THE ROLE OF NASIYAM (NASAL APPLICATION) IN THE TREATMENT OF ERAIPPU NOI (BRONCHIAL ASTHMA)

1. THE ROLE OF NASIYAM (NASAL APPLICATION) IN THE TREATMENT OF ERAIPPU NOI(BRONCHIAL ASTHMA) by K. Manicka Vasagam, Professor & HOD, Department of Maruthuvam (Medicine), National Institute of Siddha (N.I.S), Tambaram Sanatorium, Chennai, India. dr.kmvasagam@gmail.com & Thomas M. Walter,Asst. Lecturer, P.G. Department of Gunapadam (Pharmacology), Govt. Siddha Medical College, Palayamkottai, T.N., India. dr.thomaswalter@gmail.com

2. INTRODUCTION • Siddhars classified 64 varieties of medicines into two major categories, namely Agamarunthu (Internal medicine) and Puramarunthu (External medicines) 32 varieties in each. Puramarunthu plays a major role in Siddha system of medication. Among these treatment methods Nasiyam (Nasal application corrects many diseases like Neer peenisam (sinusitis), Nasika peedam (Nasal Polyp) and allergic rhinitis in Bronchial asthma. • Asthma and rhinitis co-exists with symptoms of rhinitis found in 75 to 85% of patients with asthma. Rhinitis is the risk factor for the development of asthma.

3. BRONCHIAL ASTHMA • Bronchial asthma is produced by bronchospasm due to production of some chemicals with in the trocheobronchial tree which produces the spasm. • Rhinitis describes inflammation of the nasal mucosa but is clinically defined by symptoms of • Nasal discharge • Itching • Sneezing. • Nasal blockage • Congestion

4. CAUSES OF BRONCHOSPASM • The allergen particles get stuck to the bronchial mucosa • Release of mediators • Inflammation + Bronchospasm • Denudation of the epithelium of the bronchial mucosa • Sensory nerve fibers are exposed • Nerve fibers excited • Bronchospasm

5. NASIYAM (Nasal application) • Definition • Some prepared medicines are used as nasal drops dissolving them in breast milk or fresh juice is known as Nasiyam. • The term Nasiyam is the specific sense is particularly used with reference to the snuffing of an oleaginous substance with a view to make up the deficient oily matter in the brain. It may be used as an agent to bring out mucous matter.

6. METHODS OF APPLICATION • Nasal drops should be used in the ‘head upside down’ position in order to reach the ostiomeatal complex. • Make the patient lie down, and pass the medicine into his nostril through a tube or funnel. • In normal healthy patients Nasiyam (Nasal application) should be applied once in 6 weeks for maintaining good health. AGE: Between 7 and 80 years of age.

7. ACTIONS Instill Nasal drops. Absorbed nasal mucous membrane. Reduce local level of eosinophil chemotatic factor. Reduce allergic inflammation. Reduces volume of watery secretion. Control sneezing, rhinorrhoea, itching.

8. DURATION OF NASIYAM • Due to predominant of Vatha – to be applied in the evening • Due to predominant of Pitham – to be applied in the afternoon. • Due to predominant of Kapham – to be applied in the morning. • For acute intensified diseases – to be applied in the night • Chitthirai, Vaigasi, Ipasi, Karthigai (April, May & October,November) – to be applied in the morning. • Margazhi, Thai, Maasi, Panguni (December, Janurary, February, March) – to be applied in the afternoon. • Aani, Aadi (June, July) – to be applied in the evening. • Aavani, Purattasi (August, September)– to be applied when the sun shines.

9. ADVANTAGES • The nasal mucosa is also a useful site at which to administer drugs that undergo considerable presystemic elimination (eg. by 1st pass metabolism) when given orally. • Absorption from the nasal mucosa can also be inconsistent. • Nasal mucosal epithelium has remarkable and potentially very valuable absorptive properties, notably the capacity to absorb intact complex peptides that cannot be administered by mouth because they would be digested. • It avoid drug modification by the alimentary juices and liver enzymes. • Rapid action. • Accuracy of dose are ensured. • Can be employed in uncooperative patients. • Can be employed in patients unable to swallow.

10. DISADVANTAGES • It is always advised to use this route under medical supervision. The disadvantages are • In convenient for use • Self medication being difficult. • Less safe and liable to cause infection if proper care it is not excercised. • Like to injure important structure such as nerves and arteries.

11. PRECAUTIONS • Patients who have acute fever or acute corrhyza. • Have had purgation. • Oleus enema • Had fasted. • Indigestion. • Pregnancy and lactation. It is important that no poisonous substances be administered by this route, as it may reach the brain along with lymphatic channel.

12. METHODS OF APPLICATION OF SOME IMPORTANT NASIYAM • Peenasa thylam – 2 to 3 drops to be applied once in 4 days. • Chukku thylam – 2 to 3 drops to be applied once a week. • Aqueous leaf extract of leucus – 1 to 2 drops to be applied in once in 2 days. • Aqueous flower extract of leucus – 1 to 2 drops to be applied once in 2 days.

13. CONCLUSION The application of external routes of drug administration is comparatively less than the internal route more works and researches are to be conducted in bringing out this effective methods of treatment.

14. REFERENCE • Gunapadam Thathu – Zeeva Vaguppu Part II & III, Dr. R. Thiyagarajan, 3rd edition 1981, Department of Indian Medicine and Homeopathy, Chennai – 106. • A compendium of Siddha Doctrine (English translation of the Tamil text Siddha Maruthuvanga Churukkam, Dr. K. S.uthamarayan, Editor Dr. Anandan, 1st edition, Department of Indian Medicine and Homeopathy, Chennai – 106. • Siddhar Aruvai Maruthuvam, Dr.K.S. Uthamarayan, 3rd edition 1999, Department of Indian Medicine and Homeopathy, Chennai –106. • Concise Medical physiology, Sujit K. Chaudhuri, 5th edition, New central book agency (p) ltd., Calcutta. • T.V. Sambasivam pillai, Maruthuva Agarathi. • Siddha Vaidhya Thirattu.

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