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Always keep the tip pointing downward towards the floor of the nose. Never push it straight up. When the thread reaches the back of the throat, insert the index finger and thumb, or the middle and index fingers, into the mouth. Pull the catheter or thread gently and slowly out through the mouth, leaving a few inches of thread hanging out of the nose. This action may cause retching at first but with practice it will become easier. Hold each end of the sutra or catheter with the fingers. Very slowly and gently pull it backward and forward, no more than 15 times on the first attempt. Remove it slowly through the nose and repeat the process with the opposite nostril.
Technique 2: Advanced practice
After completing technique 1, the thread should be left so that it still passes through one of the nasal passages with one end passing through the mouth and the other through the nostril. Gently insert the waxed end emerging from one nostril into the other nostril and pull the end through the mouth. In the final position both waxed ends emerge from the mouth. Loosen the hard wax at the tip of each end so that the individual strands again become separated. Push the two ends together so that they merge with one another, and twist the thread so that the two ends become joined. If the join is too thick some of the threads may be cut away so the join may pass easily through the nostrils. The thread is now circular. Slowly draw the join into the mouth, progressively sliding the thread through the nostrils. Eventually the join should be located between the entrance to the two nostrils. Disconnect the join. The thread now enters one nostril and emerges from the other; it no longer passes through the mouth.
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