Introduction

In Ayurveda, Shodhana Chikitsa (purificatory therapy) forms the foundation of holistic disease management, emphasizing not only internal detoxification but also external environmental and topical therapies. One such unique method is Dhoopan Karma - the therapeutic use of medicated herbal smoke. It has been classically used for disinfection, purification, and treatment of both external and internal ailments. The therapeutic rationale behind Dhoopan lies in the delivery of volatile phytoconstituents through smoke, which acts via inhalation, topical contact, or indirect application to infected or vulnerable sites.^[1]

Shalakya Tantra, one of the eight branches (Ashtanga Ayurveda), specifically deals with disorders above the clavicle - particularly those of Eyes (Netra), Ears (Karna), Nose (Nasa), Throat (Kantha), and Head (Shira). In this context, Dhoopan Karma is considered a supportive and effective therapy in various Karna Rogas such as Pūtikarna (foul-smelling ear discharge), Karna Srava (otorrhea), Karna Shoola (ear pain), and Karna Daha (burning sensation in ear), where antimicrobial and deodorizing actions are crucial.^[2]

Classical texts like Sushruta Samhita - a primary reference for Shalakya Tantra - and Ashtanga Hridaya elaborate on various types of Dhoopan, such as Rakshoghna, Krumighna, and Vranashodhaka Dhoopan, suitable for both surgical and medical conditions of the head and neck.^[3] These fumigations are especially valuable in conditions where direct topical application may be painful, contraindicated, or ineffective. In recent years, growing antibiotic resistance, frequent recurrence of ENT infections, and a demand for natural, side-effect-free alternatives have reignited interest in such classical therapies. Ayurvedic Dhoopan, with its multipronged properties like Krimighna (antimicrobial), Shothahara (anti-inflammatory), and Sugandhikara (deodorizing), stands out as a potential adjunct or primary therapy in the domain of Shalakya Tantra, particularly in otological conditions.^[4] This review article aims to provide a comprehensive classical-to-contemporary analysis of Dhoopan Karma, with a special focus on its applications in Karna Rogas, blending scriptural insights with modern evidence to support its clinical utility in ENT care.^[5]

where inherent Rasa (taste), Guna (quality), Virya (potency), and Karma (action) of herbs determine their therapeutic use. For Dhoopan Karma, herbs possessing Tikshna (penetrating), Ushna (hot), and Krimighna (anti-microbial) properties are primarily preferred to target doshas and eliminate pathogenic organisms.^[11] Classical Ayurvedic texts recomm-end a wide range of substances for Dhoopan, including Guggulu (Commiphora mukul), Haridra (Curcuma longa), Vacha (Acorus calamus), Nimba (Azadirachta indica), Shallaki (Boswellia serrata), and Agaru (Aquilaria agallocha). These herbs are known for their anti-inflammatory, antimicrobial, antifungal, and deodorant properties, making them highly suitable for ENT infections including Karna Rogas.^[12] Guggulu, most frequently used resin in Dhoopan, is praised for its ability to absorb toxins, reduce foul odors, and neutralize pathogens. It acts as a Shothahara (anti-inflammatory) and Krimighna Dravya, useful in managing suppurative ear conditions like Karna Srava and Pūtikarna.^[13] Similarly, Haridra (turmeric), with its curcumin con-tent, demonstrates powerful antibacterial, antiviral, & antioxidant actions, validated by modern pharma-cology & widely used in both clinical & household fumigation practices.^[14] The herb Vacha, described in Ayurvedic Nighantus as Kaphahara & Kandughna, provides benefit in controlling excessive ear dis-charge & irritation. It is also known for its central nervous system stimulating effect & its use in neuro-sensory conditions, making it valuable in ENT & Shalakya Tantra.^[15] Additionally, Dhoopan form-ulations often include aromatic substances like Kapur (camphor) & Ela (cardamom), which not only enh. sensory quality of smoke but also contribute to its Srotoshodhana (channel-purifying) & Manahsh-odhana (mind-cleansing) effects -highlighting psycho-somatic depth of Ayurvedic therapeutics.

Guggulu

Saindhava Lavana

Nimba

Vacha

Karnadhoopana Varti

Dhoopan Karma Procedure

Execution of Dhoopan Karma requires systematic & well-defined proce. to ensure both safety & efficacy.

D. Precautions and Post-care

It is essential to monitor patient comfort, especially in ENT conditions, to avoid overexposure that could result in mucosal dryness, irritation, or burning sensation. Post-fumigation, the area may be cleaned with warm oil-soaked cotton or medicated ear drops can be instilled. The room should be well-ventilated to avoid secondary inhalation by others.^[20] This systematic and localized use of Dhoopan offers a non-invasive, antimicrobial, and anti-inflammatory modality, especially useful in ENT pathologies like Pūtikarna, Karna Srava, and chronic otitis media, which are often resistant to conventional antibiotic therapy.

Contemporary Scientific Insights on Dhoopan in Karna Rogas

With the rise of antibiotic-resistant organisms, there has been a resurgence of interest in Ayurvedic bio-interventions such as Dhoopan Karma, particularly in the management of Karna Rogas. Modern research has explored the antimicrobial, anti-inflammatory, and analgesic properties of various Dhoopan Dravyas, validating their use in conditions like chronic suppurative otitis media (CSOM), Pūtikarna, and Karna Srava.^[21] Studies on medicated smoke have demonstrated its broad-spectrum antibacterial effects against Staphylococcus aureus, Pseudomonas aeruginosa, and E. coli, which are commonly implicated in ENT infections. Herbal Dhoopan using Haridra, Vacha, and Nimba has shown significant zone of inhibition against these pathogens, comparable to standard antibiotics in in-vitro studies.^[22] These findings support the classical view of Dhoopan as Krimighna and Doshashamaka. Moreover, clinical trials have reported reduced ear discharge, foul smell, and pain in patients suffering from Pūtikarna and Karna Srava after regular administration of Dhoopan Karma. A randomized controlled study comparing Ayurvedic Dhoopan with conventional antibiotic ear drops showed statistically significant improvements in symptom relief and recurrence rate in the Dhoopan group.^[23] Additionally, the volatile oils present in Dhoopan herbs - such as terpenoids, eugenol, curcuminoids, and camphene - are known to penetrate mucosal linings and exert deep tissue antimicrobial effects. Modern gas chromatography and mass spectrometry (GC-MS) studies of Dhoopan smoke have confirmed the presence of these active components.^[24]

especially significant in the management of Karna Rogas within the domain of Shalakya Tantra. By harnessing therapeutic potential of herbal smoke, it provides an effective and non-invasive approach to conditions involving infection, inflammation, and chronic discharge in ear. The therapy not only targets physical manifestations of ear diseases but also offers psychological relief, improved hygiene, and enhanced immunity. Its integration into contemporary clinical practice can support antibiotic stewardship, minimize emergence of resistance, and provide a sustainable healthcare solution, especially in primary and community settings. Looking ahead, there is immense scope for scientific validation, standardization of Dhoopan Samagri, and development of user-friendly devices to make this therapy widely acceptable. Collaborative efforts between Ayurvedic scholars, clinicians, and biomedical researchers can help in bridging traditional wisdom with modern evidence, opening new avenues in integrative ENT care. Thus, Dhoopan Karma holds promising potential not only as a therapeutic measure but also as a preventive & promotive health tool, aligning well with principles of both Ayurveda and global public health goals.

References