Shwasa-roga Series-5 : Approach to mahashwasa by Professor S. N. Ojha

Charakokta mahāshvāsa 

dūrādvijñāyatē bhr̥śam: 

breathing sound is such that it can be heard from distance. Stridor (Latin for "creaking or grating noise") is a high-pitched breath sound resulting from turbulent air flow in the larynx or lower in the bronchial tree. Stridor is a physical sign which is caused by a narrowed or obstructed airway. It can be inspiratory, expiratory or biphasic, although it is usually heard during inspiration. Inspiratory stridor often occurs in children with croup. It may be indicative of serious airway  obstruction  from severe conditions such as epiglottitis, a foreign body lodged in the airway, or a laryngeal tumor. Stridor should always command attention to establish its cause. (https://en.wikipedia.org/wiki/Stridor)

mattarṣabha ivāniśa: 

explains the nasal flares. Nasal flaring  is when the nostrils widen while a person is breathing. It is a sign that the person is having difficulty breathing. It is most commonly seen in children and infants; in those cases nasal flaring can indicate respiratory distress. Respiratory distress occurs in connection with various physical ailments, such as acute respiratory distress syndrome, a serious reaction to various forms of injuries to the lung, and infant respiratory distress syndrome, a syndrome in premature infants caused by developmental insufficiency of surfactant production and structural immaturity in the lungs.

Rapid and loud breathing is observed in a metabolic acidosis which soon produces hyperventilation, but at first it will tend to be rapid and relatively shallow. 

Kussmaul breathing develops as the acidosis grows more severe. Indeed, Kussmaul originally identified this type of breathing as a sign of coma and imminent death in diabetic patients. Blood gases of a patient with Kussmaul breathing will show a low partial pressure of CO2 in conjunction with low bicarbonate because of a forced increased respiration (blowing off the carbon dioxide). Base excess is severely negative. The patient feels an urge to breathe deeply, an "air hunger", and it appears almost involuntary.

Duration of fasting, presence or absence of liver enlargement and Kussmaul breathing provide clues to the differential diagnosis of high blood sugar in the inborn errors of metabolism.

Kussmaul's respiration, as German physician Adolph Kussmaul himself described, is technically deep, slow, and labored breathing, which we now know is in response to severe acidemia stemming from metabolic acidosis. However, nowadays, it is sometimes used to describe rapid and shallow breathing patterns in cases of less severe acidemia as well.

Agonal respiration, gasping respiration or agonal breathing is an abnormal pattern of breathing and brainstem reflex characterized by gasping, labored breathing, accompanied by strange vocalizations and myoclonus. It may be due to cerebral ischemia, extreme hypoxia or even anoxia. It may also occur in case of cardiogenic shock or cardiac arrest. (en//Wikipedia.org/wiki/ Agonal _respiration).

***********************************************************************************************************************

Prof. Satyendra Narayan Ojha  

MD PhD

(Kayachikitsa)
Director,

Yashwant Ayu. College & P.G.Training & Research Center, 

Kodoli, Kolhapur, Maharashtra, India.

Mobile No.- +91 9822177155     

email: drsnojha@rediffmail.com