This document provides an overview of chronic obstructive pulmonary disease (COPD) including its definition, prevalence, risk factors, pathogenesis, symptoms, diagnosis, management according to modern and Ayurvedic literature. COPD is characterized by airflow limitation and includes conditions like chronic bronchitis and emphysema. Common causes include smoking, air pollution, occupational exposure and genetic factors. Management involves lifestyle changes, medications, pulmonary rehabilitation and managing exacerbations.

1. By – Dr. Unique Sharma – 2nd year M.D.
Guide - Dr. Muralidhar P. Pujar , Professor
Dept. of Panchakarma
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2. • Introduction
• Aetio – Pathogenesis
• Pathogenesis
• Risk factors
• Symptoms
• Physical signs
• Clinical Manifestation
• Diaganosis
• Lab. Investigations
• Management
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3. • Definition – The global initiative for Chronic obstructive lung
disease(COLD) defines COPD as a disease characterized by
progressive development of chronic airflow limitation that is
not fully reversible and is used to describe a number of
conditions, which include Chronic bronchitis, emphysema and
small airway disease
• In India, COPD is the second most common lung disorder after
pulmonary tuberculosis.
• The disease is frequently encountered in the middle aged
patients and is rare below the 35 years.
• COPD affects male more frequently because of smoking and is
a leading cause of chronic morbidity and mortality among
patients over 55 year.
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4. • It is equally prevalent in rural and urban areas.
• In Ayurveda respiratory diseases occur due to involvement of
Pranavaha Srotas where cough, breathing difficulties, disturbed
respiratory pattern occurs.
• Though it is impossible to correlate COPD with any single
condition of Pranavaha Sroto Dushti, but advanced condition
of Doshika Kasa and Tamaka Shvasa may result into COPD.
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5. 1) Chronic Bronchitis
2) Emphysema
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6. • Defined as chronic productive cough for three months in each
of two successive years in a patient in which other cause of
chronic cough have been excluded.
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7. • Abnormal and permanent enlargement of the airspaces distal to
the terminal bronchioles that is accompanied by the destruction
of the airspace walls, without obvious fibrosis.
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9. • Faulty diet and life style patterns form the basis of
pathogenesis of any disease as per Ayurveda.
• Etiological factor of COPD mentioned in classical and modern
literature include diet articles, food habits and life style errors.
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10. Diet Excessive intake of kidney beans, black
gram oil, sesam oil, white flour prepations,
tubers, curd, unboiled milk, aquatic and
marshy meat or any dietic articles difficult
to digest causing indigetion
Dietic Habits Irregular and untimely eating of food
(Vishamashana).
Life Style Exposure to dust, fume, smoke, wind,
residing in cold place and using cold
water, reduced physical exertion or over
exertion, day time sleep, irregular or
reversed sleep pattern
Other Injury to vital parts
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11. Smoki
ng
Air
Wall
inflam
mation
Hypert
rophy
of
mucus
secreti
ng
glands
Increas
e in
numbe
r of
goblet
cells in
bronch
i
decrease
number
of
ciliated
cells
increase
d
mucous
transport
become
less
Airway
obstruc
tion
and
loss of
pulmo
nary
elastici
ty
COPD
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12. Nidana sevana
Vitiated prana and
udana situated in
pranavaha srotas
enforces kapha
Resulting in
obstruction of
channels of the
pranavaha
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14. • The characteristic symptoms of COPD are chronic and
progressive dyspnea, cough, and sputum production that can be
variable from day to day.
• Dyspnea :- Progressive , persistent and characteristically worse
with exercise
• Chronic cough :- May be intermittent and may be unproductive
• Chronic sputum production :- COPD patients commonly cough
up sputum
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15. • Wheezing
• Chest tightness
• Weight loss
• Respiratory infections
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17. • INSPECTION
 Barrel – shaped chest
 Accessory respiratory muscle participate
 Prolonged expiration during quite breathing
 Expiration through pursed lips
 Paradoxical retraction of the lower interspaces during
inspiration ( i.e. hoovers’s sign )
 Tripod position
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20. • Palpation :-
 Decreased fermitus vocalis
• Percussion :-
 Hyperresonant
 Depressed diaphragm
 Dimination of the area of absolute cardiac dulness
• Auscultation :-
 Prolonged expiration
 Reduced breath sounds
 The presence of wheezing during quite breathing
 Crackle can be heard if infection exists
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22. • The presence of a post-bronchodilator FEV1/FVC < 0.70
confirms the presence of persistent airflow limitation and thus
of COPD.
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27. • Marked over inflation is noted with flattened and low
diaphragm
• Intercostal space becomes widen
• A horizontal pattern of ribs
• A thin heart shadow
• Decreased markings of lung peripheral vessels
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30. • Blood Examination :-
 In excerbation or acute infection in airway, leucoctes may be
detected
• Sputum Examination :-
 Streptococcus pneumonia
 Haemophilus influenzae
 Moraxella catarrhalis
 Klebsiella pneumonia
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31. 1) Nidanaparivarjana (Avoiding etiological factors)
2) Shodhana (Biopurifactory methods)
3) Shamana (Pacification treatment)
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32. • Find out the causative factor for COPD in individual, such
as to stop smoking, taking appropriate precaution in
certain type of occupational environment, avoiding close
contact with people suffering from respiratory infection,
exposure to excessive heat, cold and high altitudes,
exposure to environmental irritants and day sleep
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33. • Exercising regularly, taking fresh, warm diet which is low in
saturated fat but rich in fruits, vegetables, and whole grain
foods and maintaining a normal weight, to be in well ventilated
hygienic environment.
• Nasya of two drops of Anutaila / Shadbindu Taila in each
nostrils daily may prevent coming in contact with irritant or
pollutant with the nasal mucosa.
• Waking up early in the morning at regular time and taking glass
of warm water early morning empty stomach and avoiding
Irregular and untimely eating of food may help to prevent
complication of COPD
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34. • Use of Katu, Lavana, Ushna, Snigdha, Laghu, Ahara,
vegetables including of gourd, bottle gourd, Spinach, Methi,
garlic, ginger, Karvellaka, Patola, Shigru and pulses like
Mudaga daal, Kulatha should be encouraged in the patients of
COPD.
• Excessive use of tomato, cauli flower, potatoes, preparation of
rice flour, sweets, curd, whole milk, black gram, coconut oil,
fermented and sour food articles and cold drinks, refrigerated
food articles etc. shall be avoided in the daily diet.
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35. • Timely and seasonal Shodhana (biopurification)should be
performed in accordance with the patients strength like strong
patients may undergo Vamana, Virechana, and Niruha basti as
well as Nasya therapy in a appropriate seasons. These type of
therapies alleviate Kapha and may dry up excess mucous
secretions in the Pranavaha Srotasa(respiratory system).
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36. • Single drugs: Ardraka, Ela, Haridra, Trikatu, Pippali,
Ashvagandha, Agnimantha, Ajmoda, Ajaji, Guduchi, Ativisha,
Aragvadha, Karanjabija, Daruharidra, Lashuna,Rasona, Hingu.
• Preparations: Kaphketurasa, Gojihvadi Kvatha, Dashmula
Kvatha, Chitraka Haritaki Avleha, Choshath Prahari Pippali,
Tamra Bhasma, Mahalakshmi Vilas Rasa, Loknath Rasa,
Vyoshadi Churna, Sarpi Guda, Shringyadi Churna, Haritakyadi
Modaka, Pippalyadi Gutika, Sitopaladi Churna, Talishadi
Churna, Vyaghri Haritaki Avaleha.
• Rasayana: Pippali Rasayana, Chyavanaprasha, Agtsya Haritaki
, Vyaghri Haritaki, Haridra Khanda, Ashwagandha, Guduchi
etc. can be used as Rasayana.
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37. • Pranayama :- Kapalabhati
• Yoga :- Bhujangasana, Savasana, Shalabhasana,
Paschimotasana are useful Asana for Pranavaha Srotas
as it accelerates the blood circulation of the lungs and
thus increase the vital capacity of lung.
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38. • COPD being a chronic progressive disease with irreversible
changes needs early diagnosis and proper management. An
extra care of diet, diet-pattern modifications and life style
modifications with judicious use of Rasayana can play major
role in the prevention or progresion of COPD.
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