. Presented by Dr. Manish V Patel Associate Professor & Senior Physician Department of Kayachikitsa J S Ayurveda College & P D Patel Ayurveda Hospital, Nadiad 386001 Gujarat India. Mobile No.- +91 9979589865 [J. S. Ayurveda College, Nadiad, Dist. Kheda, Gujarat, India is 55 kms. away from Ahmedabad airport. Nadiad is situated between Vadodara and Ahmedabad on Mumbai Ahmedabad railway track.] Reviewed & edited Dr.Surendra A. Soni M.D.,PhD (KC) Associate Professor Dept. of Kaya-chikitsa Govt. Ayurveda College Vadodara Gujarat, India. EMAIL: surendraasoni@gmail.com Mobile No. +91 9408441150

Tamaka shwas exacerbarates with shita whereas shita is treatment for pratamaka shwas. Chakrapani has given 2 reasoning for the same. Pittanubanda in pratamaka pacifies by shita treatment or as in madatyaya wherein madyapana is treatment of mada which is caused by excessive alcoholic intake, similarly shita chikitsa by its viparitharthakari chikitsa helps in pratamka condition of tamaka shwas. Features of Pratamaka and Santamaka Shvasa resembles exacerbations. Vata and kapha when associated with pitta lead to pratamaka wherein fever is the main symptom which explains the presence of pitta. Infection is main cause of exacerbation which leads to secretion of inflammatory factors which may stimulate prostaglandins and thereby fever cascade. Studies suggest that acquiring a new strain of bacteria is associated with increased near-term risk of exacerbation and that bacterial infection/superinfection is involved in over 50% of exacerbations. Viral respiratory infections are

d īrghaṁ śvasiti means Prolonged expiration which is observed in following diseases  Asthma, Bronchietasis, Bronchitis, Collapse, COPD, Emphysema, Epiglottitis, Fibrosis, Foreign body, Good Pasture syndrome, Lung cancer, Meconium aspiration syndrome, Pneumoconiosis, Pneumonia, Pneumonia, eosinophilic, Rostan asthma, Sarcoidosis, Tuberculosis. Airflow limitation during the expiratory phase in airway obstructive disease (ślēṣma āvr̥ta mukhasrōtāḥ) causes prolonged expiration, which is one of the hallmarks of COPD.  Acute respiratory acidosis occurs when an abrupt failure of ventilation occurs. This failure in ventilation may be caused by depression of the central respiratory center by cerebral disease or drugs, inability to ventilate adequately due to neuromuscular disease (e.g., myasthenia gravis, amyotrophic lateral sclerosis, Guillain-Barré syndrome, muscular dystrophy), or airway obstruction related to asthma or chronic obstructive pulmonary disease (COPD)