E-ISSN:2456-3110

Review Article

Bronchial Asthma

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 1 January
Publisherwww.maharshicharaka.in

A Literary Review on Tamaka Shwasa (Bronchial Asthma)

Pandey M.1*, Mishra M.2, Srivastava S.3
DOI:

1* Mahima Pandey, Post Graduate Scholar, Department of Roga Nidan, Pt. Khushilal Sharma Govt. (Auto.) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.

2 Meenu Mishra, Assistant Professor, Department of Kayachikitsa, Radharaman Ayurveda Medical College Research Hospital, Bhopal, Madhya Pradesh, India.

3 Sanjay Srivastava, Professor & HOD, Department of Rog Nidan, Pt. Khushilal Sharma Govt. (Auto.) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.

Respiratory disorders are significant public health burden worldwide. Bronchial asthma is one of the commonest respiratory disorders. The WHO estimates that 300 million people currently are suffering from bronchial asthma. In India prevalence of asthma has been found to be 15-20 million people. Prevalence of asthma is more in urban areas than rural areas due to smoke, pollution and environmental factors. Management of Bronchial asthma as per contemporary treatment modalities include use of bronchodilators, corticosteroid, anticholinergics and several other drugs having long term side effects and dose dependency. Tamaka Shwasa which is described in Ayurveda as a disease entity through its sign & symptoms, pathogenesis, prognosis and treatment can be correlated with Bronchial asthma in modern parlance. So, the present conceptual study helps to understand the disease of the modern era by the Ayurvedic perspective and contributes in the integrative approach in the management of Tamaka Shwasa or bronchial asthma.

Keywords: Bronchial Asthma, Nidana, Pathogenesis, Tamaka Shwasa, Ayurveda

Corresponding Author How to Cite this Article To Browse
Mahima Pandey, Post Graduate Scholar, Department of Roga Nidan, Pt. Khushilal Sharma Govt. (Auto.) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.
Email: 		Mahima Pandey, Meenu Mishra, Sanjay Srivastava, A Literary Review on Tamaka Shwasa (Bronchial Asthma). J Ayu Int Med Sci. 2023;8(1):107-117.
Available From
https://jaims.in/jaims/article/view/2227

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-11-26 2022-11-28 2022-12-05 2022-12-12 2022-12-19
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 19%

© 2023by Mahima Pandey, Meenu Mishra, Sanjay Srivastavaand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Journal of Ayurveda and Integrated Medical Sciences 2023;8(1)107
Pandey M et al: A Literary Review on Tamaka Shwasa (Bronchial Asthma)

Introduction

Respiratory disease is responsible for a major burden of morbidity and untimely death.[1] Asthma is one of the most common chronic non communicable diseases currently affecting a large mass of people with almost worldwide distribution.[2] Ayurveda has described five types of Shwasa Roga and Tamaka Shwasa is one amongst them. Tamaka Shwasa is a “Swatantra” Vyadhi i.e., independent disease entity and having its own etiology, patho-physiology and management. Shwasa Roga has been considered as a Yapya Vyadhi (palliative).[3] It is well co-related with bronchial asthma which results due to derangement of Pranavah Srotasa (respiratory system) in which Prana Vayu is vitiated that is unable to perform its normal physiologic function due to obstruction through cough and moves in upward direction (Pratilom Gati).[4] Bronchial asthma is characterized by difficulty in breathing, cough, wheezing and chest tightness.[5] Paroxysm attacks can last for days to months which results in sleepless night, thus disturbing the normal life style of the person. Worldwide, equally affecting both sexes in adult but in children male female ratio is 2:1.[6] The varieties of indigenous and exogenous factors are responsible for the incidence of this disease.[7] Out of these genetic susceptibilities, environmental factors, drugs, infection, smoking, anxiety & psychological factors are major cause of concern.[8] In Indian context asthma is now a serious public health problem and it is seen as one of the leading cause of morbidity and mortality in India.[9] Although the prevalence of asthma in India is seen to be somewhat similar to other Asian countries, the incidence in the country has increased significantly.[10] There has been an increase in the prevalence and similar trend is observed in India. This disease is more predominant in children and aged population.[11] At the age of six to seven years, the prevalence ranges from 4-32%. As stated by W.H.O., 100-150 million of global population is suffering from bronchial asthma; out of which 1/10th are Indians and the prevalence of asthma is increasing everywhere.[12] Lots of advances have been achieved through modern medicine in combating this disease i.e., advanced antibiotics, corticosteroids, bronchodilator, etc.[13] All these fight the disease and offer relief but patient with weak immune status due to recurrent infection, malnutrition, drug toxicity, chronicity of disease

and stress disorder etc,[14] become prone to further infection and exacerbations of disease, hampering their life quality.[15] Thus, due to these similarities, Tamaka Shwasa and bronchial asthma can be taken as a similar disease condition. The present review helps to understand bronchial asthma through an Ayurvedic perspective and helps in an integrative approach in the treatment.

Aim and Objectives

1. To understand bronchial asthma in terms of Ayurveda.

2. To review causative factors, pathogenesis and treatment modalities of Tamaka Shwasa.

Ayurvedic Disease Review

The disease is called Tamaka as attack of the disease precipitate during night and during the state of attack Dyspnoea becomes so severe that patient feels entering into the darkness.

Types of Tamaka Shwasa: Charaka has mentioned two-allied condition of Tamaka Shwasa known as two types or further complication of disease proper i.e., Pratamaka and Santamaka. Sushruta and Vagbhata have only mentioned the name as Pratamaka, which includes clinical manifestation of Santamaka.[16]

Pratamaka Shwasa: When Patients suffering from Tamaka Shwasa gets afflicted with fever and fainting, the condition is called as Pratamaka Shwasa. It is suggestive of involvement of Pittadosha in Pratamaka Shwasa. It is aggravated by Udavarta, Dust, Indigestion, Humidity (Kleda), suppression of natural urges, Tamoguna, Darkness and gets alleviated instantaneously by cooling regimens.[17]

As a matter of fact, cooling regimen is one of the causative factors of Tamaka Shwasa but in Pratamaka Shwasa, the patient gets relief by administering cooling agents due to Pitta Dosha involvement.

Santamaka Shwasa: When the patients of Pratamaka Shwasa feels submerged in darkness, the condition is called as Santamaka Shwasa.

Though Chakrapani has mentioned these two as synonyms of each other Charaka refers them as two different ailments representing


Journal of Ayurveda and Integrated Medical Sciences 2023;8(1)108
Pandey M et al: A Literary Review on Tamaka Shwasa (Bronchial Asthma)

two different conditions of Tamaka Shwasa, these two conditions differ from each other according to intensity of attack.[18]

Nidana (Causative Factors/Risk Factor)

The table below shows comparison between five treatises regarding presence of various risk factors.

Table 1: Showing Hetu of Shwasa / Tamaka Shwasa

Factors C.S.[19] S.S.[20] A.H.[21] A.S.[22] M.N.[23]
Vata Parakopaka Ahara          
Rukshana (dry food) + + - - +
Vishamashana (irregular eating habits) + + - - +
Adhyashana (frequent eating) - + - - -
Anasana (very long gap between two meals) - + - - +
Dvandvatiyoga (mutually contraindicating foods)          
Sheetashana (cold foods) - + - - +
Visha (food poisoning) + + - - +
Sheetapana (cold drinks) - + - - +
Pitta Prakopaka Ahara          
Tila Taila (sesame oil) + - - - -
Vidahi (food causing burning sensation) + + - - +
Katu (spicy food) - - - + -
Ushna (hot food) - - - + -
Amla (sour) - - - + -
Lavana (salt) - - + + -
Kapha Prakopaka Ahara          
Nishpava (dolichos lablab) + - - - -
Masha (vinga radiates) + - - - -
Pistanna (food prepared using very fine flours) + - - - -
Shaluka (rhizome of lotus) + - - - -
Guru Dravyas (food that is very heavy to digest) + + - - +
Jalaja Mamsa (meat of aquatic animals) + - - - -
Aanoopa Mamsa (meat of marshy animals) + - - - -
Dahi (curd) + - - - -
Amakshir (un-boiled milk) + - - - -
Utkleda (food that generates more waste products) + + - - +
Vishtambhi (food that generates constipation) + + - - +
Vata Prakopaka Vihara          
Rajas (dust,pollens) + + + + +
Dhuma (smoke) + + + + +
Vata (cold breeze) + + + + +
Sheeta Sthana (cold places) + + - - +
Sheeta Ambu (cold water) + + + + +
Ativyayam (excessive exercise) + + - - +
Gramya Dharma (excessive sexual intercourses) + - - - +
Apatarpana (excessive emaciating) + - + - +
Shuddhi Atiyoga (excessive purification) + + - - +
Kanth / Urah Pratighata (injury to throat / chest) + - - - +
Bharakarshita (emaciation due to lifting heavy weights) + + - - +
Adhwahata (excessive walking) + + - - +
Karnmahata (excessive work) + + - - +
Veganirodha (suppression of natural urges) - - + - -
Abhighata (injury) - + + + -
Marmabhighata (injury to vital structures) + - - - +
Pitta Prakopaka Vihara          
Ushna (hot environment) - - - + -
Kapha Prakopaka Vihara          
Abhishyandi Upchara (administration of substances which obstruct the channels) + - - + -
Avastha Sambandhi Nidana          
Vata Prakopajanya Vyadhi          
Anaha (flatulence) + - - - -
Dourbalya (weakness) + - - - -
Atisara (diarrhea) - - - - +
Kshaya (tuberculosis) + + - - -
Kshatakshaya (bronchiectasis) + - - - -
Udavarta (eructation) + - - - -
Visuchika (dysentery) + - - - -
Panduroga (anemia) + + + + -
Visha sevana (poison intake) + + + + -
Vibandha (constipation) + - - - -
Pitta Prakopajanya Vyadhi          
Raktapitta (bleeding disorders) + - - - -
Jwara (fever) + - - - +
Kapha Prakopajanya Vyadhi          
Kasa (bronchitis) - - + + -
Amapradosha (autoimmune disorders) + + - - -
Chardi (vomiting) + - + + -
Pratishyaya (corhyza) + - - - -
Amatisara (diarrhea) - - + + -
Vyanjakahetu          
Megha (cloudy weather) + -   + +
Ambu (rainy season) + -   + +
Sheeta (cold atmosphere) + -   + +
Shleshmkara things (Kapha aggravating factor) + -   + +

Samprapti [Etio-pathology/mechanism of disease development]

Illustration 1: Showing the schematic representation of Samprati.

Nidana Sevana: Raja, Dhuma, Prag-Vatasevana, Marmaghata, Vata-Kapha Prakopaka Ahara Vihara etc.
↓
Sanchayavastha: Sanchaya of Vata occurs in Pranavaha Srotas and that of Kapha in Uras
↓
Prakopavastha: Sheeta Kaala and Durdina etc. will provoke the Sanchita Doshas. As a result the Vata Dosha in Pranavaha Srotas and Kapha in Uras tries to move to other places
↓
Prasaravastha: vitiated Doshas hampers the Agni and causes Agnimandya and in turn produces Ama. Both Vata and Kapha begins to move all over their Aashaya
↓
Sthanasanshrayavastha: the aggravated Dosha i.e. Vata and Kapha are moving all over the body, as well in Pranavaha Srotas, will lead to the Kha-Vaigunyatha. There will be obstruction to the movement of Vata and as a result of this, prodromal features of the disease are menifested
↓
Vyaktavastha: Prakupita Vata which is obstructed by Kapha will attain Pratiloma Gati, results in Vimarga Gamana of Kapha from Annavaha and Udakavaha Srotas. Peenasa and ghurghuraka etc. symptoms menifestest
↓
Bhedavastha: in the absence of proper treatment there will be permanent changes in the Srotas resulting in complications (Deerghakaala Anubhandhatwa).



Journal of Ayurveda and Integrated Medical Sciences 2023;8(1)109
Pandey M et al: A Literary Review on Tamaka Shwasa (Bronchial Asthma)

Poorvarupa [Predisposing signs and symptoms]

When the vitiated Doshas begin to localize, affecting a particular organ or system, certain prodromal symptoms are observed before the full-fledged manifestation of the diseases, which are noted in table below:

Table 2: Showing the Purvarupa of Tamaka Swasa.

Symptoms C.S.[24] S.S.[25] A.H.[26] M.N.[27]
Anaha (Distension of the abdomen) + + + +
Adhmana (Fullness of the abdomen) - - - +
Arati (Restlessness) - + - -
Bhaktadwesha (Aversion to take food) - + - -
Vadanasya Vairasya (Abnormal taste in mouth) - + - -
Parshwa Shoola (Pain in the sides of the chest) + + + +
Peedanam Hridaayasya (Tightness of the chest) + + + +
Pranasya Vilomata (Sinusitis or Rhinitis) + - + +
Shankha Nistoda (Temporal headache) - - + +

Table 3: Showing the Rupa of Tamaka Shwasa

Symptoms C.S.[28] S.S.[29] A.S.[30] A.H.[31]
Peenas (Running nose, sneezing, stuffiness of the nose) + + + +
Shwasa (Dyspnoea) + + + +
Tivravega Shwas (Rapid breathing) + + + +
Amuchyamane Tu Bhrisham (Severe breathlessness if sputum is not expectorated out) + + + +
Vimokshante Sukham (Slight relief in breathlessness on spiting out the sputum) + + + +
Anidra (Breathlessness disturbs sleep) + - - -
Sayanah Shwas Peeditaha (discomfort worsens on lying) + + + +
Aseeno Labhate Soukhyam (Feels easy to breath in sitting position) + + + +
Pratamyati Ati Vega (Deterioration of consciousness) + - + +
Kasa (Cough) + + + +
Pramoham Kasamanashcha (Frequent deterioration of consciousness during paroxysm of cough) + - + +
Kanth Gurghurak (rattling) + - - -
Kanthodhwamsa (Soreness of the throat) + - - -
Utshoonaksa (Oedema around the eyes) + - + +
Vishushkasya (Dryness of mouth) + - + +
Lalat Sweda (Sweating on the forehead) + + + +
Meghaihi Abhivardhate (Cloudy weather worsens the attack) + - + +
Sheeta Ambu (Cold water) + - + +
Pragvata (breeze) + - + +
Shleshmala (Kaphakara) + - + +
Ushnabhinandate (Likes hot things) + - + +
Aruchi (Anorexia) - + + +
Trishna (Excessive thirst) - + + +
Vepathu (Tremors) - - + +
Vamathu (Expectoration) - + - -


Rupa [Presenting symptoms/clinical manifestation]
Rupa means signs and symptoms of the disease. It appears in the 4th Kriyakala i.e., Vyaktavastha in which signs and symptoms of a disease are completely manifested. All the symptoms of Tamaka Shwasa described in Ayurvedic texts have been shown in the table below:

Cikitsa Sutra (Principle of Treatment)

In the classical texts of Ayurveda, the approach of treatment has been made in the following way.

1. Nidana Parivarajan: In all the four types of patients for the treatment, Nidana Parivarjan or avoidance of all types of precipitating or predisposing factors are to be strictly followed. If the precipitating or predisposing factors are not avoided, the Doshas involved in the pathogenesis will further be aggravated and the prognosis will be worse.

2. Samsodhana: Charaka emphasized that strong build patient with the dominance of Kapha and Vata should be treated with Samsodhana therapy, i.e., Vamana and Virecana as per necessities. (S.Ci.17/89).

The author of Yogaratnakar has mentioned that except Sneha Basti, all other methods of Sodhana Chikitsa should be adopted in Tamaka Swasa (Y.R.Swa.Ci.1).

Samsodhana Karma should be performed in following steps.

a. Snehana: Taila mixed with Lavana should be gently massaged on the chest to loose the tenacious sputum in the channels. (S.Ci.17/71)

b. Swedana: Swedana by Nadi, Prastara and Sankara method should be performed by these processes the Kapha which has become inspissated in the patient’s 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. (S.Ci.17/71-72)

c. Vamana: To eliminate or expectorate the deranged 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 supernatent of curds may be given to the patients for the Utklesana of Kapha.


Journal of Ayurveda and Integrated Medical Sciences 2023;8(1)110
Pandey M et al: A Literary Review on Tamaka Shwasa (Bronchial Asthma)

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)

d. Dhumapana: After Vamana, to eliminate the hidden pathogenic substances i.e., the Dosha 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).

e. Virechana: as defined by Charaka, is a process in which waste products (Dosa, Mala) are eliminated through lower channels (Adhobhaga) i.e., anus (C.S.Ka.1/4). Though all Virecana drugs are Panchabhautika in constitution, Jala and Prithvi Mahabhuta dominant in their constitution (C.S.Ka.1/5). An ideal Virecana preparation, according to Charaka must have five properties. These Gunas are Vyavayi, Vikasi, Suksma, Ushna and Tikshna (C.S.Ka.1/5).

2. Samsamana: The scope of Samsamana therapy in this disease is more wide and practical, which is applicable in all cases in all stages. For the patient who is not eligible for Samsodhana Karma (Durbala), Samsamana therapy should be adopted. Samsamana therapy in this case includes Deepana, Pacana, Kapha Vatasamaka drugs and regimen along with drugs that purity Pranavaha Srotas. Children and old subjects are also managed with Samsamana.

Brimhana and Rasayana Chikitsa

Recurrent attacks of the illness in a long run tend to debilitate the patient due to depletion of the Dhatu.

This Dhatukshaya further adds to the pathogenesis and prevents from employment of energetic treatment during the attack of Tamak Shwas. Therefore, it is mandatory to maintain the physical strength of the patient by employing Brihana treatment. Further the illness runs a chronic course with persistent nature. This nature of the illness may be best aborted by the administration of Rasayana Chikitsa. In this way the Brihana and Rasayana Chikitsa are said to be beneficial in patients suffering from Tamak Shwas.

In short, sequential administration of Lavana Taila Abhyang, Swedan, diet ‘Snigdha’

enough to control ‘Rukshana’ and balanced enough not to aggravate Kapha. Sadya Vaman (emergency emesis), Dhoomapana followed by Shaman Chikitsa is the treatment to relieve the attack of Tamak Shwasa.

Virechan followed by Vyadhihara Rasayana and Brihana Chikitsa is the ideal line of treatment in between the attacks. These procedures are very much efficacious in remitting the symptoms as well as preventing subsequent attacks of Tamak Shwas. Formulations those could act on controlling Vata Kapha and at the same time boost tissue and organ strength, control remodeling and increase immunity against risk factors are selected to treat Tamak Shwasa.

Modern Disease Review

Asthma is a disease of airways that is characterized by increased responsiveness of the tracheobronchial tree to a variety of stimuli resulting in widespread spasmodic narrowing of the air passages which may be relieved spontaneously or by therapy. Asthma is an episodic disease manifested clinically by paroxysms of dyspnoea, cough and wheezing. However, a severe and unremitting form of the disease termed status asthmaticus may prove fatal.[32]

Prevalence[33]: Asthma is very common; it is estimated that 5 to 10 percent of the population worlwide is affected. Similar figures have been reported from other countries. Bronchial asthma occurs at all ages but predominantly in early life. About one-half of cases develop before age 10, and another third occur before age 40. In childhood, there is 2:1 male/female preponderance, but the sex ratio equalizes by age 30.

Etiopathogenesis and Types[34]

Based on the stimuli initiating bronchial asthma, two broad etiologic types are traditionally described: extrinsic (allergic, atopic) and intrinsic (idiosyncratic, non-atopic) asthma. A third type is a mixed pattern in which the features do not fit clearly into either of the two main types.

1. Extrinsic (Atopic, Allergic) Asthma

This is the most common type of asthma. It usually begins in childhood or in early adult life. Most patients of this type of asthma have personal and/or family history of preceding allergic diseases such as rhinitis, urticaria or infantile


Journal of Ayurveda and Integrated Medical Sciences 2023;8(1)111
Pandey M et al: A Literary Review on Tamaka Shwasa (Bronchial Asthma)

eczema. Hypersensitivity to various extrinsic antigenic substances or allergens is usually present in these cases. Most of these allergens cause illeffects by inhalation e.g. house dust, pollens, animal danders, moulds etc. occupational asthma stimulated by fumes, gases, organic and chemical dusts is a variant of extrinsic asthma.

There is increased level of IgE in the serum and positive skin test with the specific offending inhaled antigen representing an IgE-mediated type 1 hypersensitivity reaction which includes an ‘acute immediate response’ and a ‘late phase reaction’.

  • Acute immediate response is initiated by IgE - sensitised mast cells on the mucosal surface. Mast cells on degranulation release mediators like histamine, leukotrienes, prostaglandins, platelet activating factor and chemotactic factors for eosinophils and neutrophils. The net effects of these mediators are bronchoconstriction, oedema, mucus hypersecretion and accumulation of eosinophils and neutrophils.
  • Late phase reaction follows the acute immediate response and is responsible for the prolonged manifestations of asthma. It is caused by excessive mobilization of blood leucocytes that include basophils besides eosinophils and neutrophils. These result in further release of mediators which accentuate the above-mentioned effects. In addition, inflammatory injury is caused by neutrophils and by major basic protein (MBP) of eosinophils.

2. Intrinsic (Idiosyncratic, Non-Atopic) Asthma

This type of Asthma develops later in adult life with negative personal or family history of allergy, negative skin test and normal serum levels of IgE. Most of these patients develop typical symptom-complex after an upper respiratory tract infection by viruses. Associated nasal polypi and chronic bronchitis are commonly present. There are no recognizable allergens but about 10% of patients become hypersensitivity to drugs, most notably to small doses of aspirin (aspirin-sensitive asthma).

3. Mixed Type: Many patients do not clearly fit into either of the above two categories and have mixed features of both. Those patients who develop the disease late tend to be non-allergic. Either type of asthma can be precipitated by cold, exercise and emotional stress.

Discussion

Description of Shwasa is available in Brihattrayee as well as Laghuttrayee. Sushruta has mentioned Tamaka Shwasa as Kapha dominant disease. Out of five varieties, Tamaka Shwasa is having "Swatantra" nature. Kshudra Shwasa may present as a symptom in many conditions & does not require any medication where as Maha, Urdhva & Chinna Shwasa were present at terminal stage. Literary Simulation of Tamaka Shwasa is coincided with the description of bronchial asthma as described in modern literature. Charaka has mentioned two allied conditions of Tamaka Shwasa i.e., Pratamaka & Santamaka. Sushruta & Vagbhata have only mentioned the name of Pratamaka which includes clinical manifestation of Santamaka. Pratamaka Shwasa shows involvement of Pitta Dosha in Pathogenesis. Santamaka Shwasa is a severe condition of Pratamaka Shwasa, when patient feels that he is submerging in darkness. Chakrapani has commented Pratamaka & Santamaka are synonyms but differ from each other in intensity of attack, but Charaka explains them as two different ailments. Various Nidanas were mentioned in Samhita. Charaka has given list of Vata & Kaphaprakopaka Nidana separately. Various risk factors mentioned in modern science are of two types: those which act as predisposing factor and those which cause acute exacerbation of asthma. In the pathogenesis Charaka has explained Pittasthana Samudbhava Vyadhi where as Vagbhata explained as Aamashaya Samudbhava Vyadhi. Chakrapani has quoted that Pittasthana is related with upper part of Aamashaya. But no clear description regarding Pittasthana is available in Samhita. Whether all Pittasthana should be considered or it is confined to only Aamashaya remains controversial. Different opinion & research works are carried out in relation with this topic. Association of HCL of gastric juice seems to be controversial as Achlorhydria & Hyperchlorhydria both conditions are associated with asthma.

In the pathogenesis, vitiated Kapha and Pratiloma Vayu play an important role & inflammatory condition of airway results due to Saama Vayu (vitiated body humor) which causes Shotha (inflammation) & Srotorodha (obstruction). Hence patients of Tamaka Shwasa should be classified broadly under Vata Pradhana (chronic) & Kapha Pradhana (acute) Samprapti (pathogenesis).


Journal of Ayurveda and Integrated Medical Sciences 2023;8(1)112
Pandey M et al: A Literary Review on Tamaka Shwasa (Bronchial Asthma)

Aacharya has described various guideline principles for management. Among that Nidanaparivarjana plays major role. Various preventive measures are explained which helps in preventing asthma exacerbation as well as development of asthma. Treatment modality mainly includes Shodhana & Shamana therapy. Among Shodhana, Vamana & Virechana have been advised whereas Aacharya Sushruta has contraindicated Sneha Basti. During Vegavastha local Snehana with Salavana Taila & Swedana is advised. Charaka has explained different Management principles according to stages of disease. In Shamana therapy drugs having Kaphahara, Vataghna, Ushna & Vatanulomana properties were described. Charaka has given importance to Brihana therapy rather than Shamana & Shodhana. Brihana therapy is just like Rasayana therapy. Management of Bronchial asthma as per contemporary treatment modalities include use of bronchodilators, corticosteroid, anticholinergics. So, the signs and symptoms of Tamaka Shwasa are similar to that of Bronchial Asthma as mentioned in the modern Medical Science.

Conclusion

This conceptual study has enlightened various fields from historical review to the recent information about the disease of the modern era. Bronchial asthma is the common respiratory disease of the current scenario which needs preventive and therapeutic approach. Ayurveda through its harmless modalities may be considered as the best approach for bronchial asthma. Through the literature review, we get a clear idea of the disease and an attempt has been made to understand bronchial asthma according to Ayurvedic and as well as modern perspective.

Reference

1. Stuart H Ralston, Ian D Penman, Mark WJ Strachan & Richard P Hobson, Davidson’s Principles and Practice of Medicine, Ch.17/ Page 548, 23rd edition 2018.

2. Global Initiative for Asthma (GINA): https://www.ginasthma.com.

3. Pt. Kashinath Shastri & Dr. Gourakha Nath Chaturvedi, Charak Samhita, Vidhyotini Hindi Commentry, Vol-2, Hikkashwasa Chikitsa Adhyaya 17, Chaukhamba Sanskrit Sansthan, Varanasi Reprint 2017.

4. Kaviraj Dr. Ambikadatta Shastri, Bhaisajyaratnavali, Vidhyotini Hindi Commentry, Vol-1, Kasa Chikitsa Prakaran 15/127-129 & Hikka-Shwasa Chikitsa Prakaran 16/44-45, Chaukhamba Sanskrit Sansthan, Varanasi 16th edition 2002.

5. Clinical research protocols for traditional health sciences, Central Council for Research in Ayurveda & Siddha

6. Santavelkarkuljen Damodarbhatt Shri pad Sharma, Yajurveda Samhita Sutra. 25/2, Published by Vasant Shripad Salvelkar, Mumbai, Edition VI, Year of Publication 2003

7. Santavelkarkuljen Damodarbhatt Shri pad Sharma, Atharvaveda Samhita, Part 2, Kanda19, Sukta 6-7, Published by Vasant Shripad Salvelkar, Mumbai, Edition 6, Year of Publication 1999, pg no.363

8. Amanashkopanishad 1:33 retrieved from Agarwal Sweta, Effect of Shirishadighanavati in the management of Tamaka Shvasa w.s.r. to bronchial asthma, P.G. thesis, I.P.G.T. & R.A., Jamnagar, Year March 2008, pg no.4

9. Agarwal Sweta, Effect of Shirishadighanavati in the management of Tamaka Shvasa w.s.r. to bronchial asthma,P.G. thesis,I.P.G.T. & R.A., Jamnagar, Year March 2008, pg no.4

10. Swami Nikhilananda, The Upnishads translation, Brihada Aranyaka Upanishad, Part 1/3/8, pg no.109

11. Swami Nikhilananda, The Upnishads translation, Chhandogya Upanishad 1/2/10, pg no.220

12. Agnivesha, Charaka Samhita, revised by Charaka and Dridhbala with ‘Ayurveda Dipika’ commentary by Chakrapanidatta, Edited by Trivikram Atmaja Yadav Sharma, Published by Rashtriya Sanskrit Samsthana, Chaukhambha Publications New Delhi , Year of reprint 2006, Chikitsasthana 17/8, pg no.533

13. Sushruta, Sushruta Samhita, revised by Sushrutavimarshini Hindi commentary by Acharya Priyavrata Sharma, Edited by Dr.Anantram Sharma, Published by Chaukhambha Surbharati Prakashana, Varanasi, reprint 2004, Uttaratantra 51/6, pg no.424

14. Vagbhata, Ashtanga Hridaya, revised by Sarvanga Sundari commentary by Arundatta and Ayurveda Rasayana commentary by


Journal of Ayurveda and Integrated Medical Sciences 2023;8(1)113
Pandey M et al: A Literary Review on Tamaka Shwasa (Bronchial Asthma)

Hemadri, Annoted by Dr.Anna Moreshwar Kunte et al, Published by Chaukhambha Surbharati Prakashana, Varanasi, Year of reprint 2007, Nidanasthana 4/3, pg no.472

15. Vriddha Jivaka, Kashyapa Samhita, revised by Vatsya with Sanskrit introduction by Pandit Hemaraj Sharma with Vidyotini Hindi commentary and Hindi translation of Sanskrit introduction by Ayurvedalankar Shri Satyapala Bhishagacharya, Published by Chaukhambha publications, New Delhi,Edition 10, reprint 2005,Sutrasthana 25/17, pg no.34

16. Madhavakar, Madhava Nidana, revised by Vijayarakshita and Kanthadatta ‘Madhukosha’ commentary with english translation by Prof.Himasagara Chandra Murthy, Published by Chaukhambha Krishnadas Academy, Varanasi, Edition 1, Year of publication 2006, Purvardha 12/15,pg no.175

17. Acharya J.T., Charaka Samhita, Chikitsasthana 17/19-20, Chaukhamba Surbharati Prakashan, Banaras.

18. Sharma PV, Sushruta Samhita, Uttartantra 51/6, Chaukhamba Orientalia, Banaras.

19. Tripathi B., Vaghbhatt. Astanga Hridaya, Nidana sthana 4/4, Chaukhamba Surbharati Prakashan, Banaras.

20. Acharya J.T., Charaka Samhita, Chikitsasthana 17/55-61, Chaukhamba Surbharati Prakashan, Banaras.

21. Sharma PV, Sushruta Samhita, Uttartantra 51/8-10, Chaukhamba Orientalia, Banaras.

22. Athavale Anant, Vaghbhatt. Astanga Sangraha, Nidana Sthana 4/8-12, Pune publication, Pune.

23. Tripathi B., Vaghbhatt. Astanga Hridaya, Nidana sthana 4/6-10, Chaukhamba Surbharati Prakashan, Banaras.

24. Acharya J.T., Acharya Charaka, Charaka Samhita, Chikitsasthana 17/10-11,60, Chaukhamba Surbharati Prakashan, Banaras.

25. Agnivesha, Hikka-Shwasa Chikitsa adhyaya, Chikitsa Sthana, Charaka Samhita, Chakrapani Datta (Commentator) Dr. Yadavji Trikamji (Editor), 5th Edition, Chaukambha Sanskrit Prathistana, Varanasi, 2001, pp.533-539.

26. Amarakosha, Amarasimha, Mani Prabha Hindi Commentary, Pd. Haragovinda Shastri, Chowkambha Sanskrit Series, Varanasi, 4th ed., 1978: 31,36,47,521

27. Astanga Sangraha, Indu com. Edr. Vaidya Anantha Damodara Atavale, Shrimat Atreya Prakashana, Pune, 1st ed., 1988: 360-62, 444-48

28. Apte students Sanskrit English Dictionary, VS Apte, Motilala Banarasidas.

29. Aruna, Essentials of Kayachikitsa-II, Volume 1, Shwasa Adhyaya, edr.Dr.Aruna, Sri Basavanappa Halashetty, Bidar, pp 220-225, 231-237

30. Mohan Harsh, Textbook of pathology, 7th edition 2015, Ch. 15, Page no.463.

31. H Ralston Stuart, D Penman Ian, et. Al., Davidson's Principles and Practice of Medicine, 23rd edition 2018, Ch. 17, Page no. 567.

32. Mohan Harsh, Textbook of pathology, 7th edition 2015, Ch. 15, Page no.464.

33. Kasper Dennis L., Fauci Anthony S. et. Al., Harrison’s Principles of Internal Medicine, 19th edition 2015, Mc Graw Hill Publication, Section 2/252, Page no. 1420-1421.

34. Tripathi KD, Essentials of Medical Pharmacology, 7th edition 2013, Chp. 16, Page no. 222, 232 & 233.


Journal of Ayurveda and Integrated Medical Sciences 2023;8(1)114