The document presents an overview of Pancha Shwasa, including its objectives, cardinal features, dosha predominance, distinctions among different types, and correlations with modern medical understanding. It describes various conditions such as Mahashwasa, Urdhwa Shwasa, Chinna Shwasa, Kshudra Shwasa, and Tamaka Shwasa, detailing their symptoms and prognoses. The presentation concludes with references to classical texts.

1. Dr AKSHAY SHETTY
PANCHA SHWASA
Dr Akshay Shetty
Associate Professor
SSRAMC & H
Inchal

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Contents
• Objectives
• Cardinal features of Pancha shwasa and correlate with the current
science
• Dosha predominance of Shwasa
• Vishishta lakshana of Tamaka shwasa with its avastha bheda
• Difference between Pancha shwasa
• Summary
• References

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Objectives
At the end of the presentation the students must be able to-
1. Identify cardinal features of Pancha shwasa
2. Correlate Panchashwasa with the current science
3. Explain Dosha predominance of Shwasa
4. Describe Vishishta lakshana of Tamaka shwasa with its avastha
bheda
5. Differentiate between Pancha shwasa

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महाश्वासः
उद्धूयमानवातो यः शब्दवद्दुखितो नरः |
उच्चैः श्वसिति संरुद्धो मत्तर्षभ इवानिशम् ||४६||
प्रनष्टज्ञानविज्ञानस्तथा विभ्रान्तलोचनः |
विकृताक्ष्याननो बद्धमूत्रवर्चा विशीर्णवाक् ||४७||
दीनः प्रश्वसितं चास्य दूराद्विज्ञायते भृशम् |
महाश्वासोपसृष्टः स क्षिप्रमेव विपद्यते ||४८||
इति महाश्वासः | Ca.Chi 17

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• The patient breathes with a loud noise during the night due to the
upward movement of aggravated vayu like intoxicated bull.
• The vayu gets obstructed and the person becomes unconscious. The
eyes get distorted and he cannot visualize properly.
• The eyes and face become abnormal and the elimination of urine and
feces is obstructed and the voice becomes feeble and the person
looks tired and respiration could be heard from distance, such person
suffering from mahashwasa succumbs to death very fast.

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ऊर्ध्वश्वास:
दीर्घं श्वसिति यस्तूर्ध्वं न च प्रत्याहरत्यधः |
श्लेष्मावृतमुखस्रोताः क्रुद्धगन्धवहार्दितः ||४९||
ऊर्ध्वदृष्टिर्विपश्यंश्च विभ्रान्ताक्ष इतस्ततः |
प्रमुह्यन् वेदनार्तश्च शुष्कास्योऽरतिपीडितः ||५०||
ऊर्ध्वश्वासे प्रकुपिते ह्यधःश्वासो निरुध्यते |
मुह्यतस्ताम्यतश्चोर्ध्वं श्वासस्तस्यैव हन्त्यसून् ||५१||
इत्यूर्ध्वश्वासः |

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• The vitiated kapha obstructs channels of respiration leading to
aggravation of vata resulting in prolonged expiration and shallow
inspiration (breath doesn’t get deeply inspired).
• The patient looks up with moving eye balls as if he is scared of
something.
• When he gets afflicted with this type of shwasa he suffers from
unconsciousness, dryness of mouth, restlessness.
• The upward movement of vayu is aggravated resulting in obstruction
of downward movement and unconsciousness, black outs and he
succumbs to death quickly.

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छिन्नश्वासः
यस्तु श्वसिति विच्छिन्नं सर्वप्राणेन पीडितः |
न वा श्वसिति दुःखार्तो मर्मच्छेदरुगर्दितः ||५२||
आनाहस्वेदमूर्च्छार्तो दह्यमानेन बस्तिना |
विप्लुताक्षः परिक्षीणः श्वसन् रक्तैकलोचनः ||५३||
विचेताः परिशुष्कास्यो विवर्णः प्रलपन्नरः |
छिन्नश्वासेन विच्छिन्नः स शीघ्रं प्रजहात्यसून् ||५४||
इति छिन्नश्वासः |

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• The patient suffering from chhinna shwasa has interrupted breath as the
prana is afflicted.
• There is complete stoppage of breath, such individual suffers from intense
pain as if cutting of the marma (vital parts), constipation with abdominal
distension, sweating, unconsciousness, burning sensation in basti (bladder
and urinary system), excessive tears in the eyes, emaciation of the body,
• The eyes become red when patient struggles to breath, mental
disorientation, dryness of mouth, discoloration of skin, delirium, looseness
of joints.
• An individual suffering from above said features of chhinna
shwasa succumbs to death very quickly

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क्षुद्रश्वास:
रूक्षायासोद्भवः कोष्ठे क्षुद्रो वात उदीरयन् |
क्षुद्रश्वासो न सोऽत्यर्थं दुःखेनाङ्गप्रबाधकः ||६५||
हिनस्ति न स गात्राणि न च दुःखो यथेतरे |
न च भोजनपानानां निरुणद्ध्युचितां गतिम् ||६६||
नेन्द्रियाणां व्यथां नापि काञ्चिदापादयेद्रुजम् |
स साध्य उक्तो बलिनः सर्वे चाव्यक्तलक्षणाः ||६७||

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• Due to intake of dry food and exertion, vata is mildly vitiated
in koshtha and moves in the upward direction i.e respiratory tract
resulting in kshudra shwasa.
• The patient suffering from this type of shwasa does not have any
affliction of various body parts and the functions are not affected.
• It is not very painful as it does not affect the channels of food and
drinks nor does it cause pain to the sense organs.
• This is curable if the symptom is not completely manifested and the
patient is strong.

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Sl.no Type of shwasa Modern corelation
1 Maha shwasa Boits breathing
2 Urdhwa shwasa Stretorous breathing
3 Chinna shwasa Chyne stockes breathing
4 Kshudra shwasa
5 Tamaka shwasa Bronchial asthama

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Dosha predominance of Shwasa
Sl.no Type of Shwasa Dosha dominance
1 Maha shwasa Vata
2 Urdhwa shwasa Vata
3 Chinna shwasa Kapha +Vata
4 Kshudra shwasa Vata
5 Tamaka shwasa kapha

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क्षुद्रको वातिकः श्लेष्मभूयिष्ठस्तमकः स्मृतः|
”
छिन्नः पित्तप्रधानः स्यादन्यौ मारुतकोपजौ - इति||४|| Dalhana Su Ut 51

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तमकश्वासः
प्रतिलोमं यदा वायुः स्रोतांसि प्रतिपद्यते |
ग्रीवां शिरश्च सङ्गृह्य श्लेष्माणं समुदीर्य च ||५५||
करोति पीनसं तेन रुद्धो घुर्घुरुकं तथा |
अतीव तीव्रवेगं च श्वासं प्राणप्रपीडकम् ||५६||
प्रताम्यत्यतिवेगाच्च कासते सन्निरुध्यते |
प्रमोहं कासमानश्च स गच्छति मुहुर्मुहुः ||५७||
श्लेष्मण्यमुच्यमाने तु भृशं भवति दुःखितः |
तस्यैव च विमोक्षान्ते मुहूर्तं लभते सुखम् ||५८||

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अथास्योद्ध्वंसते कण्ठः कृच्छ्राच्छक्नोति भाषितुम् |
न चापि निद्रां लभते शयानः श्वासपीडितः ||५९||
पार्श्वे तस्यावगृह्णाति शयानस्य समीरणः |
आसीनो लभते सौख्यमुष्णं चैवाभिनन्दति ||६०||
उच्छ्रिताक्षो ललाटेन स्विद्यता भृशमर्तिमान् |
विशुष्कास्यो मुहुः श्वासो मुहुश्चैवावधम्यते ||६१||
मेघाम्बुशीतप्राग्वातैः श्लेष्मलैश्चाभिवर्धते |
स याप्यस्तमकश्वासः साध्यो वा स्यान्नवोत्थितः ||६२||
इति तमकश्वासः |

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• The vayu moves in the opposite direction due to the obstruction in the respiratory tract,
stiffness in the neck, head aggravates the kapha and produces rhinorrhoea,
and gurghuraka sound (rhonchi).
• Exceedingly severe attack afflicts the prana and enhances severity.
• During severe attack, the patient faints repeatedly, has severe cough and becomes
unconscious.
• The patient finds it difficult to expectorate the phlegm and feels relieved for period of
1 muhurta after expectoration of phlegm.
• There is hoarseness of voice and patient speaks with difficulty, even he does not get proper
sleep, and on lying down he suffers from dyspnea as his flanks are afflicted by vayu.
• He feels comfortable in the sitting position.
• He likes hot things.

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• His eye balls are always prominent, there is sweat on the forehead,
dryness of the mouth, gets repeated attacks of dyspnea, and it
increases and subsides repeatedly.
• In gets aggravated when appearance of clouds in the sky, rains, cold
weather, easterly winds and kapha enhancing food and behavior.
• The tamaka shwasa having above mentioned features
is yapya (palliable) and in the initial stages it is curable disease

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Types of Tamaka shwasa
ज्वरमूर्च्छापरीतस्य विद्यात् प्रतमकं तु तम् | उदावर्तरजोऽजीर्णक्लिन्नकायनिरोधजः
||६३||
तमसा वर्धतेऽत्यर्थं शीतैश्चाशु प्रशाम्यति |
मज्जतस्तमसीवाऽस्य विद्यात् सन्तमकं तु तम् ||६४||
इति प्रतमकसन्तमकश्वासौ |

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• In a patient of tamaka shwasa if jwara (fever) and unconsciousness
are occurring as complication, then it is called as pratamaka shwasa.
• The shwasa produced due to udavarta (upward movement of vayu
in koshtha), dust, indigestion, excessive liquid accumulation in the
body (klinna kaya), and suppression of natural urges results in
increase of tama. This gets relieved by following of cooling regimen.
The person suffering from this shwasa feels as if he is submerged in
darkness, thus it is known as santamaka

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Sl.no Type of Shwasa Dosha
dominance
Prognosi
s
Cardinal features Sub Types
1 Maha shwasa Vata Asadhya The patient breathes with a loud noise during the
night due to the upward movement of
aggravated vayu like Mata vrushabha
-
2 Urdhwa shwasa Vata Asadhya The upward movement of vayu is aggravated
resulting in obstruction of downward movement
and unconsciousness, black outs and he succumbs
to death quickly
-
3 Chinna shwasa Kapha +Vata Asadhya The patient suffering from chhinna shwasa has
interrupted breath as the prana is afflicted
-
4 Kshudra shwasa Vata Sadhya The patient suffering from this type of shwasa does
not have any affliction of various body parts and the
functions are not affected
-
5 Tamaka shwasa kapha Yapya Gurghuraka, मुहूर्तं लभते सुखम्, आसीनो लभते सौख्यमुष्णं
चैवाभिनन्दति , मेघाम्बुशीतप्राग्वातैः श्लेष्मलैश्चाभिवर्धते
Pratamaka
santamaka

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Summary
Cardinal features
of Pancha shwasa
and correlate with
the current science
Dosha
predominance of
Shwasa
Vishishta lakshana
of Tamaka shwasa
with its avastha
bheda
Difference
between Pancha
shwasa

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References
• Charaka Samhita
• Madhava nidana

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THANK YOU