Tamaka Swasa (Bronchial Asthma): Aetioology & Management

Tamaka Swasa
(Bronchial Asthma)
Aetioology & Management
Vd. Sujit Dalai
M.D.(NIA), Ph.D.(S.U)
Professor
Deptt. of Rasashastra & Bhaisajya Kalpana(BAMC)
(Pt. Deendayal Upadhyay Memorial Health Sciences and Ayush University), Chhattisgarh

Swasa
“Swasana swakarmani”
Obstruction related to Jeevan or Vayu is called
Swasa Roga
Vd. Sujit Dalai
drsujitdalai@gmail.com

Components of the Upper Respiratory Tract
Vd. Sujit Dalai

Human Respiratory System
Vd. Sujit Dalai

Upper Respiratory Tract Functions
Passageway for respiration
Receptors for smell
Filters incoming air to filter larger foreign material
Moistens and warms incoming air
Resonating chambers for voice
Vd. Sujit Dalai

Components of the Lower Respiratory Tract
Vd. Sujit Dalai

Functions
Larynx: maintains an open airway, routes food and air
appropriately, assists in sound production
Trachea : transports air to and from lungs
Bronchi : branch into lungs
Lungs : transport air to alveoli for gas exchange
Lower Respiratory Tract
Vd. Sujit Dalai

Gas Exchange Between the Blood and Alveoli
Vd. Sujit Dalai

Classification of Swasa
Swasa is mainly caused by the Vata and Kapha doshas.
Swasa is broadly classified into five types
1. Maha swasa
2. Urdha swasa
3. Chhinna swasa
4. Tamak swasa
5. Kshudra swasa
Vd. Sujit Dalai

Pathology
Due to excessive intake of kapha aggravating food
and regimen, the kapha along with vata gets into
pittasthana and causes swasa.
Vd. Sujit Dalai

Classification of Tamak Swasa
Tamaka swasa is of two types namely Pratamaka
swasa associated with fever, fainting, distention
of abdomen and indigestion. Santamaka swasa is
pacified by taking of cold regimen.
Vd. Sujit Dalai

Factors that vitiate the Pranvaha Sarotus: run ‘Vyadi’ (disease)
Kshaya : Physical wasting.
Veg-Dharan : Retention of natural physical urges.
Rookshata : Loss of unctuousness in body.
Vyajama : Unaccustomed physical exercises.
Kshudha : Prolonged Starvation
Darunawastha : Chronic ailments. These factors are
not only applicable in weakening the
strength of Lungs and Heart but make
them prone to ailments of Lungs and
Heart.
Vd. Sujit Dalai

Factors Responsible for Bronchial Asthma (TamakSwasa)
Raja and Dhooli n Vayu
Gaseous and Suspended particulate polluting air.
Sheersthana
Dwelling in cool and damp place.
Apa tarpana
Indulgence in activities causing wasting of body.
Amma pradoshaja
Metabolic and immune calerrors in body.
Marmabhighat
Damagetovitalorgans.
Vishamashanat
Intake of unwholesome food.
Vd. Sujit Dalai

Difficulty in breathing or shortness of breath may be simply
termed as Swasa (Asthma).
Tamak Swasa (Bronchial Asthma) is a chronic disease
causing inflammation and occasional obstruction of the
airways.
Tamak Swasa (Bronchial Asthma) exacerbations are acute
episodes of progressively worsening shortness of breath,
coughing, wheezing and chest discomfort.
Vd. Sujit Dalai

Causes
TS is caused by inflammation in the airways. When an
asthma attack occurs, the muscles surrounding the airways
become tight and the lining of the air passages swells. This
reduces the amount of air that can pass by.
In sensitive people, TS symptoms can be triggered by
breathing in allergy-causing substances (called allergens or
triggers)
Types: 1. Episodic. 2. Chronic
Vd. Sujit Dalai

Triggering factors: Can aggravate symptoms in a patient
who is having Bronchial Asthma
1. Inhalation of Allergens: House dust, pollen, mold,
animal dander
2. Environment: Cold and dry climate, cooking gas
fumes, passive cigarette smoking, paints, sprays
3. Infections: Upper Respiratory Tract infections, Viral
infections
4. Drugs: Aspirin, Pain killers (NSAIDs)
5. Food: Colouring agents of food, food preservatives,
ice creams
6.Exercise: Vigorous exercise particularly on cold
and dry day
7. Psychological factor: Stress
8. Occupation: Wood and cotton dust, chemicals
Vd. Sujit Dalai

Causes of Tamaka Swasa as per Ayurveda
1. Intake of dry, cold , heavy, incompatible food and
irregular intake of food
2. Excessive Intake of black gram, beans, sesame, meat of
aquatic animals.
3. Intake of cold water and exposure to cold climate
4. Exposure to dust, smoke and wind
5. Excessive exercise, over indulge in the sexual activity
6. Trauma to throat, chest and vital organs.
7. Suppression of natural urges.
Vd. Sujit Dalai

Signs and symptoms
1. Breathlessness along with forcible expiration
2. Cough
3. Wheezing
4. Tightness of chest
5. Thick mucus sputum
6. Aggravation of above symptoms during night and
early morning
7. Fainting during the bought of cough.
8. Sleeplessness, discomfort increases when lied
down on bed
9. Gets comfort in sitting posture.
10. Sweating on the forehead.
Vd. Sujit Dalai

Most people with asthma have attacks separated by symptom-
free periods. Some people have long-term shortness of breath
with episodes of increased shortness of breath. Either
wheezing or a cough may be the main symptom.
Asthma attacks can last for minutes to days, and can
become dangerous if the airflow is severely restricted.
Symptoms include:
Cough with or without sputum (phlegm) production
Pulling in of the skin between the ribs when breathing (inter
costal retractions)
Shortness of breath that gets worse with exercise or activity
Vd. Sujit Dalai

Emergency symptoms
Bluish colour to the lips and face
Decreased level of alertness, such as severe drowsiness or
confusion, during an asthma attack
Extreme difficulty breathing
Rapid pulse
Severe anxiety due to shortness of breath
Sweating
Other symptoms that may occur with this disease
Abnormal breathing pattern --breathing out takes more than
twice as long as breathing in
Breathing temporarily stops
Chest pain
Tightness in the chest
Vd. Sujit Dalai

Who gets asthma?
If someone in the family already has asthma that persons
are more likely to develop asthma. Children with eczema
or food allergy are more likely to develop asthma than
other children.
Allergy to pollen, house dust, mites or pets also increases
your chance of developing asthma.
Exposure to tobacco smoke, air pollution or other inhaled
irritants can also cause asthma symptoms in those with
an underlying tendency to asthma.
Vd. Sujit Dalai

Is there any relation with age for starting asthma?
Asthma can start at any age, although about half of all
people with asthma have had their first symptoms by
the age of 10, and many children with asthma have had
their first asthma attack before the age of 6.
Vd. Sujit Dalai

What causes asthma?
The causes of asthma are not fully understood. Asthma is
probably usually caused by a mixture of hereditary factors
(those you are born with) and environmental factors, but
how these factors work together is still largely unknown.
Allergens from house dust, mites and pets are the most
common causes, but many other allergens such as pollen
and moulds can cause asthma. Some patients with
asthma have no obvious allergies.
Vd. Sujit Dalai

What are the main aggravating factors of asthma ?
Inhalation of Allergens like House dust, Pollen, Mold,
Animal dander, Cold and dry climate, cooking gas
fumes, passive cigarette smoking, paints, sprays. Upper
Respiratory Tract infections, viral infections.
Drugs like Aspirin, Pain killers (NSAIDs), Colouring
agents of food, food preservatives, ice creams ,
Vigorous exercise particularly on cold and dry day,
Stress, Wood and cotton dust, chemicals etc.
Vd. Sujit Dalai

Can weather changes trigger asthma?
Yes, sudden weather changes (e.g. cold winds, humidity and
storms) can trigger asthma in some people. Some of these
sudden changes can cause the release of allergens such as
pollen that can make asthma worse in people whose asthma
is allergy-related. Cold air can also have a direct irritant
effect on inflamed airways.
Vd. Sujit Dalai

Is asthma a psychological (psychosomatic) disease?
No, asthma is not a psychological condition; it is a long-term
(chronic) inflammatory disease that leads to extra-sensitive
and easily irritated airways, especially when it is not properly
treated.
Although asthma is not a psychological condition, emotional
stress can trigger the symptoms. For example, financial
problems, not enjoying your work or worrying about your
family can all help to trigger symptoms if you already have
asthma.
Vd. Sujit Dalai

What is acute asthma and what is chronic asthma?
Acute asthma is a severe form of asthma which is of recent
origin (a few minutes to a few hours) while a chronic asthma
is a condition where one experiences either a prolonged
breathless or more commonly recurring attacks of acute
asthma.
Vd. Sujit Dalai

When to Contact a Medical Professional
1. An asthma attack requires more medication than
recommended
2. Symptoms get worse or do not improve with
treatment. You have shortness of breath while talking
3. Your peak flow measurement is 50% -80% of your
personal best
4. Drowsiness or confusion
5. Severe shortness of breath at rest
6. A peak flow measurement is less than 50% of your
personal best
5. Severe chest pain
6. Bluish colour to the lips and face
7. Extreme difficulty breathing Rapid pulse
Vd. Sujit Dalai

Outlook (Prognosis)
There is no cure for asthma, although symptoms some times
improve over time.
With proper self management and medical treatment, most
people with asthma can lead normal lives. Possible
Complications
The complications of asthma can be severe. Some includes:
 Death
 Decreased ability to exercise and take part in other
activities
 Lack of sleep due to night time symptoms
 Permanent changes in the function of the lungs
 Persistent cough
 Trouble breathing that requires breathing
assistance (ventilator)
Vd. Sujit Dalai

Exam. and Tests
1. Allergy testing : may be helpful to identify allergens in people
with persistent asthma.
2. Wheezing or other asthma-related sounds may be heard.
However, lung sounds are usually normal between asthma
episodes.
Tests may include
3. Arterial blood gas
4.Eosinophil count (a type of white blood cell) and IgE (a type
of immune system protein called an immunoglobulin)
5. Chest x-ray is useful in differentiating the asthma from other
lung diseases
6. Pulmonary function tests include Spirometry and peak flow
which estimate the narrowing of the bronchial tubes and how fast an
individual can breathe
7. Peak flow measurements
8. Methacoline challenge test and Nitric oxide tests are confirmatory
tests in Bronchial asthma.
Vd. Sujit Dalai

Management of Swasa Roga
Nidan parivarjan - Avoid disease triggers and etiogenic
factors
Shodhan Chikitsa - Purification of morbid factors from
body
Shaman Chikitsa - Symptomatic and palliative
management
AaharVihar - Dietetics and lifestyle in disease
Vegkala Chikitsa - Management of acute episode
Rasayana Chikitisa - Rejuvenation
Pranayama - Deep breathing exercises
Vd. Sujit Dalai

Nidana Parivarjan-Avoid disease triggers and
aetiogenic factors
Smoking
Cold air
Gaseous and dust pollution including deodorants,
fresheners
Heavy unctuous diet/indigestion
Fasting
Unwanted drugs
Un accustomed exertion
Pratishaya-Rhinitis
Humidity
Kshaya-physical wasting
Vd. Sujit Dalai

Tobacco Elimination:
Eliminate tobacco smoke from the home. This is the single
most important thing a family can do to help a child with
asthma.
Smoking outside the house is not enough. Family members
and visitors who smoke outside carry smoke residue inside on
their clothes and hair --this can trigger asthma symptoms.
Persons with asthma should also avoid air pollution, industrial
dusts, and other irritating fumes as much as possible.
Vd. Sujit Dalai

Shodhan Chikitsa
Purification of morbid factors from body
Nitya Virechan - Regular purgation.
Snehana & Swedan - Uro Snehana followed by Nadi
Swedana and vamana.
Vd. Sujit Dalai

Vd. Sujit Dalai

Shaman Chikitsa
Symptomatic and Palliative management
1. Expectorants/Mucolytics ( Kapha nissarak)-e.g. Sitopladi ch 3
gm, Suddha tankan 500 mg, Swaskuthar ras 120 mg two to
three times a day with honey, Madhuyashti Quath 100 ml
twice day.
2. Bronchodilators (Swasnalika vispharak)-e.g.-Kantkari avleha
10 gm twice a day, Kanakasva 10 ml with water twice a day.
Somlata ch 2 gm BD if acute episode
3. Anti allergics-e.g.-Haridra khanda 3 gm, Rasmanikaya 60 mg,
Praval panchamrit 100 mg mix with honey two to three times
a day. Sirishavleha 10 gm BD, Sirishadi kwatha 100 ml twice
a day. Somlata ch. 2 gm three times a day with hot water.
Vd. Sujit Dalai

Aahar Vihar-Dietetics and lifestyle
Avoid-High fat milk, Excessive oils in food, Curd, Tubors, Fish,
Cold water and drinks, etc. In life style routine avoid Cold air,
getting wet in rains, humid places, excessive physical and
mental exertion, physical and mental stress, factors and
medications leading to physical and immunological debility, etc.
Take-Cereals like wheat floor, seasoned rice, low fat milk, lean
meat, vegetable. And meat soups, light drink s and beverages,
honey, Luke warm water, lemon, green leafy vegetables, etc. In
life style engage in accustomed physical exercises, day time
rest, engage in activities that assure physical and mental
relaxation
Vd. Sujit Dalai

Vegkala Chikitsa - Management of acute episode
• Complete rest
• Plenty of fluids
• Oxygen
• Som Churna - 2 to 3 gm with Vasadi qwath 3 to 4 times a day.
• Kanakasva -10 ml (with equal quantity water) thrice a day.
• If possible and patient is relatively fit and have entrapped
secretions in chest try to induce emesis by giving
Madhuyashti quath or Takan leha especially in children.
• If the condition does not improve patient be referred to
intensive care.
Vd. Sujit Dalai

Rasayana Chikitisa - Rejuvenation
Chyavanprash Rasayana
Ashwagandha Rasayana
Amritprash Rasayan etc
Vd. Sujit Dalai

Useful medicinal plants for Bronchial Asthma
Kantakari (Solanum xanthocarpum)
Vasa (Adhatoda vasica)
Sunthi (Zingiber officinalis)
Bharangi (Clerodendrum serratum)
Pushkara moola (Innula racemosa)
Karkata Shringi (Pistacia inergerrima)
Haridra (Curcuma longa)
Sirisa (Albezia lebeck)
Vd. Sujit Dalai

Kantakari
Vasa
Vd. Sujit Dalai

Sirisa
Karkata Shringi
Vd. Sujit Dalai

Haridra
Sunthi
Vd. Sujit Dalai

Tamaka Swasa (Bronchial Asthma): Aetioology & Management

Tamaka Swasa (Bronchial Asthma): Aetioology & Management

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