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EVALUATING THE EFFICACY OF BRIHAT KATPHALADI
YOGA IN COMPARISON WITH VYOSHADI GUTIKA NITYA
SHODHANA IN TAMAKA SWASA
By
UMESH. S. KUMBAR Dissertation submitted to the
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore
In partial f
Ayurved
KaUnd
Dr. Shiva RamM.D. (Ayu) (Os
DepartmPost Grad
ReseaD.G. MELMALAGI AYURV
ulfilment of the degree of
a Vachaspati M.D. In
yachikitsa er the Guidance of
a Prasad Kethamakka m) M.A. (Jyotish), [Ph.D (Jyotish)]
ent of Kayachikitsa uate Studies & rch Centre EDIC MEDICAL COLLEGE, GADAG 2004-2007
Declaration by the candidate
I here by declare that this dissertation / thesis entitled “EVALUATING
THE EFFICACY OF BRIHAT KATPHALADI YOGA IN COMPARISON WITH
VYOSHADI GUTIKA NITYA SHODHANA IN TAMAKA SWASA” is a bonafide
and genuine research work carried out by me under the guidance of Dr. SHIVA
RAMA PRASAD KETHAMAKKA, M.D. (Ayu) (Osm) M.A. (Jyotish), [Ph.D
(Jyotish)], Reader in Kayachikitsa, DGMAMC, PGS&RC, Gadag.
Date
Place
(Umesh. S. Kumbar)
D.G.M.AYURVEDIC MEDICAL COLLEGE
POST GRADUATE STUDIES AND RESEARCH CENTRE
GADAG - 582 103
This is to certify that the dissertation entitled “EVALUATING THE EFFICACY OF
BRIHAT KATPHALADI YOGA IN COMPARISON WITH VYOSHADI GUTIKA NITYA
SHODHANA IN TAMAKA SWASA” is a bonafide research work done by Umesh. S.
Kumbar in partial fulfilment of the requirement for the post graduation degree of “Ayurveda
Vachaspati M.D. (Kayachikitsa)” Under Rajiv Gandhi University of Health Sciences,
Bangalore, Karnataka.
Dr. SHIVA RAMA PRASAD KETHAMAKKAM.D. (Ayu) (Osm) M.A. (Jyotish), [Ph.D (Jyotish)]
GuideREADER IN KAYACHIKITSADGMAMC, PGS&RC, Gadag
Date:
Place: Gadag
J.S.V.V. SAMSTHE’S
D.G.M.AYURVEDIC MEDICAL COLLEGE
POST GRADUATE STUDIES AND RESEARCH CENTRE GADAG, 582 103
Endorsement by the H.O.D, Principal/ head of the institution
This is to certify that the dissertation entitled “EVALUATING THE
EFFICACY OF BRIHAT KATPHALADI YOGA IN COMPARISON WITH
VYOSHADI GUTIKA NITYA SHODHANA IN TAMAKA SWASA” is a bonafide
research work done by Umesh. S. Kumbar under the guidance of Dr. SHIVA
RAMA PRASAD KETHAMAKKA, M.D. (Ayu) (Osm) M.A. (Jyotish), [Ph.D
(Jyotish)], Reader in Kayachikitsa, DGMAMC, PGS&RC, Gadag, in partial fulfilment
of the requirement for the post graduation degree of “Ayurveda Vachaspati M.D.
(Kayachikitsa)” Under Rajeev Gandhi University of Health Sciences, Bangalore,
Karnataka.
. DP
(Dr. G. B. Patil) Principal,
DGM Ayurvedic Medical College, Gadag
Date: Place:
(Dr. V. Varada charyulu) Professor & HOD
Dept. of Kayachikitsa PGS&RC
ate: lace: Gadag
Copy right
Declaration by the candidate
I here by declare that the Rajiv Gandhi University of Health Sciences,
Karnataka shall have the rights to preserve, use and disseminate this
dissertation/ thesis in print or electronic format for the academic / research
purpose.
Date
Place
(Umesh. S. Kumbar)
© Rajiv Gandhi University of Health Sciences, Karnataka
Acknowledgement
Any research is not an individual effort. It is a contributory effort of many hearts and
hands and heads. I am very much thankful to the subjects of this study.
My deep senses of gratification to my inspirations of this study are my parents,
Shivarudrappa and Veeravva and my brother Dr.Mallikarjun, who are architects of my
career.
I am extremely happy to express my deepest sense of gratitude to my beloved and
respected guide Dr. K.Shiva Rama Prasad, M.D., C.O.P. (German), M.A., [Ph.D.] Jyotish,
Professor, Department of Kayachikitsa, for his guidance and timely help.
I express my gratitude to Dr. V.V.Varadacharyulu M.D. (Ayu), Goldmedalist,
Professor and H.O.D of Kayachikitsa for his advice and encouragement in every step of this
work.
I am sincerely gratefulness to Dr.G.B.Patil, Principal, for his encouragement and
providing all necessary facilities for this research work
I extend my gratitude to Dr. R.V.Shettar, Dr.P. Shivaramudu, Dr. G.
Purushottamacharyulu, Dr.M.C.Patil, Dr. G.Danappagoudar, Dr.S.H.Doddamani,
Dr.S.N.Belawadi, Dr.Nedugundi, Dr.Samudri, Dr, Kubersankh. Dr.Mulgund, Dr.J.Mitti,
Dr.Mulki Patil, Dr. Yasmin A.P. and all my U.G. Lecturers for time-to-time help offered by
them.
I express my immense gratitude to my statistician Nandakumar, librarian V.B.
Mundinamani and assistant Sureban for facilitating me in collection and production of my
thesis.
Last but not least I express my deepest thankfulness whose names are not taken here
but helped me a lot along with my kith and kins Dr. Shanta and Prasanna.
Dr. Umesh. S. Kumbar
Table of contents Evaluation of the efficacy of Brihat
Katphaladi yoga and
Vyoshadi Gutika in Tamaka Swasa
Chapter Heading Page Numbers
1 Introduction 1 to 4
2 Objectives 5 to 8
3 Literature Review 9 to 56
4 Methodology 57 to 68
5 Results 69 to 110
6 Discussion 111 to 127
7 Conclusion 128 –130
8 Summary 131
9 Bibliographic References 1-11
10 Annex – Case sheet 1-7
Figures of Evaluation of the efficacy of Brihat Katphaladi yoga and Vyoshadi Gutika in Tamaka Swasa
Page
Numbers
1 Schematic diagram of Samprapti of Tamaka Swasa 28
2 Internal medicine – ingredients of Brihat Katphaladi yoga 47
3 Nitya Shodhana Vyoshadi Gutika Ingredients 52
Tables Evaluation of the efficacy of Brihat Katphaladi yoga and Vyoshadi Gutika in Tamaka Swasa
Page
Numbers
1 Nidana of Tamaka Swasa 14-15
2 Porva Roopa of Tamaka Swasa 22
3 Roopa (Lakshana) of Tamaka Swasa 24-25
4 Vyavachedaka Nidana of Tamaka Swasa 34
5 Pathya in Tamaka Swasa 43-45
6 Apathya in Tamaka Swasa 45-46
7 Internal medicine – ingredients of Brihat Katphaladi yoga 47
8 Nitya Shodhana Vyoshadi Gutika Ingredients 52
9 Table showing the demographic data of Group –A 70
10 Table showing the demographic data of Group -B 70
11 Distribution of patients by Age- gender in Groups – A & B 71
12 Results of Patients by Age in Group - A 71
13 Results of Patients by Age in Group - B 72
14 Results of patients by Gender in Group - A 72
15 Results of patients by Gender in Group - B 73
16 Distribution of patients by Religion in Groups – A & B 74
17 Results of patients by Religion in group - A 75
18 Results of patients by Religion in group - B 75
19 Distribution of patients by Occupation in Groups – A & B 76
20 Results of patients by occupation in Group -A 77
21 Results of patients by occupation in Group -B 77
22 Distribution of patients by Economical status in Groups – A & B 78
Tables Evaluation of the efficacy of Brihat Katphaladi yoga and
Vyoshadi Gutika in Tamaka Swasa – continued
Page
Numbers
23 Results of patients by Economic status in Group –A 78
24 Results of patients by Economic status in Group -B 79
25 Distribution of patients by Food Habits in Group – A & B 80
26 Patients enlisted by presenting complaints in Group –A & B 82
27 Distribution of patients by Associated features Group –A & B 83
28 Results of patients by mode of on set group –A 84
29 Results of patients by mode of on set group -B 85
30 Distribution of patients by course of on set groups A & B 86
31 Distribution of patients by frequency of attack in Group – A & B 87
32 Distribution of patients by duration of attack in Group – A & B 87
33 Distribution of patients by mode of progress in Group – A & B 88
34 Distribution of patients by periodicity in Group – A & B 88
35 Distribution of patients by preceding factors in Group – A & B 88
36 Distribution of patients by aggravating factors in Group – A & B 89
37 Distribution of patients by comfort posture at attack in Group – A & B 89
38 Distribution of patients by Agni in Group – A & B 90
39 Distribution of patients by bowel habits in Group – A & B 90
40 Distribution of patients by Addiction in Group – A & B 91
41 Distribution of patients by Prakruti in Group – A & B 91
42 Distribution of patients by Dosha Vruddhi` 92-93
43 Distribution of patients by Dosha Kshaya 94
44 Distribution of patients by Ahara Nidana 95
45 Distribution of patients by Vihara Nidana 96
46 Distribution of patients by Anya Nidana 97
47 Distribution of patients by srotas 98
48 Distribution of patients by poorva roopa 99
Tables Evaluation of the efficacy of Brihat Katphaladi yoga and
Vyoshadi Gutika in Tamaka Swasa – continued
Page
Numbers
49 Subjective parameter assessment Group – A 100
50 Subjective parameter assessment Group – B 101
51 Table showing the Objective parameters of Group –A 102
52 Table showing the Objective parameters of Group –B 103
53 Mean of Objective parameters of Group –A & B 103
54 Statistical assessment of Group – A subjective parameters 104
55 Statistical assessment of Group – B subjective parameters 105
56 Statistical assessment of Group – A Objective parameters 106
57 Statistical assessment of Group – B Objective parameters 106
58 Comparative statistical assessment of Groups subjective parameters 107
59 Comparative statistical assessment of Groups Objective parameters 108
60 Over all assessment and Result of Group-A & B 110
Graphs of Evaluation of the efficacy of Brihat Katphaladi yoga and
Vyoshadi Gutika in Tamaka Swasa
Pages
1 Distribution of patients by Age – Gender in Groups – A & B - Pictorial
presentation
73
2 Distribution of patients by Religion in Tamaka Swasa 74
3 Distribution of patients by Occupation 76
4 Distribution of patients by Economic status 80
5 Distribution of patients by food habits in Tamaka Swasa 81
6 Graphical presentation of patients by presenting complaints in Group – A & B 82
7 Graphical presentation of patients by Associated features in Group – A & B 84
8 Graphical presentation of patients by Mode of onset in Group – A & B 85
9 Graphical presentation of patients distribution by course of onset in Group – A & B
86
10 Over all assessment and Result of clinical trail 110
Abstract “Evaluating the efficacy of Brihat Katphaladi yoga in comparison with Vyoshadi
Gutika Nitya Shodhana in Tamaka Swasa”
Key words: Tamaka Swasa, Asthma, Swasa Roga, PEFR, AEC, Nitya Shodhana, BHT,
Tamaka Swasa vis-à-vis Bronchial asthma is one of the important diseases pertaining
to the respiratory disorder is a sub type of Swasa roga affects the people of all age groups.
The objectives of the study are – evaluating the Tamakaswasa haratwam (Anti
asthmatic effect) of Brihat Katphaladi yoga and Vyoshadi gutika Nitya shodhana by
assessing the Broncho-dilatory effect through pulmonary function test - Peak Expiratory
Flow Rate. In further Anti asthmatic effect and Broncho- dilatory effect in Group A and
Group B are compared. Simple random sampling technique - comparative clinical trial is
adopted here under two groups to test the significance.
The imbalance of Vata and Kapha Dosha afflicts the Rasa Dhatu in the pathogenesis
of Tamaka Swasa, treated with “Tamaketu Virechanam” other wise understood, as Nitya
Shodhana administration. Teevra vega Swasa and Ghurgurukatwam is pratyatma niyata
lakshana of Tamaka Swasa observed 100% in all patients. Statistically all subjective and
objective parameters in both Groups individually are Highly significant except
Kantodhwamsa, which is Non Significant. But in comparison Vyoshadi Gutika Nitya
Shodhana and Brihat Katphaladi Yoga internally doesn’t show any marked significance
suggests that both drugs on their respective places are the best in action.
Thus Vyoshadi Gutika Nitya Shodhana and Brihat Katphaladi Yoga internally at
Tamaka Swasa are best recommended drugs with their requisite actions.
Chapter - 1
Introduction
reathing is one of the normal physiological functions of body starts with birth
and en
breathi
Prana 2
disease
disease
similar
human
atmosp
these f
effectiv
Purgati
with B
elimina
present
B
ds with death. Pranavata and Apanavata are responsible for the breathing in andng out 1. To and fro movement of air through the Pranavaha Srotas is the vital sign of
.
Normalcy of breathing in and breathing out suggests health and abnormality indicates
s and its cessation indicates death 3. This is the unique sign of life, is affected in the
Tamaka Swasa 4. The disease Tamaka Swasa has been mentioned in the classics. Its
ities with the bronchial asthma according to the contemporary sciences are well known.
Heat and dust are the factors developed by urbanization and industrialization made the
life hazardous. Apart from so many allergic factors, which are present in the
here, are spreading incidences of Tamakaswasa throughout the globe. Controlling
actors can make a prophylaxis for the disease, but it is necessary to offer natural
e non chemo-therapeutic management modalities for the ailed.
Thus the present study was designed on the bases of “tamaketu virechanam”,
on, as a Shodhana therapy to relieve the doshas. The effect of Shodhana is compared
rihat Katphaladi yoga palliative management i.e. Pitta sthana samudbhava Dosha
tion with pacification of disease.
The presentations of the Pranavaha Srotas disorders are more emblematic. They
s with generation of a variety of abnormal musical sounds. The organ of breathing also
Introduction of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
1
Introduction of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
2
the producer of the vital sign of life turns into a musical box. It produces all sorts of music,
which is never melodious; rather it is the cry of the organ heading towards complete failure
for want of air. Among which Tamaka Swasa is one, well known for its episodic chronic
course 5. In modern parlance this illness is best compared to Bronchial asthma.
Effect of pollution on human beings
The incidence of Swasa as a disease is an increased at the present time due to various
reasons like, environmental pollutions, altered food habits; changed life style, stress and
strain, etc are discussed in detail at the literary review.
Asthmatic patients seem to be recovered completely after an attack. However there
can be a phase in which patient experiences some degree of airway obstruction daily in
unusual circumstances 6. Acute episodes can cause death. Hence respiratory diseases are
responsible for the major burden for morbidity and mortality.
Prevalence
Tamaka Swasa vis-à-vis Bronchial asthma is one of the important diseases pertaining
to the respiratory disorder. It affects the people of all age groups 7. Some times it is severe and
fatal also. It is the serious public health problem in the countries through out the world.
Nearly 5 to 10% of the world population at some stage during life suffers from asthma 8. The
disease can occur at any age and affects 5% of adults and 7-10% children commonly 9.
Between 100 and 150 million people around the globe, suffer from asthma and this
number is rising. Worldwide, deaths from this condition have reached over 180,000 yearly 10.
Tamaka Swasa is also generally comes in proximal attacks and one has to manage the attack
immediately 11. Tamaka Swasa if not treated properly it will kill the patients like the fire burns
the dried bush even though it is a Yapya Vyadhi, it become Sadya if it is Navothitha 12.
Introduction of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
3
Aim of study
So many research works have been curried out in relation to Shodhana and Shamana
treatments as mentioned in classics and their therapeutic effect is proved. Present research
work is intended to evaluate the comparative therapeutic effect of herbal combinations used as
different line of treatments.
About concept
The word Tamaka Swasa in terms of ‘Asthma’ is derived from the Greek word.
Meaning is panting or gasping. Commonly it can be said as difficulty in breathing wherever it
is present it cannot be said as asthma. The prefix bronchial specifies that the basic problem
will be in tracheo-bronchial tree. By these two word we can definitely say that any problem in
the tracheo-bronchial tree produces difficulty in breathing i.e., bronchial asthma.
For the prevention and cure of this major disease so many remedies are mentioned by
the Acharyas like, Snehana, Swedana, kaphotkleshakara ahara, Shodhana, shamana,
dhoomapana, Rasayana Nitya Shodhana etc., (Among there line of treatments Shamana
includes oral administration of medicine is very easy and also effective) 13.
There is no necessary to compare the two drugs as a Shodhana and Shamana groups.
Shodhana groups always holds good. But here the concept of adopting a technique “Nitya
Shodhana” to eliminate the accumulated “Dosha” even though normal, eliminating a patient
with the debilitated body and strength with the Nitya i.e. daily is specific.
The present study was designed as ‘Evaluating the comparative efficacy of Brihat
Katphaladi yoga and Vyoshadi Gutika Nityashodhana’. Here an attempt is maid of evaluating
the efficacy of shodhaka Dravya (virechana) in the form of Nitya Shodhana i.e., Vyoshadi
Gutika (with reducing the dosage) with shamanoushadhi Brihat Katphaladi yoga.
Introduction of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
4
As the Swasa is Kapha Vata pradhana Vyadhi Brihat Katphaladi yoga 14 seems to be
very effective. It contains katphala, pushkarumoola sringi shati musta, trikatu. All these drugs
are Kapha Vata Shamana property with Ushna virya.
Another formulation Vyoshadi Gutika is a vireechaka Dravya. This line of treatment
has chosen concentrating the Charaka statement. Where ever the Kapha obstructs Vata then
Anulomana in terms of Nitya Shodhana treatment holds good 15.
None of researchers have tried the management of Tamakaswasa by Nitya Shodhana
as Vata Anulomana, as par my knowledge, even though the Tamaka Swasa is a disease with
predominant Vata. With the addition of this one more attempt has made to compare the
efficacy of Nitya shamana aushadha with Nitya Shodhana.
Chapter - 2
Objectives T amaka Swasa vis-à-vis Asthma and allergies, such as atopic diseases (i.e., bronchial
ast
me
viz
sro
eff
as
alm
à-v
sha
the
mg
tex
bro
In
hma, allergic rhinitis, atopic dermatitis and allergic contact dermatitis), are common
dical problems. Tamaka Swasa and its management through various methods are possible
. Abhyanga Swedana, Virechana, Vamana, Dhoomapana, Shamana, Kapha nissarana,
tomardavata, Vata kaphahar Kapha vilayana, kasagnee, brumhana effects will be very
ective in combating the Tamaka Swasa. Considering the above the Brihat Katphaladi yoga
a shamanaoushadi and Vyoshadi Gutika Nitya Shodhana is under taken for the trial that has
ost all of these therapeutic effects is opted for this study.
The present study intended to focus on the disease evaluation i.e., Tamaka Swasa vis-
is. Bronchial asthma and the management with Brihat Katphaladi yoga as a
manaoushadi and Vyoshadi Gutika Nitya Shodhana. Among the drugs we have selected
above drugs, which are prepared according to GMP, finally which are weighing about 500
tablet and 250 mg capsule respectively for this vati we named it as it exists in the classical
t. Hypothetically this has the best therapeutic efficacy on the Tamaka Swasa vis-à-vis
nchial asthma.
this regard the objectives proposed in the study are –
1. To assess the Tamakaswasa haratwam (Anti asthmatic effect) of Brihat Katphaladi
yoga in Tamakaswasa.
2. To assess the Tamakaswasa haratwam (Anti asthmatic effect) of Vyoshadi gutika
nitya shodhana in Tamakaswasa.
Objectives of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
5
3. To assess the Broncho-dilatory effect of Brihat Katphaladi yoga through pulmonary
function test - Peak Expiratory Flow Rate in Tamakaswasa.
4. To assess the Broncho-dilatory effect of Vyoshadi gutika nitya shodhana through
pulmonary function test - Peak Expiratory Flow Rate in Tamakaswasa.
5. To compare and Assess Anti asthmatic effect and Broncho- dilatory effect in Group A
and Group B
1) To assess the Tamakaswasa haratwam (Anti asthmatic effect) of Brihat Katphaladi
yoga in Tamakaswasa.
The Tamaka Swasa is a disease manifested from Amashaya 16 i.e. “Pitta sthana
samudbhabva” with the vitiation of the Dosha Kapha and Vata 17. The ingredients of the
Brihat Katphaladi yoga are with Kapha Vata Dosha hara action and are of Katu, Tikta Rasa
predominance, thus they are potent Deepana and Pachana 18.
All ingredients of the yoga are of Ushna veerya dravyas are also does the Kapha Vata
shamana and acts as Agni vardhaka 19. The gunas like Laghu 20, Rookasha 21, Teekshna 22 and
Snigdha 23 are also help in Kapha Vata Shamana.
By observing all these characteristics of drugs Brihat Katphaladi yoga seems to be
very much beneficial in the management of Tamaka Swasa for obtaining the requisite results
of Tamaka Swasa haratwam.
2) To assess the Tamakaswasa haratwam (Anti asthmatic effect) of Vyoshadi Gutika nitya
Shodhana in Tamakaswasa.
Basically the contents of the Vyoshadi Gutika are Katu, Tikta rasa and Ushna veerya.
These drvyas are competent to eliminate the Kapha that is accumulated and also inducting the
effect of virechana there by successful elimination of the Pitta stana Dosha. The actions
Objectives of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
6
embedded in the compound are adhobhaga Dosha haratwam and vata anulomana and
individually the components of the drug helpful to pacify the vitiated Dosha.
Considering the characteristic features of the medicine and cumulative properties
hypothetically can draw a conclusion that the Nitya virechana concept with the Vyoshadi
Gutika is capable of exhibiting the anti asthmatic effect by eliminating the accumulated
Dosha regularly.
3) To assess the Broncho-dilatory effect of Brihat Katphaladi yoga through pulmonary
function test - Peak Expiratory Flow Rate in Tamakaswasa.
As the Brihat Katphaladi yoga is hypothetically capable of inducing the anti asthmatic
effect in terms of broncho dilatory effect it has to be measured for the justification of the
research. An attempt is made here to measure the pulmonary function test through peak
expiratory flow rate. The evidential PEFR 24 is recorded before and after the study discussed
in detail later.
4) To assess the Broncho-dilatory effect of Vyoshadi gutika nitya shodhana through
pulmonary function test - Peak Expiratory Flow Rate in Tamakaswasa.
As the Vyoshadi Gutika is hypothetically capable of inducing the anti asthmatic effect in
terms of broncho dilatory effect has to be measured for the justification of the research. An
attempt is made here to measure the pulmonary function test through peak expiratory flow
rate. The evidential PEFR is recorded before and after the study discussed in detail later.
5) To compare and Assess Anti asthmatic effect and Broncho- dilatory effect in Group A
and Group B
The study is a comparative clinical Trialwhere the effect of the Brihat Katphaladi yoga
internally to pacify the Dosha in Tamaka Swasa and Vyoshadi Gutika Nitya Shodhana
Objectives of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
7
intended to eliminate the Dosha with out any trouble inducing to patient 25. Thus the two
different aspects of the management modalities are to be compared at the clinical efficacy
with respect to the subjective and objective parameters chosen is necessary. In this attempt
the group-A and group-B designated medicaments are observed and for the efficacy of
broncho-dilatory effect and anti asthmatic effect and drawn the comparative statement.
Objectives of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
8
Chapter - 3
Literary review
Etymological Derivations
The criteria for naming the disease in Ayurveda are not uniform. The predominant
symptoms of breathlessness are the basis for naming the disease Swasa. The word Tamaka
Swasa is the name of illness consisting of the two words Tamaka and Swasa. The word Swasa
refers to the name of the disease, where as the word Tamaka refers to a subtype of the Swasa
roga.
Tamaka:
As per derivation ‘Tamyati anena iti Tamaka’ 26, ‘Tamaka Glanou’ the word Tamaka
represents a diseased condition that presents with darkness in front of the eyes or tiredness.
‘Tamyati anena iti Tamaka’, ‘Tama eva Tama’ according to this derivations the illness that
causes darkness or the illness itself is the darkness is called by the name Tamaka.
Swasa:
The word Swasa is derived from the Sanskrit root “Shwas”, meaning, “to respire”
Swasa (pul) = swasa + karane dhanj – swasati root derives “Swasati Anena iti Swasa”, which
means respiration 27. This derivation represents the physiological aspect of breathing. But
rapid or interrupted breath is “Swasa” disease.
As per this derivation “Swasasthu Bhasthrikadhmana Vatordwagamitha” 28 the word
Swasa refers to expiration of the air, producing sound similar to the one generated while
blowing the air with a blower by the blacksmith. This refers to the forceful labored breathing,
Literary review of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
9
Literary review of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
10
probably with wheezing sound. The description conceals the pathological expression of
breathing and is the cardinal symptom of Swasa Roga.
Tamaka Swasa:
We understand that the manifestation of the difficulty in breathing which occurs
mainly during the nighttime or cloudy day is called Tamaka Swasa 29. Difficulty in breathing
is the cardinal Symptom of Tamaka Swasa and in extreme cases it may be associated with
darkness in front of the eyes. Also the attacks of Tamaka are considered to be worst during
the night. These natures of the illness are unrevealed in the above said etymological
derivation.
Acc to contemporary science Definition of Asthma
Asthma (n) is a respiratory condition marked by wheezing derived from Greek word
“azo” which means breathe hard 30. Medically it is said as a term used to mean “difficult
breathing”; now used to denote bronchial asthma 31. Asthma is a disease characterized by
recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from
person to person. In an individual, they may occur from hour to hour and day to day. It attacks
all age groups but often starts in childhood 32.
HISTORICAL REVIEW
Pre-vedic and Vedic Period
The available literatures of Pre-vedic and Vedic period reveal that the physiology of
respiration, the role of Prana in respiration, the concept of Apana are mentioned at a number
of occasions.
In Rigveda, the word Prana is coined to describe the act of respiration - like
pranadvayu jayate 33, ayumapranaha 34. Yajurveda explains the process of respiration, the act
Literary review of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
11
of inspiration, the effort of expiration and involvement of Prana Vayu in respiration are
elaborated vatam pranena nasike 35 pranasya apyathatvam 36. Atharvaveda also contributes
the concept of respiration and the role of Pranavayu in respiration is also clearly described 37.
Atmopanishath reveals the act of inspiration and expiration is mentioned as the
Pranavata is important in the moment of shareera as prime physical sign of life. Further, the
opinion of absence of respiration suggesting the death is also described 38.
Brhadaranyakopanishath explains the Prana is referred by the names Angirasa and Ayusya.
The functions of controlling the body mechanisms are attributed to Prana Vayu 39.
Chandogyopanishath also elucidate the Prana has been named as Angeera and Brhaspati. The
role of Prana in nourishing the body is elaborated here 40. Hamsopanishath refers the organ
of respiration is compared to the bird Crane; the two wings of the bird representing the organ
of respiration, the trunk indicating the heart, and the neck of the bird symbolically expressing
the wind pipe are discussed in detail 41.
SAMHITA PERIOD
The detailed description of Swasa roga is available in Charaka 42 Chikitsa 17th
chapter. The detail explanation of etiological factors, pathogenesis, premonitory symptoms,
and clinical manifestations as well as complete radical treatment of Swasa roga is available.
The whole description of Swasa roga along with its Nidana Chikitsa is available in Susruta 43
Uttara tantra 51st chapter. In the form of complication of many disorders Swasa is described
and also as a symptom is mentioned in Bhela 44 Samhita treatise. Etiopathogenesis, line of
treatment and dietetics of Swasa Roga are described at full length in Harita Samhita 45, 14th
chapter of Third Sthaana. The brief description of Swasa Roga with its treatment is described
along with Kasa Roga, In Khila Sthana Kasyapa Samhita 46. Ashtanga Hridaya 47 and
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Ashtanga Sangraha 48 also explain the relevant description of Swasa Roga. Complete
diagnostic description of Swasa Roga is detailed in Madhava Nidana 49.
MEDIEVAL PERIOD
Apart from the commentaries on the Brihatrayee, Chakrapanidatta in his treatise
Chakradatta 50 discusses Swasa Chikitsa in detail. Sarvangasundari on Ashtanga Hridaya by
Arunadatta has revealed the hidden factors of Swasa and has opined the predominant
involvement of Kapha Dosha in the etio-pathogenesis of Swasa Roga. Indu, in his
commentary titled Ayurvedarasayana on Ashtanga Sangraha affrms that the aggravated
Kapha is the cause of Swasa.
Bhavaprakasha 51 and Yogaratnakara 52 are individual works of this period,
describes the Swasa Roga at full length and this is in accordance with the description
available in Brihatrayee.
Same nature of Works undertaken by various Institutions 53
1) Modh. K.G., Role of Virechana and Rasayana in the prevention and cure of Tamaka
Swasa, Gujarat Ayurvedic University, Jamnagar, 1991
2) Jaram Singh, Comprehensive study of Katphala w.s.r. To Tamaka Swasa, Gujarat
Ayurvedic University, Jamnagar, 2001
3) Sangeeta, Clinical study on the effect of Pippalyavaleha and Virechana karma in the
management of Swasa, Gujarat Ayurvedic University, Jamnagar, 2002
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Nidana – Aetiology
Chakrapani commenting 54 on the nidanas of the tamaka Swasa classified them into
two heading like -
a) Vata prakopaka Nidana
b) Kapha prakopaka Nidana.
Further screening through the nidanas reveals that Nidanas like –
• Amotpadaka Nidana 55
• Khavaigunyotpadaka nidana are observed 56
Vata prokopaka nidana: The nidanas which vitiates vata are grouped here. e.g.:
Sheetapana and ashana, Ruksha bhojana, Sheetavata sevana, Raja sevana, Vyayama and
Vegadharana, etc.
Kapha Prakopaka Nidana: The nidanas which vitiates kapha are grouped here. e.g.
Gurubhojana, Adhyashana, Shleshmala ahara, Sheetapana, etc.
Amotpadaka Nidana and Agni Mandyakara: The causitive factors by their virtue supresses
the Agni there by resulting in the Amotpadana. As all the diseases are produced by Ama,
Tamaka Swasa is not exception to this. e.g. Abhishyandi bhojana, Adyashana, Amaksheera,
Dadhi, etc.
Khavaigunyotpadaka Nidana: Some causitive factors apart from their action on the Dosha,
cause damage to the srotas resulting in susceptibility of that Srotas. In Tamaka Swasa the
pranavaha srotas particularly cause the airways damage by the causative factors resulting in
hyper-responsiveness of the airways. e.g.: Raja, Dhooma, etc.
For better understanding of this disease nidanas are classified into four varieties
discussed in the form of chart-1 as clasified below.
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1. Aaharaja – Nidanas related to food and drinks
2. Viharaja - Nidanas related toexternal activities of the person
3. Vyadhinimittaja – Other diseases are also can cause the disease
4. Agantuja and Kalaja – Injuries or trauma are also can cause the disease .
Table- 1
Nidana of Tamaka Swasa 57-64
Nidana C.S. S.S. A.S. A.H. Y.R. B.P. M.N. G.N.
A. Ahara Sambandi
Sheetapan + + + + + + + +
Sheeta ashana - + - - + + + +
Guru bhojana + + - - + + + +
Abhishyandi bhojana + + - - + + + +
Rooksha bhojana + + - - + + + +
Vidahi ahara + + - - + + + +
Vitambi ahara + + - - + + + +
Adyashana + + - - - - - -
Sleshmala ahara + - - - - - - -
Jalaja mamsa + - - - - - - -
Anupa mamsa + - - - - - - -
Ama ksheera + - - - - - - -
Dadhi + - - - - - - -
Shaluka + - - - - - - -
Masha + - - - - - - -
Nishpava + - - - - - - -
Vishamashana + + - - - - - -
Pinyaka + - - - - - - -
Tila taila + - - - - - - -
Pista padartha + - - - - - - -
Ama rasa - + - - - - - -
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Nidana C.S. S.S. A.S. A.H. Y.R. B.P. M.N. G.N.
B. Vihara sambandhi Sheeta vata sevana + + + + + + + +
Raja sevana + + + + + + + + Dooma sevana + + + + + + + + Vyayama + + + + + + + + Vega dharana + + - - - - + +
Sheeta sthaana - + - - + + + +
Bhara vahana - + - + + + + + Stree sevana - - - - + + - - Atapa sevana - - - - + - + + Abhishyndi upachara + - - - - - - - Seetasana - + - - - - - - Adhwagamana + - - - - - - - Dwandwa sevana + - - - - - - - Vyadhi/Avastha Sambandhi Nidana
Apatharpana + + - - + + + + Atisara + - + + + + + - Jwara + - + + + + + - Chardi + - + + + - - - Kasa - + + + + - - - Pandu + - + + + - - - Rookshana + - - - - - - - Anaha + - - - - - - - Vibandha + - - - - - - - Amaprodosha + + - - - - - - Shuddhi atiyoga + - - - - - - - Pratishyaya + - - - - - - - Kashata kshaya + - - - - - - - Dourbalya + - - - - - - - Vishoochika + - - - - - - - Udavartha + - - - - - - - Raktapitta + - - - - - - -
Agantu Karana
Nidana C.S. S.S. A.S. A.H. Y.R. B.P. M.N. G.N. Marmaghata + + + + + - - -
Visha + - + + + - - - Kantorasa pratighata + - - - - - - - Kala
Durdina - + - - - - - - Meghacchadit dina + - + + + + + +
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Causes of Asthma from contemporary system
In Modern Medical Science, the features explained in respect to Bronchial Asthma are
seems to resemble with Tamaka Swasa, hence a study of the aetiology is as follows.
According to contemporary Medical system, they do not know exactly what causes even
asthma. Researchers are trying to find the events that cause Asthma 65. The causative factors
of asthma can be classified as inducers and trigger factors.
Inducers 66: After birth several factors intact to result in the clinical manifestations of asthma
factors are called inducers.
Trigger factors 67: Substances or factors, which cause narrowing of airways and therefore
induce asthma, are called trigger factors. Each person with asthma has his or her own unique
set of triggers. Most triggers cause attacks in some people with asthma and not in others.
Based on mechanism of induction of asthma trigger factors are divided in two categories.
1. Allergic - Allergic trigger factors induce attack by triggering allergic reaction in the
body.
2. Non-allergic.- Non allergic factors trigger asthma without inducing allergic reaction in
the body.
Some of the examples of allergic and non allergic trigger factors are -
Allergic trigger factors Non allergic trigger factor
Dust mite Exercise
Pollen Psychological factors (Stress)
Animals and Insects Kitchen fumes
Mold Cold
Drugs Pollution
Food and Drinks Chest infection
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Allergic trigger factors
1) Dust and mites 68
Most atopic asthmatics report symptoms on exposure to house dust. Usually when
making beds and when dusting exposure while in bed may cause perennial rhinitis and
nocturnal attacks of asthma. An occasional patient shows sensitivity to house dust and not to
mites.
2) Pollen 69
Plant pollen grains are major causes of seasonal rhinitis and in such patients
commonly provoke asthmatic symptoms as well. Allergy to the pollen causes a distinctive
illness in that rhinitis is usually associated also with itchy conjunctivitis and lacrimination and
the symptoms have a distinctly seasonal pattern. Pollens may travel hundreds of miles in the
air but high concentrations obviously are only likely to occur close to a source.
3) Animals (insects)70
Up to 25% of atopic asthmatics show skin sensitivity to an animals. Sensitization
usually arises as a result of regular contact normally cats, dogs, horses, etc. If the sensitization
is of clinical significance the patient is likely to have noticed rhinitis conjunctivitis and
wheeze on contact with the animals. This stimulus differs from other naturally occurring
provocations. It does not evoke long-term squealae not does it change airway reactivity.
4) Molds 71
Molds are a species of plants, which grows on damp places with high humidity. They
are green - black reticular growths commonly seen over damp places in monsoon season.
Molds are microscopic fungi. These reproduce by releasing spores into the air, which then
settles on organic matter, and grow into new molds. Air born spores when inhaled can lead to
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asthmatic attacks. Asthma caused by molds gets aggravated during the later part of rainy
season. Optimum temperature for this growth is 20-30 degree Celsius and humidity above 70
percent.
5) Drugs
Drugs are the important occasional cause of asthmatic attack. Aspirin and other
NSAID’s are most frequent offenders followed closely by beta blockers, asprin sensitivity
occur particularly in non atopic adult asthmatics 72. Beta blockers can induce broncho
constriction even when administered in the form of eye drops, approximately 10% of the
asthmatic patients when given salicylates (eg. aspirin) or NSAIDs agents 73.
6) Food and drinks
Atopic asthmatics may occasionally notice that their symptoms are provoked by
certain foods and drinks. It occurs about 10% of such individuals. The foods most suspected
are milk, eggs, fish, cereals, nuts and chocolates etc. Food may also provoke asthma via
mechanisms that may not be related to Ig E related allergy 74.
Non-allergic trigger factor 1) Exercise
Exercise is one of the most common precipitants of acute episodes of asthma. This
stimulus differs from other naturally occurring provocations. Exercise probably provokes
bronchospasm to some extent in every asthmatic patient and in some it is only the trigger that
produces symptoms. Thus the onset of this problem frequently is the first manifestation of the
full down asthmatic syndrome 75.
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2) Psychological factors (stress)
Psychological factors like shock bereavement or excitement, such factors are the
dominant cause of the disease. Any cause of severe anxiety or stress can exacerbates asthma
and acute emotion may provoke an acute attack but there is no evidence of asthmatics that are
primarily psychologically disturbed 76.
3) Kitchen fumes
Kitchen with poor ventilation causes more problems for an asthmatic patient. Cooking
and the kitchen have a lot to do with triggering asthma attacks. Kitchen fumes are an
important trigger factor of asthma in Indian housewives.
During healthy periods inner lining of respiratory tract becomes normal and trivial
irritation of kitchen fumes does not aggravate asthma. During asthmatic attack the inner layer
of respiratory tract is inflamed, ulcerated and becomes very delicate. Even slight irritation by
kitchen fumes hurts it and results into an asthmatic attack. Combustion products of fuels,
cooking oil, and fumes generated by frying of pepper and other spices in oil or ghee are very
irritant to nasal and bronchial mucosa. Regular exposure can prolong duration of asthma
episodes to make it a chronic disease 77.
4) Cold
Climatic variations have massive effect on an asthmatic person who is prone to dust,
humidity, high temperature, and dusty environment the cold weather is more dangerous.
Many persons with asthma or rhinitis get aggravation of their disease on exposure to cold. It
has been shown that airway cooling is an important trigger factor causing asthma. Airway
cooling enhances inflammation thereby causing narrowing of airways and an asthma attack.
Breathing cold air also causes congestion of inner layer of nose (nasal mucosa) and therefore
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leads to nasal obstruction. Cooling of other parts of the body has also been shown to
aggravate asthma 78
5) Pollution
Atmospheric pollutions, irritants like cigarette, smoke, strong perfumes, dusts, haze of
fumes can provoke or worsen attack of asthma 79. Asthmatic patients may notice
exacerbations in relation to episodes of air pollution. Like high traffic density sunlight and
temperature inversion may promote exacerbations of asthma and smokes containing Sulphur
dioxide 80.
6) Chest Infection
Many viral and bacterial infections of the respiratory system produce transient.
Increase in airway responsiveness in asthmatic patients. Viruses in particular are an important
cause of asthma exacerbations 81. Viral infection in childhood may predispose to the
development of asthma and bronchial hyper reactivity in later life. Viral infections in adults
are frequently followed by protected cough and wheeze in distinguishable form asthma 82.
Other Triggering factors
Sore throat, Bacterial infection, sleep, sudden climatic change, Rainy days, Mosquito
repellants, Tobacco smoke, Pets, Fireworks & crackers, Worship lighting agarbatti / hawan,
Lady's Head Washing, and Farming works, etc 83.
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Poorvarupa of Tamaka Swasa
The Lakshana which appear before the onset or manifestation of disease are
considered as Poorva Roopa 84. No specific Poorva Roopa has been explained for Tamaka
Swasa, but the Poorva Roopa explained in the context of Swasa holds good for Tamaka
Swasa even.
Pathology of Tamaka Swasa includes the vitiation of Vata and Kapha Dosha afflicting
the Rasa Dhatu in the Uras 85. This unique pathology determines the premonitory symptoms
in the premonitory stage. The symptoms like Anaha, Adhmana, Bhakthadwesa, and Vairasya
all are the result of the illness stemming out from the Pittasthana. Needless to say, these are
also suggestive of imbalance of Kapha Dosha. Further, Parswa Shoola and Shankha Nistoda
indicate the extent of Doshic circulation. Hridaya pidana and Pranavilomata are pathogenic of
localization of the Dosha in the Uras.
Following table gives the glance of the Poorva roopa of the illness, which are also
premonitory symptoms of other types of Swasa.
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Table-2
Porva Roopa of Tamaka Swasa 86-93
POORVA RUPA CS SS AS AH BP YR GN MN
1 Anaha + + + + + + + +
2 Adhmana - - - - + + + +
3 Arati - + - - - - - -
4 Bhaktadwesha - + - - - - - -
5 Hritpeeda + + + + + + + +
6 Kantha Gurutwa + - - - - - - -
7 Kashaya vadanata + - - - - - - -
8 Parshva Shula + + + + + + + +
9 Prana Vilomata + - + + - - - -
10 Shankha Toda - - + + + + + +
11 Uro Guruta + - - - - - - -
12 Vaktra Vairasya - + - - + + + +
Contemporary medical Science has also mentioned the poorva roopa on the heading of
‘Early Warning Signs of Asthma’ 94. These signs are experienced before the start of an asthma
episode. And these signs are unique to each person, and signs may be the same, similar or
entirely different with each episode. Some early warning signs may be noticed only by the
individual, while other early warning signs are more likely to be noticed by other persons.
Those signs are as follows - Breathing changes, Sneezing, Moodiness, Headache,
Runny/stuffy nose, Coughing, Chin or throat itches, Feeling tired, Dark circles under eyes,
Trouble sleeping, Poor tolerance for exercise and Downward trend in peak flow number. It
has been clearly explained in all the related Ayurvedic classics as Hritpeeda, Parshva shula,
Adhmana, etc
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Lakshana (Roopam) of tamaka Swasa
Vata as well as Kapha Dosha, Rasa Dhatu and Pranavaha Srotas are the predominant
factors involved in the pathogenesis of Tamaka Swasa. And for apparent reasons these factors
determine the course and clinical manifestation of the disease.
The lakshana of Tamaka Swasa has been explained with clinical course of the disease
rather than listing of signs and symptoms. The appreciable lakshana of Tamaka Swasa are
explained as –
1) Vishista or Pratyatma niyata lakshana
2) Upashayanupashaya rupi lakshana
3) Samanya lakshana
1) Vishista / Pratyatma lakshana:
The symptom specific Tamaka Swasa is considered as Vishistha / Pratyatma lakshana
of Tamaka Swasa. Those lakshana are Svasakrichrata, Kasa, and Ghurgurakam etc
2) Upashayanupashaya rupi lakshana:
Some lakshana explained under Tamaka Swasa indicates the upashaya-anupashaya
swaroopi lakshana. They are considered as aggravating and relieving factors of
Tamaka Swasa.
3) Samanya lakshana are enlisted in table -3 as below.
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Table No- 3
Roopa (Lakshana) of Tamaka Swasa 95-102
Laxanas C.S. S.S. A.H. A.S. M.N. B.P. Y.R. G.N.
Swasa (Dyspnoea) + + + + + + + +
Ghurughuraka (Wheezing) + + + + + + + +
Prana prapeedana (Discomfort) + + + + + + + +
Kasa (Cough) + + + + + + + +
Pratamyati (loss of consciousness) + + + + + + + +
Sannirudyati (Immobilized) + - - - + + + +
Pramoham Kasamanascha + + + + + + + +
Sleshma vamokshante
Labhate sukham + + + + + + + +
Kantodwamsa (Throat irritation) + - - - + + + +
Krichrena bhashitam
(Difficulty in speaking) + - - - + + + +
Na labhate nidra (Sleeplessness) + - - - + + + +
Shayanasya swasa peeditha
(Discomfort in lying down posture, + + + + + + + +
Shayanasya sameesana
Parswe shoola (sides pain) + - + + + + + +
Ushna abhinandana(Like hot thing) + - + + + + + +
Uchritaksha (wide opened eyes) + + + + + + + +
Latat Sweda (Sweating on forehead) + + + + + + + +
Brushrmarthi (maximum distress) + - + + + + + +
Shushkasyata (Dryness of mouth) + - + + + + + +
Muhur Swasa, Muhuschaiva avadhamyati-
(Short breath with all effort to breath) + + + + + + + +
Megha, ambu, sheeta, pragwaha
shelshmalancha pravardhanti
(Increase after exposure to
kaphakara ahara) + - + + + + + +
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Laxanas C.S. S.S. A.H. A.S. M.N. B.P. Y.R. G.N.
Pratishyaya (normal discharge) + - + + + + + +
Aruchi (Anorexia) - + + + - - - -
Trishna (Excessive thirst) - + + + - - - -
Vepathu (Tremors) - - + + - - - -
Vamathu (Expectoration) - + - - - - - -
Ghoshena Mahate - + - - - - - -
Samprapti (Pathogenesis) of Tamaka Swasa
Swasa Roga Samprapti
Charaka opines that the Vitiated kapha along with vitiated vata obstructs the srotas,
the obstructed vayu tries to over come the obstruction and moves in all the direction resulting
in Swasa 103.
Susruta says the Pranavayu goes against its individually (Prakriti) combines with
Kapha causing Swasa Roga 104.
Bhavamishra 105 and Yogarathnakara’s 106 opinion regarding Samprapti coincides with
Charaka, Madhavakara’s 107 corresponds with Sushruta.
Vagbhata 108 further emphasised that the Annavaha Srotas is also involved and hence
the production of Kapha in Amashaya is affected. Thus Swasa Roga is regarded as Amasaya
Samudbhava.
Tamaka Swasa Samprapti
Vata Dosha and Kapha Dosha are invariably involved in the pathogenesis of Tamaka
Swasa 109. Imbalance of Vata Dosha is best treated by Snigdha line of treatment 110. Whereas,
vitiated Kapha Dosha is treated by Ruksha line of treatment 111. Theoretically, when both
Vata and Kapha Dosha are vitiated mutually, contradictory therapeutic procedures have to be
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employed, thus posing a practical problem in planning the final treatment. Kapha Dosha and
Rasa Dhatu both belong to the same category in relation to their properties 112. It is a general
principle of pathogenesis, that the Dosha and the Dhatu belonging to the same category have a
natural tendency to rapidly progress in the process of pathogenesis 113.
Similar to this in Tamaka Swasa also, Kapha Dosha that afflicts the Rasa Dhatu
contributes to the rapid development of the illness. Further, during the course of the illness,
the Hridaya marma is said to be afflicted 114. This adds to the severity of illness.
Put together, the mutual contradictory treatment, involvement of Dosha and Dushya
belonging to the same category, as well as affliction of Hridaya marma explains the acute
onset, chronic course and severity of the illness.
The normal upward course of the Pranavata is obstructed by the abnormally stiff
Pranavaha srotas. Secondly, like the other Srotas, secretion is the natural process seen in the
Pranavaha Srotas. Here Kapha is the normal secretion and the vitiated Prana Vata abnormally
increases it. In further it adds to the obstruction of the passage and Pranavata leading to Prana
vilomata. Narrowing of the Pranavaha srotas together with accumulation of Sleshma obstructs
the smooth flow of Pranavata. Pranavilomata and the resultant turbulent breathing lead to
abnormal audibility of respiration or to say this produces wheezing. Charaka opines that the
obstruction to the passage of Pranavata also leads to rapid breathing 115.
Vitiated Prana Vata irritates the Nasa causing increased secretion and manifestations
like Peenasa, Kshawathu etc 116.
Further the presence of Kapha in Pranavaha srotas more particularly in the Kantha
(neck) region obstructs the Pranavata. The Pranavata passing through this Kapha, causes
bubbling and a peculiar sound, which is called as Kantha Ghurghuraka is, produced 117.
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It is said that this Sleshma is thick, sticky and tenacious and contributes to the
obstruction in the Pranavaha srotas. Excessively secreted tenacious Sleshma is expectorated
out with much difficulty during the bouts of coughing 118.
Productive cough is another effect of obstruction of Pranavata in the Pranavaha srotas.
As the cough brings out the Sleshma, obstruction to the Pranavata is minimized, leading to
temporary relief in breathlessness to the patient 119.
Other than the usual presentation, involvement of the Pitta Dosha may be seen in
certain patients of Tamaka Swasa 120. When this is the case the over all presentation of the
Tamaka Swasa is also changed accordingly. The frequent episodes of Tamaka Swasa are
related to the exposure to cold, cloudy days, and heavy breeze and/or such other factors that
are provocative to Vata and Kapha Dosha, which is the usual presentation in Tamaka Swasa
121. If the association of Pitta Dosha is present this nature of the illness is reversed and hence
exposure to these factors may bring about remittance of symptoms in the patient. This unique
nature of the illness is attributed to Pitta Dosha involvement. These symptoms like Jwara,
Murcha are suggestive of Pitta vitiation. Such a variant form of Tamaka Swasa with the
typical symptoms of Pitta Dosha is called as Pratamaka and Santamaka Swasa 122.
The imbalance of Vata and Kapha Dosha afflicts the Rasa Dhatu in the pathogenesis
of Tamaka Swasa. During the attack of Tamaka Swasa almost all the symptoms of Kapha
Dosha vitiation are mediated through the Rasa Dhatu. Among the list of symptoms:
productive cough, sputum etc are the symptoms pathognomonic of Rasa Dhatu abnormality.
Moreover, abdominal symptoms like Anaha, etc. are also the result of incriminated Rasa
Dhatu 123. As the disease runs a chronic course, the vitiated Vata Dosha dries up the
circulating Rasa Dhatu contributing to the weakness and emaciation in the patient.
Figure - 1
Schematic diagram of Samprapti of Tamaka Swasa
Nidana
Vata prakopa kapha prakopa
Vata vrudhi kapha prakopana
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Pranavaha sroto pravesha
Vata prakopana
Vata avarana by urasthita prakupita Kapha
Pranavata margavarodha
Sarvato gachati
Pratiloma gati
Tamaka Swasa
Pratamaka Santamaka
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SAMPRAPTI GHATAKA
Dosha : Charaka - Kapha, Vata.
i
t
t
: Susruta - Dom nance of Kapha
: Arunadatta – Both Kapha and Vata are involved
Dushya : Rasa
Srotas : Pranavaha, Udakavaha, Annavaha
Srotodusthi : Atipravra ti
Utpatti sthana : : Vagbhata - Amashaya.
: Charaka - Pitta s hana
Sanchara sthana : Ura kantha Siras
Vyaktha sthana : Uras
Rogamarga : Abhyantara
Adhisthana : Shareerika
Samprapti Bhedas
For the complete understanding of the disease, Samprapti can be classified as
Sankhya, Pradhanya, Vidhi, Vikalpa, Bala and Kala 124.
In the disease Tamaka Swasa also detail study of Hetu, Samprapti, lakshana and
Sadhyasadhyata can be elaborated in the framework of Samprapti bhedas as -
1) Sankhya Samprapti
The Tamaka Swasa is categorized under pancha bheda of Swasa 125. Tamaka Swasa
doesn’t have direct classification to fit in the sankhya samprapti, but have Pratamaka and
Santamaka as the avastha bhedas 126.
2) Pradhanya Samprapti
Charaka has considered Tamaka Swasa, as kaphavatatmaka Vyadhi 127 where as
Madhavakara has considered it as Kapha pradhana 128. Its Samprapti indicates the kapha
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pradhanyata, as per the clinical course of the disease and principles of treatment both kapha
and vata seems to be pradhana 129. Vata holds prime importance in the management.
3) Vidhi Samprapti
Under vidhi samprapti, Tamaka Swasa can be classified in different categories as,
Ashukari 130, Yapya 131, and Krichra sadhya 132. According to Charaka Hikka and Swasa are
Ashukari, Ghora, and Sheeghra Pranaharaka.
Further he explained with chronicity as more than one year are considered as yapya
and of duration less than one year in the durbala rogi, as krichra sadhya. Acharya Sushruta has
considered Tamaka Swasa as krichrasadhya; and asadhya in durbala rogi.
4) Vikalpa Samprapti
Observing the Tamaka Swasa Samprapti, lakshana, Upashaya and Anupashayas
presence of vikriti in Pranavata and is aggravated by the properties such as Sheeta, Ruksha
gunas and increase in its Chala guna 133. Similarly Urosthita Avalambaka kapha gets
aggravated by Guru, Snigdha, Sheeta, Abhishyandi gunas and becomes Ghana and Picchila.
5) Bala Samprapti
Bala of Vyadhi depends on virulence of the hetus, presence of poorva rupa or rupa in
the course of development of disease or in developed form. And also it depends on the
involvement of different Srotases, Rogamarga and vital parts of the body. Hence the bala of
the Vyadhi differs for individual patients, thus the Tamaka Swasa is considered as Krichra
sadhya, Yapya and Ashukari Vyadhi by various authors 134.
6) Kala Samprapti
The name of disease itself indicates of the nature of disease with respect to time factor.
It is episodic, paroxysmal and mostly nocturnal in its nature. Sometimes it is even observed
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that the symptoms get aggravated in the early morning, and with respect to seasons it
aggravates in the winter and autumn due to cold climate 135.
Pathogenesis of asthma from contemporary system 136
The common denominator underlying the asthmatic diathesis is a nonspecific
hyperirritability of the tracheo-bronchial tree. When airway reactivity is high, symptoms are
more severe and persistent. In both normal and asthmatic individuals, airway reactivity rises
after viral infections of the respiratory tract and exposure to oxidant air pollutants such as
ozone and nitrogen dioxide (but not sulfur dioxide). Viral infections have more profound
consequences, and airway responsiveness may remain elevated for many weeks after a
seemingly trivial upper respiratory tract infection. In contrast, airway reactivity remains high
for only a few days after exposure to ozone. Allergens can cause airway responsiveness to rise
within minutes and to remain elevated for weeks. It is widely believed that the physiologic
and clinical features of asthma derive from an interaction among the resident and infiltrating
inflammatory cells in the airway surface epithelium, inflammatory mediators, and cytokines.
The cells thought to play important parts in the inflammatory response are mast cells,
Eosinophils, lymphocytes, and epithelial cells.
Pathophysiology from contemporary system 137
Asthma is multifunctional in origin, arising from the interaction of both genetic and
environmental factors. Airway inflammation characterizing asthma occurs when genetically
susceptible individuals are exposed to environmental factors but the exact process may vary
from patient to patient. The timing intensity and mode of exposure to aero-allergens are
important environmental factors which stimulate the production of Ig E.
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Pathology from contemporary system 138
The bronchiectatic activities may be lined by lined by granulation tissue, Squamous
epithelium or normal ciliated epithelium. There may also be inflammatory changes in the
deeper layer of the bronchial wall and hypertrophy of the bronchial arteries. Chronic
inflammatory and fibrotic changes are usually found in the surrounding lung tissue.
Upashaya of Tamaka Swasa
Any of the Dravya bhuta (Oushadhi, Ahara etc.) or Adravyabhuta (Vihara)
Upacharas leads to Sukhanubandha is defined as Upashaya 139. Sleshma Vimokshana is
considered as Upashaya in Tamaka Swasa 140, which can be achieved by mechanical process
such as coughing etc, by pharmacological measures such as administering Sleshmavilayana
dravyas.
The dravyas possessing Ushna guna i.e. properties can be administered as Upashaya in
Tamaka Swasa. 141. Non-pharmacological procedures such as change of position; changing to
the sitting position from recumbent position; relives from the severity for short period 142.
Anupashaya of Tamaka Swasa
Ahara, Vihara, and Oushadhi aggravates the condition of the Tamaka Swasa are called
as Anupashaya of Tamaka Swasa. They are Asatmya to the Vyadhi 143. Meghambu sheeta
pragvatai Sleshlmalaischa abhivardheyate is considered as Anupashaya 144.“Nacha
pinidramlabhate Shayanahasvasapeeditaha” indicates the aggravation of the disease in the
recumbent position 145.
Upadrava of Tamaka Swasa
There is an in direct reference regarding the upadravas of Tamaka Swasa mentioned in
‘Trishna chikitsa’ is Trishna appears as upadrava in Jwara, kshaya, Swasa etc 146.
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Aristha of Tamaka Swasa
Regarding the aristha lakshana, there is no direct reference in the context of Tamaka
Swasa, where as in reference with different contexts aristha lakshana for Swasa can be
established. At the time of death whatever the disease he may suffer, ultimately he will die
with Hikka and Swasa 147.
It is mentioned that the person producing unnatural sounds with heavy breath, suffering
with Atisara, Trishna, Shushkasyata and loss of body strength is definitely going to die 148.
The person who’s Urdhva Swasa is rapid, throat occluded by Kapha; reduction in strength,
complexion and food intake is not going to survive for longer period 149. The person taking
long inspiration and gives of short expiration gets fainted; such person is stated to die within
short period 150.
Sadhyasadhyata of Tamaka Swasa
Tamaka Swasa, which is chronic of more than one year, is considered as yapya and of
duration less than one year in the durbala rogi, as krichra Sadhya 151. If Tamaka Swasa is
Navotita (newly developed) it is as sadya (curable) 152. Susruta has considered Tamaka Swasa
as krichrasadhya vyadhi and asadhya in durbala rogi 153. According to Vagbhata Tamaka
Swasa is yapya, but can be Sadhya if it is treated in early stages in the strong persons 154.
Table – 4
Vyavachedaka Nidana of Tamaka Swasa
Differential diagnosis between panchavidha Swasa 155
Lakshana Tamaka Swasa Maha Swasa Urdhva Swasa Chinna Swasa Kshudra Swasa
Swasa Ateva teevra vega Swasa
Uchaihi swasati Dheergam swasati, Urdhvam swasati, adhoswasa nirodha
Swasate vichinnam Ruksha aayasottha Swasa
Shabdha Ghur-ghuraka Matta vrashabho vatt
Consciousness Pramoha Pranastha jnana vijnana
Pramoha Moorcha
Netra Uchritaksha Vibhranta lochana and vivrataksha
Urdhvadristhi and vibhrantaksha
Viplutaksha, raktaika lochana
Shula Shayanasya parshvagraha
VedanartaMarmachedavat rugarditaha
Vak Kruchrakrichnoti bhashitaha
Viksheena vak Pralapana
Asya Vishushkasya Shushkasya Parishushkasya
Sweda Lalata sweda Sarva daihika sweda
Upashaya Sleshma vimokshana
Sadhyasadhyata Yapya Asadhya Asadhya Asadhya Sadhya
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Chikitsa in Tamaka Swasa
The effective treatment of Tamaka Swasa cannot be unified, as the pathology
involves multiple varying factors. Vitiated Vata and Kapha Dosha stemming out from the
Pitta Sthana, afflicting the Rasa Dhatu in the Pranavaha Srotas produces the illness.
Therefore, the procedures aimed at the rectification of the imbalances of Vata Dosha, as
well as Kapha Dosha forms the sheet anchor of treatment of Tamaka Swasa, which is
individually quite opposite. Thus, the unique pathogenesis poses complexity in planning
the treatment. The final treatment planned should pacify the Vata as well as Kapha Dosha
effectively, simultaneously not causing any further addition to the imbalance of Vata and
Kapha Dosha. With the due consideration of this, following principles of treatment are
advocated in the Ayurvedic classics.
1. Abhyanga and Swedana –Application of the oil over the chest followed by sudation.
2. Vamana – Therapeutic emesis
3. Nitya Shodhana – Daily clanging the Dosha by Anulomana
4. Virechana Karma – Therapeutic purgation
5. Pratisyaya Chikitsa – Treatment of rhinitis
6. Kasaroga Chikitsa – Treatment of Kasaroga
7. Dhoomapana – Therapeutic inhalation of the smoke from the burning herbs
8. Kaphahara Chikitsa – Pacification of vitiated Kapha Dosha.
9. Vatahara Chikitsa – Elimination of vitiated Vata Dosha
10. Kapha Vilayana Chikitsa –Liquefaction of the sputum
11. Srotomardavakara Chikitsa – Softening of the channels of respiration
12. Kaphanissaraka Chikitsa – Expectoration of sputum
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13. Kasaghna Chikitsa – Treatment of cough
14. Manasa Dosha Chikitsa –Correction of emotional disturbances
15. Rasayana Chikitsa – Rejuvenating the Pranavaha Srotas and body 156
For the prevention and cure of any disease so many remedies are mentioned in
Ayurvedic classics according to the Vyadhi. Vyadhibala. rogibala, doshavastha,
doshanubandhata etc. The proper management of Tamaka Swasa seems to be difficult by
observing these points.
For the proper management of this disease exclusively Charaka has explained so
many different management and treatment principles. With comparison of other authors
the principles of management are as follows.
Nidana Parivarjana
The disease Tamaka Swasa has wide range of etiologic factors, it becomes difficult
to identify the specific cause and avoid it. More ever it is a typical disease where in the
initial sensitizations by specific factor, sets a platform for the onset of acute episodes, with
exposure to even smallest or mildest stimuli. Hence it is difficult to manage the condition
only by nidana parivarjana.
One has to be very precise regarding the precipitating or triggering factors. Avoid
exposing to that particular factor, which mostly helps to prevent the onset of acute
episodes or acute attacks. Acaryas have clearly explained nidanas of the Swasa roga are to
be avoiding as a Nidana Parivarjana 157.
Management of Swasa rogi depends on:
1. Bala bala (Balawan or Durbala)
2. Doshadhikya (Kaphadhikya or Vatadhikya)
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If the patient is kaphadhikyata and balawan rogi - Doshas are to be expelled by
vamana and virechana. After pathya ahara, vihara and later followed by Swasa nashaka
dhuma, avaleha etc are to be administered.158.
If the patient is vatadhikyata and durbala, Baala, vruddha rogi- Vata has to be
alleviated by vatanashaka dravyas, tarpana, sneha, yusha, mamsarasa etc are to be
administered 159.
If the samshodhana karma is performed in condition anutklistha kapha dosha,
durbala and those who have not undergone swedana, vata gets grossly provoked; becomes
fatal with causing marma samshoshana.
In case of balawan, kaphabahula rogi- Before performing the Vamana karma
anoopa and jalaja mamsa rasa and swedana are to be given. Contradictory to it, in durbala,
alpa kaphavastha, he has to be treated with brumhana chikitsa 160. Swasa rogi having
ruksha shareera, suffering from shushkata in uras, kantha and talu has to be treated by
ghrita 161.
Doshanubandhi Swasa Chikitsa
In case of vatanubandhi Swasa, the ghrita prepared by mamsa of shasha, shallaka
etc. or ghrita prepared by pippali, mamsa and shonita has to be administered 162. In case of
vatapittanubandha Swasa Shali Odana prepared with Suvarchala swarasa, dugdha, ghrita
and trikatu has to be administered 163. Gangadhara commenting on this suvarchala
swarasa, dugdha, ghrita can be administered separately with trikatu churna after food 164.
In case of pittanubandhata utkarika gritha are to be administered 165.
In case of kaphapittanubandha swasa shirisha pushpa swarasa or saptaparna
swarasa, mixed with pippali choorna and madhu has to be administered 166.
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According To Doshas Swasa Chikitsa
Acharya Charaka explained a special line of treatment in managing the Swasa rogi,
with respect to doshas 167.
1. Vatakruddha kaphahar. The upakramas those aggravate Vata and mitigate Kapha.
2. Kaphakruddha anilapham. The upakramas those aggravate Kapha and mitigate
Vata.
Both the principles can be used differently according to the condition, but
treatment aiming towards single Dosha must not be performed i.e. Vata karaka, Kapha
karaka, Vata shamaka or Kapha shamaka, in indispensable condition to implement one
amongst the above four. It is superior to go for vatashamaka upakramas 168.
Snehana And Swedana
Acharyas have considered bahya snehana on uras by Tila taila with Lavana as an
initial treatment and it is followed by swedana either of Nadi, Prastara or Sankara, with the
help of snigdha dravyas. This helps for liquefaction of the grathita Kapha i.e. facilitating
easy expelling of vitiated kapha. It also helps for Vata Anulomana and leads for
smoothness of Srotas 169.
Swedana karma is contraindicated for the Swasa rogis in case of Pittaja Prakrati,
Pitta dosha pradhanayata and persons suffering from Daha, Raktapitta, Atisweda, Dhatu
Ksheenata, Bala Ksheenata, Gharbhini or the persons with Ruksha Prakrati.
If the Swedana is necessary in above said persons mrudu swedana has to be
performed for a short period i.e. pariseka by ushna snehas; sharkara yukta ushna utkarika
or upanaha 170. Swasa rogis suffering with associated Swaraksheena, Atisara, Raktapitta,
and Daha; they are to be treated with madhura, snigdha, sheetal dravyas 171.
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Swasa rogis, suffering with Navajwara or Amadosha, they has to be treated with
ruksha sweda, Langhana or Vamana has to be performed by administering Ushnajala and
Saindhava Lavana 172. After samyak swedana, snigdha odana, matsya / shukara
mamsarasa or dadhi manda has to be administered, which helps for sleshma vardhana 173.
Kosta Shodhana with Vamana and Virechana:
After snigdhadi bhojana, when kapha gets increased sufficiently, then vamaka
yogas such as pippali choorna, saindhava lavana and madhu have to be administered. Thus
the vitiated Kapha is expelled. Also obstruction to Vata is relieved facilitating its normal
movements and srotas becomes clear. The vamaka dravyas should not be Vata virodhi 174.
Chakrapani commenting on vata avirodhi word, he says not to use ruksha and teekshna
vamaka yogas. That indicates to use mridu vamaka dravyas.
For the proper management of Swasa some more clues are given by the acaryas
as, to expel vitiated doshas by vamana, if patient is suffering from Swasa along with kasa,
swarabheda and for Tamaka Swasa Kapha Vata hara dravyas are to be used for Virechana.
Gangadhara comments as - in swarabheda yukta Swasa and Tamaka Swasa Virechana and
swatantra kasa, swarabheda vamana has to be administered 175.
If Vata gets aggravated due to atiyoga of Vamana, patient has to be treated by
vatashamaka upakramas. Patient has to be provided food along with mamsa rasa,
abhyanga with Vata nashaka dravyas. Which are neither too hot nor too cold 176.
If Swasa rogi is suffering from udavarta and adhmana vatanulomana has to be
performed with matulunga, amlavetasa, hingu, pilu and bida lavana 177.
Abnormal response of patients for simple factors like dust is said to be due to
Khavaigunyata of the Pranavaha Srotas. In the modern counterpart, this is described as
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hypersensitivity or allergy of the respiratory system. This may be said as Khavaigunyata,
or else called as Asatmyata or even may be named as faulty Vyadhikshamatva. And the
fact is that, the patient unfavorably responds to simple factors like dust, atmospheric
change, or food. The friendly environment in which the patient has to live becomes hostile
to him and is like the enemy of the patient. The interaction in such a situation between the
patient and the environment is just like the two mirrors facing each other. The mirrors
facing each other produce infinite number of images and quite similar to this, the patient
suffers from innumerable attacks of Tamaka Swasa.
Charaka pronounced this as “Tamake Tu Virechanam” 178. The Virechana
procedure may not be of much use during the attack of Tamaka Swasa. But when
employed in between the attack, prevents the attacks of Swasa, reduces its severity, and
minimizes the duration of illness.
After Virechana, Samasarjana Karma is advised for about 3 to 5 days 179. This
procedure eliminates Doshas in Tamaka Swasa eliminated, as is told in the classics;
Doshas stemming out from Pitta Sthana is best eliminated by Virechana procedure. It is
worth mentioning here that; Vata Dosha is the predominant Dosha involved in the
Samprapti of Tamaka Swasa. Virechana normalizes the course of Vata Dosha and thus
helps in the reversal of the Vilomagati of Pranavata. Distension of the abdomen,
constipation and such other symptoms may be associated in some patients and these
symptoms are best treated by this procedure.
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Rasayana Chikitsa in Tamaka Swasa
The one more answer for such a nature of illness is Rasayana Chikitsa. Even in
some patients, this procedure Virechana in combination with Rasayana Chikitsa brings
about complete cure.
Dhumapana
After completion of Vamana karma smaller quantity of vitiated dosha will remain in
the srotas. To expel such leena doshas, Dhumapana has been explained. For the purpose of
dhumapana; haridradi dhuma varti is generally indicated in classics 180.
Nasya
Different yogas; such as rasona, palandu, grinjanaka swarasa, madhura varga
dravyas siddha ghrita are indicated for nasya karma for hikka in the context of hikka and
Swasa Chikitsa 181, but it is not directly indicated in Swasa; Vagbhata also supports the
same; where as Arunadatta commenting on the same indicates nasya prayoga in Swasa
also. Susruta explains the utility of bhringraja siddha taila as nasya, abhyanga and
acchapana in swasa and hikka 182.
Kshara prayoga
If Kapha obstructs the path of Pranavata; ksharaavaleha has to be administered, in
order to relieve the obstruction of Pranavata. It makes the Kapha vilayana and anulomana
183.
Brumhana and Shamana Chikitsa
If Swasa rogi are treated with brumhana; the complication that take place due to
treatment are milder in nature and can be easily managed as brumhana leads to increase in
bala and Kapha. If the same has been treated with shamana Chikitsa, there is a least
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possibility of complication due to Chikitsa as it pacifies both Kapha and Vata; on contrary
karshana will lead to decrease the bala of rogi, also aggravates the Vata and the
complications due to treatment are difficult to manage 184.
Apart from all Chikitsa modalities Charaka says even though the Swasa rogi is
shodhita or ashodhita, he has to be treated with shamana and brumhana Chikitsa 185.
Susruta says Nidigdhikadi yoga as Swasa, kasahara siddhatama yoga, containing
kantakari kalka of amalaka pramana; half the quantity hingu has to be administered for
three days along with madhu, which will positively relieve the patient from the Swasa
roga 186. Vagbhata has explained the use of pippalyadi takra in treating Swasa and hikka187.
With all the above principles of management of Tamaka Swasa, there are still many
number of Swasahara yogas explained in the context of Swasa Chikitsa by the various
authors.
Asthma management in contemporary medical science
In contemporary medical science Asthma management principles are as follows –
1) Patient education
2) Avoidance of the aggravating factors
3) Avoiding respiratory irritants
4) Psychological treatment
5) Disintegration or immune therapy
6) Prevention of infection
7) Physiotherapy and
8) Drug management
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Pathyapathya in Tamaka Swasa
A number of predisposing factors may initiate an attack of Tamaka Swasa or may
worsen the episode, if the patients are already in the symptomatic phase. In a patient who
has reduced immune mechanism of the Pranavaha srotas, which is described, as
Khavaigunyata or Asathmyata, exacerbation or else initiation of an attack of the Swasa
Roga is likely. Hence, understanding of Pathya as well as Apathya gains importance both
in preventing as well as planning the treatment. Mainly, the factors that influence the
balance of Vata Dosha as well as Kapha Dosha are either Pathya or Apathya as per their
role in pacifying or else aggravating these Doshas respectively. Following table depicts
the list of Pathya and Apathya factors in Tamaka Swasa.
Table No 5
Pathya in Tamaka Swasa
Pathya Ahara C .S.189 S .S.190 A .H.191 Y.R.192 B.R.193
I Shaali Dhanya
Purana Shali + - - + + Tandula - - - + +
II Vrihi Dhanya
Shashtika + - + + +
III Shooka Dhanya
Yava + - + + + Godhuma + - + + +
IV Shimbi
Mudga + - + - - Kulatha - - + + +
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V Shakha Varga
Pathya Ahara C .S.189 S .S.190 A .H.191 Y.R.192 B.R.193
Guduchi + - - + + Patola - - - + +
Vartaka - - + + + Rasona - - - + + Bimbi - - - + +
Vastuka - - - - + Moolaka + - + - + Potaki - - - - + Shigru + - - - -
Kasamarda + - - - -
VI Mamsa Varga
Janghala - - - + + Shasha - - - + + Titira - - - + + Bhuka - - - + + Lava - - - + +
Dhanva - - - + + Shuka - - - + +
Mruga Dwija - - - + +
VII Phala Varga
Jambira - - - + + Draksha + + - + +
Mathulunga + + + - + Amalaka + + + - -
Bilwa + + + - -
VIII Madhya Varga
Sura - + - + + Varuni - - + - -
IX Madhu Varga
Madhu + + + + +
X Mootra Varga
Gomutra - - - - +
XI Dugdha Varga
Aja Kshira - - - + +
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XII Ghrta Varga
Pathya Ahara C .S.189 S .S.190 A .H.191 Y.R.192 B.R.193
Purana sarpi - + - + + Ajasarpi - - - + +
XIII Krtanna Varga
Yusha + - + - - Yavagu + - - - -
Peya + - + - - Satthu - - + - - Varuni - - + - -
Pathya Vihara
Virechana + - - + + Swedana + - - + +
Dhoomapana + - - + + Prachardana - - - + +
Swapanam Diva - - - + + Table No.6
Apathya in Tamaka Swasa
Apathya Aahara I Shimbi Dhanya
Pathya Ahara C .S.189 S .S.190 A .H.191 Y.R.192 B.R.193
Nishpava + - - + - Masha + - - + - Thila + - - - -
Sarshapa - - - + +
II Shaaka Varga Kanda - - - + +
III Mamsa Varga Jalaja + - - - - Anupa + - - - + Pishita + - - - - Matsya - - - + +
IV Dadhi Varga Dadhi + - - - -
V Kshira Varga Kshira + - - + +
Mahisha Kshira + - - - -
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VI Grita Varga Pathya Ahara C .S.189 S .S.190 A .H.191 Y.R.192 B.R.193
Mahisha Gritha - - - + +
VII Krtanna Varga Tailabhrsta Nishpava - - - - +
Pistanna + - - - - Pinyaka + - - - -
Apathya Vihara Sheeta Snana + + + - -
Raja + + + + + Dhooma + + + + +
Anila + + + + + Vyayama Karma + + - - -
Bhara - + - - + Adhwa - + - - +
Vegaghata - + - - - Apatharpana + + - - - Rakta srava - - - - -
Pragvata - - - - - Marmaghata + - + + + Sooryatapa - - - - + Daurbalya + - - - -
Aanaha + - - - - Abhighata - + - - - Strigamana - + - - -
Vegavarodha-Mootra, Udgara, Chardi, Trushna,
Kasa
- + - - -
In a nutshell, the factors that help in maintenance of normalcy of Vata Dosha and
Kapha Dosha, both during the symptomatic and asymptomatic period are considered as
Pathya. Added to this, the factors that favour the normal physiological functioning of
Pranavaha srotas, is popularly known by the name Pathya.
In contrast to this, the factors either related to food or behavior that can affect the
balance of the Vata and Kapha Doshas are regarded as Apathya. Any factor that has
detrimental effect on the Pranavaha srotas is listed as Apathya. Strict observation of the
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Pathya and Apathya prevents an episode of the illness in patients who are asymptomatic.
Likewise, Pathya and Apathya have great influence in modifying the severity of the illness
during the acute attack of breathlessness.
Drug Review
Table -7 Internal medicine – ingredients of Brihat Katphaladi yoga194
Katphala Myrica esculenta 3 Parts
Poushkara / Pushkaramoola Inula racemosa 3 Parts
Sringi (Karkatasrinigi) Pistacia intergerrima 3 Parts
Musta Cyperus rotundus 3 Parts
Shati Hydychium spicatum 3 Parts
Shunti Zingibera officinale 1 Part
Pippali Piper longum 1 Part
Maricha Piper nigrum 1 Part
All the ingredients of Brihat Katphaladi Yoga are well identified and
collected from local area; good manufacturing practice will be followed for preparation.
Even though above yoga mentioned in “churna kalpana” for easy administration it is
tabulated after 3 times fortification. The prepared drug is preserved in glass jars to protect
the shelf life of the medicine. Later at the time of distribution requisite quantity of the
medicine is packed and given to patients. The individual components of the composition
are as follows under specified headings.
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1) Katphala - Myrica esculenta – 195-197
Prayojyanga Twak
Rasa Kashaya, tikta, katu
Guna Laghu, teekshna
Veerya Ushna
Vipaka Katu
Prabhava Sweda janaka, Shothaghna,
Doshagnata Kapha vata hara
Rogaghnata Swasa, Jwara
Chemical consttiuents Tannin, Saccharine, Salts
Prepared Medicines useful at Pranavaha Srotas
Brihat Katphaladi churna
2) Poushkara / Pushkaramoola - Inula racemosa198-200
Prayojyanga Moola,
Rasa Tikta, katu
Guna Laghu, teekshna
Veerya Ushna
Vipaka Katu
Prabhava Anulomaka, Uttejaka, Shothagna
Doshagnata Kapha vata shamaka
Rogaghnata Parshwa shoola, Swasa, Kasa, Arochaka, Shopha, Pandu
Chemical consttiuents Tridin, Glucosoide, Tannin, Calcium oxalate
Prepared Medicines useful at Pranavaha Srotas
Dashamoola Rasayana, Sringyadi Churna
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3) Sringi (Karkatasrinigi) - Pistacia intergerrima 201-203
Prayojyanga Kosha
Rasa Tikta, Kashaya
Guna Laghu, Rooksha
Veerya Ushna
Vipaka Katu
Prabhava Swasaghna, Balya, Kapha nissaraka
Doshagnata Kapha vata shamaka
Rogaghnata Swasa, Kasa, Hikka, Aruchi
Chemical constituents Crystalline hydrocarbon, Tannin, Essential oils
Prepared Medicines useful at Pranavaha Srotas
Brihat Katphaladi yoga
4) Musta - Cyperus rotundus 204-206
Prayojyanga Kanda,
Rasa Tikta, Katu, Kashaya
Guna Laghu, Rooksha
Veerya Sheeta
Vipaka Katu
Prabhava Deepana, Pachana, Grahi
Doshagnata Kapha pitta shamaka
Rogaghnata Aruchi, Amatisara
Chemical consttiuents Essential oils, Carbohydrate
Prepared Medicines useful at Pranavaha Srotas
Chyavanaprasha, Kantakaryava lehya
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5) Shati - Hydychium spicatum 207-209
Prayojyanga Kanda
Rasa Katu, Tikta, Kashaya
Guna Laghu, Teekshna
Veerya Ushna
Vipaka Katu
Prabhava Mootra janaka, Deepana, Swarya
Doshagnata Kapha vata hara
Rogaghnata Swasa, Kasa,
Chemical consttiuents Methyl parachamarin acitate
Prepared Medicines useful at Pranavaha Srotas
Agastya Hareetaki, Dashamoola Rasayana
6) Shunti - Zingibera officinale 210-212
Prayojyanga Kanda
Rasa Katu
Guna Laghu, Snigdha
Veerya Ushna
Vipaka Madhura
Prabhava Truptighna, Deepana, Vatanulomana
Doshagnata Kapha vata shamaka
Rogaghnata Swasa, Kasa, Pratishyaya,
Chemical consttiuents Camphene, Phellandrene, Zinguberine, Cinol, Borncol
Prepared Medicines useful at Pranavaha Srotas
Dashamoola Katurohinyadi Kashaya, Chyavanaprasaha
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7) Pippali - Piper longum 213-215
Prayojyanga Phala
Rasa Katu
Guna Laghu, Snigdha, Teekshna
Veerya Anushna sheeta
Vipaka Madhura
Prabhava Vrushya, Medhya, Agni vardhaka
Doshagnata Kapha vata hara
Rogaghnata Swasa, Kasa, Jwara
Chemical consttiuents Piparine, Resin,
Prepared Medicines useful at Pranavaha Srotas
Sitopladi churna, Haridra Khanda
8) Maricha -Piper nigrum 216-218
Prayojyanga Phala
Rasa Katu
Guna Laghu, Teekshna
Veerya Ushna
Vipaka Katu
Prabhava Agni deepaka, Kaphaghna
Doshagnata Kapha vata hara
Karma Swasa, Shoola, Krimi
Chemical consttiuents Piparine, Piparidine, Balmaric volatile essential oil
Prepared Medicines useful at Pranavaha Srotas
Vasarista, Kushmanda Rasayana
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Table – 8, Nitya Shodhana with Vyoshadi Gutika
Nitya Shodhana Vyoshadi Gutika Ingredients 219
Snaskrit Name Botanical Name Proportion
Shunti Zingibera officinale 1 part
Pippali Piper longum 1 part
Maricha Piper nigrum 1 part
Twak Cinnamomum zeylanicum 1 part
Patra ( Tejapatra ) Cinnamomum zeylanicum 1 part
Musta Cyperus rotundus 1 part
Ela Eletteria cardomum 1 part
Vidanga ( Vayu vidanga ): Embelica ribes 1 part
Amalaki Emblica officinalis 1 part
Abhaya Terminalia chebula 1 part
Mukulaka ( Danti ) Baliospermum montanum 20 parts
Trivrut Operealanta terpethum 80 parts
Sharkara Sugar 60 parts
All the ingredients of Vyoshadi Gutika are well identified and collected
from local area; good manufacturing practice will be followed for preparation. Vyoshadi
Gutika for easy administration is capsulated after preparation. The prepared drug is
preserved in glass jars to protect the shelf life of the medicine. Later at the time of
distribution requisite quantity of the medicine is packed and given to patients. The
individual components of the composition are as follows under specified headings.
1) Shunti - Zingibera officinale
2) Pippali - Piper longum
3) Maricha - Piper nigrum
4) Musta - Cyperus rotundus
- are detailed above when discussing the ingredients of Brihat Katphaladi yoga.
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5) Twak - Cinnamomum zeylanicum 220-222
Prayojyanga Twak
Rasa Katu
Guna Laghu, Rooksha, Teekshna
Veerya Ushna
Vipaka Katu
Prabhava Shukrala, Vrushya
Doshagnata Kapha Vata shamaka, Pitta vardhaka
Rogaghnata Mukha shosha, Trushna
Chemical consttiuents Cinnamic acid, Tannin,
Prepared Medicines useful at Pranavaha Srotas
Marichyadi Gutika, Talisadi churna
6) Patra ( Tejapatra ) - Cinnamomum zeylanicum 223-225
Prayojyanga Patra
Rasa Madhura
Guna Laghu, Picchila
Veerya Ushna
Vipaka -
Prabhava -
Doshagnata Kapha vata hara
Rogaghnata Aruchi, Peenasa, Arsha
Chemical consttiuents -
Prepared Medicines useful at Pranavaha Srotas
Dashamoola Hareetaki, Kushmanda Rasayana
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7) Ela - Eletteria cardomum 226-228
Prayojyanga Beeja
Rasa Katu, Madhura
Guna Laghu, Rooksha
Veerya Sheeta
Vipaka Madhura
Prabhava Mootrala, Vatanulomaka
Doshagnata Vata hara
Rogaghnata Swasa, Kasa, Arsha, Mootra kruchra
Chemical consttiuents Terpinyl acetate, Cineole, Terpincol
Prepared Medicines useful at Pranavaha Srotas
Kushmanda Rasayana, Dashamoola Hareetaki
8) Vidanga ( Vayu vidanga )- Embelica ribes 229-231
Prayojyanga Phala
Rasa Katu, Kashya
Guna Laghu, Rooksha, Teekshna
Veerya Ushna
Vipaka Katu
Prabhava Krimighna
Doshagnata Kapha vata shamaka
Rogaghnata Shoola, Adhmana, Udara, Krimi
Chemical consttiuents Embelic acid, Cbristernbine
Prepared Medicines useful at Pranavaha Srotas
Vyoshadi Gutika
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9) Amalaki - Emblica officinalis 232-234
Prayojyanga Phala
Rasa Madhura, Amla, Katu, Tikta, Kashaya
Guna Guru, Rooksha,
Veerya Sheeta
Vipaka Madhura
Prabhava Rasayana
Doshagnata Tridosha hara
Rogaghnata Raktapitta, Aruchi, Agnimandya
Chemical consttiuents Gallic acid, Eligic acid,
Prepared Medicines useful at Pranavaha Srotas
Chyavanaprasha, Chandramruta Rasayana, Agastya Hareetaki
10) Abhaya - Terminalia chebula 235-237
Prayojyanga Phala
Rasa Kashaya, Tikta, Katu, Madhura, Amla
Guna Laghu, Rooksha
Veerya Ushna
Vipaka Madhura
Prabhava Anulomaka, Mala shodhaka
Doshagnata Tridosha hara
Rogaghnata Swasa, Kasa,
Chemical consttiuents Tannic acid, Galic acid, Lucilage, Chebulimic acid
Prepared Medicines useful at Pranavaha Srotas
Agastya Rasayana, Pushkaramruta
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11) Mukulaka ( Danti ) - Baliospermum montanum 238-340
Prayojyanga moola
Rasa Katu
Guna Guru, Teekshna
Veerya ushna
Vipaka Katu
Prabhava Adhobhaga hara
Doshagnata kapha pitta hara
Rogaghnata shotha, Udara, Krimi
Chemical consttiuents Baliospermin, Montanine
Prepared Medicines useful at Pranavaha Srotas
Vyoshadi Gutika
12) Trivrut - Operealanta terpethum 241-243
Prayojyanga Moola
Rasa Tikta, Katu
Guna Laghu, Rooksha, Teekshna
Veerya Ushna
Vipaka Katu
Prabhava Sukha Virechaka
Doshagnata Kapha pitta hara
Rogaghnata Shotha, Udara
Chemical consttiuents � and � Turphethine
Prepared Medicines useful at Pranavaha Srotas
Haridra khanda
Chapter - 4
Methodology
Tamaka Swasa is a pranavaha sroto janya vikara, where cold, dust, smoke and
excessive work are the causative factors for it. The severity of the disease is seen during
conditions like meghavarana, sheeta rutu, sheeta sthana, and excessive intake of sheeta jala
and purva dishagata vayu according to Ayurveda. In most of atopic subject allergy out of
many factors including exercise, infection and emotional upsets provokes attacks of Tamaka
Swasa.
All age groups of people are prone to get this condition, but it is commonly seen in
early age groups, as Kapha is predominant and at the late ages as the Vata dominance. As this
disease is Kapha Vata pradhana, and Pitta sthana samudbhava, the general line of
management is tamaketu virechanam. Here Nitya shodhana protocol of this study relieves
avarodha of Vata by Kapha. Vyoshadi Gutika as a Nitya shodhana medicine mainly acts on
Kapha and Vata. Brihat Katphaladi yoga with its Vata Kapha shamaka dravyas acts on
Tamaka Swasa. It is necessary to discuss the materials and methods in detail at this juncture.
Materials and Methods
Method of Collection of data
1) Patients:
Patients suffering from Tamaka Swasa will be selected from department of
Kayachikitsa Post Graduation studies and Research OPD of D G Melmalgi Ayurvedic
medical college and Hospital by preset inclusion and exclusion criteria.
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2) Literary:
Literary aspect of study is collected from classical Ayurvedic and modern texts, which
is discussed widely in literary review.
3) Study design:
Simple random sampling technique - comparative clinical trial is adopted here under
two groups.
4) Sample size:
Minimum of 15 patients in each group irrespective of sex is under taken in the study.
5) Exclusion Criteria –
1. Patients suffering form any systemic or congenital diseases are excluded
because, it is very difficult to assess the disease condition with other
systemic disorders and congenital diseases associated.
2. History above 10 years of period are excluded because, commonly history
above 10 years are chronic asthmatic patients which falls under the COPD
conditions, difficult for treatment and also assessment.
3. Patient below 18 years and above 60 years are excluded because, study
restricted only to adults, the drug efficacy cannot be assessed in full length.
4. Status asthmatics are excluded because this condition is chronic and needs
hospitalization with supervision.
5. Pregnant and lactating women are excluded because; drug may affect the
foetus or lactating baby, through its placental barrier alkaloids. Even
though the composition is herbal and safe still they are excluded.
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6) Inclusion criteria –
1. Patients having stated lakshana as per Ayurvedic classics are included
because, they are the prime subjective parameters of assessment.
2. Patients between 18 to 60 years irrespective of sex are included because,
restriction of the study as the assessment of these groups are easy.
3. History below 10 years are included because, the disease said as kasta
sadhya from the Ayurvedic classics.
4. Shodhana Arha are included because, the drug chosen rapidly relieves the
Dosha accumulated in the body.
7) Criteria of Diagnosis
The signs and symptoms of Tamaka Swasa mentioned in the Ayurvedic texts and
objective investigations mentioned in contemporary texts are the criteria for the diagnosis.
8) Posology-
1) Brihat Katphaladi yoga – 3 gms /per day in divided doses
2) Vyoshadi Gutika – 500 mg daily morning at 6 AM
Anupana = Madhu
9) Study Duration:
14 days for each group
10) Follow up:
14 days for each group
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11) Assessment of Result
Results are assessed form subjective and objective parameters of base line data of
before and after treatment as discussed in the result section. The cumulative effect of the drug
over disease and the body are considered here.
12) Subjective parameters
As explained in classical Ayurvedic texts and modern texts the subjective
parameters are noted here under are vividly discussed in the literary review -
1. Teevra vega Swasa – Swasa krichrata (Dyspnonea)
2. Kasa (cough)
3. Duhkhena Kapha nissaranam (Expectoration)
4. Ghurghuratwam (Wheezing)
5. Peenasa (Coryza)
6. Kruchrena bhasate (difficulty in speech)
7. Kantodhwamsham (Hoarseness of voice)
8. Greevashirasangraha (Headache & Stiffness)
9. Urah Peeda (Chest Pain)
10. Shayane Swasa peedita (Discomfort at supine)
13) Objective Parameters
As explained in different texts the objective parameters are noted here under
are vividly discussed in the context of examination of patient in the same
chapter.
1. Peak expiratory flow rate
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2. Breath holding time
3. Absolute Eosinophil counts
4. Erythrocyte sedimentation rate
5. Haemoglobin percentage
14) Statistical analysis:
The parameters, Subjective and Objective parameters are tested with the paired, and
un -paired T-test and non parametric test used for the testing of hypothesis. If p<0.05, the test
is highly significant.
15) Examination of a Tamaka Swasa Patient vis-à-vis asthma
1) Demographic data
The patient identity is prime in diagnosing the disease as Ayurveda specifies the
Sadhya and Asadhya based on age and relative factors such as desha, Kala etc. thus Name,
Age, Gender, Occupation, Economical status, Birth place and Food habits are recorded in the
demographic data of the case sheet along with the consent signed.
2) Chief complaints (Subjective parameters) and Associated complaints
The symptoms enumerated in the classical textbooks and contemporary systems are
detailed for the studies are noticed here under the pre prescribed grades of declarations. The
detailed discussion is made in the literary review. The grades of observation are as follows.
Swasa kricchrata –
Teevra vega Swasa
0 – Normal - no symptoms
1 – Mild – breathless with activity, frequency 1 to 2 times/week
2 – Moderate – breathless with talking, frequency 2 to 4 times/week
3 – Severe – breathless at rest, frequency 4 to 6 times/week, limited
activity
Kasa 0 – Normal - no cough
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1 – Mild - morning bouts or after exercise - don’t disturb work
2 – Moderate - continuous cough during day and morning disturbing
work
3 – Severe - continuous and night cough disturb activities
Dukhen kapha
nissaranu
0 – Normal - no phlegm
1 – Mild - less than 2.5 ml/day without pain
2 – Moderate - 2.5 ml to 15 ml/day with mild pain
3 – Severe - 15 to 25 ml/day with pain
Ghurghurtwam
0 – Normal - no wheezing
1 – Mild - moderate wheezing at mid to end respiration, brief, not more
than 1 to 2 times/week
2 – Moderate - loud wheeze through out expiration, not more than 2 to
4 times/week
3 – Severe - loud inspiration and expiration wheeze, more than 4 to 6
times/week
Peenasa
0 – Normal - no common cold & cough
1 – Mild - initially present or occasionally
2 – Moderate - continuous day with cough
3 – Severe - continuous day and night
Krucchana bhasate
0 – Normal - difficult to speak
1 – Mild - able to speak in sentences
2 – Moderate - able to speak in phrases
3 – Severe - able to speak in words
Kantodwamsa
0 – Normal - no hoarseness of voice
1 – Mild - 0 or 1 bout while speaking sentence
2 – Moderate - 1 or 2 bout while speaking phrase
3 – Severe - associated with words and phrase
Greeva shira
samgrah
0 – Normal – no symptoms
1 – Mild - occasionally
2 – Moderate - 1 to 2 times in a week.
3 – Severe - 2 to 4 times or often
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Uraha peeda
0 – Normal - no chest tightness
1 – Mild - able to tolerate the tight or pain
2 – Moderate - Persists during cough + mild differs
3 – Severe - feels difficulty to tolerate pain and tightness
Shayanasy Swasa
peedita
0 – Normal – no discomfort
1 – Mild - < 1 or 2 time/month
2 – Moderate - 2 time/week
3 – Severe - > 3 or frequently
3) History of present illness
At the history of present illness, Mode of onset, Course, Frequency of attack, Duration
of attack, Mode of progress, Periodicity, Preceded by what factors, Sputum, Aggravating
factors and Comfort posture at attack are discussed as listed in the annex-1 (Case sheet).
4) Personal history
The personal history is discussed as - Food habits with reference to taste, Taste
preferred, Agni, Kosta, Nidra, Addictions, Bowel habits, Menstrual History, Family history –
Specify if any has the same disease, Treatment history and History of past illness.
5) Examination of Patients (RS) 244, 245
The Sequence of the Respiratory Examination done in two positions 1) Patient supine
or seated, examining anteriorly and Patient in sitting position, examining posteriorly along
with the standard inspection, palpation, percussion and auscultation. Apart from these under
the headings of Darshana, Sparshana Akotana, shravana are sub classified with symptoms for
convenience of study. They are as follows –
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Patient supine or seated, examining anteriorly
Inspection:
Respiratory rate, depth
Muscle use
Respiratory distress
Chest wall anomalies
Palpation:
Tracheal position
Thoracic excursion
Abdominal, costal paradox
Percussion
Auscultation
Patient in sitting position, examining posteriorly
Inspection:
Anomalies of spine and back
Palpation:
Thoracic excursion
Percussion:
Diaphragmatic excursion
Auscultation:
Breath sounds, adventitious sounds
Transmission of sounds
Darshana (Inspection) Shape
Movement
Resp. Rhythm
Respiration
Accessory muscles
Inter coastal spaces
Visible veins
Venous pulses
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Sparshana (Palpation) Tracheal position
Pain / Tenderness
Swelling
Vocal fremitus
Shape
Lymph nodes
Akotana (percussion) As dull, resonant etc
Shravana (Auscultation) Type of breath
Vocal resonance
Respiratory Sounds
6) Ayurvedic examination
In Ayurvedic examination Dosha Vruddhi, Kshaya lakshanas are examined along with
the Dasha vidha and Astastana pareeksha. The emphasis of the Agni is made specially. The
srotas is important to examine for the disease diagnosis, as it is one of the Samprapti ghataka.
Thus the Pranavaha, Annavaha and Udakavaha srotases are examined with their vitiated
symptoms.
7) Observation of Pancha Lakshana Nidana
The pancha lakshana Nidana i.e. Nidana, Poorva roopa, Lakshana along with the
Upashaya and nupashaya are examined according to the classical references as detailed in the
annex-1.
8) Investigations and Objective parameters
The investigations and objective parameters considered in the study are –
a) Breath holding time
b) Peak expiratory flow rate
c) Absolute eosinophilic count
d) Erythrocytes sedimentation rate
e) Haemoglobin %
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a) Breath holding time 246
Breath in can be held for variable period of time by different individuals depending
upon the functional states of lungs development of respiratory muscles practice, age, and sex
etc. The normal BHT after deep inspiration may vary from 40 seconds to over a minute. The
BHT decreases in many diseases such as chronic bronchitis emphysema, asthma, etc. of lung
disease.
Procedure:
Breath holding time (BHT) is a simple test, in which, ask the patient to take a deep
breath and count the time in seconds.
Grading of BHT
BHT Grades are declared for the sake of final assessment is as follows.
Grade 0 30 and above
Grade 1 30 to 20
Grade 2 20 to 10
Grade 3 10 and below
b) Peak expiratory flow rate 247
The Wright’s peak flow meter, introduced in 1959 is a simple, portable device. PEFR
has a very good correlation with FEVI and for measuring the ventilatory function of lungs.
This simple objective measurement of lung function helps detecting early deterioration of
lung function. Measurement of PEFR is valuable in medical care settings to measure response
to therapy during an acute exacerbation. Out of lung function, the PEFR is more useful.
Procedure
Step 1) ask patient to hold the PEFR in position
Step 2) let the patient take a deep breath in
Methodology of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
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Step 3) patient keep the PEFR instrument in the mouth with out any leakage of
air from sides in to the flow meter with a sharp blast
Step 4) the movement of the needle on the dial indicates the PEER in
liters/minute, which is to be noted
Taken 3 readings at one minute intervals and recorded the average of higher readings
brought to the needle back to zero by pressing the button located near the mouth piece.
Normal Range of PEFR is 350-500liters/minute.
Grading of PEFR
PEFR Grades are declared for the sake of final assessment is as follows.
Grade 0 350 and above
Grade 1 350 to 250
Grade 2 250 to 150
Grade 3 150 and below
c) Absolute Eosinophilic count 248
Eosinophils are important in the defence against parasites, worms, and to any
infection. Because they are also sensitive to circulating allergens (materials that trigger
allergies), Eosinophils increase in number during allergic reactions as well. Thus the absolute
Eosinophils count is a good parameter to study the Asthma. Normal range of AEC is 40-440.
Grading of AEC
AEC Grades are declared for the sake of final assessment is as follows.
Grade 0 240 and below
Grade 1 240 to 440
Grade 2 440 to 640
Grade 3 640 and above
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d) Erythrocytes sedimentation rate 249
Westergren’s method (pipette method) Erythrocytes sedimentation rate measures in
the graduated tubes facilitate to understand possible presence of organic disease. It is
universally accepted that it is a good prognostic method in clinical laboratory.
Procedure:
Steps 1) draw the sufficient blood sample from patient vein
Step 2) add anti coagulant to the blood
Steps 3) suck the blood in to the ESR tube
Step 4) note the point of sedimentation on graduated tube
e) Haemoglobin % 250
Hemoglobin is responsible for the cell's ability to transport oxygen and carbon
dioxide. The haemoglobin content of whole blood is reported in terms of grams of Hb per 100
ml of whole blood (g/dl). Normal ranges are 14-18 g/dl in males and 12-16 g/dl in females.
This is estimated with the Shali’s method in general, which will show the Hb% in grams/ dl.
9) Differential diagnosis
It is observed that the Tamaka Swasa for the differences of diagnosis as told in
Ayurveda texts viz. santamaka and pratamaka with its stipulated symptoms.
10) Result declaration
Result declaration is made upon the cumulative assessment of the parameters. Out of
Subjective parameters, Teevravega Swasa, Kasa and Urah peeda were considered. At the
objective parameters BHT, PEFR and AEC are considered. The Result is declared as Well
Responded, Moderately Responded, Poorly Responded and Not Responded categories. The
discontinued patients were not considered for the result declaration.
Chapter - 5
Results
Present study registers 35 patients, out of 58 approached patients. Out of this, 5
patients were discontinued hence their data has not been included in the assessment. The
remaining 35 patients of Tamaka Swasa viz. Asthma, fulfilling the criteria of diagnosis
and inclusive criteria were included in the study, fewer than two groups as discussed in
the Methodology, distributed patients in Group-A are 15 and Group-B are 15.
All the patients were examined before and after the trail, according to the case
sheet format given in the annex. Both the subjective and objective criteria were recorded.
The data recorded are presented under the following headings.
A. Demographic data
B. Evaluating disease Data and
C. Statistical analysis of the clinical and objective parameters
Result of the Brihat Katphaldi Yoga and Vyoshadi Gutika in Tamaka
Swasa viz. asthma are group wise dealt at every event.
A) Demographic data:
The details of Age, Gender, Religion, and Occupation etc. of the 15 patients in
each group are as follows.
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 69
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 70
Table - 9
Table showing the demographic data of Group -A
S.No OPD Age Gender Religion Occupation Economical status
Food habits
Result
1 3803 38 Female Hindu Sedentary HM Veg MR 2 3876 53 Female Hindu Active High Mix PR 3 4861 42 Male Hindu Active HM Mix PR 4 1299 35 Male Hindu Labor Poor Veg WR 5 1329 47 Female Hindu Sedentary Mid Veg MR 6 1347 27 Male Hindu Labor Poor Mix PR 7 1353 49 Male Hindu Active Mid Veg MR 8 1399 31 Male Hindu Active Mid Mix PR 9 1401 56 Female Hindu Active Mid Veg WR 10 1421 40 Female Muslim Labor Poor Mix PR 11 1423 57 Male Hindu Sedentary Mid Veg PR 12 1426 59 Male Hindu Active Mid Veg PR 13 1427 28 Male Hindu Active Poor Veg MR 14 1430 42 Female Muslim Active Mid Mix NR 15 1431 56 Male Hindu Sedentary Mid Veg PR
Table - 10
Table showing the demographic data of Group -B
S.No OPD Age Gender Religion Occupation Economical status
Food habits
Result
1 4146 45 Male Hindu Active Mid Mix MR 2 4163 36 Male Hindu Active Mid Veg MR 3 1300 42 Female Hindu Sedentary HM Veg NR 4 1328 56 Male Hindu Labor Poor Veg NR 5 1330 41 Male Hindu Active HM Mix WR 6 1348 40 Male Muslim Labor Poor Mix PR 7 1349 53 Female Hindu Sedentary Mid Veg PR 8 1354 45 Female Hindu Active Mid Veg PR 9 1400 47 Male Hindu Active Poor Veg WR 10 1422 51 Male Hindu Sedentary Mid Veg PR 11 1424 45 Female Hindu Labor Poor Mix PR 12 1425 56 Female Hindu Labor Poor Veg MR 13 1428 25 Male Hindu Active Poor Mix NR 14 1929 32 Male Hindu Labor Mid Veg MR 15 1932 29 Male Muslim Active Mid Mix WR
HM = Higher Middle, Mid = Middle class, High = Higher class,
Veg = Vegetarian, Mix = Mixed diet, WR = well Responded, MR = Moderately
Responded, PR = Poorly Responded, NR = Not Responded
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 71
A1) distribution of patients by Age
An interval of 10 has considered from the ages 20 to 60 as discussed in the
methods. In the study it is revealed that allergy is continued from the ages of 20 onwards
and as age advances the samples are settled. A wide distribution of the disease is
observed in the 40-50 as 10 patients and 50-60- as 9 patients in the study.
Table- 11 Distribution of patients by Age- gender in Groups – A & B
Group –A Group -B Total patients Age
Mal
e
%
Fem
ale
%
Mal
e
%
Fem
ale
%
Num
ber
%
20-30 2 13.3 0 0 2 13.3 0 0 4 13.4
30-40 2 13.3 2 13.3 3 20 0 0 7 23.3
40-50 2 13.4 2 13.3 3 20 3 20 10 33.3
50-60 3 20 2 13.4 2 13.3 2 13.4 9 30
Total 9 60 6 40 10 66.6 5 33.4 30 100
Table- 12
Results of Patients by Age in Group - A
Age
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oorl
y R
espo
nded
% N
ot
Res
pond
ed
%
20-30 2 13.3 0 0 1 6.6 1 6.7 0 0
30-40 4 26.6 1 6.7 1 6.6 2 13.4 0 0
40-50 4 26.6 0 0 2 13.4 1 6.7 1 6.6
50-60 5 33.3 1 6.7 0 0 4 26.6 0 0
Total 15 100 2 13.4 4 26.6 8 53.4 1 6.6
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 72
Table- 13
Results of patients by Age in Group - B
Age
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oorl
y R
espo
nded
% N
ot
Res
pond
ed
%
20-30 2 13.4 1 6.6 0 0 0 0 1 6.6
30-40 3 20 0 0 2 13.4 1 6.6 0 0
40-50 6 40 2 13.4 1 6.6 2 13.4 1 6.7
50-60 4 26.6 0 0 1 6.6 2 13.4 1 6.7
Total 15 100 3 20 4 26.6 5 33.4 3 20
A2) distribution of patients by Gender
Table- 14
Results of patients by Gender in Group - A
Age
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oorl
y R
espo
nded
% N
ot
Res
pond
ed
%
Male 9 60 1 6.7 2 13.3 6 40 0 0
Female 6 40 1 6.7 2 13.3 2 13.4 1 6.6
Total 15 100 2 13.4 4 26.6 8 53.4 1 6.6
The results in the group-A as depicted in the table are encouraging. Here we
observe an over all well responded 2 patients with moderately responded 4 patients out of
15 patients in the group. A maximum 8 patients are exhibited with poor response as par
the gender differentiation.
Table- 15
Results of patients by Gender in Group - B
Age
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oorl
y R
espo
nded
% N
ot
Res
pond
ed
%
Male 10 66.6 3 20 3 20 2 13.4 2 13.4
Female 5 33.4 0 0 1 6.6 3 20 1 6.6
Total 15 100 3 20 4 26.6 5 33.4 3 20
The results in the group-B as depicted in the table are encouraging. Here we
observe an over all well responded 3 patients with moderately responded 4 patients out of
15 patients in the group. A maximum 5 patients are exhibited with poor response and 3
patients in the not responded as par the gender differentiation.
Graph – 1
DISTRIBUTION OF PATIENTS BY AGE – GENDER IN GROUPS – A & B - PICTORIAL PRESENTATION
Re
Age- Gender Distribution of Tamaka Swasa Patients
0
2 2 22
3 3
2
0 0
3
2
3
2 22
0
1
2
3
4
Gr-A Male 2 2 2 3Female 0 2 2 2Gr-B Male 2 3 3 2Gr-B female 0 0 3 2
20-30 30-40 40-50 50-60
sults of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 73
A3) distribution of patients by Religion
Table – 16 Distribution of patients by Religion in Groups – A & B
Group –A Group -B Total patients Religion
Male % Female % Male % Female % Number %
Hindu 9 60 4 26.6 8 53.3 5 33.4 26 86.7
Muslim 0 0 2 13.4 2 13.3 0 0 4 13.3
Christian 0 0 0 0 0 0 0 0 0 0
Others 0 0 0 0 0 0 0 0 0 0
Total 9 6 10 5 30 100
The distribution of demographic data under the hedging in both Groups are as
depicted in the table are encouraging. Here we observe an over all Hindu patients with
Muslim 4 patients out of 30 patients.
Graph – 2
Distribution of patients by Religion in Tamaka Swasa
Results of Br
Christian Muslim Others
ihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 74
Distribution of patients by Religion in Tamaka Swasa
0%
Hindu86.67%
13.33% 0%
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 75
Table- 17
Results of patients by Religion in group - A
Religion
T
otal
no
of
pati
ents
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oorl
y R
espo
nded
% N
ot
Res
pond
ed
%
Hindu 13 86.6 2 13.4 4 26.6 7 46.7 0 0
Muslim 2 13.4 0 0 0 0 1 6.7 1 6.6
Christian 0 0 0 0 0 0 0 0 0 0
Others 0 0 0 0 0 0 0 0 0 0
Total 15 100 2 4 8 1
The results in the Group –A of Religion category as depicted in the table are
encouraging. Here we observe an over all well responded 2 patients with moderately
responded 4 patients out of 15 patients in the group. A maximum 8 patients are exhibited
as per the religion differentiation.
Table- 18
Results of patients by Religion in group - B
Religion
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oor
Res
pond
ed
% N
ot
Res
pond
ed
%
Hindu 13 86.6 2 13.4 4 26.6 4 26.7 3 20
Muslim 2 13.4 1 6.6 0 0 1 6.7 0 0
Christian 0 0 0 0 0 0 0 0 0 0
Others 0 0 0 0 0 0 0 0 0 0
Total 15 100 3 4 5 3
The results in the Group –B of Religion category as depicted in the table are
encouraging. Here we observe an over all well responded 3 patients with moderately
responded 4 patients out of 15 patients in the group. A maximum 5 patients are exhibited
with poor response and 3 patients in the not responded as per the religion differentiation.
A4) Distribution of patients by Occupation
Table –19
Distribution of patients by Occupation in Groups – A & B
Group –A Group -B Total patients Occupation
Number % Number % Number %
Sedentary 4 26.6 3 20.0 7 23.4
Active 8 53.4 7 46.6 15 50
Labour 3 20.0 5 33.4 8 26.6
Total 15 100 15 100 30 100
Graph - 3 DISTRIBUTION OF PATIENTS BY OCCUPATION
Results of B
PATIENTS BY OCCUPATION
Active50.00%
Sedentary23.33%Labour
26.67%
rihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 76
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 77
Table - 20
Results of patients by occupation in Group -A O
ccup
atio
n
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oor
R
espo
nded
%
Not
Res
pond
ed
%
Sedentary 4 26.6 0 0 2 13.4 2 13.3 0 0
Active 8 53.4 1 6.6 2 13.3 4 26.6 1 6.6
Labour 3 20 1 6.6 0 0 2 13.3 0 0
Total 15 100 2 13.3 4 26.6 8 53.4 1 6.6
The results in the Group –A of occupation category as depicted in the table are
encouraging. Here we observe an over all well responded 2 patients with moderately
responded 4 patients out of 15 patients in the group. A maximum 8 patients are exhibited
as per the occupation differentiation as tabulated below.
Table- 21
Results of patients by occupation in Group -B
Occ
upat
ion
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oor
R
espo
nded
% N
ot
Res
pond
ed
%
Sedentary 3 20 0 0 0 0 2 13.4 1 6.6
Active 7 46.6 3 20 2 13.3 1 6.6 1 6.6
Labour 5 33.4 0 0 2 13.3 2 13.4 1 6.6
Total 15 100 3 20 4 26.6 5 33.4 3 20
The results in the Group –B of occupation category as depicted in the table are
encouraging. Here we observe an over all well responded 3 patients with moderately
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 78
responded 4 patients out of 15 patients in the group. A maximum 5 patients are exhibited
with poor response and 3 patients in the not responded as per the occupation
differentiation as tabulated above.
A5) Distribution of patients by Economical status
Table –22 Distribution of patients by Economical status in Groups – A & B
Group –A Group -B Total patients Economical status
Number % Number % Number %
Poor 4 26.6 6 40.0 10 33.3
Middle 8 53.4 7 46.6 15 50
Higher Middle 2 13.4 2 13.4 4 13.4
Higher 1 6.6 0 0 1 3.3
Total 15 100 15 100 30 100
Table- 23
Results of patients by Economic status in Group -A
Eco
nom
ic s
tatu
s
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oor
R
espo
nded
% N
ot
Res
pond
ed
%
Poor 4 26.6 1 6.7 1 6.6 2 13.4 0 0
Middle 8 53.4 1 6.7 2 13.4 4 26.6 1 6.6
Higher
Middle 2 13.4 0 0 1 6.6 1 6.7 0 0
Higher 1 6.6 0 0 0 0 1 6.7 0 0
Total 15 100 2 13.4 4 26.6 8 53.4 1 6.6
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 79
The results in the Group –A of Economical status category as depicted in the table
are encouraging. Here we observe an over all well responded 2 patients with moderately
responded 4 patients out of 15 patients in the group. A maximum 8 patients are exhibited
as per the Economical status differentiation.
Table – 24
Results of patients by Economic status in Group -B
Eco
nom
ic
sta
tus
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oor
R
espo
nded
% N
ot
Res
pond
ed
%
Poor 6 40 1 6.7 1 6.7 2 13.4 2 13.4
Middle 7 46.6 1 6.7 3 20 3 20 0 0
Higher
Middle 2 13.4 1 6.6 0 0 0 0 1 6.6
Higher 0 0 0 0 0 0 0 0 0 0
Total 15 100 3 20 4 26.6 5 33.4 3 20
The results in the Group –B of Economical status category as depicted in the table
are encouraging. Here we observe an over all well responded 3 patients with moderately
responded 4 patients out of 15 patients in the group. A maximum 5 patients are exhibited
with poor response and 3 patients in the not responded as per the Economical status
differentiation.
The graphical representation of the economical status is depicted as under.
Graph- 4
DISTRIBUTION OF PATIENTS BY ECONOMIC STATUS
A6) Distrib
Food habi
Vegetarian
Mixed diet
Total
The
groups for
under.
Results of Br
4
8
2
1
6
7
2
00
1
2
3
4
5
6
7
8
9
Poor Middle Higher Middle HigherResult by economical statusPatients
Group_AGroup_B
ution of patients by Food Habits
Table - 25
Distribution of patients by Food Habits in Group – A & B
Group –A Group -B Total patients ts
Number % Number % Number %
9 60 9 60 18 60
6 40 6 40 12 40
15 100 15 100 30 100
results in the Group –A & B of food habits show 3: 2 distributions in both
the vegetarian to mixed diet consumers. The graphic representation is as
ihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 80
Graph – 5
Distribution of patients by food habits in Tamaka Swasa
B) Data
B1) Dis
A
paramet
Bronchi
most co
Kruchra
patients
(Expect
Peeda (
bhasate
Results o
0 2 4 6 8 10
Vegetarian
Mixed diet
Distribution of patients by diet in Tamaka Swasa
Group-BGroup-A
related to the disease.
tribution of patients by presenting complaints
s explained in the literary review, the symptoms that are taken as subjective
ers are evaluated at this study under the heading of Tamaka Swasa vis-à-vis
al Asthma with the presenting complaints are put forth here. The first and fore
mplaint in Tamaka Swasa in both groups are Teevra vega Swasa – Swasa
ta (Dyspnonea) Ghurghuratwam (Wheezing) with all patients involved. 14
of each group are included with the Duhkhena Kapha nissaranam
oration) and Kasa (cough). Later to that the symptoms Peenasa (Coryza), Urah
Chest Pain), Shayane Swasa peedita (Discomfort at supine) and Kruchrena
(difficulty in speech) are also seen enlisted in the table below.
f Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 81
Table-26
Patients enlisted by presenting complaints in Group –A & B Presenting complaints Group – A Group –B
Patients Percentage Patients Percentage
Teevra vega Swasa (Dyspnonea)
15 100 15 100
Kasa (cough) 14 93.3 14 93.3
Duhkhena Kapha nissaranam (Expectoration)
14 93.3 14 93.3
Ghurghuratwam (Wheezing)
15 100 15 100
Peenasa (Coryza) 13 86.6 12 80
Kruchrena bhashate (difficulty in speech)
10 66.6 8 53.3
Kantodhwamsham (Hoarseness of voice)
5 33.3 4 26.6
Greevashirasangraha (Headache & Stiffness)
8 53.3 9 60
Urah Peeda (Chest Pain) 11 73.3 10 66.6
Shayane Swasa peedita (Discomfort at supine)
12 80 11 73.3
Graph – 6 Graphical presentation of patients by presenting complaints in Group – A & B
Results of Br
Distribution by Presenting Complaints
15
14
13
15
13
10
5
8
11
12
8
9
10
11
1413
15
15
4
12
0 2 4 6 8 10 12 14 16
Dyspnonea
Cough
Expectoration
W heezing
Coryza
Difficulty in speech
Hoarseness of voice
Headache & Stiffness
Chest Pain
Discomfort at supine
ihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 82
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 83
B2) Distribution of patients by Associated features
Table – 27
Distribution of patients by Associated features
Group – A Group –B
Patients Percentage Patients Percentage
Anidra (disturbed sleep) 8 53.3 6 40
Pratamyati or
Bhrushamarta (distressed) 3 20 2 13.3
Aruchi (Anorexia) 4 26.6 4 26.6
Vishukasyata (Dryness of mouth)
6 40 5 33.3
Lalata sweda (sweat over forehead)
4 26.6 3 20
Trushna (Thirst) 4 26.6 5 33.3
Angamarda (Malaise) 7 46.6 9 60
Kampa (Tremors) 1 6.6 0 0
Jwara (fever) 2 13.3 2 13.3
Pramoha (fainting) 0 0 0 0
Vamathu (nausea) 2 13.3 1 6.6
Muhur Swasa (frequent respiration)
8 53.3 6 40
Muhuchaiva dhamyati (puts all effort to breath)
4 26.6 3 20
Muhur Swasa along with Anidra and Angamarda are the major associated
symptoms observed in both groups. Pamoha and Kampa are the symptoms seldom
witnessed. Other wise all symptoms are some or the other time expressed by the patients.
All the observations pertained to the both groups are enlisted in the above table. The
pictorial expression is as follows below.
Graph – 7
Graphical presentation of patients by Associated features in Group – A & B
B3) Dis
A
groups.
response
Mode of
on set
Gradual
Sudden
Total
Results o
tribution of patients by mode of on set
s the mode of onset is observed more gradual onset patients are listed in both
In this study sudden onset patients express only response but not a maximum
to the management, enlisted below.
Table - 28 Results of patients by mode of on set group -A
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oor
R
espo
nded
% N
ot
Res
pond
ed
%
11 73.4 2 13.4 4 26.6 4 26.7 1 6.6
4 26.6 0 0 0 0 4 26.7 0 0
30 100 2 13.4 4 26.6 8 53.4 1 6.6
Distribution by Associated Complaints
8
34
6
4 4
7
12
0
2
8
45
0
2
01
6
32
45
6
9
3
0123456789
10
Anidra
Pratam
yati o
r Bhru
sham
artaAru
chi
Vishuka
syata
Lalata
swed
a
Trush
na
Angamard
a
Kampa
Jwara
Pramoh
a
Vamath
u
Muhur Swasa
Muhuchaiv
a dham
yati
f Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 84
Table- 29
Results of patients by mode of on set group -B
Mode
of
on set
Tot
al n
o of
pa
tien
ts
% W
ell
Res
pond
ed
%
Mod
erat
ely
Res
pond
ed
% P
oor
R
espo
nded
% N
ot
Res
pond
ed
%
Gradual 12 80 3 20 4 26.6 3 20 2 13.3
Sudden 3 20 0 0 0 0 2 13.4 1 6.6
Total 15 100 3 20 4 26.6 5 33.4 3 20
Graph – 8
Graphical presentation of patients by Mode of onset in Group – A & B
Resu
lts of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 85
Distribution by Associated Complaints
11
43
12
0
2
4
6
8
10
12
14
Gradual Sudden
B4) Distribution of patients by course
Table- 30
Distribution of patients by course of on set groups A & B
Group – A Group –B
Patients Percentage Patients Percentage
Episodic 8 53.4 10 66.6
Continuous 4 26.6 3 20
Initially episodic 3 20 2 13.4
Total 15 100 15 100
Graph – 9
Graphical presentation of patients distribution by course of onset in Group – A & B
Results o
I
initially
Graph.
Patients distribution by course of onset in Group – A & B
8
433
2
10
0
2
4
6
8
10
12
Episodic Continuous Initially episodic
Group-AGroup-B
f Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 86
t is observed that people of episodic are more than that of either continuous or
episodic patients in both groups of the study as enlisted and expressed in the
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 87
B5) Distribution of patients by frequency of attack
Table - 31
Distribution of patients by frequency of attack in Group – A & B
Group – A Group –B
Patients Percentage Patients Percentage
Few hours 1 6.6 1 6.6
Few weeks 4 26.6 5 33.3
Few days 10 66.6 9 60
Total 15 100 15 100
B6) Distribution of patients by duration of attack
Table – 32
Distribution of patients by duration of attack in Group – A & B
Group – A Group –B
Patients Percentage Patients Percentage
Continuous 2 13.3 2 13.3
Intermittent 7 46.6 6 40
Subsides with medication 6 40 7 46.6
Total 15 100 15 100
The listed tables are expressive of the contents. In this B5 and B6 tables 31 and 32
it is expressed that the frequency and duration of the attacks at the time of observations
made. 60 % of patients noticed that the attack is of few hours and subsides with
medication and appears intermittently in 40% of each category. Thus the statements
drawn at the observations are supportive to the pathogenesis of the disease Tamaka
Swasa.
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 88
B7) Distribution of patients by mode of progress
Table – 33 Distribution of patients by mode of progress in Group – A & B
Group – A Group –B
Patients Percentage Patients Percentage
Typical 6 40 5 33.3
Rapid 3 20 3 20
Long term progress 6 40 7 46.6
Total 15 100 15 100
B8) Distribution of patients by periodicity
Table – 34 Distribution of patients by periodicity in Group – A & B
Group – A Group –B
Patients Percentage Patients Percentage
Seasonal 4 26.6 3 20
Irregular 9 60 9 60
Permanent 2 13.3 3 20
Total 15 100 15 100
B9) Distribution of patients by preceding factors
Table – 35
Distribution of patients by preceding factors in Group – A & B Group – A Group –B
Patients Percentage Patients Percentage
Sneezing 5 33.3 4 26.6
Nasal irritation 2 13.3 3 20
Cough with Nasal irritation 8 53.3 8 53.3
Total 15 100 15 100
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 89
The listed tables are expressive of the contents. In this B7 to B9 tables 33 to 35 it
is expressed that the typical progress in all groups, irregular periodicity and cough and
sneezing as precipitating factors of the Tamaka Swasa. Thus the statements drawn at the
observations are supportive to the pathogenesis of the disease Tamaka Swasa.
B10) Distribution of patients by aggravating factors
Table – 36 Distribution of patients by aggravating factors in Group – A & B
Group – A Group –B
Patients Percentage Patients Percentage
Dust 4 26.6 3 20
Smoke 2 13.3 2 13.3
Both of above 9 60 10 66.6
Total 15 100 15 100
B11) Distribution of patients by comfort posture at attack
Table – 37 Distribution of patients by comfort posture at attack in Group – A & B
Group – A Group –B
Patients Percentage Patients Percentage
Sitting 8 53.3 6 40
Lying 1 6.6 2 13.3
Sitting & Forward bending 6 40 7 46.6
Total 15 100 15 100
The listed tables are expressive of the contents. In this B10 and B11 tables 36 and
37 it is expressed that the dust and smoke are the aggravating factors and where in the
sitting posture offers the comfort to the patients of Tamaka Swasa. Thus the statements
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 90
drawn at the observations are supportive to the pathogenesis of the disease Tamaka
Swasa.
B12) Distribution of patients by Agni
Table – 38
Distribution of patients by Agni in Group – A & B Group – A Group –B
Patients Percentage Patients Percentage
Samagni 4 26.6 2 13.3
Vishamagni 4 26.6 4 26.6
Mandagni 7 46.6 9 60
Total 15 100 15 100
B13) Distribution of patients by bowel habits
Table – 39 Distribution of patients by bowel habits in Group – A & B
Group – A Group –B
Patients Percentage Patients Percentage
Constipation 5 33.3 6 40
Loose 0 0 0 0
Normal 10 66.6 9 60
Total 15 100 15 100
The listed tables are expressive of the contents. In this B12 and B13 tables 38 and
39 it is expressed that the Mandagni patients are predominantly susceptible for Tamaka
Swasa along with normal bowel habits. Thus the statements drawn at the observations are
supportive to the pathogenesis of the disease Tamaka Swasa.
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 91
B14) Distribution of patients by Addiction
Table – 40 Distribution of patients by Addiction in Group – A & B
Group – A Group –B
Patients Percentage Patients Percentage
Tobacco 3 20 2 13.3
Alcohol 0 0 1 6.6
Alcohol + Tobacco 3 20 4 26.6
Drugs 0 0 0 0
Total 6 40 7 46.6
The listed table above expressive of the contents. In this B14 of table 40, it is
expressed that the additions are the aggravating factors in which alcohol and tobacco-
consuming patients of male category are recorded. Thus the statements drawn at the
observations are supportive to the pathogenesis of the disease Tamaka Swasa.
B15) Distribution of patients by Prakruti
Table – 41
Distribution of patients by Prakruti in Group – A & B Group – A Group –B
Patients Percentage Patients Percentage
Vata 1 6.6 1 6.6
Pitta 0 0 0 0
Kapha 1 6.6 0 0
Vata Pitta 2 13.3 3 20
Vata Kapha 8 53.3 9 60
Pitta Kapha 3 20 2 13.3
Tridosha 0 0 0 0
Total 15 100 15 100
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 92
The listed table above expressive of the contents. In this B15 of table 41, it is
expressed that the prakruti impact over the Tamaka Swasa. In which Vata Kapha patients
of category are recorded maximum. Thus the statements drawn at the observations are
supportive to the pathogenesis of the disease Tamaka Swasa.
B16) Distribution of patients by Dosha Vruddhi
Table –42 Distribution of patients by Dosha Vruddhi
Dosha Vruddhi Group – A Group –B
Patients Percentage Patients Percentage
Karshya 3 20 3 20
Karshnya 4 26.6 5 33.3
Ushna kamitwa 10 66.6 11 73.3
Kampa 2 13.3 1 6.6
Anaha 3 20 2 13.3
Shakrudgraha 1 6.6 2 13.3
Balabhrmsha 2 13.3 0 0
Nidrabhramsha 10 66.6 9 53.3
Pralapa 0 0 0 0
Vat
a
Bhrama 0 0 0 0
Peeta mootrata 0 0 0 0
Peetanetra 0 0 0 0
Peetavit 0 0 0 0
Peetatwak 0 0 0 0
Adhikshudha 3 20 1 6.6
Pit
ta
Adhidaha 0 0 0 0
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 93
Dosha Vruddhi Group – A Group –B
Patients Percentage Patients Percentage
Agni sadana 5 33.3 6 40
Praseka 3 20 3 20
Alasya 6 40 7 46.6
Swetangata 5 33.3 2 13.3
Sheetangata 10 66.6 11 73.3
Gowrava 7 46.6 5 33.3
Slathangata 0 0 0 0
Swasa 15 100 15 100
Kasa 14 93.3 14 93.3
Kap
ha
Atinidra 0 0 0 0
The listed table above expressive of the contents. In this B16 of table 42, it is
expressed that the Dosha vruddhi impact over the Tamaka Swasa. In which Vata lakshana
patients of category are recorded maximum with Ushna kamitwa and Nidra bhramsha. Pitta
predominant symptoms noted are Adhika kshudha. Kapha related symptom Swasa is the
pratyatma niyata lakshana seen in all patients along with Kasa, Sheetangata and Alasya. Thus
the statements drawn at the observations are supportive to the pathogenesis of the disease
Tamaka Swasa.
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 94
B17) Distribution of patients by Dosha Kshaya
Table 43
Distribution of patients by Dosha Kshaya
Presenting complaints Group – A Group –B
Patients Percentage Patients Percentage
Angasada 2 13.3 3 20
Alpabhashite ahitam 0 0 0 0
Chesta heenata 0 0 0 0
Vyamoha 0 0 0 0
Vat
a
Sleshma vruddhi 0 0 0 0
Mandagni 7 46.6 9 60
Shareera sheetatwam 10 66.6 11 73.3
Pit
ta
Prabha hani 0 0 0 0
Bhrama 0 0 0 0
Urah shoonyata 0 0 0 0
Shira soonyata 0 0 0 0
Hridrava 0 0 0 0
Kap
ha
Sandhi saithilya 0 0 0 0
The listed table above expressive of the contents. In this B17 of table 43, it is
expressed that the Dosha kshaya impact over the Tamaka Swasa. In which Vata lakshana
patients of category are recorded with Angasada. Pitta predominant symptoms noted are
shareera sheetatwam and mandagni. Kapha related symptoms are not seen in any patients.
Thus the statements drawn at the observations are supportive to the pathogenesis of the
disease Tamaka Swasa.
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 95
B18) Distribution of patients by Ahara Nidana
Table 44 Distribution of patients by Ahara Nidana
Group – A Group –B Ahara Nidana Patients Percentage Patients Percentage
Visamashana 3 20 2 13.3 Adhyashana 5 33.3 4 26.6 Anasana 1 6.6 0 0 Sheetashana 0 0 0 0 Visha 0 0 0 0 Sheetapana 13 86.6 14 93.3
Vat
a
Rukshanna 12 80 13 86.6
Tilataila 0 0 0 0
Pit
ta
Vidahi 0 0 0 0
Pistanna 3 20 2 13.3
Nispava 0 0 0 0
Saluka 0 0 0 0
Guru dravyas 9 60 11 73.3
Jalajamamsa 2 13.3 2 13.3
Anupa mamsa 4 26.6 4 26.6
Abhishyandi 12 80 10 66.6
Masa 4 26.6 2 13.3
Dadhi 11 73.3 10 66.6
Vistambhi 2 13.3 2 13.3
Kap
ha
Amaksira 0 0 0 0
The listed table above expressive of the contents. In this B18 of table 44, it is
expressed that the Ahara Nidana impact over the Tamaka Swasa. In which Vata Ahara
Nidana consuming patients of category sheeta pana and Rookshanna are recorded with
Adhyasana. Pitta Ahara are not seen. Kapha related Nidana are Abhishyandi ahara and
Dadhi. Thus the statements drawn at the observations are supportive to the pathogenesis
of the disease Tamaka Swasa.
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 96
B19) Distribution of patients by Vihara Nidana
Table –45 Distribution of patients by Vihara Nidana
Vihara Nidana Group – A Group –B
Patients Percentage Patients Percentage
Rajas (V) 15 100 15 100
Vata (V) 15 100 15 100
Sheeta Sthana (V) 0 0 0 0
Sheeta ambu (V) 6 40 7 46.6
Ativyayama (V) 3 20 5 33.3
Abhighata (V) 0 0 0 0
Dhuma (V) 7 46.6 5 33.3
Apatarpana (V) 1 6.6 2 13.3
Bharakarshita (V) 1 6.6 0 0
Adhwahata (V) 5 33.3 4 26.6
Kanthapratighata (V) 0 0 0 0
Karmahata (V) 0 0 0 0
Veganirodha (V) 2 13.3 4 26.6
Shuddhi Atiyoga (V) 0 0 0 0
Gramya dharma (V) 0 0 0 0
Urahpratighata (V) 0 0 0 0
Marmabhighata(V) 0 0 0 0
Usna (P) 0 0 0 0
Abhishyandi Upacara (K) 0 0 0 0
Divasvapna (K) 5 33.3 3 20
The listed table above expressive of the contents. In this B19 of table 45, it is
expressed that the Vihara Nidana impact over the Tamaka Swasa. In which Vata Vihara
Nidana consuming patients of category Rajas and Vata are recorded with Sheetambu
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 97
sevana and Karmahata. Pitta Vihara are not seen. Kapha related Vihara Nidana is
Divaswapna. Thus the statements drawn at the observations are supportive to the
pathogenesis of the disease Tamaka Swasa.
B20) Distribution of patients by Anya Nidana
Table –46
Distribution of patients by Anya Nidana
Anya Nidana Group – A Group –B
Patients Percentage Patients Percentage
Ksataksaya 0 0 0 0
Udavarta 0 0 0 0
Kshaya 0 0 0 0
Atisara 0 0 0 0
Vibandha 5 33.3 6 40
Anaha 3 20 2 13.3
Visucika 0 0 0 0
Panduroga 2 13.3 0 0
Vat
a
Dourbalya 2 13.3 0 0
Rakta pitta 0 0 0 0
pitta
Jwara 2 13.3 2 13.3
Kasa 14 93.3 14 93.3
Pratisyaya 9 60 10 66.6
Amapradosha 0 0 0 0
Amatisara 0 0 0 0
Kap
ha
Chardi 3 20 2 20
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 98
The listed table above expressive of the contents. In this B20 of table 46, it is
expressed that the Vihara Nidana impact over the Tamaka Swasa. In which Vata Anya
Nidana consuming patients of category Vibandha and Anaha are recorded with Pandu
Roga and Dourbalya. Pitta Anya Nidana only Jwara is recorded. Kapha related Anya
Nidana are Kasa and Pratishyaya along with Chardi for 3 patients. Thus the statements
drawn at the observations are supportive to the pathogenesis of the disease Tamaka
Swasa.
B21) Distribution of patients by srotas
Table –47
Distribution of patients by Srotas
Srotas Group – A Group –B
Patients Percentage Patients Percentage
Atisrustam 11 73.3 10 66.6
Kupitam 8 53.3 9 53.3
Alpalpa 11 73.3 10 66.6
Ati badhdama 5 33.3 5 33.3
Abheekhnam 8 53.3 7 46.6 Pran
avah
a
Sashoolam 7 46.6 5 33.3
Aruchi 7 46.6 5 33.3
Chardi 3 20 2 13.3
Ajeerna 5 33.3 6 40
Ann
avah
a
Anannabhilasha 2 13.3 3 20
Jihwashosha 4 26.6 2 13.3
Ostashosha 3 20 3 20
Talushosha 2 13.3 2 13.3
Udk
avah
a
Pipasa 9 60 7 46.6
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 99
The listed table above expressive of the contents. In this B21 of table 47, it is
expressed that the Srotas examination in Tamaka Swasa. In which Pranavaha srotas
symptoms are predominant in patients as Atisrusta, Alpalpa Abheeshan and Sashoola. On
the other hand symptoms of Annavaha stoats also expressed as Aruchi and Ajeerna. Out
of Udakavaha srotas pipasa is predominant. Thus the statements drawn at the
observations are supportive to the pathogenesis of the disease Tamaka Swasa.
B22) Distribution of patients by Poorva Roopa
Table -48
Distribution of patients by Poorva Roopa
poorva roopa Group – A Group –B
SN Patients Percentage Patients Percentage
1 Hrutpeeda 4 26.6 3 20
2 Kshudra Swasa 5 33.3 4 26.6
3 Shankha bheda 6 40 6 40
4 Shoola 1 6.6 2 13.3
5 Pranavilomata 8 53.3 10 66.6
6 Vaktra vairasya 0 0 0 0
7 Parshwashoola 7 46.6 6 40
8 Vibandha 5 33.3 6 40
9 Anaha 3 20 2 13.3
10 Arati 7 46.6 6 40
11 Bhakta dwesha 7 46.6 8 53.3
12 Admana 0 0 0 0
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 100
The listed table above expressive of the contents. In this B22 of table 48, it is
expressed that the Poorva Roopa examination in Tamaka Swasa. In which Prana
vilomana, Parshwa shoola, Arati and Bhakta dwesha are predominant. Occasionally
Kshudra Swasa and Shankha Bheda are also observed along with other symptoms
enlisted in the tabular statements drawn at the observations are supportive to the
pathogenesis of the disease Tamaka Swasa.
C1) Subjective parameter assessment Group – A
Table – 49
Subjective parameter assessment Group – A
Patients Before % Patients
After % Patients Relived %
Teevra vega Swasa
(Dyspnonea) 15 100 11 73.3 4 26.6
Kasa (cough) 14 93.3 10 66.6 4 26.6
Duhkhena Kapha
nissaranam (Expectoration) 14 93.3 11 73.3 3 20
Ghurghuratwam
(Wheezing) 15 100 11 73.3 4 26.6
Peenasa (Coryza) 12 80 8 53.3 4 26.6
Kruchrena bhasate
(difficulty in speech) 10 66.6 5 33.3 5 33.3
Kantodhwamsham
(Hoarseness of voice) 5 33.3 3 20 2 13.3
Greevashirasangraha
(Headache & Stiffness) 8 53.3 6 40 2 13.3
Urah Peeda (Chest Pain) 11 73.3 7 46.6 4 26.6
Shayane Swasa peedita
(Discomfort at supine) 12 80 8 53.3 4 26.6
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 101
C2) subjective parameter assessment Group – B
Table – 50
Subjective parameter assessment Group – B
Patients Before % Patients
After % Patients Relived %
Teevra vega Swasa
(Dyspnonea) 15 100 11 73.3 4 26.6
Kasa (cough) 14 93.3 10 66.6 4 26.6
Duhkhena Kapha
nissaranam (Expectoration) 14 93.3 12 80 2 13.3
Ghurghuratwam
(Wheezing) 15 100 10 66.6 5 33.3
Peenasa (Coryza) 12 80 9 60 3 20
Kruchrena bhasate
(difficulty in speech) 8 53.3 5 33.3 3 20
Kantodhwamsham
(Hoarseness of voice) 4 26.6 2 13.3 2 13.3
Greevashirasangraha
(Headache & Stiffness) 9 60 5 33.3 4 26.6
Urah Peeda (Chest Pain) 10 66.6 5 33.3 5 33.3
Shayane Swasa peedita
(Discomfort at supine) 11 73.3 6 40 5 33.3
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 102
C3) Objective parameters of Group -A
Table – 51
Objective parameters of Group -A
PEFR BHT AEC ESR Hb% S.No OPD
B A B A B A B A B A
Result
1 3803 150 270 13 25 500 400 10 8 10.8 11.4 MR
2 3876 120 250 11 22 450 350 8 10 10 10.6 PR
3 4861 70 160 8 15 650 550 16 14 11.5 11.2 PR
4 1299 210 370 22 36 450 300 12 12 12.6 13 WR
5 1329 130 260 12 23 500 400 8 6 9.4 10.2 MR
6 1347 150 240 13 20 500 450 14 12 13 13.2 PR
7 1353 160 290 15 25 450 300 12 10 11.5 12.2 MR
8 1399 130 300 12 26 550 450 14 12 11.8 11.4 PR
9 1401 180 380 18 32 550 400 10 8 9.5 9.2 WR
10 1421 110 200 11 18 550 450 10 6 10.4 10.6 PR
11 1423 90 140 8 14 650 600 14 14 9 9 PR
12 1426 140 240 14 22 500 450 16 14 9.6 10 PR
13 1427 190 350 15 28 550 450 12 14 12.8 13 MR
14 1430 120 230 12 20 600 500 8 6 10.6 11.2 NR
15 1431 100 170 10 16 600 550 12 10 9 9.4 PR
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 103
C4) Objective parameters of Group –B
Table - 52 Objective parameters of Group –B
PEFR BHT AEC ESR Hb% S.No OPD
B A B A B A B A B A
Result
1 4146 180 290 15 24 550 450 14 12 11.6 12 MR
2 4163 160 310 12 25 550 450 12 10 12.4 12 MR
3 1300 110 190 10 16 600 600 10 10 10 10.6 NR
4 1328 180 240 14 20 450 400 14 10 9.5 9.8 NR
5 1330 220 380 25 35 450 350 12 8 11.5 11.8 WR
6 1348 70 150 7 13 650 650 12 14 11.5 11.5 PR
7 1349 130 200 11 17 600 550 8 6 10.4 10.8 PR
8 1354 170 260 14 18 550 550 8 8 10 10.5 PR
9 1400 280 400 25 38 450 400 10 8 11.2 11.5 WR
10 1422 190 280 15 23 550 450 10 12 10.4 11.2 PR
11 1424 90 170 8 15 650 600 10 9 9.5 9 PR
12 1425 200 310 18 28 500 400 8 9 10.2 11 MR
13 1428 160 240 12 20 550 500 12 10 13.2 13.4 NR
14 1929 150 270 12 23 500 400 12 12 12.5 12.8 MR
15 1932 240 360 21 32 450 350 12 10 12 12.4 WR
TABLE –53 MEANS OF OBJECTIVE PARAMETERS
PEFR BHT AEC ESR Hb% B A B A B A B A B A
Group-A 136.6 256.6 12.9 22.8 536.6 440 11.73 10.4 10.76 11.04Group-B 168.6 270 14.6 23.13 536.6 473.3 10.93 9.86 11.06 11.35
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 104
C5) Statistical assessment of Group – A subjective parameters
Table –54
Statistical assessment of Group – A subjective parameters
Mean SD SE t Value P value Remarks
Teevra vega Swasa
(Dyspnonea) 1.066 0.258 0.066 16.15 <0.001 HS
Kasa (cough) 0.866 0.516 0.133 6.511 <0.001 HS
Duhkhena Kapha
nissaranam (Expectoration) 0.666 0.487 0.125 5.328 <0.001 HS
Ghurghuratwam
(Wheezing) 0.8 0.414 0.106 7.54 <0.001 HS
Peenasa (Coryza) 0.533 0.516 0.133 4.0 <0.01 HS
Kruchrena bhasate
(difficulty in speech) 0.466 0.516 0.133 3.503 <0.01 HS
Kantodhwamsham
(Hoarseness of voice) 0.133 0.351 0.090 1.477 >0.05 NS
Greevashirasangraha
(Headache & Stiffness) 0.4 0.507 0.1309 3.076 <0.02 HS
Urah Peeda (Chest Pain) 0.4 0.507 0.1309 3.076 <0.01 HS
Shayane Swasa peedita
(Discomfort at supine) 0.6 0.507 0.1309 4.58 <0.001 HS
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 105
C6) Statistical assessment of Group – B subjective parameters
Table –55
Statistical assessment of Group – B subjective parameters
Mean SD SE t Value P value Remarks
Teevra vega Swasa
(Dyspnonea) 0.933 0.258 0.066 14.13 <0.001 HS
Kasa (cough) 0.666 0.487 0.125 5.328 <0.001 HS
Duhkhena Kapha
nissaranam (Expectoration) 0.666 0.487 0.125 5.328 <0.001 HS
Ghurghuratwam
(Wheezing) 0.733 0.457 0.118 6.211 <0.001 HS
Peenasa (Coryza) 0.533 0.516 0.133 4.007 <0.01 HS
Kruchrena bhasate
(difficulty in speech) 0.266 0.457 0.118 2.25 <0.05 HS
Kantodhwamsham
(Hoarseness of voice) 0.133 0.351 0.090 1.477 >0.05 NS
Greevashirasangraha
(Headache & Stiffness) 0.33 0.487 0.125 2.64 <0.05 HS
Urah Peeda (Chest Pain) 0.466 0.516 0.133 3.495 <0.01 HS
Shayane Swasa peedita
(Discomfort at supine) 0.466 0.516 0.133 3.495 <0.01 HS
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 106
C7) statistical assessment of Group – A : Objective parameters
Table –56
Statistical assessment of Group – A Objective parameters
Mean SD SE t Value P value Remarks
PEFR 120.0 40.53 10.46 11.47 <0.001 HS
BHT 9.866 3.044 0.785 12.568 <0.001 HS
AEC 96.66 35.186 9.085 10.639 <0.001 HS
ESR 1.866 0.915 0.236 7.906 <0.001 HS
Hb% 0.393 0.212 0.054 7.27 <0.001 HS
C8) Statistical assessment of Group – B : Objective parameters
Table –57
Statistical assessment of Group – B Objective parameters
Mean SD SE t Value P value Remarks
PEFR 100 23.9 6.172 16.202 <0.001 HS
BHT 8.33 2.49 0.644 12.93 <0.001 HS
AEC 63.33 39.94 10.31 6.142 <0.001 HS
ESR 1.733 1.222 0.315 5.501 <0.001 HS
Hb% 0.48 0.407 0.105 4.571 <0.001 HS
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 107
C9) Comparative statistical assessment of Groups subjective parameters
Table –58
Comparative statistical assessment of Groups subjective parameters
GR
OU
P
Mean SD SE PSE
t Val
ue
P v
alue
Rem
arks
A 0.933 0.7037 0.181 Teevra vega Swasa
(Dyspnonea) B 0.933 0.7037 0.181 0.255 - - -
A 0.8666 0.639 0.165 Kasa (cough)
B 0.8 0.676 0.174 0.239 0.276 >0.05 NS
A 0.733 0.457 0.118 Duhkhena Kapha
nissaranam
(Expectoration) B
0.866 0.516 0.133 0.178 0.747 >0.05 NS
A 0.733 0.457 0.118 Ghurghuratwam
(Wheezing) B 0.733 0.593 0.153 0.193 - - -
A 0.666 0.617 0.159 Peenasa (Coryza)
B 0.666 0.617 0.159 0.225 - - -
A 0.4 0.507 0.130 Kruchrena bhasate
(difficulty in speech) B 0.333 0.487 0.125 0.181 0.386 >0.05 NS
A 0.2 0.414 0.106 Kantodhwamsham
(Hoarseness of voice) B 0.133 0.351 0.0908 0.139 0.482 >0.05 NS
A 0.6 0.507 0.1309 Greevashirasangraha
(Headache & Stiffness) B 0.4 0.632 0.163 0.209 0.956 >0.05 NS
A 0.466 0.516 0.133 Urah Peeda (Chest Pain)
B 0.333 0.487 0.125 0.182 0.730 >0.05 NS
A 0.533 0.516 0.133 Shayane Swasa peedita
(Discomfort at supine) B 0.4 0.507 0.1309 0.1866 0.738 >0.05 NS
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 108
C10) Comparative statistical assessment of Groups Objective parameters
Table - 59
Comparative statistical assessment of Groups Objective parameters
GR
OU
P
Mean SD SE PSE
t Val
ue
P v
alue
Rem
arks
A 256.66 73.15 18.88 PEFR
B 272.0 71.73 18.52 26.44 0.58 >0.05 NS
A 22.8 6.155 1.589 BHT
B 23.13 7.424 1.917 2.489 0.132 >0.05 NS
A 440.0 87.013 22.46 AEC
B 473.33 96.11 24.81 33.47 0.995 >0.05 NS
A 10.4 3.042 0.785
ESR B 9.86 2.030 0.524
0.944 0.572 >0.05 NS
A 11.04 1.373 0.354 Hb%
B 11.42 1.158 0.299 0.463 0.820 >0.05 NS
Statistical report– Brihat Katphaladi yoga and Vyoshadi Gitika in Tamaka Swasa
To compare the mean effect of two groups using un-paired t-test by assuming that
the mean effect of the two groups is same in all the parameters does the statistical
analysis. From the analysis all the parameters show non-significant (as p>0.05 (table)
among objective parameters the mean effect of AEC is more with more variation after the
treatment in-group –B.
Among the subjective parameters the parameter ‘Kasa’ is having more mean
effect in the group –A where as the parameter Ghurghurata shows more variation after
Results of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa 109
the treatment in group-a the mean effect of Tivravega Swasa, Ghurghurata and Penesa is
more in both the groups (by comparing mean and standard deviation from table).
To compare the mean effect of drug with in the group the statistical analysis done
by using paired t-test by assuming that the drug is not responsible for the change in the
observations before and after the treatment.
Over all the group- A shows more highly significant than group-B among
subjective parameters Tivravega Swasa, Kasa, Greeva Shira Sangraha, Krucherena
bhashita and Shayana Swasa peedita shows more highly significant in group – A than
group – B.
The parameter Dhukhena Kapha nissaranam and Peenasa are having equal highly
significance in both the groups. The parameter Kantodwamsa shows not significant in
both the groups (by comparing p value and t value from tables). Among objective
parameters in the group – A absolute Eosinophils count Erythrocyte sedimentation rate
and Hemoglobin percentage are more highly significant in group-A than group-B.
The parameter peak expiratory flow rate and breath holding time shows more
highly significant in-group – B (by comparing p value and t value from the tables)
D1) Over all assessment and Result of the Brihat Katphaladi yoga and Vyoshadi
Gutika Nitya Virechana in Tamaka Swasa
Table -60
Over all assessment and Result
Category Group – A
Brihat Katphaladi yoga
Group –B
Vyoshadi Gutika
Nitya Virechana
Patients % Patients %
Well responded 2 13.4 3 20
Moderate Responded 4 26.6 4 26.6
Poor Responded 8 53.4 5 33.4
Not Responded 1 6.6 3 20
Total 15 100 15 100
Graph - 10
Over all assessment and Result of clinical trail
Results of Brihat Katphaladi yoga / Vyoshadi Gutika N
RESULT _ Group A
Poor Responded
53%
Well responded
13.33%
Moderate Responded
26.67%
Not Responded
7%
Well Not
itya Shodhana in Tamaka Swasa 110
Result of Group -B
Poor Responded
33%
responded20.00%
Moderate Responded
26.67%
Responded20%
Chapter - 6
Discussion Mortality due to Tamaka Swasa vis-à-vis asthma is not comparable in size to the
day-to-day effects of the disease. Although largely avoidable, asthma tends to occur in
epidemics and affects young people. The human and economic burdens associated with
this condition are severe. The costs of asthma to society could be reduced to a large
extent through concerted international and national action 251.
Between 100 and 150 million people around the globe, suffer from asthma and
this number is rising. Worldwide, deaths from this condition have reached over 180,000
annually. Asthma is not just a public health problem for developed countries. In
developing countries like India, however, the incidence of the disease varies greatly 252.
• India has an estimated 15-20 million asthmatics.
• In India, rough estimates indicate a prevalence of between 10% and 15% in 5-11
year old children.
WHO recognizes asthma as a disease of major public health importance and plays
a unique role in the co-ordination of international efforts against the disease. International
action is needed to:
• Increase public awareness of the disease to make sure patients and health
professionals recognize the disease and are aware of the severity of associated
problems;
• Organize and co-ordinate global epidemiological surveillance to monitor global
and regional trends in asthma;
Discussion of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
111
• Develop and implement an optimal strategy for its management and prevention
(many studies have shown that this will result in the control of asthma in most
patients); and
• Stimulate research into the causes of asthma to develop new control strategies and
treatment techniques 253.
Out of the above policies of WHO, the ancient Ayurveda, a medical system of
India places lots of management modalities to neutralize the effect of Tamaka Swasa, a
demon in the present air polluted society. The present trial entitled “evaluating the
efficacy of Brihat Katphaladi yoga in comparison with Vyoshadi Gutika Nitya Shodhana
in Tamaka Swasa” is an optimal strategy to develop and implement a perfect treatment to
the Tamaka Swasa as a research Stimulation into the causes of asthma. The word
derivation is from Tama root with Kwip Pratyaya, which means to darkness, to choke or
to be suffocated seen in the Tamaka Swasa predominantly.
At this context here the causes and pathogenesis discussion is necessary. Thus the
discussion on disease Tamaka Swasa is divided and discussed under following headings,
as expressed below.
1. Discussion on Nidana (etiological factors)
2. Discussion on Roopa (symptoms) and Samprapti (Patho-physiology)
3. Discussion on Chikitsa (treatment)
4. Effect of Brihat Katphaladi yoga in Tamaka Swasa (Group-A)
5. Effect of Vyoshadi Gutika in Tamaka Swasa (Group-B)
6. Discussion on comparative Results
Discussion of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
112
1) Discussion on Nidana
Nidana parivarjana i.e. prevention of etiological factors as a part of supportive
therapeutic measures of the treatment is idol any time. Especially as Tamaka Swasa
patients are very much exposed to the different verities of the subjects at different times
and places in the atmosphere particularly air and dust, it is very much necessary to
evaluate.
Specific Nidana for Tamaka Swasa is not mentioned in classics as it is a sub type
of Swasa roga same Nidana are applicable to Tamaka Swasa also. We cannot find a clear
view regarding the patho-physiological changes occurring due to specific type of Tamaka
Swasa Nidana. Chakrapani commenting on the Nidana verses as he explains about Vata
prakopaka gana and Kapha prakopaka gana, which are responsible for the development
of Tamaka Swasa.
For the better under standing causative factors are classified as Ahara sambhandi
(rukshanna pisthanna), Vihara sambhandi (sheetambhu stivyayana), Anya vyadhi avastha
sambhandi ( pratishaya chardi ), Agantuja (marmabhigata kanta urobhighata) and Kalaja
Nidana (durdina mega chadita dina etc) discussed in the literary review. Summarizing the
etiological factors, it is noticed that they are responsible either for Dosha drusti
amotpadana or kha vaigunyotpadaka. Ayurveda expressed Nidana i.e. etiology are
vividly discussed here under specified headings.
a) Vata Nidana
Out of Vata Nidana Ahara, Sheeta Ashana and Visha Ashana are not
recorded in either of groups. Out of the enlisted Nidana, in the Group – A,
Sheeta pana is 86.6% and in Group –B it is 93.3%. Second bests of
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recording is Rooksha Anna which is 80% in Group-A and 86.6% in
Group-B. Adhyashana is 33.3% and 26.6% in Group A & B respectively.
The other recorded are – Vishamashana 20% and 13.3%, Anashanana
6.6% and 0% in Group –A & B respectively.
Vata Vihara Nidanas are many as shown in table. Out of these many, Vata
(wind) and Rajas (Spores & Dust) are 100% observed in both groups.
Karmahata is 46.6% in Group –A and 33.3% in Group-B respectively
observed. Sheetambu utilization is observed as one of the cause in Group-
A 40% and 46.6% in Group-B.
The other Nidana observed as Vata alleviators, Vibandha (33.3% and
40%), Pandu, Anaha and Dourbalya in fewer percentages are observed.
The above data is strongly suggestive of the involvement of Vata in
causation of Tamaka Swasa.
b) Pitta Nidana
As the Pitta Ahara Nidana is not relevant to cause any pathogenesis of the
Tamaka Swasa and also they are not found in the patients under taken, the
involvement of these Nidana are ruled out.
No Pitta vihara also observed as like the Ahara Nidana.
Jwara a condition related to Pitta is observed out of Anya Nidana, suggests
the infection in the upper respiratory tract with 13.3% in both Groups.
c) Kapha Nidana
Out of the Kapha Ahara Nidana Abhishyandi Ahara is 80% and 66.6% in
Group –A & B respectively suggests the blockage of Kapha in the
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channels. Guru dravya 60% and 73.3% in Groups A & B suggest that the
involvement of Kapha productive factors in the Tamaka Swasa. The third
one is Dadhi, which is a factor of Kapha vitiation and Ama genesis is
observed as 73.3% and 66.6% in Group-A & B respectively. The other
relevant Nidana are – Anupa Mamsa (26.6% in each Group), Jalaja
Mamsa (13.3% in each Group), Pistanna (A - 20 & B -13.3%), Vistambhi
(13.3 in both Groups), and Masha (26.6% and 13.3%). Ama Ksheera,
Nishpava and Shalooka are not in use by any patients observed.
Divaswapna is one Kapha Vihara Nidana observed in the pathogenesis of
Tamaka Swasa in both groups viz. Group-A is 33.3% and Group –B is
20%.
Kasa is observed 93.3% in both Groups along with Pratishyaya as 60% in
Group A and 66.6% in Group-B. Chardi is one more compliant observed
as a symptom of elimination of Kapha from Amashaya in 20% both
groups.
2) Discussion on Roopa (symptoms) and Samprapti (Patho-physiology)
As per the Tamaka Swasa Samprapti is concerned the vitiated Kapha Dosha along
with Vata Dosha obstructs the srotas to secrete Kapha from Pranavaha srotas. Here the
Kapha is the normal secretion and is abnormally increased by the vitiated Pranavata.
Further this action adds to the obstruction of the passage where Pranavata gets the Prana
vilomata. Narrowing of the Pranavaha srotas along with accumulation of Kapha in it
obstructs the smooth flow of Pranavata. Prana vilomata is resultant with turbulent
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breathing which leads to abnormal audibility of respiration even to out side or to say
produces wheezing.
In Tamaka Swasa the course of the illness starts from Hridya said to be afflicted
adds the severity of illness. Kapha Dosha (Dosha) and Rasa dhatu (dushya) belonging to
the same category and affliction of Hridaya indicates the acute onset chronic course and
severity of illness.
a) Poorva Roopa
Prana vilomata: it is observed as 53.3% and 66.6% in both groups respectively
suggest that the symptom is related to Prana, Pranavaha srotas and the obstructive
phenomenon of it.
Bhakta dwesha: 46.6% and 53.3% in Group A & B respectively, suggests that the
disease is Amashaya samutha, producing Ahara dwesha.
Arati and Parshwa shoola: these are observed as 46.6% and 40% respectively
inGroup –A and B supports strongly above point.
Shankha Bheda: It is a pain condition occurred because of Prana Urdhwa gati and
there by observed as 40% in both Groups.
Vibandha: It is observed as 33.3% and 40% respectively in Group-A and B is
because of the Prana Vata Urdhwa gati in Tamaka Swasa.
b) Lakshana in Tamaka Swasa:
Teevra vega Swasa and Ghurgurukatwam is pratyatma niyata lakshana of Tamaka
Swasa observed 100% in all patients.
Kasa and Duhkhen kapah anissarana observed almost all i.e. 93.3% in both
Groups.
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Peenasa is a relevant disease associated and also a symptom, observed in 86.6%
and 80% in Group-A and B respectively.
Shayane Swasa peeditam, which is causing inconvenience in Tamaka Swasa, is
seen in 80% and 73.3% of the Group-A and B respectively suggests the blockage
of Kapha while sleeping.
Urah peeda i.e. chest pain is observed as 73.3% and 66.6% in Group A & B as the
chest is the seat of the disease.
c) Samprapti Ghataka
Agni: as Agni is observed it is found that 46.6% in Group A and 60% of patients
in Group-B are subjected for the Agnimandya or Mandagni. It is told in Ayurveda
the mandagni is the root cause of development of disease and Ama.
Prakruti: Many patients are of Vata Kapha prakruti observed in the study viz.
Group-A 53.4% and Group-B 60%. The disease manifest to the people with Vata
Kapha people as the disease is of Kapha Vata Dosha predominant.
Prana vaha Srotas: 73.3% of patients are reported in Group-A, with prime
symptom of pranavaha sroto dusti are Atisrustam and Alpalpam, where as in
Group-B they are 66.6%. The adhistana of the vyadhi is uras i.e. chest in terms of
pranavaha srotas, thus the symptoms pertained to that of pranavaha srotas is
relevant.
Annavaha Srotas: Symptoms observed in this are Aruchi (A = 46.6%, B = 33.3%)
and Ajeerna (A = 33.3%, B = 40%). All the disease manifestation as it is
discussed from GIT and that too from stomach. The importance of Annavaha
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srotas and Amashaya is relevant with symptoms of Aruchi exhibited to state the
disease is Amashaya samudbhava.
Udakavaha Srotas: In this category Pipasa in Group-A is 60% and Group-B is
46.6%. The other symptoms are Jihwa sosha (A = 26.6%, B = 13.3%) and
Ostashosha (20% in both Groups). The air ventilation is naturally through nasal
cavity but when it is not possible gives rise to oral breathing, which causes the
jihwa sosha, which is a Udakavaha srotas symptom.
Onset of disease: The onset is observed as gradual in many patients viz. Group-A
73.3% and Group-B 80%. It suggests that the disease in chirakari and takes the
long time to manifest its symptoms.
Course of onset: Patients are observed with the episodic onset maximum as 53.4%
in Group –A and 66.6% in Group-B.
Frequency of attack: it is observed that few day onset in Group-A 66.6% patients
and 60% in Group-B patients.
Mode of progress: The disease development is typical as observed in Group-A
with 40% and Group-B 33.4% patients.
Periodicity: An irregular periodicity is observed in the study with 60% in both
groups.
Preceding factors: These are sneezing, nasal irritation and cough out of cough is
in 53.4% of patients in both Groups.
Mode of progress: it is observed that the disease is of long-term progress with the
40% and 46.6% in Group-A & B patients respectively.
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Aggravating factors: Dust and Smoke are observed as the aggravating factors in
60% of Group-A and 66.6% of Group-B patients.
Comfort posture: The comfort posture recorded for the patients is sitting with
forward bending. It is 40% and 46.6% in Groups A & B respectively.
3) Discussion on Chikitsa (treatment)
The treatments suggested in the clinical trial are internally with Brihat Katphaladi
Yoga pacifying the Dosha viz. Kapha and Vata in the group-A patients and Vyoshadi
Gutika Nitya Shodhana in Group-B patients.
The former management is a routine method of treating patients of Tamaka
Swasa, as they are not strong enough to with stand the massive elimination methods, such
as Vamana etc. The selected drug management has specific action on the Dosha
distribution and also to induce a Dosha dooshya vighatana. Out of the composition many
alkaloids found in different individual herbs and also the pharmacological properties
suggests that the Brihat katpahaladi yoga is a unique medicament as a palliative
management.
The later is a unique technique, in the unfit persons of strong shodhana i.e.
elimination of the Dosha. Here many times it is stated that the Anulomana or a mild
rechana makes the Kosta suddhi. In these patients who suffer from a chronic disease of
upper respiratory tract with continuous exposure to the causative factors needs an
elimination therapy, which could relieve the pains and accumulated phlegm of patients.
Thus the Vyoshadi Gutika is implied in the management of Tamaka Swasa as a Nitya
shodhaka. In further as the Kapha obstructs the passage of Vata in Tamaka Swasa a
clanging method is adopted in terms of Nitya shodhana.
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5) Effect of Brihat Katphaladi yoga (Group-A) in Tamaka Swasa
All the ingredients of the Brihat Katphaladi yoga are of Kapha Vata hara
action and these are of Katu, Tikta and Kashaya rasa in general. There fore all
these acts as Kapha hara. Thus the Brihat Katphaladi yoga is good choice in
Tamaka Swasa.
Agni deepana is a prime treatment as “Kayasya antaragni Chikitsa” is
Kayachikitsa. In this concern Katu and Tikta rasa along with Ushna veerya
does the Deepti of Agni. In further it takes care of non-formation of Ama,
which helps the prevention of disease progression. Thus the Brihat Katphaladi
yoga is good choice in Tamaka Swasa.
All the dravya in Brihat Katphaladi yoga are of Ushna veerya except Musta,
by which acts as Pitta kara and Kapha Vata shamaka. Laghu, Teekshna,
Snigdha and Rooksha guna does act as Kapha Vata shamaka.
Vata and Kapha are of Sheeta guna nature. The veerya of the selected Brihat
Katphaladi yoga are of Ushna. Thus the Ushna veerya evaporates the Kapha
and pacifies the Vata even though it increases the Pitta.
Laghu guna is said as Kapha hara and Snigdha guna is Vata hara. Teekshna
guna is Kapha Vata hara. This combination of Brihat Katphaladi yoga by it
Guna helps in keeping the Dosha in equilibrated state.
Shunti specifically by its pharmacological action it is Kanta vishodhana i.e.
relieves the obstruction at the neck which is plugged by the vitiated Kapha.
Karkata Srungi is Kapha Nissaraka, which means evaporation, or drying of
Kapha is undertaken.
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Maricha, which is Ushna veerya but helps in elimination of Kapha by its
Rechaka action.
Age: More prevalence i.e. 33.4% is observed in the category of 50-60 age
group. As observations are noticed it is clearly evidential that the higher age
group people are prone to get this disease because of the decreased lung
capacity in terms of Vata Dosha predominance. Results are encouraging in 30-
40 and 50-60 age groups with Well response. Only one patient in the age
group of 40-50 not responded with treatment.
Gender: The male female ratio of the study is 3:2. It is because of Male
dominant society observing and moving or exposing to the etiology much
more than that of Females who are staying at home. Out of which no much
gender specifications were observed as par the results are concerned.
Religion: Most of the cases are of Hindu community with 86.6%. The rest are
of Muslim community with 13.4%. It may not discriminate the community.
As results are observed all 2 patients of well responded are from Hindu
community. The one patient who is Not responded to the treatment is from
Muslim community. This may be because of the dietetics (Jalaja and Anupa
Mamsa) followed at this community.
Occupation: At the study 53.3% of patients show Active Occupation suggests
that people who are exposure to the external atmosphere with pollution are
getting the disease Tamaka Swasa.
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Economical Status: Middle class people are always recorded much in any
study because of incapability of getting corporate treatment. Here in this study
it is 53.4%.
Dietetic Habits: Vegetarian to Mixed diet practitioners ratio is 3:2. This ratio
may not be significant in the study but else where discussed as Mixed diet
practice impacts the result and creates Ama in the body and aggravates the
Kapha.
The Results of the Brihat Katphaladi yoga are in Tamaka Swasa as followed
in Group-A are declared as Well responded, Moderately Responded, Poorly
Responded and Not Responded.
Well-responded patients are only 2 i.e. with 13.4% and Moderately responded
patients are 4 i.e. 26.6%. It is clear evidence that the disease is not possible to
be treated in perfect when the patients are subjected from the etiological
factors such as Dust and fumes in day-to-day life.
Poor Responded patients are 8 i.e. 53.3% and 1 patient i.e. 6.6% of Not
responded. This result is observed irrespective of the gender.
An effort is made to uproot the ailment in this trial ultimately observed with
the less percentage of maximum relief patients suggests that the Brihat
Katphaladi yoga is a good choice of palliative medicament in Tamaka Swasa.
Statistically all subjective and objective parameters show High significance
except Kantodhwamsa, which is Non Significant.
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6) Effect of Vyoshadi Gutika in Tamaka Swasa
Mrudu virechakas are not causing any difficulties to patients, where the Dosha
is in tarunavasta 254. Administration of these medicaments repeatedly holds
good.
In a weak patient holds with excessive accumulation of Dosha, mrudu
virechaka medicaments are advised for repeated administration 255.
Whenever Kapha obstructs Vata it is essential that the continuous elimination
through Anulomana dravyas as Nitya Shodhana to eliminate Vata 256.
Vagbhata offers Pratimarsha Nasya 257 to practice many times when any
elimination is needed, like the same here to remove the Dosha many times
kosta Dosha is eliminated through Anulomaka Nitya rechana Shodhana.
As the kosta of these Tamaka Swasa patients are not possible to assess or
irrespective of Kosta practice (Aparijnata Kosta) 258 of management through
the Anulomaka Nitya rechana Shodhana with Vyoshadi Gutika makes one’s
Dosha elimination and Kosta suddhi for better practice if palliative medicines.
Many patients because of lack of time not practicing the proper Virechana
elimination methods. The Anulomaka Nitya rechana Shodhana. With
Vyoshadi Gutika doesn’t disturb the daily routines of individual and possible
to administer any time anywhere.
Vyoshadi Gutika is used as Nitya shodhana material at this trial. The Nitya
shaodhana means
Vyoshadi Gutika cumulatively consists of Laghu, Rooksha and Teekshna
Guna, by which Drvya invades in to srotas and eliminates the accumulated
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Kapha. Laghu guna makes the sroto vishodhana thus the Kapha moving in the
srotas are eliminated by the rechaka property.
Katu, Tikta, Kashaya and Madhura rasa in Vyoshadi Gutika makes Deepana
and Pachana along with kindling of the fire at Jathara and Dhatu. It impacts
the Dosha Kapha to get vilayana i.e. melt and eliminate easily.
Ushna Veerya predominant Vyoshadi Gutika pacifies the Kapha and Vata by
rapid elimination through its sroto shodhaka property.
Vyoshadi Gutika by virtue of combination it is Kapha Vata shamaka and
Tridosha shamaka. It is used here to evacuate the Dosha in small quantity
daily with out giving any problem to the patient.
The qualities of Vyoshadi Gutika are said as Mrudu virechaka, Rechaka,
Anulomaka and Sukha virechaka other wise said as Adhobhagahara. At the
time of mentioning properties, Charaka affirmed that the medicament of
Tamaka Swasa should be Kapha Vata hara and Anulomaka.
Age: More prevalence i.e. 40% is observed in the category of 40-50 age
group. As observations are noticed it is clearly evidential that the active age
group people are prone to get this disease because of the increased lung
infiltration with dist and smoke in terms of Vata Dosha predominance. Results
are encouraging in 40-50 and 20-30 age groups with Well response. One
patient in each age group viz. 20-30, 40-50 and 50-60 not responded with the
treatment.
Gender: The male female ratio of the study is 2:1. It is because of Male
dominant society observing and moving or exposing to the etiology much
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more than that of Females who are staying at home. Out of which no much
gender specifications were observed as par the results are concerned. All 20%
of well-responded patients are Males, means to understand the phenomenon of
elimination actively administrated in Males.
Religion: Most of the cases are of Hindu community with 86.6%. The rest are
of Muslim community with 13.4%. It may not discriminate the community.
As results are observed 2 patients of Hindu and 1 patient from Muslim
community are well responded. The patients who are Not responded to the
treatment are Hindu community. This may be because of the dominance of
Hindus at this locality.
Occupation: At the study 46.6% of patients show Active Occupation suggests
that people who are exposure to the external atmosphere with pollution are
getting the disease Tamaka Swasa.
Economical Status: Middle class people are always recorded much in any
study because of incapability of getting corporate treatment. Here in this study
it is 46.6%.
Dietetic Habits: Vegetarian to Mixed diet practitioners ratio is 3:2. This ratio
may not be significant in the study but else where discussed as mixed diet
practice impacts the result and creates Ama in the body and aggravates the
Kapha.
The results of the Vyoshadi Gutika as Nitya Shodhaka in Tamaka Swasa as
followed in Group-B are declared as Well responded, Moderately Responded,
Poorly Responded and Not Responded.
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Well-responded patients are only 3 i.e. with 20% and Moderately responded
patients are 4 i.e. 26.6%. It is clear evidence that the disease is not possible to
be treated in perfect when the patients are subjected from the etiological
factors such as Dust and fumes in day-to-day life.
Poor Responded patients are 5 i.e. 33.3% and 3 patient i.e. 20% of Not
responded. This result is observed irrespective of the gender.
An effort is made to uproot the ailment in this trial ultimately observed with
the less percentage of maximum relief patients suggests that the Vyoshadi
Gutika as Nitya Shodhaka in Tamaka Swasa is a good choice of elimination
medicament in Tamaka Swasa.
Statistically all subjective and objective parameters show High significance
except Kantodhwamsa, which is Non Significant.
7) Discussion on Results
The Result of the study from Group-A and B with Brihat Kayphaladi Yoga
and Vyoshadi Gutika are discussed at above paragraphs, which are highly
significant at individual aspect. Even though the medicaments are of very
effective individually they are not valued at the efficacy of Result with Well-
Response at the patients.
To compare the mean effect of two groups using un-paired t-test by assuming
that the mean effect of the two groups is same in all the parameters does the
statistical analysis.
Over all the group-A shows more highly significant than group-B among
subjective parameters Tivravega Swasa, Kasa, Greeva Shira Sangraha,
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Krucherena bhashita and Shayana Swasa peedita shows more highly
significant in group – A than group – B.
The parameter Dhukhena Kapha nissaranam and Peenasa are having equal
highly significance in both the groups. The parameter Kantodwamsa shows
not significant in both the groups (by comparing p value and t value from
tables).
The parameter peak expiratory flow rate and breath holding time shows more
highly significant in-group – B (by comparing p value and t value from the
tables)
To get a less result of the well responded, many causes could be attributed.
Viz. the patients are of well-established disease, the medicament chosen is
Kapha suppresser, Kapha is not totally eliminated with the medicine, dose
may be insufficient, duration of the study is less etc.
As observed in the study the both groups are effective at the time trial and
give symptomatic relief to the all patients i.e. all subjective parameters taken
for the study show remarkable differences at the time of management.
With the above observations it is clear that the medicaments used in the study
for the Tamaka Swasa viz. Brihat Katphaladi Yoga in Group-A and Vyoshadi
Gutika in Group-B are effective at their functional area to relieve Kapha from
the pranavaha sroatas to pacify and to eliminate in terms of Nitya Shodhana
by Vyoshadi Gutika.
Discussion of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
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Chapter - 7
Conclusions The predominant symptoms of breathlessness are the basis for naming the disease
Swasa. The word Tamaka Swasa is the name of illness consisting of the two words Tamaka
and Swasa. The word Swasa refers to the name of the disease, where as the word Tamaka
refers to a subtype of the Swasa roga.
Specific Nidana for Tamaka Swasa is not mentioned in classics as it is a sub type of
Swasa roga same Nidana are applicable to Tamaka Swasa also.
Lakshana (Roopam) of tamaka Swasa corresponds Vata as well as Kapha Dosha.
The imbalance of Vata and Kapha Dosha afflicts the Rasa Dhatu in the pathogenesis
of Tamaka Swasa. During the attack of Tamaka Swasa almost all the symptoms of Kapha
Dosha vitiation are mediated through the Rasa Dhatu.
If Tamaka Swasa is Navotita it is as sadya. Susruta has considered Tamaka Swasa as
krichrasadhya vyadhi and asadhya in durbala rogi.
Therefore, the Brihat Katphaladi Yoga in Group-A and Vyoshadi Gutika in Group-B
aimed at the rectification of the imbalances of Vata Dosha, as well as Kapha Dosha forms the
sheet anchor of treatment of Tamaka Swasa, which is individually quite opposite.
The final treatment planned should pacify the Vata as well as Kapha Dosha
effectively, simultaneously not causing any further addition to the imbalance of Vata and
Kapha Dosha. If the patient is Kapha adhikyata and balawan rogi - Doshas are to be expelled
by vamana and Virechana. Here at this trial Vyoshadi Gutika eliminates the Dosha in
sequence i.e. through Nitya Shodhana.
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128
Tamaka Swasa is treated with “Tamaketu Virechanam” other wise understood, as
Nitya Shodhana administration.
One out of such is Brihat Katphaladi Yoga said by Sharangadhara is safe and effective
palliative medicament.
Even though much number of predisposing factors may initiate an attack of Tamaka
Swasa or may worsen the episode, the Brihat Katphaladi Yoga with its combination effect
cures the Tamaka Swasa patients.
Teevra vega Swasa and Ghurgurukatwam is pratyatma niyata lakshana of Tamaka
Swasa observed 100% in all patients.
Vibandha is observed as 33.3% and 40% respectively in Group-A and B is because of
the Prana Vata Urdhwa gati in Tamaka Swasa.
An effort is made to uproot the ailment in this trial ultimately observed with the less
percentage of maximum relief patients suggests that the Brihat Katphaladi yoga is a good
choice of palliative medicament in Tamaka Swasa. Well-responded patients in Group-A i.e.
Bruhat Katphaladi Yoga internally, are only 2 i.e. with 13.4% and Moderately responded
patients are 4 i.e. 26.6%. Poor Responded patients are 8 i.e. 53.3% and 1 patient i.e. 6.6% of
Not responded.
Statistically all subjective and objective parameters in Group-A i.e. Bruhat Katphaladi
Yoga internally, show High significance except Kantodhwamsa, which is Non Significant.
Vyoshadi Gutika by virtue of combination it is Kapha Vata shamaka and Tridosha
shamaka. At the time of mentioning properties, Charaka affirmed that the medicament of
Tamaka Swasa should be Kapha Vata hara and Anulomaka.
Conclusions on Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
129
An effort is made to uproot the ailment in this trial ultimately observed with the less
percentage of maximum relief patients suggests that the Vyoshadi Gutika as Nitya Shodhaka
in Tamaka Swasa is a good choice of elimination medicament in Tamaka Swasa. Well-
responded patients in Group-B i.e. Vyoshadi Gutika Nitya Shodhana, are only 3 i.e. with 20%
and Moderately responded patients are 4 i.e. 26.6%.
It is clear evidence that the disease is not possible to be treated in perfect when the
patients are subjected from the etiological factors such as Dust and fumes in day-to-day life.
Poor Responded patients are 5 i.e. 33.3% and 3 patient i.e. 20% of Not responded. This result
is observed irrespective of the gender.
Statistically all subjective and objective parameters in Group-B i.e. Vyoshadi Gutika
Nitya Shodhana, show High significance except Kantodhwamsa, which is Non Significant.
With the above observations it is clear that the medicaments used in the study for the
Tamaka Swasa viz. Brihat Katphaladi Yoga in Group-A and Vyoshadi Gutika in Group-B are
effective at their functional area to relieve Kapha from the pranavaha sroatas to pacify and to
eliminate in terms of Nitya Shodhana by Vyoshadi Gutika.
Recommendations for further study
1) It would be worth to test by large sample study.
2) Spirometry studies may be applied to extend the study.
3) Long standing administrations of medicaments required for long standing disease.
4) As texts avow the usage of Muhurmuhu administration irrespective of fixed quantity
may be tried with these medicines viz. Brihat Katphaladi Yoga.
Conclusions on Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
130
Chapter - 8
Summary The word Tamaka Swasa is the name of illness consisting of the two words
Tamaka and Swasa.
Specific Nidana for Tamaka Swasa is not mentioned in classics, as it is a sub type
of Swasa roga, same Nidana are applicable to Tamaka Swasa also.
The imbalance of Vata and Kapha Dosha afflicts the Rasa Dhatu in the
pathogenesis of Tamaka Swasa.
Tamaka Swasa is treated with “Tamaketu Virechanam” other wise understood, as
Nitya Shodhana administration.
Even though much number of predisposing factors may initiate an attack of
Tamaka Swasa or may worsen the episode, the Brihat Katphaladi Yoga with its
combination effect cures the Tamaka Swasa patients.
Teevra vega Swasa and Ghurgurukatwam is pratyatma niyata lakshana of Tamaka
Swasa observed 100% in all patients.
Statistically all subjective and objective parameters in both Groups individually
are Highly significant except Kantodhwamsa, which is Non Significant.
But in comparison Vyoshadi Gutika Nitya Shodhana and Brihat Katphaladi Yoga
internally doesn’t show any marked significance suggests that both drugs on their
respective places are the best in action.
Thus Vyoshadi Gutika Nitya Shodhana and Brihat Katphaladi Yoga internally at
Tamaka Swasa are best recommended drugs with their requisite actions.
Summary of Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
131
Bibliographic References
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Krishnadas academy, Varanasi, pp 167 4) Ibid, Chikitsa, 17/5, pp 533 5) Ibid, 17/62, pp 535 6) Petersdorf R.G editor, Harison principles of internal medicine, Vol-2, 252 ch. 14th ed.
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chapter, Harcourt (India) Pvt. Ltd., India, pp 455 9) G.S.Sainani ed, API Textbook of Medicine, 6th ed, 1999, sec 6-ch 7, The Association
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12) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/9, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 533
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15) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/122, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 538
16) K.R. Srikantha Murthy edited, Astanga Hrudaya Nidana 4/13, 3rd ed, 1996, Krishnadas academy, Varanasi, pp 37-38
17) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/8, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 533
18) K.R. Srikantha Murthy edited, Astanga Sangraha Sutra 1/34, 2rd ed, 1998, Chaukhambha Orientalia, Varanasi, pp 30
19) P.V.Sharma, Dravyaguna Vijnana, Vol-1, part 2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 229
20) Ibid, pp 138 21) Ibid, pp 141 22) Ibid, pp 142
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23) Ibid, pp 140 24) G.S.Sainani ed, API Textbook of Medicine, 6th ed, 1999, sec 6-ch 7, The Association
of physicians of India, Mumbai, pp 229 25) Yadavji Trikamji Acharya edited, Charaka Samhita Kalpa, 12/68, Chakrapani
Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 674
26) Raja Radhakanta Dev, Shabda Kapla Druma, Vol-5, 3rd ed, 1967, Chaukhambha Samskrut seeris, Varanasi, pp 178
27) Ibid, 28) Ambika Datta Shastri, Susruta Samhita Uttara 51/8, 17th edition, 2003, Choukumbha
Sanskrit Samsthana, Varnasi, p 374-5 29) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51/8 Dalhana comentary,
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pp 273 38) Sriram Sharma Acharya, 101 Upanishat, vol-2, 7th ed, Atmopanishat, 18 sl, Brahma
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Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 533-9
43) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51st chapter, Dalhana comentary, Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 761-5
44) P.V.Sharma, Bhela Samhita Chikitsa 20th chapter, 1st ed., 2005,Varanasi: Chaukhambha Bharati academy, Varanasi, pp 429-32
45) Ramavallabha Shastri ed, Harita Samhita, 20/1, Dhanvantari Granthalaya no –2, 1985, Prachya Prakashana, Varanasi, pp 309
46) P.V. Tiwari, Kashyapa Samhita, Khila stana, 2/12, 1st ed, 2002, Chaukhambha Bharati academy, varanasi, pp 164
47) K.R. Sriknta Murty ed, Astanga Hridaya Nidana, 4th chapter, 3rd ed, 1996, Krishnadas Academy, Varanasi, pp 245-54
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48) K.R. Srikantha Murthy edited, Astanga Sangraha Nidana 4th chapter, 2nd ed, 1998, Chaukhambha Orientalia, Varanasi, pp 168-72
49) Yadunandan Upadhyay, Madhava Nidana, Vol-1, 12th chapter, 15th ed, 1985, Choukumbha Samskrut samstan, Varanasi, pp 281-301
50) P.V. Sharma, Chakradatta, 12th chapter, 2nd ed, 1998, Choukumbha Orientalia, New Delhi, pp 145-49
51) Bramha Shankar Mishra edited, Vidyotini commentary on Bhavaprakasha, Madhayma Khanda Swasarogadhikara, 13th chapter, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp 159-166
52) Brahma Shankara Shastri, Yogaratnakara, Swasadhikara, 4th ed, 1998, Choukumbha Sanskrit samsthan, Varanasi, pp 427-37
53) Kalmat. B.L, Evaluation of the efficacy of Ardhedashemaniya Swasaharavati in the management of Tamaka Swasa, DGMAMC, Gadag, RGUHS Thesis, 2006,
54) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/10-16, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 533
55) Ibid, 17/12, pp 533 56) Ibid, 17/10-16, 533 Chakrapani, pp 533 57) Ibid, 58) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 50/3-5, Dalhana
comentary, Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 758
59) K.R. Srikantha Murthy edited, Astanga Sangraha NIdana 4/2-3, 2rd ed, 1998, Chaukhambha Orientalia, Varanasi, pp 168
60) K.R. Srikantha Murthy edited, Astanga Hrudaya Nidana 4/1-2, 3rd ed, 1996, Krishnadas academy, Varanasi, pp 37
61) Brahma Shankara Shastri, Yogaratnakara, Swasadhikara Nidana, 1-4, 4th ed, 1998, Choukumbha Sanskrit samsthan, Varanasi, pp 427-8
62) Bramha Shankar Mishra edited, Vidyotini commentary on Bhavaprakasha, Madhayma Khanda Swasarogadhikara, 13/1-2, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp 159
63) Yadunandan Upadhyay, Madhava Nidana, Vol-1, 12/1-2, 15th ed, 1985, Choukumbha Samskrut samstan, Varanasi, pp 281
64) Ganga Sahay Pande ed, Gadanigraha, 11/2-3, 1st ed. Vol-2, 1969, Choukumbha Samskrut Samstan, Varanasi, pp 357
65) http://www.asthmacure.com/triggers/asthma_triggerfirst.htm 66) Aspi F Golwal, Golwal Medicine for students, 17th ed, 1999, A F Golwal Publishers
pvt. Ltd. Mumbai, pp 226 67) http://www.asthmacure.com/triggers/asthma_triggerfirst.htm 68) Antony Seaton, et.al, Crofton and Dougla’s Respiratory diseases, chapter 26, edited
by Neil O. Brein, published by Oxford University press, New Delhi, 4th edition, 1989, pp 677
69) Ibid, pp 678-9 70) Ibid, pp 679 71) http://www.asthmacure.com/triggers/asthma_triggerfirst.htm
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3
72) Antony Seaton, et.al, Crofton and Dougla’s Respiratory diseases, chapter 26, edited by Neil O. Brein, published by Oxford University press, New Delhi, 4th edition, 1989, pp 680
73) CRW Edwords, Davidson’s Principles of Practice of Medicine, 13th chapter, 19th edition, 1979, Churchill Livingstone, London, pp 514
74) Antony Seaton, et.al, Crofton and Dougla’s Respiratory diseases, chapter 26, edited by Neil O. Brein, published by Oxford University press, New Delhi, 4th edition, 1989, pp 680
75) Petersdorf R.G editor, Harison principles of internal medicine, Vol-2, 252 ch. 14th ed. 1998, India: Mcgraw Hill, New York, pp 1422
76) Antony Seaton, et.al, Crofton and Dougla’s Respiratory diseases, chapter 26, edited by Neil O. Brein, published by Oxford University press, New Delhi, 4th edition, 1989, pp 681
77) http://www.asthmacure.com/triggers/asthma_triggerfirst.htm 78) Ibid 79) G.S.Sainani ed, API Textbook of Medicine, 6th ed, 1999, sec 4-ch 7, The Association
of physicians of India, Mumbai, pp 228 80) Antony Seaton, et.al, Crofton and Dougla’s Respiratory diseases, chapter 26, edited
by Neil O. Brein, published by Oxford University press, New Delhi, 4th edition, 1989, pp 680
81) CRW Edwords, Davidson’s Principles of Practice of Medicine, 13th chapter, 19th edition, 1979, Churchill Livingstone, London, pp514
82) Antony Seaton, et.al, Crofton and Dougla’s Respiratory diseases, chapter 26, edited by Neil O. Brein, published by Oxford University press, New Delhi, 4th edition, 1989, pp 680
83) http://www.asthmacure.com/triggers/asthma_triggerfirst.htm 84) Yadunandan Upadhyay, Madhava Nidana, Vol-1, 1/5-6, 15th ed, 1985, Choukumbha
Samskrut samstan, Varanasi, pp 32 85) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/17, Chakrapani
Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 533
86) Ibid, 17/18-20, pp 533 87) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51/6 Dalhana comentary,
Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 761
88) K.R. Srikantha Murthy edited, Astanga Sangraha Nidana 4/6, 2rd ed, 1998, Chaukhambha Orientalia, Varanasi, pp 168
89) K.R. Srikantha Murthy edited, Astanga Hrudaya Nidana 4/4, 3rd ed, 1996, Krishnadas academy, Varanasi, pp 38
90) Bramha Shankar Mishra edited, Vidyotini commentary on Bhavaprakasha, Madhayma Khanda Swasarogadhikara, 14/3, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp 161
91) Brahma Shankara Shastri, Yogaratnakara, Swasadhikara, 4th ed, 1998, Choukumbha Sanskrit samsthan, Varanasi, pp 428
92) Ganga Sahay Pande ed, Gadanigraha, 11/18, 1st ed. Vol-2, 1969, Choukumbha Samskrut Samstan, Varanasi, pp 361
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93) Yadunandan Upadhyay, Madhava Nidana, Vol-1, 12/5, 15th ed, 1985, Choukumbha Samskrut samstan, Varanasi, pp 285
94) http://www.diseases-asthma-recognisng asthma signs and symptoms-national Jewish medical and research center.html
95) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/55-62, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 535
96) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51/8-10 Dalhana comentary, Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 762
97) K.R. Srikantha Murthy edited, Astanga Hrudaya Nidana 4/6-10, 3rd ed, 1996, Krishnadas academy, Varanasi, pp 38
98) K.R. Srikantha Murthy edited, Astanga Sangraha NIdana 4/8-13, 2rd ed, 1998, Chaukhambha Orientalia, Varanasi, pp 169
99) Yadunandan Upadhyay, Madhava Nidana, Vol-1, 12/27-34, 15th ed, 1985, Choukumbha Samskrut samstan, Varanasi, pp 296-7
100) Bramha Shankar Mishra edited, Vidyotini commentary on Bhavaprakasha, Madhayma Khanda Swasarogadhikara, 14/14-21, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp 163
101) Brahma Shankara Shastri, Yogaratnakara, Swasadhikara/5-8, 4th ed, 1998, Choukumbha Sanskrit samsthan, Varanasi, pp 430
102) Ganga Sahay Pande ed, Gadanigraha, 11/29-38, 1st ed.vol-2, 1969, Choukumbha Samskrut Samstan, Varanasi, pp 363-4
103) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/17, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 533
104) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51/4 Dalhana comentary, Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 761
105) Bramha Shankar Mishra edited, Vidyotini commentary on Bhavaprakasha, Madhayma Khanda Swasarogadhikara, 14/4, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp -161
106) Brahma Shankara Shastri, Yogaratnakara, Swasadhikara, 4th ed, 1998, Choukumbha Sanskrit samsthan, Varanasi, pp 427
107) Yadunandan Upadhyay, Madhava Nidana, Vol-1, 12/4, 15th ed, 1985, Choukumbha Samskrut samstan, Varanasi, pp 283
108) K.R. Srikantha Murthy edited, Astanga Hrudaya Nidana 4/6-7, 3rd ed, 1996, Krishnadas academy, Varanasi, pp 37
109) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/8, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 533
110) K.R. Srikantha Murthy edited, Astanga Hrudaya Sutra 13/1, 3rd ed, 1996, Krishnadas academy, Varanasi, pp 182
111) Ibid, 13/10, pp 183 112) Ibid, 11/8, pp 156
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113) Yadavji Trikamji Acharya edited, Charaka Samhita Sutra, 10/14 , Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 66
114) Ibid, Chikitsa 17/8-9, pp 533 115) Ibid, 17/17, pp 533 116) Ibid, 17/55, pp 535 117) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51/8 Dalhana comentary,
Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 762
118) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/57, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 535
119) Ibid, 17/58, pp 535 120) Ibid, 17/63-4, pp 535 121) Ibid, 17/62, pp 535 122) Ibid, 17/63 Chakrapani, pp 536 123) K.R. Srikantha Murthy edited, Astanga Hrudaya Sutra 11/6, 3rd ed, 1996, Krishnadas
academy, Varanasi, pp 156 124) Yadavji Trikamji Acharya edited, Charaka Samhita Nidana, 1/11, Chakrapani
Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 196
125) Ibid, Chikitsa, 17/63-64 Chakrapani, pp 536 126) Ibid, Sutra 19/4, pp 110 127) Ibid, Chikitsa, 17/8, pp 533 128) Yadunandan Upadhyay, Madhava Nidana, Vol-1, 12/12, 15th ed, 1985, Choukumbha
Samskrut samstan, Varanasi, pp 286 129) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/148, Chakrapani
Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 539
130) Ibid, 17/68, pp 536 131) Ibid, 17/62, pp 535 132) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51/13 Dalhana comentary,
Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 762
133) Yadunandan Upadhyay, Madhava Nidana, Vol-1, 12/17, 15th ed, 1985, Choukumbha Samskrut samstan, Varanasi, pp 290-2
134) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/68, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 536
135) Antony Seaton, et.al, Crofton and Dougla’s Respiratory diseases, chapter 26, edited by Neil O. Brein, published by Oxford University press, New Delhi, 4th edition, 1989, pp 682
136) Petersdorf R.G editor, Harison principles of internal medicine, Vol-2, 252 ch. 14th ed. India: Mcgraw Hill, New York, 1998.p 1420
137) CRW Edwords, Davidson’s Principles of Practice of Medicine, 19th edition, 1979, Churchill Livingstone, London, pp 513
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6
138) Ibid, 514 139) Yadunandan Upadhyay, Madhava Nidana, Vol-1, Madhukosha 1/8, 15th ed, 1985,
Choukumbha Samskrut samstan, Varanasi, pp 44 140) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/58, Chakrapani
Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 535
141) Ibid, 17/60, pp 535 142) Ibid, pp 535 143) Yadunandan Upadhyay, Madhava Nidana, Vol-1, 1/9, 15th ed, 1985, Choukumbha
Samskrut samstan, Varanasi, pp 53 144) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/62, Chakrapani
Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 535
145) Ibid, 17/59, pp 535 146) Ibid, 22/17, pp 567 147) Ibid, 17/7, pp 533 148) Ibid, Indriya, 7/24, pp 366 149) Ibid, 7/25, pp 366 150) Ibid, 8/15, pp 367 151) Ibid, Chikitsa 17/62, pp 535 152) Bid, 17/58, pp 535 153) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51/13 Dalhana comentary,
Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 762
154) K.R. Srikantha Murthy edited, Astanga Hrudaya Nidana 4/18, 3rd ed, 1996, Krishnadas academy, Varanasi, pp 40
155) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/49-67, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 534-6
156) Ibid, 17th chapter, 533-9 157) Ibid, 17/138, pp 539 158) Ibid, 17/89, pp 537 159) Ibid, 17/90, pp 537 160) Ibid, 17/91-92, 537 161) Ibid, 17/139, pp 539 162) Ibid, 17/112, pp 538 163) Ibid, 17/113, pp 538 164) Rajeswar Dutt Shastri, Charaka Samhitachikitsa 17/113, 1st ed, reprint 1998,
Chaukhambha bharathi academy, Varanasi, pp 524 165) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/111, Chakrapani
Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 538
166) Ibid, 17/114, pp 538 167) Ibid, 17/148, pp 539 168) Ibid, 17/48 Chakrapani, pp 539 169) Ibid, 17/71, 536
Bibliographic References - Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
7
170) Ibid, 17/82, pp 536 171) Ibid, 17/81, pp 536 172) Ibid, 17/85, pp 536 173) Ibid, 17/74-75, pp 536 174) Ibid, 17/74-76, pp 536 175) Ibid, 17/121, pp 538 176) Ibid, 17/86, pp 537 177) Ibid, 17/87, pp 537 178) Ibid, siddhi \, 1/11, pp 678 179) Ibid, 17/121, pp 538 180) Ibid, 17/77-80, pp 536 181) Ibid, 17/131, pp 538 182) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51/30 Dalhana comentary,
Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 763
183) Yadavji Trikamji Acharya edited, Charaka Samhita Chikitsa, 17/120, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 538
184) Ibid, 17/149, pp 539 185) Ibid, 17/151, pp 539 186) Yadavji Trikamji Acharya edited, Susruta Samhita Uttara, 51/55 Dalhana comentary,
Dalhana Nibandha Sangraha, Chaukhambha Ayurvijnana Grandhamala - 42, 1st ed, reprint 1994, published by Chaukhambha Surabharathi Prakashan, Varanasi, pp 765
187) K.R. Srikantha Murthy edited, Astanga Hrudaya Chikitsa 4/29, 3rd ed, 1996, Krishnadas academy, Varanasi, pp 534
188) Satya Narayan Shastri, Charka Samhita Chikitsa 17/47, 1st ed. 2001,Choukumbha Bharati Academy, Varanasi, pp 529
189) Ambika Datta Shastri, Susruta Samhita Uttara 51/46-47, 15th edition, 2002, 190) Choukumbha Sanskrit Samsthana, Varnasi, p 381 191) K.R. Sriknta Murty ed, Astanga Hridaya Chikitsa, 4/25, 2nd ed, 1996, Krishnadas
Academy, Varanasi, pp 249 192) Brahma Shankara Shastri, Yogaratnakara, Swasadhikara, 1-8 sl, 5th ed, 1993,
Choukumbha Sanskrit samsthan, Varanasi, pp 435-36 193) Ambikadatta Shastri, Govindadas, Bhaishajya Ratnavali, 16/132-6, 6th ed, 1981,
Choukumbha Samskrut Pratistan, Varanasi, pp 339 194) Srikanta Murthy edited, Sharangadhara Samhita Madhyama Khanda, 6/ 40-41, 4th
edition 2001, Jaikrishnadas Ayurved Series - 58, published by Chaukhambha Orientalia, Varanasi, pp 89
195) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 575-77
196) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 100
197) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, popular prakashan, Bombay, 1996, pp 828
Bibliographic References - Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
8
198) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 296-8
199) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 94
200) Ibid, pp 95 201) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati
academy, Varanasi, pp –184-6 202) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd
edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 98
203) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, popular prakashan, Bombay, 1996, pp 1062
204) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp –370-72
205) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 244
206) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, popular prakashan, Bombay, 1996, pp 428
207) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 292-3
208) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 247
209) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, popular prakashan, Bombay, 1996, pp 608
210) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 331-5
211) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 12
212) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, popular prakashan, Bombay, 1996, pp 1309
213) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp –275-9
214) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 19
215) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, popular prakashan, Bombay, 1996, pp 965
216) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 362-5
217) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 17
Bibliographic References - Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
9
218) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, 1996, popular prakashan, Bombay, pp 969
219) Yadavji Trikamji Acharya edited, Charaka Samhita Kalpa, 7/46-49, Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 664
220) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 250-2
221) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 226
222) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, popular prakashan, Bombay, 1996, pp 333
223) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 250-2
224) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 228
225) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, 1996, popular prakashan, Bombay, pp 333
226) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 719-21
227) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 222
228) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, 1996,popular prakashan, Bombay, pp 475
229) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 503-6
230) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp -52
231) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, 1996,popular prakashan, Bombay, pp 478
232) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 758-60
233) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 10
234) Ibid, pp 11 235) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati
academy, Varanasi, pp 753-58 236) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd
edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp – 1-8
237) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, 1996, popular prakashan, Bombay, pp 1206
Bibliographic References - Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
10
238) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 426-8
239) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp - 399
240) Yadavji Trikamji Acharya edited, Charaka Samhita Kalpa, 7/46-49 Chakrapani Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp
241) P.V.Sharma, Dravyaguna Vijnana, Vol-2, 14th ed, 1990, Chaukhambha Bhrati academy, Varanasi, pp 419-22
242) Bramha Shankar Mishra edited, Bhavaprakasha (Vidyotini commentary), vol-1, 2nd edition, Kashi Sanskrit series –130, Chaukhambha Sanskrit Sansthan, Varanasi, pp – 397
243) K.M Nadakarni, Indian Materia Medica, Vol I, 3rd edition, 1996, popular prakashan, Bombay, pp 398
244) GEORGE L. ACKERMAN, M.D. et.al., Department of Medicine, University of Arkansas College of Medicine, Little Rock, Arkansas, Clinical Methods, ch 35, An Overview of the Pulmonary System by Eric Honig @ http://www.ncbi.nlm.nih.gov/books/bookres.fcgi/cm/ch035pdf.pdf, pp 194
245) Michel Swash, Hutchinson’s Clinical Methods, 21st ed, 2002, Saunders, Totonto, pp 60-78
246) Suresh R.D, The Evaluation of Padmapatradi Yoga in Tamaka Swasa (Broncheal Asthma), DGMAMC, Gadag, RGUHS, 2001, pp 66
247) Ibid, pp 67 248) Ramnik Sood, Medical Lab Technology, 4th ed, 1994, Jaypee Brothers, New Delhi,
pp 224 249) Ibid, pp 184-85 250) Ibid, pp 171 251) http://www.who.int/respiratory/asthma/burden/en/print.html 252) http://www.who.int/respiratory/asthma/scope/en/print.html 253) http://www.who.int/respiratory/asthma/activities/en/print.html 254) Yadavji Trikamji Acharya edited, Charaka Samhita Kalpa, 12/69, Chakrapani
Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 674
255) Ibid, 12/68, pp 674 256) Ibid, Chikitsa, 17/122, pp 538 257) K.R. Srikantha Murthy edited, Astanga Hrudaya Sutra 20/26-29, 3rd ed, 1996,
Krishnadas academy, Varanasi, pp 260-1 258) Yadavji Trikamji Acharya edited, Charaka Samhita Kalpa, 12/67, Chakrapani
Ayurveda deepika, Chaukhambha Ayurvijnana Grandhamala - 34, reprint 1992, Chaukhambha Surabharathi Prakashan, Varanasi, pp 674
Bibliographic References - Brihat Katphaladi yoga / Vyoshadi Gutika Nitya Shodhana in Tamaka Swasa
11
SPECIAL CASE SHEET FOR THE EVALUATION OF BRIHAT KATPHALADI YOGA IN COMPARISON WITH VYOSHADI GUTIKA NITYA SHODHANA IN TAMAKA SWASA” POST GRADUATE STUDIES AND RESEARCH CENTER (KAYACHIKITSA)
SHRI. D.G.M.AYURVEDIC MEDICAL COLLEGE, GADAG
Guide: Dr. K. Shiva Rama Prasad
Scholar: Umesh Kumbar
1) Name of the Patient Sl.No
2) Sex Male Female OPD No
3) Age Years IPD No
4) Religion Hindu Muslim Christian Other
5) Occupation Sedentary Active Labor
6) Economical status Poor Middle Higher middle Higher class
7) Address
Pin
8) Birth data Place of Birth
AM Date Month Year Time
Hours Minutes PM
9) Selection Included Excluded
10) Schedule dates Initiation completion
11) Result Well
Responded
Moderately
Responded
Not
responded
Discontinued
INFORMED CONSENT I Son/Daughter/Wife of
am exercising my free will, to participate in above study as a subject. I have been informed to
my satisfaction, by the attending physician the purpose of the clinical evaluation and nature of
the drug treatment. I am also aware of my right to opt out of the treatment schedule, at any
time during the course of the treatment. EzÀÄ £Á£ÀÄ ²æÃ/²æêÀÄw _________________________________________________ £À£Àß ¸ÀéEZÀÑ ¬ÄAzÀ
PÉÆqÀĪÀ aQvÁì ¸ÀªÀÄäw. ¥Àæ¸ÀÄÛvÀ £ÀqÉ¢gÀĪÀ aQvÁì ¥ÀzÀÞw0iÀÄ §UÉÎ £À£ÀUÉ aQvÀìPÀjAzÀ ¸ÀA¥ÀÇtð ªÀiÁ»w zÉÆgÉwzÀÄÝ ªÀÄvÀÄÛ
0iÀiÁªÁUÁzÀÄgÀÄ aQvÀì¬ÄAzÀ »AwgÀÄUÀ®Ä ¸ÁévÀAvÀæ÷å «zÉ JAzÀÄ w½¢gÀÄvÀÛ£É.
gÉÆV0iÀÄ gÀÄdÄ / Patient's Signature
“Evaluating the efficacy of Brihat Katphaladi yoga in comparison with Vyoshadi Gutika nitya shodhana in Tamakaswasa” 1
“Evaluating the efficacy of Brihat Katphaladi yoga in comparison with Vyoshadi Gutika nitya shodhana in Tamakaswasa” 2
12) CHIEF COMPLAINTS WITH DURATION (Subjective Parameters) Complaints Duration
1 Teevra vega Swasa (Dyspnonea) 2 Kasa (cough) 3 Duhkhena Kapha nissaranam (Expectoration) 4 Ghurghuratwam (Wheezing) 5 Peenasa (Coryza) 6 Kruchrena bhasate (difficulty in speech) 7 Kantodhwamsham (Hoarseness of voice) 8 Greevashirasangraha (Headache & Stiffness) 9 Urah Peeda (Chest Pain) 10 Shayane Swasa peedita (Discomfort at supine) 13) ASSOCIATED COMPLAINTS Associated Complaints Duration
1 Anidra (disturbed sleep) 2 Pratamyati or Bhrushamarta (distressed) 3 Aruchi (Anorexia) 4 Vishukasyata (Dryness of mouth) 5 Lalata sweda (sweat over forehead) 6 Trushna (Thirst) 7 Angamarda (Malaise) 8 Kampa (Tremors) 9 Jwara (fever) 10 Pramoha (fainting) 11 Vamathu (nausea) 12 Muhur Swasa (frequent respiration) 13 Muhuchaiva dhamyati (puts all effort to breath)
14) HISTORY OF PRESENT ILLNESS Mode of onset - sudden / Gradual Course episodic/ continuous/ initially episodic Frequency of attack few hours / few days / few weeks Duration of attack continuous / intermittent / subsides with medication Mode of progress Typical / Rapid / Longtime non progressive Periodicity seasonal / irregular / perennial Preceded by sneezing / nasal irritation/ cough/ Talking Aggravating factors dust/ food/ smoke/ pets / pollens/ Stress Comfort posture at attack sitting/ lying/ standing/ forward bending
15) Occupational History if any
“Evaluating the efficacy of Brihat Katphaladi yoga in comparison with Vyoshadi Gutika nitya shodhana in Tamakaswasa” 3
16) PERSONAL HISTORY
Food habits Vegetarian Mixed diet
Taste preferred Sweet Sour Salty Pungent Bitter Astringent
Agni Sama Vishama Manda Teekshna
Kosta Mrudu Madhyama Krura
Nidra Day Night Sound Disturbed
Addictions Tobacco Alcohol Drugs
Bowel habits Normal Loose Constipated
Menstrual History Regular Irregular Amenorrhea Menopause
Family history – Specify if any has the same disease
Other system medications Bronchodialtors Treatment history Cortico steroids Other medicines RS Since how long
History of past illness
17) EXAMINATION (a) Vitals
Temperature ºF Pulse / min Respiration rate / min
Height Cms Weight Kg Blood pressure mmHg
(b) General
Oedema Present Absent Icterus Present Absent
Pallor Present Absent Cyanosis Present Absent
Clubbing Present Absent Palpable lymph nodes
Present Absent
(c) Respiratory system
Shape Normal / Kyphosis / Scoliosis/ Flattening/ over inflation Movement Normal / Reduced Resp. Rhythm Normal / Abnormal Respiration Thoracic/ Abdominal / Thoraco abdominal Accessory muscles Not involved / Involved / Inter coastal spaces Visible veins Absent / present
Dar
shan
a
Venous pulses Normal / Raised Tracheal position Centrally placed / Deviated Pain / Tenderness Swelling Vocal fremitus Shape Symmetrical / Asymmetrical Sp
arsh
ana
Lymph nodes Not palpable / palpable at Akotana Normal / Resonant / Hyper Resonant / Dull
Type of breath Broncho-vesicular/ Vesicular / Bronchial Vocal resonance Normal / Increased/ Decreased/ Absent
Shra
vana
Resp. Sound Rales/ Ronchi/ Crepitating/ Plural Rub /
“Evaluating the efficacy of Brihat Katphaladi yoga in comparison with Vyoshadi Gutika nitya shodhana in Tamakaswasa” 4
(d) Dosha Examination (Ayurvedic)
Desham (Deha) Bhumi Jangala Anupa Sadharana Vata B A Pitta B A Kapha B A
Karshya Peeta mootrata Agni sadana
Karshnya Peetanetra Praseka
Ushna kamitwa Peetavi t Alasya
Kampa Peetatwak Swetangata
Anaha Adhikshudha Sheetangata
Shakrudgraha Adhidaha Gowrava
Balabhrmsha Slathangata
Nidrabhramsha Swasa
Pralapa Kasa
(a) Dosha Vruddhi
Bhrama At in idra
Vata B A Pitta B A Kapha B A
Angasada Mandagni Bhrama Alpabhashite
ahitam Shareera sheetatwam Urah
shoonyata
Chesta heenata Prabha hani Shira soonyata
Vyamoha Hridrava
(b) Dosha Kshaya
Sleshma vruddhi Sandhi saidhi lya
Nadi V P K VP VK PK VPK
Prakruti V P K VP VK PK VPK
Sara Pravara Avara Madhyama Samhanana Susamhita Asamhita Madhyma samhita Pramana Height in Cms Weight in Kgs Satmya Ekarasa Sarvarasa Ruksha Sneha Satwa Pravara Avara Madhyama Ahara Shakti Abhyavaharana Jarana Vyayam Shakti Pravara Avara Madhyama Vaya Balya Yauvana Vardhakya
Nadi Dosha Pravrutti Gati Varna Purnata Gandha
Spandana Kathinya
Mutra
Jihwa Ardra Sushka Sama Nirama Lepa Nirlepa
Mala
Shabda Sparsha Sheeta Ushna
Ast
asth
ana
Drik Akruti
“Evaluating the efficacy of Brihat Katphaladi yoga in comparison with Vyoshadi Gutika nitya shodhana in Tamakaswasa” 5
(e) Srotas Before After Before After Pranavaha Atisrustam Ati badhdama Kupitam Abheekhnam Alpalpa Sashoolam Annavaha Aruchi Ajeerna Chardi Anannabhilasha Udakavaha Jihwashosha Talushosha Ostashosha Pipasa
18) Tamaka Swasa Nidana Visamashana (V) Tilataila (P) Pistanna (K) Masa (K)
Adhyashana (V) Vidahi (P) Nispava (K) Dadhi (K)
Anasana (V) Saluka (K) Vistambhi (K)
Sheetashana (V) Guru dravyas (K) Amaksira (K)
Visha (V) Jalajamamsa (K)
Sheetapana (V) Anupa mamsa (K)
Aha
ra
Rukshanna (V) Abhishyandi (K)
Rajas (V) Abhighata (V) Kanthapratighata (V) Urahpratighata (V) Vata (V) Dhuma (V) Karmahata (V) Marmabhighata(V) Sheeta Sthana (V) Apatarpana (V) Veganirodha (V) Usna (P) Sheeta ambu (V) Bharakarshita
(V) Shuddhi Atiyoga (V) Abhishyandi
Upacara (K) Vi
hara
Ativyayama (V) Adhwahata (V) Gramya dharma (V) Divasvapna (K) Ksataksaya Atisara Visucika
Udavarta Vibandha Panduroga
Vata
Kshaya Anaha Dourbalya
Pitta Rakta pitta Jwara
Kasa Amapradosa Chardi
Any
a / V
yadh
i Ava
sta
sam
band
ha
Kapha
Pratisyaya Amatisara
19) Tamaka Swasa Poorvaroopa
BT AT BT AT
Hrutpeeda Parshwashoola
Kshudra Swasa Vibandha
Shankha bheda Anaha
Shoola Arati
Pranavilomata Bhakta dwesha
Vaktra vairasya Admana
“Evaluating the efficacy of Brihat Katphaladi yoga in comparison with Vyoshadi Gutika nitya shodhana in Tamakaswasa” 6
20) Tamaka Swasa Vikalpa Samprapti
Santamaka Pratamaka
Udavarta Jwara
Rajaobhighata Moorcha
Ajeerna
Vata nirodha
21) Upashaya and Anupashaya
Asheene labhate sowkhyam Sleshma vimokshante sukham Upashaya
Usnamchaivabhinandate Shayanasya sameerane parshwe ghrnnati
Anupashaya Shayanasya Swasa peedita Meghambu sheeta pragwata
22) INVESTIGATIONS (Objective parameters) Investigations for screening
Sputum examination (if necessary) Chest-X-Ray (if necessary) Erythrocyte Sedimentation Rate Absolute Eosinophil count Total Count WBC
Lymphocytes Neutrophils Eosinophils Basophils
Differential count
Monocytes 23) Assessment A) Disease Assessment 1) Subjective parameters Before After Follow-up Comment
1 Teevra vega Swasa (Dyspnonea)
2 Kasa (cough)
3 Duhkhena Kapha nissaranam (Expectoration)
4 Ghurghuratwam (Wheezing)
5 Peenasa (Coryza)
6 Kruchrena bhasate (difficulty in speech)
7 Kantodhwamsham (Hoarseness of voice)
8 Greevashirasangraha (Headache & Stiffness)
9 Urah Peeda (Chest Pain)
10 Shayane Swasa peedita (Discomfort at supine)
“Evaluating the efficacy of Brihat Katphaladi yoga in comparison with Vyoshadi Gutika nitya shodhana in Tamakaswasa” 7
2) Objective parameters Before After Follow-up
1 Breath holding time /sec /sec /sec
2 Peak expiratory flow rate L/m L/m L/m
3 Erythrocytes sedimentation rate mm/1st Hour mm/1st Hour mm/1st Hour
4 Haemoglobin % Gm% Gm% Gm%
5 Total Count WBC
6 Absolute eosinophilic count /cumm /cumm /cumm
7 Eosinophilic Differential count
B) Assessment of Nitya Shodhan: (Samyak Virechana Lakshana) (for Group-B only) Sno Symptom Before Day 7 Day 14 Day 21 Final
Pranavaha Udakavaha
1 Sroto Prasadanam (VAS 100 each, 300 max) Annavaha
Srotra Sparsha Chkshau Rasana Ghrana
2 Mano Indriya Prasadanam (VAS100 each, 600 max)
Manas 3 Laghava (Body Lightness) (VAS100 max) 4 Agni Vruddhi (VAS100 max) 5 Anamayatwa (As depicted in subjective
parameters VAS 100 each, 1000 max)
6 Ayoga lakshana abhava (VAS100 max) Total
(ArÉÉåaÉ sɤÉhÉ = ¾ÒûiÉ MÑüÍ¤É AvÉÑÌ®, MüTü ÌmÉ¨É EiYsÉåvÉ, AÂÍcÉ, MüÇQÒû, ÌuÉSÉWû, ÌmÉÌQûMü, mÉÏlÉxÉ, uÉÉiÉÌuÉÄQûaÉëWû)
24) Treatment schedule of “Brihat Katphaladi yoga / Vyoshadi gutika Tamakaswasa” Schedule Investigator’s observation
Day 1
Day 7
Day 14
Day 21 1st Follow up
Day 28 (Final Follow up)
Investigators Note:
Signature of Guide
(Dr. K. Shiva Rama Prasad)
Signature of Scholar
(Umesh Kumbar)