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Current Traditional Medicine, 2016, 2, 22-33 ISSN: 2215-0838 eISSN: 2215-0846

Is There Any Scientific Basis of Hawan to be Used in the Alzheimer’s Disease Prevention/Cure?

R.P. Kaur1, Parveen Bansal1*, R. Kaur1, V. Gupta1 and S. Kumar2 1

UCER, Baba Farid University of Health Sciences, Faridkot, India; 2National Medicinal Plant Board, Dept. of AYUSH, New Delhi, India

Current Traditional Medicine

Abstract: Alzheimer’s disease (AD) is a neurodegenerative disorder of the central nervous system. As per modern science and ancient literature on medicine, nasal drug delivery systems are the best for the diseases related to brain and head. In older times Rishi Muni, ancient scholars and physicians used to recommend Hawan for mental peace and well being. Mritunjay Mantra also tells that sughandhim (aroma, fragrance) gives rise to good health. Om triambkum yajamahe, sughandhim puushtivardhanam, urvarukmev vandhanaat, mrityu mokshay mamritaat!!!! Hawan is a scientific experiment in which special herbs (Hawan Samagri) are offered in the fire of medicinal woods ignited in a specially designed fire pit called agni-kuñda. Aromatherapy was also employed in ancient times for a number of mental disorders. The hypothesis is based on action of Hawan components on Alzheimer Disease through integration of modern and ancient concepts. Hawan seems to be designed by the ancient scholars to fight with the diseases of the brain. Our review demonstrates that the components of Hawan are having a number of volatile oils that are specifically useful for AD through one or the other mechanism of action. Due to high temperature of fire the vapors of these oils enter into the central nervous system through nasal route. The routine of performing Hawan might keep the threshold value of the therapeutic components in the body and help in preventing AD. In the present manuscript authors have tried to highlight and integrate the modern and ancient concepts for treatment and prevention of AD.

Keywords: Alzheimer disease, Apoptosis, Hawan, Inflammation, Mental Health, Rishis, Sanskar. Received: July 02, 2015

Revised: December 02, 2015

INTRODUCTION Alzheimer’s disease (AD) is a neurodegenerative disorder of the central nervous system associated with progressive cognitive and memory loss. AD is a subtype of dementia with a prevalence of 3.1 % in India (0.6 % to 3.5% in rural areas and 0.9% to 4.8 % in urban areas) [1]. Recent research has shown that, over 4.7 million people of 65 years of age and older in the United States (estimated to increase to 7.7 million by 2030) and around 496,000 people in the UK are living with Alzheimer’s disease. The term “Alzheimer’s disease”, was first described by a German neurologist, named Alois *Address correspondence to this author at the UCER, Baba Farid University of Health Sciences, Faridkot, India; Tel: 08872016290; E-mail: [email protected] 2215-0846/16 $58.00+.00

Accepted: December 03, 2015

Alzheimer. Molecular markers of the disease are characterized by extracellular deposition of the Amyloid β peptide (Aβ) in senile plaques, the appearance of intracellular neurofibrillary tangles (NFT), cholinergic deficit, extensive neuronal loss, synaptic changes in the cerebral cortex, hippocampus and other areas of brain essential for cognitive and memory functions. Aβ deposition causes neuronal death via a number of possible mechanisms including oxidative stress, excitotoxicity, energy depletion, inflammation and apoptosis [2]. People with Alzheimer’s disease have a shortage of some important chemicals involved with the transmission of messages in their brain. It’s a progressive disease that gradually affects and damages major part of the brain over time.

© 2016 Bentham Science Publishers

Is There Any Scientific Basis of Hawan

Pathogenesis The pathology of AD is complex and multifaceted with several pathogenic pathways believed to contribute to the progression of disease. The senile plaque deposition occurs having a major component Amyloid beta (Aβ) peptide which is formed as a result of proteolytic cleavage of amyloid precursor protein (APP) by secretases. The amyloid metabolic cascade and the posttranslational modifications of tau protein are considered to be the most important hypothesis in AD, although none of them or other theories alone is sufficient to explain the diversity of biochemical and pathological abnormalities of AD, which is believed to involve a multitude of cellular and biochemical changes [3]. According to the Amyloid beta theory, it has been proposed that Aβ peptide deposits or even the partially aggregated soluble form is responsible for triggering a neurotoxic cascade of events which ultimately results in neuro-degeneration [4]. The result of the proteolytic steps is the formation of Aβ (1-40) and Aβ (1-42) fragments with the former being most abundant of the two species. The Aβ (1-42) fragment is the pathogenic species that aggregates more readily and forms amyloid fibrils [5]. The hyper-phosphorylation of tau protein starts in AD intracellularly and leads to sequestration of the protein and other microtubule associated proteins, thus preventing microtubule assembly and impairing axonal transport. This results in compromised neuronal function that ultimately precipitates to neuronal death [6]. In non-amyloidogenic pathway, α-secretase a membrane bound enzyme hydrolyses APP within the Aβ domain so that there is no Aβ peptide formed as a result of proteolysis. Present Status of Anti Alzheimer Disease Therapies A number of drugs are available (Table 1) in the market that acts through different mechanisms of action; however these are having potential side effects as mentioned. In order to reduce brain amyloid levels, both reduction in Aβ production as well as considerable removal of Aβ is required. Aβ is produced by β and γ-secretase from APP. βsecretase inhibitors have gone to phase II human trials. Agents that particularly cause inhibition of γ-secretase could prove problematic from a side

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effect perspective, as γ-secretase is required for processing Notch3, a protein of developmental importance and brain maintenance. Notch3 mutations cause another dementia syndrome, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). NSAIDS like ibuprofen and flurbiprofen influence the γ-secretase but do not inhibit it outright. In general, these “selective amyloid lowering agents” (SALAs) alter where γsecretase cuts the APP protein. Some of the therapeutic approaches that have progressed to the clinical area are the use of acetylcholinesterase inhibitors, nerve growth factors, nonsteroidal inflammatory drugs, estrogen and the compounds such as antioxidants, neuronal calcium channel blockers or antiapoptotic agents. Inhibition of secretase activity and blocking the formation of β-amyloid oligomers and fibrils that inhibit fibrilization as well as fibrilization-dependent neurotoxicity are the most promising therapeutic strategies against the accumulation of β-amyloid fibrils associated with AD. Ayurvedic Concept for Alzheimer’s Disease According to Ayurveda, Alzheimer’s disease is termed “smruthi nasha” (smruthi=Memory + nasha= loss), a problem of old age where “Vata Dosha” is much aggravated. Nervous system disorders called “Vata Vyadhi” in Sanskrit were thought to be brought on by imbalances of vata, the biological air humor, the energy that moves through the brain and the nerves (the ancient scholars considered nerve impulses to be a kind of wind or air travelling through the body) controlling both voluntary and involuntary functions hence, vata derangements always involve some weakness, disturbance or hypersensitivity of nervous system. The vata passes from the Majja Dhatu (Bone marrow and spine) to the Mano Vaha Srotas (parts of central nervous system), thereby causing disorders such as paranola, memory loss and delusions. In Ayurveda, Alzheimer’s can result from three main factors known as imbalance of the dosha, mind and karmas. The mind is described to be in one of the 3 states: sattva (the best memory, alertness, enthusiastic, courageous, stable, and intelligent), Rajas (described as a mental state dominated by attachments and is characterized by anger, passion, greediness, constant action, excessive work, and anxiety), and the Tamasic mind (tends

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Parveen Bansal

Table 1. Present drug modules for AD with mechanism of action. Name of drug

Mechanism of action

Common Side effects

Other side effects

Tacrine [7]

Cholinesterase inhibitor

Donepezil [8]

Reversible acetylcholinestrase inhibitor

Nausea, Vomiting, Diarrhea, Headache, Dizziness, Hepatotoxic, Muscle Pain, Weight Loss

Decreased urination, fainting, allergic reactions

Rivastigime [9]

A pseudo-irreversible cholinesterase inhibitor selective for acetylcholinesterase and butyrylcholinestrase

Galantamine [10]

Competitive and selective acetylcholinestrase inhibitor action

Memantine [11]

Uncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, protect against overstimulation of NMDA receptors as well as consequent glutamate and calcium mediated neurotoxicity.

Constipation; Dizziness; Headache

Piracetam [12]

Neurotransmission via modulation of ion channels (i.e., Na+, K +)

Anxiety, Insomnia, Irritability, Headache, Agitation, Nervousness, Tremor, Weight Gain, Clinical Depression and Weakness

Dihydroergotoxine [13]

Adrenergic blocking property

Burning or tingling sensation, dryness, soreness, or pain in the nose, change in sense of taste, diarrhea, dizziness, dry mouth, fatigue, and headache.

to develop delusions and is described as dull, ignorant, and slow). Tamasic characteristics of Alzheimer’s include slow cognition, poor memory; and difficulty performing tasks. Ayurvedic treatment for Alzheimer’s disease is through complete nourishment (Apatarpana-aimed to reduce and Santarpana-to nourish by using appropriate herbs), removal of causes (such as dryness, roughness, instability and high mobility in body or mind) and healthy diet and lifestyle.

Fast or slow heart rate, chest pain, high blood pressure

Internal Medications It includes medicines for strengthening of the brain and preventing the degeneration. Such treatments for Alzheimer’s comprise of the use of herbs like Brahmi (Bacopa monnieri), Vacha (Acorus calamus), Aswagandha (Withania somnifera), etc, that act upon the majja dhatu (Bone marrow) and mano vaha srotas (The channel for mind) [17]. Aromatherapy

Other Treatments Panchakarma A special part of treatment in Ayurveda aimed to remove toxins from the body and servicing it for a better efficacy. Vamana (process of therapeutic emesis), Virechana (purgation), Basti (enema), Nasya (nasal delivery of medication), Rasayana therapies (rejuvenation therapy), Shiro vasti (use of medicated oils as irrigation on head in form of a cap), Shiro Dhara (use of medicated oils as irrigation on fore head in form of a capillary), Shiro Pichu (use of herbs and oil in form of a patch), Abhyanga (use of medicated oils for body massage) are commonly prescribed for Alzheimer’s patients [14-16].

Now a days another popular method, aromatherapy involves the use of volatile essential oils for healing purposes for altering a person’s mood and cognitive function. The essential oils are incorporated through steam inhalation or are topically applied to the face and arms. Aromatherapy used with massage may help to calm agitated people with dementia. There is some preliminary evidence that aromatherapy using various essential oils may have some potential effects for improving cognitive function, especially in patients with AD. Aromatherapy used with massage may help to calm agitated people with dementia [18].


What is Hawan Hawan is a Sanskrit word which refers to any ritual that involves making offerings into a consecrated fire. It was done by ‘Rishis’ in early period and is an important religious practice in Hinduism where it is a part of most Sanskar ceremonies. They are also prevalent in current-day Buddhism and Jainism. A consecrated fire is the central element of every Hawan ritual however the procedure and items offered to the fire vary by occasions/ceremony or by the benefit expected from the ritual. A Hawan (Homam, Yagya or Agnihotra) is a scientific experiment in which special herbal/plant medicinal preparations (Hawan Samagri) are offered in the fire of medicinal woods ignited in a specially designed inverted pyramid shaped fire pit or container (called agni-kuñda). The specific shape and size of the agni-kuñda, the arrangement of wood pieces in it, the time-frequency and amount of Hawan Samagri account for controlled chemical processing in the fire and lead to sublimation, chemical conversion and/or transformation into vapor phase of the herbal/plant medicinal preparation leading to release of medicinal phytochemicals [14]. The decomposition and transformation (into vapor or gaseous phase/colloidal forms, etc) of specific substances in the yagya-fire are scientific methods of subtlization of matter into energy and expanding its potential and positive effects. The electromagnetic waves generated thereby compounded with the sonic signals encoded in the mantras help in intensifying and transmitting the desired benefits of yagya in the surroundings and far beyond [14, 19]. Hypothesis Behind Action of Hawan on AD It is to be noted here that the traditional systems of treatment of physical diseases employ medicines which are mostly administered orally. They, therefore, produce effects only after they have been digested and absorbed into the system. Most part of the medicine taken orally is not even utilized by the digestive system and not absorbed. Such medicines may also disturb digestion seriously and can have serious side effects too. The same is more or less true when medicines are directly injected into the blood through intravenous route. They produce quicker results, but their adverse side effects are often more pronounced.


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The hypothesis behind action of Hawan on AD is the integration of modern and ancient concepts. As per modern science, it is a known fact that nasal drug delivery systems are the best drug delivery systems for the diseases related to brain [20]. According to oldest ancient literature on medicine, Nasya hi shirsho dwaram means nose is the best route for administration of the drugs for the diseases related to brain and head. There are some disorders that may require a constant concentration of medicine for curative and prophylactic measure. For medication and direct delivery of drugs to the brain, drugs need to pass blood brain barrier. Other prerequisite for brain delivery is the nano-form or vapor form of drug that can be easily taken up through mucous membrane. These days the formulations are being designed in such a way that drug delivery is targeted and desired concentration of the drug is delivered at a target site where required drug concentration is needed. Hawan seems to be designed by the ancient scholars to fight with the diseases of the brain. The components of Hawan are having a number of volatile oils that volatilize due to high temperature of fire. The vapors of these oils enter to the central nervous system through nasal route. The routine of performing Hawan might keep the threshold value of the therapeutic components in the body and help in preventing AD. The scientific studies conducted on various components of Hawan clearly demonstrate that Hawan was designed for multifaceted action to clean the environment as well as to cleanse the body of the toxins responsible for causing diseases related to brain [20]. Hawan fumes are not only used for the disinfection of air but also it can be environmentally oppressed for the physical, mental, intellectual and spiritual development based on nanotechnology of Hawan [21]. The rapid intranasal delivery of therapeutic agents such as nerve growth factor to mouse brain allowed the by-passing of the blood brain barrier. The olfactory neural pathway provides both intraneuronal (via axonal transport a highly time consuming process) and extra-neuronal (via bulk flow transport through peri-neural channels taking only few minutes) access to the brain [22]. Traditional aroma-therapeutic practices, dating back thousands of years, are thus verified by 21st

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century neuroscience. Equally fascinating is the evidence that an odour-enriched environment increases neurogenesis in adult mouse brain [23]. Since agents promoting neurogenesis in adult human brain, including the hippocampus, are being investigated in a variety of psychiatric disorders (e.g. depression, dementia and schizophrenia) [24, 25]. Thus aromatherapy may have long-term protective potential in terms of regeneration is fascinating [17]. One novel method of herbal delivery, called ‘Nasya’, involves intranasal delivery of dry herbal powders or medicated oils and is a practical, non-invasive, rapid, and simple method to deliver the therapeutic agents into the CNS [20]. There are a number of advantages of intranasal delivery as it bypasses the BBB, targets the CNS, reduces systemic exposure and systemic side effects. Rich vasculature and highly permeable structure of the nasal mucosa greatly enhance drug absorption and minimize the degradation problem of peptide drugs, significantly increases accessibility to blood capillaries, avoid destruction in the gastrointestinal tract, hepatic “first pass” elimination and gut wall metabolism, allowing increased reliable bioavailability. The process of yagya magnifies the advantages of the desirable medicinal phytochemicals and other healthy nutritional substances. Medicines and herbs are vaporized by offering them into the sacrificial fire and enter the human body in a gaseous form through the nose, lungs and the pores of the skin. This might be proven to be easiest, least taxing, least risky and most effective method of administering a medicine so as to reach every single cell of the body. Further, the thermal and associated aerodynamic characteristics of the base-fire cause the sublimated/vaporized substances to traverse and diffuse everywhere in the surrounding where yagya is being conducted. The present manuscript is intended to highlight and integrate the modern and ancient concepts for the treatment and prevention of AD. Basically, Hawan is a procedure that is supposed to purify environment and body through its innate properties attributed to its components. Scientific Evidences for Effect of Hawan on AD Apart from the significant physical and medical applications like cleansing of the environment, curing bodily ailments and augmenting vitality and

Parveen Bansal

physical potentials, yagyopathy is also found to be of immense use in the treatment of psychosomatic disorders and psychological and psychiatric problems. The sublimated vital elements and herbal medicines inhaled in Yagya first reach the brain and then the lungs and other parts, the gross as well as the subtle components of the body. Thus, it has a direct healing effect on brain diseases and complexities. The body absorbs the heat of its sacrificial fire and inhales the vapors of sublimated herbs through the skin-pores and respiration. This elevated level of antioxidants upon reaching the brain and the nerves eliminates the major cause of mental tensions. The specific energy currents reduced by yagyagni and mantra shakti have significant remedial effect on the disorders and diseases ranging from headache, migraine, cold to mental dullness, intellectual deficiencies, depression, insomnia, intemperance, epilepsy, schizophrenia and varieties of manias [26]. The presently available drugs for the treatment of Alzheimer’s disease are symptomatic only and do not alter the course or progression of the underlying disease and produce adverse reactions in patients thereby having limited scope for the treatment of patients of Alzheimer’s syndrome. In recent years, many novel compounds isolated from herbs that improve dementia with fewer side effects as compared to conventional drugs are regarded as potential AD drugs. The purpose of Hawan is to enhance the energy of the human body and make it healthy and progressive. The therapeutic value of Hawan is based on the ingredients used (Table 2). One of the main ingredients used is cow “Ghee” or “Clarified Butter” which has enormous beneficial properties. This ghee when burnt like oil will produce natural fumes that heal the respiratory system and clear any blood clots and bacterium affecting the nasal, lungs and veins. In the bible, the Book of Samuels, Chapter 2, “the burning of sins, using the sticks and clarified butter” infers that ghee was frequently used for fire rituals in biblical times. Essential oil constituents that penetrate the nasal passages, skin or lungs have direct actions on the autonomic nervous system that can be grouped as relaxing or stimulating in terms of basic responses such as heart rate, blood pressure and respiration, in addition to localized dermal and bronchial



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Table 2. List of Hawan components with their volatile components. S. No.

Name

Botanical name

Volatile component

1

Camphor laurel

Cinnamomum camphora

Camphor, linalool, 1,8-cineole, nerolidol, safrole, orborneol.

2

Guggal

Commiphora wightii

Terpenes, seaquiterpenoids, cuminic aldehyde, eugenol and the ketone steroids Z and E, guggalsterone and guggulsterols I, II, III, ferulic acids, phenols and other non-phenolic aromatic acids.

3

Saffron

Crocus sativus

Safranal, isophorone, 2,2,6-trimethyl-1,4- cyclohexanedione, 4-ketoisophorone, 2-hydroxy-4,4,6trimethyl-2,5- cyclohexadien-1-one as well as 2,6,6-trimethyl-1,4-cyclohexadiene-1-carboxaldehyde

4

Almond

Prunus amygdalus

Aldehydes, ketones, alcohols, a pyrazine

5

Jatamansi

Nardostachys jatamansi

Calerene, patchouol, α-gurjunene, aristolone, β-maaliene, spathulenol,

6

Coconut

Cocos nucifera

Monounsaturated fatty acids

7

Peepal

Ficus religiosa

Eugenol, itaconic anhydride, 3-methyl-cyclopenetane-1,2-dione, 2-phenylethyl alcohol, and benzyl alcohol.

8

Chirongi

Bauchanania lanzan

α-pinene, sabinene, β-myrcene, limonene, 1, 8 cineole, γ-terpinene, terpinolene, linallol, linalyl acetate, terpinen-4-ol, α-terpinylacetate, β- terpineol, geraniol, geranial, β-caryopyllene, cis-trans farnesol, cis-cis farnesol

9

Kapurkachri

Hedychium spicatum

Sesquiterpene alcohol

10

Red sandal

Pterocarpus santalinus

Pterocarpol, santalins A and B, pterocarptriol, is pterocarpolone, pterocarpodiolones with β-eudeslol and cryptomeridol

11

Sesame seeds

Sesamum indicum

1-(5-methyl-2-furanyl)-1-propanone, 3-formylthiophene, 2-propyl-4-methylthiazole, 2-ethyl-4methyl-1H-pyrrole, 2-ethyl-6-methylpyrazine, 2-ethyl-5-methylpyrazine, 4,5-dimethylisothiazole, 4,5dimethylthiazole, 2,6-diethylpyrazine, 2-ethyl-2,5-dimethylpyrazine, 1-(2-pyridinyl)ethanone, and 1(1-methyl-1H-pyrrol-2-yl)ethanone

12

Clove

Eugenia caryophyllus

Eugenol, acetyl eugenol, β-caryophyllene, vanillin, crategolic acid, tannins, gallotannic acid, methyl salycylate, flavonoids eugenin, kaempferol, rhamnetil, eugenitin and triterpenoids like oleanolic acid.

13

Nutmeg

Myristica fragrans

Myristicin and macelignan

14

Sandalwood

Santalum album

α and β santalol

15

Nagkesar

Mesua ferra

Sesquiterpene, diterpenes, triterpenes, carboxylic acids and saturated hydrocarbons

16

Tagar

Valeriana wallichi

Valerian, Valipotriates and GABA

17

Nagarmotha

Cyperus scariosus

Cyperone, Selinene, Cyperene, Cyperotundone, Patchulenone, Sugeonol, Kobusone and Isokobusone, Pinene (Monoterpene) derivatives of Sesquiterpenes such as Cyperol, Isocyperol and Cyperone.

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Ber

Ziziphus mauritiana

bis(2-ethylhexyl) phthalate, dibutyl phthalate, 5-hexyldihydro-2(3H)-furanone,dodec-2-en-4-one,2tridecanone,tetradecane, eicosane,2-tetradecanone,(E)-2-decenal, 2-nonen-4-one, hexanoic acid hexyl ester, nonanal, propyl-propanedioic acid, 5-methyl-2-furancarboxaldehyde, nonacosane, ethyl tridecanoate, hexanoic acid ethyl ester, 6-methyl-2-tridecanone, tetradecanoic acid ethyl ester, 4hydroxy-6-methyl(2H)-pyran-2-one and butylated hydroxytoluene.

effects. The direct neuro-pharmacological properties of an essential oil, aroma of the oil may exert a pleasant response via the olfactory system in turn, altering the hypothalamic control of hormones and neurotransmitters. The medium chain fatty acids (MCFA) in pure Ghee get converted into ketones and supply the Alzheimer’s patient brain with the energy it needs to survive and if given on a continual basis will support processes in the brain

that are involved in healing and repair. Further antiviral, antibacterial, antifungal, antioxidant, anti-inflammatory and immuno-restorative properties of certain essential oils support a multiplicity of CNS and autonomic nervous system effects [26, 27]. Another important ingredient in Hawan is “Camphor” from the plant Cinnamomum camphora.

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When the camphor is burnt in the fire ritual, the body’s breathing system is cleared quickly and the person will experience a “high” or elevated feeling during the ceremony. Guggal (Commiphora wightii) known for oleogum resin is a mixture of 30% to 60% water soluble gum, 20% to 40% alcohol soluble resins and about 8% volatile oils. The volatile constituents obtained are terpenes, seaquiterpenoids, cuminic aldehyde, eugenol and the ketone steroids Z and E, guggalsterone and guggulsterols I, II, III, ferulic acids, phenols and other non-phenolic aromatic acids. Gugulipids have a significant protective effect against the streptozotocin induced memory deficient model of dementia. The effect has been attributed due to its cholesterol lowering, antioxidant and anti acetylcholine esterase property. Thus Gugulipid being a potential anti-dementia drug may be helpful in patients of AD [28]. Saffron (Crocus sativus) extract and its active constituent crocin have been shown to prevent the impairment of learning and memory as well as oxidative stress damage to hippocampus [29]. Almond (Prunus amygdalus) fruit also has antioxidant activity and contains approximately 49% oils. This oil contains 62% monounsaturated oleic acid (an omega- 9 fatty acid), 24% linoleic acid (a polyunsaturated omega -6 essential fatty acid), 6% palmitic acid (a saturated fatty acid) and the bioactive compounds such as phenols and flavonoids correlated to antioxidant activity. It protects skin from environmental damage and boosts the natural repair mechanisms in skin. In Ayurveda almond is considered as nutritive for the brain and nervous system [30]. Jatamansi (Nardostachys jatamansi) rhizomes and roots contain variety of sesquiterpenes and coumarins. The sedative sesquiterpene valeranone, is found in valerian and is major component of the root essential oil. Jatamansi is helpful in improving learning power and memory. It acts as an antioxidant and facilitates the transmission of acetylcholine in brain. Jatamansi is used in the treatment of AD [31]. Coconut (Cocos nucifera) is source for Coconut oil that contains approximately 92.1% saturated fatty acids, 6.2% monounsaturated fatty acids, 1.6% polyunsaturated fatty acids. All of the medium chain fatty acids (MCFA) in coconut oil are saturated. The MCFA is automatically converted into ketones regardless of blood glucose levels or what other foods are eaten at the same time. The ketones supply the Alzheimer patient

Parveen Bansal

brain with the energy it needs to survive and if given on a continual basis will support processes in the brain that are involved in healing and repair. Thus the neurological disorders involving defects in glucose metabolism can be successfully treated with the regular consumption of coconut oil [32]. In AD, the half life of acetylcholine is curtailed by acetylcholinestrase enzyme. If inhibition of Acetylcholinestrase enzyme occurs then that leads to prolonged half life of acetylcholine hence may be used in the treatment and prevention of Alzheimer’s disease. Peepal (Ficus religiosa) methanolic extract of stem bark acts as an acetylcholinestrase enzyme inhibitor [33]. Gular (Ficus racemosa) bark extract is also used to increase acetylcholine level by inhibition of acetylcholinestrase hence can be good for treatment of Alzheimer’s disease. It also acts as memory enhancer and can be used in the treatment of dementia [34]. Chirongi (Bauchanania lanzan) extract has also been used for memory enhancement and treatment of alzheimer disease [35]. Cardamom seeds volatile oil are rich in phenolic components, flavonoid components, starch, protein, waxes, sterols and other components of oil. The volatile oil contains α-pinene, sabinene, βmyrcene, limonene, 1, 8 cineole, γ-terpinene, terpinolene, linallol, linalyl acetate, terpinen-4-ol, α-terpinylacetate, β- terpineol, geraniol, geranial, β-caryopyllene, cis-trans farnesol, cis-cis farnesol. These are responsible for CNS depressant and anticonvulsant activity [36]. Kapurkachri (Hedychium spicatum) has anti inflammatory properties. The active components present in rhizomes are sesquiterpene alcohol, furanoid diterpene like hedechnone, glycosides, carbohydrates, steroids, etc which are responsible for brain tonic, immunomodulatory and anti inflammatory activities. Biochemical and neuropathological studies of brains from individuals with Alzheimer disease (AD) provide clear evidence for thectivation of inflammatory pathways, and long-term use of antiinflammatory drugs is linked with reduced risk to develop the disease [37]. Red sandal (Pterocarpus santalinus) wood contain pterocarpol, santalins A and B, pterocarptriol, pterocarpolone, pterocarpodiolones with β-eudeslol and cryptomeridol in heartwood. Ether, alkalis and other three crystalline principles santal, pterocarpin, homopterocarpin, small quantity


of tannin and kino-tannic acid have also been found in the wood. The paste of red sandal acts as a cooling agent for external application treating inflammations and headache, mental aberrations and ulcers [39]. Sesame seeds (Sesamum indicum), a main part of Hawan Samagri have been shown to act by inhibiting Aβ aggregation. The sesame oil is mainly composed of stearic and polyunsaturated fatty acids (PUFAs) such as linolenic acid and high levels of vitamin E that make it a potential antioxidant. PUFAs can be effective on the neurophysiological processes e.g. learning and memory processes [39]. The PUFAs in the sesame oil increase the dendrite branches, number of neural synapses and synaptic efficiency [40]. Clove (Eugenia caryophyllus) contains 7290% components like eugenol, acetyl eugenol, βcaryophyllene, vanillin, crategolic acid, tannins, gallotannic acid, methyl salycylate, flavonoids eugenin, kaempferol, rhamnetil, eugenitin and triterpenoids like oleanolic acid. Clove oil stimulates the circulatory system, clearing the mind and reducing mental exhaustion and fatigue. It is also used to aid insomnia, memory loss, anxiety and depression like problems [41]. Clove is responsible for behavioral changes.Nutmeg (Myristica fragrans) extract also used for the treatment of alzheimer disease. One of the lesser known benefits of adding nutmeg in any variety to your diet are the various components of its essential oil, called myristicin and macelignan. These compounds have been proven to reduce the degradation of neural pathways and cognitive function that commonly afflicts people with dementia or Alzheimer’s disease [42, 43]. Manganese and copper are present in nutmeg and these are used by the body as co-factors for the antioxidant enzyme, superoxide dismutase [44]. Sandalwood (Santalum album) has good quantity of volatile oil. It contains about 90% α and β santalol with minor components includes sesquiterpene hydrocarbons used as memory booster. It improves memory and induces concentration, keeps brain cool and relaxed and saves from undue stress, anxiety and also used for its sedative property oil sedates inflammation, anxiety, fear, stress, restlessness, calmness, concentration, inner vision, positive thoughts and induce relaxation. It acts as a good tonic for digestive system, circulatory and nervous system. It has been reported that santalols act via circulatory system by adsorption into the blood through respiratory mucosa. Hence


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demonstrating implication in patients having sleep related difficulties [45, 46]. Nagkesar (Mesua ferra) is known to have xanthones used for CNS depression characterized by pitosis, sedation, decreased spontaneous minor activity and loss of muscle tone [47]. Agar (Aquilana Malaccensis) and Tagar (Valeriana wallichi) are important components of Hawan Samagri. Both are involved in fumigation process. Tagar is involved in modulating monoamine levels in brain. Studies relating neuronal markers to the symptomatology of Alzheimer’s disease indicate that dysfunction of monoamine neurons are more closely linked to non-cognitive than to cognitive changes in behavior. In addition, monoaminergic therapies have been successful in ameliorating affective and psychotic behaviors along with sleep disturbances in both Alzheimer's disease and senescence. It seems likely that monoaminergic therapies (developed as we learn more about alterations in dopamine, noradrenaline and serotonin) will continue to be necessary to treat such behavioral disturbances. Supplementation of 100mg/kg valerian root or an equivalent amount of valerenic acid (340μg/kg) for three weeks in rats cognitive aged with D-galactose beforehand appears to improve memory and learning associated with a decrease in corticosterone in serum and a decrease in lipid peroxidation in the hippocampus [48, 49]. The use of CO2 as a cerebral stimulant to assist the patients suffering from lack of ventilation is common in medical world. Its use to control and cure many mental disorders is also known to medical science. Small amount of CO2 inhaled by the persons performing Yagna acts as a stimulant and more and more aromatic fumes are inhaled which help in curing mental disorders. DISCUSSION From time immemorial, human beings have used smoke of medicinal plants for curing disorders. Smoke produced from natural substances has been used extensively in many cultures and famous ancient physicians have described and recommended such use. According to old concept in Hinduism, the basis of life is a successive chain of food, earth, water and air. If air is pure, all the elements of the chain will become pure, thus purifying and cleansing life itself.

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Aromatherapy, another popular method in the Ayurvedic system, involves the use of volatile plant materials known as essential oils for healing purposes for altering a person’s mood and cognitive function. The essential oils are incorporated through steam inhalation or are topically applied to the face and arms. Aromatherapy used with massage may help to calm agitated people with dementia. There is some preliminary evidence that aromatherapy using various essential oils may have some potential for improving cognitive function, especially in patients with AD [50-52]. In fact, the biggest challenge to drug delivery into the CNS is bypassing the blood-brain barrier (BBB) as it limits access to the CNS. For decades, the BBB has prevented the use of many therapeutic agents for treating brain-related diseases and injuries, including AD, stroke, brain tumor, head injury, and other CNS disorders. Traditional therapies rely on some novel methods of administering herbs or their preparations (or both) to treat CNS disorders. However, there is lack of proper data to demonstrate whether these herbs or their components given orally or by some other means cross the BBB and reach the CNS. As mentioned

Parveen Bansal

earlier ‘Nasya’ involves intranasal delivery of dry herbal powders or medicated oils and is a practical, non-invasive, rapid, and simple method to deliver the therapeutic agents into the CNS. The use of medicated oils ensures the transport of lipophilic and lipid-soluble molecules across the BBB membrane, where hydrophilic compounds demonstrate minimal permeation [53]. Intranasal administration offers numerous benefits like rapid drug delivery into the CNS, bypasses the BBB, and directly targets the CNS, thereby reducing systemic exposure and side effects [20, 54-57]. The pathogenesis of AD has been shown in (Fig. 1). Authors have tried to hypothesize and pinpoint the probable site of action of each component of Hawan Samagri and action of ingredients is shown in Table 3. Role of free radicals in pathogenesis of AD is well established. Components of Hawan like Guggal, Saffron, Almond, Jatamansi and Coconut scavenge free radicals and hence stop the pathogenesis of the disease. Amyloid- β proteins are formed from amyloid precursor protein with the action of enzyme γ-secretase. Amyloid-β protein is responsible for the formation of amyloid plaques

Fig. (1). Possible mechanism of action of Hawan Samagri components in treatment of Alzheimer’s disease.


i.e. clumps of amyloid β that are toxic to nerve cells. The formation of these clumps is inhibited by sesame seeds which is one of the major components of Hawan. The inflammation caused by amyloid plaque is inhibited by Kapurkachri and Red sandal and excitotoxicity is inhibited by cardamom. These Aβ clumps may block cell signaling at the synapses and also responsible for post translation changes (hyperphosphorylation) in Tau proteins. In AD all the six Tau isomers present in tangled form lead to the death of cholinergic, serotonergic and adrenergic neurons and hence lead to the decrease in concentration of neurotransmitters like acetylcholine, serotonin and epinephrine. Decline in concentration of acetylcholine causes memory loss whereas lower levels of serotonin and epinephrine are responsible for neuropsychiatric and behavioral changes. The contents of Hawan like Peepel, Gular, Chirongi and Guggal have been shown to be responsible for inhibiting the acetylcholinestrase. So from the various pharmacological actions exerted by components of Hawan it seems that Hawan might be involved in protecting the body from AD.


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Hawan seems to be designed by the ancient scholars to fight with the diseases of the brain. The components of Hawan are having a number of volatile oils that volatilize due to high temperature of fire. The vapors of these oils enter into the central nervous system through nasal route. The routine of performing Hawan might keep the threshold value of the therapeutic components in the body and help in preventing AD. It may be concluded that herbal components used during the Hawan procedure may have potential to overcome the disease like alzheimer. Fumes delivered by intranasal route bypass the BBB and targets CNS, reducing systemic exposure and thus reduce the systemic side effects which are usually expressed by current drug therapy. Thus Hawan procedure may be used for treatment and prevention of many different neurologic and psychiatric disorders CONFLICT OF INTEREST The author(s) confirm that this article content has no conflict of interest. ACKNOWLEDGEMENTS Declared none.

CONCLUSION

REFERENCES

It is a known fact that nasal drug delivery systems are the best drug delivery systems for the diseases related to brain [20]. There are some disorders that may require a constant concentration of medicine for curative and prophylactic measure. For medication and direct delivery of drugs to the brain drugs need to pass blood brain barrier. Other prerequisite for brain delivery is the nano-form or vapor form of drug that can be easily taken up through mucous membrane. The analysis of available data on pharmacological actions and therapeutic actions of components of Hawan, it seems that Hawan was designed by our ancestor physicians to keep away from AD. The periodic Hawan procedure is likely to create a threshold concentration of anti AD components in human body specifically brain tissue that may be sufficient to prevent pathogenesis of the disease. These days the formulations are being designed in such a way that drug delivery is targeted and desired concentration of the drug is delivered at a target site.

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