A CRITICAL ANALYSIS ON STANDARDIZATION OF BINDU FOR MARS’A NASYA

Abstract: Nasya, based on the dose of oil used, is classified in to two types, as Mars’a and Pratimars’a. Bindu is the unit of measurement explained for the dose of oil. In routine Aayurvedic practice one Bindu is considered as one drop (0.05ml) while according to the definition of Bindu and standardized quantity mentioned by S’aaran’gadhara, it is 0.5ml. Thus the dose of Mars’a nasya is such an area where lot of disparity exists. Although the routinely practiced dose is ten
times less and instilled only once, this itself have been proved significantly
effective by many postgraduate researches. The present paper deals with
classical concept of Bindu and its standardization for Mars’a nasya.

Key words:
Standardization, Dose, Bindu, Mars’a nasya,

Introduction:

Aayurveda the art and science of living is at the doorstep of global acceptance. Among the various treatment
modalities of Aayurveda, Pancakarma procedures are the ones which are mostly
highlighted in the present scenario. Among five purification (Pancakarma)
procedures, Nasya is said to be effective in curing the diseases of
Oordhvajatru (supraclavicular region). The procedure by which medicine is
administered through nasal route is called as Nasya.

Nasya is practiced in many clinical conditions in different medicinal forms, such as Swarasa, kalka, kwaatha, coorna, sneha etc. Among these Sneha (oil) is routinely practiced because of its practical feasibility, easy availability and inherent Kaphahara property (As. H. Su. 20/33).

Dose is a very important factor in any of the Pancakarma procedures to get optimum efficacy of the therapy. Change in dose can change the result and it can lead to side effects or no effect. Because of this reason, on the basis of dose of oil used, Nasya is classified in to two types as, Mars’a and Pratimars’a. Bindu is the unit of measurement explained for the dose of oil, Bindu is such an area where lot of disparity exists when compared with classical references and routine practice.

Classical concept of Bindu in Nasya:

In the context of dose of Sneha nasya (S. Ci. 40/28) the term Bindu was first coined by Sushruta: Except Caraka all other Aacaaryas used the term Bindu as the unit of measurement for any medicine in liquid form used for Nasya.

Definition of Bindu:

Bindu is the unit of measurement and defined as the quantity of Drava (sneha, swarasa, kashaaya etc.) that dribbles down when the first two parts of index finger (Patient’s) are dipped into it and taken out (As. H. Su.20/10). 

The comment on this by Hemaadri proves beyond doubt that not just the first drop is one Bindu, but it is the total quantity dribbling down from the index finger when immersed in the liquid should be considered as one Bindu

Yaavatpatati taavaan binduh`, na prathamapatita eva / Hemaadri on As. H. Su. 20/10

Bindu pramaana for Sneha nasya:

Asht’aangasamgraha has first classified Sneha nasya in to two types depending on the Bindu as, Mars’a nasya and Pratimars’a nasya (As. Sam. Su. 29/14).

For Sneha nasya the term Mars’a was first coined by Asht’aangasamgraha. For Sneha nasya, Caraka has used the term Naavana while Sushruta used the term Nasya (S. Ci. 40/22). Vaagbhat’a has mentioned three different doses as 10 Bindu (uttama) 8 Bindu (Madhyama) & 6 Bindu (Heena) for Mars’a nasya (Sneha nasya) depending on the Dosha and Bala of the patient. (As. Sam. Su. 29/14, As. H. Su. 20/10). Sushruta has not classified Nasya depend on the dose of Sneha used, but has mentioned three different doses for Sneha nasya. In Sushruta samhitaa the dose is mentioned as, 8 Bindu, S’ukti and Panis’ukti, which are the Heena, madhyama and Uttama maatraa respectively.D’alhana comments that Heena maatraa 8 Bindu is to be instilled in each nostril. He says that S’ukti is 32 Bindu and Panis’ukti is 64 Bindu. Similar opinion is also mentioned by S’aaran’gdhara (S’aa. Utt. 8/25) Cakradatta (C. D.73/10) Vangasena (Vanga 86/15) and Bhaavaprakaas’a (B. P. Po.kha. 5/213).Caraka has not mentioned specific dose for Sneha to be used in Nasya. Only for Anu taila, Caraka mentions the dose as ½ Pala (24ml)(C.Su.5/62). Except Caraka,all other Aacaaryas have mentioned Bindu pramaana for deciding the dose of Drava dravya to be used for Nasya.

As from the above explanations it is evident that for Drava dravya, Bindu is the unit and it is measured by patient’s index finger. Thus the quantity of one Bindu may vary from person to person as the size of the index finger is different. The quantity of Bindu also varies according to the Drava dravya used for the Nasya. It would be practically convenient if standard
or fixed quantity of one Bindu can be decided for any of the Drava dravya used
for Nasya. such an attempt of Standardization of Bindu for Sneha nasya Mars’a nasya was at first successfully done by S’aaran’gadhara in 14 th century.

Critical analysis on standardization of Bindu in the context of Mars’a nasya:

Evam`vidhairbindusanjn`airsht’bhih` s’aana ucyate / S’aa. Utt. 8/40

S’aaran’gadhara has stated that, 8 Bindu is equals to one S’aana and further the dose of Mars’a nasya is explained in multiples of S’aana itself, as 8 S’aana, 4 S’aana and 2 S’aana for Pradhaana, madhyama and heena maatraa

According to S’aaran’gdhara 1 S’aana = 4 Maasha

4 Maasha = 4 gm = 4ml (Aayurvedic Formulary of India)

Thus, 8 Bindu = 1 S’aana = 4 ml

1 Bindu = 0.5 ml

According to Aayurvedic Formulary of India, 1 drop = 0.05ml,

10 drops = 0.5 ml

It can be stated from the above explanation that standardized quantity of one Bindu for Mars’a nasya is 0.5 ml (10 drops)

Relevance of s’aarangadhara’s bindu in present period:

As S’aarangadhara has given the quantity of one Bindu for Mars’a nasya in the 14th century, it was essential to find it’s relevance in present period

A pilot study was conducted in 30 samples to assess the quantity of one Bindu of oil, between age group 18 to 60 yrs, irrespective of sex, height, weight and dimensions of index finger.

Table no 01: Quantity of one Bindu as per pilot study

Sample Size (n)	Mean Bindu in ml	SD	SE
30	0.49 ml	0.07	0.01

It was observed that mean Bindu is 0.49 ml +/_ 0.07 with SE of 0.01.Thus it was established that S’aarangadhara’s standardized quantity of one Bindu (0.5 ml) is relevant in the present period.

Analysis on dose of Mars’a nasya as per standardized Bindu:

From above analysis the doses mentioned by various Aacaaryas for Mars’a nasya can be converted according to standardized quantity of Bindu as follows,

Table no 02: Revised doses of Vaagbhat’a as per the standardized Bindu.

AACAARYA		Uttama   Maatraa	Madhyama   maatraa	Heena   maatraa
Asht’aangahr`daya (As. H. Su. 20/6)   Asht’aangasamgraha   (As. Sam.Su. 29/1	Bindu	10 Bindu	8 Bindu	6 Bindu
	Drops	100 drops	80 drops	60 drops
	ML	5ml	4 ml	3 ml
Sushruta (S.Ci.40/36)   S’aaran’gdhara   (S’aa.Utta.8/25)   Cakradatta(C.D.73/10)   Vangasena (86/15)   Bhaavaprakaas’a   (B.P.Po.kha. 5/213)	Bindu	64 Bindu	32 Bindu	16 Bindu
	Drops	640 drops	320 drops	160 drops
	ML	32 ml	16 ml	8 ml

It is observed that there is huge difference between the dose of Vaagbhat’a and other Aacaaryas. It is clear that the dose mentioned by Sushruta and other Aacaarya with similar opinion is 16 Bindu (8 ml) 32 Bindu (16 ml) and 64 Bindu (32 ml), and according to Vaagbhat’a it is 6 Bindu (3 ml), 8 Bindu (4 ml) and 10 Bindu (5 ml) for Uttama, madhyama and Heena maatraa respectively. 

INTERPRETATION OF CLASSICAL DOSES:

The answer for this variation among Aacaaryas regarding the dose lies in the procedure of Nasya.

Virecayet trirdvirathaikas’o vaa balam` sameekshya trividham` malaanaam / (C. Si. 1/50)

Tatas’caivameva dviteeyam`s’manushecayettatha tr`teeyam`a doshadibalena vaa / ( As. Sam. Su. 29/18)

Dvistrirvaa nasyamaacaret /( As. H. Su 20/19)

Mars’asya dvitrivelam`a vaa
veekshya doshabalaabalam / (S’aa.
Utt. 8/26)

Above references tell that Nasya can be done once, twice or even thrice according to Dosha and Bala of the patient in the same sitting. If the dose of Vaagbhat’a and Sushruta is compared, the reason for this huge variation in dose can be found in above reference, if e.g. according to Vaagbhat’a madhyama maatraa ( 8 Bindu – 4 ml in each nostril) is instilled thrice, i.e. 8 ml x 3 = 24 ml (48 Bindu) then the total quantity used for the Nasya on same day same sitting will be in between Sushruta’s madhyama and Uttama maatraa.

Nasye Put’asankhyaamaah`-evamiti(Hemadri on As. H. Su 20/19)

Hemadri says that 2 or 3 put’a of Nasya has to be done according to patient’s Bala and Dosha in one sitting of Nasya.

In similar way Caraka’s dose of Sneha nasya can be also interpreted. Caraka have mentioned the dose of Anu taila as half Pala (24 ml). Thus the dose will be 48 Bindu (standardized Bindu = 0.5ml) and which is the quantity mentioned for one sitting of Nasya and not for the 7 days.

So it is very clear that there is no variations of doses exist among Aacaaryas. Vaagbhat’a mentioned the dose for each instillation and it is the range given from 6 Bindu to 10 Bindu. While Sushruta, s’aaran’gadhara, cakradatta, vangasena and bhaavaprakaas’a have given the dose
for the complete Nasya in one sitting and it is the range given from 16 Bindu
to 64 Bindu.

Table no 03: Interpretation of variations in classical doses

Dose in BINDU   (In each nostril)	FIRST   INSTILLATION	SECOND   INSTILLATION	THIRD   INSTILLATION
Uttama maatraa   10 Bindu	10 Bindu each nostril X1 =    20 Bindu	10 Bindu each nostril X 2 =   40 Bindu	10 Bindu each nostril X 3 =   60 Bindu
Madhyama maatraa   8 Bindu	8 Bindu each nostril X 1 =   16 Bindu	8 Bindu each nostril X 2 =   32 Bindu	8 Bindu each nostril X 3 =   48 Bindu
Heena maatraa   6 Bindu	6 Bindu each nostril X 1 =   12 Bindu	6 Bindu each nostril X 2 =   24 Bindu	6 Bindu each nostril X 3 =   36 Bindu

From the above analysis it can be stated that there may not have been any difference of opinion among Aacaarya regarding the dose of Mars’a
nasya.

ROUTINELY PRACTICED BINDU:

The definition of Bindu is followed with the similar reference but it is interpreted in different way. In routine practice only the first single drop which dribbles down from the first two parts of index finger is considered as one Bindu.

Bindu = 1 drop = 0.05 ml

Routinely practiced dose of Mars’a nasya

Uttama maatraa :10 drops(0.5ml)

Madhyama maatraa : 8 drops (0.4ml)

Heena maatraa : 6 drops (0.3ml) 

NUMBER OF INSTILLATION IN ROUTINE PRACTICE:

In routinely practiced procedure of Nasya only one instillation is done in one sitting, i.e. 10 drops, 8 drops or 6 drops is instilled only once in each nostril. Second or third instillation is not done in the same sitting of Nasya.

ANALYSIS BETWEEN ROUTINE PRACTICE AND CLASSICAL PRACTICE OF NASYA:

Dose:

On comparison the classical Bindu is 0.5ml and routinely practiced Bindu is 0.05ml, which is 10 times less.

Number of instillation:

As already stated above the Nasya can be done twice or even thrice according to Dosha and Bala of the patient. Thus it is not always mandatory to stop Nasya after first instillation, if necessary second or even third instillation can be done. Thus in routine practice, if second instillation is avoided the 10 times less dose becomes 20 times less and if, the third instillation is avoided it becomes 30 times less, provided the Dosha and Bala of the patient demands the further instillations.

On comparison the classical
Bindu is 0.5ml and routinely practiced Bindu is 0.05ml, which is 10 times less.
It can be stated that routinely practiced highest dose of 10 Bindu (10 drops) of Mars’a nasya itself is half the quantity of classical dose of Pratimars’a. It can be really a point of debate that the dose which is half of Pratimars’a, can ever do S’odhana? Thus it can be concluded that,

CONCLUSION:

* Bindu is not equivalent to drop (Bindu ≠ Drop).

* Routinely practiced dose is due to misinterpretation of concept of Bindu.

* Routinely practiced dose is 10 times less compared to classical dose.

* Standard dose of one Bindu for Mars’a nasya is 0.5ml (as according to S’aaran’gadhara, 1 S’aana = 8 Bindu) and it is relevant in present period.

* As per classical procedure dose can be repeated for two to three instillation according to need of clinical condition and if complications are not present, which is not followed in routine practice of Nasya.

* 10, 8 & 6 Bindu is the range of dose mentioned for one instillation of Mars’a nasya.

* 64, 32 & 16 Bindu is the range of dose mentioned for one sitting of Mars’a nasya.

* Measurement of Bindu should be defined in milliliter in standard literature or in formulary so as to avoid the misinterpretation of quantity of Bindu.