3. Introduction
mÉëÉhÉÉmÉÉhÉÉæ ÌlÉqÉãwrÉɱç
eÉÏuÉlÉqÉç qÉlÉxÉÉã aÉÌiÉ:|
CÎlSìrÉÉliÉU xÉgcÉÉUÉ: mÉëãUhÉqÉç
kÉÉUhÉqÉç cÉ rÉãiÉ||
(cÉ. vÉÉ.
1/70)
The following is the proof of the existence of the Absolute
soul:
Inspiration and expiration
Twinkling of eye
4. Prana and apana or to say breathing in is the si-ne
qua phenomenon of life. To and fro movement of air
through the pranavaha srotas is the vital sign of Prana .The
normalcy of which suggests health. The abnormality of
respiration indicates diseases and its cessation marks
death. This unique sign of life is affected in the disease of
Tamaka swasa. This abnormality of breathing as indicative
of forthcoming death. This organ of breathing 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.
9. Nirukti
The word iÉqÉMü µÉÉxÉ composed of two
conjoint words. They are iÉqÉMü and µÉÉxÉ . The
word iÉqÉMü is derived from the Dhatu “Tamaka
glanou” with Kwip Pratyaya. It suggests to
choke, darkness, be suffocated.
It is also defined as “Tamayati iti Tamaka”.
“iÉqÉ eva iÉqÉMü ” in Shabdha Kalpa dhruma.
It means where “iÉqÉ” occurs that is iÉqÉMü .
10. • „Shwasathi iti Shwasa‟. It means to
breath, by which respiratory movements
takes place.
The word Tamaka Shwasa is formed
by Karmadhareya Samasa as “Tamakaccha
Aska Shwasacha Tamaka Shwasa‟. It
means difficulty in breathing which occurs
mainly during night hours.
11. Paribhasha
Susruta: Defines “
:”
( : :
/ )
It means the attack of Shwasa with tamapravesha which occurs
especially during “Durdhina”.
The meaning of durdhina is not explained in this context. But in
Charaka Samhita it is stated that symptoms
aggravated during cloudy
days.
Vijaya Rakshita: Explains Tamaka Shwasa as:
It is a disease where in the expiration of air produces
a sound similar to the sound of bellow of blacksmith.
13. Exposure to dust, smoke and wind
Residing in a cold space and use of cold water
Exercise sexual intercourse and long walk
beyond one‟s capacity
Intake of food, deficient or excessive in
quantity, and before or long after the meal time
Vitiation by ama
14. Constipation associated with flatulence
Dryness of body
Fasting in excess
Weakness and injury to vital organs
Use of mutually contradictory ingredients
Excessive administration of elimination
therapies
15. Purvroopa
mÉëÉaÉëÔmÉÇ iÉxrÉ WØûimÉÏQûÉ
vÉÔsÉqÉÉkqÉÉlÉqÉåuÉ cÉ|
AÉlÉÉWûÉå uÉY§ÉuÉæUxrÉÇ
vÉXçZÉÌlÉxiÉÉåSqÉåuÉ cÉ ||
Discomfort in the heart(chest), pain in
chest, distention in chest, constipation(with
flatulence), anorexia, and pain in the temporal
region are the of Purvroopa swasa roga.
17. Roopa
Aachrya CHARKA explains that vata moving
in the reverse order pervades the channels, afflicts
the neck and head, and stimulates kapha to cause
rhinitis. This vata, thus obstructed, produces the
following signs and symptoms:
Ghurghuraka (wheezing sound)
Dyspnoea of exceedingly deep velocity
Because of acute spasm, the patient gets
tremors and coughs, and become motionless
18. He faints again and again while coughing
Since the kapha does not come out, he becomes
all the more restless
He is relieved for sometime soon after the kapha
comes out
His throat is choked because of which he is
unable to speak freely
He does not get sleep. While lying down, he gets
dyspnoea because the sides of chest in that
position get afflicted by vata. But he is relived of
this discomfort in sitting position
19. He develops special liking for hot things
His eyeballs become prominent
Too much of sweating appears in his forehead
and he becomes restless
His mouth becomes dry frequently
He gets frequent episodes of dyspnoea
The attack gets aggravated when clouds appear
in sky, when he is exposed to water, and cold
when the easterly wind blows, and when he
resorts to kapha aggravating food and regimens
20. Upasaya and Anupasaya
Upasaya
Factors relieving the severity of disease
Asino labhate saukhyam (sitting posture
gives relief).
Shleshma vimokshe sukham (expectoration
of kapha gives relief).
Ushnabhinandati (liking toward hot things).
21. Anupasaya
Factors aggravating the severity of the
disease
Sheeta pana (cold drinks).
Sheeta vata (cold weather).
Guru bhojana (heavy eatables).
Vyayama (exercise).
Shayane shwasavriddhi (sleeping or lying
down intensify swasa).
22. Samnya Samprapti
qÉÉÂiÉ: mÉëÉhÉuÉÉÌWûÌlÉ
xÉëÉãiÉÉÇxrÉÉÌuÉvrÉ MÑümrÉÌiÉ|
EU:xjÉ: MüTüqÉÑ®ÕrÉ
ÌWûYMüɵÉÉxÉÉlMüUÉãÌiÉ xÉ:||
( cÉ.ÍcÉ. 17/17)
Vata located in the chest after afflicting the channels
(pranavaha srotas), gets aggravated and stimulates kapha.
This leads to the causation of two deadly diseases, viz.,
HICCA and SAWASA
23. Vishtha Samprapti
rÉSÉ xÉëÉãiÉÉÇÍxÉ xÉÇÂkrÉ
qÉÉÂiÉ:MüTümÉÔuÉïMü:|
ÌuÉwuÉauÉëeÉÌiÉ xÉÇ®xiÉSÉ
µÉÉxÉÉlMüUÉãÌiÉ xÉ:||
(cÉ.ÍcÉ 17/45)
If vata, predominantly associated with
kapha, obstructs the channels of circulation all
over the body, then being itself obstructed(in the
circulatory course), this aggravated vata causes
SWASA
24. iÉqÉMü µÉÉxÉ Samprapti
MüTüÉåmÉÂkSaÉqÉlÉ: mÉuÉlÉÉå
ÌuɵÉaÉÉÎxjÉiÉ:|
mÉëÉhÉÉåSMüɳÉuÉÉWûÏÌlÉ SÒ·:
xÉëÉåiÉÉÇÍxÉ SÕwÉrÉlÉ||
EU:xjÉ MÑüÂiÉå
µÉÉxÉqÉÉqÉÉvÉrÉxÉqÉÑ°uÉqÉç||
(A.WØû.ÌlÉ
4/3)
Vata obstructed in its movement by kapha,
25. NIDANA SEVANA
AGNIMANDYA
DOSHA DUSHTI ( VATA & KAPHA
DUSHTI)
AMARASOTPATTI
MALAROOPA KAPHA
PARIBHRAMANA
PRATILOMAGATI OF VATA
PRANAVAHA SROTOGAMANA
KAPHA makes AVARANA to PRANA VAYU
PRANA
try to overcome the
AVARANA
SHWASA (shwasavarodha, shwasativriddhi, Ghurghurkam etc.)
28. If the patient suffering from Tamaka swasa
gets afflicted with fever and fainting, the condition
is called as PRATAMAKA SWASA. This is caused
by UDAVARTA(upward movement of vata in
abdomen), dust, indigestion, humidity (kleda) and
suppression of the natural urge (kaya nirodha). It
gets aggravated in darkness (TAMA) and gets
alleviated by cooling regimens
29. Cont….
Santamaka is further variant of Pratamaka
according to Aachrya CHAKRAPANI.
GANGADHARA considered it as an Upadrava of
Pratamaka.
If a patient of Pratamaka Shwasa feel darkness
around him or sinks into unconsciousness due to
Tamadosha of Manas, it is considered as Santamaka.
In both these conditions though Kapha and Vata
are involved the Pittadosha also has main role in the
pathogenesis of the disease. Hence it will get relieved
by Sheetopachara.
30. Arista Laxana
The patient presenting with Deergha
Uchwasa, Nishwasa. The patient passing Gratitha
Mootra, Pureesha associated with Agnimandya.
The Shwasa complicated with Atisara, Jwara,
Hikka, Chardi.
31. Sadyasadhyata
Aachrya CHARAKA mentions that Tamaka
Shwasa becomes sadhya if it is treated in early
stages, even though it is stated as Yapya Vyadhi.
Aachrya DALHANA mentions that it also
becomes Asadhya if it is associated with Jwara
and Murcha.
Aachrya VAGBHATA mentions that
Tamaka Shwasa is Yapya, but can be Sadhya if it
is treated in the beginning and if it occurs in a
strong person.
33. Pranavilomta is a pathological event during
an episode of tamaka shwasa and is said to be
due to the vikrath kapha obstructing the passage
of prana vayu. Bringing it out by liquifying the
sputum is the principle and first treatment of this
condition. This can be achieved by abhyanga and
swedana over the chest there by allowing the free
passage of prana vayu. Acharya CHARAKA has
prescribed application of oil added with rock salt
over the chest followed by sudation in the form of
nadi prastara or sankara sweda.
34. uÉÉiÉM×ü²É MüTüWûUÇ MüTüM×ü²É
AÌlÉsÉÉmÉWûqÉç|
MüÉrÉï lÉ LMüÉÎliÉMüÇ iÉÉprÉÉ
mÉëÉrÉ: ´ÉårÉÉåÅÌlÉsÉÉmÉWûqÉç||
(cÉ.ÍcÉ 17/148)
Ingredients, which exclusively alleviate
kapha but aggravate vata or which exclusively
alleviate vata but aggravate kapha must never be
used in the treatment of HIKKA and SAWSA.
Between these categories of treatment, however,
the latter category, i.e. the administration of
ingredients which alleviate vata but may aggravate
kapha can, if necessary, be used in exceptional
circumstances.
35. Chikitsa
ÌlÉSÉlÉ mÉËUuÉeÉïlÉ
ÌWûYMüɵÉÉxÉÌuÉMüÉUÉhÉÉÇ
ÌlÉSÉlÉÇ rÉiÉ mÉëMüÐÌiÉïiÉqÉç|
uÉerÉïqÉÉUÉåarÉMüÉqÉæxiÉSè
ÌWûYMüɵÉÉxÉÌuÉMüÉËUÍpÉ:||
(cÉ.ÍcÉ. 17/138)
The etiological factors described to be
responsible for the manifestation of HIKKA and
SWASA should be eschewed by the patients
suffering from these diseases, if they wanna good
36. Treatment of tamaka shwasa differs
both during the attack (vegavastha) and in
between the attacks (Avegavastha)
38. Since the SWASA is born from the
obstruction of the passage of Prana vata by
kapha, it is beneficial to clear the passage by
administration of purifactory therapy of both the
upper and lower parts of the body. By the
obstruction of the passage the internal fluid
becomes greatly increased, so also vata also
obstruct the passage hence its passage should be
cleared.
41. After ascertaining that the patient is properly
fomented, the patient should be given rice mixed
with ghee, or the soup of the fish or pork, followed
by the cream of curd(sara of dahdi) to eat. This
causes aggravation of kapha. The patient, should,
then be given emetic therapy, mixed with pippali,
saindhava and honey. Care should be taken to
ensure that no vata aggravating ingredients are
added to the recipe.
43. This is another procedure aimed at
eliminating the kapha dosha from the srotas.
Dhoomapana is advised after the vamana karma
and it eliminates some amount of kapha dosha
that is still left out after the vamana karma.
Dhoomapana may be performed alone without
prior vamana karma. Further in debilitated
patients, where purifactory procedure is not
possible. Added to this the drugs used in
dhoomapana also reduces spasm or stiffness of
pranavaha srotas bringing about srotomardavata
that ensures free passage of vata dosha.
44. lÉxrÉ
sÉvÉÑlÉxrÉ mÉsÉÉhQûÉåuÉÉï
qÉÔsÉÇ aÉ×geÉlÉüxrÉ uÉÉ|
lÉÉuÉrÉåccÉlSlÉÇ uÉÉÅÌmÉ
lÉÉUϤÉÏUåhÉ xÉÇrÉÑiÉqÉç||
(cÉ.ÍcÉ 17/131)
Mixed with the breast milk of woman
lausuna, palandu, root of gunjana or chandan can
be administered as inhalation therapy.
45. ÌuÉUåcÉlÉ
MüÉÍxÉlÉã cNûSïlÉÇ S±ÉiÉç
xuÉUpÉXçaÉã cÉ oÉÑ̬qÉÉlÉç |
uÉÉiÉvsÉãwqÉWûUærÉÑï£üÇ
iÉqÉMãü iÉÑ ÌuÉUãcÉlÉqÉç||
(cÉ.ÍcÉ.17/121)
If the patient suffering from shwasa gets
afflicted with hoarseness of voice then they should
be given vamana. Patient suffering from tamaka
type of shwasa he should be given virechana. The
46. Abnormal response of patient for simple
factors like dust is said to be due to khavaigunyata
of the pranavaha srotas and this is described as
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 vyadhikshmatva.The answer for such a
nature of illness is virechana karma and Rasayana
chikitsa.Charaka pronounced this as
„TAMAKETU VIRECHANA’
48. After shodhna karma samsarjana karma is
advised. Immediately after the shodhna karma as
the digestive power is very weak only liquid food is
advisable. As the digestion power shows a gradual
increase the food is also slowly changed to solid or
to regular foods.
50. The patient suffering from shwasa can be
given nourishing therapy and its adverse effects
will be minimal and curable. Shamana for such
patients are free from any adverse effects. But the
administration of depletion therapy is likely to
produce serious adverse effects which is difficult to
cure. Therefore the patient should generally be
treated with brumhana or shamana therapy.
56. Depending upon the nature of the dosha and
the disease the pippali should be taken. Pippali
should be taken along with milk by gradually
increasing at the rate of 10 pippali per day. After
10 days this should be gradually decreased. Thus
in total the person should take one thousand
pippali for the purpose of rejuvenation. After
digestion take sastika type of rice along with milk
and ghee.
57. MANASA DOSHA CHIKITSA
Patients expression of anxiety may not be in
the eyes face or their activity but it may be through
the pranavaha srotas in the form of shwasa. The
absolute cause is related to the mind but its
reflection is through the pranavaha srotas. In such
clinical presentation addition of manasa dosha
chikitsa are more beneficial.