Introduction:-
A condition in which a person's airways become inflamed, narrow and swell and produce extra mucus, which makes it difficult to breathe. In some cases, it may lead to a life-threatening attack. Asthma may cause difficulty breathing, chest pain, cough and wheezing. The symptoms may sometimes flare up. Asthma can usually be managed with rescue inhalers to treat symptoms (salbutamol) and controller inhalers that prevent symptoms (steroids). Severe cases may require longer-acting inhalers that keep the airways open (formoterol, salmeterol, tiotropium), as well as inhalant steroids. According to Ayurveda “Tamaka Swasa.” There are five classes of Swasa: Kshudra, Tamaka, Chhinna, Maha and Urdhava. Tamaka Swasa is a type of Swasa Roga affecting the Pranavaha Srotas and characterized by prolonged expiration, wheeze, dyspnoea of exceedingly deep velocity, which is immensely injurious to life. Vata moving in the reverse order pervades the channels (of vital breath), afflicts the neck and head, and stimulates Kapha (phlegm) to cause Margavarodha (blockage of respiratory passage) by producing broncho constriction. Tamaka Swasa classified as Vata Pradhana and Kapha Pradhana. Signs and symptoms of Tamaka Swasa are very much similar to that of bronchial asthma. Partamaka Shwas & Satamaka Swasa are the two types of Tamaka Swasa.
Aims And Objective:-
To assess the effectiveness of internal i.e. herbal and herbo-minerals drugs (Shamana Chikista) and procedure Karna Vedhan for the treatment of Tamaka-Swasa (Bronchial Asthama).
Tamaka Swasa
Tamak swasa is a Pitasathanasamudhawa.
It is two types –1. Partamak Swasa.2. Santamak Swasa.
Etiological factor :-1. Vidahi Guru And Vishtmbhi Ahar
2. Ruksha and Shit Ahar- Vihar
3. Atimargagman
4. Ativayayama And Atimehun
5. Visamahar
6. Pragvat and Varsha-Shishir Ritu
Signs and Symptoms:-
1) Patients develops special liking for hot things.
2) Dyspnea of exceedingly deep velocity which is immensely injurious to life.
3) Too much of sweating appears in his forehead and he becomes restless.
4) Patient throats is choked because of which he is unable to speak freely.
5) The attack gets aggravated when clouds appear in the sky, when he is exposed to water (Humidity), and cold when the easterly wind blows, and when he resorts to Kapha aggravating food and regimens.
6) The patient is relieved (of restlessness) for some time soon after the phlegm comes out.
7) The patients faints again and again while coughing.
8) The patient does not get sleep While lying down (for sleep) he gets (more of) dyspnea because the side of chest in that position get afflicted by Vayu. But he is relieved of this discomfort in sitting posture.
9) Ghurghuraka (wheezing or murmuring sound).10) The patient eye-balls become prominent (project outside).
11) Because of acute spasms, the patient gets tremors and coughs, and becomes motionless.
Pathophysiology/Samprapti:- Nidan seven--Kapha Adhikya--Due to Kapha Margavavrodh-- Vata prakopa--Vayu Vimargaman--Tamaka Swasa.
Criteria for the selection of patients for Karna vedhan :-
Asthama- Condition that affect the smaller airways.• COPD-Chronic Obstructive Pulmonary Disease. (Condition which includes chronic bronchitis and Emphysema)Emphysema-Damage to the smaller airways and air sacs(alveoli)of the lungs.• Bronchiectasis-Abnormal widening of one or more airways.Main symptoms is coughwhich produces lot of sputum.•Bronchiolitis- Infection of the smaller airways of the lungs (the bronchioles), Common condition in babies.
Management of Tamaka swasa:-
Procedure:- Karna Vedhan.
Poorva Karma:-Abhyanga and swedna-(Localize massage and steaming).
Pradhan Karma:- 1.Prakshalan (Wash) - With Triphala /Panchvalkal kwath.
2.Mantra chanting.
3.Karna Vedhan karma:-Site of puncture - CONCHA of auricle.
Karna Vedhana procedure is done at the external ear (particularly at concha) by pointed Gold,silver needle. right ear is generally preferred for the procedure. Patient is to be prepared mentally for the procedure by convincing him for Karna Vedhana.
Nerve supply-Auricular Branch of Vagus Nerve. Concha of the Ear is the only place on the surface of the body where the Vagus nerve can be easily stimulated producing a broad parasympathetic effect.
Vagus nerve stimulation (VNS) can be used to reduce broncho constriction associated with asthma. stimulation of the vagus nerve with relatively high voltages (10–25 V) results in direct bronchoconstriction due to the release of acetylcholine from efferent parasympathetic nerves traveling in the cervical vagus nerve to the lung.
Mode of Action of Karna Vedhan:-
Concha and most of the area around external auditory meatus is supplied by Auricular branch of the Vagus nerve governing the sensory part at that region. Moreover this relation of Vagus nerve that its part is supplying to Trachea, Bronchi and external ear. Stimulation of the Auricular branch by Karna Vedhana indirectly stimulates cholinergic fibres resulting in dilatation of Trachea and th Broncheal tree. Hence this mechanism is helpful in chronic Asthmatic patients due to its prolonged bronchodilatory effect.
4.Jatyadi Taila application locally.
Paschat Karma:- Vran ropan hetu (Wound Healing) 7-10 days application of Jatyadi taila.
internal medication for 40-60 days.
Ear pin - Golden, Silver ear pin.
Pathya and Apathya:-
The diet should be fresh, warm, light nutritious and well balanced.
Avoid Fried and fatty food, heavy diet, over eating, smoking, alcohol drinking, paan masala, eggs, meat, milk, curd, beans, urad pulse, cold drinks, ice cream and rice for at least 45 days.
The patient is advised to avoid facing dust, smoke and cold winds.
Protect pierced ear from getting wet by water.
By:-Dr. Nitin kumar.
Asst.Prof and Consultant in Kayachikitsa Dept @ GGIMS ,Gorakhpur.
MD in Medicine, BAMS, PGDEMS, DIHM, CCPT.