PUYARAKTA - NASAPAKA - NASASHOPHA

PUYARAKTA, NASAPAKA, NASASHOPHA

PUYARAKTA

NIDANA (ETIOLOGY)

• Dushta raktaprakopa due to excessive intake of katu, amla, ushna, and viruddha ahara

• Exposure to excessive raja, dhuma, and sheeta

• Trauma to nose or excessive nose picking

• Krimi (microbial infection)

• Poor nasal hygiene

• Agantuja nidana such as injury or foreign body

SAMPRAPTI (PATHOGENESIS)

• Rakta is vitiated by pitta and kapha

• This vitiated rakta circulates to nasa and produces dushti in nasal vessels

• Leads to suppuration and bleeding mixed with pus

SANSKRIT REFERENCE
सुश्रुत संहिता उत्तरतंत्र 22/7
पूययुक्तं च रुधिरं स्रवेत् स्रस्तनासिकः |
दाहशूलयुतः शीघ्रं पूयरक्तं विनिर्दिशेत् ||

LAKSHANAS (CLINICAL FEATURES)

• Nasal discharge mixed with pus and blood

• Burning sensation and pain in nose

• Ulceration and foul smell

• Difficulty in breathing

• Swelling in the nasal mucosa

MODERN CORRELATION

• Chronic rhinitis with secondary infection

• Atrophic rhinitis

• Chronic sinusitis with purulent and blood-stained discharge

• Nasal vestibulitis

CHIKITSA (TREATMENT)
Shodhana Chikitsa:

• Nasya with tikta, kashaya, and ushna dravyas

• Virechana to eliminate pitta and rakta dushti

• Raktamokshana in severe cases

Shamana Chikitsa:

• Gandhaka rasayana

• Triphala guggulu

• Manjishtadi kwatha

• Nasal irrigation with lukewarm saline water

• Pratisarana with Haridra-churna and honey

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NASAPAKA

NIDANA (ETIOLOGY)

• Similar nidanas to Puyarakta with a predominance of kapha-pitta

• Secondary bacterial infection due to chronic rhinitis

• Unhygienic nasal practices

• Excessive sheeta abhighata (cold exposure)

SAMPRAPTI (PATHOGENESIS)

• Vitiated kapha and pitta accumulate in nasa

• Srotorodha and dushti of nasal tissues

• Formation of pus with edema and pain in nasal cavity

SANSKRIT REFERENCE
अष्टाङ्गहृदय उत्तरस्थान 24/17
नासायां पूयसम्भूते शोथे पीडा च जायते |
स तु नासापकः प्रोक्तो यथासन्नं विधिः स्मृतः ||

LAKSHANAS (CLINICAL FEATURES)

• Localized swelling in nasal cavity

• Painful, red, and tender nasal mucosa

• Foul-smelling purulent nasal discharge

• Low-grade fever may be present

• Headache and heaviness

MODERN CORRELATION

• Acute suppurative rhinitis

• Acute bacterial sinusitis

• Furunculosis of nasal vestibule

CHIKITSA (TREATMENT)
Shodhana:

• Nasya karma with shodhana dravyas like shadbindu taila

• Vamana or virechana depending on dosha predominance

Shamana:

• Kaishora guggulu

• Nimbadi kwatha

• Use of lepa with Haridra, Daruharidra, and Guggulu

• Antiseptic nasal drops or povidone-iodine rinses (modern)

• Antibiotics in severe infection (modern ENT)

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NASASHOPHA

NIDANA (ETIOLOGY)

• Dust exposure, dhooma, atisevana of tikshna ahara

• Repeated trauma or friction to nose

• Pratishyaya (rhinitis) complications

• Pitta-kaphaja prakopa with srotorodha

SAMPRAPTI (PATHOGENESIS)

• Vitiation of doshas especially kapha and pitta

• Stasis and inflammation in nasal passages

• Local edema and dushti of nasal tissues

SANSKRIT REFERENCE
सुश्रुत संहिता उत्तरतंत्र 22/3
वातादिभिः समुत्पन्नं शोफं नासागते स्मृतम् |
दाहशूलसमायुक्तं नासाशोफं तदुच्यते ||

LAKSHANAS (CLINICAL FEATURES)

• Swelling in nasal cavity or externally on nose

• Pain and burning sensation

• Redness of nasal mucosa

• Obstruction of nasal airflow

• Watery or mucopurulent discharge

MODERN CORRELATION

• Allergic rhinitis with edema

• Nasal polyps (early stage)

• Acute rhinosinusitis

• Nasal vestibulitis

CHIKITSA (TREATMENT)
Shodhana:

• Mild virechana to remove pitta

• Nasya karma with soothing oils like Anu taila

• Seka with Triphala kwatha or chandana

Shamana:

• Chandanasava

• Drakshadi kwatha

• Haridra khand

• Application of lepa with Shunthi, Haridra, and Ghee

• Antihistamines and nasal corticosteroid sprays in allergic rhinitis (modern)

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INTEGRATIVE MODERN ENT PERSPECTIVES

• Diagnostic tools: Nasal endoscopy, CT scan for sinus involvement

• Common microorganisms: Staphylococcus aureus, Streptococcus pneumoniae

• Management includes:

  • Broad-spectrum antibiotics for bacterial infections

  • Nasal decongestants

  • Steroid sprays

  • Nasal saline irrigation

  • Surgical drainage in abscess or chronic sinusitis