Introduction
Tamaka Swasa is among five types of Swasa and one among the Pranavaha Srothodushti Vikara. “Tama” means - अंधकार (darkness). During the attacks, the patients feel as if they are entering darkness. Tamaka Swasa is having symptoms such as Peenasa (Rhinitis), Gurghuraka (wheezing sound), Teevra Vega (fast breath)[1], Moha (unconscious), Aruchi (anorexia), Trushna (thirst). In Swasa, there are mainly three factors Karana, Sthana, Moola.[2]
Karana is Bahya Karana (external factor) which includes Raja(dust), Dhooma (smoke), pollen etc. These enter the respiratory tract and release mast cells. After the rupture of mast cells, surfactants will be the released. These surfactants engulf the foreign body causing the production of cough reflux and plugs the respiratory tract to produce abnormal breathing sounds. Sthana, which include Nabhyadi, can be understood in terms of cardiac, renal and pulmonary problems. Dosha can be understood in terms of predominance of Dosha. Bronchial Asthma is a chronic inflammatory disorder of the airways, associated with recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night and in the early morning.[3]
Paroxysm attacks can last for days to months which results in sleepless nights, thus disturbing the normal lifestyle of the person. The available treatment in modern medical science are bronchodilators, steroids, even in the form of inhalers and leukotrienes modifiers[4], anti-tussive, expectorants, demulcent’s etc. can be used as instant or symptomatic relief in Bronchial asthma. The pathophysiology of lung diseases is mainly of two types namely, constrictive and restrictive. Asthma is constrictive. The disease originates from Pitta Sthana, which gets localised in Kaphasthana and is characterised by dominance of Kapha and Vata Dosha.[5]
Case Report
A 44-year-old female patient comes with chief complaints of difficulty in breathing and wheezing sounds for the past 6 years which aggravated in the last 10 days. It is also associated with fever, headache, tiredness and severe cough with sputum and inability to sleep in the past 10 days.
History of Present Illness
Patient was apparently normal before 6 years. One day she got fever, running nose, difficulty in breathing and nausea. For this, she consulted a nearby physician and took some medication [details unknown] which reduced symptoms temporarily. After that she started facing breathing difficulty and cough with expectoration repeatedly which often worsens at night and during cold seasons. During those times, she took one cetirizine tablet and salbutamol syrup and managed symptoms. In November 2023, she had a severe episode of fever, cold, breathing difficulty, cough with expectoration and sleep disturbance. For these complaints, she was admitted to Kaveri hospital, Bangalore. They gave injections, nebulisations and oral medicines [details unknown] which gave some relief. For past 10 days, she has been suffering from difficulty in breathing and wheezing sounds along with fever, head ache, tiredness and severe cough with sputum and disturbed sleep. For same complaints, patient consulted at Sri Kalabyraveshwara Swamy Ayurvedic Medical College Hospital and Research Centre and was admitted on 03/10/2024
Treatment History
She was taking cetirizine tablet and salbutamol syrup during the episodes in the past 6 years
Past History
k/c/o bronchial asthma in the last 6 years
n/k/c/o diabetes, hypertension and thyroid dysfunction.
Personal History
Occupation - self-employed [working in an air-conditioned room]
Diet - mixed / Sama Ahara
Habits - Coffee 3-4 times/ day. No alcohol or smoking.
Examination
Table 1: Assessment of General condition
| Appetite | Reduced |
|---|
| Bowel | Regular, once/ day |
| Micturition | Normal |
| Sleep | Disturbed |
Family History
All family members are healthy.
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