Introduction

Tamaka Swasa is a Pranavaha Sroto Vikara and one among 5 types of Swasa. In Pranavaha Srotovikaras individuals mainly get affected from symptoms like cold, cough and breathlessness. Tamaka Swasa is Vata-Kaphaja Vikara according to Acharya Caraka but it is Kapha predominant disorder according Acharya Sushruta, Madhavakara and Yogaratnakara and its site of origin is Pittasthana. The Lakshanas of Tamaka Swasa includes Gurghuraka, Peenasa, Shirogourava, Aasine Labhate Soukhyam, Shayanah Swasa Peedita. Tamaka Swasa can be correlated to Branchial Asthma based on similarities in symptoms which includes breathlessness, wheeze, cough.

Case Report

A 55-year-old female patient came with the chief complaints of occasional breathlessness and on and off cough in the last 2 years aggravated in the last 1 month.

History of present illness

Patient was apparently asymptomatic before 2 years. On 2^nd March 2020, there was sudden onset of abdominal pain at night which was not relieved after taking medicines which made her suffer that whole night. Then in the morning, she visited nearby hospital where relevant investigations were done and was found to have Hiatus hernia and was advised for surgery. Surgery done on 8^th March, 2020 and got discharged on 11^th March 2020. After 1 month duration she had gradual onset of on and off mild cough with shortness of breath, visited at local clinic in Bangalore, took medicines for 15 days. Cough was persistent with expectoration which was thick and white coloured, more in early morning and was disturbing her sleep also. Hence, she again visited Manasa Ganga hospital, Tumkuru for the same, got treated but found no relief. Along with cough she had multiple episodes of on and off breathlessness and would find mild relief after expectoration. Later on, 10^th of March 2022, she visited City hospital Bangalore, where she was prescribed Rotahalers (Forocort 200 and Levolin ). After 2 months she took Ayurvedic treatment at SDM Ayurveda hospital, Hassan found mild relief. Later after 15 days, cough again exacerbated, then she visited Siddaramaiah Hospital, Tumkur. She was advised for routine investigations and advised to continue same treatment.

Samhanana - Madhyama
Pramana - Madhyama
Sathmya - Katu Rasa Pradahana
Satwa - Madhyama
Aharashakti - Madhyama
Vyayamashakti - Avara
Vaya - Madhyama

Systemic Examination

CNS - Patient is oriented to self, time and place

HMF : Intact

Sensory perception : Intact

Motor functioning : Intact

Cranial Nerves : NAD

CVS - S1, S2 heard, no murmurs

RS -

Inspection : Shape of chest – bilaterally symmetrical

Palpation : Trachea – centrally placed

Auscultation : RR : 18 cycles/min

Basal crepitations ++ (right)

P/A -

Inspection : umbilicus inverted and central.

Palpation : Soft, no tenderness, no organomegaly.

Auscultation : Bowel sounds heard.

Materials and methods:

Source of data

Patient suffering with Tamaka Swasa is selected from IPD of Sushruta Ayurvedic Medical College and Hospital Bangalore. Ip no- IP2302325 (Ward- Nagarjuna).

Study design - A Single Case Study.

Treatment:

1. Deepana - Pachana with Agnitundi Vati 2 tab T.I.D given for 4 days
2. Snehapana with Kantakari Ghrita given for 4 days with increasing dose 30ml, 60ml, 90ml, 120ml.
3. Sarvanga Abhyanga done with Ksheera Bala Taila followed by Bashpa Sweda for 4 days.
4. On 4^th day after Abhyanga and Sweda,

Table 2: Showing the effect of adopted Chikitsa on cardinal symptoms.

Discussion

Tamaka Shwasa manifests due to obstruction to the Pranavaha Srotas where due to Nidana vitiation of Kapha in Pranavaha Srotas takes place and does Avarana to Prana Vayu causing Sroto Avarodha, further aggravation causes Shotha and Sankocha in Pranavaha Srotas causing Pratiloma Gati of Pranavayu leading to Tamaka Swasa. Treatment protocol was aimed at Vata-Kapha Hara and Vatanulomana Karma. Since the Vyadhi is Pitta Sthana Samudbhava which is the Sthana of Agni. Initially Agni is corrected, later Snehana is adopted for Dosha Utkleshana and Vatanulomana. Swedana given for Dosha Pravilayana and to bring doshas from Shaka to Koshta. Virechana Karma, as it is said in classics “Tamaketu Virechane” is adopted in order to achieve Dosha Shodhana and to correct Pratiloma Gati of Vata. Madhyama Shuddhi was attained. Dashamoola Rasayana as Naimittika Rasayana was prescribed for 1 month at the time of discharge along with other Shamanoushadhis.

Discussion On Probable Mode of Action of Dashamoola Rasayana.

Major drugs used in the preparation of the yoga are primarily Ushna veerya and few Sheeta Veerya drugs. Contains Tikta-Katu-Madhura and Kashaya Rasa with Laghu, Ruksha, Tikshna Gunas predominantly and few drugs with Guru, Picchila, Snigdha Guna. Dashamoola is one of the best Vata Kapha Hara group which continuously controls Vata and Kapha aggravation. Haritaki present in the Rasayana removes Shesha Dosha and does Vatanulomana continuously.

Guru-Snigdha Guna, Ushna Veerya, Madhura Rasa Does Vata Hara Karma. Laghu -Ruksha-Teekshna Guna, Ushna Veerya, Katu-Tikta-Kashaya Rasa helps in reducing Kapha. This in turn removes Sroto Avarodha and helps in proper movement of Vata.