I have been treating a young man with Down Syndrome mostly with acupuncture over the course of years. His mother has him in a home with other people with Down Syndrome. As with many of these people, he seems very good-natured and sweet, and he looks forward to our weekly acupuncture sessions. His caregivers at the center where he stays said they notice that acupuncture helps his responsive alertness which can be a huge issue with people who have Down Syndrome.
When he comes to see me, he struggles to find words, uttering a string of meaningless syllables which can go on indefinitely until he happens to alight on a simple word such as ‘yes’ or ‘no’ or my name. His ability to respond to simple commands such as to lie down on my treatment table, also seems to be a struggle. The overriding issue with this young man and many Down Syndrome patients is a problem with communication, responsiveness and staying alert.
The inability to respond can increase with age leaving them more isolated seemingly within the confines of their mind. Acupuncture treatments, especially to points on the head and the Heart meridian, has proven beneficial for him based on the fact that his caregivers noticing a significant improvement in his communicative responsiveness when he is receiving regular weekly treatments and less so when not.
Why is the Heart meridian in treated according to TCM theory for such conditions as autism and Down Syndrome? The reason is that TCM equates an expanded function of the Heart to include the mind, consciousness and the ability to speak. I remember one dramatic case many years ago where two painless needles bilaterally applied to Bladder 15, a point corresponding to the spinal nerves affecting the Heart, resulted in an autistic patient, age fourteen, to uncharacteristically respond with immediate positive awareness and increased speech ability. Both his parents and I were amazed.
In this case, it was not only the acupuncture that improved my Down Syndrome patient but the insertion of five drops of medicated herbal oil inserted in both nostrils. To help him understand what I wanted to do, I first inserted the drops into my nostrils, following which he let me inject them into his. What transpired within 15 minutes was astounding. It seemed that for the first time he could look me straight in the eye, with a big glowing smile of approval as if a trapped spirit previously unable to communicate had been freed from its cage. The remarkable change of his expression was noticed with equal astonishment by his mother who was in the room and then by my office assistant.
Down Syndrome is an incurable, genetic disease. In contrast, autism, another disease associated with communicative disabilities, may be either genetic or acquired. Western medicine has nothing to offer these patients. However, natural herbs and methods such as Ayurvedic nasya (nasal oiling) can have a profound effect in relieving, to a degree, some of the psycho-physiological and spiritual limitations these individuals must live with.
After hearing the above story of my patient, my close friend and colleague, KP Khalsa, who is the coauthor of our book The Way of Ayurveda published by Lotus Press (which, by the way, has several pages on calamus), wrote: “Inspiring, Michael. I regularly see similar effects in autism with Calamus. Asian source. Often the fantastic increase in clarity of thought, verbal skills, eye contact, verbalizations. I use it orally with patients. Great for seizure prevention, also.”
KP shares my opinion, too, that “Most available Nasya oils are generic one-size-fits-all, with a small % calamus as compared to many East Indian Calamus Nasya that kicks ass but is hard to get.”
Nasya therapy is the administration of herb-infused medicated sesame oil (about 5 to 10 drops) or ghee (clarified butter) into the nasal orifice. This is best done lying on one’s back with the head slightly tilted back. Anywhere from one to five or five to ten drops are gently inserted in each nostril drop by drop, then take a big sniff in and lie there long enough to allow it to penetrate the sinus membranes. Another way Is to place a drop of nasya oil on one’s finger and gently massage around the nasal cavity. 
While this is an ancient traditional treatment, modern research supports nasal administration of medications targeted to brain issues:
“The unique relationship between the nasal cavity and cranial cavity tissues in anatomy and physiology makes an intranasal delivery to the brain feasible. An intranasal delivery provides some drugs with short channels to bypass the blood-brain barrier (BBB), especially for those with fairly low brain concentrations after a routine delivery, thus greatly enhancing the therapeutic effect on brain diseases.” –
This recognizes a physiological relationship between the nose and the brain, a fact known for millennia in Traditional Ayurvedic medicine. In fact, many herbs that are traditionally known to have a beneficial effect on consciousness are variously used for Nasya treatment.
Calamus Root (Acorus calamus)
Calamus is an herb that thrives in semi-aquatic environments and in a terrain of mud and sludge found along the shallow banks of lakes and ponds (similar to the muddled state of mind that it apparently is well known for treating). Keeping in mind that the Heart in TCM equates to consciousness and the mind, so imbalances in this system include a variety of consciousness issues ranging from memory impairment to schizophrenia and psychosis, all described as “invisible phlegm obstructing the Heart’s orifices.” In Ayurveda, this condition would be associated with kapha (mucus humour) and ama, a condition where excess mucus has transformed to a toxic phlegm. Ayurveda considers the toxic accumulation of ama as primary cause for all disease with the botanical guggul (Commiphora mukul) resin being the primary herb for clearing ama from the body generally. Calamus specifically clears ama from the nasal passages and the brain.
Calamus has been widely used internally in both Chinese and Ayurvedic medicine usually in formula with complementary herbs such as brahmi (Bacopa monnieri) and gotu kola (Centella asiatica) for degenerative central nervous system disorders associated with communication, focus, memory and learning. Paradoxically, calamus has both stimulating and sedating properties. Its main mechanism involves a potent interaction involving GABA receptors. Of note, calamus that is sold with its asarone and b-asarone removed was found to lack potency.
I have found no better remedy to immediately open and clear the sinuses that calamus nasya therapy. It is highly recommended for the prevention and treatment of sinusitis, colds, flu and sinus congestion generally. Its effects, gratefully are immediate. If used specifically for
upper respiratory and sinus congestion, calamus is often combined with ginger root. I highly recommend herbalist Subhuti Dharmananda’s article “An Epidemic of Sinus disorders.”
European herbalist Chanchal Cabrera says, “The British herbal tradition recommends small doses of European calamus root to balance stomach acid for conditions such as acid reflux, gastritis and other digestive problems. As such, it is often included with many other herbs in many stomach bitters formulas.”
In the case of my Down Syndrome client, he showed many signs of head and ear congestion. He was prone to ear infections for which antibiotics offered no benefit. Each time I successfully treated these episodes by inserting several drops of echinacea tincture each night directly into the ears followed by a wad of cotton to aid retention. Most ear infections treated this way clear within 3 to 4 days. (Don’t be shy of the small drops of alcohol in the ears. This is a well known treatment for drying water from the ear and the prevention of ‘swimmer’s ear,’ caused by prolonged exposure to water in the ear.) Frequent ear infections are usually a sign of excess mucus in the ears and sinus cavity of the head. This is precisely what calamus oil Nasya treats.
Calamus is one of the most under-rated herbs in Western herbal medicine and the fear of toxicity and being banned by the FDA dissuades many from availing themselves of its many unique virtues. I hope that this short presentation might overcome some of the trepidation some may have for exploiting the many benefits this herb, whether one uses Asian or North American calamus.
In India, morning calamus nasya application is practiced to clear the mind, improve mental focus and to prevent colds and flu. This is a very effective practice.
What is it about calamus that makes it so effective for communication? The Sanskrit name for calamus, vacha, means ‘to speak’ (also implying to speak more clearly). In India, it is also known as ‘the singer’s herb’ because it is chewed by Bengali singers who sing devotional Indian songs and chants sometimes throughout the night. This attribute of calamus has not been lost to Native American singers who must sustain high pitched, long periods of singing in Pow-Wow ceremonies. Its flavors are pungent, bitter and astringent with a heating or stimulating energy. It is dry, light and penetrating with a special affinity for decreasing Kapha (mucus humour) and Vata (nervous humour derangement) and stimulating Pitta (fire or stimulating humour). It has similar properties according to TCM usage, and for more on calamus, I refer you to my wife, Lesley Tierra’s blog “Calamus (Sweet Flag).”
As mentioned by KP Khalsa above, calamus root nasya treatment is also effective for autistic patients. Michigan herbalist Jim McDonald published an excellent monograph on this herb, from which is excerpted the following:
K.P. Khalsa tells a very moving story in a presentation he offered on herbal remedies for autism (that link goes to a recorded presentation; calamus is discussed at 45:45) that illustrates the immense potential of vacha: “I was talking to someone the other day whose child [is] 16… he’s been essentially nonverbal his entire life. He’s said a couple of things here and there, but really he doesn’t communicate verbally. She was telling me that recently they were sitting in their living room watching TV and mom and dad were sitting on the sofa behind the child… he was sitting a few feet from the TV on the floor watching his favorite TV show… and he’d never said a word to them in their entire life. He had started taking calamus from their therapist about 2 weeks previously, and in the middle of his favorite TV show, he turned around, looked at both of them on the couch, and said “Mom and dad, I love you.”
Where to find good quality calamus oil
Finding quality calamus oil can be challenging for at least three reasons.
- After the powder is dried, unless it is kept frozen or refrigerated, it will quickly lose potency. Test it by taste and determine how much pungency it has. Be sure to find it fresh or relatively recently harvested.
- The traditional process of making your calamus oil, using sesame oil, ghee or a combination of both, is somewhat time-consuming.
- Most of the calamus oil available from US standard suppliers is weak and lacks the ‘bite’ that the best calamus oil should have when it is most effective.
You can purchase high-quality Asian calamus root powder from Banyan Botanicals or other quality Ayurvedic herb suppliers.
If you have the time and top-quality calamus, make your own calamus oil. Gently warm 1 ounce of calamus root with 1 pint of sesame oil, stirring often, until the herb is crisp. Cool and strain. Store in a dark colored jar. Calamus oil can be bottled in one-ounce dropper bottles, which will last a long time.
Based on my experience, calamus is very safe when used in appropriate doses and certainly so in the form of 1 to 5 drops of calamus-infused sesame oil. Unfortunately no discussion regarding the internal use of calamus, even if it is only the injecting of a few drops of calamus oil into the nostrils, would be complete without a discussion of its toxicity concerns.
Some Asian species, however, contain asarone and beta-asarone, which are well-known carcinogens, based on in vitro and in vivo studies performed on mice.  It is said that these studies used abnormally high doses of calamus causing liver toxicity. A more recent study comparing the effects of lower, more rational doses of calamus (2012) reported that an “ethanolic extract of Acorus calamus (up to a dose of 600mg/kg BW) lacked any potential toxicity, as it neither caused any lethality nor changed the general behaviour in both acute and chronic toxicity studies in rats.”  As to the dose of calamus likely to be present in 1 to 5 drops of medicated sesame oil, it is minimal as to preclude any toxicity whatsoever.
The opinions of most Ayurvedic and Western herbalists who regularly use calamus as part of their clinical herbal practice, backed up by hundreds (if not thousands) of years of history of use, is that calamus is safe for human consumption when used in rational doses. Ayurvedic herbalist Prashanti de Jager considers the matter of calamus toxicity to be just “another case of an uninformed witch hunt.” Jim McDonald believes as I, that the issue of calamus toxicity is overblown. Unfortunately, legally speaking, in the US, calamus is prohibited for human consumption. It continues however to be supplied by Ayurvedic herb distributors but only if it is labeled “not for human consumption.” Bypassing this warning is how individuals desiring to have access to this valuable herb for medicinal purposes obtain it.
Finally, if there remains any question regarding toxicity, one can use North American calamus virtually devoid of any trace of asarone. The taste test of good quality Asian calamus-sesame nasya oil is that it has more ‘bite’ or pungency than oil made with North American calamus. This can be experienced as a minor irritation in the nasal passages and as it drips down to the throat. throat. If one has an accumulation of mucus lodged in the sinus cavity, one may also feel an urge to spit it out which I recommend doing. This is part of the sinus-mind clearing effect of vacha nasya. Herbalist David Winston, who has harvested a good amount of north American calamus, describes that potency may vary based upon where it is harvested. The question of which is more potent for me remains just that, a question pending further clinical use. KP Khalsa specifically mentioned his use of Asian calamus for the treatment of autism and seizure prevention.
I sincerely hope that the use of nasya treatment with calamus oil (one can also add other herbs such as gota kola) will be more widely used by parents, clinicians and other caregivers for Down Syndrome, autistic patients and perhaps Asperger syndrome.
 Shah PG, Ghag M. Deshmukh PB, Kulkarni Y. joshi SV, Vyas BA, et al. Toxicity study of ethanolix extract of Acorus calamus rhizome, International journal of Green Pharmacy 2012:29 found in http://jddtonline.info/index.php/jddt/article/viewFile/528/303