Case presentation: Tamaka Shwasa/Jirna Vatika Kasa (Bronchial Asthma/Byssinosis)

Patient’s information

 

A 65-year-old male patient presented to OPD no. 4 (PG Kayachikitsa Department) at Govt. Akhandanand Ayurveda College and Hospital, Ahmedabad, with the following symptoms…

 

1. Shushka Kasa (Dry coughing) since 3 year

2. Shwasa Kruchhata (Breathlessness) since 4 year

3. Kanth Pradeshe Kapha Anubhuti since 1 year

4. Urah Shoola (Pain in chest) since 1 year

 

General physical examination

Pulse- 62/min

Respiratory rate- 20/min

BP- 140/74 mmHg

Built- Medium

 

Dhashavidha Pariksha

Prakruti- Vata-Kapha

Vikruti- Mahat Hetu Linga Bala - Cotton particles, constant severe coughing

Sara- Rasa-Rakta Madhyama Sara

Samhanan- Madhyam

Praman- Madhyama

Satmya- Shad Rasa Satmya

Ahara Shakti- Madhyama

Vyayam Shakti- Alpa

Vaya- Vruddha Avastha

 

 

Therapeutic intervention(IPD)

	Medicine	Duration	Anupana
28/08/24- 02/09/24	1)Shivakshar Pachan Churna 6gm +Lauha Bhasma 125 mg	BD before meal	1 tsp Goghrita
	2)Shankha Vati 2tab	2 BD After meal	Water
	3)Talishadi Churna 5gm +Tankana Bhasma 125 mg + Sphatika Bhasma 125 mg + Abhraka Bhasma 125 mg	TDS  Empty stomach	Kantakari Avaleha
	4)Kanakasav 4tsp	BD	water
03/09/24- 10/09/24	1,2,3,4 5)Arogyavardhini Vati 4tab	BD	Warm water

 

Date	Procedure
28/08/24- 10/09/24	1)Sthanika Abhyanga and Nadi Swedana (Urah evam Prustha Pradeshe)	Nirgundi Taila
	2)Matra Basti (50 ml)	Mahanarayan Taila

 

OPD Follow Up

	Medicine	Duration/Time	Anupana
10/09/24- 24/09/24	1)Dashamoola Kwatha 10 gm + Bharangyadi Kwatha 10 gm	Bd Empty stomach
	2)Kantakari Ghruta 20 ml	Suryodaya Kala	Warm water
24/09/24	3) Talishadi Churna 5gm +Tankana Bhasma 125 mg + Sphatika Bhasma 125 mg + Abhraka Bhasma 125 mg	TDS  Empty stomach
	4) Avipattikar Churna 6gm	BD Before food	Go ghrita
	5) Tab Dekofcyn (Alarsin) 2 tab	BD After food

 

Before treatment report

Patient was well diagnosed case of bronchial Asthma since 4 Year. The patient works in Cotton manufacturing factory since many years. On consultation with the physician, he was advised for X-ray chest (13/03/23) and that showed both lung fields to show prominent broncho-vascular markings. The patient had availed conventional allopathic treatment for 2 years. However, due to unresolved and persistent symptoms, the patient sought Ayurveda treatment. After the Ayurvedic treatment X-ray become normal.

After treatment report

        

Discussion

Patient exposed to cotton particle as a part of profession for many years, but symptoms started 4 years back when naturally his body immunity decreased because of aging phenomenon and continue residing in hot humid environment of Ahmedabad, Gujarat.

So as per principle 

इह खलु निदानदोषदूष्यविशेषेभ्यो  विकारविघातभावाभाव प्रतिविशेषा भवन्ति| (Ch.ni 4/4), 

all 3 Nidana, Dosha, Dushya combined together in the presence of compromised immunity and sign and symptoms occurred accordingly.

The patient had migrated from UP to Gujarat. Compared to Uttar Pradesh, Gujarat's climate is hotter, and moister, which put impact on health.

The patient's regular dietary and daily regimen, appropriate Bala-Mamsa-Satva-Satmya Sampad etc. kept the pathology localized. Chronic constant dry coughing because of  cotton dust particles, exertion due to the coughing process and progressive generalized and localized Rukshatva/dryness along with no relief from allopathic medications, exhausted and depressed the patient so much that he had accepted that there is no cure for his disease. 

As per Ayurveda disease manifestation process is very simple as stated by both Acharya Charaka and Acharya रजसा धूमवाताभ्यां शीतस्थानाम्बुसेवनात्…. and that constant Kshobha/ irritation caused by cotton particles in Pranavaha Strotas lead to Rasa Rakta Prakopa locally and Pratiloma Vayu generally.

As patient was unable to do Nidana Parivarjana because it is an inseparable part of his Job so, he was advised to use nasal mask.

We aimed to manage the patient by administrating Snehana, Swedana, Dipana, Pachana, Anuloman procedures to install the strength in the body along with Dosha-Vyadhi Pratyanika medications.

So, the efforts were made to break the vicious pathogenesis of the disease, and it showed the efficacy as route cause eradication.

Following Samprapti Ghatakas has been framed/ identified.

Samprapti Ghatak

Dosha- Vata Pradhan Tridosha

Dushya- Rasa, Rakta

Strotas- Pranavaha, Rasavaha, Raktavaha

Stroto Dusti Prakar- Sanga, Atipravruti,

Adhisthan- Sharira, Mana

Udbhavsthan- Pakwashaya

Vyaktisthan- Urah Pradesha/ Phupphusa

Roga Marga- Madhyama (Kostha)

Agni- Mandagni, Vishamagni

Sama/Niram- Niram

Vyadhi Prakar- Chirakari

Sadhyaasadhyata- Kruccha Sadhya 

The patient was so exhausted, depressed, fade up and hopeless with his complains that in his first visit he agreed for IPD admission and management started as per his condition. Initially Dipan, Pachan, vatanuloman, Started with Shivakshara Pachana Churna combination with Shapana, Go ghrita in Apana Kala.

Shankha Vati and Kanakasav was given after meal Uttara Bhakta for Dipana, Pachana, Strotosodhana and anti-spasmodic action.

Talishadi combination given as Vyadhi Pratyanika with Sahapan Kantakari Avaleha to counter the dryness/ Rukshata in empty stomach condition.

Additionally, Sthanika Abhyanga and Swedana to the Uraha and Prustha Pradesha was administered as per the principle of line of treatment of Tamaka Shwasa. 

There was excessive condition of dryness / Rukshata in the body and the on-going Vata Prakopa Kala/ rainy season Virechana Karma was not planned and Matra Basti was selected to administer. Matra Basti helped a lot in installing Snehana Guna in the body. Patient used to hold Matra Basti initially 24 hours and later on the duration was reduced along with increase in Sneha Gunas in the body. Matra Basti also acted and showed vary good Vata-nulomana effect. Aarogyavardhiin vati was added after 7 days in high dose to induce mild 'pitta-virechan' effect.

This treatment protocol was given for 13 days, and patient was discharged on his request after achieving 80% relief in symptom.

In follow up treatment Matra Basti was replaced with oral use of Kanatakari Ghrita 20 ml in Rasayana Kala (Sunrise time). Additionally, Tab. dekofcyn (Alarsin) was prescribed 2 TDS.

Shivakshara Pachan Churna replaced with Avipattakar Churna as per availability in Govt. OPD dispensary and because starting of Sharad Ritu. Now patient has got 100% relief.

 

Conclusion

It can be concluded that if a patient has appropriate immunity, good-built Pravar Satva, Satmya with a regulated daily regimen, and appropriate 4 qualities of Atura, then chronic bronchial asthma case with the dominant feature of coughing (Byssinosis) can be cured successfully with the Ayurvedic principle of Tamaka Swasa.

Patient's video

Presented by- 

Dr. Urvashi Makhesana

P G Final year Scholar

P G Kayachikitsa Department 

Government Akhandanand Ayurved College, Ahmedabad, Gujarat, India

E-mail- urvashipatel294@gmail.com

Guided by-

Prof. Surendra A. Soni

H.O.D. 

P G Kayachikitsa Department 

Government Akhandanand Ayurved College, Ahmedabad, Gujarat, India

E-mail- kayachikitsagau@gmail.com