Causes: - Excessive indulgence in sexual intercourse, heating of the head, entrance of the minute particles of dust or smoke into the nostrils, excessive application of cold or heat, voluntary retention of stool and urine are the causes which may instantly usher in an attack of nasal catarrh (Pratis'yaya). The fundamental principles of Vayu, Pitta and Kapha, jointly and separately, as well as of blood becoming aggravated by various aggravating causes, bring on an attack of nasal catarrh in course of time. 2-3.

Premonitary Symptoms

Heaviness of the head, sneezing and aching" in the limbs, appearance of goose-flesh upon the body, as well as many other different kinds of supervening symptoms are seen to precede an attack of nasal catarrh (Pratis'yaya). 4.

Specific Symptoms

Hoarseness of voice, a sense of stuffedness and obstruction in the nostrils accompanied by a thin mucous secretion, dryness of the throat, of the palate and of the lips, a pricking, and piercing pain in the region of the temples, as well as excessive sneezing and a bad taste in the mouth are the characteristics of Vataja type of catarrh (Pratis'yaya). A hot and yellowish secretion from the nose, heated skin, thirst, emaciation and yellowness of the complexion, as well as the secretion being sudden, hot and smoky - these are the characteristics which mark the Pittaja type of catarrh. Constant running at the nose, the secretion being white and cold, paleness (of the skin) and swelling (D. R.

whiteness) of the eyes, heaviness of the head, flabbiness of the face* and tickling and itching sensation in the regions of the head, throat, lips and of the palate are the features which mark the Kaphaja type of the disease. 5-7.

The spontaneous disappearance, as well as reappearance of Pratis'yaya - be it acute or chronic - is the charracteristic symptom of Tri-doshaja Pratis'yaya, wherein the specific symptoms of all (the three) kinds of Apinasa are present. 8.

Symptoms Of Raktaja Pratisyaya

Discharge of blood (from the nose), redness of the eyes, a bruised pain in the chest which seems as if struck with a blow, fetid smell in the breath and the mouth, and loss of the faculty of smelling are the characteristic symptoms of the Raktaja type of Pratisyaya which has its origin in the deranged condition of the blood. In these cases † hosts of extremely small worms of whitish or blackish ‡ hue are found to infest the affected localities (viz., the nostrils) which show symptoms identical with those of the head-disease due to the germination of parasites in that region. 9.

Prognosis: - The malignant nature of the disease (Dushta-Pratis'yaya) should be inferred from the constant alternate sliminess and dryness, as well as constant alternate contraction and expansion of the nostrils,

* In place ofSymptoms Of Raktaja Pratisyaya 30044 ' - some read_ i. e. "the man (patient) gets heaviness of the head." In this case the flabbiness of the face is not seperately mentioned.

† According to some this is the characteristic symptom of another kind of Pratis'yaya, and not one of the symptoms of the Raktaja type as appears at the first sight.

‡ Madhava Kar readsSymptoms Of Raktaja Pratisyaya 30046 i- e., glossy white in hue, in place ofi. e. whitish and blackish in hue.

fetour in the breath and loss of the faculty of smell. Such a case of Pratis'yaya should be regarded as extremely hard to cure. Neglected and not properly remedied at the outset of an attack, any type of catarrh (Pratis'yaya) may bring on cases of malignant Pinasa, which in time gives rise to a number of diseases and produces in its train deafness, blindness, loss of smell, violent ocular affections, cough, dulness of appetite, and Sopha (swelling). 10 - 11.

General Treatment of Pratisyaya:

Potions of clarified butter, various sorts of emetics, and fomentations (Sveda) may be prescribed in nasal catarrh (Pratis'yaya), except in fresh and acute cases. Errhines (Nasya) of Avapida type may also be employed in time, if required. Fomentation should be applied and diet should be taken in a tepid state with articles of acid taste, and draughts of milk should be administered with green ginger * and with any modification of the expressed juice of sugar-cane † for the purpose of thickening and maturing the secreted mucus, in cases where that maturing process has not already spontaneously set in. The mucus found matured, thick and pendent should be made to secrete by applying head-purgatives (Siro-vireka). Purgatives, Vasti of the Asthapana kind, smoke-inhalations and medicinal gurgles should also be prescribed according to the exigencies of each case under treatment and in consideration of the nature and intensity of the deranged Dosha involved therein. 12-14.

* Some explain "A'rdraka" to mean the expressed juice of fresh ginger, while others explain it to mean the powder of dried ginger.

† In place ofSymptoms Of Raktaja Pratisyaya 30048 - with any modification of the expressed juice of sugar-cane, such as treacle, sugar, etc , some read i. e., with articles of pungent taste.

Regimen Of Diet And Conduct

In a case of Pratis'yaya the patient should sit, lie, or move about in closed and windless rooms and wear warm and thick turban on his head. He should take Vijayd (Haritaki) and partake of meals consisting of Palanna * cooked without clarified butter. He should also be subjected to a course of strong head-purging as well as of smoke-inhalations. Use of new wine and cold drink, cold baths, sexual intercourse, anxious cares, lamentations, voluntary retention of stools and urine, as well as partaking of fares which are excessively dry (and beget dryness in the system), should be foregone by a person suffering from an attack of Pinasa. 15-16.

Fastings and employment of digestive (Pachana) and appetising (Dipaniya) remedies should be the medical treatment in cases of Pinasa (nasal catarrh) accompanied by such distressing symptoms as vomiting, aching, heaviness in the limbs, feverishnes, non-relish for food, apathy, and Atisara (diarrhoea). In case of an adult person suffering from an attack of Pinasa due to the concerted action of Vayu and Kapha, the patient should be made to vomit by taking in a large quantity of any liquid substance. The complications (Upadrava) involved therein should be remedied by appropriate diet and remedial agents and after their subsidence, the patient should be treated according to the instructions given before. 17-18.

Treatment Of Vataja Type

In cases of

Vataja-Pratisyaya clarified butter duly cooked with the drugs of the Viddri-gandhddi group or with the five officinal salts should be prescribed for internal use, according to the rules of taking Sneha (see chapter XXXI (Medicinal Uses (Both Internal And External) Of The Snehas , I.e., Oleaginous Substances (Snehaupayogika-Chikitsita)., Chikitshita-Sthana). The process of snuffing, etc., should also be resorted to, if necessary, as in a case of Ardita (Facial paralysis). 19.

* Palanna is generally prepared by cooking together rice, meat and clarified butter as well as other spices, but in this case clarified butter should not be used.