Wednesday, March 14, 2018

Complicated respiratory disorders like COPD or ILD, Bronchiectasis, allergic bronchitis - according to #Ayurveda


Views shared by several Ayurveda professionals and non-Ayurveda people in discussion group:
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Next topic for discussion: Complicated respiratory disorders like  COPD or ILD, Bronchiectasis, allergic bronchitis - according to #Ayurveda
Ayulink: According to Ayurveda books Charak has described Swas roga in length and details. Can we correlate them with modern lables? Let me start with COPD and ILD are not asthma. It's completely different conditions. Can anyone differentiate between bronchitis and bronchiectasis, allergic bronchitis and asthma?
Dr. Piyush Dodiwadiya: Bronchitis is an inflammation – reversible. May present with fever dry cough sometime productive cough. Bronchiectasis is a permanent dilation of alveoly – irreversible. Plenty of sputum will be there, history of continue coughing, morning hours plenty of sputum.
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Ayulink: Similarly COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure. All forms of interstitial lung disease cause thickening of the interstitium. The thickening can be due to inflammation, scarring, or extra fluid (edema). Some forms of interstitial lung disease are short-lived; others are chronic and irreversible.
Now today's topic is how to correlate these modern terms with out science. How to interpret and treat with our science .
Dr. Bhavesh Modh: महाश्वास - The person, in whom  the expiratory movement of वात is aroused is greatly afflicted and being  obstructed in his respiration, breathes  incessantly with a loud & long stertor  like an intoxicated bull. He loses  all sense  of knowledge and understanding.. His eyes are restless, His face gets distorted , His urine & faces get constipated ,His voice is weakened , He gets into a moribund state & his intensely hurried breathing is noticeable even from a distance ,A person afflicted with  this greatest of disorders  of breathing will indeed succumb to it soon... . चि. . हिक्का श्वास .THUS HAS BEEN DESCRIBED  DYSPNEA MAJOR_  ~ *Terminal Dyspnea*
उध्व श्वास  = Expiratory Dyspnea...
छिन्न श्वास = Cheynestoke's Respiration
तमकश्वास - Bronchial Asthma
संतमक श्वास = Cardiac Asthma
Dr. Madhuri Patil Chaudhari: Kshudra Shwas-  can we consider it as  Swabhavbalpravrutta vyadhi or  pathological conditiin due to various reasons? how to differentiate? esp. if lung cancer is not detected but 1st symptom is breathlessness only
Dr. P. A. Deshpande: Recently  I have  put my thoughts on use of tulsi ,H2O2  nebuliser treatment  cronic resparatory disorders.  How successfully  we can treat such pts a case discussion below first video of pt  of COPD. She was on non stop oxygen support bed ridden for more than 5 years. before 3  moths.  She was  diagnose.. Glayo  blastona  with sever additional physical problems. Age 79  -no treatment was available and rejected .  I started purely my advanced naturopathy treat blastom. Treatment just in one months agressive treatment of  40 days  the oxygen support is more and  MRI shows reduction tumour. Now pts walks independently with walker look her face . Both eyes have now normal level.
Ayulink: Still our questions remain unclear. What kind of different approach we need to handle these respiratory complains.Tamake tu virechanam is there. But what about cardiac asthma? What about bronchiectasis?  Or ILD? Fibrosis is due to  vata aggravation and if we give ruksha treatment considering it as kapha symptoms, it will not respond. Some herbs are common like ajwain, Tulsi etc can be used blindly  in all conditions as they control Vata and Kapha both. But let's share our experiences with precise line of treatment.
Dr. P. A. Deshpande: I will try to explain from naturopathy angle . for this we consider conditions before disease, after disease.  Main cause of problem  is  lack of pranayam.  If we observe our breathing is shallow and below required level due to  stress and tension. This is from childhood and ultimately it becomes habit.  The lungs become lithargic  inactive . So natural process of inhale / exhaust  suffer. Become week.  I remember in initial programe  of Yog Guru Ramdev Baba  he was explaining his childhood healt proble
Ayulink: In most cases, I have observed that we treat all respiratory problems  almost in same manner. With same herbs or formulations.
Dr. Pritam Veer: may be but I don't diagnose these big term diseases. I diagnose only dosh ' which dosh aggravated or dosh dushti sthan vaigunya.
Ayulink: It's like whenever we look at any respiratory disease we go for svaskaschintamani, pippali, Trikatu, bharangmul, kantakari, vasa etc. And I have seen that many times it has not worked at all in cases of Fibroma or ILD. Proper diagnosis - may be as per ayurveda or modern , must be there.
Dr Jayesh Patel: Sometimes we use vitasti bhasm in acute condition With honey.Pt is feeling better within minutes. I think it work as bronco- dilator
Ayulink: But many modern diagnosis and understanding are difficult to interpret in our terms. Same way our terminology cannot explain such conditions like lungs Fibroma. Bronchodilator or expectorant does not work in copd or ILD
Dr. P. A. Deshpande: The efforts taken to correct through Yoga Sadhana diet he mastered all health problems. The quantity of  burnt gases in lungs is around five litres. These toxic gases harms lungs and create favourable atmosphere for bacteria and viruses . Slowly problem developed and agravates  now to find out solution and reversal we have strengthn lungs with pranayam diet exercise and medicines to support recovery.  I have developed a innovative system of prayam which has  proved very effective.  Take one litr plastic bottle fill with water.  Take plastic tube ( RT 12 no)  deep one end in water and other in mouth. Take deep breath through nose and exel it through mouth slowly . The pressure if  water column in tube creates condition to exhale all satured gases through out body.  Lungs starts improving its strength to its required level and defeat disease of its own.  effective.
Ayulink: As these conditions does not have any problem with bronchi. But when elasticity of lungs are lost and fibrous muscles get rigid. That creates difficulty in lung functions. And breathlessness is most common symptom.This is a kind of situation thay whenever we hear any complaints related with heart we start prescribing Arjuna. But we don't know exactly where Arjuna can work better or can't work.Bronchitis and bronchiectasis should have different approach. Similarly lung Fibroma and asthma needs complete opposite line of treatment. Asthma is more concerned with bronchi and it's capacity of exhale and inhale. But Fibroma is related with fibrous tissues of the lung, which are responsible for inflation- deflation  etc. Now how can we treat both conditions same way? Bronchi or alvioly are different structure - dhatu, updhatu and inflammation is different condition, while stiffness or dryness or  rigidness of fibrous tissue is different condition. But both conditions are expressed by breathlessness. There I am confused. Should I treat them as Maha svash or tamak svash ?
Dr. Madhuri Patil Chaudhari: Very true. We need to list all conditions, granthokta,  where shwas and or Kaas is metioned as purvrup or rup. To dd properly.
Ayulink: I know we ayurveda doctors are not having large number of patients of COPD or ILD, but it is always good to know. ILD is considered as terminal illness. Patient when cones to us they are fully aware that they are not going to be cured. Or they are going to be deteriorated till death. Allopath doctors also knows it and they inform the patient the same. But when patient comes to us, it is our duty to give most comfort and try to avoid side effects of modern medicines.
I have nearly 35 patients of ILD in last 2 -3 years, that forced me to think again and again.  I could not find any similar or exact description in books. I tired with panchkarma - Virechan and basti course. That gave me and my patients some improvement. Few patients felt comfort till last minute and they passed away silently. Family members of such patients gave credit to Ayurveda. In few cases, the patient who  were constant on oxygen were able to reduce oxygen dependability. So panchkarma works in such cases that I can say. Particulary I believe that snehan works better. Marta basti works better then niruha basti. But no ruksha guna herbs, no kapha reducing herbs worked in my any patients.
I have specific approach with ayurveda treatment, which is strictly observed and compliment by modern leading chest physician. Surprisingly Dr. Gopal Raval, a leading pulmonologist in the city is very happy to see the improvement and he referred ayurveda book for more detauls. But still I want to know more from ayurveda books. If someone can help me to interpret or understand these conditions.
Dr. Mrugeshkumar Patel: cupping  therapy is effective in copd,bronchial asthma ?
 Ayulink: I am not aware. Frankly it is not a part of syllabus in our Ayurveda education.
Dr. P. A. Deshpande: No, Cupping has no role in COPD. Dear all.  It is good that serious concern  is noticed.  Fibroma or fibrosis is soft and can be managed with combined treatment of Ayurveda and advanced naturopathy developed by me. C O P D case how I treated successfully  has been explained.  If sufficient cases say 5 I can send my team to Ahmedabad  fir demo and training.  it help practitioners and pts.  Soft fibrom or fibrosis  can also be managed  . Of course faith is necessary
Dr. Madhuri Patil Chaudhari: Is lung fibrosis reversible like liver fibrosis. But liver tissues have a better rate of regeneration than lung tissues. So, asking. I have not managed such a patient. But post Koch's fibrosis.  Leading to breathlessness,   how to manage such cases as per Ayurveda.
Ayulink: According to modern doctors, it is not reversible. It is terminal disease. Slowly patient can't breathe properly, depends on oxygen most of the time of day and night, and ultimately dies with lot of pain and discomfort. They also try with steroids and heavy drugs to give relief and comfort. But in my experience, Ayurveda gives more comfort till death. It is very serious condition where all - patient, doctors and Ayurveda Vaidya and family members - all know the final condition of the patient and yet we have to do our best.
Dr. Madhuri Patil Chaudhari: Rasayana Chikitsa for Pranvah strotas, can it work for fibrosis? Abhrak  bhasma is mentioned for improving Pranvah strotas bal or immunity. Has any1 tried Abhrak bhasma in such cases? I have only one case, post Kochs fibrosis, very limited damage,but seems to hv worked fine. As no kaas n shwas a little better.
Dr. Ravibhusan S Sonawale: Vardhman pimpili rasayan also useful
Ayulink: Tried in several cases. No significant response. Not used any bhasma, as i don't have quality assurance for bhasma . And this is not a condition where you can make many trial and errors.
Dr. Madhuri Patil Chaudhari: Yes if Kaphanubandhi. If Pitta more,, then hv to be used judiciously. Exactly that’s why i asked. Ethical considerations.
 Ayulink: Lung fibrosis according to me is Vata major problem. Anything becomes stiff or rigid or dry means the vata is increased. Particularly in fiber tissues vata in increased. May be we can term as 'snayu gat vata'. And that's why I use more Sneha or matra basti. Which give me more hopes and responses. Snayu or Kandara gat vata.
Dr. Madhuri Patil Chaudhari: Snayugat vaat causing dhaatukshay esp maans and med..or asthi majja dhaatu  located@ lungs. ? If we understand Samprapti properly we can think of ways to treat. I hv nt understood full smprapti of Fibrosis.
Dr. Supratim Bir: Katinya can't be alone by Vata, it should be Vata kapha involvement.
Dr. Madhuri Patil Chaudhari: Nature of fibrotic structure. Brittle, hard, etc. As per gruvadi 20 gunas. Yes vaat n kapha. Aakashiy and Pathiv if we think on Panchbhautik siddhant.
Pradip hira: I have treated only 1 patient, in 2006, pt. Was suffering from pulmonary fibrosis/COPD with Hyperthyroidism also. I have given vardhman pippali for 40 days in winter, increase from 1to 20 then decreased. Also used shrung bhashma, kajjali, abhrak bhashma and other medicines. When i started pt.'s age was 69, pt was on oxygen for 20hrs a day, not able to walk. After treatment of 6 months, oxygen reduce to 2 hrs/day. continue treatment of 2 years give very good result. Pt was able to walk, do her daily works, without any allopathic or ayurvedic medicines. After that pt. Lives for more 7 years without any complaints of COPD.
Dr. Supratim Bir: In lung fibrosis the condition may be sannipatik as the inflammatory condition is triggered from pitta Axis.
Ayulink: I have use some parameters to know improvement, like,  Walking capacity - how many steps or meters patient can walk,  Stair climbing capacity - how many steps patient can climb. Oxygen dependability - how long per day and with how much pressure (many patients does not need oxygen in initial stage)
Dr. Vishva Joshi: In Ild and pul fibrosis we can see the' rukshata ', so in this case we can treat gunviparit snigdh chikitsa, and I think it should work, We can't get exact ayu diagnosis of all allopathy disease,
 Gary Yuen: Has anyone noted dietary patterns in those with lung disorders? There are several modern studies linking increased consumption of fruits and vegetables with lower risk of COPD and other lung disorders. Certain substances such as sulforaphane (found in brassicas: cauliflower, mooli, with higher sources being mustard greens & moringa) have also been found to be protective against air pollution, cigarette smoke, and other lung irritants.There are also studies linking frequent meat and fish intake with increased risk of asthma, including a study among Indians. This one finds dairy (milk) associated with lower risk along with fruits and vegetables, though other studies have found milk to increase asthma risk.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284294/
Vd. Anand R Dugal: Dear friends in ayurvedic point of view hetu finding is to be must rather labelling it. As samhitas itself speak about hetu then purvarup then lakshan then samprapti so that what ayurved work  i guess. i believe and practicing on the behalf of samhita said and result are much better and all is that how much we understand samhita and follow it to apply on patient even for all diseases
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Compiled by - Dr. Dhruti Kagrana

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