medulla. In
general, larger diameter hairs, such as those located on the scalp, are more likely to
contain a medulla than finer body hairs.
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Surrounding the cortex is a protective layer of overlapping, keratinized scales
known as the cuticle, which can account for up to 10% of the hair fiber by weight.
The cuticle free edges are directed outward with the proximal edges resting against
the cortex. The cuticular scales are arranged much like roofing shingles to provide
five to ten overlapping cell layers, each 350–450nm thick, to protect the hair shaft
along its entire length. The cell structure of the cuticle is composed of three major
layers: the A-layer, the exocuticle, and the endocuticle. It is the clear A-layer, which
is high in sulfur containing proteins, which protects the hair from chemical, physical,
and environmental insults. A healthy hair shaft is characterized by an intact, well-
organized cuticle. It is this unusual structure of the hair shaft that provides for the
unique physical properties of hair.
Hair Pigmentation:
Hair Pigmentation is a process, in which there is a precise interaction in the
hair follicle unit between follicular melanocytes, keratinocytes, and dermal papilla
fibroblasts. Follicular pigmentation involves follicular Melanogenesis (FM) which is
sequential melanogenic activity of follicular melanocytes, the transfer of melanin
granules into cortical and medulla keratinocytes, and the formation of pigmented hair
shafts. Follicular pigmentation is under complex genetic control .This activity is in
turn regulated by an array of enzymes, structural and regulatory proteins, transporters,
and receptors and their ligands, acting on the developmental stages, cellular, and hair
follicle levels. FM is coupled to anagen stage of the hair cycle, being regression in
catagen to remain absent through telogen. At the organ level FM is precisely coupled
to the life cycle of melanocytes with changes in their compartmental distribution and
accelerated melanoblast/Melanocytes differentiation with enhanced secretory activity.
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Thus Follicular Melanogenesis is characteristically cyclic in nature, as apposed to the
continuous melanogenesis of epidermal pigmentation.
Melanin:
It is water- insoluble polymer of various compounds derived from the amino-acid
Tyrosine. It is a poly quinone, brown or red pigment and protein, formed by the
oxidation of tyrosine and 3,4-dihydrxiphenylealaninein the presence of tyrosinase. It is
one of the two pigment found in human skin and hair and adds brown to skin color; The
other pigment is Carotene, which contributes yellow color. There exist two main groups
of melanin;
1. Eumelanins-Insoluble (Black to Dark brown)
2. Pheomelanins- Alkali soluble ( Yellow to reddish brown)
Melanin serves 2 main functions in the epidermis:
1. The pigment protects underlying structures from the harmful effects of
sunlight;
2. It serves to influence the color of the epidermis.
The first mechanism by which hormones can influence the amount of melanin,
involves changes in the activity to the enzyme tyrosinase. In the melanoblasts which
synthesize the pigment. The second mechanism may involve changes in the activity of
keratinocytes which engulf the melanin discharged from melanoblasts.
The synthesis of melanin reactions is catalyzed by the tyrosinase; Tyrosine is
found in only one specialized type of cell, the melanocyte, and in this cell melanin is
found membrane –bound bodies called melanosomes. Melanosomes can be
transferred from their site of synthesis in the melanocytes to other cell types. The
various hues and degrees of pigmentation found in the skin of human beings are
directly related to the number, size, and distribution of melanosomes within the
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melanocytes and other cells. Besides its role in the pigmentation, Melanin, which
absorbs U.V light, plays a protective role when skin is exposed to the damaging rays
of the sun.
Hair color – biochemistry:
In humans, all the different hair colors are due to just two types of pigment
(melanin) called eumelanins and pheomelanins. Eumelanins are the dark brown and
black pigments while pheomelanins are the red and blonde pigments. The different
colors of hair in different people are due to a combination of these two different basic
biochemical structures. By mixing the two types together in different concentrations
the many different shades of hair color are made.
Eumelanins are very strong, stable proteins made from tyrosine. The large
eumelanin biochemical structure is formed by processing the amino acid tyrosine into
dopa and dopamine and connecting several of these molecules together to form
eumelanin. The key enzyme in this process is tyrosinase. The more tyrosinase activity
the more eumelanin is formed. This is one method by which different people have
different shades of brown to black hair color. More tyrosinase activity results in more
pigment production and so a darker hair color. As we get older, tyrosinase activity
increases. It is most active in middle age and thereafter tyrosinase activity decreases.
There are also other biochemical mechanisms by which the shade of hair color is
regulated. Several factors interact with tyrosinase to help regulate eumelanin
production. In addition, another key limiting factor in hair color is the availability of
the raw tyrosine ingredient. A lack of tyrosine availability means the tyrosinase
enzyme make eumelanin at full capacity.
Pheomelanins are also made from the same tyrosine as eumelanins and the
process is much the same with tyrosinase playing a key role. Pheomelanins are
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produced when an intermediate product in the eumelanin production pathway
interacts with the amino acid cysteine. This results in the formation of a pheomelanin
molecule which contains sulfur from the cysteine. These molecules are yellow to
orange in color. So this is another way by which different shades of hair color can be
produced. The more interaction there is between dopaquinone and cysteine the more
yellow and orange pigments are produced.
Melanogenesis:
The visual appearance of humans derives predominantly from their skin and
hair color. The phylogenetical biochemical pathway underlying this phenomenon is
called Melanogenesis and results in the production of melanin pigments in neural
crest- derived melanocytes, followed by its transfer to epithelial cells. While melanin
from epidermal melanocytes clearly protects human skin, but the biologic value of
hair pigmentation is less clear. There is complex regulatory control of the biosynthetic
machinery involved in melanogenesis. It involves hormones, neurotransmitters,
cytokines, growth factors, cyclic nucleotides and nutrients.
The hair follicle and epidermal melanogenic systems are broadly distinct. The
primary distinguishing feature of Follicular Melanogenesis (FM) is the tight coupling
of hair follicle melanogenesis to the hair growth cycle, compared to the continuous
melanogenesis in the epidermis. The cycle appears to involve periods of melanocyte
proliferation (during early anagen), Maturation (mid to late anagen) and melanocyte
death via apoptosis (during early Catagen). Thus, each hair cycle is associated with
the reconstruction of an intact hair follicle pigmentary unit atleast for the first 10
cycles or so. There after, gray and white hairs appear, suggesting an age related,
genetically regulated exhaustion of the pigmentary potential of each individual hair
follicle.
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Soluble Melanogenesis regulators may reach the skin through local
production, nerve ending release or Circulatory transport. Positive Melanogenesis
regulators include alpha-MSH (melanocyte stimulating hormone), ACTH
(AdrenoCorticoTropic hormone), Beta-endorphin, prostaglandins, leukotrienes,
histamines, estrogens, Vitamin D3, and bone morphogenic proteins; In addition,
nutritional factors L-tyrosine and L-dopa function as substrates for melanin, but also
as positive regulators of the melanogenic apparatus in a proper genetic and
environmental back ground.
Melanin Synthesis and pigment transfer to bulb keratinocytes are to a large
extent controlled by signals intrinsic to the skin and represented by products of
keratinocytes, immunocytes, fibroblasts, and endothelial cells (Slominski and paus,
1993).Melanocytes can reciprocally affect the surrounding cells, e.g.; by direct
melanosome transfer (to keratinocytes), or by production of and secretion of
functional regulators. Thus anagen –coupled melanogenesis and its regulatory
network control Hair growth and Pigmentation. The Melanocyte component of this
tissue interactive cell system in hair follicles is more sensitive to aging influences than
melanocytes in the epidermis, resulting in hair graying / canities;
Anagen follicle melanocytes are melanogenically active in the hair bulb form
functional units and ultimately form pigmented hair shaft. Although follicular
melanocytes are derived from epidermal melanocytes during hair follicle
morphogenesis, these pigment cells make compartments called “Follicular Melanin
Unit”. Hair bulb melanogenic melanocytes differ from epidermal ones by being
larger, more dendritic.
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Influence of hormones on Melanogenesis:
Interstitial cell-stimulating hormones, estrogens, MSH and ACTH appear to
increase epidermal melanin by enhancing the activity of tyrosinase. Estrogens are
capable of accelerating the synthesis of melanin; it has been observed that the skin
color varies with the menstrual cycle. Such variations may result from the synergetic
action of estrogens and progesterone. A similar mechanism accounts for the
pigmentation of pregnancy.
ACTH processes some MSH activity, although it is much less potent than
MSH itself. These two hormones darken the skin in man. The influence of thyroxine
upon epidermal melanin is complex and varies from species to species. The influence
of androgens, adrenaline and nor adrenaline on melanogenesis over mammalian
melanocytes, further investigations are needed.
Aging of Hair:
Hair aging comprises weathering of the hair shaft and aging of the hair
follicle. The latter manifests as decrease of melanocyte function or graying, and
decrease in hair production .The scalp is also subjected to Intrinsic or Physiologic
aging and extrinsic aging caused by external factors. Intrinsic factors are related to
Individual genetic and Epigenetic mechanisms with inter individual variation.
Montagna and Ellis have done studies of the capillaries surrounding the hair follicles
and have called attention to some of the striking changes that occur during the aging
process in the human scalp. These observations have led to remarkable aging changes
in the human male scalp such as a receding hairline, the gradual thinning and graying
of the hair, and, frequently, the partial or complete balding are quite apparent. These
are changes that involve the hair follicle and are the result of interactions between the
sex hormones of the male and the genetic constitution of the individual.
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The Function of the hair:
The real purpose of the hair is definitely protective. Around the hair roots
there are a series of structures. There are designed to protect the scalp from heat rays,
thermal and mechanical shock etc. The functions of the hair of the eyebrows and
lashes is to protect the eyes, that of the nostrils and external ear filter out large dust
particles to stop them entering into body.
The presence of hair protects the body from the extreme temperature of the
environment by acting as a insulator, especially in animals of cold countries. When an
animal goes to fight his hair from a resitions and protective armour. The same thing is
noticed among men and women in the case of an intense fearfulness. When the shock
is sufficient, the hair of a human being actually stands on end.
The hair also does the tactile receptor functions. Hair serves a sexual function
in promotion the evaporation of the apocrine sweet and the accompanying
characteristic odour that goes along with it provides a sexual attraction for the lower
animal.
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Nidana of Akala Palitya:121, 122, 123, 124
Nidanaparivarjana is the first and foremost treatment for any disease. So
understanding the etiology of the disease is very important to avoid the causative
factors and to give appropriate medicine for that disease.
Acharya Charaka has classified the Nidanas mainly into two types; Samanya
Nidana and Vishesha Nidana. The descriptions of Nidana that have been mentioned in
the Ayurvedic classics are not uniform for all the diseases. While explaining some of
the diseases, both Samanya and Vishesha Nidana and in few of the diseases Vishesha
Nidana has been mentioned.
Based on different classification according to different authors of Ayurveda,
Akala Palita is both Swatantra and Paratantra Vyadhi and it is included under Kshudra
Roga and Kapalagata Roga. Here Paratantra Akala-palita refers to the disease caused
by some other diseases like Shwitra etc…The Nidanas mentioned for those
rogadhikaras can be applied for that of Akala-palita. Also Akala Palita Nidanas can be
studied by eliciting Vegavarodhajanya Nidanas, Atiyoga-Ayoga of Indriyartha
samyoga, Rasavaha and Asthivaha srotodusthi karanas. Akala Palita is twachagata
roga where Romakupas are lodged, so that some of the Kushtha Nidanas can also be
considered.
All the etiological factors can be elaborated in the following subtitles.
• Aharaja (dietetic factors)
• Viharaja (External and behavior factors)
• Manasika (psychic factors)
• Anya Hetuja (miscellaneous factors)
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Aharaja:
The nidana in the form of different diet / food habits is included under Aharaja
nidanas. These nidanas affect the Rasa dathu. Here Rasa dathu is the main nourishing
factor for all the dathus, and it also gives nourishing for both Kesha and Kesha Varna.
Apathya / Improper diet is a contributory factor for Akala-palitya. Food articles which
vitiates mainly pitta along with Tridosha. Thus which increase Dehoshma / which is
the cause for Rasadhatu Dushti / Asthidhatu Dushti especially Kesha poshaka Mala
bhaga Dushti are mainly responsible for Akala-Palitya.
Table No. 15. Showing the Aharaja nidana
Gunataha Rasataha Atiguru sevana Amla
Atisheeta sevana
Tikshna sevana Katu
Ushna sevana
Vidaha sevana Lavana
Laghu sevana
Ruksha sevana
Kshara sevana
Viharaja: The nidana in the form of Vihara or factors related to the habit and regimen of the
persons. Viharaja nidanas may be considered in the form of Viprakrishta i.e;
indulgence of Hetu for longer duration.
Viharaja nidanas are :-
• Ratrijagarana.
• Atapa sevana.
• Rajo sevana.
• Dhuma sevana.
• Dushita Vayu sevana.
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• Shiro Abhyanga Ayoga.
• Dushita Jala snana.
• Ati Vyayama.
• Upavasa.
Ratrijagarana: Due to regular indulgence in ratrijagarana, Vata vriddhi takes
place which in turn causes Rasavaha Srotodushti .This may be the cause for Akala-
palita.
Atapa sevana: Due to excessive Atapa sevana, like continuous working in
field farmers or other hard workers over hot sun may develop Akala-palita. This
Bahya Nidana directly increases Dehoshma in turn increases the ushma of
Keshabhumi and Roma kupa to produce Akala-palita.
Rajo sevana, Dhuma sevana and Dushita Vayu sevana: These are Bahya
Nidanas, causing same impact as heat does. They make the scalp dry due to the
increase of sthanika Rukshata, in turn sthanika Vata prakopa, resulting in reduction of
snigdhamsha may lead to Graying of hairs.
Shiro Abhyanga Ayoga: This causes the improper nourishment of both scalp
and Hair follicles.
Dushita Jala snana: This is also the Bahya Nidana. In certain parts of India
like Saurashtra, Balhika and Saindhava especially coastal areas suffer from lack of
fresh and soft water. This is because of Desha swabhava. It contains high
concentrated salt; continuous usage of such water is not helpful to scalp.
Ati Vyayama and Upavasa: Due to excess physical work and continuous
indulgence in upavasa cause vata vriddhi. The vikshepana karma of this vata to Shiras
causes Sthanika Tridosha Dushti, which in turn causing Akala-palita.
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Manasika:
Krodha, Shoka, Adhika Chinta and Manasika Shrama are considered to be
both Pitta and Vata Prakopaka Nidanas which are responsible for early graying of
hairs. These are the Specific Nidanas for Akala-Palita mentioned in classics,
• Krodha.
• Shoka.
• Adhika Mana Shrama.
• Bhaya.
Shoka: Due to Shoka Vata vriddhi takes place. This leads to Vishamagni
causing rasa-rakta Dushti and direct influence of Shoka on dehoshma vriddhi leads to
Akala-palita.
Krodha: Due to Krodha –swasthana sanchita pitta gets kupita along with
vayu, and causing shariroshma vriddhi along with other symptoms like Trishna, Daha
etc.
Shrama: Due to excess Shrama, vata gets vitiated, in turn vitiates Jatharagni
& rasa dushti, and direct influence of Shrama on sharirika ushma vriddhi causing
Akala-palita.
Anya Hetuja:
Akala-Palita is Janma Jaata Vyadhi. So genetically tendency can be elucidated
in the families having graying of hairs. Acharya Charaka in Indriyasthana has
mentioned according to Prakriti, Jaati, Kula, Desha, Kaala, and Vaya specific Bhavas
will differ. Those Bhava Vishesha are Varna, Swara, and Gandha etc.
• Janmabala Pravritta Hetu.
• Prakriti Hetu.
• Jaati and Kula Hetu.
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• Desha Hetu.
• Vayo Hetu.
Janmabalapravrittahetu: Charaka accepts in the context of garbhahanikarabhavas, a
pregnant woman on taking continuous Lavana rasa may become responsible for an
early graying of hairs in offspring. While mentioning the types of Vyadhi, Sushruta
has considered Akala jarajanya vyadhis in Janmabalapravritta Vyadhis; these are
considered into two, and Rasakrita and Douhrida apachaaraja. Achrya Vagbhata have
made the observations in regard with excess intake of Pittala Ahara by pregnant lady
may cause Kesha vikara in the progeny.
Prakriti prasakta: Pitta Prakriti persons naturally develop Akala palitya of hairs.
Jaati and kula prasakta: As far as Vamshaja / Kulaja / Hereditary factors are
concerned, there are no direct references available to consider the Hetu of the disease.
But one can find that the heredity is considered to be one of the color deciding factors.
However this factor can be considered indirectly for the formation of disease Akala-
palita. Acharya Charaka mentions in Sharira sthana about beeja & beeja bhaga vikriti
causing different avayava vikaras. So according to Charaka Vali palita roga can be
considered under Adibala pravritta vyadhi.
Desha prasakta: According to different Desha / Areas – The Color and Texture of
hair will change. While telling the excessive usage of Khsara, Pippali, and Lavana
,Acharya Charaka told about the incidence of Akala-palita which is more prevailing in
the areas like Balhika , Saurashtra , Saindhava ,where Ushara / Lavanamsha is more
in soil. In such conditions even though persons are having Lavana Satmya, they
develop Akala-Palita.
Vayo anupatini: According to age two types,
Kaalaja - Swabhavika (Physiological) and Akaalaja - Vikritijanya (Pathological)
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Samprapti:
The Acharyas of Ayurveda are having more or less similar opinion about the
Samprapti of Palitya. Samprapti is nothing but the pathogenesis, which occur at
different levels of the disease. The knowledge of Samprapti / understanding of each
sequence of Samprapti is essential in diagnostic and prognostic aspects of disease.
The samprapti initiates with the continuous impact of emotional stresses like
Shoka, Krodha and Shrama and physical causes like Asatmendriyartha Samyoga and
Bahya hetu.
Acharya Sushrutha94 and Madhavakara99 have explained pathogenesis as
followes, due to causative factors like Soka, Kroda and Srama, Pittadosha is agrivated
and there by increases Pittoshma and Shareeroshma. Vata which is also aggravated by
Soka and Srama carries this Pittoshma to the Shiras. Stanika Kapha is also get vitiated
as the Shiras is the important location of Kapha. Thus vitiated tridosha settled in the
romakoopa (Stanasamsraya). Locally settled Tridosha further vitiate locally available
Brajaka Pitta, which gives colour to the hair. In this way the natural colour of the hair
is affected and Akala Palitya is caused.
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Samprapti ghatakas:
Dosha: Sharirika Dosha - Tridosha (Pitta dosha pradhana)
Sthanika Dosha - Bhrajaka Pitta.
Dushya: Rasa and Asthi.
Agni: 1) Jatharagni
2) Dhatwagni
a) Rasagni.
b) Asthyagni.
3) Bhutagni
a) Prithvi.
b) Teja.
4) Malagni
a) Asthimala.
Srotas: Rasavaha Srotas.
Asthivaha Srotas.
Manovaha Srotas.
Srotodushthi prakara: Sanga.
Roga marga: Bahya Rogamarga.
Udbhava sthana: Amashaya.
Sanchara sthana: Rasayanis.
Vyadhi adhishthana: Shirogata Romakupa.
Vyakta sthana: Shirogata Kesha.
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Schematic Presentation of Samprapti ofAkalapalita:
Prakopa of Vata and Pitta
Due to Soka,Krodha and Srama
Pittoshma
Sthanika Bhrajaka Pitta Dushti
Sthanasamshraya in Keshabhumi/Romakupa
Sthanika tridosha dusti
Vata carries pittoshma to Shiras
Sharira Ushma
Kesha Varna utpatti vikriti
Keshamula Dushti/Romakupadushti
Akala Palitya
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Purva-roopa:
It refers to the features, which indicates the forth-coming disease. It usually
happens during fourth kriya kala called “Sthana samshraya”. Clinically, this is important
for early diagnosis, treatment and prognosis. No specific Purva Roopa has been
mentioned for Akala-palita in classics.
Roopa:
When the Vyadhi kriya kala is in fifth stage (Vyakthavastha), the disease will
produces the features called as “Roopa”. These roopa will indicate the manifestation of
disease. These are the signs and a symptom of the disease. This is the stage when Dosha
–Dushya Sammurchana is completed.
Prakrita Palitya symptoms are developed in Vriddhapya. And Vaikrita Palitya
symptoms are usually developed in Akala Vaya, that is nothing but Akala palitya.
The lakshanas are as follows;
Table No. 16. Showing the Palita lakshanas of Palitya acc. to Vagbhata Dosha Kesha Lakshanas
Vataja Sphutita, Shyava, Khara, Ruksha, Jala Prabha.
Pittaja Pitabha , Dahayukta.
Kaphaja Snigdha , Sweta , Sthula ,Vivriddha
Dwidoshaja Mixed laxanas of doshas
V
agbh
ata
Tridoshaja Sarva Laxanas
Table No. 17. Showing the Palita lakshanas of Palitya acc. to Yogarathnakara
Dosha Kesha Lakshanas
Vataja Vishama , Ruksha
Pittaja Pitabha
Yog
arat
naka
ra
Kaphaja Sarvarupanvita
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Classification:
According to Acharya Sushrutha;
• Prakrita Palitya.
• Vaikrita Palitya.
According to Acharya Sharangadhara;
• Kalajanita palita.
• Akalajanita palita.
According to Acharya Vagbhata;127
• Vataja.
• Pittaja.
• Kaphaja.
• Dwandwaja.
• Tridoshaja.
According to Acharya Yogaratnakara;
• Vataja.
• Pittaja.
• Kaphaja.
According to Acharya Bhela;128
• Vataja.
• Pittaja.
• Kaphaja.
• Tridoshaja.
• Agantuja.
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Sadhyasadhyata:129
The prognosis of the disease depends upon the factors like Nidana, Kala,
Desha, Bala, Ashraya, and Lakshana etc. Here the wise physician must analyze
samprapti ghataka first. The knowledge of sadhya-sadhyata is essential while
selecting medicine and therapy for the particular disease.
According to Acharya Vagbhata;
• Vataja.
• Pittaja.
• Kaphaja.
• Sannipataja
• Kalajanita pality Asadhya
Sadya
Chikitsa:
According to Dosha involvement the Chikitsa sutra for Akala-palitya are carried out.
The following are the Chikitsa Sutra to treat premature graying of hairs;
• Sthanika Snehana / Abhyanga and sthanika Swedana.
• Samshodhana (Sarvadaihika and Shirovirechana).
• Nasya (Navana type).
• Samana.
• Palliative Measures (Shiro-lepa).
• Preventive Measures.
Pathyapathya:
It plays an important role as much as of medicine and it is rightly mentioned
that, if one follows Pathya, then there is no need of medicine Pathya plays an
important role in preventing the recurrence of the disease.
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Ahara: Shashtika shali, Mudga, Goghritha, Dugdha, Kushmanda, Dadima, Kharjura,
Narikela.
Vihara: Regular Hair washes, Regular shiro Abhyanga, Murdha Taila, Prayogika
Dumapana, Anutaila pratimarshya nasya, Timely sleeping.
Kesha Ranjana Drugs: Bhringaraja, Vibhita Majja, Amrasthi, Madayantika, Japa,
Loha bhasma, Neelini, Saireyaka.
Apathya:
Ahara: Lavana rasa Atisevana, Katu rasa Atisevana, Amla Rasa Atisevana, Shushka,
Ruksha,
Viruddha ahara, Lashuna, Masha, Kulatta.
Vihara: Exposure to Raja, Dhuma, Ati Atapa sevana, Ati Vyayama, Krodha, Shoka,
Excess consumption of Alcohol & Smoking, Vegavarodha and Improper sleeping habits.
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Premature Graying of Hairs:
Hair has a tendency to lose its natural colour with advancing age. It is
therefore natural for the hair to turn grey with age. But premature graying is a morbid
condition and it makes even the young looks older. This causes a great deal of
concern to the effected persons.
Pathogenesis of premature Graying of Hairs:
The timeframe of normal greying of hairs occurs independently of hair color
or gender, but it is, however, different among the various peoples of the world. A
study of Australians in 1965 showed that among Caucasians, on average 50% of the
population are 50% gray by 50 years of age. In African Americans, onset is shifted to
slightly later in life at 43.9 ± 10.3 years, whereas the late 30’s are the rule for Asians.
In the individual, canities is usually first observed in the beard, followed by scalp
involvement with the first gray hairs appearing over the temples, then the vertex, and
finally moving toward the occipit. In general, the age of onset of canities in the
individual is believed to be inherited as an autosomal dominant trait.
Canities occurs secondary to a progressive decline in the number and function
of hair follicle melanocytes. In a recent article by Tobin and Paus, they suggest that
canities occurs following an eventual fatigue of the follicular melanocyte reservoir’s
ability to repopulate the new hair matrix with pigment forming melanocytes. They
explain that the average hair follicle is able to produce 7-15 cycles of pigmented hair
growth before melanocytes become unable to migrate and produce melanin allowing
for roughly 45 years of pigmented hair growth. For every decade after 30 years, the
pigment-producing melanocyte population is reduced by 10-20%. This progressive
decline in the number and function of melanocytes can be explained perhaps using the
free radical theory of aging, in that successive cycles of melanogenesis produce large
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amounts of reactive oxygen species capable of damaging both mitochondrial and
nuclear DNA, leading to the accumulation of mutations and progressive loss of
function of melanocytes. Gray hairs show a reduction in tyrosinase activity (the rate
limiting enzyme of melanogenesis), whereas white hairs do not possess active enzyme
at all. In general, the development of physiologic gray hair is permanent; however, it
may darken transiently following inflammatory processes, x-irradiation, and some
chemotherapy. During early canities, hair may temporarily repigment with
intermittent bursts of melanogenesis, but this is short lived and should not be taken as
a reversal of the inevitable course of human graying. Although there is no treatment
for physiologic canities, chemical dyes can provide a satisfactory cosmetic solution.
Aging of the Hair Follicle Pigmentary Unit:
Individual scalp hair follicles go through approximately 7-15 melanocytes
seeding / replacements cycles, potentially produce sufficient melanin to intensely
pigment up to 1.5m of hair shaft in the average “Gray free” life span of 45years.Age
of onset of graying also appears to be hereditary, developing in the fourth decade.
There is a specific defect of melanosome Transfer in graying hair follicles, as
keratinocytes may lack melanin granules despite their close proximity to melanocytes
with melanosomes. The remaining hair bulb melanocytes in canities-affected anagen
hair follicles often appear enlarged. Melanocytes in graying and white hair bulbs may
be vacuolated, a common cellular response to increased oxidative stress, and may
disappear very rapidly. Gray hair may be more resistant to incorporating artificial
color.
Melanocyte aging may be associated with reactive oxygen species –mediated
damage to nuclear and mitochondrial DNA with resultant accumulation of mutations
with age, in addition to dysregulation of anti-oxidant mechanisms or pro/anti-
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apoptotic factors within the cells. This dilution is due to a reduction in tyrosinase
activity of hair bulbar melanocytes, sub-optimal melanocyte –cortical keratinocytes
interactions, and defective migration of melanocytes from a reservoir in the upper
outer root sheath to the pigment permitting Microenvironment close to the dermal
papilla of the hair bulb. Dermatological studies are in advance to prove the ability to
grow hair follicle melanocytes in vitro, that the possibilities of reversing canities have
been raised. Melanocytes taken from gray and white hair follicles can be induced to
pigment invitro.
Etiology of Premature Graying of Hairs:
Although the pathophysiology of melanin depletion in hair follicles is
unknown, genetic factors regulate the expression of this trait. Hair graying is
considered a feature of aging. Early hair depigmentation, however, has been linked to
several disorders, including vitiligo, pernicious anemia, and Graves disease.
Regardless of pathophysiology, impaired production of melanin is inherited in an
autosomal dominant pattern. The etiology of premature hair graying is unknown.
Although some of the etiology can be predicted like;
Causes of Premature Graying of Hair:
• Nutritional deficiencies (especially iron or vitamin A, B vitamins, iron,
copper, and iodine in the daily diet & Faulty diet are said to be a contributory
factor.
• Mental worries.
• Unhygienic condition of scalp
• Heredity
• Stress (emotional and physical)
• Hormonal imbalance, specifically androgen sensitivity
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• Genetics
• Immune system irregularities
• Thyroid disorders
• Cosmetics (allergies and harsh treatments)
• Radiation/chemotherapy
• Blood loss
• Drugs
• Disease
• Surgery
Environment, weathering and hair color changes:
While the primary causes of hair color are due to our genes and their effects
on the amount and type of melanin pigment production, there can also be changes in
hair color due to environmental influences. The environment can affect hair in two
ways, by physical action and by chemical reaction. Chemical action on the hair is
arguably becoming more of a problem with the increased frequency of chemical
exposure that individuals encounter with modern living. Melanin pigment can be
altered through interaction with acids and alkalis. Acid interaction darkens hair while
alkali lightens hair color. Whether acid and alkali in air are present in high enough
quantities to significantly interact with hair pigment remains to be determined, but
acids and alkali are encountered in water supplies and as detergents in shampoos.
Such exposure to acid and alkali solutions can affect hair color.
The effect of sunlight on hair can have a direct effect on color that may be
accentuated in the presence of polluted air. With time, UV light degrades melanin
pigment and bleaches the hair fiber. Black and dark brown hair may change into a
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lighter brown. Light brown and blonde hair can be bleached completely white with
chronic sunlight exposure.
Hair color may seem to change as a result of physical actions on the hair or
"weathering". A healthy hair cuticle is fairly smooth and this gives hair a richer color.
However, a poor cuticle is rough and flaky or sometimes the cuticle may be
completely stripped away. This rough surface to the hair fiber results in much
reflection and refraction of light. This gives an observer the impression that the hair
color is lighter than it actually is. The color also has a dull dry appearance. Such
physical weathering and consequent hair color changes most commonly occurs in
people with heavily processed hair, those who use harsh detergents for washing, and
those who excessively brush or otherwise manipulate their hair. In people with long
hair the observer may see a color change from root to tip. The ends of the hair are the
oldest hair and thus will be the most weathered hair. The hair roots are new hair and
the cuticle here should be least damaged. As a result, the hair ends may seem to have
a lighter color than the hair roots.
Bathing in salt water, whether it is sea water or high mineral salt containing
tap water, can affect hair color. Whilst the salts dissolved in water might chemically
interact with the pigment in hair, they may also affect the physical properties of the
hair fiber. As hair washed in salt rich water dries out the salts may crystallize within
the hair fiber and cuticle. This may physically break down the structural integrity of
the hair and lift up the cuticle. The result may be weathered hair and an apparent
reduction in hair color.
Some people are more susceptible to environment induced hair color changes
than others as a result of secondary internal factors such as hormones and general
genetic disposition. So while some people can wash their hair with strong alkali
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detergents with impunity, others with exactly the same hair color may find the same
treatment significantly affects their hair color.
Premature graying has been observed in association with autoimmune disease.
Patients with vitiligo may show generalized depigmentation of scalp hair without
associated amelonotic scalp macules.
Premature graying has also been found among patients with hyperthyroidism
and less commonly hypothyroidism. The pathophysiology of premature aging is
unknown, but its association with various diseases and other traits has been
hypothesized to occur via genetic linkage.
Premature graying also occurs in patients suffering from various genetic
disorders. This is a prominent feature of two premature aging syndromes, Werner’s
syndrome (pangeria) and Hutchinson-Gilford syndrome (progeria). Prematurely gray
hair is often one of the earliest signs of Werner’s syndrome, a rare autosomal
recessive disorder, which usually presents in persons at about 20 years of age, but
sometimes appears as early as 8 years. Other features include sclerodermoid and
atrophic cutaneous changes, accompanied by early cataracts (mean age, 30 years),
arteriosclerosis, osteoporosis, and an increased incidence of malignancy with a
reduced life expectancy.
Stress responses:
Almost any type of physical or mental stress can lead within minutes to
greatly enhanced secretion of ACTH and consequently cortisol as well, often
increasing cortisol secretion as much as 20 fold. This is believed to result from
increased activity in limbic system, especially in the region of Amygdala and
Hippocampus. The inhibitory effect of cortisol on the hypothalamus and on the
anterior pituitary to cause decreased ACTH secretion. So Cortisol has –ve feed back
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effects on 1) The hypothalamus to decrease the formation of CRF and 2) The anterior
pituitary gland to decrease the formation of ACTH. Anterior pituitary hormone is
secreting certain hormones along with ACTH and MSH.
When cortisol secretions is depressed, the normal –ve feed back to
hypothalamus and anterior pituitary gland is also depressed, therefore allowing
tremendous rates of ACTH secretion as well as simultaneous secretion of increased
amounts of MSH. This causes most of the pigmenting effect because they stimulate
formation of Melanin by Melanocytes.
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Hair care:
Beauty has very important role in our life. Hair plays very vital role in our
beauty. A human body without hair would be seen just as a tree without leaves. So
everyone has an ambition that his/her hair should be long, black and thick. As the hair
is a beauty for women as well as men also, hair plays a significant role in personality.
From the ancient time, hair has got exceptional place in our poetry especially for
describing the beauty of women.
It is important to know how we should take care of the hair for its lustrous
ness, blackness, neat, clean and devoid of various germs and diseases.
To maintain the health the causative factors should be mined and due attention should
be paid for the care of hair.
Ayurveda emphasizes self-knowledge and appropriate self-care to keep body
both inwardly and outwardly beautiful and healthy. The conventional practice of
Ayurveda gives guideline to educate people about self-healthcare and provides
medicines or interventions to bring individuals back to a point from where self-
healthcare can be continued. Ayurveda has given special importance to the hair care
in Swastharritta i.e. Dinacharya, Ratricharya, Ritucharya, etc. Different methods and
procedures should be adopted for hair care, which are as follows,
Diet:
It is a fact that, living body requires nutrition and care. Hair is a growing part
on the head of a living person. If the nutrition is not proper the growth is disturbed,
and if the care is not taken at proper time the hairs stars to fall.
Ayurveda says that beauty, health and a fully happy long life is achievable
only by understanding all the aspects of life. Contributing to bringing balance of the
body and mind. There are many guidelines given in the classics, but ultimately this
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information is useful only if it becomes part of our daily life. Getting results is the
best incentive for developing the self-discipline.
Proper diet plays vital role in maintenance of our health. The illness
influences the health of hair.
Table No. 18. Showing the food items which will be helpful to maintain the health of hair:
Vitamins/
Minerals
Sign of deficiency in hair
Found in
A Dandruff, split hair Dark green & orange vegetables, butter, whole milk, corn soy, eggs.
B-12 Hair Loss Corn Soy, whole wheat, wheat germ, almonds, beans, milk, nuts.
B-5 Hair Loss Whole grains, corn, beans, cabbage, cauliflower, sunflower seeds, vegetable oils.
B-6 Dandruff, thinning hair
Brown rice, beans, carrots, cabbage, bananas, wheat germ, buckwheat.
B-9 Hair loss, dull hair Whole grains, salad & green vegetables, wheat germ, milk, mushroom.
C Weak hair roots Asparagus family, Cabbage family, red & green peppers, mung beans, tomatoes, citrus fruits, mangoes, papayas, pineapples, amala.
D Weak hair Sunlight, whole grains, dark greens, butter eggs.
Essential fatty acids
Brittle and lusterless hair, dandruff
Wheat germs, cod liver oil.
Calcium Weak hair Sea vegetable, dark greens, sunflower seeds, milk, cheese, nuts, dried fruit, eggs.
Copper Loss of hair colour Whole grains, eggs.
Iron Brittle hair, thinning hair
Leafy greens, nuts, egg yolk, whole grains.
Silica Dull hair Horsetail herb
Sulphur Brittle lusterless hair Fish, eggs, nuts, cabbage family, apples, beans, onions, currants, sea- food, mushrooms, wheat germ, sunflower seeds.
Zinc Hair loss Seafood, mushrooms, eggs, wheat germs and sunflower seeds.
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Our diet is high in whole grains and other fibers rich foods that provide lasting
energy throughout the day. Fiber helps in proper digestion so Ama will not prepare
and system will be clean.
Diet, which is low in fat, helps to keep the blood clean and prevent a clogging
up of veins, arteries and organ, commonly associated with a diet rich in saturated fats.
Good circulation and the circulatory system work efficiently to cleanse and nourish
the whole system and naturally help weight control.
Low in refined sugars those are empty calories, which only serve to pack on
the weight.
Food which is high in minerals that keeps the body looking a live and charged
with energy. Minerals greatly contribute to that intangible radiant, fresh and magnetic
look of a person in good health. Vegetable proteins fully nourish to body, being
quickly and efficiently metabolized.
Highly salty diet tends to make the mind and body stiff and tight. Having a
constricting influence on the body, it tends to slow circulation and create retention of
fluid.
High in fresh organic foods whenever possible we should eat. These are
nutritionally the richest, coming from healthy soil and thus carry the strongest vital
energy.
A balanced diet rich in protein, minerals, vitamins especially iron, sulphur,
zinc, B complex and vitamin C as well as essential fatty acids is essential for healthy
hair.
Our Acaryas mentioned regarding diets in Dincharya and Ritucharya. They
also stated that person can eat everything according to his own Prakriti but it should
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be taken in particular season and in the day time according to the natural impact of
Dosas at that time.
Shiroabhyanga:
Application of oil on head is called Shiroabhyahga. Acarya Carak stated that
who oiliates his head daily, does not get headache, baldness, gray hair and hair fall.
The strength of his cranial bones is greatly increased and his hair becomes firmly
rooted, flowing and very black83.
So the massage is very important for hair. For thick, strong glossy hair the
roots and scalp must be firm, healthy and well nourished. Too much sunlight exposure
dries the hair and heats the head scalp and hair roots. In this case Massage is
particularly beneficial for hair roots and scalps.
When oil is applied to the head, it gets absorbed deep into the scalp through
the roots of the hair. This nourishes, lubricates and strengthens the hair roots and the
skin of the scalp, preventing hair loss and premature graying. This helps to refresh
both the mind and the body relieving tension and fatigue and improving the
complexion.
This happens because massaging the head will increase fresh oxygen and
glucose supply to the brain and improve the circulation of the spinal fluid around the
brain and spinal cord.
Nutrients are key to the healthy hair, but to be effective they must reach the
roots. Often tension in the scalp or fatty deposits block circulation, drying the sebum
and thus literally starving the hair roots. Massage is the answer for tension relief to
improve circulation and freeing the hair roots of dry sebum.
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Oil massage (Abhyanga) is useful for hair because it gives softness, longness,
blackness and good quantity of hair.
Nasya:
Nasya is a nasal administration of medicated powder or liquid drops. The
word referred here, in the context of hair care denotes the applying of oil through the
nostrils. Nasya has been further classified various subtype.
Pratimarsha nasya is one of them, which is most useful and advisable because
it will be applied any time in the day, in very small dose. Acarya Susruta says that the
proper use of Nasya leads to the stoppage of hair fall, increases length and number of
hair by preventing hair from being gray or white.
According to Acarya Vagbhata, Nasya should be used for the treatment of
Urdhavjatrugataroga. Palitya is taken under this title. It will be Sodhana Karma for
srotas and also helpful to nourish the hair roots.
Snana:
The process of taking bath has been named of Snana in our literature. Acarya
Susruta beholds Snana as a cause of purification of blood. He has stated that it
removes baring sensation, sweating, itching, fatigue and excessive thirst. It is the best
cleaning medium. It relives drowsiness & evil and stimulates the digestive power130.
But the advice against the washing of head and hair with hot water He forbids
the use very cold water for overhead bath too. He further advises that bathing should
be done keeping in view the season and the place. Wash of the hair should be with
warm water that has been advised by our Acarya. The use of strong alkaline soap,
shampoos and the use of dyes should be avoided.
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A massage & washing with herbal shampoo is good to give a thick, strong and
glossy look to the hair, it also makes the scalp healthy and firms the roots of hair.
Traditionally powdered herbs were used to cleanse the hair, lifting dirt without
disturbing the natural functioning of the scalp, such as Amala, Aritha, Heena,
Shikakai, Bhringraj etc.
Avoid shampoos that act as shedding agents such as sodium and ammonium
laurel sulphate. The foam they make has little to do with their cleansing effect. They
are simple harsh chemicals that strip the outer layer of protein of the hair and dry the
scalp, making the use of conditioners necessary. conditioners do little more then
provide an oily film that traps dirt and makes the hair look dull. They are not
necessary for healthy hair.
Ushnishadarana :
Acarya Susruta has stated that the wearing of Ushnisha gives protection from
wind, sun rays and dust etc. it maintains cleanliness and is beneficial for hair.131
Heat is the most detrimental factor for the hair. Too much sunlight exposure
dries the hair and heats the head and makes the scalp and hair roots weakened. High
level of heat caused by Pitta within the body can also damage the hair from the roots.
As Pitta naturally has the greatest amount of body heat, they are most prone to
premature graying and balding who are naturally having high amount of Pitta in their
body.
Protection to the hair can be obtained by wearing a hat or head scarf. Other
Acarya have also mentioned Ushnisha as a Keshya (good for hair).
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Dhoomapana:
The procedures of inhaling of medicated smokes to the nose through a smoke
stick are called Dhoompana. It has been described in the Dincharya. Acarya Carak
says that Dhoomapana is beneficial for Palitya and Khalitya. Further he added that
oral smoking might be useful to other parts of the body and head132.
According to Acarya Susruta inhalation of medicated fumes improve the
firmness of hair on the head, beard and teeth133.
Combing and Cutting: (Kshaura karma)
The care of the hair includes good hygienic habits and also avoidance of bad
practice that damage the scalp. Combs and brushes must be kept thoroughly clean.
Accumulated hair and dandruff scales are made return to the scalp from uncleaned
combs and brushes may irritate the scalp and thus harm the hair.
Combs and brushes are the tools for the care of the hair; they should be
properly made and well cared to accomplish this purpose. The comb should not be so
sharp as to injure the scalp. Generally the teeth should be smooth and not be set too
closely. Brushes should be made of stiff bristles, set for a part and should be kept
clean and occasionally sterilized. The barbers, of course, use a common comb and
brushes, but that should also be sterilized them each time before use. A careless
barber should be avoided thereafter.
Cutting the hair & change the hairstyle is a fashion. But it is a harmful because
combs & brushes used by barber, it may be causes for infection, dandruff and loss of
hair. In these cases, the nutritional state of the hair is below par. We should avoid the
frequent use of these.
In Bhavaprakash Acarya Bhavmishra says that we have to use comb regularly,
because it protects hair from Jantu & Mala etc. Acarya Susruta has explained a
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combing procedure also. The management of hair (Keshprasaadhana) is said to be
done with Kesha Prasaadhani (Combs & Brushes) and believed to be “Keshya”,
which increases the beauty of hair. By regularly cutting the hair (Keshavamarjana) a
person may achieve vigor, happiness, lightness and good look etc.
Nowadays everyone use hair tonic/lotion/cream/dye etc. to make the hair
healthy. They are virtually cosmetic drugs, which give temporary improvement, but it
becomes harmful for hair when it is made by chemical. If improved appearance can
be accomplished without making the hair brittle or irritating the scalp, there is no
objection to their use. Hair spray may be used to smooth the hair to cause certain
pattern of appearance. The spray contains various chemical substances, which is also
harmful for hair.
Tips to protect hair: Dietaries:
• Balanced diet is basic requirement for keeping the hair halthy.
• Frequent fasts should be avoided.
• Food should be taken in time regularly as per routine schedule.
• All the food items from the bazaar should be avoided and especially the items
with acrid taste, Excessive oil, Soda bicarbonate, Citric acid and Sourness
should be avoided.
• Cold and unfresh food items kept in freeze should not be used.
• Wheat, Ghee, Milk, Buttermilk, sprouted beans, Butter and Pulses are
beneficial for hair.
• All addiction like Tea, Coffee, Tobacco, Betel nuts, Smoking and Cold
beverages, Ice-cream etc. must be restricted, as they are harmful for hairs.
• The use of Vegetable ghee must be ceased and the intake of green vegetable,
beans should be increased.
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Behavioral:
• Oil should be applied only after the hair are properly dried after washing.
• Hair and scalp must be oilated daily.
• Oiling the hair before washing them is a must as washing dry hair is harmful.
• If possible, the tender and warm rays of the sun of early morning should be
seeked after massaging oil all over the body.
• The massage must be done with the fingertips all over the scalp especially
around the hair roots.
• Vigorous massage or rubbing must be avoided.
• The use of artificial chemical hair cream, hair lotion, hair dye etc. must be
avoided.
Washing the hair:
• Always a luke warm water i.e. neither very hot nor very cold must be used to
wash the hair according to the season.
• Washing of hair with hard water should be avoid, because contain of water are
harmful for hair.
• If the hairs are greasy and itching is persistent, then the hair should be washed
with slightly hot water.
• While washing the hair, they must be rinsed by the tips of the fingers.
• For washing the hair keep the head at slight high level or lower level and keep
the hair in front side there after pour the water over the scalp.
• The hair should be dried with the help of a clean towel, with very light hands,
in open air.
• Vigorous throbs, jerks or rubbing must be avoided.
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• The use of shampoo, strong soaps etc. should be ceased for washing the hair
and instead of that herbal drugs must be used.
• Hair must be washed regularly.
Management of hair:
• The cogs of the combs and the bristles of the brushes must not be very hard
and sharp and round ended. They must be blunt at the tips.
• Hairs should be combed or managed with soft and light hands.
• The hair must be combed and managed properly before going to bed at night.
• The Brushes, Combs etc. must be kept separate for each individual and they
must be washed with the help of germicide at least once in week in hot water.
• The Brushes, Clips, Combs etc. should not be borrowed from others.
• The use of Clips, Curling the hairs and the use of hot and dryers is harmful to
hairs.
• Frequent hair cutting, repeated use of hair dyes, change of hairstyles, use of
various hair sprays etc. are harmful for hairs.
Miscellaneous:
• The bed sheets, pillows etc. should be neat and clean.
• Open air or properly ventilated place must be sought for sleeping.
• Loitering on moist lawn early in the morning is beneficial for hair.
• Getting up early in the morning is good.
• Regular and proper sleep must be taken. Waking up till late in night and
sleeping during the day, both are equally harmful for hair.
• One should always keep away from anger, worries, grief, and mental stress
and strain as well as lead a calm and quite life full of joy.
• Roaming with open head in sun light and excessive labor are the risk factors
for hair loss.
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Drug review
Drug review:
Charaka has said that for the successful management of the disease, it is
essential to select proper medicine134. The treatment without drug would be same as
ciphers without figures. Etymological derivation of the word “Drug” is from the
French word “Drogue”. It may be defined as “any substance which when taken by a
living organism may modify one or more functions”. Acharya Charaka has asserted
that each substance on this earth is useful in combating illness when applied with
planning and for a specific purpose135.
In Ayurveda, the success of Chikitsa depends totally upon Chikitsa
Chatushpada. Drug is a part of quadruped of the treatment, which has been placed
next to the physician136. The selection of the proper drug in the management of
disease is very important.
W.H.O. defines drug as a substance or product that is used or intended to be
used to modify or explore physiological system or pathological status for the benefit
of the recipient.’ Ayurveda was the first to give an elaborate description of various
therapeutic measures not merely of radical removal of the causative factors but also at
the restoration of Dosha equilibrium.
To have an idea about the qualities of the drugs used in this study the
description of those drugs are given here below.
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Nimba:137, 138
Latin Name: Azadirecta indica.
Family: Meliaceae.
Figure No. 04. Showing the drug Nimba:
Synonyms: Pichumarda, Aristha, Tiktaka Gana: Shirovirechaka gana (Cha.Vi.8)
Chemical composition: It contains glycerides of Saturated and Unsaturated fatty
acids. The main fatty acids are Oleic acid-50% and Stearic acids- 20%. It contains
2% of bitters, which are Sulphur compounds, having Anti viral, insecticide
Antimicrobial, and Nematicide actions. The unsaponifiable part contains chemical
Nimbosterol (0.03%). It is Steroidal Alkaloid.
Useful parts: Beeja, Twak, Patra, Pushpa.
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Table No. 19. Showing the properties of Nimba:
Dravya Nimba Nimba Taila Nimba beeja
Rasa Tikta , Kashaya Tikta Tikta
Guna Laghu Laghu Laghu
Virya Sheeta Ushna Ushna Vipaka Katu
Katu
Katu
Doshagnata Kapha –Pitta Vatahara, Kaphahara
Vatahara
Karma
Grahi, Krimigna,
Twagdoshahara,
Bahya: Kushtagna , Vranaropana, Keshya
Antaha :Nasya – Palitya ,Khalitya , Rasayana
Krimi, KushtaShodhana. Yoni Vishodhana, Garbhashaya Uttejaka
• ÌlÉqoÉ . . . . . . . .iÉæsÉÉÌlÉ iÉϤhÉÉÌlÉ sÉbÉÔÌlÉ EwhÉuÉÏrÉÉïÍhÉ
MüOÕûÌlÉ MüOÒûÌuÉmÉÉMüÉÌlÉ xÉUÉÍhÉ AÌlÉsÉ MüTüM×üÍqÉMÑü¸
mÉëqÉåWû ÍzÉUÉåUÉåaÉWûUÉÍhÉ cÉåÌiÉ ||
(xÉÑ.xÉÔ45/115)
• ÌlÉqoÉxrÉ iÉæsÉÇ mÉëM×üÌiÉxjÉqÉåuÉ lÉxrÉå ÌlÉÌwÉ£ÇüÌuÉÍkÉlÉÉ
rÉjÉÉuÉiÉç |
qÉÉxÉålÉ aÉÉå¤ÉÏUpÉÑeÉÉå lÉUxrÉ rÉjÉÉaÉëpÉÔiÉÇ mÉÍsÉiÉÇ
ÌlÉWûÎliÉ ||
(pÉæ.U)
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Bringaraja:139, 140
Latin Name: Eclipta Alba.
Family: Compositae.
Figure No. 05. Showing the drug Bringaraja:
Synonyms: Markava, Kesharanjana, Markav, Bhringha, Keshya.
Chemical Constituents: Alkaloids like Ecliptin and Nicotin.
Useful parts: Panchanga Swarasa.
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Table No. 20. Showing the properties Bringaraja:
Dravya Bhringaraja
Rasa Katu , Tikta
Guna Ruksha , Laghu
Virya Ushna
Vipaka Katu
Doshagnata Kapha – Vata
Karma Keshya , Varnya , Rasayana , Twachya
• pÉ×…¡ûUÉeÉÉxiÉÑ cɤÉÑwrÉÉÎxiÉ£üÉåwhÉÉÈ MåüzÉUgeÉlÉÉÈ|
MüTüzÉÉåTüÌuÉwÉblÉÉ¶É iÉ§É lÉÏsÉÉå UxÉÉrÉlÉ|| (UÉ.ÌlÉ)
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Drug review
Narikela taila:141 Latin name: Cocos nucifera.
Family: Palmaeae.
Figure No. 06. Showing the drug Narikela:
Synonyms: Narikela taila ,Narikera taila ,shriphala taila, Sadaphala taila
Chemical composition: Matured fruit contains 60-70% oil, Oil ontains Vit-A&B,
lipids-100gms, Iron-0.04gms,VitA-0.28gms, fattyacids-86.5gms, coproice-
600gms,caprolice-7.5gms, capric-6.0gms,lauric-44.6gms, miristic-
8.2gms,palmitic-8.2gms, steamic-2gms, monounsaturated fattyacids-5.8gms,
linoleic -1.8mgs,phytosterol-86.0mg.
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Drug review
Table No. 21. Showing the properties of Narikela:
Dravya Narikela
Rasa Madhura
Guna Guru, Snigdha
Virya Sheetha
Vipaka Madhura
Doshagnata Vata – Pitta shamaka
lÉÉËUMåüsÉÉå°uÉÇ iÉæsÉÇ oÉ×ÇWûhÉÇ oÉsÉuÉkÉïlÉqÉç |
MåüzrÉÇ ÌmɨÉÉÌlÉsÉWûUÇ SlirÉÇ qÉSÒUqÉåuÉ cÉ|| (Mæü.ÌlÉ)
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Methodology
Methodology:
Materials used for the study:
The materials used for the study were;
Nimba beeja Taila(Moorchita) – For Nasya.
Bringaraja Taila – For Shiroabyanga.
Materials used for Nasya karma:
• Nasya Shayana table.
• Bashpasweda yantra.
• Gokarna.
Materials used for Shiroabyanga:
• A chair. (for sitting the patient)
• Small bowl. (to take oil)
Moorchana of Nimba beeja Taila:
Nimba Taila was collected from the market and done Moorchana in the
department of Rasashastra and Bhaishajya kalpana, D.G.M.A.M.C. and H. Gadag,
according to the classical method explained in Sharangadara Samhitha142.
For the Taila Moorchana 1/16 part of manjishta, 1/64 part of Haritaki,
Vibhitaki, Amalaki, Musta, Haridra, Lodra, Vatankura, Hrivera, Nalika,
Ketakipushpa, 1 part of Nimba Taila and 4 parts of Jala was taken and reduced for
Taila avasesha.
Preparation of Bringaraja Taila:
Ingredients: Coconut oil.
Bringaraja swarasa.
Bringaraja kalka.
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Methodology
A total of 15 liter of taila was prepared in the department of Rasashastra and
Bhaishajya kalpana, D.G.M.A.M.C. and H. Gadag. The taila was prepared according
to the tailapaka method of Sharngdhara Samhita.
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Methodology
Methods:
Type of study:
An observational clinical study.
Source of data:
Patients suffering from Palitya were selected from O.P.D & I.P.D, Dept of
Panchakarma, P.G.S & R.C, Shri D.G.M.A.M.C. & H, Gadag after following the
Inclusion and Exclusion criteria.
Sample size:
30 patients of Palitya irrespective of sex, aged between 15-35 year were
selected in a single group.
Selection of patients:
After fulfilling the criteria set in the form of inclusion and exclusion criteria,
30 patients were randomly selected and distributed in single group.
Inclusion criteria:
• All males and females with premature graying of hair.
• Patients aged between 15-35 years.
• Patients fit for Nasya and Shiroabyanga.
Exclusion criteria:
• Hereditary diseases like Albinism.
• Nutritional deficiency.
• Diagnosed case of infertility.
• Patients with infectious diseases of the scalp.
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Methodology
• Patient unfit for Nasya and Shiroabyanga.
Diagnostic criteria:
Diagnosis is made on the basis of the classical signs and symptoms as
mentined in ayurvedic classics, like
• Split/broken hair (spuditha)
• Ash colored hair (shyava varna)
• Hair resembling like water (jala prabham)
• Yellowish hair (peetabham)
• White hair (sukla varna)
Posology:
Nasya: 8 drops of Nimba taila in each nostril143.
Study duration:
3 Courses of Nasya- Each course of 7 days with 3 days rest in between each
course.
Follow up: 30 Days
Assessment of result:
Assessment of results was done on the basis of readings of subjective and
objective parameters before and after the treatment. The outcome of the observation
were analysed statistically for ‘p’ value using‘t’ test.
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Methodology
Subjective parameters:
The following four parameters were taken as subjective parameters for the
assessment of results. The readings before and after the treatment were assessed for
result.
Table No. 22. Showing the subjective parameters: Assessment Score Krishna varna 0 Ash colored hair (zrÉÉuÉ uÉhÉï) 1 Yellowish/Copperish hair (mÉÏiÉÉpÉÇ) 2
1
Color of the hair (Kesha varna)
White hair (zÉÑYsÉ uÉhÉï) 3
Assessment ScoreNormal 0 Dryness visible 1 Dryness felt by touch 2
2
Dry splited hair (RookshaSpudita) Dryness felt with splitted hairs 3
Assessment ScoreNormal 0 Unctuous visible 1 Unctuous felt by touch 2
3
Unctuous thick hair (Snigda Sthula)
Unctuous felt with splitted hairs 3
Assessment ScoreNo burning sensation 0 Mild (localized burning without disturbed sleep) 1 Moderate (localized burning with disturbed sleep) 2
4
Burning- sensation (Daha)
Severe (burning all over the scalp with disturbed sleep)
3
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Methodology
Objective parameters:
1. Area of scalp involved (%)
The percentage of the effected scalp area was estimated with Olsen/Canfield
visual aid144. In this the scalp is divided in four regions: frontal (F), bitemporal (T),
midscalp (M), and vertex (V).
Figure.7. showing Olsen/Canfield visual aid:
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Methodology
Using this diagram, the percentage of scalp grey hair in a given quadrant was
determined and multiplied this by the total scalp area delineated by that quadrant and
sum the resultant numbers for each quadrant to give the total percent of grey hair in
the scalp. Then the percentage difference was calculated before and after the
treatment.
Table No. 23. Showing the parameter Area of scalp involved: Assessment Very good Response >75% Good Response 50-75% Satisfactory Response 25-50%
Area of scalp involved (%)
Poor Response <25%
2. Random hair count:
One square centimeter area of scalp was chosen where more gray hairs are
present from this site gray hairs were counted randomly before and after the
treatment.
Table No. 24. Showing the parameter random hair count: Assessment Score No hairs gray 0 1-10 gray hair 1 More than 10 and less than 25 gray hairs 2
Random hair count
More than 25 gray hairs 3
Overall assessment of clinical response:
Very good Response : >75% improvement in overall clinical parameters.
Good Response : 50-75% improvement in overall clinical parameters.
Satisfactory Response : 25-50% improvement in overall clinical parameters.
Poor Response : <25% improvement in overall clinical parameters.
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Methodology
Procedure:
Previous day patients were examined and explained about the Shiroabyanga
and Nasya briefly and were asked to bring extra clothing, napkin, towel etc.
preferably the time chosen was morning hours.
Shiroabyanga :
Requirements:
1. Comfortable knee height chair.
2. Bowl of 100ml capacity.
3. Bringaraja taila – 20ml approximately.
Poorvakarma:
• Patient asked to evacuate the bowel and urine.
• Mangalacharana.
Pradhanakarma:
Patient made to sit on a Knee height chair. Procedure was carried out by
standing behind the patient. Approximately 20ml of lukewarm Bringaraja taila was
taken in the hands and applied over the head of the patient. Then the oil was spread all
over the head including neck, ear pinna and face. After that mild massage was done
with fingers for 15min.
Paschathkarma:
• Rest for 10min.
• Prepared the patient for Nasya karma.
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Methodology
Nasya karma:
Requirements:
1. Table with the facility to lower the head portion.
2. Nimba taila (8 drops).
3. Cotton towel for Swedana.
4. Nasya droper.
5. Dhooma netra.
6. Spittoon.
Poorvakarma:
• Abyanga over face, scalp and neck.
• Mrudu Swedana over face, scalp and neck.
Pradhanakarma:
Patient made to lye down in supine position on Nasya table. The head of the
patient is lowered (Pravilambita) up to an extent. Eyes of the patient were covered
with a clean cloth, the tip of patients nose was drawn upward by the left thumb. At the
same time with the right hand instilled 8 drop of lukewarm Nimba taila in both the
nostrils, alternately and asked the patient to inhale deeply.
Paschathkarma:
Patient in lying position is asked to count up to 100 matra i.e. approximately 2
minutes. After administration of Nasya feet, shoulders, palms and ears were
massaged. Again mild fomentation was done on forehead, cheeks and neck. For
pacifying Vata dosha, Rasna churna was rubbed on head. The patient was asked to
expel out the drug which comes in oropharynx. Medicated Dhumpana and Gandusha
were advocated to expel out the residue mucous lodged in Kanta.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
110
Methodology
Procedure of Shiroabhyanga and Nasya
Fig.8. Shiroabhya
Fig.9. Nasya karma
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
111
Observation & Results
Observation:
The observation of the patients and the disease was done by providing the
questionnaire to those patients who can fill the case sheet and from those who can’t
fill; the information was collected by translating the questions in the local language.
The case sheet is attached in the appendix. All the patients were examined thoroughly
before their inclusion in the study. The observation was done by considering the
subjective and objective parameters strictly.
The observations were done and are depicted in form and graphs are used
where ever necessary.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 114Shiroabhyanga in Akala Palitya
Observation & Results
Observation of demographic data:
Table No 25: showing the distribution of patient’s age group:
Age Group No of Patients Percentage 15 - 25 21 70 26 - 35 09 30
Among 30 patents 21 (70%) were from 15-25 age group, 9 (30%) from 26-35 age group.
Fig No 10: showing the distribution of patient’s age group:
0
5
10
15
20
2515-25
26-35
Table No 26: showing the distribution of patients according to sex:
Sex No of Patients Percentage Male 12 40 Female 18 60 Among 30 patients Distribution of sex was; male 12 (40%) and females were 18 (60%) Fig No 11: showing the distribution of patient’s sex group:
0
5
10
15
20Male
Female
Table No 27: showing distribution of patients by Religion:
Religion No of Patients Percentage Hindu 27 90 Muslim 02 6.6 Christian 01 3.3 Others 00 00
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 115Shiroabhyanga in Akala Palitya
Observation & Results
Among 30 patients, Hindus were 27 (90%), were Muslims were 02 (6.6%), and
Christians were 01 (3.3%).
Fig No 12: showing the distribution of patient’s Religion:
0
5
10
15
20
25
30 Hindu
Muslim
Christian
others
Table No 28: Showing distribution of patients by occupation:
Occupation No of Patients Percentage Labor 00 00 Student 28 93.3 Executive 00 00 Sedentary 02 6.6 Among 30 patients, no labors, no executives, students were 28 (93.3%), and sedentary
workers were 02 (6.6%)
Fig No 13: showing the distribution of patient’s Occupation:
0
5
10
15
20
25
30Labour
Student
Executive
Sedentary
Table No 29: showing distribution of patients by Economical status:
Economical status No of Patients percentage Poor 00 00 Middle class 30 100 Higher class 00 00
Among 30 patients all were from middle class family.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 116
Shiroabhyanga in Akala Palitya
Observation & Results
Fig No 14: showing distribution of patients by Economical status:
0
5
10
15
20
25
30Poor
middle class
higher class
Table No 30: Showing the distribution of Patients by Dietary habit:
Diet No of Patients Percentage Vegetarian 22 73.3 Mixed 08 26.6 Among thirty patients 22(73.3%) were vegetarian, 08(26.6%) were having mixed dietary habit, Fig No 15: Showing the distribution of Patients by Dietary habit:
05
10
15
20
25Vegetarian
Mixed
Table No 31: Showing the distribution of Patients by Agni: Agni No of Patients Percentage
Mandha 03 10.00 Teekshna 00 00.00 Vishama 01 03.33 Sama 26 86.66 Among thirty patients 03(10%) were having Mandha agni, 00 (00%) were having
Teekshna agni, 01 (3.3%) were having vishama agni and 26 (86.66%) were having
sama agni .
Fig No 16: Showing the distribution of Patients by Agni:
0
5
10
15
20
25
30 Mandha
Teekshna
Vishama
Sama
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 117Shiroabhyanga in Akala Palitya
Observation & Results
Table No 32: Showing the distribution of Patients by Koshta:
Koshta No of Patients Percentage Mrudu 00 00 Madhyama 30 100 Krura 00 00 Among thirty patients all were having Madhyama koshta.
Fig No 17: Showing the distribution of Patients by koshta:
0
5
10
15
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 118
20
25
30Mrudu
Madhyama
Krura
Table No 33: Showing the distribution of Patients by Nidra:
Nidra No of Patients Percentage Prakruta 10 33.3 Alpa 19 63.3 Ati 00 00 Diwaswapna 01 3.3 Among thirty patients 19(63.3%) were having Prakrutha nidra, 10 (33.33%) were
having Alpa nidra, none were having Ati and 01 (3.33%) Diwaswapna category.
Fig No 18: Showing the distribution of Patients by Nidra:
0
5
10
15
20Prakruta
Alpa
Ati
Diwaswapna
Table No 34: Showing the distribution of Patients by Vysana:
Vysana No of Patients Percentage None 22 73.3 Tea 00 00 Coffee 00 00 Tobacco 03 10 Smoking 02 6.6 Alcohol 03 10
Shiroabhyanga in Akala Palitya
Observation & Results
Among 30 patients 22 (73.33%) patients were not having any habits, 03 (13.33%)
patients were had Tobacco chewing habit, 02 (06.66%) were had smoking habit and
03 (10.00%) were had the habit of taking alcohol.
Fig No 19: Showing the distribution of Patients by Vysana:
0
5
10
15
20
25 Noneteacoffeetobaccosmokingalcohol
Table No 35: Showing the distribution of Patients by Deha prakrithi :
Deha prakriti No of Patients Percentage Vata 00 00% Pitta 00 00% Kapha 00 00% Vata-pitta 14 46.66% Vata-kapha 04 13.33% Pitta-kapha 12 40% Sannipataja 00 00% Among 30 patients, 14 patients of Vata–pitta prakriti (46.66%), 04 patients of Vata–
kapha prakriti (13.33%) and12 patients of Pitta–kapha prakritti (40%). No patients
reported with Vata, Pitta , Kapha, sannipatha prakriti in this study.
Fig No 20: Showing the distribution of Patients by Deha prakrithi:
0
2
4
6
8
Vata PittaKaphaVata-pittaVata-kaphaPitta-kaphaSannipataja
14 12
10
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 119Shiroabhyanga in Akala Palitya
Observation & Results
Table No 36: Showing the distribution of patients by Satmya:
Satmya No of patients Percentage Ekarasa 00 00
Sarvarasa 00 00 Vyamisra 30 100
Among 30 patients all the patients were i.e.30 (100%) Vyamisra satmya. None of
them were in other two catogary.
Fig No 21: Showing the distribution of patients by Satmya:
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 120
0
8
16
24
32 ekarasa
sarvarasa
vyamisra
Data Related to Disease: Table No 37: Showing the distribution of patients by color of hair:
Color No. Of Patients Percentage Krishna varna 00 00.00 Shyava varna 01 03.33 Peeta varna 08 26.66 Shukla varna 21 70.00 Among the 30 patients, 21 patients had the shukla varna(70%) and 08 patients were
having peetha varna(26.66%) and one patient was having Shyava varna(03.33%).
Fig No 22: Showing the distribution of patients by color of hair:
0
5
10
15
20
25 krishna
shyava
peetha
shukla
Shiroabhyanga in Akala Palitya
Observation & Results
Table No 38: Showing the distribution of patients by nature of hair:
Nature of hair No of Patients Percentage
Sphuditha 10 33.33 Khara 00 00.00 Rooksha 18 60.00 Snigdha 12 40.00 Stoola 00 00.00 Among the 30 patients, 10 patients had Spuditha hair(33.33%) and 18(60%) patients
had the Rookshata of hairs and 12 (40%) were having Snigdhata of hairs, and nobody
was having khara and stoola type of hair.
Fig No 23: Showing the distribution of patients by nature of hair:
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 121
0
5
10
15
20
1 0
khara
rooksha
snigdha
stoola
Table No 39: Showing the distribution of patients by Anubandha vedana:
Anubandha vedana No. of Patients Percentage Shirashoola 07 23.33 Kapala daha 07 23.33 sparshanasha 00 00.00
Among 30 patients 07 patients had Shirashoola (23.33%).07 patients had Kapala
daha(23.33%) and no patients were suffering from sparshanasha.
Fig No 24: Showing the distribution of patients by Anubandha vedana:
0
2
4
6
8shirashoola
kapaladahasparshanasaha
Shiroabhyanga in Akala Palitya
Observation & Results
Table No 40: Showing the distribution of patients by Mode of onset:
Mode of onset No of Patients Percentage Sudden 00 00.00 Gradual 30 100 Insidious 00 00.00 Among 30 patients all the patients were i.e.30 (100%) having gradual onset. None of
them were in other two catogary.
Fig No 25: Showing the distribution of patients by Mode of onset:
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
122
0
0.5
1
1.5
2 sudden
gradual
insidious
Table No 41: Showing the distribution of patients by Site of onset:
Site of onset No of Patients Percentage Vertex 12 40.00 Frontal 11 36.66 Temporal 09 30.00 Parietal 07 23.33 Occipital 06 20.00
Among the30patients, 12 patients had onset on vertex (40%), 11 patients had onset on
frontal (36.66%) 09 patients had onset on temporal (30%) 07 patients had onset on
parietal (36.66%) and 06 patients had onset on occipital (20%)
Fig No 26: Showing the distribution of patients by Site of onset:
0
2
4
6
8
10
12 vertex
frontal
temporalparietal
occipital
Observation & Results
Table No 42: Showing the distribution of patients by Kula vrutantha:
Kula vrutantha No of Patients Percentage Maternal 18 60.00 Paternal 19 63.33
Among the 30 patients, 18 patients (60%) had maternal history and 19 patients
(63.33%) had paternal history
Fig No 27: Showing the distribution of patients by Kula vrutantha:
17.5
18
18.5
19maternal
paternal
Table No 43: Showing the distribution of patients by head bath:
Head bath No of Patients Percentage Daily 13 43.33 Occasionally 17 56.66
Among the 30 patients, 13 patients had (43.33%) daily head bath, and 17 patients had
(56.66%) occasional head bath.
Fig No 28: Showing the distribution of patients by head bath:
0
5
10
15
20daily
occasionally
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 123
Shiroabhyanga in Akala Palitya
Observation & Results
Table No 44: Showing the distribution of patients by Type of water for head bath
Type of water No of Patients Percentage Cold 04 13.33 Hot 26 86.66 Hard water 30 100 Soft water 00 00.00 Among the 30 patients 04 patients (13.33%) were using cold water for head bath, 26
patients (86.66%) were using hot water for head bath, all 30 patients (100%) were
using hard water for head bath, and none of them were using soft water for head bath.
Fig No 29: Showing the distribution of patients by Type of water for head bath:
0
10
20
30cold
hot
hard
soft
TableNo45:Showing the distribution of patients by Materials used for hair wash:
Materials No of Patients Percentage Shampoo 22 73.33 Soap 11 36.66 Herbal 01 03.33 Among the 30 Patients, 22 patients (73.33%) were using shampoo for hair wash, 11
patients (36.66%) were using soap for hair wash, and 01patient(03.33%) was using
herbal material for hair wash.
Fig No 30: Showing the distribution of patients by Materials used for hair wash:
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 124
5
0
10
15
20
25 shampoo
soap
herbal
Shiroabhyanga in Akala Palitya
Observation & Results
Table No 46: Showing the distribution of patients by Methods of hair drying:
Methods of hair drying No of Patients Percentage Towel 30 100 Electric hair dryer 08 26.66 Sunlight 09 30.00 Among the 30 Patients, all 30 patients (100%) were using towel for drying the hair,
08 patients (26.66%) were using electric hair dryer, and 09 patient(30%) were using
sunlight for drying the hair.
Fig No 31: Showing the distribution of patients by Methods of hair drying
05
10
15
20
25
30 towel
electrichair dryer
sunlight
Table No 47: Showing the distribution of patients by using hair oil:
Hair oil No of Patients Percentage Daily 14 46.66 Occasionally 16 53.33 Among the 30 patients, 14 patients were (46.66%) using hair oil daily head, and 16
patients (53.33%) were occasionally using hair oil.
Fig No 32: Showing the distribution of patients by using hair oil
13
14
15
16daily
occasionally
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 125Shiroabhyanga in Akala Palitya
Observation & Results
TableNo 48: Showing the distribution of patients by using hair dye:
Hair dye No of Patients percentage Herbal 08 26.66 Chemical 06 20.00 Not applies 18 60.00 Among the 30 patients 08 patient (26.66%) were using herbal hair dye, 06 patient
(20%) were using chemical hair dye and 18 patient (60%) were not applies any hair
dye.
Fig No 33: Showing the distribution of patients by using hair dye
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 126
0
5
10
15
20 herbal
chemical
not applies
Data Related to Overall Response to the treatment: TableNo 49: Showing the distribution of patients according to response
Response No. Of Patients Percentage Very good 00 00.00
Good 00 00.00
Satisfactory 13 56.66
Poor 17 43.33
In the study, no patients had very good as well as good response. Among 30 patients
13 Patients (43.33%) had satisfactory response to the treatment (25%-50%
improvement in all the parameters), 17 Patients (56.66%) had poor response to the
treatment (<25% improvement in all the parameters).
Fig No 34: Showing the distribution of Overall Response to the treatment
0
5
10
15
20very good
good
satisfactory
poor
Shiroabhyanga in Akala Palitya
Observation & Results
Observation of the statistical out comes of the study: Table No 50: Showing the before treatment and after treatment values of all Parameters.
Clinical parameters Color of the hair
Dry splited
hair
Unctuous thick hair
Burning sensation
Random hair
count
Area of scalp
involved (%)
Sl. No.
OPD No.
B A B A B A B A B A B A
01. 4247 3 3 0 0 2 0 0 0 3 2 22 17 02. 5064 3 3 3 0 0 0 1 0 3 2 34 29 03. 5065 3 3 2 0 0 0 0 0 2 2 37 30 04. 4046 3 3 2 0 0 0 0 0 3 2 44 39 05. 4048 3 3 2 0 0 0 0 0 3 2 22 18 06. 4053 3 3 2 0 0 0 0 0 3 2 25 18 07. 4054 3 3 0 0 2 0 0 0 2 1 42 35 08. 7576 2 2 2 0 0 0 0 0 2 2 40 35 09. 7577 3 3 3 0 0 0 1 0 3 3 50 45 10. 8843 3 3 0 0 2 0 0 0 2 1 21 15 11. 8981 2 1 0 0 3 1 1 0 2 2 34 28 12. 13259 1 1 2 0 0 0 0 0 3 2 23 18 13. 13261 3 3 3 0 0 0 0 0 2 1 16 12 14. 13262 3 3 0 0 2 0 2 0 2 2 20 18 15. 13265 3 3 2 0 0 0 0 0 3 3 40 36 16 13403 3 3 0 0 2 0 0 0 3 2 30 26 17 14638 2 2 2 0 0 0 1 0 3 3 42 37 18 15220 3 3 2 0 0 0 0 0 2 1 20 16 19 15222 2 1 0 0 3 0 0 0 3 2 35 30 20 15224 3 3 2 0 0 0 0 0 2 2 21 16 21 15231 2 1 0 0 3 0 0 0 2 2 14 11 22 15232 3 3 2 0 0 0 2 0 2 1 27 20 23 15233 2 1 2 0 0 0 0 0 2 2 28 23 24 15318 3 3 0 0 3 1 2 0 2 2 26 19 25 15322 2 1 3 1 0 0 0 0 3 2 31 24 26 15324 3 3 3 1 0 0 0 0 3 2 30 22 27 15327 2 1 2 0 0 0 0 0 2 2 22 19 28 15331 3 3 0 0 3 1 0 0 3 2 33 29 29 15336 3 3 0 0 2 0 0 0 2 2 27 20 30 18228 3 3 0 0 2 0 0 0 2 2 26 22
Abbrevation Used: B- Before treatment
A- After treatment
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 127Shiroabhyanga in Akala Palitya
Observation & Results
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
128
Table No 51: Showing Statistical analysis of parameter value:
Mean Parameter BT AT
Net Mean
SD SE T-value
P-value Remarks
Colour of Hair
2.666 2.466 0.2 0.406 0.0742 2.695 <0.02 HS
Dry splitted
Hair
1.366 0.066 1.3 1.118 0.204 6.375 <0.001* HS
Unctuous thick Hair
0.966 0.1 0.8667 1.105 0.201 4.311 <0.001* HS
Burning Sensation
0.333 0.0 0.333 0.660 0.120 2.775 <0.01 HS
Random Hair count
2.466 1.933 0.533 0.5074 0.0926 5.755 <0.001* HS
Area of Scalp
involved
29.4 24.233 5.166 1.464 0.267 19.348 <0.001* HS
This study will be more effective on Area of Scalp involved, Dry splitted hair,
Random Hair count and Unctuous thick Hair parameters with this treatment
procedure.
Conclusion:
From the analyses all parameters shows highly significant as P<0.05. There is
a more highly significant in the parameters Area of Scalp involved, Dry splitted hair,
Random Hair count and Unctuous thick Hair (as P<0.001). The parameters color of
Hair and Burning sensation shows less highly significant (By comparing P-value and
T-value).
* = More highly significant. To know on which parameters the combined efficacy of Nimba taila Nasya
and Bringaraja taila Shiroabyanga is more effective, the statistical analyses is done by
using paired t-test, by assuming that the treatment procedure is same in all the
parameters.
Demographic data
Table No. 52. Showing Demographic data in patients: Sex Religion Occupation Economical
status Response Sl.
no OPD No.
Age Yrs
M F H M C O St L E S P M H V G S P01 4247 15 - + + - - - + - - - - + - - - + -02 5064 17 + - + - - - + - - - - + - - - - +03 5065 17 + - + - - - + - - - - + - - - - +04 4046 26 + - + - - - + - - - - + - - - - +05 4048 27 + - + - - - + - - - - + - - - - +06 4053 27 + - - - + - + - - - - + - - - + -07 4054 26 + - + - - - + - - - - + - - - - +08 7576 25 - + + - - - + - - - - + - - - - +09 7577 30 + - + - - - + - - - - + - - - - +10 8843 20 - + + - - - + - - - - + - - - + -11 8981 24 + - + - - - - - - + - + - - - - +12 13259 20 - + + - - - + - - - - + - - - + -13 13261 20 - + + - - - + - - - - + - - - + -14 13262 20 - + - + - - + - - - - + - - - - +15 13265 23 - + + - - - + - - - - + - - - - +Abbreviations used: Sex: M – male, F – female. Religion: H- Hindu, M – Muslim, C – Christian, O – others. Occupation: S – student, L – labor, E – executive, S – sedentary. Economical status: P – poor, M– middle class H– higher class. Response: V– very good, G – good response, S– satisfactory response, P– poor response.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
129
Demographic data
Table No. 53. Showing Demographic data in patients: Sex Religion Occupation Economical
status Response Sl.
no OPD Age No. Yrs
M F H M C O St L E S P M H V G S P16 13403 22 - + + - - - + - - - - + - - - - +17 14638 23 - + + - - - + - - - - + - - - - +18 15220 27 + - + - - - + - - - - + - - - + -19 15222 27 + - + - - - + - - - - + - - - - +20 15224 26 + - + - - - + - - - - + - - - + -21 15231 22 - + + - - - + - - - - + - - - + -22 15232 22 - + + - - - + - - - - + - - - + -23 15233 23 - + + - - - + - - - - + - - - - +24 15318 21 - + - + - - + - - - - + - - - + -25 15322 22 - + + - - - + - - - - + - - - + -26 15324 22 - + + - - - + - - - - + - - - + -27 15327 22 - + + - - - + - - - - + - - - - +28 15331 27 - + + - - - + - - - - + - - - - +29 15336 21 - + + - - - + - - - - + - - - + -30 18228 23 + - + - - - - - - + - + - - - - +Abbreviations used: Sex: M – male, F – female. Religion: H- Hindu, M – Muslim, C – Christian, O – others. Occupation: S – student, L – labor, E – executive, S – sedentary. Economical status: P – poor, M– middle class H– higher class. Response: V– very good, G – good response, S– satisfactory response, P– poor response.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
130
Demographic data
Table No. 54. Showing Demographic data in patients:
Abbreviations used: Ahara: V –Vegetarian, M –Mixed. Vihara: H- Hard, M – Moderate, S –Sedentary. Agni: S – Sama, M – manda, T – teekshna, V –vishama. Koshta: Mr – mridu,M– madhyama, K– krura. Nidra: P– prakruta, A – alpa, Ad – adhika,D–diwasapna. Vysana: T – tea, C– coffee, A–alcohol, S – smoking, T – tobacco.
Ahara Vihara Agni
Koshta Nidra VysanaSl. no
OPD No.
V M H M S S M T V Mr M K P A Ad D T C A S TO 01 4247 + - - + - + - - - - + - + - - - - - - - - 02 5064 + - - + - + - - - - + - - + - - - - - - -03 5065 + - - + - - + - - - + - + - - - - - - - -04 4046 + - - + - + - - - - + - - + - - - - - - -05 4048 + - - + - + - - - - + - - + - - - - - - -06 4053 - + - + - + - - - - + - - + - - - - - - -07 4054 + - - + - + - - - - + - + - - - - - - - -08 7576 + - - + - + - - - - + - - + - - - - - - -09 7577 - + - + - + - - - - + - + - - - - - - - +10 8843 - + - + - + - - - - + - - + - - - - - - -11 8981 - + - + - - + - - - + - + - - - - - + + -12 13259 + - - + - + - - - - + - - + - - - - - - -13 13261 + - - + - + - - - - + - + - - - - - - - - 14 13262 - + - + - + - - - - + - - + - - - - - - - 15 13265 + - - + - + - - - - + - - + - - - - - - -
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
131
Demographic data
Table No. 55. Showing Demographic data in patients:
Abbreviations used: Ahara: V –Vegetarian, M –Mixed. Vihara: H- Hard, M – Moderate, S –Sedentary. Agni: S – Sama, M – manda, T – teekshna, V –vishama. Koshta: Mr – mridu,M– madhyama, K– krura. Nidra: P– prakruta, A – alpa, Ad – adhika,D–diwasapna. Vysana: T – tea, C– coffee, A–alcohol, S – smoking, T – tobacco.
Ahara Vihara Agni
Koshta Nidra Vysana Sl. no
OPD No.
V M H M S S M T V Mr M K P A Ad D T C A S TO 16 13403 + - - + - + - - - - + - - + - - - - - - - 17 14638 + - - + - + - - - - + - + - - - - - - - - 18 15220 - + - + - + - - - - + - - + - - - - - - - 19 15222 + - - + - + - - - - + - - + - - - - - - - 20 15224 - + - + - - - - + - + - + - - - - - + - + 21 15231 + - - + - + - - - - + - - + - - - - - - - 22 15232 + - - + - + - - - - + - - - - + - - - - - 23 15233 + - - + - + - - - - + - - + - - - - - - - 24 15318 - + - + - + - - - - + - - + - - - - - - - 25 15322 + - - + - + - - - - + - + - - - - - - - - 26 15324 + - - + - + - - - - + - - + - - - - - - - 27 15327 + - - + - + - - - - + - - + - - - - - - - 28 15331 + - - + - + - - - - + - + - - - - - - - - 29 15336 + - - + - - + - - - + - - + - - - - - - - 30 18228 + - - + - + - - - - + - - + - - - - + + +
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
132
Demographic data
Table No. 56. Showing Demographic data in patients: Sl. no
OPD No.
Prakruti Sara Samhanana Satmya Satva Ahara shakti
Vyama shakti
Vaya
01 4247 VP MS M V M M M M 02 5064 PK MS M V M M M M 03 5065 PK MS M V M M M M 04 4046 VP A M V M M M M 05 4048 VK A M V M M M M 06 4053 VP MS M V M M M M 07 4054 PK MES M V M M M M 08 7576 PK MS M V M M M M 09 7577 VP A M V M M M M 10 8843 VK MS M V M M M M 11 8981 VP A M V M M M M 12 13259 VP A M V M M M M 13 13261 PK MES M V M M M M 14 13262 PK MES M V M M M M 15 13265 PK MES M V M M M M
Abbreviations used: Prakruti: V – vataja, VP – vatapittaja, VK – vatakaphaja, PK – pittakaphaja. Sara: T – twak sara, R – raktasara, MS – mamsasara, MES – medasara, A – asthisara, MJS – majjasara, S –shukrasara Samhanana: S – susamhata, M – madhyama, A – asamhata. Satmya: S – sarvarasa, E – ekarasa, R – rooksha, S - snigda V – vyamishra. Satwa: P – prvara, M – madhyama, A – avara. Ahara shakti: P – prvara, M – madhyama, A – avara. Vyamashakti: P – prvara, M – madhyama, A – avara. Vaya: B – bala, M – madhyama, V – vruddha
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
133
Demographic data
Table No. 57. Showing Demographic data in patients: Sl. no
OPD No.
Prakruti Sara Samhanana Satmya Satva Ahara shakti
Vyama shakti
Vaya
16 13403 VP MS M V M M M M 17 14638 PK MS M V M M M M 18 15220 PK MES M V M M M M 19 15222 VP MS M V M M M M 20 15224 PK MES M V M M M M 21 15231 VP A M V M M M M 22 15232 VP A M V M M M M 23 15233 VK MS M V M M M M 24 15318 VK MES M V M M M M 25 15322 PK MS M V M M M M 26 15324 VP MS M V M M M M 27 15327 PK MES M V M M M M 28 15331 VP A M V M M M M 29 15336 VP A M V M M M M 30 18228 VP MS M V M M M M
Abbreviations used: Prakruti: V – vataja, VP – vatapittaja, VK – vatakaphaja, PK – pittakaphaja. Sara: T – twak sara, R – raktasara, MS – mamsasara, MES – medasara, A – asthisara, MJS – majjasara, S –shukrasara Samhanana: S – susamhata, M – madhyama, A – asamhata. Satmya: S – sarvarasa, E – ekarasa, R – rooksha, S - snigda V – vyamishra. Satwa: P – prvara, M – madhyama, A – avara. Ahara shakti: P – prvara, M – madhyama, A – avara. Vyamashakti: P – prvara, M – madhyama, A – avara. Vaya: B – bala, M – madhyama, V – vruddha
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
134
Demographic data Table No. 58. Showing Demographic data in patients:
Mode of onset Site of onset Anubandhi vedana Kula vruttantaSl. no
OPD No. S G I V F T P O SH K SP M P
01 4247 - + - + - + - - + - - + - 02 5064 - + - - + - + - - + - + - 03 5065 - + - - - + - - - - - + - 04 4046 - + - + - - - + + - - - + 05 4048 - + - + - - - - - - - + + 06 4053 - + - + - + - - - - - - + 07 4054 - + - - + - - + + - - + - 08 7576 - + - - + - - - - - - - + 09 7577 - + - + - - + - - + - + - 10 8843 - + - - - - + - - - - + + 11 8981 - + - + - + - - - + - - + 12 13259 - + - + - - - - - - - - + 13 13261 - + - - + - - + + - - - + 14 13262 - + - - - + - - - + - + - 15 13265 - + - + - - + - - - - + -
Abbreviations used: Mode of onset: S– sudden, G – gradual, I – insidious.
Site of onset: V – vertex, F – frontal, T – temporal, P – parietal, O – occipital. Anubandhi vedana: SH – shirashoola, K – kapala daha, SP – sparshanasha. Kula vruttanta: M – maternal, P – paternal.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
135
Demographic data
Table No. 59 Showing Demographic data in patients: Mode of onset Site of onset Anubandhi vedana Kula vruttantaSl.
no OPD No. S G I V F T P O SH K SP M P
16 13403 - + - - + - - - - - - + + 17 14638 - + - - + + - - - + - - + 18 15220 - + - - - - + + - - - + + 19 15222 - + - - - - - + + - - - + 20 15224 - + - + + - - - - - - + - 21 15231 - + - - + - - - - - - + - 22 15232 - + - + - - - - - + - - + 23 15233 - + - - + + - - - - - + + 24 15318 - + - - - + - - + + - + - 25 15322 - + - + + - - - - - - + - 26 15324 - + - - + - - - - - - + + 27 15327 - + - - - - + - + - - - + 28 15331 - + - + - - - + - - - - + 29 15336 - + - - - - + - - - - + + 30 18228 - + - - - + - - - - - - +
Abbreviations used: Mode of onset: S– sudden, G – gradual, I – insidious.
Site of onset: V – vertex, F – frontal, T – temporal, P – parietal, O – occipital. Anubandhi vedana: SH – shirashoola, K – kapala daha, SP – sparshanasha. Kula vruttanta: M – maternal, P – paternal.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
136
Demographic data
Table No. 60. Showing Demographic data in patients: Head bath
Hot water Type of water
Hair wash Hair drying Hair oil Hair dye Sl. no
OPD No.
D O
Cold water
E G F S H S SH SO H T E S D O H C N 01 4247 - + - - - - + + - + - - - + - - + - - + 02 5064 - + - - - - + + - - + - + - - - + - - + 03 5065 - + - + - - - + - - + - + - - - + - - + 04 4046 + - - + - - - + - + - - + - - + - - + - 05 4048 + - + - - - - + - - + - + - - + - - - + 06 4053 + - - + - - - + - + - - + - - + - - - + 07 4054 - + - - - - + + - - + - + - - + - - - + 08 7576 - + - - - - + + - + - - + + - - + + - - 09 7577 + - - - - - + + - + - - + - - + - + - - 10 8843 - + - + - - - + - + - - + - + - + - - + 11 8981 + - + - - - - + - - + - + - - - + - + - 12 13259 - + - - + - - + - + - - + + - - + - - + 13 13261 + - - - - - + + - + - - + - + + - + - - 14 13262 - + - + - - - + - + - - + - - - + - - + 15 13265 + - - - - - + + - + - - + + - + - - - + Abbreviations used: Head bath: D – daily, O – occasionally. Hot water: E – electric heater, G – geyser, F – firewood, S – solar. Type of water: H – hard, S – soft. Hair wash: SH – shampoo, SO – soap, H – herbal. Hair drying: T – towel, E – electric hair dryer, S – sunlight. Hair oil: D – daily, O – occasionally. Hair dye: H – herbal, C – chemical, N – not applies.
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
137
Demographic data
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
138
Table No. 61. Showing Demographic data in patients: Head bath
Hot water Type of water
Hair wash Hair drying Hair oil Hair dye Sl. no
OPD No.
D O
Cold water
E G F S H S SH SO H T E S D O H C N 16 13403 - + - - - - + + - + - - + + - + - - - + 17 14638 - + - + - - - + - + + - + - + - + - - + 18 15220 + - - + - - - + - - + - + - - - + - - + 19 15222 + - - - - - + + - + - - + - - + - - + - 20 15224 + - + - - - - + - - + - + - - - + - - + 21 15231 - + - - - - + + - + - - + - + - + + - - 22 15232 + - - - - + + - + - - + + - - + - - + 23 15233 - + - + - - - + - + - + + - + + - - - + 24 15318 - + - - - - + + - + - - + - + - + + + - 25 15322 + - - + - - - + - + - - + + - + - - - + 26 15324 - + - - - - + + - + + - + - + - + + - - 27 15327 - + - + - - - + - + + - + + - + - + + - 28 15331 - + - - - - + + - + - - + - + - + - - + 29 15336 - + - + - - - + - + - - + - + + - + - - 30 18228 + - + - - - - + - - + - + - - + - - + - Abbreviations used: Head bath: D – daily, O – occasionally. Hot water: E – electric heater, G – geyser, F – firewood, S – solar. Type of water: H – hard, S – soft. Hair wash: SH – shampoo, SO – soap, H – herbal. Hair drying: T – towel, E – electric hair dryer, S – sunlight. Hair oil: D – daily, O – occasionally. Hair dye: H – herbal, C – chemical, N – not applies.
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 139
Discussion:
Discussion is the most important part of any research where the observations
are discussed and given reasons by the researcher. Here researcher conveys the
practical experience with special reference to textual explanations. The significant
results and insignificant results will be discussed in the same section with reasons.
Hence it becomes important to discuss the clinical study in detail.
Discussions on this study are made under the following headings:
1. Akala palitya and Premature grying of hair (Canitis).
2. Discussions on the materials and methods.
3. Discussion on clinical study.
4. Discussions on the patients of Akala palitya who underwent the trial.
5. Mode of Action of Nimba taila Nasya.
6. Mode of action of Bringaraja taila Shiroabyanga.
Akala Palitya and Premature graying of hair (Canitis):
There is no much elaborated descriptions are available in Ayurvedic classics
about Akala Palitya. Acharyas had explained this disease under different headings,
Susrutacharya in Kshudrarogadhikara and Vagbhatacharya in Kapala roga. But
cosmetic consciousness might have increased by the time of Sharangadhara period.
We get perfect definitions for Akala-Palitya i.e Palitya occurs at the stage of
vardhakya, but due to ushma guna of pitta, Palita symptoms are observed early i.e
during young stage.
Sushruta specifies Jarajanyavyadhis under Janmabala pravritta Vyadhi. Also
Charaka accepts excess Lavana Rasa sevana during pregnancy is the causative factor
for the Akala-Palita. These all references of Acharya Charaka and Sushruta indicate
Akala palitya is more due to genetically predisposed.
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 140
Acharya Vagbhata had classified the disease according to the Dosha
predominance. This shows even though Pitta Prakriti persons are prone for this
disease but other Prakriti persons are also included. And also Kapha dusthi is
necessary for Kesha shuklata. So in Kaphaja Akala Palitya, Kesha Shuklata and Sweta
laxanas have told. By this one can understand different levels of samprapti where the
involvement of different Doshas at each levels.
The Nidanas of Akala Palitya can be discussed mainly under three headings. 1.
Aharaja Nidana like excessive use of Amla, Lavana and Katu rasa, Viruddhahara,
Apatyahara etc. 2. Viharaja Nidana like excessive Atapasevana, Ratrijagarana,
Vegavarodha etc. 3. Manasika Nidana like excessive Soka, Bhaya, Kopa etc. along
with Atiyoga-Ayoga of twacha Indriya, Rasavaha and Asthivaha srotodusthi karanas.
Akala Palitya is Twachagata roga where Romakupas are get lodged, so the
Kushtha Nidanas can be elicited for Akala-palita. In the present society Bahya
nidanas are very common due to busy life style peoples are not able to follow the
Dinacharya and Rthucharya. For E.g.; in our classics regular Shiro Abhyanga has
been told in Dinacharya chapters. But now a day cosmetic consciousness among
young people is increased. They use cosmetics which are devoid of oil base. This
causes both externally and internally improper nourishment to the roots. Further
exposure to the sunlight (U.V rays), Dushita jala sevana, Dushita jala snana, Dhuma
sevana, Dushita vayu sevana are the contributory causative factors for Akala Palitya.
But in classics aetiopathogenesis of Akala-Palita are specifically mentioned as
Krodha (Excess Anxiety/ Mental stress), Shoka (Emotional Stress) and Excessive
physical exertion. Contemporary science also has the similar idea about any type of
physical or mental stress can lead within minutes to greatly enhanced secretion of
ACTH and consequently cortisol as well, often increasing cortisol secretion as much
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 141
as 20 fold. The inhibitory effect of cortisol on the hypothalamus and on the anterior
pituitary to cause decreased ACTH secretion. So Cortisol has –ve feed back effects on
1) The hypothalamus to decrease the formation of CRF and 2) The anterior pituitary
gland to decrease the formation of ACTH. This ACTH is responsible for Melanin
production.
The Acharyas of Ayurveda are having more or less similar opinion about the
Samprapti of Palitya. Samprapti is nothing but the pathogenesis, which occur at
different levels of the disease.
Acharya Sushrutha and Madhavakara have explained pathogenesis with the
increase of Vayu especially due to excess of Shoka and Shrama. At the same time the
Pitta is being increased in its ushma guna. This provokated pitta circulates throughout
the body through Rasayanis by the virtue of vikshepana guna of provokated vata to
increase the Sharira ushma. This Sharirika ushma reaches to Shiras and vitiates sthanika
vata karya and Shleshma karya. By this, twacha sthita romakupas are affected especially
taamra twacha where Bhrajakagni is situated. The sthanika pitta and kapha dushana
happens, causing Bhrajakagni dushti. Bhrajaka pitta works are hindered and causing
vikrita kesha Varna utpatti. This samprapti emphasizes the involvement of dehoshma in
the disease pathology.
Another Samprapti of akalapalita initiates with Jatharagni dusthi due to pitta
Pradhana Tridosha dushti resulting adyadhatwagni dusthi to vitiate Asthi poshaka
Rasa specifically kesha poshaka Rasa. During Asthi dhatwagni Vyapara, the
poshakamshas which nourish Asthidhatu are converted into three parts viz; the Sthula
bhaga, Suksma bhaga and kitta bhaga. This kitta bhaga is processed by the action of
Malagni to produce kesha. As there is Dushti of Kesha poshaka bhavas and Dushti of
sthanika Bhrajaka pitta, shleshma and Vata, vikrita varna of kesha takes place. If the
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 142
dusthi occurs at any levels of samprapti, kesha utpatti prakriya hinders and Kesha
Varna utpatti vikriti occurs.
Dehoshma concept can be understood on the base of jwara samprapti. Acharya
Charaka says, related doshas get ashrita in amashaya & expels out the Koshtagni.
Chakrapani commenting on this clarifies, koshtagni expels out in the form of Ushma.
Also says koshtagni means Dhatwagni. This samprapti can be told for shareerika
hetus & not for Agantu hetus. Sushruta explains the samprapti of increase of
Dehoshma by Agantu hetus, i.e. through shrama, Kshata, Abhighata, kupita vata
which directly affect rasavahi srotas. Ashtanga Hridaya says Ushma doesn’t exist
without pitta. And pitta is necessary for the production of Ushma.
By Sushruta’s version we get an idea about Prakrita & vaikrita jwara. Here
Prakrita jwara occurs due to chayaadi rupa of doshas and vaikrita jwara occurs due to
particular nidanas. (Uttaratantra 39th) Prakrita jwara occurs during Swakalavastha,
during Artava kala and during Aho-Raatri kala. Also while telling abhishangaja jwara
(Ch.chi. 3/114) it is told that, during Kama, Shoka, Bhaya, & Krodha the increase of
ushma is observed. In some conditions like in sharat ritu because of pitta sanchya &
in pitta prakriti persons naturally increase in body temperature occurs in visarga kala.
This is prakrita & this increase of temperature itself is the Dehoshma. In Akala Palitya
the main Nidana contributing Dehoshma are Shoka, Kroda and Shrama.
This concept of increase in Dehoshma can be understood by various metabolic
activities of cortisol. Overall system for control of cortisol secretion the key to this
control is the excitation of hypothalamus by different types of stress. Stress stimuli
activate the entire system to cause rapid release of cortisol, & the cortisol in turn
initiates a series of metabolic effects directed towards relieving the damaging nature
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 143
of stressful state. The same concept was told by our classics that due to Krodha,
Shoka or excess of Shrama causes increase in Dehoshma.
Acharyas have mentioned mainly five types of Palitya, Tridoshaja, Dhwataja
and Sannipataja. In Vataja hair will be Sphutita, Shyava, Khara, Ruksha, Jala Prabha.
In Pittaja, Pita varna of hairs and Daha in the scalp. And in Kaphaja hair will be
Snigdha, Sweta, Sthula, Vivriddha. In Dhwantaja there will be mixed features and in
Sannipataja there will be Sarva lakshanas.
According to the contemporary medical science Hair Pigmentation is a
process, in which there is a precise interaction in the hair follicle unit between
follicular melanocytes, keratinocytes, and dermal papilla fibroblasts.
The etiology of premature hair graying is unknown. Although some of the
etiology can be predicted like; nutritional deficiency, mental worries, Unhygienic
condition of scalp, Heredity factors, any drug induced, due to any diseases etc.
The timeframe of normal grying of hairs occurs independently of hair color or
gender, but it is, however, different among the various peoples of the world. Canities
occurs secondary to a progressive decline in the number and function of hair follicle
melanocytes.
For the proper Varna of Kesha, the rasa dhatu and Asthi dhatu poshana should
be proper otherwise there will be vivarnata of Kesha as Kesha is the Upadhatu of
Astidhatu. Also Bhrajaka Pitta is necessary for the proper Varna of skin & Kesha.
Kesha is a kitta of Asthi Dhatu and Kesha and Kesha Bhavas should be nourished by
Asthi Mala.
In contemporary science, Melanin is believed to the polymer of tyrosine,
formed by the action of copper containing enzyme tyrosinase enzyme. This enzyme in
the presence of dihydroxy phenyl alamine produces a dark cytoplasmic color reaction.
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 144
So tyrosine compounds which are polymer of Melanin may be Kitta bhaga nourishing
Kesha Varna.
In Ayurveda Acharyas have mentioned many medicinal yogas and different
modalities of treatment like Nasya, Shirolepa, Shiroabyanga etc. According to
Acharya Vagbhata, Vataja, Pittaja and Kaphaja Palitya are Sadya. Sannipataja and
Kalajanitha Palitya are Asadhya, and Dhwantaja variety can be considered as Kruchra
sadya.
But in the modern medical science they are not having any specific treatment
for premature graying of hair or canitis.
Discussions on the materials and methods:
Drugs used in the trial work were, Nimba beeja taila for Nasya and Bringaraja
taila for Shiroabyanga.
i) Nimba beeja taila:
Sharangadara Samhita, Bavaprakasha, Baishajyarathnavali in these Samhitas
Nimba taila Nasya is mentioned as one of the main treatment procedure for Akala
Palitya.
Nimba taila if used without moorchana can cause amatva. To overcome this
adverse effect in this clinical study Nimba taila was used after Moorchana.
ii) Bringaraja taila:
Bringaraja is one of the best kesharanjaka drug, means that which gives
natural color to the hair. Here coconut oil was used as base for Bringaraja taila for the
clinical study. Because the main cause for the Palitya is increased Dehoshma due to
vitiated Pitta dosha and Coconut oil is best for subsiding Pitta with its sheeta guna.
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 145
iii) Posology:
Marsha is the Sneha type of Nasya adopted in this study. In classics Marsha
Nasya Matra is told to be 6 Bindu for Kanishta, 8 Bindu for Madhyama and 10 Bindu
for the Uttama. One Bindu is equal to a drop of oil dripping out when two Parvas or
the two digits of the patients fore finger have been told to dip in the oil. For this study
the dose is fixed as 8 drops in each nostril (Madyama matra). Approximately 0.6ml.
For shiroabyanga approximately 30ml of Bringaraja taila was used. The
quantity of oil varied (+ or – 10ml) according to the thickness of hair and sex. In
females comparatively more quantity of oil was needed.
iv) Nasya karma:
Sharangadhara samhita and Bhaishajyarathnavali it is clearly mentioned that,
for Palitya Nimba taila Nasya should be given for a month. So for this study three
course of Nasya was given, each course of seven days and three day gap in between
each course.
v) Shiroabyanga:
Shiroabyanga along with face and neck was done for every patient for 15min
before administering Nasya. Shiroabyanga plays both the role as Poorvakarma and
Pradhanakarma. Because Shiroabyanga was taken as a separate treatment procedure
for this study.
vi) Assesment results:
The efficacy of Nimba taila Nasya and Bringaraja taila Shiroabyanga in Akala
Palitya was assessed by setting of criteria as discussed in materials and methods
section earlier. Here the base line data was compared with the data taken after 30 days
of therapy, this is because, Palitya is such a disease where one cannot expect an
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 146
abrupt result. In this study the course of therapy was 30 days and hence the results
were assessed again after 30 days of therapy.
Discussion on clinical study:
34 patients were registered for the study. All the patients were subjected to
thorough clinical examinations. Out of which 4 discontinued during the trial. The
reason for the discontinuity was Nimba taila is very Teekshna in nature and it will
cause severe irritation to nasal mucosa. And other 30 patients appeared for the
assessment of results. After scrutinizing the whole literature of Ayurveda and Modern
Medicine, subjective parameters were fixed as, color of the hair, Dry splited hair,
Unctuous thick hair, Burning sensation in the scalp for clinical assessment. Area of
scalp involved in percentage(%) and Random hair count were fixed as the objective
parameters for clinical assessment.
All the patients were asked to be in the hospital with in 9.A.M. They were
given Abhyanga and Mrudu Swedana prior to the introduction of Nasya karma. The
abhyanga was done with Bringaraja taila to the head, neck and face. Mrudu Swedana
was given only on to the area where the abhyanga was done. Then 8 drops of
lukewarm Nimba taila was administered in both the nostrils, alternately and asked the
patient to inhale deeply. Patient was asked to expel out the drug which comes in
oropharynx. Medicated Dhumpana and Gandusha were advocated to expel out the
residue mucous lodged in Kanta.
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 147
Discussions on the patients of Akala Palitya who underwent the trial:
Age:
All the 30 patients registered in this study were having the age ranging from
15 years to 35 years. Showing the involvement of all the age groups in between 15
and 35 years. . The occurrence was highest 70% in the age group of 15 to 25 years.
The reason may be that during the Balyavastha the predominance of Kapha
prevails all over the body which checks the loss of hair, but along with the progress of
age and onset of Yuvavastha the dominance of Kapha is transferred to that of Pitta.
Moreover, this is the age when a person starts bearing and becomes conscious about
the encroaching social responsibilities. This triggers off the problems of mental
tension. Again due to the unawareness and lack of proper attention towards the
homologous food intake and a misguided zeal towards the use of chemical cosmetics
to look more beautiful/handsome and a lack of proper hair care, a person knowingly
or unknowingly invites Palitya.
Sex:
In this clinical study, among 30 patients12 patients were males and 18 patients
were females. The percentage of female (60%) was more then the males (40%).
Ayurveda says that the females are in general, dominated by the Agni Tatva, whereas,
naturally they are prone to more mental tension and worries owing to their sensitive
and emotional nature. Along with this the disturbance in endocrinal secretions also
plays a part in the occurrence of Palitya. In addition, the use of chemical cosmetics is
found to be at its peak among the ladies.
Religion:
The maximum number of the patients reported in this study 90% comprised of
Hindus. However, this data is not suggestive of any confirmed finding regarding the
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 148
Palitya in any aspect but this might have occurred due to the dominance of the Hindu
community in this region.
Occupation:
Almost all the types of occupational groups had the patients of Palitya where
the highest number was recorded in the patients who were yet studying(93.3%). The
ever-increasing tension of studies followed by averting sleep till late night for reading
and due to constant worries, irregular food habits, over indulgence in sleep etc.
aggravating the Vata and Pitta Doshas create Palitya in a long run.
Economical status:
While searching out the relation between social status and disease, data shows
that social status does not bare any direct relation with the occurrence of Palitya. In
this study all 30 patients were from middle class (100%). It is evident that these
persons are more prone to stress and strain in their routine life either socially or
financially. It is well established fact psychic as well as somatic factors together are
responsible for the initiation of disease.
Diet:
As the area of the study had a dominance of Hindu religion, most of the
patients (73.3%) were reported to have vegetarian diet. Only 26.6% patients were
used to take mixed type of diet. No significant finding may be related with these
figures. as the type of diet has no effect on Palitya. The type and the time of Ahara
were recorded as Viruddhashan and Vishamashana respectively. Most of the patients
had a tendency to indulge in Viruddhahara and Vishamashana which is said to be
aggravating all the three Doshas.
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 149
Vyasana:
In todays society, it is hard to single out any person having no addiction at all.
But in this study most of the patients were students and hardly any habits were
appreciated.
Prakruti:
All the patients were reported to have Dwandvaja Prakriti. A maximum
number of patients belongs to Vata Pittaja Prakriti (46.66%) followed by Pitta Kapha
Prakriti (40%). Pitta and Vata are the two main doshas, which play an important role
in the occurrence of Palitya. It may be concluded from this finding that when such
individuals indulge in etiological factors they are more prone to have Palitya.
Vagbhata, it has been clearly stated that the person with Vata prakriti is more
susceptible to have Alpakesha, Rukshatve and Chala Manasa (A. S. Sha. 8/9). Such
persons may be easily disturbed by very trifle psychological disturbances as well as
they always invite psychological problems by their wavering nature.
Constitutionally the individuals of Pitta prakriti normally have the premature
graying of the hair and they are always having hair loss (Ca.V.8/97, Su. Sha. 4/68).
Whereas the Kapha prakriti persons are believed to be wealthy and regards to their
trichological wealth. Thus the persons with Vata and Pitta prakritis are more prone to
have the diseases of hair.
Sara:
The Saratva is the supreme part of Dhatu, which provides strength to that
Dhatu and provides resistance to the disease. In this study there were no Rasa and Asti
sara purusahas. It may be concluded that the absence of sarata especially of Rasa
dhatu and Asthi dhatu seems to be risk factors for Palitya.
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 150
Samhanana:
In this study all 30 patients were having Madyama samhatha (100%). It may
be derived that the people with moderate or less stoutness of the body is more
susceptible of Palitya.
Satmya:
In this study all 30 patients were Vyamisra rasa satmya (100%). Most of the
time patients were not aware about their diet. So it is difficult to give any comment on
Satmya.
Satva:
Even though in this study all 30 patients were having Madyama satva (100%),
Avar Satva patients are more prone to emotional imbalance and Psychological factors
certainly increase the risk of Palitya. Tension and anxiety was observed as one of the
causative factors. These factors may be responsible for vitiation of Pitta and Vata
dosh.
Agni:
The type of the Agni is very nearly related with the Doshika constitution of a
person and the particular Doshas may be reflected by the condition of the Agni.
Visamagni (3.33%) followed maximum numbers of patients with Samagni (86.66%)
and remaining (10%) were having Mandagni. Generally Vishmagni is found in person
having Vata dominated Prakriti, provocation of Vata is causative factor of Palitya.
Koshta:
In this study all 30 patients were having Madyama koshta (100%). This also
indicate the causativity of Pitta dominated Prakriti may be responsible for Palitya.
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 151
Nidra:
Among 30 patients, 19 (63.3%) were having Alpa nidra, 13(33.3%) were
having Prakruthanidra this shows that ratri jagarna (alpa nidra) is a predisposing
factor Vata vriddhi. That intern leads to Palitya.
Mode of onset:
In this study all 30 patients were having gradual onset (100%). This gives the
conclusion that palitya will not occur suddenly unless there is involvement of external
factors like chemicals, any drugs etc.
Site of onset:
Among the30patients, 12 patients had onset on vertex (40%), 11 patients had
onset on frontal (36.66%) 09 patients had onset on temporal (30%) 07 patients had
onset on parietal (36.66%) and 06 patients had onset on occipital (20%). This gives
the conclusion that palitya begins in vertex, frontal or parietal areas of the scalp.
Water for head bath:
Among the 30 patients 04 patients (13.33%) were using cold water for head
bath, 26 patients (86.66%) were using hot water for head bath, all 30 patients (100%)
were using hard water for head bath, and none of them were using soft water for head
bath. This gives the conclusion that persons using hard water and hot water for head
bath are more prone to get Palitya.
Materials used for hair wash:
Among the 30 Patients, 22 patients (73.33%) were using shampoo for hair
wash, 11 patients (36.66%) were using soap for hair wash, and 01patient(03.33%) was
using herbal material for hair wash. This gives the conclusion that persons using
shampoo and soap for hair wash are more prone to get Palitya.
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 152
Overall response of patients:
In the study, no patients had very good as well as good response. Among 30
patients 13 Patients (43.33%) had satisfactory response to the treatment (25%-50%
improvement in all the parameters), 17 Patients (56.66%) had poor response to the
treatment (<25% improvement in all the parameters).
To assess the effect of the procedure Before treatment and After Parihara kala,
the Statistical analysis was done by using Paired ‘t’ test by assuming that therapy is
not responsible for the changes before treatment and after parihara kala.
Probable mode of Action of Nimba taila Nasya:
All ancient Acharyas have considered Nasa as the gate way of Shiras. i.e
“lÉÉxÉÉÌWû ÍzÉUxÉÉå ²ÉUqÉç” It does not mean that any channel directly connects
brain and nose, but it may be suggestive of any connection through blood vessels,
lymphatics and nerve. By all above observations one can think rationally about Mode
of actions of Nasya Karma.
Samprati Vighatana is said to be the treatment. Therefore the action of a drug
means to dismantle the Samprati Ghataka of the disease. Hence to explain the mode
of a drug means to establish a relationship between the Samprati Ghataka of the
disease and penta fold principle of Rasa, Guna, Virya, Vipaka and Prabhava of a drug.
The Rasa of the Nimba taila had the dominance of Tikta, which is said to be
Pitta shamaka. Tikta and Katu Rasa present in this drug possess the antagonistic
properties to that of Kapha and Ama. Ushna Viryatva of drug will helpful for
removing the obstruction of the Srotas.
The patho-physiology of Akala Palitya when it is considered according to the
contemporary medical science Krodha, Shoka and excessive Shrama which are stress
factors mainly acting over Hypothalamus, responsible for the secretion of C.R.F
Shiroabhyanga in Akala Palitya
Discussion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 153
(Cortisone releasing hormone) and ACTH (Adrenocorticotrophic hormone). This
ACTH in turn releases cortisol, a glucocorticosteroid produced by the cortex of the
Adrenal gland. This will increase body temperature by increasing body metabolic
rate. This can be considered as increased Shariroshma. A reduced secretion of ACTH
& CRF in turn causes MSH hormone reduction causing reduced pigmentation. The
peripheral olfactory nerves are chemoreceptor in nature. It is known that these nerves
are connected with limbic system of the brain including Hypothalamus. This limbic
system & hypothalamus are having control over endocrine secretions. Moreover,
hypothalamus is considered to be responsible for integrating the functions of the
endocrine system & the nervous system. It is known to have direct nervous
connections with the anterior lobe of pituitary. Nimba taila used in Akala-palita may
be acting through this olfacto –hypothalamo- pituitary pathway.
Probable mode of action of Bringaraja taila Shiroabyanga:
The fundamentals of Ayurvedic pharmacology are capable to give a better
scientific lead in mode of drug action. Pharmacology of Ayurveda is based on the
theory of Rasa, Guna, Virya, Vipaka and Prabhava, which were the simplest
parameters in those days to ascertain the action of the drug.
Shiroabyanga with Bringaraj taila would carry out the functions as Keshya and
Kesharanjaka. The taila prepared with Bringaraja has Snigdha, Laghu, Shita and
Sukshma properties. Snigdha guna is a Parthiva and Apya. Caraka said that Kesha is
Parthivabhava predominent, so Snigdha guna increase Kesha because of
Samanyavishesha Siddhanta (Ca.Sa. 7/16). Sheeta guna would act on Pitta dosha,
which is a main causative factor of Palitya. The obstruction of Srotas will clear by the
Sukshma guna, which affects the Varnothpathi and growth of new hair.
Shiroabhyanga in Akala Palitya
Conclusion
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 154
Conclusion:
The following conclusions are drawn after the assessment of response
clinically and statistically.
• There is no satisfactory improvement in blackening of the hair. However in
other associated parameters like Dry splitted gray hair, Unctous thick hair,
Burning sensation in the scalp, Random hair count and Area of scalp involved
were satisfactory as shown in the observation and results.
• Acceptance of Nimba taila Nasya by the patients is not favorable as it causes
lot of irritation and burning sensation during Nasya therapy.
Shiroabhyanga in Akala Palitya
Summary
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 155
Summary:
The thesis entitled “Evaluation of the combined effect of Nimba taila
Nasya and Bringaraja taila Shiroabyanga in Akala Palitya”. An observational
clinical study, comprises following parts.
• Introduction
• Objectives of the study
• Review of literature
• Methodology
• Observation and results
• Discussion
• Conclusion.
Introduction:
This part includes importance of Nasya in Urdwajartugata vyadies vyadhis
mainly Nimba taila Nasya in Akala Palitya and about the disease entity Akala Palitya
and its prevalance and regarding Premature graying of hair.
Objectives of the study:
It includes need for the study, objectives of the study, previous research works
on Akala Palitya, and reasons behind selection of specific therapy for this disease with
Nimba taila Nasya
Review of literature:
This part includes mainly historical review of Akala Palitya, Nasyakarma and
Shiroabyanga. Description regarding nirukti and paribhasha of Nasyakarma, various
Nasya bhedas, yogya-ayogya, procedure to perform Nasya. Review of Palitya
includes disease etymology, nirukti, classifications, nidana, poorvaroopa, roopa,
Shiroabhyanga in Akala Palitya
Summary
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 156
samprapti, upashaya-anupashaya, pathya-apathya etc. Description regarding the
premature graying of hair and its different types of treatments. In the drug review
description concerning about properties of Nimba, Bringaraja and coconut oil.
Methodology:
This possesses about the selection criteria, study design, plan of the study,
posology, subjective and objective parameters and gradings for assessment criteria.
Observation and result:
It includes observation on all demographic data with their percentage and
graphical representation about the same, regarding the observation nidanas,
poorvaroopas, lakshanas and results of individual symptoms followed overall
response of the treatment.
Discussion:
Akala Palitya and premature graying of hair, Discussions on the materials and
methods, Discussion on clinical study, Discussions on the patients of Akala Palitya
who underwent the trial, Mode of Action of Nimba taila Nasya, Mode of action of
Bringaraja taila Shiroabyanga.
Conclusion:
This is the last part of the present study. This section comprises of the
Conclusion on the whole study.
Shiroabhyanga in Akala Palitya
Bibliography
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 157
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36. Vaidya yadavji trikamji acharya edited, susruta samhita, nibanda sangraha commentry of dalhana,chikitsa sthana, Chapter 40, Shloka no. 44. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 556. 37. Pandith Parasurama sastri vidyasagar edited Sharangadhara samhita Uttara khanda, chapter 8, sloka 16. 3rd edition 1983. pub: chaukhamba orientalia. P.B. No:32. gopal mandir lane. Varanasi 221001. page no:341. 38. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana, chapter 9, sloka no. 107. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:723. 39.Vaidya yadavji trikamji acharya edited Charaka samhita, sutra stana,chapter5,sloka no 45. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:80. 40. Vaidya yadavji trikamji acharya edited Charaka samhita, sutra stana,chapter5,sloka no 49. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:81. 41. Vaidya yadavji trikamji acharya edited Charaka samhita, sutra stana,chapter5,sloka no 20. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:39. 42. Vaidya yadavji trikamji acharya edited Charaka samhita, sutra stana,chapter5,sloka no 45. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:80. 43. Vaidya yadavji trikamji acharya edited Charaka samhita,ayurveda deepika by chakrapani datta, siddi stana, chapter 9, sloka 117. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:723. 44. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 29, sloka 19, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:226. 45. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 20, sloka 26-28. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:292. 46. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 29, sloka 19, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:226. 47. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 20, sloka 24. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:292.
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48. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter9,sloka no 92. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:722. 49. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 20, sloka 2. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:287. 50. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter9,sloka no 96-97. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:723. 51. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 29, sloka 5, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:223. 52. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 20, sloka 2-3. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:287. 53. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 23. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 555. 54. Vaidya yadavji trikamji acharya edited Charaka samhita, vimana stana,chapter8,sloka no 139. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:284. 55. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter9,sloka no 97. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:722. 56. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 29, sloka 6, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:223. 57. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter9,sloka no 94. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:722. 58. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter9,sloka no 95. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:722. 59. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter2,sloka no 23. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:690.
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Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 162
60. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 24. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 555. 61. Pandith Parasurama sastri vidyasagar edited Sharangadhara samhita uttara khanda, chapter 8, sloka 3. 3rd edition 1983. pub: chaukhamba orientalia. P.B. No:32. gopal mandir lane. Varanasi 221001. page no:339. 62. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 20, sloka 16. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:290. 63. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 29, sloka 16, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:225. 64. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 40-43. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 556. 65. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 20, sloka 9. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:289. 66. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 46. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 556. 67. Pandith Parasurama sastri vidyasagar edited Sharangadhara samhita uttara khanda, chapter 8, sloka 9-10. 3rd edition 1983. pub: chaukhamba orientalia. P.B. No:32. gopal mandir lane. Varanasi 221001. page no:340. 68. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 25. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 555. 69. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter9,sloka no 104. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:723. 70. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 20, sloka 18-20. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:290. 71. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 26-27. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 555.
Shiroabhyanga in Akala Palitya
Bibliography
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 163
72. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter9,sloka no 106-108. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:723. 73. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 20, sloka 22. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:291. 74. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 21. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 554. 75. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter1,sloka no 51. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:685. 76. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 32-33. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 556. 77. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 20, sloka 24. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:292. 78. Pandith Parasurama sastri vidyasagar edited Sharangadhara samhita uttara khanda, chapter 8, sloka 58. 3rd edition 1983. pub: chaukhamba orientalia. P.B. No:32. gopal mandir lane. Varanasi 221001. page no:345. 79. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter9,sloka no 109-110. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:723. 80. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 49-50. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 557. 81. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana,chapter9,sloka no 113-114. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:723. 82. Dr. G.Shrinivas Acharya edited Panchakarma illustrated, chapter Shirobhyanga,1st edition, Pub: chaukhamba Sanskrit pratishtan, Delhi, 38 UA, bungalow road, Jawahar nagar, PB.no.2113, Delhi 110007, Page no.76-82. 83. Vaidya yadavji trikamji acharya edited Charaka samhita, sutra stana,chapter5,sloka no 81. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:42.
Shiroabhyanga in Akala Palitya
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Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 164
84. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 24, Shloka no. 25. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 488. 85. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 3, sloka 29, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:21. 85(a). Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 31, sloka 10, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:232. 86. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutrastana, chapter 22, sloka 24. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:301. 87. Vaidya yadavji trikamji acharya edited Charaka samhita, sutra stana,chapter5,sloka no 81-83. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:82. 88. Vaidya yadavji trikamji acharya edited Charaka samhita, chikitsa stana,chapter26,sloka no 132. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:82. 89. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, sutra stana, chapter 10, sloka 12-13. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:176. 90. Vaidya yadavji trikamji acharya edited Charaka samhita, sutra stana,chapter5,sloka no 56-70. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:42,42. 91. Dr.shivaprasad sharma edited, Astanga samgraha, sutrastana, chapter 29, sloka 8, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:223. 92. Vaidya yadavji trikamji acharya edited Charaka samhita, shareera stana,chapter8, sloka no 21. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:344. 93. Proff.P.V.sharma editted, Bhela samhita, english tansalation, chapter 16, sloka 10-11, 2005 edition, chaukhamba viswabarati, Varanasi, page no:112,113. 94. Vaidya yadavji trikamji acharya edited, susruta samhita, nidana sthana, Chapter 13, Shloka no. 37. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 322.
Shiroabhyanga in Akala Palitya
Bibliography
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 165
95. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 20, Shloka no. 30. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 479. 96. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 27, sloka 22, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:765. 97. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 28, sloka 17-18, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:770. 98. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, uttara stana, chapter 23, sloka 29. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:860. 99. Proff. Yadunandana upadyaya edited Madava nidana, uttarardha, chapter 55, sloka 32. 30th edition 2001. pub: chaukhamba Sanskrit sanstan. P.B. No:1139. K.37/116 gopal mandir lane. Varanasi 221001. page no:205. 100. Sri. Brahmasankara misra edited, Bhavaprakasha, uttarardha,chapter 61,sloka 1, 7th edition 1990, pub: choukhamba Sanskrit sanstan. K.37/116 gopal mandir lane. P.B. No:1139. Varanasi 221001. page no:584. 101. Brahmasankara sastri edited Yogarathnakara, uttarardha, chapter Kshudra roga nidana, sloka 32. 4th edition 1988. pub: chaukhamba Sanskrit sanstan. P.B. No:1139. K.37/116 gopal mandir lane. Varanasi 221001. page no:272. 102. Pandith Parasurama sastri vidyasagar edited Sharangadhara samhita pradama khanda, chapter 7, sloka 151-152. 3rd edition 1983. pub: chaukhamba orientalia. P.B. No:32. gopal mandir lane. Varanasi 221001. page no:116. 103. P.V.sharma edited Chakradatta, chapter 55, sloka 125,126. 2nd edition 1998. pub: chaukhamba publishers. Gopal mandir lane. Varanasi 221001. page no:448. 104. Brahmasankara misra edited Bhaishajyarathnavali, chapter 60, sloka 80. 18th edition 2005. pub: chaukhamba Sanskrit sanstan. P.B. No:1139. K.37/116 gopal mandir lane. Varanasi 221001. page no:953. 105. Pt.sadasiva shastri paradakara bishag acharya edited astanga hrudaya, shareera stana, chapter 3, sloka 107. Reprint 2007. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:406. 106. Vaidya yadavji trikamji acharya edited Charaka samhita, shareera stana,chapter8,sloka no 51. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:350. 107. Vaidya yadavji trikamji acharya edited Charaka samhita, sareera stana,chapter7,sloka no 14. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:338.
Shiroabhyanga in Akala Palitya
Bibliography
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 166
108. Dr.gangasahaya pandaya edited Charaka samhita, vidyadini tika, sareera stana,chapter7,sloka no 14. eddition 2000. pub: chaukhamba sanskrit sanstan. P.B. No:1139. K.37/117 gopal mandir lane. Varanasi 221001. page no:809. 109. Vaidya yadavji trikamji acharya edited, susruta samhita, shareera sthana, Chapter 4, Shloka no. 33. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 354. 110. Vaidya yadavji trikamji acharya edited Charaka samhita, sareera stana,chapter3,sloka no 7. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:310. 111. Vaidya yadavji trikamji acharya edited Charaka samhita, sareera stana,chapter8,sloka no 55. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:351. 112. Dr.shivaprasad sharma edited, Astanga samgraha, shareera stana, chapter 2, sloka 24, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:278,279. 113. Vaidya yadavji trikamji acharya edited Charaka samhita, sutra stana,chapter28,sloka no 3. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:174. 114. Vaidya yadavji trikamji acharya edited, susruta samhita, shareera sthana, Chapter 9, Shloka no. 9. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 385. 115. Vaidya yadavji trikamji acharya edited Charaka samhita, sareera stana,chapter8,sloka no 15. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:342. 116. Vaidya yadavji trikamji acharya edited, susruta samhita, shareera sthana, Chapter 2, Shloka no. 35-36. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 348. 117. Pandith Parasurama sastri vidyasagar edited Sharangadhara samhita pradama khanda, chapter 6, sloka 21-23. 3rd edition 1983. pub: chaukhamba orientalia. P.B. No:32. gopal mandir lane. Varanasi 221001. page no:73,74. 118. Vaidya yadavji trikamji acharya edited, susruta samhita, shareera sthana, Chapter 4, Shloka no.4 reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 355. 119. Lawrence H Bannister and Martine M Berry edited Grays Anatomy, chapter 5, 38th edition, Pub: Harcourt publishers limited, Edinburgh. Page no.400-405 120. Zoe diana draelos edited Haircare an illustrated dermatologic hand book. Chapter 1, pub: taylor and fransis, london, edition 2005, page no.1-24
Shiroabhyanga in Akala Palitya
Bibliography
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 167
121. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 27, sloka 22, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:765. 122. Proff. Yadunandana upadyaya edited Madava nidana, uttarardha, chapter 55, sloka 32. 30th edition 2001. pub: chaukhamba Sanskrit sanstan. P.B. No:1139. K.37/116 gopal mandir lane. Varanasi 221001. page no:205. 123. Vaidya yadavji trikamji acharya edited, susruta samhita, nidana sthana, Chapter 13, Shloka no. 37. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 322. 124. Sri. Brahmasankara misra edited, Bhavaprakasha, uttarardha,chapter 61,sloka 1, 7th edition 1990, pub: choukhamba Sanskrit sanstan. K.37/116 gopal mandir lane. P.B. No:1139. Varanasi 221001. page no:584. 125. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 27, sloka 22, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:765. 126. Sri. Brahmasankara misra edited, Bhavaprakasha, uttarardha,chapter 61,sloka 1, 7th edition 1990, pub: choukhamba Sanskrit sanstan. K.37/116 gopal mandir lane. P.B. No:1139. Varanasi 221001. page no:584. 127. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 27, sloka 22, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:765. 128. Proff.P.V.sharma editted, Bhela samhita, english tansalation, chapter 16, sloka 10-11, 2005 edition, chaukhamba viswabarati, Varanasi, page no:112,113. 129. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 27, sloka 23, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:765. 130. Vaidya yadavji trikamji acharya edited, susruta samhita, chikitsa sthana, Chapter 24, Shloka no. 57. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 489. 131. Vaidya yadavji trikamji acharya edited, susruta samhita, chikitsa sthana, Chapter 24, Shloka no. 74. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 490 132. Vaidya yadavji trikamji acharya edited Charaka samhita, sutrastana,chapter5,sloka no 30. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:40. 133. Vaidya yadavji trikamji acharya edited, susruta samhita, chikitsa sthana, Chapter 40, Shloka no. 15. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 554.
Shiroabhyanga in Akala Palitya
Bibliography
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 168
134. Vaidya yadavji trikamji acharya edited Charaka samhita, sutrastana, chapter20,sloka no 20. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:115. 135. Vaidya yadavji trikamji acharya edited Charaka samhita, sutrastana,chapter 26,sloka no 12. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:138. 136. Vaidya yadavji trikamji acharya edited Charaka samhita, sutrastana,chapter9,sloka no 7. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:63. 137. Brahma sankara misra and sri roopalalaji vaidya editted, Bavaprakasha including Nigandu portion, poorvardha, guduchi varga, sloka93-99, 11th edition 2004 chaukhamba sanskrit santan, varanasi. Page no:328. 138. Vaidya yadavji trikamji acharya edited, susruta samhita, sutra sthana, Chapter 45, Shloka no. 115. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 206. 139. Dr. Indradeo tripati edited dravyagunaprakashita hindi commentary of rajanigandu, shatahwadi varga,sloka 138-141, second edition1998, krishnadas acadamy varanasi. Page no:89. 140. Brahma sankara misra and sri roopalalaji vaidya editted, Bavaprakasha including Nigandu portion, poorvardha, guduchi varga, sloka 239-240, 11th edition 2004 chaukhamba sanskrit santan, varanasi. Page no:426. 141. Proff. P.V.sarma editted Kaiyyadeva nigandu, aoushadi varga, sloka 274, first eddition 1979, choukhamba orientalia, varanasi. Page no:53 142. Sharangadhara, Sharangadhara Samhitha, Madyama Khanda, 9th Chapter, Shloka No.1 & 2, Translated by Prof. K.R. Srikanta Murthy, First Edition 1984, Varanasi, Chawkambha Orientalia, Page No.115. 143. Dr.shivaprasad sharma edited, Astanga samgraha, sutra stana, chapter 29, sloka 12, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:224. 144. Ulrike blume-peypaba and Antonella tosti edited Hair growth and disorders, edition 2008. page no.127.
Shiroabhyanga in Akala Palitya
Annexure
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila Shiroabhyanga in Akala Palitya
169
SPECIAL CASESHEET FOR AKALA PALITYA
Post Graduate Studies and Research Centre (Panchakarma) Shri. D.G.M. Ayurvedic Medical College, Gadag
Guide : Dr. S Suresh Babu. M.D. (Ayu) P.G. Scholar: Sabareesh M
Co-Guide: Dr .Yasmeen A. Phaniband. M.D. (Ayu)
1. Name of the patient : Sl. No. 2. Father’s/ Husband’s Name : OPD. No. 3. Age : Years IPD No. 4. Sex Bed No. 5. Religion : 6. Occupation : 7. Economical Status : 8. Address :………………………………………….Phone No. ………………………………………… ………………………………………… E-mail: Pin: 9. Date of commencement of therapy : 10. Date of Completion : 11. Result:
Poor Satisfactory Good Very good
M F
Hindu Muslim Christian Others
Student Labor Executive Sedentary
Poor Middle class Higher class
CONSENT
I hereby agree that, I have been fully educated with the disease and treatment. Hereby satisfied whole heartedly, and accept the medical trial on me.
Patient’s Signature.
Annexure
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 170
A. PRADHANA VEDANA: (Main symptom)
Premature graying of hair since
B. ANUBANDHI VEDANA: (Associated Symptoms)
Lakshna Duration shirashoola
Kapala Daha Sparshanasha (In Kapala)
C. VYADHI VRUTTANTA: (History of Present Illness)
Sudden Gradual
Mode of onset
Insidious
Vertex Frontal
Temporal Parietal
Site of onset
Occipital D. CHIKITSA VRUTTANTA: (Treatment History) E. KULA VRUTTANTA: (Family History)
Maternal Paternal
Shiroabhyanga in Akala Palitya
Annexure
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 171
F. VAYUKTIKA VRUTTANTA: (Personal history) :
1. Ahaara:
Vegetarian Type of food Mixed
Madura Katu Amla Tiktha
Rasa pradanatha
Lavana Kashaya
2. Vihaara:
Hard Moderate
Nature of occupation
Sedentary 3. Agni: Samagni Mandagni Teekshnagni Vishamagni
4. Kosta:
Mrudu Madhyama Krura
5. Nidra:
Prakruta Alpa Ati Diwaswapna
Shiroabhyanga in Akala Palitya
Annexure
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 172
6. Vyasana:
Tea Coffee Alcohol Smoking Pan Tobacco
Drug addiction Any other
7. Menstrual history:
Regular Menstrual cycle Irregular
Other complaints 8. Hygiene:
Daily Head bath Once in …………. days
Electric heater Geyser Firewood
Hot water
Solar Cold water Hard water
Type of water for
head bath
Soft water
Shampoo Soap
Item used for hair wash
Herbal
Rubbing with Towel Electric hair drier
Hair Drying
Drying in sunlight
Daily Application of hair oil Once in …………. days
Hair oil used
Herbal Chemical
Hair Dye
Not applies
Shiroabhyanga in Akala Palitya
Annexure
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 173
9. Emotional Makeup: Anxiety Tension Anger Mental stress Depression
G. SAMAANYA PAREEKSHA: 1. Ashtastana Pareeksha:
Nadi /min Mala Mootra Jihwa Shabda Sparsha Druk Akruti
2. Vital examination:
Heart rate /min Resp. rate /min Blood pressure mm of Hg Body Temp F Body weight kg
3. Dasha vidha Pareeksha:
Prakriti Sara Satwa Pravara Madhyama Avara
Vyamisra Ekarasa
Snigdha
Satmya
Sarvarasa Ruksha Samhanana Susamhata Madhyama
samhata Asamhata
Pramana Sama Heena Adhika
Aharasakthi
Abhyavarana Pravara Madhyama Avara
Jarana Shakti Pravara Madhyama Avara
Vyayama Shakti Pravara Madhyama Avara Vaya Bala Yuva Vridha
Shiroabhyanga in Akala Palitya
Annexure
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 174
4. Srotho pareeksha:
Srotas Observed Lakshanas
Rasavaha Srotas
Asthivaha Srotas
Manovaha Srotas
H. VISHESHA PAREEKSHA:
Sphudita
Khara Rooksha Snigdha
Nature of the hair
Sthoola
I. VIKRITITAHA PAREKSHA:
1. Hetu:
Aharaja Viharaja Manasika Vyasanaja Excessive Amla Exposure to Dhooma Kroda Madyapana Excessive Lavana Exposure to Athapa Soka Dhoomapana Excessive Katu Excessive Srama Bhaya Tobacco
Occupational Jala kreeda Anxiety Tea Excessive Nidra Tension Coffee Ratri jagarana Stress Drug
Shyava (Ash) Peetha (Yellowish)
Sukla (Whitish) Tamra varna (Copperish)
Colour of the hair
Mishra varna (Mixed)
Daaha Kandu
Kesha Bhoomi (Scalp)
Darunaka Any other
Shiroabhyanga in Akala Palitya
Annexure
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 175
2. Samprapti gatakas: Dosha Dushya Srotas Agni
Rogamarga Adishtana
J. TREATMENT PROTOCOL: Ist course Abhyanga Day Time Avadhi Lakshana observed Any Upadravas
1 2 3 4 5 6 7
Nasyam Day Matra Time of
Performance Observation Advise
1 2 3 4 5 6 7
Shiroabhyanga in Akala Palitya
Annexure
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 176
IInd course Abhyanga Day Time Avadhi Lakshana observed Any Upadravas
1 2 3 4 5 6 7
Nasyam
Day Matra Time of Performance
Observation Advise
1 2 3 4 5 6 7
IIIrd course Abhyanga Day Time Avadhi Lakshana observed Any Upadravas
1 2 3 4 5 6 7
Shiroabhyanga in Akala Palitya
Annexure
Evaluation of combined effect of Nimba taila Nasya and Bringaraja taila 177
Nasyam Day Matra Time of
Performance Observation Advise
1 2 3 4 5 6 7
K. TREATMENT ASSESSMENT CHART:
1. Subjective parameters:
Assessment B.T A.T A.F Color of the hair (MåüzÉ uÉhÉï) Dry splited hair (Ã¤É xTÑüÌOûiÉ) Unctuous thick hair (ÎxlÉakÉ xjÉÔsÉÇ) Burning sensation in the scalp (SÉW)
2. Objective parameters:
Assessment B.T A.T A.F Area of scalp involved (%) % % %Random hair count Signature of the Scholar Signature of the Co-Guide
Signature of the Guide
Shiroabhyanga in Akala Palitya