Tuesday, June 28, 2016

Breathlessness (Shvas-kashtata).....#ayurvedic management

Views shared by several ayurveda professionals and non-ayurveda people in discussion group:
Disclaimer:
All views shared here are only for knowledge. This information doesn’t have any scientific validation. Various doctors and non-medicos have shared their views and experiences in this discussion. Please do not try any of the suggestions described here, without prior consult from your regular, qualified doctor. Dr. Prerak Shah and no other person is responsible for any unwanted effects, side effects or contra-indications in your health. Thank you.
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Next topic for discussion: Breathlessness (Shvas-kashtata)...please elaborate effect of diet, life stye; side effects of season, any medicine, or any other physical disease condition..and then treatment....Thank you.
Vd. Meghdoot Satvekar: Some of diseases where dyspnea swasa kashtata is symptom asthma,  bronchitis,  pneumonia, pneumothorax,  anemia,  lung cancer anxiety,  COPD, congestive heart failure, arrhythmia,  allergic reaction, anaphylaxis, lung disease,  obesity tuberculosis, emphysema, pulmonary fibrosis, pulmonary artery hypertension,  pleurisy,  sarcoidosis, rib fracture, carbon monoxide poisoning, obesity please elaborate these conditions.....
 Dr. Prerak Shah: Considering these many possibilities..we can't say blindfolded that shwas-kashta -> Virechana, or use of bronchodilators in all conditions.....it is always better to go for detailed history and proper diagnosis before we suggest any treatment....
 Vd. Krutika Suhas Chaudhary: According to ayurved ..santarpanpthh apatarpanothha both can be considered... And accordingly treatment will be different
 Dr. Prerak Shah: Can someone from us, take one condition and can elaborate more on that aspect.? Thnx
 Vd. Dipak Upadhyay: Allergic reaction -When someone breath particular allergen / s , bronchial tree react on that allergen/ s & constrict some  part of bronchial tree → intake of O² ↓ → blood need ↑ O² →lung has to work ↑ → resulting → breathless ness.
Treatment
Give anti allergic medicine/ mechanical activities…Avoid that allergen/ s.
 Vd. Rahul Marwah: Maha laxmi Vilas ras with ginger juice and honey in severe shwas kruchrata due to allergen is useful
Vd. Bhavdeep Ganatra: Aatap Sevan & 50% less food intake as Langhan Upakram...
 Dr. Prerak Shah: Ok. Let's continue with this sub and more focus on asthma,  bronchitis and COPD.
Can we have different Ayurvedic understanding? And different treatments?
 Vd. Sushmaben hirpara: Though lungs are affected,  i treat bronchitis and asthma  as symptoms of  aamashaya samaddbhav ( Digestive ) vyadhi. Total intake reduced by 50 %. Can take seasonal fruits in replacement of food.
Treatment is dipan and paachan aushadh like agnitundi,  shankhvati,  chitrakadivati , sooktyn. .. according to nadi,  prakruti and dosh. In every patient I give pure  yastimadhu ghanvati (without mint). It works as antidote in aam dosh.
In some cases asthma occurred coz of aam Pitt.  There we have to add kravyad ras if it's related with menopause.
------------------- end of comments from group 1-----------------------------
Canada Vd Priti Patel: Tamak shwase tu virechan!!  First treatment is virechan.
 IPR Chhayaben: Breathlessness - - very wide topic.. Asthma n heart problem both can give this.. V have patients of both problem..V can discuss breathlessness due to asthma,  breathlessness due to heart problem n so on..
 Mukesh Mehta: breathlessness due to water deposit in lungs.
 IPR Chhayaben: Breathlessness due to asthma if you eat old cooked rice..
 Colombia Dr Mario Herrera, Neiva, Huila: I agree is a wide topic
 Chile Dr. Susana Valdes: if Kapha accumulated in stomach, it could go to lungs and trachea. Kapha increased in respiratory system difficulties normal air flow. So first you have to find cause of K increased (heavy diet, winter season, dairy products, lack of exercise, etc.) and correct them. Then try have to return Kapha to stomach to eliminate it excess. and give some herbs to improve normal lungs function
 Dr. Prerak Shah: Yes. I agree. And for that you can use purgative or laxative
Dr. Lokesh Mehta: In breathlessness due to cardiac reasons I use arjunarisht plus punarnavasav along with pushkarmool. In breathlessness due to shwaas rog  combination of kankasav arjunarishta and dashmoolarishta gives good results.
 Truptesh Choksi: Is tension or stress a reason for breathlessness ?
Dr. Pulastya Vora: Bronchial asthma and cardiac asthma are totally two different things. Cardiac asthma is not actual asthma. The condition is due to inability of muscles of left ventricle to push up the blood properly. Due to this some blood remains in left ventricle only. If this condition continues for longer; heart has to work hard to compensate the volume present in the chamber. But over a period of time the congestion of the blood increases in the chamber. Heart has to work hard but cannot perform as expected. This leads to so called congestive cardiac failure (CCF) also known as congestive heart failure or cardiac asthma. In case of bronchial asthma; there is obstruction to air passage and hence there is breathlessness. So both conditions are different and hence their clinical management. Arjun twak preparations are good for cardiac asthma while Ardusi-Vasaka preparations are good for bronchial asthma.
 Vd. Kinjal Patel: Amalaki + Haridra with honey
LVG Shriram Gandhi: Vardhman pippli
 Vd. Vishal Patel: In asthmatic condition we can apply lukewarm mohari oil on chest following patra pottali sek....also in breathlessness condition sahachar oil anuvasan and dashmool +sahachar oil niruha basti works good.
 Dr. Lalit Kansal: Ark patraworks wonderful in asthmatic patients
 Dr. Komal: In asthmatic condition v can apply nilgiri oil diluted wid til oil on chest n then doing ajwain potali seka. Also taking lukewarm water adding sum drops of ghee n haridra n pinch salt at bedtym works gud.
 Dr. P. A. Deshpande: COPD is a very complex subject. It affects very badly respiratory system. Due to low supply of oxygen all other systems are also affected and gradually the patient becomes bed ridden and becomes totally dependent on  external oxygen supply which in due coursebecomes ineffective and makes the life miserable.
 Dr Sandeep kakuste Nandurbar: Plz also give information about bronchioectasis
 Dr. P. A. Deshpande: The allopathic or Ayurvedic etc. becomes ineffective due to obstruction of blood supply to the lungs. The lung cavities are also blocked which prevents breathing. The signalling system do not work hence medicine supply is also prevented. To find out an answer for this problem I am using successfully following protocol. Topically I am applying concentrated wheat grass juice added with juice of ginger and garlic. Wheat grass juice oil is then applied topically, paste of wheat grass juice and turmeric is also applied. Cotton pack soaked in juice are used to cover front and back, 4 ozone outlets - 2on nipple and 2 on back side are applied. Again soaked cotton packs are covered. Polythene sheet is wrapped on entire portion and ozone treatment is given for 1 hour. Simultaneously rectal oxygen circulation is given at the rate of 2 lt. per minute is also given to accelerate oxygen supply.  This system works to destroy fibroids support nutrition and oxygen topically and gives excellent relief to the patient. Hb increases, dependability is reduced and patient is capable to work.  If done in primary stage possible to cure. Better quality of life is not a small reward. The same  protocol is very much useful in all long term lung disorders including Koch's.  N. B. Nebulization with hydrogen peroxide and with minor / auto hemo therapy is also useful.
 Dr. Dipalee Malviya: Pipaladya avaleha,punarnava avaleha,abhayadi kwatha n sunthadi kwatha r also give good result in asthama,bronchitis.
Dr Sandeep kakuste Nandurbar: Thank you Dr deshpande sir,dr dipali mam
--------------------------- comments from group 2 ------------------------------------
Dr. Sachinkumar Jinture: Udgar veg dharan shwas is developed ..
Charak sutra 7/18
 USA Gary Yuen: am curious about diet for maintaining lungs, for example in smokers. ajmoda, yavani, amalaki, arjuna, pippali, ashwaghanda, other herbs? gaveduka is used among chinese for dampness (kapha?), though for lungs is possibly not the most important.
 Dr. Nitish Dubey: Yoga for breathing problems  especially copd is very effective. I think yoga and other aerobics r very promising in this aspect
USA Gary Yuen: Yes pranayama i think is quite helpful but in cases of disorder, food and herbs are perhaps more significant. Caraka mentions grain choice can affect lungs. Perhaps yava is an option then. Seems yava is now mainly recommended for kapha and no longer a general recommendation as with rice mung amla in caraka.
 Dr. Rammesh Natu: I fully agree.... Cycling, Gym to some extent, swimming, yoga based on breathing exercises are best especially in respiratory disorders..... Alternative approaches needs to be evaluated in place of medicines…. I fully agree.... Cycling, Gym to some extent, swimming, yoga based on breathing exercises are best especially in respiratory disorders..... Alternative approaches needs to be evaluated in place of medicines
 Dr. Nitish Dubey: Walking 20 minutes three times weekly….Pursed lip breathing….Abdominal breathing exercises…..And use of  medicine… As we know asthma is a allergic condition….I give bresol and haridra khand….Also nidan parivarjan
 Dr. Nitish Dubey: Yes sir, All above conditions r diffrent with different aetiology and pathogenesis
 Dr. Dilip Pithiya: Ac.Sushurut
Kantakari:- 1 Tola
Amlaki    :-  1 Tola
Hingu      :- 1/2 Tola
Mix All & Make Powder.
Take with Honey.
Til oil  + Sainthav lavan -à mix  warm à Chest Massage  & fomentation with Hot Towel.
 Dr. Dilip Pithiya: Tamak Shwase Virechanm.
Drugs like 1.Chavan prash avleh  Or  1.Drakshavleh
2.Kankasava
3.Dashmool kwath +Gojihwadi Kwath.
4.Shwas kuthar -   Trikatu,   Talisadi Churn,   Bharangi                        
5.Vasa Swaras
- Haridrakhand For Allergic Condition
 - Nidan Parivajan
 Dr. Sachinkumar Jinture: Muhurmuhur koshn jal sevan
 Dr. Abha. l. Ravi: Dhoomapana with powdered swasananda rasa or powdered dathura pathra has shown good results.
 Dr. Hiral Sengal: swwaskasta.
pt given ,
*sitopaladi churna+ vasa churna + abhrak bhasam+ bharandi mum churna + haridra..vth honey 2 times / day
*bharangyadi kasay+ gojihvadi kasy 3 tps + 3 tps warm water after meal
swath kuthar ras 2 tDS
hardrakhand 1 tps/ BDS
if adv for nasay.
 Dr. Yogin Patel: Seating under pippal tree also effective & pranayam in bronchial asthma
---------------------------------------- end of comments from group 3 -----------------
Dr. Meghdoot Satvekar: Disorders of the breath affect  Whether due to a common cold resulting in bronchitis or something more serious such as asthma or emphysema, difficulty  to breathing  (dyspnea) as “swasa”.kashtata The breath is disturbed when vata is obstructed by kapha. Vitiation is classically stated to occur in the pranavaha srota (respiratory system), the ambuvaha srota (water metabolism system) and the annavaha srota (stomach). Kapha is given the greatest role in the pathology. Vitiation of kapha results in obstruction to the movement of air in and out of the respiratory system. This condition has its origin in the stomach, the site of kapha. Hence, kapha accumulates and becomes aggravated in the stomach, overflows into circulation and relocates into the respiratory system where it obstructs the movement of vayu (air.)
 Dr. Bhadresh Naik: Commonest causes of breathlessness is nasal polyps and nasal septum deviation and nasal congestion 2 psychological
 Dr. Ravindra Upadhyay: Shwaskashta or breathlessness, various causes should be thought of first, treat the cause, obesity, recurrent, cold, cough, BRONCHITIS, Bronchiectasis, pneumonia, pleural effusion, enlarged heart, various lung diseases, Anaemia, Bronchial. Asthma,  congestive cardiac failure, congenital heart disease., are the causative factors, accordingly treatment can be commenced.
 Dr. Bhadresh Naik: Midnight brethlessness with perspiration and orthopnea raised pulserate is related to lvf, Ccf….Diuretic is line of treatment according to morden and ayurved(mutal gan)
 Dr. Meghdoot Satvekar: Some of diseases where dyspnea swasa kashtata is symptom : asthma,  bronchitis, pneumonia, pneumothorax, anemia, lung cancer, anxiety, COPD, congestive heart failure, arrhythmia,  allergic reaction, anaphylaxis, lung disease, obesity tuberculosis, emphysema, pulmonary fibrosis, pulmonary artery hypertension,  pleurisy, sarcoidosis, rib fracture, carbon monoxide poisoning, obesity
Vd. Tapan: Swaskastata can be due to Vata, Kapha, Aama, Anna and
Udaka…So if these five areTaken cared…All of above various conditions can be helped.
 Dr. Bhadresh Naik: I am practicing in small village I have no facilities to investigations so I always try to make dd and according to patient's problem I suggests line of treatment….So What I experience share to everybody
 Dr. Meghdoot Satvekar: Asthma -  Shwas rog
In today's stressful modern urbanized living, incidence of Asthma is considerably increasing. The rapid industrialization , excessive crowding , Increasing pollution are some of the factors responsible for this increase in incidence of Bronchial Asthma.
The vitiated 'Pranvayu' combines with deranged 'Kapha dosha' in the lungs causing obstruction in the 'Pranavaha srotasa'(Respiratory passage). This results in gasping and labored breathing. 
Types of Asthma: Five types of 'Swas Roga' are described in Ayurvedic texts
1]Maha-shwas
2]Urdhva-shwas
3]Chinna-shwas
4]Tamak-shwas
5]Kshudra-shwas
Among these five types first three are not curable. 'Tamak-shwas is 'yapya'(Controllable) and is difficult to cure. The last one is curable. More than 75% of the cases belong to last two categories.
Cause of Asthma :
A] Factors related to diet:
Excessive indulgence in lablab beans ,black grams, raw milk, soar curd, excess salt, flesh of aquatic and wet land animals.
Excessive use of 'Ruksha'(dry) and 'Guru'(heavy) diet, excessive use of cold water and cold drinks.
Excessive use of 'Abhishandi'(Kapha producing) diet, Excessive use of not easily digestible and irritant food.
B] Factors related to work :
Excessive exposure to dust and smoke.
Excessive wind, cold, cold bath or excessive heat, sun bath.
Exhaustive exercise, walking, excessive sexual activities.
Supression of natural urges
Psychological factors
C] Other Factors :
Trauma to vital organs viz. - chest, throat
Asthma may be as a sequaelae in other diseases like -
Fever, Long standing common cold, Tuberculosis , Anaemia, Heart disease, Poisoning 
Preventive Tips for Asthma :
Avoid cold and damp places.Go for morning or evening walk, do yoga mainly 'Pranayama' Avoid over eating . Take light dinner one hour before going to Bed Avoid Tobacco, wine and Smoking Keep rooms well ventilated . Avoid air conditioners, coolers and direct air of Fan Avoid perfumes , Agarbatti. Mosquito repellents Drink boiled water in Plenty Avoid over exercise 
Treatment for Asthma :
A] During attacks - Apply warm 'Til tail' over chest and back .Apply fomentation
Take 'sunth powder'1/4 tea spoon+'Kali mirch' 6+'Kala namak 1/4 teaspoon+ 5 leaves of 'Tulsi' Boil this mixture in 200 ml water reducing it to 50 ml. Filter and sip it.
Swaskuthar ras, Sitopaladi choorna, Vasavleha 
Treatment in between Attacks - 'Rasayan -chikitsa is advocated for'Pranvaha shrotasa'(Respiratory system).
'Vardhaman pippali rasayana.'
2] Take 'Agastiprash' - 2 tsf daily. 
3] Lung Tonic - Make paste of Black resin,dates, long pippali and honey,in equal quantity.Take one teaspoonful of it morning and evening with warm milk.
Panchakarma especially 'Vaman' is advocated before rainy season
 Dr. Meghdoot Satvekar: Ref site -/www.homeveda.com/Natural-Remedies/Lung-Problems/Natural-Ayurvedic-Home-Remedies-for-Asthma
 Dr. Bhadresh Naik: Pranvah strotas, Dhatuxay, Vegavrodh, Ruxahar, Ativyayam, Ati langhan,
Sign: Breathleness, Slow ness if breath, Difficult to exhale and inhale
Change of pattern of breath, Deep breath, With sound, Pain ful
Now a day wrong method of pranayam is common cause
 Dr. Bhadresh Naik: Nidanparivargan only treatment
 Dr. J. T. Contractor: We mustn't miss environment! Highly polluted metro cities are densely lead oxide filled which not only affect the normal oxygenation for human kind but damaging lungs hence respiratory system !
 Dr. Bhavesh Modh: सौवर्चलं नागरं भार्गी द्विशर्करायुक्तम्
उष्णाम्बुना पिबेदेत हिक्काश्वासविकारनुत ।।
 Dr. Ravindra Upadhyay: Sauvarchal salt, ginger, plant. Bharangi, all mixed, twice the mixture of this sugar, all should be mixed. This should be taken with lukewarm water.
 Vd. Pankaj Chhayani: Breathlessness due to Cardiac asthma:-
•  Punarnava
• Rasayana churna
Breathlessness due to Bronchial asthma:-
• vacha, talishadi, abhraka bhasma, swasakuthara, Shringa, bibhitaki, Tankan are best among all medicines..
Breathlessness due to allergy:
• Shirish, Vacha are good along with other herbs..
Allergens are like Visha dravya due to its ashukari property. Shirish is best Vishghana dravya,its also very good as antihistaminic...

 Dr. Vipin Pandey: Shring bhasm local application….Saindhav + til tail local application on chest also meet better result
Dr. Meghdoot Satvekar: Shwas – bharangi, nagara, Sitopaladi Churna
Vasa Churna, trikatu churna, shukti bhasma, vasa churna with honey three times in a day.
KANAKASAVA, SWASA KASA CHINTAMANI RASA  SUVARNA PUSHPASUGA RASA
 Dr. Prerak Shah: Pl let me know more abt local appli. How ? When? How much ? Thnx
Dr. Ravindra Upadhyay: Local application of lukewarm. Narayan Tel.
 Vd. sandeep Ahirkar: Shatpushpa, Yashtimadhu, kushta and tagar powder mix in water and then in this mixture add ghee and make it warm and apply
Like this procedure given bellow contents we can use
1)bala, rasna,til (sesame) Yashtimadhu and neel kamala (blue Lotus)
2)guggul ,devdar,rakta chandan ,nagakeshar
3)kakoli, bala,vidarikanda,bark of sahinjana and Punarnava
 Vd. sandeep Ahirkar: Charak chikitsa 8/76~80
 Dr. Bhavesh Modh: Triggering factors of Asthma: Courtesy : vishwa ayurveda
The advantages of Ayurvedic treatment of Asthma .
Asthma is labeled as fatal and persistent, but it can be healed if treated with Ayurvedic medicines. Asthma treatments taken at initial stages have shown successful results and the advanced, chronic cases have experienced a decrease in the force and recurrence of such attacks.A patient will get great help from Ayurvedic medicines to fight the infuriating factors and thus making them less dependant on other quick-relief medications.The patient’s poor resistance to environmental changes, recurrent colds and skin defects are cured completely during the Ayurvedic treatment for asthma.
👉 treatment approach
The toxins that are accumulated in the system are eliminated and the nervous system is stabilized. The immune system is also made strong, so that it can handle the stress. asthma treatment can begin with the understanding of  following factors:
🔵Patient’s genetic predisposition.
🔵Patient’s sensitivity to allergens.
🔵Physical body structure that is the patient’s immune status and obesity form.
🔵All the physical current symptoms including the occurrence and intensity of asthma attacks.
🔵Any disturbing aspects in the patient’s life.
 Vd. Kinshuk Hirpara: Breathlessness means dyspnoea,Shortness of breathing. It's only a symptom.
There are many causes
Like respiratory , cardiac, cancer which are mainly severe conditions.
Respiratory tract can include COPD,bronchial asthma, pulmonary embolism etc.
Dyspnoea related to cardiac problem has different line of treatment.
Chemotherapy or radiotherapy can also cause breathing problems.
Obesity and diabetes type 2 also can cause dyspnoea.
But what I observed in my practice is low sugar ( direct white sugar won't help in this.) Low blood pressure and anxiety leads more short breaths in kids and young adults.
Treatment
1. Amalaki Rasayana
2. Lemonade
3. Mixture of sanchal hing and sunthi all these will help to maintain potassium levels and blood pressure.
4. Dried fruits mainly raisins can help to treat low sugar.
5. If anxiety is present, go for herbs which relaxes nervous system. Like jatamansi powder.
6. When oxygen consumption is low, breathlessness happens.  Deep breathing in the morning helps to acquire more oxygen in the body.
7. Breathlessness due to chemotherapy and radiotherapy, cow ghee intake should be increased. Because in that case oja kshaya is there. Avoid oil totally, cook everything in cow ghee. Massage at feet from cow ghee also helps in reducing anxiety .
8. Cow ghee or castor oil drops in nose also helps in child asthma. But consult ayurveda doctor 1st.
🔵To strengthen the lungs, mix some cloves with peel banana and take the same product with honey after leaving it for overnight. This a good herbal remedy for Asthmatic  bronchitis.
🔵Herbal medication like juice of whole plant of yellow berried night shade-7 to 14 ml. may be taken twice a day to relieve and ease from the condition.
☕Herbal tea made up of Trchyspermum, (Ajwain), Ocimum sanctum (Tulsi), pepper, and ginger is useful natural expectorant for it
🔵Vasa, an Indian herb, control bronchitis, a boon and known for cough remedy.
🔵Turmeric, a bronchial herb, is highly useful for the chronic condition.
🔵Glycyrrhiza glabra (Yashtimadhu), soothe the trachea and prevent airways obstruction.
🔵Herbs like albezia lebbeck, clove is useful for asthmatic  bronchitis.
🔴For natural cure of the🚑 condition and to get some relief, rub brown mustard oil on the chest.To minimize congestion and reduce breathlessness, drink some pepper + 1 teaspoon honey + little onion juice. It is one of the natural ayurveda remedies.More intake of fluid should be taken if one suffered with dryness of it.
🔴Massage with sesame oil on the chest is a very useful alternative treatment.To reduce asthmatic trigger, grind 2-3 gram of nagar and Bharangi, take this medicine mixture thrice a day with lukewarm water.
🔴To ease the severity of bronchitis, take a mixture of Sitopladi Churna + liquorices+ borax powder and honey, thrice a day.Herbs like Elecompane, Mullein, Thyme, Black Pepper, Flax seed, Ginger, Manna, Myrrh also used for the treatment of it.Seed of Celery is used in the treatment of it.A solution of Ephedra provides relief to asthma attacks by clearing the congestion of respiratory tract.Chewing of the fruit chebulic myroblan at night allay asthmatic attack.Arjuna bark is helpful in treating of it.Powdered of bay berry bark an effective remedy for bronchial patients.
🔴Euphorbia facilitates easy breathing.
🔵Aniseed has expectorant characters so helpful for asthma patients.
🔴Gum of Asafetida + Honey is useful for the patients.
🔵Trachyspermum ammi has expectorant properties and ease chronic phlegm.
🔴Garlic reduces the asthmatic severity.
🔴= emergency management
 Shri Minoo parabia: Some ethnic recipes to treat breathlessness.
Take fresh radish with all of leaves and half of tuber.
Crush and drink the juice.
Singapuri loban(Styrax benzoin) and Mamro badam (Afghanistan Almond) preparation
helps even patients of effusion.
Water is boiled with dry ginger and than kept in a thermos. Whenever thirsty drink only this water.
Mixture of vasa, Belleric myrobalan, black pepper,  cinnamon, saubhagyapushpa and camphor be administered 1g every two hours, when awake.
 Shri Minoo parabia: All are Anubhut.  Use any one or two of the above.
Dr. Shriniwas Gujjarwar: श्वासभेदाः
Types of Shwas :
महोर्ध्वच्छिन्नतमकक्षुद्रभेदैस्तु पञ्चधा |
भिद्यते महाव्याधिः श्वास एको विशेषतः ||१५||
(वाताधिको भवेत् क्षुद्रस्तमकस्तु कफोद्भवः |
कफवाताधिकश्चैव संसृष्टश्छिन्नसञ्ज्ञकः |
श्वासो मारुतसंसृष्टो महानूर्ध्वस्तथा(तो) मतः) |
 Samprapti and purvaroopa :
प्राग्रूपं तस्य हृत्पीडा शूलमाध्मानमेव |
आनाहो वक्त्रवैरस्यं शङ्खनिस्तोद एव ||१६||
यदा स्रोतांसि संरुध्य मारुतः कफपूर्वकः |
विष्वग्व्रजति संरुद्धस्तदा श्वासान् करोति सः ||१७||
Madhav nidan. 12
 Dr Jayesh Patel: If Swash rog is swatantra (Primary )
Then differentiate according with charak...
Most of Tamak Swas pt came at clinic...
Giving treatment
1)Swashamrutam syrup 2 tsf tds
2)Pipli churn with apamarg kshar & mayurchandrika bhasm
Pathy-Apathya also most imp.

 Dr. Shriniwas Gujjarwar: MahaShawas Roga symptoms :
उद्धूयमानवतो यः शब्दवद्दुःखितो नरः |
उच्चैः श्वसिति संरुद्वो मत्तर्षभ  इवानिशम् ||१८||
प्रनष्टज्ञानविज्ञानस्तथा विभ्रान्तलोचनः |
विवृताक्ष्याननो बद्धमूत्रवर्चा विशीर्णवाक् ||१९||
दीनः प्रश्वसितं चास्य दूराद्विज्ञायते भृशम् |
महाश्वासोपसृष्टस्तु क्षिप्रमेव विपद्यते ||२०||
 Urdhwa Shwas symptoms :
ऊर्ध्वं श्वसिति यो दीर्घं प्रत्याहरत्यधः |
श्लेष्मावृतमुखस्रोताः क्रुद्धगन्धवहार्दितः ||२१||
ऊर्ध्वदृष्टिर्विपश्यंस्तु विभ्रान्ताक्ष इतस्ततः |
प्रमुह्यन् वेदनार्तश्च शुक्लास्योऽरतिपीडितः ||२२||
ऊर्ध्वश्वासे प्रकुपिते ह्यधःश्वासो निरुध्यते |
मुह्यतस्ताम्यतश्चोर्ध्वं श्वासस्तस्यैव हन्त्यसून् ||२३||
 Chhinna Shwas symptoms :
यस्तु श्वसिति विच्छिन्नं सर्वप्राणेन पीडितः |
वा श्वसिति दुःखार्तो मर्मच्छेदरुगर्दितः ||२४||
आनाहस्वेदमूर्छार्तो दह्यमानेन बस्तिना |
विप्लुताक्षः परिक्षीणः श्वसन् रक्तैकलोचनः ||२५||
विचेताः परिशुष्कास्यो विवर्णः प्रलपन्नरः |
छिन्नश्वासेन विच्छिन्नः शीघ्रं विजहात्यसून् ||२६||
 Tamaka Shwas symptoms :
प्रतिलोमं यदा वायुः स्रोतांसि प्रतिपद्यते |
ग्रीवां शिरश्च सङ्गृह्य श्लेष्माणं समुदीर्य ||२७||
करोति पीनसं तेन रुद्धो घुर्घुरकं तथा |
अतीव तीव्रवेगं श्वासं प्राणप्रपीडकम् ||२८||
प्रताम्यति वेगेन तृष्यते सन्निरुध्यते |
प्रमोहं कासमानश्च गच्छति मुहुर्मुहुः ||२९||
ष्मण्यमुच्यमाने तु भृशं भवति दुःखितः |
तस्यैव विमोक्षान्ते मुहूर्तं लभते सुखम् ||३०||
तथाऽस्योद्ध्वंसते कण्ठः कृच्छ्राच्छक्नोति भाषितुम् |
चापि लभते निद्रां शयानः श्वासपीडितः ||३१||
पार्श्वे तस्यावगृह्णाति शयानस्य समीरणः |
आसीनो लभते सौख्यमुष्णं चैवाभिनन्दति ||३२||
उच्छ्रिताक्षो ललाटेन स्विद्यता भृशमार्तिमान् |
विशुष्कास्यो मुहुः श्वासो मुहुश्चैवावधम्यते ||३३||
मेघाम्बुशीतप्राग्वातैः श्लेष्मलैश्च विवर्धते |
याप्यस्तमकः श्वासः साध्यो वा स्यान्नवोत्थितः ||३४||
Sadhya asadhyata of Shwas :
रूक्षायासोद्भवः कोष्ठे क्षुद्रो वात उदीरयन् |
क्षुद्रश्वासो सोऽत्यर्थं दुःखेनाङ्गप्रबाधकः ||३७||
हिनस्ति गात्राणि दुःखो यथेतरे |
भोजनपानानां निरुणद्ध्युचितां गतिम् ||३८||
नेन्द्रियाणां व्यथां नापि काञ्चिदापादयेद्रुजम् |
साध्य उक्तो बलिनः सर्वे चाव्यक्तलक्षणाः ||३९||
क्षुद्रः साध्यो मतस्तेषां तमकः कृच्छ्र उच्यते |
त्रयः श्वासा सिध्यन्ति तमको दुर्बलस्य ||४०||

 Vd. Pankaj Chhayani: ज्योतिषं जलदे मिथ्या, मिथ्या श्वासिनि वैधकम्!
योगो बह्वाशिने मिथ्या, मिथ्याग्नानं मधपे!!
This sloka shows that how swasa is difficult to cure...
Charaka has said param durjaya, ashukari ..

 Dr. Bhavesh Modh: Chas. G. Levison, of San Francisco, who made a quantitative analysis of the plant (Amer. Jour. Pharm., 1885, p. 147), found, among other substances, a trace of tannin, volatile substances, a non-volatile wax, salts of potassium, magnesium, sodium, and silica, starch, and several resins of a glucosidal character, differing mainly in the strength of alcohol required to accomplish their solution. Euphorbia pilulifera ( दुग्धिका नागार्जुनी ) was introduced to the medical profession by Parke, Davis & Co., of Detroit, through whose extensive advertising it became generally known.
👉Action, Medical Uses, and Dosage.—Euphorbia pilulifera is one of the tropical spurges. Its physiological effects are not pronounced, except that it. is irritant to the gastrointestinal tract, and may occasion epigastric distress with nausea. Upon other portions of the mucous surfaces and the skin it seems to be inactive. Its action is said to be confined chiefly, if not wholly, to the respiratory and cardiac centers, and elimination takes place by the liver. It is brought forward as a reliable anti-asthmatic, being particularly adapted to spasmodic forms of asthma. Dyspnoea of cardiac disease has been relieved by it. It is recommended for chronic bronchitis in old people. It promoted expectoration, allayed cough, and exerted an anodyne influence in a case of pulmonary consumption. It has likewise given good results in emphysema. Dose of ordinary tincture, from 10 to 60 drops, as an anti-asthmatic, for which purpose it is highly valued in Australia. The leaves may be smoked in a pipe for paroxysmal asthma. Infusion (ss to aqua Oj), ¼ to ½ fluid ounce; fluid extract, 10 to 30 drops; specific asthma-weed, 1/10 to 30 drops.
 Shri Minoo parabia: Long back we (includes my colleague Dr Krishnamurty) worked on Solanum spp. Slasodine , dexa methasone precursor was reported. Very reason for highly held kantakari for swas.
It is the natural steroid.
This Euphorbia is wonderful indeed. Someone must take up research on the Asav prepared out of this plant. As mentioned above the useful principles are ethanol soluble. Worth trying.
 Vd. Jignesh Thakkar: Kamam pran hara roga bahavo natu te tatha|
Yada swasam cha hikka cha harati pranam ashu cha|
Germany Helga Fuchs: Many interesting suggestions here. Lifestyle changes incl foodhabits is must in respiratory conditions, as in all conditions where serious problems increase
 Dr. Vipin Pandey: My personal experience heat the snuhi leaf then after rinse leaf juise come out then include salt in Very effective result in cough
I dont know how to it work but give mirakel result
 Germany Helga Fuchs: Treatments incl Pancha Karma up to conditions are most helpful and give the needed cleaning and relaxation. To build up bronchioles and strength of the lungs turmeric with honey 1/2 after meal, juice of ginger and lemon with honey 1/1/1 give best results. Second if dryness is given. Pippali boiled in little milk, for 21 days each day add little more pippali, and 21 days back to the Portion of first day. Last I have not tried, but hearing from good results. I am afraid about to aggrevate kapha in this condition in amashaya, due the poor Agni in most people in this condition. Body and mind rest is a must and as it is my experience pranayama is adviced but not possible in this time. Only awareness of the breath to give some rest in mind. Very useful for real weak patients is neti with lukewarm water morning and evening. After some time I add simple nadi shodana and Ujjai.  Kaphalbati or Bastrika both to strong and should done in health condition to avoid sickness. Controlled food and lifestyle habits give body and mind the needed protection and is  first needed point to do. And by the way, as I look now of the Yoga run in India or here, Prana is in big danger. Prana is life and should first flow easy and healthy. If this is done die lifestyle then people can start to manipulate it for higher reasons. But my stand is clear, Pranayama is not common praxis, and if it is done, first under instruction of a doctor. If doctor know about the effect what is given by holding and pressing due Prana in mind and body. Prana if wrong treated or used is easy step in serious problems. And this  is common to day and forsed. People feel not comfortable by pranayamapraxis in yogastudio but following blind instructions by thinking she itself are wrong. Prana should be seen as point, who is disturbed first if lifestyle is not helpful for life. Then Ayurveda dinacharya, routacharya is for common people good to understand. More easy for doctors. We have here yogainstructors, in teachings for 3 years who have never heard about pranas (5 Vata). This is why I add in my teaching Ayurveda knowledge as basic. Ok, and back to the point, in respiratory problems now and in future, Docs have to ask how patient is handling his breathing.
 Shri Minoo parabia:  http://scholar.google.co.in/scholar?oi=bibs&cluster=1289353153204480556&btnI=1&nossl=1&hl=en
Dr. J. T. Contractor: If I mistake not Euphorbia in China is used as cold cough medicine a home remedy, later a US company patented with some inorganic ingredients &  got patented, when put in USA market it backfired with cardiac complains, the entire lot was to be removed from market & the license was suspended, I don't remember exact year it was published in USA health magazine, but since the name euphorbia came, I thought let me put it that any natural remedy if adulterated with chemicals to make unique formulation for the sake of patenting gets back fired, we must not disturb the natural phenomenon, v should honor the virginity of its nature & character of the plant by mixing with the natural ingredients
 Dr. Bhadresh Naik: According to achray charak, Ras, Rakta, Mash dhatuxay
And Due to Increase of meddhatu anger and grid manovahstrotasdust involved leads to pranvahstrotas dusti
 Vd. Pankaj Chhayani: Swasa is vata kaphatmaka and originated from Pitta sathana.. There is rasa dushti because of Kapha prakopaka ahara, Mala rupa kapha is produced more and more from vitiated rasa, as Kapha is mala of rasa dhatu.. Dravyas having Ushana properties break this pathogenesis.
Ushna dravyas increase Jatharagni, correct pittasthana, decrease Vata and kapha and decrease mala rupa Kapha...
Cardamom, asafoetida, Ginger , cumin seed are common herbs those having properties like Ushna, Vata kapha nashak and vatanulomana..
Dr. Bhadresh Naik:
 Courtesy of kaychikista by y g joshi

 Vd. Pankaj Chhayani: In modern, there are mainly two category in respiratory diseases.
1) Obstructive
2) Restrictive(occupational)
In obstructive pathology, Emphysema, Bronchiectasis, some cases of asthma are included.
In restrictive pathology,
Silicosis, asbestosis, fibrosis etc are included..
I have observed some pts from Jodhpur where restictictive lung diseases are more common.
In such cases , Panchatikta ghrita has given good results as shamana. In restrictive lung disease, there is hardness of tissue/ fibrotic tissue, Ghee is helpful to soften this tissue..
There is Panchakasa in rogadhikara of Panchatikata ghrita..

 Dr. Meghdoot Satvekar: HERBS THAT HELP IN ASTHMA
BAMBUSA ARUDINACEA (VANSHLOCHAN)
This herb acts as a suppressant of cough and help keep the respiratory system clean. It helps in problems like dry cough and sore throat.
PIPER LONGUM (PIPPALI)
Pippali is very effective in case of mucus and cold conditions in the lungs. It enhances vasodilatation and blood circulation to the lungs. It has decongestant, bronchodilator and expectorant properties. It rejuvenates the lungs. People who are prone to frequent colds can get relief from the symptoms by using Pippali. This herb is used in  kaas-har churna.
ELLETTERIA CARDAMOMUM (ELA)
It is commonly known as cardamom. Its seeds possess warm and pungent properties. It has a sweet taste and reduces Vata and Kapha. This herb is effective in sore throat and hoarseness caused because of influenza and cold.
CINNAMOMUM ZEYLANICA (DALCHINI)
It shows properties which act against the pathogenic microbes present in the respiratory tract. Cough related problems can be eliminated effectively by using this herb. It helps in expelling excess mucus from the lungs and respiratory tract. Breathing difficulties like cough, cold and bronchitis
 Dr. Bhadresh Naik: Type Mahaswas (biots breathing) due to heart, Kidney, Brain complications, Udhavswas, (Stertotorous breathing), Due to Congestion, Consolidation, Pneumonia, Lung abscess, Chhinswas (Cheyne stroke respiration), Tamaksvas (Asthma), Due to Coryza, Renal disease, Cardiac, Bronchial, Sudrasvas (Dyspnea on exertions) Due to Anemia, Ascitis, CCF, Obesity
Due to lvf or ccf Breath lessness Occur almost midnight with perspiration.. Tachycardia….Ortopnea is cardinal symptoms…Diuretic is important line of treatment…Digitalis may start after ecg…Echocardiography..X-ray
In this no role of bronchidilater Prabhakarmisran: Arjun, Punarnava, Hradayavaranras, Mandur we may start
Dr. J. T. Contractor: Chilly leaves dry powder with zinger powder, peppy powder shows good response in any respiratory ailments(Ref:!!)
This disease found mostly in labour working in mines, of coal, asbestos, mineral powder factories like dolomite, farmers etc. even pet bird's feathers also are dangerous specially dove feathers these are main resorted of the epidemic, many times found children playing with pets are most likely to catch the disease even pneumonia
 Dr. Ravindra Upadhyay: It should be. Interstitial. Lung disease. Where lungs get fibrosed, it is a chronic lung disease
Dr. J. T. Contractor: Yes also likely to b filled with water, in winter we see youngsters drive bike with shirt's upper buttons open they also catch this disease later… I mean lungs filled with water
 Vd. Hardik bhatt, Idar: Yat kicchit kaf vatghnam ushnam vatanulomanam ........ Charakachrya aatla ma j kahi didhu badhu ...
 Vatanulomanam .... Is a very nice concept and perfect treatment
 Canada Nitin Shah: Tamake tu virechanam.
 Dr. Bhadresh Naik: Virechan for me
Mutravirechan, Laxative
 Canada Nitin Shah: Yes agreed. Even shipping warm water can give this effect as well in small amount as bronchi dilator
 Dr. Meghdoot Satvekar: Chronic Obstructive Pulmonary Disease (COPD) -
Vasadi syrup/ kwath-
Vasa, Haridra, Dhanyaka, Bharangi, Guduchi, Shunthi, Kantakari, Pippali.
Shwasaghna dhuma in a dose of 2 puffs
twice a day after meals
 Dr. Bhavesh Modh: Datura seeds and leaves are used as antiasthmatic.
Smoking blends of Datura used as smoke .It has been used by the British soldiers to treat respiratory problems. Datura has been used in Ayurveda for asthma symptoms where are smoked in cigarette or pipe.
Dr. Ravindra Upadhyay: Asthma. Relief powder was being used by my father,  Dr l b. Upadhyay, made by. Boots, then by. Zandu, 1 tsp powder to be burnt and smoke to be inhaled over a period of 15 minutes, instant bronchodilator, resulting in expulsion of phlegm
 Vd. sandeep Ahirkar: Efficacy of Vasadi Syrup and Shwasaghna Dhuma in the patients of COPD (Shwasa Roga)
Abstract
Chronic Obstructive Pulmonary Disease (COPD) threatens as emerging public health crisis. The two major drivers for this are the ageing of the world's population and the impressive, if deplorable, success of the multinational tobacco companies at forcing open world markets. One of the most striking aspect of COPD is that it is heterogenous. There are many different presentations with differing intensities of symptoms and even differing responses to the medication. Sorting out, what accounts for this phenomenon and how treatments can be best individualised, is of concern to both basic and clinical scientists. COPD is a leading cause of morbidity and mortality worldwide and results in a substantial economic and social burden to society. It is the sixth most common cause of death worldwide and expected to rise to third position by 2020. Several national and international agencies like WHO, GOLD, ATS, ERS etc. are working in a direction of finding some solution of this wicked problem. In Ayurvedic texts Shwasa Roga has been described having symptomatology close to COPD. A study was carried out in P.G.Deptt. of Kayachikitsa in R.G.G.P.G.Ayu.College Paprola, H. P. where the role and efficacy of two Ayurvedic formulations -Vasadi Syrup and Shwasaghna Dhuma was evaluated on 30 patients of COPD selected on the basis of fixed inclusion and exclusion criteria in two different groups. In both the groups drugs provided significant results based on subjective symptomatological criteria and objective spirometric criteria.
Keywords: Chronic Obstructive Pulmonary Disease, Shwasa Roga, Vasadi Syrup, Shwasaghna Dhuma
Introduction
‘Shwasa Roga’ is a disease of ‘Pranavaha srotas’ (Tracheobronchial tree). The abnormal, rapid or difficult breathing when present as a cardinal feature of a disease is called ‘Shwasa roga‘. When Prana Vayu get vitiated and becomes defiled, get obstructed by Kapha and moves in opposite direction i.e. upwards and unable to perform normal functions, this condition is termed as Shwasa roga1, which is described elaborately in almost every Ayurvedic text. This closely resembles Chronic Obstructive Pulmonary Disease (COPD). GOLD has defined COPD as a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterised by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases”2. It is currently the fourth leading cause of death worldwide and by 2020 it is expected to rise to third position3. But as far as awareness among the people is concerned, COPD remained under recognised, underdiagnosed, and under treated disease.
Now, the time has come that the physicians should come forward with some definite solutions to this problem.In the same series study has been carried out to evaluate the efficacy of two Ayurvedic formulations i.e. Vasadi syrup and Shwasaghna dhuma in these patients so that the progression of disease can be controlled and patients should be provided relief in symptomatology and hence better life.
Aims and objectives
(i) To evaluate the efficacy of trial drug in the management of COPD.
(ii) To study the reversibility of disease process if any with the help of spirometric parameters.
(iii) To study the beneficial and adverse effect of the trial drug.
Material and Methods
To conduct this study patients diagnosed with COPD fulfilling the inclusion criteria were registered from OPD/ IPD of R.G.G.P.G.A.C. and associated hospital, Paprola Distt.-Kangra (H.P.), irrespective of sex, caste, religion. Patients between the age group of 30 to 70 years were selected.

Inclusion Criteria
Selection of the patients was done on the basis of three criteriae viz. Symptomatological criteria, Radi
 Vd. sandeep Ahirkar: Exclusion Criteria

Any patient not fulfilling the inclusion criteria, not willing for trial, below 30 years or above 70 years of age and presented with complications were excluded from the study.
Selection of Trial Drugs & Preparation
In the present study those drugs were selected which predominantly have Vata andKapha pacifying properties, which are the main doshas vitiated in the disease concerned. They have bronchodilatory, mucolytic, expectorant and antimicrobial actions. Vasadi kwatha in syrup form has been taken fromYogaratnakara4 and Shwasaghna dhuma has been taken from ‘Anubhutayoga prakaran’ ofBhaishajya Ratnavali5.
Vasadi kwatha in syrup form was prepared from Ayush Herbs Pharmaceuticals at Nagrota Bagwan, Dist. Kangra (H.P.). Drugs for the same were procured from some private herbs dealer in the local market. One kg of each herb was taken in which eight times water was added and boiled till one-fourth was left. Now 24 kg sugar was added to it total 40 lt. syrup was prepared.
Shwasaghna dhuma was prepared at college pharmacy of R.G.G.P.G. Ayu. College, Paprola. Drugs were procured from local herb dealer.Yavkuta of drugs was prepared.
Administration
All the patients fulfilling the criteria of diagnosis and inclusion were randomly divided into two groups named as Trial Group-I and Trial Group-II.
Trial Group-I: Twenty patients were given Vasadi Kwatha in syrup form in a dose of 15ml thrice a day after meals for 30 days.
Contents of Vasadi syrup: Vasa, Haridra, Dhanyaka, Bharangi, Guduchi, Shunthi, Kantakari, Pippali. Each herb is taken in equal amount as kwatha dravya andMaricha churna as prakshepa dravya.
Trial Group-II: Ten patients were given Shwasaghna dhuma in a dose of 2 puffs/1g , twice a day after meals for 30 days using a smoke-pipe.Duration of inhalation of the drug varied according to the patient's own vital capacity.
Contents of Shwasaghna dhuma: Yavakuta churna of seeds ofKantakari, Dry leaves of Dhatura, Ajowan, Khurasani ajowan, Kalmishora, Haridra and Bhangain equal parts.
 Vd. sandeep Ahirkar: Assessment of the results
After the completion of trial the assessment of improvement was done on the basis of improvement in above said subjective and functional symptoms as well as on the basis of spirometric FEV1(L)
Criteria for assessment
All the patients were assessed for relief in signs and symptoms and objective parameters after the completion of trial.
Observations

In this clinical study total 30 patients were registered. Six patients i.e.4 in group I and 2 in group II out of 30 could not complete the trial, hence considered as dropout cases. General observations includes data gathered from all the 30 patients whereas only 24 patients i.e.16 in group I and 8 in group II were evaluated statistically.
In the present study maximum number of the patients i.e. 25 (83.3%) were males and belonged to (50-70yrs.) of age group. Most of the patients i.e.29 (96.7%)were having active life style. The 16 patients i.e. 53.3% were illiterate and were ignorant about the various factors which affected their health status. The 22 patients i.e.73.4% were farmers and labourers and 86.7% of the patients were belonging to lower socioeconomic class. The 29 patients i.e.90% were smokers and 81.47% of them were having chronicity of 25-35yrs.Observations on various clinical features showed that the main presenting complaints of the patients were breathlessness, cough, expectoration and fatigue. It was also observed that reduced air entry, added sounds and chest resonance were present in all the patients i.e.100%.
Results
The effects of the therapy on main symptomatological criteria like breathlessness, cough, expectoration, heaviness in chest was statistically highly significant in both the trial groups (p<0.001) (Table (Table11 & 4). Statistically significant improvement was observed in breath holding time and power of exertion in both the trial groups (Table (Table22 & 5). Statistically significant improvement was observed in spirometric parameters like FEV1(L) (p<0.05) and FEV1/FVC% (p<0.01) in trial group I, whereas it was statistically insignificant in trial group II (p>0.05) (Table (Table33 & 6).
Source nih..gov website
 Dr. Ravindra Upadhyay: Pl use. Samasharkara. Churna  I have used, very good results,  Bhaishyajya Ratnavali,  KAS,&  ARSHA ROGADHIKAR
 Vd. sandeep Ahirkar: In astang hriday in kasa chikitsa principles of treatment of shwasa given there chikitsa division found in three conditions mainly ….Vata predominant conditions ~there they told to use snehan locally (chest),ghrutpan ,basti are given
2) Kapha predominant conditions they have given various leha kalpna dhumpan, vaman
3) pittaj dominant conditions~asavas like drugd given
 - http://support.google.com/webmasters/answer/6211428?hl=
-          www.ncbi.nlm.nih.gov › PMC3215321
 Dr. J. T. Contractor: Toxin of Dhatura leaves behind a great amount of up loaded work for liver to detoxify the body metabolism. in Gujarati saying ' Bakaru kadhta Unt pethu'! Ancient people had very strong body metabolism they could sustain any amount of toxins, as we are aware of the history that King-prince were given small amount of poison as a practice to digest, in case of poison given by his enemy the king should n't die. Today our life style, adulterated food style, pollution, chemical medicine etc has already crossed ESR beyond normal range! Poor liver has become almost immune instead! So in my opinion we should turn to find better solution by cell revival therapy, with supportive supplement to help patient in fighting these ailments,instead toxic remedies which were though very effective in ancient period, today looking at the responsibility of an Ayurvedic practitioner seems more challenging against modern medicines & the attitude of allopathic branch towards Ayurveda branch we are well aware! I am really happy to see new generation of Ayurveda section has gained a good amount of share effectively, yet we have to do a lot to walk parallel with modern medicine.
 Shri Minoo parabia: Kanakasav made from Datura is highly held medicine for lungs disorders.
Our elders used to dry plenty of washed leaves, powdered and mixed with black pepper powder. Just a gram of powder with warm water used to be effective. Hyoscyamine of Datura is supposed to be of value.
 Vd. sandeep Ahirkar: Kanakasav should be taken care while used in pitta prakriti person due to it's ushna n Tikshna gunas
 Dr. Shriniwas Gujjarwar: In pregnancy with Kasa shwasa also Kanakasava is to be avoided.

Compilation courtesy: Vd. Kinshuk Hirpara

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