- This study aimed to evaluate and compare the efficacy of Nasya with Karpasasthyadi Taila and Nagara Taila in the management of Avabahuka. - 30 patients of Avabahuka were randomly divided into two groups. Group A received Nasya with Karpasasthyadi Taila while Group B received Nasya with Nagara Taila. - Results showed that 100% of Group A patients experienced 61-99% relief of symptoms, while 81% of Group B patients experienced 61-99% relief and 19% experienced 31-60% relief. - Group A showed greater improvement across all assessed symptoms like pain

1. “A COMPARATIVE CLINICAL STUDY ON THE EFFECT OF
NASYA WITH KARPASASTHYADI TAILA AND NAGARA TAILA
IN THE MANAGEMENT OF AVABAHUKA”
BY
Dr. FEBIN.P.JOSE
Dissertation Submitted to the Rajiv Gandhi University of Health Sciences,
Karnataka, Bangalore
In partial fulfilment of the degree of
AAYYUURRVVEEDDAA VVAACCHHAASSPPAATTII
IN
PANCHAKARMA
Under the guidance of
Dr. KRISHNAPRAKASH.M.K M.D. (AYU)
Professor
Dept. of Panchakarma
And co-guidance of
DR. SANATH KUMAR D.G. M.D.(AYU)
LECTURER
POST GRADUATE DEPARTMENT OF PANCHAKARMA
K.V.G.AYURVEDA MEDICAL COLLEGE AND HOSPITAL,
SULLIA – 574327
2013

2. ii
Rajiv Gandhi University of Health Sciences
Karnataka, Bangalore
DECLARATION BY THE CANDITATE
I hereby declare that this dissertation / thesis entitled “A comparative clinical study on
the effect of Nasya with Karpasasthyadi Taila and Nagara Taila in the management
of Avabahuka” is a bonafide and genuine research work carried out by me under the
guidance of Dr. Krishna Prakash.M.K M.D. (Ayu) Professor and the co-guidance of Dr.
Sanath Kumar D.G.M.D. (Ayu) Lecturer K.V.G. Ayurvedic Medical College And Hospital,
Sullia.
Date: Signature of the Candidate
Place: Sullia. Dr. Febin.P.Jose.

3. iii
Rajiv Gandhi University of Health Sciences
Karnataka, Bangalore
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled “A comparative clinical study on
the effect of Nasya with Karpasasthyadi Taila and Nagara Taila in the management
of Avabahuka” is a bonafide research work done by Dr. Febin.P.Jose in partial
fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.
(Panchakarma).
Date:
Place: Sullia
DR. KRISHNA PRAKASH.M.K. M.D. (AYU)
Professor
Dept. of Post Graduate Studies in Panchakarma
K.V.G. Ayurveda Medical College & Hospital,
Ambatedka, Sullia,

4. iv
Rajiv Gandhi University of Health Sciences
Karnataka, Bangalore
CERTIFICATE BY THE CO-GUIDE
This is to certify that the dissertation entitled “A comparative clinical study on
the effect of Nasya with Karpasasthyadi Taila and Nagara Taila in the management
of Avabahuka” is a bonafide research work done by Dr.Febin.P.Jose in partial
fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.
(Panchakarma).
Date:
Place: Sullia
DR. SANATH KUMAR D.G. M.D.(AYU)
Lecturer
Dept. of Post Graduate Studies in Panchakarma
K.V.G. Ayurveda Medical College & Hospital,
Ambatedka, Sullia

5. v
Rajiv Gandhi University of Health Sciences
Karnataka, Bangalore
ENDORSEMENT BY THE H.O.D AND PRINCIPAL OF
THE INSTITUTION
This is to certify that the dissertation entitled “A comparative clinical study on
the effect of Nasya with Karpasasthyadi Taila and Nagara Taila in the management
of Avabahuka” is a bonafide research work done by Dr.Febin.P.Jose under the guidance
of Dr. Krishna Prakash.M.K M.D. (Ayu) Professor, and co-guidance of, Dr.Sanath Kumar
D.G.M.D. (Ayu) Lecturer K.V.G.A.M.C, Sullia and contributed good values to the Ayurvedic
research.
Date: Date:
Place: Sullia Place: Sullia
Dr. N.S.Shettar M.D. (Ayu),
Principal,
K.V.G Ayurvedic Medical College & Hospital,
Sullia
Dr. N.S.Shettar M.D. (Ayu),
Prof. and H.O.D.
Dept of Panchakarma
K.V.G Ayurvedic Medical College & Hospital,
Sullia

6. vi
COPYRIGHT
Declaration by the Candidate
I hereby 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: Sullia. Dr. Febin.P.Jose
© Rajiv Gandhi University of Health Sciences, Karnataka.

7. vii
ACKNOWLEDGMENT
I have constantly witnessed Divine Providence in many instances and experiences
of my life. I thank Almighty for helping me soar to a new high today. I humbly seek this
opportunity to bow my head to the feet of the Almighty LORD DHANWANTHARI for
showering his blessings and empowering me to this eventful out-come without any
impediments.
I express my deep sense of gratitude to Sri. Kurunji Venkatramana Gowda for
giving me opportunity to study in this institution.
I give my respect at this moment to my father Dr.(Prof) T.F.Josekutty, my mother
Prof. Rosalie Jose, my Brother Fenil.F.Jose and my sister Dr.Frilla.F.Jose for their
blessings which gave me enough strength. Thanks need not but remembrance is a must.
Their warmth is vital for me throughout the life.
The inspiring forces throughout this research work; was my guide
Dr. Krishna Prakash.M.K, M.D. (Ayu). I use this opportunity to express my immense
gratitude and heart full thanks for his timely advises constant encouragement, critical
analysis, untiring help and rousing clinical knowledge.
I would like to avail the opportunity to express my gratitude to my respected co-
guide Dr. Sanath Kumar D.G, M.D. (AYU), for his humble nature, indulgence, dynamic
supervision and scholarly suggestions during the course of this research work.

8. viii
I express my gratefulness to Dr. N.S.Shettar, M.D.(Ayu), Principal and HOD, Dept
of Panchakarma for his inspiration, critical suggestions and timely help rendered me
through out this work.
I express my sincere gratitude to Dr.Deenaprakash Bharadwaj MS(Ayu)
Professor ,Dr Rohini. D .Bharadwaj M.D(Ayu) Professor , Dr Rajashekara N
M.D(Ayu) Professor ,Dr Udaya Shankar.L .M S( Ayu) Professor, Dr. Purushotham K.
G M.D (Ayu) Assist Professor,Dr Leeledhar D.V M.D (Ayu) Assist Professor, , Dr.
Hari Prasad Shetty .M , MD (Ayu) Assist Professor , Mrs. Shashikala Lecturer,
Dr.Harshitha Purushotham MD (Ayu) Lecturer Dr. Kavitha B.M. MD (Ayu), Dr
Harshavardhana.K .M S( Ayu) Lecturer , Dr. Bhagyesh.K. MD (Ayu) Lecturer, Dr.
Thasneem MD (Ayu), Lecturer
I express my sincere and deep gratitude to Mr.John winner and Dr.Gururaj M.D.
(Ayu) for their wholehearted encouragement as well as providing all necessary facilities for
the statistical work.
. I take the privilege to thank library Staffs Ms.Sahana and Ms. Thejaswini who
provided me all the necessary books and time for my literary work.
I am very much thankful to the entire Pharmacy Staffs, Hospital Staffs, Office
Staffs and Masseurs, for their help during the study.

9. ix
I pay sincere regards to my fellow colleagues Dr. Rajath K.T, Dr. Vasudevan
Moss, Dr.Amal.G.K, Dr.Soumya S.V, Dr. Vijayalakshmi , for their truly help and co-
operation.
I feel extremely thankful to Dr.Srelatha Bhattatiripade, Dr. Shobhana,
Dr.Aatish, Dr. Prajeesh, Dr. Nisamuden, Dr.Nishanth, Dr.Mini, Dr.Allex.M.George,
Dr.Jeeson N.G, Dr. Anjaly, Dr. Sreejin K, Dr. Shaiju, Dr. Mahesh, Dr. Anish, Dr.Anoop,
Dr.Jinu, Dr. Vijaygopal, Dr. Rejina Dr. Deeksha , Dr.Prasanna Aital, Dr Varun,
Dr.Sageeve M.M, Dr. Sreejith S, Dr. Lakshmeesha, Dr. Prasanna. Dr. Manish Sharma,
Dr. Varghese, Dr. Litty, Dr.Akila, Dr.Robins, Dr Swathy ,Mrs. Amjidha, Mr.Hafis and
others for valuable suggestions.
I thank specially to P G Scholars of other Departments, juniors, Internees and UG
friends for their help and supports.
It is my duty to remember and thank one and all especially my patients, Who have
helped directly and indirectly, whose works, are foundation bricks of this attempt.
Last but not the least I thank Mr. Shashidhara K., Hi-Tech Computers, for the
neat and clean printing of this research work.
Date :
Place : Sullia Dr. Febin.P.Jose

10. x
LIST OF ABBREVIATIONS USED
A.H – Ashtanga Hrudaya
A.S – Ashtanga Samgraha
B.P – Bhavaprakasha
C.S – Charaka Samhita
G.N – Gada Nigraha
M.N – Madhava Nidana
S.S – Sushruta Samhita,
Y.R – Yogaratnakara

11. xi
ABSTRACT
Avabahuka is a common condition which badly affects the routine domestic
activities of patients like combing; bathing etc. interference in occupation by the illness is
equally true both in patients with sedentary office work as well as heavy field work.
Ayurveda has a great role to manage this disease successfully. Nasya is one among the
treatments told by Acharyas for the management of this disease. A comparative clinical
study on Nasya with Karpasasthyadi Taila and Nagara Taila had been taken to assess the
effect of Nasya Karma and the drug in managing Avabahuka. The comparative effect in
managing the same disease is also assessed.
OBJECTIVE OF THE STUDY
1. To evaluate the efficacy of Karpasasthyadi Taila Nasya in Avabahuka.
2. To evaluate the efficacy of Nagara Taila Nasya in Avabahuka.
3. To compare efficacy of Karpasasthyadi Taila Nasya and Nagara Taila Nasya
in Avabahuka.
Two groups were made and the results obtained in both the individual groups
were compared. The study design selected for the present study was prospective
comparative clinical trial. The sample size for the present study was 30 patients suffering
from Avabahuka as per the selection criteria. Patients were randomly distributed to both
the groups of equal size.
Group A - 15 patients received Nasya with Karpasasthyadi Taila.
Group B – 15 patients received Nasya with Nagara Taila.

12. xii
In group A 15 patients (100%) had got Prayika Shamana(61-99%) , and no patient
(00%) had got no response to the treatment ie Guna Alabha. In group B 13 patients
(81%) had got Prayika Shamana(61-99%),02 patients(19%) had got Amshika Shamana
(31-60%), and no patient (00%) had got no response to the treatment ie Guna Alabha.
In Group A Shoola B T -53% and after follow up 91%, and in Sthabthatha i.e.
Unnamana - B T- 42% and after follow up 66%, Avannamana B T- 43% and after follow
up 84%,Akunchana B T-39 % and after follow up 81% and Prasarana B T- 61% and after
follow up 87%, Triyakgamana BT-60% and after follow up 77%.
In Group B Shoola B T -51% and after follow up 81%, and in Sthabthatha ie
Unnamana - B T- 34% and after follow up 63%, Avannamana B T- 30% and after follow
up 76%,Akunchana B T-31 % and after follow up 69% and Prasarana B T- 43% and after
follow up 80%, Triyakgamana BT-35% and after follow up 65%.
Group A had got good results while comparing with Group B.That means Nasya
with Karpasasthyadi Taila had got good effect than Nasya with Nagara Taila in
Avabahuka for the present study.
Key words; Nasya, Avabahuka, Karpasasthyadi Taila, Nagara Taila,

13. xiii
TABLE OF CONTENTS
SI. NO. TITLE PAGE
NO.
01 INTRODUCTION 1
02 OBJECTIVES 4
03 REVIEW OF LITERATURE 6
04 MATERIALS AND METHODOLOGY 77
05 OBSERVATIONS AND RESULTS 87
06 DISCUSSION 122
07 CONCLUSION 145
08 SUMMARY 147
09 BIBLIOGRAPHY REFERENCES 149
10 ANNEXURES 176

14. xiv
LIST OF TABLES
SI.
NO
TITLE PAGE
NO.
01 Nidana of Avabahuka 16
02 Sapeksha / Vyavachedaka, Nidana of Avabahuka 22
03 Pathya/ Apathya in Vatha Vyadhi 28
04 Muscles acting on Shoulder Girdle. 32
05 Showing Classification of Nasya according to Various Acharya 40
06 The difference between pratimarsha and marsha Nasya. 46
07 The indications for Shodhana Nasya. 47
08 The indications of Brumhana Nasya. 48
09 The Contraindication of Nasya 49
10 The course of Nasya karma 52
11 The Dosage of Nasya karma 53
12 The Samyaka yoga 58
13 The Ayoga Lakshana 59
14 The Atiyoga lakshana 60
15 Complications of Nasya Karma and their management 61
16 Properties of Nagara 70
17 Guna-Karma of Tila 71
18 Kasaya Dravyas of Karpasasthyadi Taila 73
19 Kalka Dravyas of Karpasasthyadi Taila 74
20 Distribution of Patients Based on Sex 87
21 Distribution of Patients Based on Age 88
22 Distribution of Patients Based on Occupation 89
23 Distribution of Patients Based on Religion Involved: 91
24 Distribution of Patients Based on Socio Economic Status 92
25 Distribution of patients by Education: 93
26 Distribution of patients by Marital Status 94
27 Distribution of Patients Based on Dietary Habit 95

15. xv
28 Distribution of Patients Based on Agni 96
29 Distribution of Patients Based on Koshta 97
30 Distribution of patients by Prakruti 98
31 Distribution of patients by Duration of illness 99
32 Distribution of patients by Vysana 100
33 Distribution of Patients Based on Rasa 101
34 Distribution of Patients Based on Onset 102
35 Distribution of Patients Based on Vihara 103
36 Distribution of Patients Based on Satva 104
37 Distribution of Patients Based on Vyadhi Bala 105
38 Distribution of Patients Based on Habitat 105
39 Distribution of Patients Based on Nidra 106
40 Distribution of Patients Based on Joint 107
41 Effect of Group-A on Shoola of Avabahuka 108
42 Effect of Group-B on Shoola of Avabahuka 109
43 Effect of Group-A Unnamana of Avabahuka 110
44 Effect of Group-B on Unnamana of Avabahuka 110
45 Effect of Group-A Avannamana of Avabahuka 111
46 Effect of Group-B on Avannamana of Avabahuka 112
47 Effect of Group-A on Akunchana 113
48 Effect of Group-B on Akunchana 113
49 Effect of Prasarana on Group-A 114
50 Effect of Prasarana on Group-B 114
51 Effect of Triyakgamana on Group-A 115
52 Effect of Triyakgamana on Group-B 116
53 Overall effect of Karpasasthyadi Taila Group-A 117
54 Overall effect of Karpasasthyadi Taila Group-B 118
55 Comparative results of Group-A and Group-B 119
56 Comparative Results of Group A and Group B 120
57 Overall results of the Patients 121

16. xvi
LIST OF FIGURES
SI
NO
TITLE PAGE
NO
01 Anatomy of the Shoulder Joint 29
02 Bursae Related to the Shoulder Joint 30
03 Exercises for frozen shoulder 35
04 Anatomy of Nose 66
05 Incidence of sex 88
06 Incidence of age 89
07 Occupation incidences 90
08 Incidence according to the religion 91
09 Distribution of patients by socio economic status. 92
10 Showing distribution of patients by Education 93
11 Distribution of patients by Marital Status 94
12 Incidence of Dietary habits 95
13 Incidence of Agni 96
14 Distribution of Patients Based on Koshta 97
15 Distribution of patients by Prakruti 98
16 Distribution of patients by Duration of illness 99
17 Distribution of patients by Vysana 100
18 Distribution of Patients Based on Rasa 101
19 Distribution of Patients Based on Onset 102
20 Distribution of Patients Based on Vihara 103
21 Distribution of Patients Based on Satva 104
22 Distribution of Patients Based on Vyadhi Bala 105
23 Distribution of Patients Based on Habitat 106
24 Distribution of Patients Based on Nidra 107
25 Distribution of Patients Based on Joint 108
26 Effect of Group A and Group-B on Shoola 109
27 Effect of Group A and Group-B on Unnamana 111
28 Effect of Group A and Group-B on Avannamana 112
29 Effect of Group A and Group-B on Akunchana 114
30 Effect of Group A and Group-B on Prasarana 115
31 Effect of Group A and Group-B on Triyakgamana 116
32 Result on Group A 117
33 Result on Group B 118
34 Comparative results of Group-A and Group-B 120

17. xvii
LIST OF ILLUSTRATION
SI
NO
TITLE PAGE
NO
01 Schematic Representation of Samprapti of Avabahuka 21
02 Nasya according to Charaka 41
03 Nasya According to the action 42
04 According to various parts of the drugs utilized in Nasya
therapy
42
05 Classification of Nasya according to Sushruta 43
06 Classification of Nasya according to Vagbhata 43
07 Classification of Nasya according to Kashyapa 44
08 Classification of Nasya according to Sharangadhara 44
09 Classification of Nasya according to Videha 45

18. xviii
LIST OF PHOTOGRAPHS
SI
NO
TITLE PAGE
NO
01 Procedure of Nasya Karma 83