Bronchial Asthma – Concept of Tamaka Shwasa

Swasa (Asthma) is a condition that simply refers to difficulty in breathing or shortness of breath. The condition can originate from the respiratory system, referred to as primary. It can also originate from other systems of the body, referred to as secondary. Bronchial Asthma is a chronic inflammatory disease. It affects the airway and causes recurrent episodes of wheezing, breathlessness, tightness of chest, and cough, particularly at night or early morning. According to Ayurveda, the Vata and Kapha doshas mainly cause Swasa. Mahaswasa (Dyspnoea major), Urdhawaswasa (Expiratory Dyspnoea), Chinna swasa (Chynestroke respiration), Kshudra swasa (Dyspnoea minor), and Tamaka swasa (Bronchial Asthma) broadly classify Swasa into five types.

Etiology of bronchial asthma

The causes of Asthma are divided into two types.

• Inducing factors – These factors can induce Asthma in susceptible persons and include genetic factors, obesity, viral infections in early life, and exposure to tobacco smoke.
• Triggering factors – These factors can aggravate symptoms in a patient who has Asthma and include:
  1. Inhalation of Allergens such as house dust, pollen, mold, and animal dander.
  2. Environmental factors such as cold and dry climate, cooking gas fumes, passive cigarette smoking, paints, and sprays.
  3. Infections such as upper respiratory tract infections and viral infections.
  4. Drugs such as aspirin and pain killers (NSAIDs).
  5. Food such as coloring agents of food, food preservatives, and ice creams.
  6. Exercise, particularly vigorous exercise on a cold and dry day.
  7. Psychological factors such as stress.
  8. Occupation, such as wood and cotton dust and chemicals.

As per Ayurveda, the causes of Tamaka Swasa are as follows:

• Intake of dry, cold, heavy, incompatible food and irregular intake of food.
• Excessive intake of black gram, beans, sesame, and meat of aquatic animals.
• Intake of cold water and exposure to cold climate.
• Exposure to dust, smoke, and wind.
• Excessive exercise and overindulgence in sexual activity.
• Trauma to throat, chest, and vital organs.
• Suppression of natural urges.

Pathology of tamaka shwasa

When a person consumes an excessive amount of kapha-aggravating food and follows lifestyle practices that promote kapha imbalance, it can cause an aggravation of the kapha dosha in the body. This kapha imbalance, along with the vata dosha, can move towards the pitta sthana, leading to an aggravation of the pitta dosha as well. This increased pitta dosha can then cause Swasa or asthma.

Signs and symptoms

• Shortness of breath during forced expiration
• Hacking
• Whistling
• Oppression in chest
• Dense phlegm sputum
• Exacerbation of above symptoms at night and early morning
• Loss of consciousness during paroxysm of cough.
• Insomnia, uneasiness intensifies when laid on bed
• Feels at ease in upright position.
• Perspiration on the forehead.

According to Ayurveda, Tamaka Swasa has two types. The first type, Pratamaka Swasa, is associated with fever, fainting, distention of the abdomen, and indigestion. The second type, Santamaka Swasa, can be pacified by taking a cold regimen.

Diagnostic tests in Bronchial Asthma

1. Pulmonary function tests, Spirometry and peak flow measurements estimate an individual’s bronchial tube constriction and breathing speed.
2. To distinguish asthma from other lung diseases, a chest X-ray proves beneficial.
3. Allergy tests can identify the allergen causing asthma.
4. Medical professionals can confirm Bronchial asthma by conducting the Methacoline challenge test and Nitric oxide tests.

Treatment in Ayurveda

According to Ayurveda, Bronchial Asthma is a Vatakaphaja ailment that starts in the stomach and progresses to the lungs and bronchi. To treat this, the aim is to redirect the excess Kapha back to the stomach and eliminate it. The following techniques are employed for this purpose –

• Sudation (Swedana)
• Therapeutic emesis (Vamana)
• Therapeutic purgation (Virechana)

These methods will be employed depending on the patient’s specific needs. The practice of Pranayama, consuming laxatives, consuming a light diet at night, and drinking warm water can aid in the treatment of Asthma.

Useful Ayurvedic drugs for Asthma

• Talisadi Churna or Sitopaladi churna – 1 to 3 gms to be taken twice a day with honey
• Somalata churna – 1 to 3 gms to be taken twice a day with honey
• Kanakasava – 5 to 10 ml with equal quantity of Luke warm water after food
• Shringyadi churna – 1 to 3 gms to be taken twice a day with honey
• Vasavalehyam – 12 to 24 gms twice daily
• Trikatu churna – 1to 2 gms with honey
• Kantakaryavalehyam – 12 to 24 gms twice daily
• Vyaghriharitaki Avaleha – 12 to 24 gms twice daily
• Agastya Haritaki Avaleha – 12 to 24 gms twice daily
• Lavangadi vati – 1 tablet for chewing 3 times a day
• Swasakutara ras – 125 to 250 mg twice daily
• Mahalakshmivilas ras –125 to 250 mg twice daily

Useful medicinal plants for Asthma

• Kantakari (Solanum xanthocarpum)
• Vasa (Adhatoda vasica)
• Sunthi (Zingiber officinalis)
• Bharangi (Clerodendrum serratum)
• Pushkaramoola (Innula racemosa)
• Karkataka Shringi (Pistacia inergerrima)
• Haridra (Curcuma longa)

Note – Only a qualified physician should oversee the consumption of these medications.

Do’s and Don’ts in bronchial asthma

Do’s (Pathya)

• Wheat, brown rice, green gram, horse gram, barley, and snake gourd
• Incorporating garlic, turmeric, ginger, and black pepper into your diet
• Drinking lukewarm water, goat milk, and honey
• Performing respiratory exercises, pranayama, and yoga

Don’ts (Apathya)

• Consumption of heavy and cold foods, black gram, deep-fried items, mustard leaves, and fish
• Exposure to cold and humid weather conditions
• Avoiding sweets, chilled water, stored food items, and curd
• Suppressing natural urges
• Engaging in excessive physical activity
• Exposure to smoke, dust, fumes, pollutants, and pollens