Introduction
Rhinitis, defined as inflammation of the nasal mucosa arising from infection, allergy, or injury, presents clinically with sneezing, nasal discharge, nasal obstruction, local irritation, body ache, feverish sensation, and headache. In Ayurvedic nosology, this clinical picture corresponds to the condition known as pratishyaya, classified under nasagata roga (nasal disorders). The term itself is etymologically derived from Acharya Charaka's definition, "pratikshnam shyayatiitipratishyaya," denoting the continuous outward movement of vata, pitta, and kapha doshas through the nostrils. The prevalence of nonallergic rhinitis stands at approximately 40%, underscoring the public health relevance of effective, non-antibiotic management strategies, particularly in acute presentations where antibiotic use is not indicated.1
Classification of pratishyaya
Pratishyaya is categorized into five distinct types based on the predominant dosha involved:
- Vataja pratishyaya: Predominantly vata-driven nasal manifestations
- Pittaja pratishyaya: Characterized by pitta-dominant features
- Kaphaja pratishyaya: Marked by kapha predominance
- Sannipataja pratishyaya: Involving all three doshas simultaneously
- Raktaja pratishyaya: Associated with rakta (blood) vitiation
The pathogenesis is rooted in the vitiation of kaphadi tridoshas, which accumulate in the head region and subsequently move toward the nasal passages, precipitating the symptomatic expression of pratishyaya.
Dhoopana as a therapeutic intervention
Among the various Ayurvedic interventions documented in classical texts for the management of pratishyaya, dhoopana (nasal fumigation) holds particular clinical relevance. In this intervention, select medicinal herbs are compounded into a stick-form preparation known as a varti (wick), and the resultant fumes are directed toward the affected nasal region for local therapeutic fumigation.
Key features of dhoopana include:
- Direct airway delivery: The fumigation route delivers active constituents directly into the upper respiratory tract, enabling localized therapeutic action
- Protective effect: The intervention provides both symptomatic relief and local protection to the nasal mucosa
- Classical authorization: Dhoopana is explicitly documented in Ayurvedic classical literature for the management of acute rhinitis
Pharmacological basis and clinical considerations
- The herbs employed in dhoopana formulations, namely tulsi, vasa, nirgundi, and nilgiri, have demonstrated utility in the management of upper respiratory tract infections when administered via steam inhalation.
- Given that the mechanism of steam inhalation and dhoopana both involve volatile herbal constituents reaching the airways, the therapeutic fumes of these ignited herbs are expected to confer comparable benefits in the management of acute rhinitis. 2
- This positions dhoopana as a plausible Ayurvedic parallel to polyherbal steam inhalation, with the added advantage of classical textual support and a non-systemic, non-antibiotic mode of action, particularly relevant in pediatric acute rhinitis management.
Conclusion
Pratishyaya, as the Ayurvedic correlate of rhinitis, is a well-defined clinical entity with a clear doshic pathogenesis and a structured classification system. Dhoopana, a classical Ayurvedic fumigation therapy utilizing herbal vartis, offers a targeted, airway-directed intervention with potential equivalence to polyherbal steam inhalation. Its documented classical basis, combined with the known efficacy of constituent herbs such as tulsi, vasa, nirgundi, and nilgiri in upper respiratory conditions, makes dhoopana a clinically relevant, non-antibiotic therapeutic option warranting further evaluation in the management of acute rhinitis.
References:
1. Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev. 2013;2013(6):CD000247. Published 2013 Jun 4. doi:10.1002/14651858.CD000247.pub3. https://pmc.ncbi.nlm.nih.gov/articles/PMC7044720/
2. Kakar M, Rathi R, Balakrishnan D, Rathi B. Evaluation of Comparative Efficacy of Polyherbal Steam Inhalation Versus Polyherbal Nasal Fumigation (Dhoopana) in Children With Rhinitis (Pratishyaya): Protocol for an Open-Label Randomized Controlled Trial. JMIR Res Protoc. 2025;14:e58197. Published 2025 Feb 21. doi:10.2196/58197. https://pmc.ncbi.nlm.nih.gov/articles/PMC11890129/#sec31