HTML Full Text

Introduction

The disease Tamaka Shwasa has been broadly described almost in all the Ayurvedic classics. It is stated that none other disease kills as instantaneously as Hikka and Shwasa. The prevalence of Respiratory disorders like Tamaka Shwasa is increasing due to Excessive pollution, Overcrowding and Poor hygiene. It is a ‘Swatantra Vyadhi' having its own Etiology, Pathology and Management. Tamak Shwasa is a disease of Shwasa which mainly involves Pranavaha Srotasa, On the basis of signs and symptoms this disease can be correlated to the Bronchial Asthma as per the modern science. In India, Bronchial Asthma is major health problem and Hyperventilation, Cold air, Tobacco smoke, dust, Respiratory Viral Infection, Emotional stress, Aspirin, Beta blockers are some of the trigerring factors. Tamaka Shwasa is one of the Shwasa Vyadhi amongst the five types of Shwasa i.e. kshudra, Chinna, Maha, Urdhava and Tamak¹. It is Characterised via Shwasakashtata, Pratiloma Vayu (Prolonged Expiration), Ghurughuraka (Wheeze), Ativa Tivra vgam Shwasam Pranaprapidakam (Dyspnea of surprisingly deep speed, which turned into immensely injurious to existance). The name of Tamaka Shwasa is due to the fact that, the symptoms or attack of this disease precipitates at night and also during the time of attack, the breathing difficulty is so severe that patient feels entering into the darkness². According to Acharya Charak, both Vata and Kapha dosha has been considered to be the chief Doshas which are involved in the Pathogenesis of Tamaka Shwasa. When Vata is obstructed by Vitiated Kapha, it get reverses and affect the Pranavaha Srotasa³. But In Sushruta Samhita, Madhav Nidana? and Yogratanakar?. It is mentioned that Tamaka Shwasa is the Kapha pradhan vyadhi. According to Modern Medical Science, Bronchial Asthma is mainly a Chronic Inflammatory disease, affecting the air tubes leading to Laboured Breathing. Asthma is an Episodic disease manifested clinically by Paroxysms of Dyspnoea, Chest tightness with Wheezing sound and coughing particularly at night or early morning Both Ayurved and Modern Medical Science agree regarding the Nidana of the disease as Host factors (Nija hetus– Dosha dushti and Aama) and Environmental factors (Agantuj Hetus – Raja, Dhuma, Sheet ambhu sevan, Pragvata etc). Nidana Parivarjan hence plays a key role in the management strategy in both Sciences. The Current Management of Tamaka Shwasa (Bronchial Asthma) by Modern Medicine is only providing Short term Symptomatic relief and also prolonged use of them are not safe. However, Ayurvedic treatment seems promising for treating Tamaka Shwasa without any causing side effects.

Material and Method – Present work is based on a reveiw of Classical information, relevant Published research work and modern literature.

Case Report – A 42 years old male patient visited the OPD of Kayachikitsa department with Chief Complaints of –

1. Shwasa Kashtata (Breathlessness)
2. Kasa (Coughing during night)
3. Dhaurbhalya (Weakness)
4. Pratishyay (Running nose)

History of Present Illness –

Patient was Asymptomatic before 1 year. Since then Patient has been suffering from the above Complaints. He had taken the Modern medication and symptoms got reduced temporarily but recurrency of symptoms occur. Then He came to our Hospital in Kayachikitsa OPD for Ayurvedic treatment.

History of Past illness :-

K/C/O Asthma (Stop medication by Doctor)

No H/O of DM, HTN, thyroid

No H/O Alcoholism

No H/O Major illness

Rugnaparikshan -

• Nadi- 90/min
• Mala- Asamyaka
• Mutra- Samyaka
• Jihwa- Sama
• Shabda- Prakrut, Spashta
• Sparsh- Samshitoshna
• Druka- Shwetabh, Pallor +
• Aakriti- Madhyama
• B.P.  -  110/70mmHg
• R.R. - 20/min
• Temperature- Afebrile
• Height – 162cm
• BMI. – 19.12

Systematic Examination -

• CNS - Conscious, Well Oriented

• CVS - S1S2 sound audible, no murmur
• Per Abdomen - Non tendor, Soft
• Respiratory System –

Inspection – On inspection of the chest – Bilateral symmetrical. Accessary muscles used for respiration is present i.e. Sternocleidomastoid muscles. Types of breathing – Abdominothoracic, No any chest deformity, No any scars.

Palpation – Tenderness – absent, Position of thr trachea is Centerally Placed, Movement of chest – Bilaterally Symmetrical.

Percursion – Resonant all over the Lung field. Hepatic and Cardiac dullness noted.

Auscultation – Ronchi was observed Bilaterally. Vocal resonance was bilaterally symmetrical.

Samprapti Ghatak -

Dosha – KaphaAnugata Vata (Prana Vayu, Kledak kapha)

.Dushya – Rasa, Pranavayu

 Strotas – Pranavaha, Annavaha, Udakavaha

 Strotodushti – Sang and Vimargaman

 Adhishthan – Amashaya

Swabhav – Chirkari

Agnidushti – Agnimandhya

SadhyaAsadhyata – krichchraSadhya

Pathya (Do's) – Godhum (Wheat), Mudga, Yava (Barley), use of Garlic, Turmeric, Ginger, Black pepper, Lukewarm water, Goat milk, Madhu, Pranayama, Yoga.

Apathya (Don’ts) – Heavy, Cold diet, Masha (Black gram), Deep fried food, Sweets, Chilled water, Curd, Stored food items, Suppression of natural urges, Physical exertion, Exposure to smoke, dust, pollen and pollutants.

Assessment Criteria - Results were assessed from Subjective Parameters (Cardinal Signs) of baseline data of Before and After treatment.

Discussion

• Tamaka Shwasa is manifested due to Obstruction of Pranavaha Strotas. Vitiated kapha obstruct the passage of Vayu and Obstructed Vayu moves in Reverse direction. It stimulates the Kapha in the throat and head causing Rhinitis. Further it manifests Wheezing Sounds and feeling of darkness in the eyes. In such condition, Drug and food which is having Ushna and Vatanulomana property are helpful in relieving the Shwasa Roga.

• In this case, we found the patient is having remarkable improvement and time period between 2 successive episodic breathlessness is increased. During this course we observed that the patient had partial relief of symptoms. Lesser the chronicity greater the relief and improvement in chronic condition was observed.

Chikitsa Sutra –

          “ ?????? ??????????????? ???????????? ??????????????? ?

             ?????  ????????  ????????????????: ??”      (?.??. ??/??)8

After Nidana Parivarjana, Abhyanga with Saindhav lavan and Tila tail should be done and followed by Nadi Sweda, Prastra and Sankar Sweda is the Main Chikitsa Siddhant in Shwasa Roga.

• Mode of Action of given treatment –

Abhyanga with Saindhav lavan and Tila tail for 8 days on the Chest and back of the Patient followed by Nadi Sweda. In this therapy, Suksham and Tikshan guna of Saindhav lavan renders the adhered kapha in the channels (Strotas) of circulation and and break down the morbid dosha and Mala Sanghatan and soften thereby. Swedan karma rectifies the function of Jathra Agni and fasten the Pakakarma which causes Strotomukhshodhan.

Tribhuvan Kirti Rasa – Contains Shudha Hingul, Shusha Vatsanabh, Trikatu and Pippali mula etc mentioned in Yogratnakar. Contents of Tribhuvan kirti rasa having properties such as Expectorants, Antiviral, Immunomodulator and reducing infection of Upper Respiratory tract.

Shwasakuthar Rasa – Its most of the ingredients are Vatakapha shamak and directly act on Pranavaha strotas. It mainly acts on Agnimandhya and break down the Kapha Pradhan Samprapti. Maricha helps in mucous drainage and Vatsanabh act as AntiSpasmodic, stimulant for mucous membrane and removes the Kapha.

Lakshamivilas Rasa – Ingredients are mostly Ushnavirya and KaphaVatahara in action. It helps to neutralize or destroy Vitiated Kapha and helps to clear unwanted things which resulting in formation of Kleda, Dushta kapha. Abhraka Bhasam, Shudha Parada, Gandhak, Shatavari and Atibala all act as Rasayana and Balya. Datura is ideal for the treatment of Asthma and having Antispasmodic properties.

Sitopaladhi Churan – Ingredients work as a potent Immunomodulator. Pippali and Cinnamon act as bio enhancer while Cardamom exhibit strong Antioxidant characterstics. Mishri calms Vata and kapha dosha. Vanshlochan having healing properties.

Trikatu Churan – works by stimulating Agni i.e. Digestive fire, improves the assimilation of nutrients and reduces the kapha and also regulates the path for the Vata.

Vasa Bharangi bharar Kwath – It enhance the Vatakaphahara, Vatanulomana and Deepan Pachan properties which will digest the Ama. It will neutralize the Strotorodha in Pranavaha Strotas. It act as AntiSpasmodic, Anti tussive, Expectorant and Bronchodilator.

Conclusion

On the Premise of the Findings, it is able to be concluded that Abhyanga with Saindhav Lavan and Tila tail (Chest and back) followed by Nadi Sweda and Abhyantar Sanshaman Chikitsa are effective in the management of Tamaka Shwasa and Marked improvement found in the Cardinal symptoms of Tamaka Shwasa.