Taila Prayoga in Netrarogas

Introduction

The practice of Shalakyatantra includes the usage of oral medications, Panchakarma procedures, as well as Kriyakalpa (specialized ocular therapies). These include Tarpana, Putapaka, Seka, Aschyotana, Anjana, Pindi and Bidalaka. ¹ These are specifically designed for Netraroga Chikitsa, while some, like Anjana, are to be practiced as a part of Dinacharya (prescribed daily routine), which are practiced in a healthy individual. Therefore, it is carried out in Swastha (healthy individual) as well as in Rogi (person having a disease), as per the condition. The Dravyas (materials) used for these procedures can range from Ghrita (ghee or clarified butter), Swarasa (fresh squeezed juice), Churna (powders), Ksheerapaka (milk-based preparations), Kashaya (decoctions).²

In the Ayurveda Samhitas, the use of all four Snehas (four major unctuous substances-oil, ghee, muscle fat, marrow) have been described in the context of eye disorders. Even then, we rarely see the use of Tailas, in this regard, and is considered Achakshushya (not conducive to the eyes) by many scholars.

An attempt has been made to compile the references in the Samhitas regarding the use of Tailas in the eyes. Acharya Vagbhata says that Taila is Achakshushya, ³ with Acharya Hemadri explaining that Achakshushya means Chakshusho hitam na bhavati (not conducive to the eyes). But when we look for the context in which this was mentioned, it was found in the Dravadravyavignaneeyaadhyayaha, where Acharya discussed the effect each of the Dravyas have on being consumed internally.³ A reasonable derivation from this is that Taila may be Achakshushya when taken internally, and may not be so if used externally.

Taila has Ushna and Teekshna Gunas, and these could be the possible reasons for its exclusion from ocular therapies. But there are references of Tailas having a Phalashrutri of Timira or Chakshurogas.⁴ This is a clear indication that Tailas can in fact be used for Netrarogas. Acharya Vagbhata mentions Jeevantyadi Taila Nasya in the context of Vataja Timira Chikitsa.

Acharya Sushrutha mentions that Seka Prayoga with Chatuh-sneha is to be done Vataja Abhishyanda. Bhaishajya Ratnavali Netraroga Chikitsa Prakaranam, explains Taila preparations like Nripativallabha Taila, Gomaya Taila, Abhijit Taila for the management of Netrarogas. ⁴

The use of Taila has been mentioned in the Gada Nigraha - Netra 147 as, Kwatha of Prapoundarika, Shatahva, Darvi, Lodhra and Chandana mixed with Eranda Taila is useful for Pariseka to relieve pain.⁵

Therefore, we see that there are some Yogas for which a direct mode of application has been mentioned, that is, Nasya, Seka. In regard to other Yogas, they can be applied in other treatment modalities like Kriyakalpa procedures, Basti, Murdhni Taila Prayoga and Padabhyanga, which are the most common ways of using such Tailas.

An attempt has been made to understand the modes of action of the different ways of using Tailas in Netra.

A) Nasya

Nayana is considered as the Pradhana among the Indriyas in the Chanakya Neeti.⁶ Shirasi Indriyani Indriya Pranavahani Srotamsi Suryamiva Gabhastaha Gabhastayaha Samshritani Acharya Charaka states that the Indriyas, and their Srotas are situated in the Shiras. ⁷ Thus, the Pradhana Indriya, Nayana, has its Samshraya in the Shiras. Acharya Vagbhata opines that the Nasa acts as a Dwara to the Shiras.⁸ Thus, Nasya is one of the most important ways to reach the Indriyas situated in it. This can be achieved either in the form of Marsha or Pratimarsha Nasya. While Marsha Nasya is one among the Panchakarmas, and has restrictions, including age, Pratimarsha Nasya is suitable to be given to people of all ages.⁹ The commonly indicated Tailas for Nasya for Netrarogas are Anu Taila,¹⁰ Shadbindu Taila,¹¹ Bhringaraja Taila.¹² They are very commonly practiced, with documented results.

B) Murdhni Taila

One of the commonest ways of application of Tailas is through Murdhni taila. They can be in the form of Shiro Basti, Dhara, Pichu or Abhyanga.¹⁶ The Shiras is considered as the Uttamanga.¹⁷ Acharya Vagbhata says that the body is considered as a tree, with the roots of the tree compared to the Shiras, and the trunk and branches are considered as the body.¹⁸ This highlights the importance of nourishment and care required for the Shiras and the Indriyas it houses.

All four Murdhni Taila applications help in strengthening the Indriyas. Shiro Pichu is specifically considered as being helpful in the condition of Netrasthambha, while Shirobasti has been for Timira. ¹⁹ Murdhni Taila applications also have a wide application in sleep, which further influence the Indriyas. Swapna Viparyaya is considered as one among the Netra Roga Nidanas. Improving the quality of sleep thus helps to prevent Netra Rogas, and helps in doing the Nidana Parivarjana, which is the foremost treatment principle.²⁰

C) Basti

Basti is considered as Ardha Chikitsa, ²¹ that is, it can act in such a way that it constitutes about half the entire treatments done. It acts on all the Rogamargas, and has its action on all parts of the body.²² Acharya Sushruta, while explaining Rajayapana Basti, says that it is Chakshushya. ²³ In the context of Bastikalpa Adhyaya, Acharya Vagbhata has mentioned about Chakshushya Basti. ²⁴ It is a type of Siddhabasti having all the contents of Madhutailikabasti along with Yashtimadhu Kalka. It is a type of Yapana Basti, having Rasayana, Pramehajit properties. This can be considered as a template, using which we can try to formulate other Bastis which have Chakshushya action.

D) Padabhyanga

There are innumerable Siras in the Sharira. Two Siras are said to form a connection between the Pada and the Akshi.²⁵ The Dravyas used on the Pada, therefore have a direct effect on the Netra.

Acharya Dalhana has explained that there is a Nadi that traverses from the feet to the eyes and hence medicines applied over the soles of feet transcend to the eyes. Nadi Darpana, while enlisting the ten important Nadis in the head, mentions Gandhari in left and Hasti Jihwa in right eye.

Gandhari Naḍi has the colour of peacock's neck, surrounds Ida Nadi and extends from Pada to the Netranta. Hasthi Jihwa, has the colour of blue lotus and surrounds the Ida Nadi in front and extends from the feet to the head.

There is also a description of two Naḍis, Pusa, and Alambusa which spread from toe towards the borders of the eye. It is present towards the right side of the body, surrounds the Pingala Nadi, and is in front of both Pusa and Alambusa, traverse from the Pada tala and Pada angustha, towards the Netranta.²⁶ Thus, Tailas that have Chakshushya properties used through Padabhyanga prove effective in the management of Netrarogas.^27,28 Padabhyanga has also been described as a part of Dinacharya, where it is explained to have Drishti Prasadana action, thus highlighting its importance.²⁹

We can therefore understand that Padabhyanga has its role not only as a treatment procedure in diseased condition, but can also be practiced daily as a disease preventive strategy.

E) Sarvanga Abhyanga

Acharya Vagbhata opines that Nitya Abhyanga has to be done by a Swastha. It helps to do Drishti Prasadana. ³⁰ Sarvanga Abhyanga helps to do Vata Shamana, and does the Jarapaha. Therefore, we can consider that the Vataja Netrarogas can be well prevented, as well as the Netrarogas commonly seen in older age, such as cataract, can be prevented.³¹

Siddha and folklore practice

Padala Thylum, a Siddha medicine is used as eye drops, having one of the ingredients as Tilataila, as explained in the Agathiyar Nagamuni Nayanavithi.

In parts of coastal Karnataka, there is a practice of applying a couple of drops of coconut oil into the eyes, as it is believed to prevent redness of eyes. It is said that even if a person using coconut oil in the eyes does get affected, he will exhibit fewer clinical features, and will recover faster.

Discussion

Lipid-based therapies closely mimic the composition of the tear film. Lipid-based therapies not only relieve patient symptoms immediately after topical administration, but may also directly improve the lipid tear film structure and thickness component in ocular surface disease, resulting in enhanced tear film stability.³²

Castor oil has been used in the management of ble-pharitis, meibomian gland dysfunction and dry eye. The co-existence of hydrophilic and hydrophobic groups in castor oil allows its structure to form a variety of esters, amides and polymers. Their individual characteristics in the interaction with the aqueous-mucin phase have been considered important in maintaining uniformity during a blink, where the highly structured polar lipid layer serves as a surfactant between the inner hydrophilic aqueous-mucin phase and the thick outer non-polar lipid layer.

It has favourable pharmacokinetics, a low risk of topical adverse consequences and acceptable lipophilicity-hydrophilicity balance, and therefore, does not need either chemical modification or a carrier to facilitate absorption of castor oil in the target tissue.

It may even have an upper hand over some conventional ophthalmic medications by circumventing common side effects of preservative toxicity, allergic reaction or an aggravation of the condition as can be observed with artificially preserved ophthalmic formulations.³³

Case Report

A 22-year-old female, with the complaints of blurriness in visualizing distant objects since one year, and wearing spectacles since six months, was administered Nasya with Abhijitha Taila for seven days.

Conclusion

There are multiple refences in the Samhitas that Tailas can be used for Netra Vikaras, but it is not widely practiced. Even when explaining the Kriyakalpa procedures in detail, there are no references quoting that Tailas cannot be used for a specific procedure. On the basis of Dravadravya Vijnaneeya chapter of Acharya Vagbhata, we can conclude that Abhyantara Sevana of Taila is Achakshushya. It gives us a good guide for advising Pathya and Apathya, where an oil rich diet can be avoided, and also hints at a possible Nidana for Netrarogas Subjects can be advised to perform Padabhyanga daily, just before going to bed. Multiple references of Tailas mentioned in the context of Netrarogas open the possibilities of using Tailas as previously mentioned. Tila Taila is said to have Ushna Veerya, and does Kapha Vata Shamana, whereas Narikela Taila possesses Sheeta Veerya, and does Pitta and Tridosha Shamana. Samskara of the Taila also plays a role here. If Taila is processed with Ushna Veerya Dravyas, they can be better suited for Vataja or Kaphaja Vyadhis, whereas, if processed with Sheeta Veerya Dravyas, they are better suited for Pittaja Vyadhis. Thus, Taila Prayoga in Netra Rogas is a vast area with Tailas being used for Panchakarma as well as Kriyakalpa procedures, which opens new avenues and can be explored in further studies.

Declaration

The authors whose names are above certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Conflict of Interest

None