Vamana Karma in Tamaka Shwasa - A Case Study

Seema D. Bahatkar; Pallavi Bhagwat Rathod

Vamana Karma in Tamaka Shwasa - A Case Study

D. Bahatkar S.¹, Bhagwat Rathod P.^2*

DOI:

¹ Seema D. Bahatkar, Professor and HOD, Department of Panchakarma, R.A. Podar Ayurved Medical College, Worli, Mumbai, Maharashtra, India.

^2* Pallavi Bhagwat Rathod, Final Year PG Scholar, Department of Panchakarma, R.A. Podar Ayurved Medical College, Worli, Mumbai, Maharashtra, India.

Tamaka Shwasa is a very common disease in India. The prevalence of the disease is increasing day by day due to genetic susceptibility, Pollution, environmental factor, stressful life, abnormal Food style that all exposes the humans to suffer from Tamaka Shwasa. Ayurveda the science of life describes the management of lifestyle diseases. In the form of proper dietary, its behavioral management i.e., daily regimen and seasonal regimen, seasonal detoxification and rejuvenation therapies In Ayurveda Shodhana (Purification) Shamana (Pacification) and Nidana Parivarjana (avoiding causative factors) are the three folds of fundamental therapeutic management of the disease. Panchakarma is Ayurveda’s prime Shodhana procedures which is basically group of detoxification procedures. In Ayurveda text Tamaka Shwasa is a disease which Is Kapha Vata Dosha predominant and disease of Pranavaha Strotasa. Tamaka Shwasa is clinically much resembled with bronchial asthma. Here Panchakarma procedure is quite effective which is based on situation of patient. In present case study Panchakarma procedure i.e., Vasantik Vamana was given to the patient for management of Tamaka Shwasa.

Keywords: Panchakarma, Vasantik Vamana, Nidana Parivarjana, Shodhana, Shamana

Corresponding Author	How to Cite this Article	To Browse
Pallavi Bhagwat Rathod, Final Year PG Scholar, Department of Panchakarma, R.A. Podar Ayurved Medical College, Worli, Mumbai, Maharashtra, India. Email:	Seema D. Bahatkar, Pallavi Bhagwat Rathod, Vamana Karma in Tamaka Shwasa - A Case Study. J Ayu Int Med Sci. 2022;7(10):215-219. Available From https://www.jaims.in/jaims/article/view/2044

Introduction

Tamaka Shwasa is one of the five types of disease. It is mainly disease of Pranavaha Strotasa.^[1] The main features of (Bronchial Asthma) Tamaka Shwasa are recurrent episodes of breathless, chest tightness, wheezing and cough. The prevalence of respiratory disorders like Tamaka Shwasa (B.A) is now a days increasing alarmingly due to excessive pollution, overcrowding, occupational conditions, stress, poor hygiene etc.

Aacharya Charaka has mentioned that Tamaka Shwasa is Kapha-Vataja Vikara and site of its origin is Pitta Sthana. ‘Kaphavatamkaveto Pitta Sthana Samudbhava.’^[2] In general Tamaka Shwasa is described as Yapya disease. However, in individual with recent origin of disease person of Pravara Bala or both said to be Sadhya.^[3] Aacharya Charaka has clearly mentioned the importance of Nidana Parivarjana and also the following principles for the management of Shwasa Roga. The medicine and dietic regimen which controls the Kapha and Vata due to their Ushna Guna and are Vatanulomaka in action must be utilized in the treatment of Shwasa Roga.^[4] Bruhana is considered the best option compared to Shamana and Karshana when treating Tamaka Shwasa patient.^[5] The current management of Tamaka Shwasa by modern medications is only providing short term symptomatic relief but does not provide any long-term relief to the patient. On the other hand, prolonged use of these drugs are not safe as it has many adverse effects with systemic manifestation and as the chronicity increases. Drug dose dependency increases and dilates the lung tissue such as an extent that at last it leads to respiratory failure. Vamana is the first Karma explained by Acharyas among the Pancha Shodhana. The reason for this may be consideration of the chronological order of Dosha. As Kapha Dosha resides in the upper part of the body, it should be eliminated first through the nearest route.^[6] The definition of Vamana is the process by which the vitiated Doshas are expelled through the Urdhwa Bhaga.^[7] To be more precise the Apakva Pitta and Kapha Doshas which get expelled out.^[8]

Case Study

Basic information of the patient

Age - 30 years

Sex - Male

Religion - Hindu

Vedana Vishesh (chief complaints)

Shwasa Kashtata
Chankramanottara and Aarohanottar Shwasa
Ura Kaphaprachiti
Recurrent Cold, Running nose
Nasanaha

Vartaman Vyadhi Vrutta (h/o present illness)
A 30 years old patient was consulted out patient department, Department of Panchakarma OPD R.A. Podar Ayurvedic Hospital, Worli. since 1 year.

Purva Vyadhi Vrutta (h/o Past illness) Since last 1 year
Patient suffering from Tamaka Shwasa (B.A)

Chikitsa Vruttant (treatment h/o)
Patient is on Rotacort 400mg BD.

Kulaj Vrutta (Family h/o) - Nil

Vaiyaktika Vrutta (Personal h/o)

Aaharaja - Daily Dadhi Sevan, Paryushit and Abhishandi Aahar Sevan.

Viharaja - Ratrojagarana, Diwaswapa, Job in AC.

Addiction - Tea.

O/E - Vitals were normal.

CVS - S1S2 normal

R/S - (occasional wheezing) clear.

P/A – normal

Liver – NPNT

Spleen - NPNT

Asthta Vidha Pariksha

Nadi - 82/min
Mala - Prakruta
Mutra - Prakruta
Jivha - Eshat Sama
Shabda - Skapha Swara
Sparsha - Snigdha
Druka - Prakruta
Aakruti - Madhyam

Treatment Protocol: Aacharya has described Vasant Rutu is Swabhavik Kapha Prakopak Kala hence Kaphaja Vikara are most common during this time. Hence Vamana Karma is advised during this time. As the Prakruti of the patient is Kapha Pradhan Pitta, Vyadhi Utpatti Kala is Vasant Rutu so Vamana Karma is selected as the line of treatment.

Intervention

Purva Karma - Deepan and Pachana

Bahya

Sthanik Shehana - Urobhagi with Tila Taila + Saindhav

Bashpa Sweda

Abhyantar

Aampachaka Vati

Aarogya Vardhini Vati

Sitopladi Churna + Mahalaxmi Vilas Ras

Haritaki Churna

Nirama Lakshanas observed, till 7 days. (Kshudha Vruddhi).

Abhyantar Vardhaman Matra Snehapana with Panchatiktaghruta till Samyak Snigdha Lakshanas observed.

1^st day – test dose 30 ml Panchatikita Ghruta given to patient at 7:30am.

2^nd day – 60 ml

3^rd day – 90 ml

4^th day – 120 ml

5^th day – 150 ml

6^th day – 180 ml

During Sneha Jiryaman and Sneha Jirna Lakshanas observed and with the help of it next day dose planned. daily assessment for symptoms of oleation was done. Proper evacuation of flatus and stools (Valanulomana) enhanced digestive function (Deeptagni), oily stood (Snigdha Varchas) unformed stools (Asamhat Varchas), suppleness of skin (Mrudvangta), oily skin (Snigdhangta), revulsion for Sneha (Snehodvega), exhausted (Glani), enthusiasm (Vimlendriyata) these are symptoms of proper oleation.^[9] On sixth day patient had following Samyaka Snigdha Lakshanas.

Adhastata Sneha Darshana
Varcha Snigdhatava

Vishram Din - Bahya Snehana and Peti Swedana was done. In the night patient was given Kaphavardhaka Aahara i.e., curd rice.

Pradhana Karma

Vamana was carried out on 1/04/2022 with Madanaphala + Yashtimadhu + Saindhav+ Pippali + madhu.

Aakantha Panartha - cow milk (1.5 lit.)

Vamanopaga - Yashtimadhu Phanta

Vamankarma observation

Vaigiki - 15 Vega
Maniki - 7.5 lit.
Laingiki - Dehalaghvata

Paschat Karma: Dhoompana was given. Samsarjan Karma was advised for 5 days (Madhyam Shuddhi)

Discussion

Tamaka Shwasa is defined as “Vischeshat Durdine Tamye Shwasa sa Tamako Mataha” means the attacks of Shwasa with Tama Pravesha which occurs especially during Durdine.^[10] Tamaka Shwasa is predominantly Vatakaphaj Vyadhi originating from Aamashaya^[11] and manifested through Pranavaha Strotas. Vata gets obstruction into Pratiloma Gati and causes Shwasakashtata. At earlier stage the curable, but in chronic condition it becomes Yapya.^[12]

Probable mode of action of Vamana

Vamana Dravyas are having the properties Vyavayi and Vikasi by virtue of Veerya (potency) they get quickly circulate into the large and small capillaries of the body. It pervades all over the body. By virtue of its Ushna and Tikshna properties, the accumulated Doshas get liquified and break up into small pieces at cellular level. Doshas started melting in the body due to Ushna Guna, we can observe the perspiration on patient’s forehead or sometimes whole body. Because of its Vikasi Guna, it detaches the Malas from Dhatus. Owing to the presence of Sukshma Guna and Anupravana properties the Malas and Doshas float because body has got Samyaka Snigdhata and passthrough smallest capillaries and ultimately Malarupi Kapha

reaches to stomach. Vamana Karma is radical therapy to treat the pathology by eliminating disease causative factor Kapha from its main site of accumulation. Vamana cleanses the different types of toxic materials from the body. On the follow up of on 5^th day all the symptoms subsided completely (Upshay). The patient was followed up to 1.5 month after the Vamana therapy and no recurrence of any symptoms was observed. After this procedure patient got rid from inhaler. After Vamana Karma patient is advised to follow life style management (daily regimens and dietary rules and regimens regulations) to prevent the recurrence of disease.

Table 1: Showing the effect before and after treatment on cardinal symptoms.

SN	Signs and symptoms	BT (before treatment)	AT (after treatment)	Result in %
1.	Night awakening	3	1	50
2.	Morning worsening of asthma symptoms	2	0	60
3.	Limitation of activity	2	1	70
4.	Shortness of breath	2	0	60
5.	Wheezing	3	1	70
6.	Use of bronchodilator	1	0	80

Fig. 1: Vaman Karma

Fig. 2: Dhoompana

Conclusion

Vamana therapy has substantial role in treating Tamaka Shwasa not only symptomatically but also to cure the disease from root. Panchakarma procedures are meant for purification of the body which are helpful for management of certain chronic and life style disorders and they are an important and integral part of Ayurvedic line of treatment. More and more research work had to be carried out to explore the scientific basis of Panchakarma therapy and create a better understanding of its usefulness in lifestyle disorders. Shodhana Chikitsa facilitates the expulsion of vitiated Doshas from the body, there by cures the disease from root, thus Shodhana Chikitsa can prevent the recurrence in future.

Reference

1. Goyal HR Clinical study of tamaka shwasa central council of research in ayurveda and siddha; new Delhi; 1997.

2. Agnivesha, Charaka Samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, Chikitsa Sthana 17/62. Chaukhambha Prakashan, Varanasi, p- 525.

3. Agnivesha, Charaka samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, Chikitsa Sthana 17/147. Chaukhambha Prakashan, Varanasi, p- 529.

4. Agnivesha, Charaka Samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, Chikitsa Sthana 17/149. Chaukhambha Prakashan, Varanasi, p- 529.

5. Agnivesha, Charaka Samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, Chikitsa Sthana 17/148. Chaukhambha Prakashan, Varanasi, p- 529.

6. Agnivesha, Charaka Samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, sutra Sthana 20/16. Chaukhambha Prakashan, Varanasi, p- 600.

7. Agnivesha, Charaka Samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, kalpa Sthana 1/4. Chaukhambha Prakashan, Varanasi, p- 940.

8. Sharangdhar Samhita, prathamkhanda, by Dr. Brahmananda tripathi.517, Varanasi 2004 p-560.

9. Agnivesha, Charaka Samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, Chikitsa Sthana 17/133. Chaukhambha Prakashan, Varanasi, p- 525.

10. Agnivesha, Charaka Samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, Chikitsa Sthana 17/170. Chaukhambha Prakashan, Varanasi, p- 535.

11. Agnivesha, Charaka Samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, Chikitsa Sthana 17/220. Chaukhambha Prakashan, Varanasi, p- 576.

12. Agnivesha, Charaka Samhita Ayurveda Dipika commentary of Chakrapanidatta, by Kashinath Shastri, Chikitsa Sthana 17/255. Chaukhambha Prakashan, Varanasi, p- 582.

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-09-29	2022-10-01	2022-10-08	2022-10-15	2022-10-22
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	16%

Case Report

Vamana Karma

Journal of Ayurveda and Integrated Medical Sciences