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Prof. Dr. K.Shiva Rama Prasad
            M.D (KC); MA, Ph.D (Jyotish)
            doctorksrprasad@gmail.com



          ...
Thought of 2008

           • “Following western scientist blindly
             is not admissible. The information
       ...
LET - Introduction
                 • Life starts with breath
                 • Ends with breathlessness
                ...
Pranavaha srotas
• Pranavaha Srotas is a vital input capability
  structure, maintaining the Life = Pranavata
• Prana is s...
Pranavaha Sroto Moola
• Moola refers to developmental or generative
  place
• PVS have Hrudaya (Heart), Mahasrotas
  (trac...
Source of life
           • The Prana is specific air breathed
             into the lungs during the act of
             ...
Pranavata
• Pranavata initiates impulse
  from Shirasa (Buddhi
  Hrudayendriya chittam –
  druk = aspect) travels
  throug...
Vata

                     • Vata defined as Gati –
                       momentum = motor and
                       Gan...
Types of Evoked Potentials
• MOTOR = Gati =Measured from arm or leg muscle
• VISUAL = Druk = Monocular visual stimulation ...
Motor evoked potentials (MEP) = Vata Gati
• Action potentials generated in the cortex
  travel down the pyramidal pathway ...
Fundamentals of
Neurology1sted
2006.Thieme.3HA
XAP,
Mumenthaler /
Mattle, pp 59




      Vata can be
  calculated in term...
Somatosensory evoked potentials
     (SSEP) = Vata Gandhana
• When a repetitive electrical stimulus is applied to
    the ...
•   Fundamentals of
                                           Neurology1sted
                                           2...
Embryological appreciation of
          Pranavaha Srotas
• Puppusa develop from the blood
  froth
• Heart that bears the b...
•
              Development of Lung
      Lungs are the essential organs of respiration
•     substance of the lung is of ...
Physiological appreciation of Lung unit




8-1-2008      doctorksrprasad@gmail.com   16
Present day Understanding
       •   The entoderm consists at first of flattened cells, which
           subsequently beco...
Organ (Lung)
                                                        Pathology
                                           ...
Srotas Pathology
      Vitiated Dosha moving all the way in the body develops the
         disease where ever is obstructe...
Pranavaha srotodusti Hetu
Dhatu kshaya (wasting)
Vega sandharana (natural urges suppression)
Rooksha padartha sevana (indu...
Pranavaha srotodusti Lakshana
Atisrustam (too long respiration)
Atibaddham (restricted respiration)
Kupitam (agitated resp...
Pranavaha sroto Abhighata Lakshana

     Akroshana (loud grooming)
     Vinamana (deformation of the thoracic region)
    ...
SYMPTOMS
•   Cough = A sudden explosive forcing of air through the glottis,
    occurring immediately on opening the previ...
SYMPTOMS
•   Stridor = A high-pitched, noisy respiration, like the blowing of the
    wind; a sign of respiratory obstruct...
Krichra swasa (Dyspnoea) cardinal
  symptom of Pranavaha srotodusti
                                Common disease with
  ...
qÉÂiÉ: mÉëÉhÉuÉÉWûÏÌlÉ                     Symptoms of Importance
    xÉëÉåiÉÉÇxrÉÉÌuÉzrÉ MÑümrÉÌiÉ
    – EU:xjÉ MüTüqÉÑ®Õ...
Examination of
  PVS ailment
General Examination
   Vital data
Systemic Examination
   Inspection
   Palpation
   Percussi...
PVS Diagnostic Instruments
    Pulmonary Function Testing
    Pulmonary Exercise testing
    Pleural / Pulmonary pathology...
Haematological and biochemical
              tests
• Haemoglobin, to detect the presence of anaemia or
  polycythaemia
• P...
Sputum
• yellowish green indicates inflammation (infection
  or allergy)
• the presence of blood suggests neoplasm or
  pu...
Pulmonary Function Testing
• STATIC LUNG
  VOLUMES
• Gas Dilution
  Techniques
• Plethysmography
• Radiographic Total
  Lu...
Respiratory function tests and exercise tests
Vitalograph
spirometer
Micro Medical Micro Loop and
   Micro Lab spirometers
Pulmonary Exercise testing
• Clinical integrative cardiorespiratory exercise testing is
  the ability to assess oxygen upt...
Pleural/Pulmonary pathology
              diagnostic procedures
             •   Thoracentesis
             •   Pleural Fl...
Pulmonary Imaging
                                                Five important internal tissue
• Standard plain X-Ray PA...
Pre operative evaluation & diagnostic
               procedures
• Atelectasis = Collapse of an expanded lung
• Shunting wi...
• Inflammation – infection, Rhinitis (coryza), Allergy,
         laryngitis, Tracheitis, bronchitis, bronchiectasis,
     ...
PROTECTIVE AGENTS IN THE
  EPITHELIAL LUNG FLUID
       • Defensins
       • Secretory lactoperoxidase A2
       • Lactope...
• Alveolar macrophages.
  Scanning electron micrograph
  showing alveolar macrophages
  (arrow) patrolling the alveolar
  ...
Methodical approach to diagnose
• MåüÍcÉcNûUÏUÉmÉaÉiÉÉÈ vÉoSÉÈ xrÉÑxiÉ§É ´ÉÉå§ÉåhÉ mÉUϤÉåiÉç
                                                 cÉ.ÌuÉ. 4/7...
Areas of
examination
• Major Points
     –     Shape of the chest
     –     Tracheal position
     –     Apical position
...
• lÉÉQûÏ = zsÉåwqÉåMüÉxÉå ÎxjÉUÉ qÉlSÉ μÉÉxÉå iÉÏuÉëaÉÌiÉpÉïuÉåiÉç –
  UÉuÉhÉlÉÉÌQû
• qÉÔ§ÉÇ = oÉ®qÉÔ§ÉÇ / AsmÉqÉÔ§ÉqÉç Må...
• Methods of        • Internal Environment
  Management          – Ushna vs Sheeta
  –   Eliminative     – Snigdha vs Rook...
MüÉxÉ                 MüxÉÌiÉ MühPûÉSÕ²ïÇ aÉcNûiÉÏÌiÉ CÌiÉ MüÉxÉ
                                                         ...
NˇÁà éú¿Áuõo -
  ú¿ÁmÁz —ÆÏtÁåÁåÏTo: ú¿tÏ…b: à ußãåNˇÁÊÀÆÀƒåoÏ¡ÆVÁz : @
  uå∫zuo ƒMfiÁnÓÃÁ ÃtÁz Áz ™åyu uß: NˇÁà Fuo ú¿ut...
Cough reflex
Acute Bronchitis
                          ICD 10 = J20 & J21
  •    Include:                               Exclude:
  •  ...
Chronic Bronchitis




8-1-2008       doctorksrprasad@gmail.com   51
Bronchiectasis




8-1-2008    doctorksrprasad@gmail.com   52
8-1-2008   doctorksrprasad@gmail.com   53
Kasa Chikitsa sutra
qÉÑWÒûqÉÑïWÒûÌuÉïwÉcNûÌSïÌWïûkqÉÉiÉ×Oèû μÉÉxÉMüÍxÉwÉÑ – A.WØû. xÉÔ. 13/-
MåüuÉsÉÉÌlÉsÉÇ MüÉxÉÇ xlÉåWæû...
A total 1238 compounds for
      treating Kasa in Ayurveda
          342 Rasa aushadhi
•   Talisadi churna – srungyadi chu...
Kasa Yoga
• Kadaliphala yoga = kadali +
  Maricha (Basava Rajiya)
• Swarna Bhupati Ras =
  Sarva Kasaharam (Vaidya
  chint...
• Ahara = Vidahi, Vistambhi, Abhishyandi, Vidruddha,
  Vishamashana, Amapardosha, Anaha,
• Guna = Guru, Rooksha, sheeta
• ...
≈ƒÁà éú¿Áuõo -
ÆtÁ ÿÁzoÁÊuà ÃʪÜÆ ™Áªo: Nˇ¢ˇúÓƒîNˇ: @
uƒ…ƒSƒ¿uo Ãʪt‚áÀotÁ ≈ƒÁÃÁå‚ Nˇ∫Ázuo Ã: @@17@@
                   ...
Tamaka swasa
  • Normalcy of Pranavata suggests health in the
    body, abnormality indicates disease
  • Pranavata and Pr...
Tamaka Swasa Nidana
    • Either Bahya or Abhyantara Nidana
      (etiological factors) cause Bronchial
      asthma which...
o™Nˇ≈ƒÁà -
ú¿uo¬Áz™Ê ÆtÁ ƒÁÆÏ: ÿÁzoÁÊuà ú¿uoú˘oz @          •   Asthma is defined as intermittent,
                      ...
Nidana Sevana (Diet, Regimen & Climate)

 Vatadushti                                               Kaphadushti

          ...
Asthma




8-1-2008   doctorksrprasad@gmail.com   63
J45-Asthma
               Excludes:
               acute severe asthma ( J46)
               chronic asthmatic (obstructiv...
Areas of management interest in
         Tamaka Swasa
                        Kasahara


                                 ...
Swasa / Tamaka swasa Chikitsa
• MüÉUhÉ xjÉÉlÉ qÉÔsÉæYrÉÉSåMüqÉåuÉ ÍcÉÌMüÎixÉiÉqÉç – cxÉç.ÍcÉ.17/70
• xlÉåWûuÉÎxiÉÇ ÌuÉlÉÉ ...
Swasa yoga
•   962 yogas for Swasa Hikka Chikitsa            Karpuradi chrna (SY)
                                        ...
•   oÉëͼ bÉ×iÉ
•   aÉÑSÕcrÉÉÌS bÉ×iÉ
•   aÉÑaaÉÑsÉÑmÉÇcÉÌiÉ£üMüqÉç bÉ×iÉ
•   aÉÑaaÉÑsÉÑ ÌiÉ£üMü bÉ×iÉ
•   MülOûMüÉËU bÉ×i...
pÉUÎlaÉ bÉ×iÉ rÉÉåaÉ
                       cÉÇaÉåËU bÉ×iÉ
                       MülOûMüÉËU bÉ×iÉ
                       ...
MülOûMüËU     bÉ×iÉ
Pushkara Moola         mÉlcÉÌiÉ£ü    bÉ×iÉ
                         SzÉqÉÔsÉ    bÉ×iÉ
 Ghruta Yoga    ...
Tamaka Swasahara rasa Aushadhi




•   ¤ÉrÉMÑüsÉÉliÉMü UxÉ
•   sÉbÉÑÍzÉuÉ aÉÑÌOû
•   ÍzÉsÉÎeÉiÉÑ uÉÌOûMü
•   xÉÔrÉïmÉëpÉ a...
Points to observe at PVS Management
• Transport of oxygen and carbon dioxide
  (Ambara peeyusha)
• Regulation of Acid base...
Note
               This is
             Not an end
           But a big start !
     • Dr. K. Shiva Rama Prasad
     • do...
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srotas Diseases “Ayurvedic Pulmonology” Slide 28 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 29 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 30 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 31 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 32 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 33 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 34 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 35 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 36 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 37 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 38 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 39 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 40 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 41 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 42 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 43 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 44 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 45 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 46 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 47 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 48 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 49 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 50 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 51 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 52 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 53 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 54 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 55 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 56 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 57 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 58 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 59 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 60 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 61 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 62 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 63 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 64 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 65 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 66 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 67 Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” Slide 68 Management of Pranavaha 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Pranavata initiates impulse from Shirasa (Buddhi Hrudayendriya chittam – druk = aspect) travels through nose, tongue, pharynx, neck till Uras understood as – reticular formation form the Medulla oblongata with higher center connected especially “Respiratory center”

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Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology”

  1. 1. Prof. Dr. K.Shiva Rama Prasad M.D (KC); MA, Ph.D (Jyotish) doctorksrprasad@gmail.com Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology” 8-1-2008 doctorksrprasad@gmail.com 1
  2. 2. Thought of 2008 • “Following western scientist blindly is not admissible. The information available should be used discriminatively to enrich the knowledge and adopted to the Indian territory and population”. Dr. Manmohan Singh, PM India 8-1-2008 doctorksrprasad@gmail.com 2
  3. 3. LET - Introduction • Life starts with breath • Ends with breathlessness • The maintenance of life throughout life is maintained by Pranavaha srotas with its – initiative points i.e. Hrudaya – Heart; Mahasrotas - Lungs and 10 Dhamani 8-1-2008 doctorksrprasad@gmail.com 3
  4. 4. Pranavaha srotas • Pranavaha Srotas is a vital input capability structure, maintaining the Life = Pranavata • Prana is said as – Pavana / Anila – wind/ Air • Life sustenance relays on maintenance of Oxygen – Ambara peeyusha and water in the body • mÉëÉhÉuÉWûÉÌlÉÌiÉ mÉëÉhÉxÉÇ¥ÉÉMüuÉÉiÉuÉWûÉlÉÉqÉç LiÉŠ mÉëÉhÉÉZrÉÌuÉÍzɹxrÉxÉëÉåiÉ – cÉUMü ÌuÉqÉÉlÉ 5/8 cÉ¢ümÉÉÍhÉ • mÉëÉhÉmÉuÉlÉ: mÉëÉhÉÉÌlÉsÉ: mÉëÉhÉÉÍ´ÉiÉÉå uÉÉrÉÑËUÌiÉ – zÉÉ.xÉÇ.mÉÔ. 5/48 -AÉRûqÉssÉ 8-1-2008 doctorksrprasad@gmail.com 4
  5. 5. Pranavaha Sroto Moola • Moola refers to developmental or generative place • PVS have Hrudaya (Heart), Mahasrotas (trachea) and Rasavahini dhamani (pulmonary vessels) added by Susruta as originative places • Technically any organ takes in and sends out is Hrudaya – either Heart or Lungs • qÉÔsÉÍqÉÌiÉ mÉëpÉuÉxjÉÉlÉqÉç – cÉ.ÌuÉ.5/8 – cÉ¢ümÉÉÌlÉ • iÉ§É mÉëÉhÉuÉWûÉlÉÉÇ xÉëÉåiÉxÉÉÇ WØûSrÉÇ qÉÔsÉÇ qÉWûÉxÉëÉåiÉ¶É – cÉ.ÌuÉ.5/8 • iÉrÉÉåqÉÔïsÉÇ WØûSrÉÇ UxÉuÉÉÌWûlrÉ¶É kÉqÉlrÉ: - xÉÑ.zÉÉ.9/12 8-1-2008 doctorksrprasad@gmail.com 5
  6. 6. Source of life • The Prana is specific air breathed into the lungs during the act of inspiration. • The effect of indoor and outdoor air pollution on allergic disease has received considerable attention • Human is continuously under the influence of environmental changes subjected pollution. • Urbanized life style and industrialization etc. compound the problem. 8-1-2008 doctorksrprasad@gmail.com 6
  7. 7. Pranavata • Pranavata initiates impulse from Shirasa (Buddhi Hrudayendriya chittam – druk = aspect) travels through nose, tongue, pharynx, neck till Uras understood as – reticular formation form the Medulla oblongata with higher center connected especially “Respiratory center” xjÉÉlÉÇ mÉëÉhÉxrÉ qÉÔkÉÉåïU: MühPûÎeÉÀûÉxrÉlÉÉÍxÉMüÉ ¹ÏuÉlɤÉuÉjÉÔªÉUμÉÉxÉÉWûÉUÉÌS MüqÉï cÉ – cÉ.ÍcÉ.28/6 • Promotes expulsion of mÉëÉhÉÉå§ÉqÉÔkÉïaÉ: EU:MühPûcÉUÉå oÉÑήWØûSrÉåÎlSìrÉ ÍcÉ¨É SØMçü phlegm, gas and intake of ÌlɹÏuÉlÉ ¤ÉkÉÔªÉU ÌlÉ:μÉÉxÉÉ³É mÉëuÉåzÉM×üiÉç – A.WØû.xÉÔ.12/ air and food. 8-1-2008 doctorksrprasad@gmail.com 7
  8. 8. Vata • Vata defined as Gati – momentum = motor and Gandhana – sensory perceptional or said as information / knowledge transformation uÉÉ aÉÌiÉaÉlkÉlÉrÉÉå – xÉÑ.xÉÔ.21/5 8-1-2008 doctorksrprasad@gmail.com 8
  9. 9. Types of Evoked Potentials • MOTOR = Gati =Measured from arm or leg muscle • VISUAL = Druk = Monocular visual stimulation with a checkerboard pattern is used to elicit visual evoked potentials, which are recorded from the midoccipital region of the scalp. • AUDITORY = Srotra = Monaural stimulation with repetitive clicks is used to elicit brainstem auditory evoked potentials, which are recorded at the vertex of the scalp. • SOMATOSENSORY = Gandhana = Electrical stimulation of a peripheral nerve is used to elicit the somatosensory evoked potentials, which are recorded over the scalp and spine. 8-1-2008 doctorksrprasad@gmail.com 9
  10. 10. Motor evoked potentials (MEP) = Vata Gati • Action potentials generated in the cortex travel down the pyramidal pathway to the muscles. • Surface electrodes placed on an arm or leg muscle are used to record the summed motor potentials. These potentials are larger and easier to record when the subject lightly contracts the corresponding muscle beforehand. • An abnormality of the MEP implies a lesion in the peripheral or central portion of the motor pathway. 8-1-2008 doctorksrprasad@gmail.com 10
  11. 11. Fundamentals of Neurology1sted 2006.Thieme.3HA XAP, Mumenthaler / Mattle, pp 59 Vata can be calculated in terms impulse transportation time CMCT (Central Motor Conduction Time) 8-1-2008 doctorksrprasad@gmail.com 11
  12. 12. Somatosensory evoked potentials (SSEP) = Vata Gandhana • When a repetitive electrical stimulus is applied to the skin, impulses are generated at the terminal sensory branch of a peripheral nerve and conducted centrally via the peripheral nerve, nerve root, posterior columns/ spinothalamic tract, medial lemniscus, and thalamocortical connections. A lesion at any point along this pathway can alter the evoked potentials, which are recorded first over Erb point (for the median n.) or the lumbar spine (for the tibial n.), and then through a scalp electrode in the parietal region on the side opposite the stimulation. An example of delayed conduction in the central somatosensory pathway is shown in Fig. 8-1-2008 doctorksrprasad@gmail.com 12
  13. 13. • Fundamentals of Neurology1sted 2006.Thieme.3HA XAP, Mumenthaler / Mattle, pp 58 8-1-2008 doctorksrprasad@gmail.com 13
  14. 14. Embryological appreciation of Pranavaha Srotas • Puppusa develop from the blood froth • Heart that bears the blood, build from blood and phlegm • Anatomical relations are – from heart in the left lies the “Puppusa – Left lung” and on the right “Kloma – Right lung” • zÉÉåÍhÉiÉTåülÉmÉëpÉuÉ: mÉÑmmÉÑxÉ: - xÉÑ.zÉÉ.4/25 • zÉÉåÍhÉiÉMüTümÉëxÉÉSeÉÇ WØûSrÉÇ – rÉSÉ´ÉrÉÉ ÌWû kÉqÉlrÉ: mÉëÉhÉuÉWûÉ: - xÉÑ.zÉÉ 4/31 • WØûSrÉxrÉ AkÉÉå uÉÉqÉiÉ: msÉÏWû mÉÑmTÑüxɶÉ; SͤÉhÉiÉÉå rÉM×üiÉç YsÉÉåqÉ cÉåÌiÉ YsÉÉåqÉÌiÉsÉMüqÉç -xÉÑ.zÉÉ 4/31QûsWûhÉ 8-1-2008 doctorksrprasad@gmail.com 14
  15. 15. • Development of Lung Lungs are the essential organs of respiration • substance of the lung is of a light, porous, spongy texture; it floats in water, and crepitates when handled, owing to the presence of air in the alveoli; it is also highly elastic • Right (Kloma) and left (Puppusa) lung buds grow out behind the ducts of Cuvier • Each lung is invested by an exceedingly delicate serous membrane, the pleura • The lungs provide an alveolar surface area of approximately 40 m2 for gaseous exchange. • Each lung has: an apex which reaches above the sternal end of the 1st rib; a costovertebral surface which underlies the chest wall; a base overlying the diaphragm and a mediastinal surface which is moulded to adjacent mediastinal structures. 8-1-2008 doctorksrprasad@gmail.com 15
  16. 16. Physiological appreciation of Lung unit 8-1-2008 doctorksrprasad@gmail.com 16
  17. 17. Present day Understanding • The entoderm consists at first of flattened cells, which subsequently become columnar. It forms the epithelial lining of the whole of the digestive tube excepting part of the mouth (Asya) and pharynx (kanta) and the terminal part of the rectum (Pakwashaya) (which are lined by involutions of the ectoderm), the lining cells of all the glands which open into the digestive tube, including those of the liver and pancreas, the epithelium of the auditory tube and tympanic cavity (srotra), of the trachea, bronchi, and air cells of the lungs (Puppusa-Kloma), of the urinary bladder (Vasti) and part of the urethra, and that which lines the follicles of the thyroid gland and thymus. 8-1-2008 doctorksrprasad@gmail.com 17
  18. 18. Organ (Lung) Pathology • Inflammatory Lung diseases • Interstitial Lung diseases • Infectious Lung diseases • Environmental Lung diseases • Obstructive Lung disease • Respiratory Insufficiency • Pulmonary manifestations of systemic diseases • Pulmonary Vascular diseases • Neoplastic Lung diseases • Congenital Lung diseases • Developmental Lung diseases • Genetic Lung diseases • Pleural diseases • Common bronchial and pulmonary diseases – exposure to infectious pathogens and/or air, • Apart from the above many including tobacco smoke, causes the disorders categories are placed in URT shown pathology 8-1-2008 doctorksrprasad@gmail.com 18
  19. 19. Srotas Pathology Vitiated Dosha moving all the way in the body develops the disease where ever is obstructed in its channel - Atipravrutti = Excited / hyper functional activity – Hypercapnia Sanga = Acute/chronic obstructive disorders - Asthma Vimargagamana = Abnormal passage / infiltration or diverticular of srotas content – pulmonary fistula Sira-Granthi = vascular / abnormal mass tissue – makes the extra luminal compression – Malignant Tumor MÑüÌmÉiÉÉlÉÉÇ ÌWû SÉåwÉÉhÉÉÇ zÉUÏUå mÉËUkÉÉuÉiÉÉqÉç rÉ§É xÉ…¡û: ZÉuÉæaÉÑhrÉÉSèurÉÉÍkÉxiɧÉÉåmÉeÉÉrÉiÉå – xÉÑ.xÉÔ.24/10 AÌiÉmÉëuÉ×̨É: xÉ…¡ûÉå uÉ ÍxÉUÉhÉÉÇ aÉëÎlkÉrÉÉåÅÌmÉ uÉÉ ÌuÉqÉÉaÉïaÉqÉlÉÇ cÉÉÌmÉ xÉëÉåiÉxÉÉÇ SÒ̹sɤÉhÉqÉç –cÉ.ÌuÉ.5/24 8-1-2008 doctorksrprasad@gmail.com 19
  20. 20. Pranavaha srotodusti Hetu Dhatu kshaya (wasting) Vega sandharana (natural urges suppression) Rooksha padartha sevana (indulgence in dry food) Vyayama (excessive physical exertion) Kshudhita (excessive hunger) Anya daruna (other health violations pertained to PVS) ¤ÉrÉÉiÉç xÉÇkÉÉUhÉÉSìÉæ¤rÉÉiÉç urÉÉrÉÉqÉÉiÉç ¤ÉÑÍkÉiÉxrÉ cÉ – mÉëÉhÉuÉÉÌWûÌlÉ SÒwrÉÎliÉ xÉëÉåiÉÉÇxrÉlrÉÉæ¶É SÉÂhÉÉæ: – cÉUMü ÌuÉqÉÉlÉ 5/10 8-1-2008 doctorksrprasad@gmail.com 20
  21. 21. Pranavaha srotodusti Lakshana Atisrustam (too long respiration) Atibaddham (restricted respiration) Kupitam (agitated respiration) Alpalpam (shallow / short respiration) Abhikshanam (frequent/ increased/ repeated respiration) Sashabdam (stertrous respiration) Sashoola (painful respiration) AÌiÉxÉ×¹qÉÌiÉoÉ®Ç MÑüÌmÉiÉqÉsmÉÉsmÉqÉpÉϤhÉÇ uÉÉ xÉzÉoSzÉÔsÉqÉÑcduÉxÉliÉÇ SØwOèuÉÉ mÉëÉhuÉWûÉlrÉxrÉ xÉëÉåiÉÉÇÍxÉ mÉëSÒ¹ÉlÉÏÌiÉ ÌuɱÉiÉç – cÉUMü ÌuÉqÉÉlÉ 5/8 8-1-2008 doctorksrprasad@gmail.com 21
  22. 22. Pranavaha sroto Abhighata Lakshana Akroshana (loud grooming) Vinamana (deformation of the thoracic region) Mohana (loss of consciousness) Bhramana (illusion / giddiness) Vepana (tremors) Marana (death) iÉ§É ÌuÉ®xrÉÉ¢üÉåzÉlÉ ÌuÉlÉqÉlÉ qÉÉåWlÉ pÉëqÉlÉ uÉåmÉlÉÉÌlÉ qÉUhÉÇ uÉÉ pÉuÉÌiÉ – xÉÑ zÉÉ 9/12û 8-1-2008 doctorksrprasad@gmail.com 22
  23. 23. SYMPTOMS • Cough = A sudden explosive forcing of air through the glottis, occurring immediately on opening the previously closed glottis, and excited by mechanical or chemical irritation of the trachea or bronchi, or by pressure from adjacent structures. • Wheeze = A whistling, squeaking, musical, or puffing sound made by air passing through the fauces, glottis, or narrowed tracheobronchial airways in difficult breathing. • Dyspnea = Shortness of breath, a subjective difficulty or distress in breathing, usually associated with disease of the heart or lungs; occurs normally during intense physical exertion or at high altitude. 8-1-2008 doctorksrprasad@gmail.com 23
  24. 24. SYMPTOMS • Stridor = A high-pitched, noisy respiration, like the blowing of the wind; a sign of respiratory obstruction, especially in the trachea or larynx. • Hoarseness voice , Chest pain, Haemoptysis • Cyanosis = A dark bluish or purplish coloration of the skin and mucous membrane due to deficient oxygenation of the blood, evident when reduced hemoglobin in the blood exceeds 5 g per 100 ml. • Clubbing = A condition affecting the fingers and toes in which proliferation of distal tissues, especially the nail-beds, results in thickening and widening of the extremities of the digits; the nails are abnormally curved and shiny. 8-1-2008 doctorksrprasad@gmail.com 24
  25. 25. Krichra swasa (Dyspnoea) cardinal symptom of Pranavaha srotodusti Common disease with Dyspnoea are - euÉU WØûSìÉåaÉ U£üÌmÉ¨É eÉsÉÉåSU qÉåSÉåUÉåaÉ zÉÉååjÉ AÌiÉxÉÉU mÉëqÉåWû (qÉkÉÑqÉåWû) aÉsÉaÉlQû aÉÑsqÉ AÉl§ÉuÉ×ή zÉÔsÉ 8-1-2008 doctorksrprasad@gmail.com 25
  26. 26. qÉÂiÉ: mÉëÉhÉuÉÉWûÏÌlÉ Symptoms of Importance xÉëÉåiÉÉÇxrÉÉÌuÉzrÉ MÑümrÉÌiÉ – EU:xjÉ MüTüqÉÑ®ÕrÉ ÌWû‚üÉμÉxÉÉlÉç MüUÉåÌiÉ xÉ; - cÉ ÍcÉ17/17 Swarabheda rÉ: mÉëÉhÉuÉÉÌWûÌlÉ Urah shoola xÉëÉåiÉÇxrÉluÉåÌiÉ iÉålÉ μÉÉxÉ: Kasa mÉëÌiÉzrÉÉrÉ¶É eÉÉrÉiÉå – cÉ ÌlÉ 6/4 Raktasteevana Hikka Swasa Pratishyaya 8-1-2008 doctorksrprasad@gmail.com 26
  27. 27. Examination of PVS ailment General Examination Vital data Systemic Examination Inspection Palpation Percussion Auscultation Instrumental Examination Imaging PEFR etc, 8-1-2008 doctorksrprasad@gmail.com 27
  28. 28. PVS Diagnostic Instruments Pulmonary Function Testing Pulmonary Exercise testing Pleural / Pulmonary pathology diagnostic procedures Pulmonary Imaging Pre operative evaluation & diagnostic procedures 8-1-2008 doctorksrprasad@gmail.com 28
  29. 29. Haematological and biochemical tests • Haemoglobin, to detect the presence of anaemia or polycythaemia • Packed cell volume (secondary polycythaemia occurs with chronic hypoxia) • routine biochemistry (often disturbed in carcinoma and infection). • B-type natriuretic peptide may be a useful test to distinguish cardiac from non-cardiac breathlessness. A rapid bedside test is available but is not yet in routine clinical use. • D-dimer can be measured to detect intravascular coagulation. A negative test makes pulmonary embolism very unlikely.
  30. 30. Sputum • yellowish green indicates inflammation (infection or allergy) • the presence of blood suggests neoplasm or pulmonary infarct • Microbiological studies (Gram stain and culture) are not helpful in upper respiratory tract infections or in acute or chronic bronchitis. They are of value in: • pneumonia • the diagnosis of tuberculosis (Ziehl-Neelsen or auramine- phenol stains) • unusual clinical problems • Aspergillus lung disease.
  31. 31. Pulmonary Function Testing • STATIC LUNG VOLUMES • Gas Dilution Techniques • Plethysmography • Radiographic Total Lung Capacity • Spirometry • Peak Expiratory Flow and Peak Flow Meters 8-1-2008 doctorksrprasad@gmail.com 31
  32. 32. Respiratory function tests and exercise tests
  33. 33. Vitalograph spirometer
  34. 34. Micro Medical Micro Loop and Micro Lab spirometers
  35. 35. Pulmonary Exercise testing • Clinical integrative cardiorespiratory exercise testing is the ability to assess oxygen uptake (VO2) from measurements of ventilation and respired gas concentrations as Fick's relationship • Where VE is ventilation, K is a constant, VCO2 is CO2 production, and D is dead space volume flow (VD × respiratory rate). The linkage of CO2 and VD to ventilatory demand is clear. These factors represent the metabolic rate and the fraction of wasted ventilation. Ventilation is tightly linked to CO2 rather than to O2. • Anaerobic (Lactate) Threshold = At a certain work intensity, usually about 50% of the individual VO2max, lactic acid starts to accumulate in the muscles and in the blood at a faster rate, and this metabolic level can be detected from measurements of gas exchange. 8-1-2008 doctorksrprasad@gmail.com 35
  36. 36. Pleural/Pulmonary pathology diagnostic procedures • Thoracentesis • Pleural Fluid Analysis • Pleural Biopsy • Open Pleural Biopsy • Thoracoscopy 8-1-2008 doctorksrprasad@gmail.com 36
  37. 37. Pulmonary Imaging Five important internal tissue • Standard plain X-Ray PA & types may be easily Lateral/ Apical Lordotic Films identified on CT or MRI • Chest Fluoroscopy scans: 1. Gas (cavitation) • COMPUTED TOMOGRAPHY 2. Low-density material • NUCLEAR IMAGING OF THE (lipid) 3. High-density material THORAX (hemorrhage) • PULMONARY ANGIOGRAPHY 4. Intermediate-density material (soft tissue) • MAGNETIC RESONANCE 5. Calcification IMAGING • INTERVENTIONAL PROCEDURES - percutaneous biopsy 8-1-2008 doctorksrprasad@gmail.com 37
  38. 38. Pre operative evaluation & diagnostic procedures • Atelectasis = Collapse of an expanded lung • Shunting with Hypoxemia • Factors Predisposing to Postoperative Pneumonia • Impaired Transport of Mucus • Aspiration • Pre-existing Lung Infection • Impaired Coughing • Respiratory Failure • Pulmonary Embolism 8-1-2008 doctorksrprasad@gmail.com 38
  39. 39. • Inflammation – infection, Rhinitis (coryza), Allergy, laryngitis, Tracheitis, bronchitis, bronchiectasis, bronchial asthma extrinsic/ intrinsic, emphysema, lung collapse, pneumonia, lung abscess, TB, Anthracosis, silicosis, asbestosis, fibrosis, • Environmental • Tumors – epithelial, connective tissue; benign/ malignant, Acinus (primary lobule) / secondary lobule, macropahse • Respiration – insufficiency, Atelectasis (Collapse of an expanded lung), gas exchange supply /demand • Pulmonary vascular • Pulmonary plural Types of diseases in PVS 8-1-2008 doctorksrprasad@gmail.com 39
  40. 40. PROTECTIVE AGENTS IN THE EPITHELIAL LUNG FLUID • Defensins • Secretory lactoperoxidase A2 • Lactoperoxidase • IgA • Lysozyme • Lactoferrin • Surfactant proteins (collectins) • Antiproteinases: • α1-antiproteinase, secretory leucocyte protease inhibitor (SLPI), elafin • Antioxidants: glutathione
  41. 41. • Alveolar macrophages. Scanning electron micrograph showing alveolar macrophages (arrow) patrolling the alveolar spaces of the lung
  42. 42. Methodical approach to diagnose
  43. 43. • MåüÍcÉcNûUÏUÉmÉaÉiÉÉÈ vÉoSÉÈ xrÉÑxiÉ§É ´ÉÉå§ÉåhÉ mÉUϤÉåiÉç cÉ.ÌuÉ. 4/7 Auscultation of the PVS is most important • uÉhÉï xÉÇxjÉÉlÉ mÉëqÉÉhÉÉcNûÉrÉÉÈ vÉUÏUmÉëM×üÌiÉÌuÉMüÉUÉæ, cɤÉëÑUçuÉæwÉÌrÉMüÉÍhÉ rÉÉÌlÉ cÉÉlrÉÉlrÉÑ£üÉÌlÉ iÉÉÌlÉ cɤÉÑwÉÉ mÉUϤÉåiÉ | cÉ. ÌuÉ. 4/7 The colour changes viz. Cyanosis, because O2 deprivation or Anemia is noticed as generalized symptom. The edema – shotha is observed and conformed by sparsha. • xmÉzÉïÇ cÉ mÉÉÍhÉlÉÉ mÉëM×üÌiÉ ÌuÉM×üÌiÉrÉÑ£üqÉç|| cÉ. ÌuÉ. 4/7 Examination of PVS 8-1-2008 doctorksrprasad@gmail.com 43
  44. 44. Areas of examination • Major Points – Shape of the chest – Tracheal position – Apical position – Respiratory movement • Additional Points – Spine – Shape & contour of chest – Pulsations – Veins – Respiratory sounds like • cough, wheeze, stridor, grunt 8-1-2008 doctorksrprasad@gmail.com 44
  45. 45. • lÉÉQûÏ = zsÉåwqÉåMüÉxÉå ÎxjÉUÉ qÉlSÉ μÉÉxÉå iÉÏuÉëaÉÌiÉpÉïuÉåiÉç – UÉuÉhÉlÉÉÌQû • qÉÔ§ÉÇ = oÉ®qÉÔ§ÉÇ / AsmÉqÉÔ§ÉqÉç MåüÍcÉiÉç EwhÉqÉÔ§ÉqÉç • qÉsÉqÉç = oÉ®uÉcÉïxÉç • ÎeÉÀûÉ = zsÉåwqÉÉuÉ×iÉ qÉÑZÉ / sÉåmÉ / ÌlÉUÉSìï ÎeÉÀûÉ /ÌuÉzÉÑwMüÉxrÉ Ayurvedic Diagnostic tools • zÉoS = ÌuÉzÉÏhÉïuÉÉMçü / xÉzÉoS EcduÉÉxÉ • xmÉzÉï = SåWû zÉÏiÉ xmÉzÉï / mÉëlɹ¥ÉÉlÉqÉç • SØMçü = iÉqÉÉåpÉÉuÉÇ / ÌuÉpÉëÉliÉsÉÉåcÉlÉqÉç / FkuÉïSØ̹ / • AÉM×üÌiÉ = SÏlÉ / AÉxÉÏlÉÉå sÉpÉiÉå xÉÑZÉÇ
  46. 46. • Methods of • Internal Environment Management – Ushna vs Sheeta – Eliminative – Snigdha vs Rooksha – Suppressive • Lung Disease is – Palliative Suggested as – Reductive Sheeta-Rooksha • Should under go Vyadhi requires either Volatile or Ushna-Snigdha Stable medicament chikitsa management Management principles
  47. 47. MüÉxÉ MüxÉÌiÉ MühPûÉSÕ²ïÇ aÉcNûiÉÏÌiÉ CÌiÉ MüÉxÉ - uÉÉiÉeÉ Dhoomopaghata - ÌmɨÉeÉ Anna Vimarga gamana - MüTüeÉ Ama Rasa - ¤ÉiÉeÉ Rookshanna sevana - ¤ÉrÉeÉ Kshaya Vegadharana NˇÁà “zoÏ - áÓ™ÁzúVÁoÁ¸ÃoÀos{ƒ Vyayama √ÆÁÆÁ™øqÁãåuå zƒmÁXY @ uƒ™ÁTîTnƒÁXY u“ ßÁzåÀÆ ƒzTÁzú∫ÁzáÁo‚ qƒsÁzÀos{ƒ @@1@@ 8-1-2008 doctorksrprasad@gmail.com 47
  48. 48. NˇÁà éú¿Áuõo - ú¿ÁmÁz —ÆÏtÁåÁåÏTo: ú¿tÏ…b: à ußãåNˇÁÊÀÆÀƒåoÏ¡ÆVÁz : @ uå∫zuo ƒMfiÁnÓÃÁ ÃtÁz Áz ™åyu uß: NˇÁà Fuo ú¿ut…b: @@2@@ M×üiÉblÉÉå eÉÉrÉiÉå qÉirÉï: MüTüuÉÉlÉç μÉÉxÉMüÉxÉuÉÉlÉç – uÉæ±ÍcÉÇiÉÉqÉÍhÉ AjÉ: mÉëÌiÉWûiÉÉå uÉÉrÉÑÃkuÉïçÇxÉëÉåiÉ:xÉqÉÉÍ´ÉiÉ: ESÉlÉpÉÉuÉqÉÉmɳÉ: (FkuÉïaÉÌiÉxuÉpÉÉuÉqÉÉmɳÉ) MühPåû xÉiMüxiÉjÉÉåUÍxÉ AÉÌuÉzrÉ ÍzÉUxÉ: ZÉÉÌlÉ xÉuÉÉïÍhÉ mÉëÌiÉmÉÔUrÉlÉç AÉpÉÉgeɳÉͤÉmÉlÉç SåWÇû WûlÉÑqÉlrÉå iÉjÉÉÅͤÉhÉÏ lÉå§É mÉ׸qÉÑU:mÉÉμÉåï ÌlÉpÉÑïerÉ xiÉqpÉrÉÇxiÉiÉ: zÉÑwMüÉå uÉÉ xÉ MüTåü uÉÉÅÌmÉ MüxÉlÉÉiMüÉxÉ EcrÉiÉå – cÉ. ÍcÉ 18/6-8 MüÉxÉ 8-1-2008 doctorksrprasad@gmail.com 48
  49. 49. Cough reflex
  50. 50. Acute Bronchitis ICD 10 = J20 & J21 • Include: Exclude: • bronchitis: · NOS, in those • bronchitis: · NOS, in those 15 under l5 years of age years of age and above ( J40) · acute and subacute (with): · allergic NOS ( J45.0) · bronchospasm · chronic: · fibrinous · NOS ( J42) · membranous · mucopurulent ( J41.1) · purulent · obstructive ( J44.-) · septic · simple ( J41.0) · tracheitis • tracheobronchitis: · NOS ( J40) • tracheobronchitis, acute · chronic ( J42) · chronic obstructive ( J44.-) ICD-9CM CODES = 466.0 Acute bronchites 8-1-2008 doctorksrprasad@gmail.com 50
  51. 51. Chronic Bronchitis 8-1-2008 doctorksrprasad@gmail.com 51
  52. 52. Bronchiectasis 8-1-2008 doctorksrprasad@gmail.com 52
  53. 53. 8-1-2008 doctorksrprasad@gmail.com 53
  54. 54. Kasa Chikitsa sutra qÉÑWÒûqÉÑïWÒûÌuÉïwÉcNûÌSïÌWïûkqÉÉiÉ×Oèû μÉÉxÉMüÍxÉwÉÑ – A.WØû. xÉÔ. 13/- MåüuÉsÉÉÌlÉsÉÇ MüÉxÉÇ xlÉåWæûUÉSÉæmÉÉcÉUåiÉç – A WØû ÍcÉ 3/1 mÉæ̨ÉMåü xÉMüTåü MüÉxÉå uÉqÉlÉÇ xÉÌmÉïwÉÉ ÌWûiÉÇ – cÉ. ÍcÉ. 18/83 mÉëcNûkÉïlÉÇ MürÉÍzÉUÉåÌuÉUåMüÉxiÉjÉæuÉ kÉÔqÉÉ: MüuÉsÉaÉëWû¶É EwhÉ¶É sÉåWûÉ: MüOÒûMüÉ ÌlÉWûliÉÑ: MüTÇü ÌuÉzÉåwÉåhÉ MüTüzÉÉåwÉhÉÇ cÉ – xÉÑ.E.52/28 MüÉxÉqÉÉirÉÌrÉMÇü qÉiuÉÉ ¤ÉiÉeÉÇ iuÉUrÉÉ eÉrÉåiÉç qÉkÉÑUæeÉÏïuÉlÉÏrÉæ¶É oÉsÉqÉÉÇxÉÌuÉuÉkÉïlÉæ: - cÉ ÍcÉ 18/138 SÏmÉlÉÇ oÉ×ÇWûhÉqÉåuÉÉSÉæ MÑürÉÉïSalÉå¶É SÏmÉlÉqÉç urÉirÉÉxÉÉiÉç ¤ÉrÉMüÉÍxÉprÉÉå oÉsrÉÇ xÉuÉïÇ ÌWûiÉÇ pÉuÉåiÉç – cÉ. ÍcÉ 18/187 AaêrÉ – ÌuÉSÎaSMüÉ - MülOûMüËU (Solanum xanthocarpum) MüxÉWûU uÉaÉï :- SìɤÉpÉrÉÉqÉsÉMü ÌmÉmmÉsÉÏSÒUÉsÉpÉÉ zÉ×…¡ûÏMühOûMüËUMüÉ uÉ׶ÉÏUmÉÑlÉlÉïuÉÉiÉÉqÉsÉYrÉÉ CÌiÉ SzÉåqÉÉÌlÉ MüxÉ WûUÉÍhÉ pÉuÉÎliÉ – cÉ. xÉÔ.4/16 8-1-2008 doctorksrprasad@gmail.com 54
  55. 55. A total 1238 compounds for treating Kasa in Ayurveda 342 Rasa aushadhi • Talisadi churna – srungyadi churna • Abhraka bhasma – Shrungi bhasma • Trijatakadi vati – Lavangadi vati • Dashamoolarista – Vasarista • Amrutaprasha ghruta – Vasa ghruta • Vasakantakari Avaleha – Agastya Rasayanam • Mahalaxmivilasa Ras - Agni kumara ras • Hemagarbha pottali – Hemabhra sindhura - Swarnamalivi vasantam
  56. 56. Kasa Yoga • Kadaliphala yoga = kadali + Maricha (Basava Rajiya) • Swarna Bhupati Ras = Sarva Kasaharam (Vaidya chintamani)
  57. 57. • Ahara = Vidahi, Vistambhi, Abhishyandi, Vidruddha, Vishamashana, Amapardosha, Anaha, • Guna = Guru, Rooksha, sheeta • Bahya = rajas, Dhooma, Atapa, anila, • Other = Vyayama, Bharadhwa, Vegarodha, Apatarpana, Gramyadharma, Dourbalya, Marmabhighata, Shodana viparyaya, • Nidanarthakara roga = Atisara, Jwara, Chardi, Peenasa, Urahkshata, Raktapitta, Udavarta, Vishuchi, Alasaka, Pandu, Visha u“MNˇÁ≈ƒÁà “zoÏ - uƒtÁu“TϪuƒ…bu©ßøqÁuß…ÆuãtßÁzå{: @ ∆yoúÁåÁ∆åÀsÁå∫ÁzáÓ™ÁoúÁuå¬{: @@1@@ √ÆÁÆÁ™Nˇ™îßÁ∫Á܃ƒzTÁVÁoÁúoúîm{: @ Hikka- Swasa u“MNˇÁ ≈ƒÁÃ≈Y NˇÁÃ≈Y åwmÁÊ Ã™ÏúÁÆoz @@2@@ 8-1-2008 doctorksrprasad@gmail.com 57
  58. 58. ≈ƒÁà éú¿Áuõo - ÆtÁ ÿÁzoÁÊuà ÃʪÜÆ ™Áªo: Nˇ¢ˇúÓƒîNˇ: @ uƒ…ƒSƒ¿uo Ãʪt‚áÀotÁ ≈ƒÁÃÁå‚ Nˇ∫Ázuo Ã: @@17@@ Nidana Vata • Prana vaha, Udana vaha, Kapha Ruddhopagamana Annavaha = obliterated by it self Srotoroodha Swasa 8-1-2008 doctorksrprasad@gmail.com 58
  59. 59. Tamaka swasa • Normalcy of Pranavata suggests health in the body, abnormality indicates disease • Pranavata and Prana vikruti leads to the Swasa, which is an emergency condition, leads to death even. • WHO 1998 estimates asthma as 155 millions which increases 50% every decade worldwide. • India has an estimated 15-20 million asthmatics. • Tamaka - is derived from “Tamyati iti Tamaka”- means; to choke, darkness, be suffocated. • Dalhana and Chakrapani commented Tamah praveshana which refers to the darkness or black curtains in front of the eyes. 8-1-2008 doctorksrprasad@gmail.com 59
  60. 60. Tamaka Swasa Nidana • Either Bahya or Abhyantara Nidana (etiological factors) cause Bronchial asthma which is heterogeneous disease. • Aggravating factors like meghambu(rainy season) sheeta sthana(cold place) and preceding factors like peenasa (common cold) kasa(cough) are clearly explained in the pathology of Tamaka Swasa. 8-1-2008 doctorksrprasad@gmail.com 60
  61. 61. o™Nˇ≈ƒÁà - ú¿uo¬Áz™Ê ÆtÁ ƒÁÆÏ: ÿÁzoÁÊuà ú¿uoú˘oz @ • Asthma is defined as intermittent, reversible airway obstruction in T¿yƒÁÊ u∆∫≈Y ÃÊTw—Æ≈¬z…™ÁmÊÙÏtyÆîÊ Y @@27@@ association with increased Nˇ∫Ázuo úyåÃÊ ozå ªt‚áÁz VÏVîÏ∫NÊˇ osÁ @ nonspecific bronchial reactivity. EoyƒÊ oyƒ¿ƒzTÊ Y ≈ƒÁÃÊ ú¿Ámú¿úygNˇ™‚ @@28@@ These physiologic changes are ú¿oÁ©Æuo à ƒzTzå ow…Æoz ÃuãåªÜÆoz @ now known to exist in the context ú¿™Áz“Ê NˇÁÙÁå≈Y à TXZuo ™ÏÛ™ÏîÛ: @@29@@ of airway inflammation. The addition of inflammation to the ≈¬{…™lÆ™ÏXÆ™Áåz oÏ ßw∆Ê ßƒuo tÏ:uQo: @ definition has shifted the oÀÆ{ƒ Y uƒ™ÁzqÁãoz ™Ï˜oîÊ ¬ßoz ÃÏQ™‚ @@30@@ understanding of asthma from a osÁDÀÆÁzt‚܃ÊÃoz Nˇle: NwˇXZ~ÁXZMåÁzuo ßÁu oÏ™‚ @ disease of airway nerves and å YÁuú ¬ßoz uå¸ÁÊ ∆ÆÁå: ≈ƒÁÃúyugo: @@31@@ smooth muscle to one that úÁ≈ƒzî oÀÆÁƒTw—mÁuo ∆ÆÁåÀÆ Ã™y∫m: @ identifies inflammation as the driving force for the symptoms EÁÃyåÁz ¬ßoz ÃÁ{PƙυmÊ Y{ƒÁußåãtuo @@32@@ associated with the disease. This GuXZ~oÁqÁz ¬¬Ábzå uÀƒ˘oÁ ßw∆™Áuoî™Áå‚ @ realization has led to a dramatic uƒ∆Ï…NˇÁÀÆÁz ™Ï“Ï: ≈ƒÁÃÁz ™ÏÛ≈YƒÁƒá©Æoz @@33@@ shift in the treatment of the ™zVÁ©§Ï∆yoú¿ÁSƒÁo{: ≈¬z…™¬{≈Yuƒƒáîoz @ disease in the past 10 years. à ÆÁõÆÀo™Nˇ: ≈ƒÁÃ: ÃÁÜÆÁz ƒÁ ÀÆÁãåƒÁzunso: @@34@@ Tamaka Swasa 8-1-2008 doctorksrprasad@gmail.com 61
  62. 62. Nidana Sevana (Diet, Regimen & Climate) Vatadushti Kaphadushti Agnimandhya Ama Kapha vridhi Rasadushti Pranavaha Sroto Avarodha Vimarga gamana Sanga of Pranavata Kloma Nalika Shaka Tamaka Shwasa 8-1-2008 doctorksrprasad@gmail.com 62
  63. 63. Asthma 8-1-2008 doctorksrprasad@gmail.com 63
  64. 64. J45-Asthma Excludes: acute severe asthma ( J46) chronic asthmatic (obstructive) bronchitis ( J44.-) chronic obstructive asthma ( J44.-) eosinophilic asthma ( J82) lung diseases due to external agents ( J60-J70) status asthmaticus ( J46) J45.0 Predominantly allergic asthma Allergic: · bronchitis NOS · rhinitis with asthma Atopic asthma Extrinsic allergic asthma Hay fever with asthma J45.1 Nonallergic asthma Idiosyncratic asthma Intrinsic nonallergic asthma J45.8 Mixed asthma Combination of conditions listed in J45.0 and J45.1 J45.9 Asthma, unspecified Asthmatic bronchitis NOS Late-onset asthma J46 Status asthmaticus = Acute severe asthma 8-1-2008 doctorksrprasad@gmail.com 64
  65. 65. Areas of management interest in Tamaka Swasa Kasahara Swasahara Parshwashoolahara Shothahara Deepaneya & Hrudya 8-1-2008 doctorksrprasad@gmail.com 65
  66. 66. Swasa / Tamaka swasa Chikitsa • MüÉUhÉ xjÉÉlÉ qÉÔsÉæYrÉÉSåMüqÉåuÉ ÍcÉÌMüÎixÉiÉqÉç – cxÉç.ÍcÉ.17/70 • xlÉåWûuÉÎxiÉÇ ÌuÉlÉÉ MåüÍcÉSÕ²ïcÉÉkÉ¶É zÉÉåkÉlÉqÉç qÉ×SÒmÉëÉhÉuÉiÉÉÇ ´Éå¹Ç μÉÉÍzÉlÉÉqÉÉÌSzÉÎliÉ – xÉÑ.E.51/15 • rɲÌmÉ μÉÉxÉå xlÉåWûuÉÎxiÉ mÉëÉÍgÉÌwÉ®: - QûsWûhÉ • iÉmÉïrÉåSåuÉ zÉqÉlÉæ: xlÉåWûrÉÔwÉUxÉÉÌSÍpÉ: - cÉ. ÍcÉ. 17/90 • rÉÎiMÇüÍcÉiÉç MüTüuÉÉiÉblÉqÉÑwhÉÇ uÉÉiÉÉlÉÑsÉÉåqÉlÉqÉç • pÉåwÉeÉÇ mÉÉlÉqɳÉÇ uÉÉ iÉήiÉÇ μÉÉxÉÌWûÌ‚ülÉå – cÉ. ÍcÉ. 17/147 • xÉuÉåïwÉÉÇ oÉ×ÇWûhÉÉå½smÉ: zÉYrÉ¶É mÉëÉrÉzÉÉåpÉuÉåiÉç - - - iÉxqÉÉcNÒû®ÉlÉ zÉÑ®ÉÇ¶É zÉqÉlÉæoÉ×ïÇWûhÉæUÌmÉ – cÉ.ÍcÉ. 17/149-150 • mÉÉhQÒûUÉåaÉåwÉÑ zÉÉåkÉåwÉÑ LrÉÉåaÉÉ: xÉqmÉëMüÐÌiÉïiÉÉ: • μÉÉxÉMüÉxÉÉmÉWûliÉåÅÌmÉ MüxÉblÉÉrÉåcÉ MüÐÌiÉïiÉÉ – xÉÑ.E. 51/43-44 • ÌuÉUåcÉlÉ xuÉåSlÉ kÉÔqÉëmÉÉlÉ mÉëcNûSïlÉÉÌlÉ xuÉmÉlÉÇÌSuÉÉlÉç – uÉæ±ÍcÉliÉÉqÉÍhÉ
  67. 67. Swasa yoga • 962 yogas for Swasa Hikka Chikitsa Karpuradi chrna (SY) Shatyadi churna (VC) • 102 Ghruta yoga Vidangadi churna (VC) • 283 rasa yoga Shrungyadi churna Dashamoola katutrayadi kwatha Vasadi kwatha • Vasa Vasaghruta • Pushkaramoola Trushana ghruta Talisa ghruta • Bharangi Bharngi guda haritaki (VC) • Kantakari Abhraka bhasma • Sunthi – Haritaki (BR) Swasa kuthara ras Swasakasa chintamani • Gandhaka + Maricha (BR) Swasa kaleshwara ras (VC) Sameerapannaga ras Rasamanikya Aswagandha kshara Mayurapincha bhasma 8-1-2008 doctorksrprasad@gmail.com 67
  68. 68. • oÉëͼ bÉ×iÉ • aÉÑSÕcrÉÉÌS bÉ×iÉ • aÉÑaaÉÑsÉÑmÉÇcÉÌiÉ£üMüqÉç bÉ×iÉ • aÉÑaaÉÑsÉÑ ÌiÉ£üMü bÉ×iÉ • MülOûMüÉËU bÉ×iÉ Vasa Ghruta • sÉzÉÑlÉ bÉ×iÉ • ÌlÉÇoÉÉÌS bÉ×iÉ yoga • ÍxÉÇWûÉqÉ×iÉ bÉ×iÉ • qÉWûÉMÔüwqÉÉlQûMü bÉ×iÉ • iÉÉÍVûxÉÉÌS bÉ×iÉ Panchatikta ghruruta of Yogaratnakara has Vasa and • uÉÉxÉÉ bÉ×iÉ Pushkaramoola that are • ÌuÉSÉËU bÉ×iÉ swasahara and the Brumhana - Ghruta
  69. 69. pÉUÎlaÉ bÉ×iÉ rÉÉåaÉ cÉÇaÉåËU bÉ×iÉ MülOûMüÉËU bÉ×iÉ MÑüÍsÉjÉwÉOèTüsÉ bÉ×iÉ lÉÉaÉUÉ±Ç bÉ×iÉ mÉÇcÉaÉurÉÇ bÉ×iÉ AqÉ×iÉmÉëÉzÉ bÉ×iÉ kÉluÉliÉUÇ bÉ×iÉ oÉ×WûiÉç MülOûMüÉËU bÉ×iÉ
  70. 70. MülOûMüËU bÉ×iÉ Pushkara Moola mÉlcÉÌiÉ£ü bÉ×iÉ SzÉqÉÔsÉ bÉ×iÉ Ghruta Yoga mÉlcÉaÉurÉÇ bÉ×iÉ zÉPûÉ±Ç bÉ×iÉ μÉSl·íÉÌS bÉ×iÉ kÉluÉliÉUÇ bÉ×iÉ iÉåeÉÉåuÉirÉÉÌS bÉ×iÉ uÉ×WûMülOûMüÉËU bÉ×iÉ
  71. 71. Tamaka Swasahara rasa Aushadhi • ¤ÉrÉMÑüsÉÉliÉMü UxÉ • sÉbÉÑÍzÉuÉ aÉÑÌOû • ÍzÉsÉÎeÉiÉÑ uÉÌOûMü • xÉÔrÉïmÉëpÉ aÉÑÌOûMü
  72. 72. Points to observe at PVS Management • Transport of oxygen and carbon dioxide (Ambara peeyusha) • Regulation of Acid base balance (Niramleekarana – Nirlavaneekarana) • Control of breathing (Kumbhaka – Rechaka Pranayama) • Regulating the water balance in the body (Ambu)
  73. 73. Note This is Not an end But a big start ! • Dr. K. Shiva Rama Prasad • doctorksrprasad@gmail.com 8-1-2008 doctorksrprasad@gmail.com 73
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Pranavata initiates impulse from Shirasa (Buddhi Hrudayendriya chittam – druk = aspect) travels through nose, tongue, pharynx, neck till Uras understood as – reticular formation form the Medulla oblongata with higher center connected especially “Respiratory center”

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