Palitya shirobhyanga pk023-gdg

“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



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



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

X

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.

XI

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.

XII

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

XIII

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

XIV

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

XV

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

1

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.


2

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.


3

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.


4

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,lÉuÉ²ÉU…….” (Atharvaveda, 10/2/32)

Bhagvad Gita: While describing Indriyas, the Nasa is mentioned.

“lÉuÉ²ÉU mÉÔuÉÉïSåÌWû lÉåuÉÉ…….” (Bhagawat Gita 5/13)


5

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


6

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.


7

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).


8

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.


9

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.


10

Review of Nasya

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


11

Review of Nasya

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


12

Review of Nasya

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.


13

Review of Nasya

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.


14

Review of Nasya

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


15

Review of Nasya

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


16

Review of Nasya

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.


17

Review of Nasya

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.


18

Review of Nasya

• 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.


19

Review of Nasya

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)


20

Review of Nasya

• 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 - + -


21

Review of Nasya

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.


22

Review of Nasya

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.


23

Review of Nasya

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


24

Review of Nasya

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 - + -


25

Review of Nasya

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.


26

Review of Nasya

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


27

Review of Nasya

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)


28

Review of Nasya

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


29

Review of Nasya

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.


30

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 + - + + - -


31

Review of Nasya

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 - - - - - -


32

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.


33

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.


33


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


34


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.


35


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.


36

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.


37

Review of Palitya

• 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.


38

Review of Palitya

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.


39

Review of Palitya

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: ÌmÉ¨ÉxrÉ 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||


40

Review of Palitya

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.


41

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 )


42

Review of Palitya

• 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)


43

Review of Palitya

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.


44

Review of Palitya

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.


45

Review of Palitya

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.


46

Review of Palitya

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


47

Review of Palitya

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


48

Review of Palitya

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.


49

Review of Palitya

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.


50

Review of Palitya

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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Review of Palitya

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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Review of Palitya

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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Review of Palitya

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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Review of Palitya

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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Review of Palitya

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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Review of Palitya

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, seafood, 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.


94

Review of Palitya

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.


95

Review of Palitya

• 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.


96

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.


97

Drug review

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.


98

Drug review

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 iÉÏ¤hÉÉÌlÉ 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)


99

Drug review


100

Drug review

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.


101

Drug review

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 cÉ¤ÉÑwrÉÉÎxiÉ£üÉåwhÉÉÈ MåüzÉUgeÉlÉÉÈ|

MüTüzÉÉåTüÌuÉwÉblÉÉ¶É iÉ§É lÉÏsÉÉå UxÉÉrÉlÉ|| (UÉ.ÌlÉ)


102

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.


103

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 ÌmÉ¨ÉÉÌlÉsÉWûUÇ SlirÉÇ qÉSÒUqÉåuÉ cÉ|| (Mæü.ÌlÉ)


104

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.


104

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.


105

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.


104

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.


105

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


106

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:


107

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.


108

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.


109

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.


110

Methodology

Procedure of Shiroabhyanga and Nasya

Fig.8. Shiroabhya

Fig.9. Nasya karma


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 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



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


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



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


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



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



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:


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



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:


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



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:


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


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




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:


5

0

10

15

20

25 shampoo

soap

herbal



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



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


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%



Fig No 34: Showing the distribution of Overall Response to the treatment

0

5

10

15

20very good

good

satisfactory

poor



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




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.


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.


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 + - - + - + - - - - + - - + - - - - - - -


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 + - - + - + - - - - + - - + - - - - + + +


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


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


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.


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.


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.


137

Demographic data


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


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.


Discussion


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


Discussion


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


Discussion


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


Discussion


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.


Discussion


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.


Discussion


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


Discussion


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.


Discussion


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


Discussion


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.


Discussion


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.


Discussion


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.


Discussion


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.


Discussion


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%



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


Discussion


(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.


Conclusion


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.


Summary


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,


Summary


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.


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13. Vaidya yadavji trikamji acharya edited Charaka samhita, sutrastana, chapter 1, sloka 85. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:21. 14. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana, chapter 9, sloka 89-92. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:722. 15. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana, chapter 9, sloka 90. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:722. 16. Vaidya yadavji trikamji acharya edited Charaka samhita, vimana stana, chapter 8, sloka 154. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:286. 17. 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. 18. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 29, sloka 4, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:223. 19. Dr.shivaprasad sharma edited, Astanga samgraha, uttara stana, chapter 29, sloka 7, edition 2006. pub: choukhamba Sanskrit series. K.37/99 gopal mandir lane. P.B. No:1008. Varanasi 221001. page no:223. 20. 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. 21. Sri Satyapala bhishakacharya edited Kashyapa samhita, siddistana, chapter 4, Sloka no.3, 2nd edition 1976. pub: choukhamba Sanskrit sanstan. K.37/116 gopal mandir lane. P.B. No:139. Varanasi 221001. page no:365. 22. Pandith Parasurama sastri vidyasagar edited Sharangadhara samhita Uttara khanda, chapter 8, sloka 2. 3rd edition 1983. pub: chaukhamba orientalia. P.B. No:32. gopal mandir lane. Varanasi 221001. page no:339 23. Vaidya yadavji trikamji acharya edited, susruta samhita, nibanda sangraha commentry of dalhana,chikitsa sthana, Chapter 40, Shloka no. 31. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 556. 24. Vaidya yadavji trikamji acharya edited Charaka samhita, sutra stana, chapter 5, sloka 68. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:41.


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25. 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. 26. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 22. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 555. 27. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 36. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 556. 28. 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. 29. 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. 30. Vaidya yadavji trikamji acharya edited, susruta samhita, nibanda sangraha commentry of dalhana,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. 31. 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. 32. Pandith Parasurama sastri vidyasagar edited Sharangadhara samhita Uttara khanda, chapter 8, sloka 12. 3rd edition 1983. pub: chaukhamba orientalia. P.B. No:32. gopal mandir lane. Varanasi 221001. page no:341 33. Vaidya yadavji trikamji acharya edited Charaka samhita,ayurveda deepika by chakrapani datta, siddi stana, chapter 9, sloka 92. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:722. 34. Vaidya yadavji trikamji acharya edited, susruta samhita,chikitsa sthana, Chapter 40, Shloka no. 29. reprint 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. Page no. 556. 35. Vaidya yadavji trikamji acharya edited Charaka samhita, siddi stana, chapter 9, sloka 90. eddition 2008. pub: chaukhamba surabarathi prakashan. P.B. No:1129. K.37/117 gopal mandir lane. Varanasi 221001. page no:722.


Bibliography


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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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.


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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.


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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.


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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


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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.


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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.


Annexure


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


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


Annexure


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


Annexure


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


Annexure


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


Annexure


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


Annexure


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


Annexure


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


Annexure


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


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