AYURVEDIC CONCEPT OF ASTHMA AND ROLE OF KAPHA IN ASTHAMA

The features of Bronchial Asthma can be compared to Tamak shwasa  explaindes in Ayurveda.

Shwasa is a major clinical condition according to Ayurveda and it has classes and subclasses. There are five types of Shwasa roga, Maha svasa  Urdhava svasa  chinna shwasa Tamak shwasa  Kshudra  shwasa. Among these five first three are incurabe, Tamak shwasa is difficult to cure but is controllable(Yapya roga). Kshudra shwasa is curable.

ETIOPATHOGENESIS OF ASTHMA

It originates at the site of Pitta(in the stomach) with simultaneous aggravation of Kapha and vata. 

Kledak kapha accumulates and moves to the lungs. Kapha has properties like cold, slimy, unctuous, heavy and vata is cold dry rough and mobile in nature. These two intermix in lungs and and mucous present in the lungs becomes sticky, thick and it adheres to the walls of bronchi and narrows the bronchial tubes which leads to episodes of breathlessness or Asthma attack.

Charak Samhita says ” If vata predominantly associated with Kapha obstructs the circulation channels and moves in all directions in the body then this obstructed vata causes Shwasa.

Ashtang Hridyam has similar concept as Charaka. It says “Vata is obstructed in its movement by kapha and it spreads in all directions, vitiates the Pranavaha srotas(Channels of respiration), Udakvaha srotas(channels of water), Annavaha srotas(Channels of food), located in our chest and causes Shwasa, arising from stomach”

FACTORS AGGRAVATING  KAPHA AND VATA

Environmental factors are listed but most of the factors involved are due to lifestyle and dietary habits that aggravates vata and kapha.

• Exposure to dust, smoke, wind(airborne pollens)
• Residing in cold places
• Exercise or walk beyond one’s own capacity
• Stress that may be induced by exercise
• Improper food combining and habitual eating of unhealthy food leading to Vitiated metabolism(causing Agnimandya and Ama)
• Constipation associated with flatulence
• Intake of food in deficient or excessive quantity
• Excess fasting or excess eating and agitated digestion resulting from it.
• Dryness in Respiratory tract(particularly lower) and upper GIT due to non unctuous food.
• Trauma to throat, chest and vital organs

SYMPTOMS

PRODROMAL :

• Pain in the heart region and flanks
• Upward movement of Prana (Respiration)
• Flatulence
• Splitting pain in the temples

VATAJ  ASTHMA SYMPTOMS  PRESENTATION 

• • Dryness, cough and wheezing
  • Dry mouth and skin
  • Thirst
  • Constipation
  • Anxiety
  • Craving warm drinks

• Aggravation of the condition or episodes  occur at dawn and dusk (Vata times)

PITTAJ  ASTHMA  SYMPTOM PRESENTATION

• • Wheezing
  • Coughing with yellow Phlegm
  • Fever may be there
  • Sweating and need for cold air
  • Irritability

• Attacks occur during Pitta times, Noon and midnight

KAPHAJ  ASTHMA  SYMPTOMS  PRESENTATION

• • Wheezing and coughing with abundant white or clear phlegm(mucous)
  • Instead of wheezing there will be a Railing sound produced by fluid in the lungs

• Attacks occur during Kapha times of the day, Morning and Evenings.

LINE  OF TREATMENT  OF  ASTHAMA

Avoidance of triggering factors, improving quality of life with minimum medication is the aim of Astma management.

NIDAN  PARIVARJAN(Avoidance of triggering factors)  : Causative factor,  Exposure to allergen or factor causing recurrent exacerbation should be avoided.  For example

• Oily greasy fried food.
• Cold and refrigerated food and drinks
• Excessive physical exercise or other activities
• Smoking (Active and passive) 
• Heavy foods like milk, cheese, banana

SHODHAN CHIKITSA : It is purification process which eliminates vitiated doshas from the body. It includes  

• Snehan : Massaging body with Til oil mixed with saindhav lavan, specifically on chest and back region.
• Swedana
• Vaman
• Virechan(Purgation) : Ayurveda says “Tamke tu virechanam”. Virechana is best in Tamak shwasa(Bronchial Asthama).  Kutaki(picrorhiza kurroa ) 1-3gm with honey in Asthma and Bronchitis is given twice daily for virechana.
• Dhumpana : Chandan, Guggulu, Haridradi, Lehsunadi dhumpana

SHAMAN CHIKITSA : People who are too weak to be given Shodhan therapy are given Shaman chikitsa.  It includes internal medication that pacifies doshas, are Vatanuloak, ushna, have deepan pachan properties, Some ayurveda Shaman drugs and formulations are as follows 

CAC Cough Go Tablets : It is a herbo mineral preparation and helps in balancing Kapha dosha. It shows effective results in  all respiratory diseases along with seasonal allergies and bronchial asthma.

It has ingredients :

1. Sonth (Zingiber officinale)
2. Mulethi (Glycyrrhiza glabra)
3. Pippali(Piper longum)
4. Kali mirch(Piper nigrum)
5. Abhrak bhasm
6. Tankan bhasm
7. Lakshmivilas rasa

These ingredients are Anti inflammatory, Anti oxidant, immuno modulator, Bronchodialator, Expectorant.

Other than Bronchial asthma it is useful in Chronic cough, whooping cough, common cold, Bronchitis.

DOSAGE  : One tablet(650mg) twice a day with normal water.

SHWASKUTHAR RASA  :  It is an broncho dialator, expectorant, antioxidant.

 Useful in cough, breathlessness, restlessness, chronic bronchitis, Indigestion.

DOSE : 125-250mg, once or twice daily, with honey or water

Few other formulations used in Asthma are : Sitopaladi churan, Talisadi churana, Kantakari avleha, vasa haritaki leha, vyoshadi vati, Dashmool kwath.

SINGLE  DRUGS IN ASTHMA

• Powder of Talisa(Abies wabbiana) mixed with juice of leaves of VASA(Adhatoda vasica) should be used in cough caused by kapha and pitta
• Juice of Vasa leaves should be taken with honey in cough caused by Kapha and pitta and intrinsic haemorrhage
• In dry cough Vasa juice cooked Haridra (Curcuma longa) with fatty layer of milk
• Cold infusion(Phanta) of Vasa checks cough, fever and intrinsic haemorrhage
• Powder of Agaru(Aquilaria agalocha) mixed with honey is taken
• Shunthi(Zingiber officinale), Pippali(Piper longum), and Amalaki(Emblica officinalis) with honey
• Powdered seed of Timir(Eleusine aegyptiaca) and Karkatsringi(Pistacia integerria) mixed with ghee and honey
• Ghee cooked with double quantity of decoction of Sariva(Hemidesmus indicus)
• Decoction of Nirgundi, Guduchi, Haritaki, Marich in equal parts with salt

APATHYA

• Heavy foods like cheese, rice, sugar,lentils, curd, buttermilk, paneer
•  Masha, Tila, Sarshap(Brassica niagra), beans, Tubers like Potato
• Buffalo milk and ghee
• Fruits like Guava, Banana, Watermelon, Papaya 

PATHYA

• Garlic, Spinach, Brinjal, Grapes, Indian Gooseberry, Goat milk, Honey
• fruits like figs, dry grapes(raisins), pomegranate, fruits full of vitamin C such as oranges, strawberries, blueberries
• Maintain a gap of atleast  1hour between eating and sleeping.

YOGA  AND PRANAYAMA

These yoga asanas can relieve asthma symptoms by opening chest muscles

• Bridge pose
• Cobra pose
• Seated spinal twist

Breathing exercises relives stress and helps with the shortness of breath in asthma

• Alternate nostril breathing
• Victorious breathing or Ujjayi Pranayaa.