3. INTRODUCTION
Tamaka Shwasa, a Pranavaha Srotovikara is such a disease which
affects an individual due to Atma Asatmya and reduced Vyadhi
Pratibandakatvam.
Bronchial Asthma is chronic debilitating disease of varied etiology.
Various causative factors such as dust, fumes and pollen grains
along with genetic factors have been studied and investigated which
are aggravates the Asthma.
The growing environmental pollution with rapid and extensive
industrialization is also responsible for aggravation of this disease.
The alarming rise in the incidence of this disease in metropolitan
cities has posed a serious problem.
Shwasa Krichrata and Kasa are found to be predominant features of
Tamaka Shwasa.
4. CONT....
The principle pathology is the Avarodha of Pranavayu.
The predominant morbidity of Vata and Kapha Dosha, stemming
out from Pittasthana, afflicting Rasadhatu, disturbing the
functioning of Pranavaha Srotas, these pathological events
collectively leads to the occurrence of Tamaka Shwasa.
Panchakarma has been given a special place in all the ancient
Ayurvedic texts.
In present scenario PANCHAKARMA therapy is the best way to
effectively & safely manage the condition without any drug
dependency.
Acharya Charaka has mentioned the extensive use of Panchakarma
therapy for almost all the major diseases.
5. SAMPRAPTHI
Nidana Sevana
Sanchaya -- Agnimandya Dosha Dusthi (Vata and Kapha Dusthi)
Prakopa -- Amarasotpatti Pratiloma gati ofVata
Mala Rupa Kapha
Prashara
Paribhramana
Pranavaha Srotogamana
Sthana
Sanshraya Kapha makes avarana to Phrana Vayu
Prahana try to overcome the Avharana
Vyakthavastha Shwasa (Shwasavarodha, Shwasativriddhi, Ghurghurkam etc.)
6. TYPES
PRATAMAKA SHWASA:
• In this condition there is
association of Jawara&
Murcha.
• This condition develops due to
Udavarta (reversible of natural
urges of body), dust,
indigestion, old age or excess
humid environment, here the
Pitta aggravates.
SANTMAKA SHWASA:
• In this condition is aggravated
due to darkness or mental
stress but relieved by cold and
feels that he is drowning in the
darkness. Usually the attacks
precipitate early in the
morning.
• Here Jejatta elobarate the
involvement of mansik dosas
(psychosomatic). Patient feels
relief after sheetopachar
7. Management in Tamaka Shwasa
The management Shwasa in practical of Tamaka sense has two aspects
SHAMANA THERAPY:
• Kapha and Vata are the pre-dominant doshas, so the medicines and the
dietetic regimen which controls the Kapha and Vata due to their Ushna Guna and
are Vata Anulomaka in action must be utilized in the treatment of Shwasa roga.
SAMSODHAN THERAPY:
• Caraka emphasized that strong build patient with the dominance of Kapha
and Vata should be treated with samsodhana therapy, i.e. Vamana and virechana as
per necessities. (C.S.ci. 17/89).
If the patient is kaphadhikyata and balawan rogi - Doshas are to be expelled
by Vamana and Virechana. After pathya ahara, vihara and later followed by Swasa
nashaka dhuma, avaleha etc are to be administered.
• “focus on alleviating Vata without agitating Kapha, and balance the Kapha, liquefy
it and expel it from the Pranavaha Srotas, without agitating vata.”
• Hence the drug of choice should be of Ushna veerya.
9. Snehana:
• Taila mixed with lavana should be gently massaged on the chest
and back to loose the Grathita Kapha in the channels.
• Taila is having Ushna property, and thus alleviates vata, and does
not increase Kapha. There fore it is better for Abhyanga.
• In Shwasa, Grathita Kapha (Mucous plug) is present; and Salavana
Sneha is useful in vilayana of this grathitha kapha, thereby removing
the sanga (Obstruction of airway).
Swedana:
• Swedana by nadi, prastara and Sankara method should be
performed, by these processes the kapha which has become grathita
in the patients body, gets dissolved in the body srotas, the body srotas
become softened and as a result, the movement of Vata is restored to
normal condition.
10. • Vamana
To eliminate or expectorate the liquefy Kapha, vamana should
be given with proper method with drugs not antagonist to vata. After
proper swedana, snigdha odana(rice),with soup of fish or pigflesh
and the supernatant of curds may be given to the patients for the
utklesana of kapha .
There after Vamana should be performed with the help of
Madanaphala. Pippali mixed with saindhava and Madhu. Thus the
vitiated and stagnant Kapha has been expelled from the system, the
patient attains ease and body channels (srotas) are purified, the Vata
moves through the srotas, unimpeded (C. S. ci.17/74-76)
Dhumapana
After Vamana, to eliminate the hidden pathogenic substances ie the
Dosa which are in the Linavastha (not completely purified), the
physician should endeavour to remove it by Dhuma Cikitsa
(inhalation therapy) (C.S. ci 17/77).
A varthi is made of Haridra, erand moola, laksa, manashila,and is smeared with
11. Virechana:
Cikitsa Sutra in Tamaka Swasa,kapha obstructs the passage of vayu,
the obstrtucted vayu take the pratiloma gati. Virecana drugs having
the quality of vatanulomana, usna guna, kaphavataghna may be more
beneficial in the condition of Swasa (C.S.ci. 17/147)
• Dosa hara properties of virecana:virecana removes mainly Kapha and
Pitta Dosas and makes Vata in anuloma gati.
Vasti:
For the patients of dyspoea according to some scholar expect unctous
enema upper and lower cleaning(emesis and purgation) also is
beneficial, apart from these other mild therapies should be
administered.
12. DISSCUSSION
• The management of Tamaka Shwasa depends on the Dosha
predominance and physical stage of the patient.
• Therefore the treatment modalities classified according to patient like
Kaphadhika, Vatadhika, Balawana, and Durbala. Vata and Kapha
involve in the pathogenesis of Tamaka Shwasa.
• So the treatment modalities depend upon state of vitiation of Dosha
in the disease process.
• The therapy which alleviates both the Dosha should be adopted.
• In Snehana and Swedana, they help to liquefy the solidified Kapha
adhering inside the Srotas and the liquefy Kapha comes into the
Koshta, from where it can be eliminated out easily. The Srotas
become soft and Maruta (vata) attains its downward movement.
13. Vamana karma
It follows the poorva karma like Snehana and Swedhana.
This poorva karma was liquefying the doshas and helps in bringing the
doshas to kostha.
• As the Vamana dravya contain ushna, tikashna, sukshma, vyavayi
and vikasi gunas and because of their potency they reach the heart
through the minute channels. Due to Snehana and Swedana the
vitiated dosha become liquefied and enter into minute channels.
• There the Vamaka dravya further liquefies the doshas due to ushna
guna and break down into pieces because of tikshna, vikasi gunas,
from there the liquefied doshas reach the kosta without sticking to
the channels as honey runs through the walls of the earthen ware
which has been anointed with oil. From there the vitiated doshas will
be expelled through mouth, because of the drugs having the
dominancy of Agni and Vayu Mahabhutas, involvement of
Udhanavata and also the upward movement of drugs.
14. • Virechana karma:
• The efficiency of Virchana was observed in clinical study and even
today Charaka’s “Tamake tu Virechanam”, statement is very
effective in the management of Tamaka Shwasa. The probable
mode of action can be proposed as below.
• This Virechana follows the Poorva Karma like Snehana and
Swedana. These Poorva Karma liquefying the Doshas and bring
back to Kostha.
• This therapy useful in Kapha Samsrusta and Pitta Stanagata Kapha.
Also it is useful in Vata disorders. Snehana, Swedana, and Mrudu
Virechana are the treatment of Vata disorder.
• a) The qualities of Virechana drugs are Ushna, Tikshna, Sukshma,
Vyavayi and Vata Anulomaka
• b) Effect of Virechana- Srotoshuddhi Vatanulomaka, Agni Deepti,
expel the Mala from the body.
16. CONCLUSION
• Tamaka Shwasa is the life threatening disease in the modern era.
• As we know “Na Tesham Punarudbhavaha” indicates importances
of Panchakarma i.e. diseases treated with Panchakarma are having
less chances of reoccurrence by prohibiting the aggravation of
doshas.
• Snehna and Swedna karma helps to liquefy the Grahita dosha in
srotas.
• Vamana and Virechana karmas are good and effective treatments in
Tamaka Swasa. Both removes the vitiated doshas and cure the
disease through its root.
• Vamana is a specific treatment for Kapha and Kapha samsargaja
doshas.
• Dumpana, Kavala, Gandusha helps to expel Kanthasata Kapha after
the Vamana.
• Virechana is a specific treatment for Pitta and Pitta samsargaja
doshas, also the treatment for Kapha and Vata doshas.