Management of Pranavaha srotas Diseases “Ayurvedic Pulmonology”

Pranavata initiates impulse from Shirasa (Buddhi Hrudayendriya chittam – druk = aspect) travels through nose, tongue, pharynx, neck till Uras understood as – reticular formation form the Medulla oblongata with higher center connected especially “Respiratory center”

1. [email protected]
Management of Pranavaha
srotas Diseases
“Ayurvedic Pulmonology”
Prof. Dr. K.Shiva Rama Prasad
M.D (KC); MA, Ph.D (Jyotish)
[email protected]

2. [email protected]
Thought of 2008
•

“Following western scientist blindly
is not admissible. The information
available should be used
discriminatively to enrich the
knowledge and adopted to the
Indian territory and population”.
Dr. Manmohan

Singh, PM India

3. [email protected]
•

Life starts with breath
•

Ends with breathlessness
•

The maintenance of life
throughout life is
maintained by Pranavaha
srotas

with its –

initiative
points i.e. Hrudaya

–
Heart; Mahasrotas

-

Lungs
and 10 Dhamani
LET -

Introduction

4. [email protected]
Pranavaha srotas
• mÉëÉhÉuÉWûÉÌlÉÌiÉ

mÉëÉhÉxÉÇ¥ÉÉMüuÉÉiÉuÉWûÉlÉÉqÉç

LiÉŠ

mÉëÉhÉÉZrÉÌuÉÍzɹxrÉxÉëÉåiÉ

– cÉUMü

ÌuÉqÉÉlÉ

5/8 cÉ¢ümÉÉÍhÉ
• mÉëÉhÉmÉuÉlÉ: mÉëÉhÉÉÌlÉsÉ: mÉëÉhÉÉÍ´ÉiÉÉå

uÉÉrÉÑËUÌiÉ
– zÉÉ.xÉÇ.mÉÔ. 5/48 -AÉRûqÉssÉ • Pranavaha Srotas is a vital input capability
structure, maintaining the Life = Pranavata
• Prana is said as – Pavana / Anila – wind/ Air
• Life sustenance relays on maintenance of
Oxygen – Ambara peeyusha and water in the
body

5. [email protected]
Pranavaha Sroto Moola
• qÉÔsÉÍqÉÌiÉ

mÉëpÉuÉxjÉÉlÉqÉç

– cÉ.ÌuÉ.5/8 – cÉ¢ümÉÉÌlÉ
• iɧÉ

mÉëÉhÉuÉWûÉlÉÉÇ

xÉëÉåiÉxÉÉÇ

WØûSrÉÇ

qÉÔsÉÇ

qÉWûÉxÉëÉåiɶÉ

– cÉ.ÌuÉ.5/8
• iÉrÉÉåqÉÔïsÉÇ

WØûSrÉÇ

UxÉuÉÉÌWûlrɶÉ

kÉqÉlrÉ: -

xÉÑ.zÉÉ.9/12• Moola refers to developmental or generative
place
• PVS have Hrudaya (Heart), Mahasrotas
(trachea) and Rasavahini dhamani (pulmonary
vessels) added by Susruta as originative places
• Technically any organ takes in and sends out is
Hrudaya – either Heart or Lungs

6. [email protected]
Source of life
•

The Prana is specific air breathed
into the lungs during the act of
inspiration.
•

The effect of indoor and outdoor
air pollution on allergic disease
has received considerable
attention
•

Human is continuously under the
influence of environmental
changes subjected pollution.
•

Urbanized life style and
industrialization etc. compound
the problem.

7. [email protected]
Pranavata
xjÉÉlÉÇ

mÉëÉhÉxrÉ

qÉÔkÉÉåïU: MühPûÎeÉÀûÉxrÉlÉÉÍxÉMüÉ
¹ÏuÉlɤÉuÉjÉÔªÉU μÉÉxÉÉWûÉUÉÌS MüqÉï

cÉ

– cÉ.ÍcÉ.28/6
mÉëÉhÉÉå§ÉqÉÔkÉïaÉ: EU:MühPûcÉUÉå

oÉÑήWØûSrÉåÎlSìrÉ

ÍcɨÉ

SØMçü
ÌlɹÏuÉlÉ

¤ÉkÉÔªÉU

ÌlÉ:μÉÉxÉɳÉ

mÉëuÉåzÉM×üiÉç

– A.WØû.xÉÔ.12/
• Pranavata initiates impulse
from Shirasa (Buddhi
Hrudayendriya chittam –
druk = aspect) travels
through nose, tongue,
pharynx, neck till Uras
understood as – reticular
formation form the Medulla
oblongata with higher center
connected especially
“Respiratory center”
• Promotes expulsion of
phlegm, gas and intake of
air and food.

8. [email protected]
Vata
uÉÉ

aÉÌiÉaÉlkÉlÉrÉÉå

– xÉÑ.xÉÔ.21/5
• Vata defined as Gati –
momentum = motor and
Gandhana – sensory
perceptional or said as
information / knowledge
transformation

9. [email protected]
Types of Evoked Potentials
•

MOTOR = Gati =Measured from arm or leg muscle
•

VISUAL = Druk = Monocular visual stimulation with
a checkerboard pattern is used to elicit visual evoked
potentials, which are recorded from the midoccipital

region of the scalp.
•

AUDITORY = Srotra = Monaural stimulation with
repetitive clicks is used to elicit brainstem auditory
evoked potentials, which are recorded at the vertex
of the scalp.
•

SOMATOSENSORY = Gandhana = Electrical
stimulation of a peripheral nerve is used to elicit the
somatosensory

evoked potentials, which are
recorded over the scalp and spine.

10. [email protected]
Motor evoked potentials (MEP) = Vata Gati
•

Action potentials generated in the cortex
travel down the pyramidal pathway to the
muscles.
•

Surface electrodes placed on an arm or leg
muscle are used to record the summed
motor potentials. These potentials are larger
and easier to record when the subject lightly
contracts the corresponding muscle
beforehand.
•

An abnormality of the MEP implies a lesion in
the peripheral or central portion of the motor
pathway.

11. [email protected]
Vata can be
calculated in terms
impulse
transportation time
CMCT (Central
Motor Conduction
Time)
Fundamentals of
Neurology1sted
2006.Thieme.3HA

XAP,
Mumenthaler

/
Mattle, pp 59

12. [email protected]
Somatosensory evoked potentials
(SSEP) = Vata Gandhana
•

When a repetitive electrical stimulus is applied to
the skin, impulses are generated at the terminal
sensory branch of a peripheral nerve and conducted
centrally via the peripheral nerve, nerve root,
posterior columns/ spinothalamic tract, medial
lemniscus, and thalamocortical connections. A
lesion at any point along this pathway can alter the
evoked potentials, which are recorded first over Erb
point (for the median n.) or the lumbar spine (for the
tibial n.), and then through a scalp electrode in the
parietal region on the side opposite the stimulation.
An example of delayed conduction in the central
somatosensory pathway is shown in Fig.

13. [email protected]
•

Fundamentals of
Neurology1sted
2006.Thieme.3HA

XAP,
Mumenthaler

/
Mattle, pp 58

14. [email protected]
Embryological appreciation of
Pranavaha Srotas
• Puppusa develop from the blood
froth
• Heart that bears the blood, build
from blood and phlegm
• Anatomical relations are – from
heart in the left lies the “Puppusa –
Left lung” and on the right “Kloma
– Right lung”
• zÉÉåÍhÉiÉTåülÉmÉëpÉuÉ: mÉÑmmÉÑxÉ: -

xÉÑ.zÉÉ.4/25
• zÉÉåÍhÉiÉMüTümÉëxÉÉSeÉÇ

WØûSrÉÇ

– rÉSÉ´ÉrÉÉ

ÌWû

kÉqÉlrÉ:
mÉëÉhÉuÉWûÉ: -

xÉÑ.zÉÉ

4/31
• WØûSrÉxrÉ

AkÉÉå

uÉÉqÉiÉ: msÉÏWû

mÉÑmTÑüxɶÉ; SͤÉhÉiÉÉå

rÉM×üiÉç

YsÉÉåqÉ

cÉåÌiÉ

YsÉÉåqÉÌiÉsÉMüqÉç

-xÉÑ.zÉÉ

4/31QûsWûhÉ

15. [email protected]
Development of Lung
•

Lungs are the essential organs of respiration
•

substance of the lung is of a light, porous,
spongy texture; it floats in water, and
crepitates when handled, owing to the
presence of air in the alveoli; it is also highly
elastic
•

Right (Kloma) and left (Puppusa) lung buds
grow out behind the ducts of Cuvier
•

Each lung is invested by an exceedingly
delicate serous membrane, the pleura
•

The lungs provide an alveolar surface area of
approximately 40 m2 for gaseous exchange.
•

Each lung has: an apex which reaches above
the sternal

end of the 1
st

rib; a costovertebral
surface which underlies the chest wall; a base
overlying the diaphragm and a mediastinal
surface which is moulded

to adjacent
mediastinal

structures.

16. [email protected]
Physiological appreciation of Lung unit

17. [email protected]
Present day Understanding
•

The entoderm

consists at first of flattened cells, which
subsequently become columnar. It forms the epithelial
lining of the whole of the digestive tube excepting part
of the mouth (Asya) and pharynx (kanta) and the
terminal part of the rectum (Pakwashaya) (which are
lined by involutions of the ec toderm), the lining cells of
all the glands which open into the digestive tube,
including those of the liver and pancreas, the
epithelium of the auditory tube and tympanic cavity
(srotra), of the trachea, bronchi, and air cells of the
lungs (Puppusa-Kloma), of the urinary bladder
(Vasti) and part of the urethra , and that which lines the
follicles of the thyroid gland and thymus.

18. [email protected]
Organ (Lung)
Pathology • Inflammatory Lung diseases
• Interstitial Lung diseases
• Infectious Lung diseases
• Environmental Lung diseases
• Obstructive Lung disease
• Respiratory Insufficiency
• Pulmonary manifestations of
systemic diseases
• Pulmonary Vascular diseases
• Neoplastic Lung diseases
• Congenital Lung diseases
• Developmental Lung diseases
• Genetic Lung diseases
• Pleural diseases
• Apart from the above many
categories are placed in URT
pathology
• Common bronchial and pulmonary diseases –
exposure to infectious pathogens and/or air,
including tobacco smoke, causes the disorders
shown

19. [email protected]
Srotas Pathology
MÑüÌmÉiÉÉlÉÉÇ

ÌWû

SÉåwÉÉhÉÉÇ

zÉUÏUå

mÉËUkÉÉuÉiÉÉqÉç
rɧÉ

xÉ…¡û: ZÉuÉæaÉÑhrÉÉSè urÉÉÍkÉxiɧÉÉåmÉeÉÉrÉiÉå

– xÉÑ.xÉÔ.24/10
AÌiÉmÉëuÉ×̨É: xÉ…¡ûÉå

uÉ

ÍxÉUÉhÉÉÇ

aÉëÎlkÉrÉÉåÅÌmÉ

uÉÉ
ÌuÉqÉÉaÉïaÉqÉlÉÇ

cÉÉÌmÉ

xÉëÉåiÉxÉÉÇ

SÒ̹sɤÉhÉqÉç

–cÉ.ÌuÉ.5/24
Vitiated Dosha moving all the way in the body develops the
disease where ever is obstructed in its channel -
Atipravrutti = Excited / hyper functional activity – Hypercapnia
Sanga = Acute/chronic obstructive disorders - Asthma
Vimargagamana = Abnormal passage / infiltration or
diverticular of srotas content – pulmonary fistula
Sira-Granthi = vascular / abnormal mass tissue – makes the
extra luminal compression – Malignant Tumor

20. [email protected]
Pranavaha srotodusti Hetu
¤ÉrÉÉiÉç

xÉÇkÉÉUhÉÉSìÉæ¤rÉÉiÉç

urÉÉrÉÉqÉÉiÉç

¤ÉÑÍkÉiÉxrÉ

cÉ

–
mÉëÉhÉuÉÉÌWûÌlÉ

SÒwrÉÎliÉ

xÉëÉåiÉÉÇxrÉlrÉÉæ¶É

SÉÂhÉÉæ:
– cÉUMü

ÌuÉqÉÉlÉ

5/10Dhatu kshaya (wasting)
Vega sandharana (natural urges suppression)
Rooksha padartha sevana (indulgence in dry food)
Vyayama (excessive physical exertion)
Kshudhita (excessive hunger)
Anya daruna (other health violations pertained to PVS)

21. [email protected]
Pranavaha srotodusti Lakshana AÌiÉxÉ×¹qÉÌiÉoÉ®Ç

MÑüÌmÉiÉqÉsmÉÉsmÉqÉpÉϤhÉÇ

uÉÉ
xÉzÉoSzÉÔsÉqÉÑcduÉxÉliÉÇ

SØwOèuÉÉ

mÉëÉhuÉWûÉlrÉxrÉ

xÉëÉåiÉÉÇÍxÉ
mÉëSÒ¹ÉlÉÏÌiÉ

ÌuɱÉiÉç

– cÉUMü

ÌuÉqÉÉlÉ

5/8
Atisrustam (too long respiration)
Atibaddham (restricted respiration)
Kupitam (agitated respiration)
Alpalpam (shallow / short respiration)
Abhikshanam (frequent/ increased/ repeated respiration)
Sashabdam (stertrous respiration)
Sashoola (painful respiration)

22. [email protected]
Pranavaha sroto Abhighata Lakshana
iɧÉ

ÌuÉ®xrÉÉ¢üÉåzÉlÉ

ÌuÉlÉqÉlÉ

qÉÉåWlÉ

pÉëqÉlÉ

uÉåmÉlÉÉÌlÉ

qÉUhÉÇ
uÉÉ

pÉuÉÌiÉ

– xÉÑ

zÉÉ

9/12û
Akroshana (loud grooming)
Vinamana (deformation of the thoracic region)
Mohana (loss of consciousness)
Bhramana (illusion / giddiness)
Vepana (tremors)
Marana (death)

23. [email protected]
SYMPTOMS
•

Cough = A sudden explosive forcing of air through the glottis,
occurring immediately on opening the previously closed glottis, and
excited by mechanical or chemical irritation of the trachea or bronchi,
or by pressure from adjacent structures.
•

Wheeze = A whistling, squeaking, musical, or puffing sound made by
air passing through the fauces, glot tis, or narrowed tracheobronchial
airways in difficult breathing.
•

Dyspnea = Shortness of breath, a subjecti ve difficulty or distress in
breathing, usually associated with disease of the heart or lungs;
occurs normally during intense physical exertion or at high altitude.

24. [email protected]
SYMPTOMS
•

Stridor = A high-pitched, noisy respirat ion, like the blowing of the
wind; a sign of respiratory obstruc tion, especially in the trachea or
larynx.
•

Hoarseness voice , Chest pain, Haemoptysis
•

Cyanosis = A dark bluish or purplish coloration of the skin and
mucous membrane due to deficient oxygenation of the blood, evident
when reduced hemoglobin in the blood exceeds 5 g per 100 ml.
•

Clubbing = A condition affecting the fingers and toes in which
proliferation of distal tissues, es pecially the nail-beds, results in
thickening and widening of the extremities of the digits; the nails are
abnormally curved and shiny.

25. [email protected]
Krichra swasa (Dyspnoea) cardinal
symptom of Pranavaha srotodusti
euÉU
WØûSìÉåaÉ
U£üÌmɨÉ
eÉsÉÉåSU
qÉåSÉåUÉåaÉ
zÉÉååjÉ
AÌiÉxÉÉU
mÉëqÉåWû

(qÉkÉÑqÉåWû)
aÉsÉaÉlQû
aÉÑsqÉ
AÉl§ÉuÉ×ή
zÉÔsÉ
Common disease with
Dyspnoea are -

26. [email protected]
Symptoms of Importance
qÉÂiÉ: mÉëÉhÉuÉÉWûÏÌlÉ
xÉëÉåiÉÉÇxrÉÉÌuÉzrÉ

MÑümrÉÌiÉ
– EU:xjÉ

MüTüqÉÑ®ÕrÉ
ÌWû‚üÉμÉxÉÉlÉç

MüUÉåÌiÉ

xÉ;
-cÉÍcÉ17/17
rÉ: mÉëÉhÉuÉÉÌWûÌlÉ
xÉëÉåiÉÇxrÉluÉåÌiÉ

iÉålÉ

μÉÉxÉ:
mÉëÌiÉzrÉÉrɶÉ

eÉÉrÉiÉå

–
cÉ

ÌlÉ

6/4
Swarabheda
Urah shoola
Kasa
Raktasteevana
Hikka
Swasa
Pratishyaya

27. [email protected]
Examination of
PVS ailment
General Examination
Vital data
Systemic Examination
Inspection
Palpation
Percussion
Auscultation
Instrumental Examination
Imaging
PEFR
etc,

28. [email protected]
PVS Diagnostic Instruments Pulmonary Function Testing
Pulmonary Exercise testing
Pleural / Pulmonary pathology diagnostic
procedures
Pulmonary Imaging
Pre operative evaluation & diagnostic
procedures

29. Haematological

and biochemical
tests
•

Haemoglobin, to detect the presence of anaemia

or
polycythaemia
•

Packed cell volume (secondary polycythaemia

occurs
with chronic hypoxia)
•

routine biochemistry (often disturbed in carcinoma and
infection).
•

B-type natriuretic

peptide may be a useful test to
distinguish cardiac from non-cardiac breathlessness. A
rapid bedside test is available but is not yet in routine
clinical use.
•

D-dimer

can be measured to detect intravascular
coagulation. A negative test makes pulmonary embolism
very unlikely.

30. Sputum
•

yellowish green indicates inflammation (infection
or allergy)
•

the presence of blood suggests neoplasm or
pulmonary infarct
•

Microbiological studies (Gram stain and culture)
are not helpful in upper respiratory tract
infections or in acute or chronic bronchitis. They
are of value in:
•

pneumonia
•

the diagnosis of tuberculosis (Ziehl-Neelsen

or auramine-

phenol stains)
•

unusual clinical problems
•

Aspergillus lung disease.

31. [email protected]
Pulmonary Function Testing
•

STATIC LUNG
VOLUMES
•

Gas Dilution
Techniques
•

Plethysmography
•

Radiographic Total
Lung Capacity
•

Spirometry
•

Peak Expiratory Flow
and Peak Flow Meters

32. Respiratory function tests and exercise tests

33. Vitalograph
spirometer

34. Micro Medical Micro Loop and
Micro Lab spirometers

35. [email protected]
Pulmonary Exercise testing
•

Clinical integrative cardiorespiratory

exercise testing is
the ability to assess oxygen uptake (VO
2

) from
measurements of ventilation and respired gas
concentrations as Fick's

relationship
•

Where V
E

is ventilation, K is a constant, VCO
2

is CO
2
production, and D is dead space volume flow (V
D ×
respiratory rate). The linkage of CO
2

and V
D

to ventilatory

demand is clear. These factors represent the metabolic
rate and the fraction of wasted ventilation. Ventilation is
tightly linked to CO
2

rather than to O
2

.
•

Anaerobic (Lactate) Threshold = At a certain work
intensity, usually about 50% of the individual VO
2max

,
lactic acid starts to accumulate in the muscles and in the
blood at a faster rate, and this metabolic level can be
detected from measurements of gas exchange.

36. [email protected]
Pleural/Pulmonary pathology
diagnostic procedures
•

Thoracentesis
•

Pleural Fluid Analysis
•

Pleural Biopsy
•

Open Pleural Biopsy
•

Thoracoscopy

37. [email protected]
Pulmonary Imaging
•

Standard plain X-Ray PA &
Lateral/ Apical Lordotic

Films
•

Chest Fluoroscopy
•

COMPUTED TOMOGRAPHY
•

NUCLEAR IMAGING OF THE
THORAX
•

PULMONARY ANGIOGRAPHY
•

MAGNETIC RESONANCE
IMAGING
•

INTERVENTIONAL
PROCEDURES -

percutaneous

biopsy
Five important internal tissue
types may be easily
identified on CT or MRI
scans:
1. Gas (cavitation)
2. Low-density material
(lipid)
3. High-density material
(hemorrhage)
4. Intermediate-density
material (soft tissue)
5. Calcification

38. [email protected]
Pre operative evaluation & diagnostic
procedures
•

Atelectasis

= Collapse of an expanded lung
•

Shunting with Hypoxemia
•

Factors Predisposing to Postoperative
Pneumonia
•

Impaired Transport of Mucus
•

Aspiration
•

Pre-existing Lung Infection
•

Impaired Coughing
•

Respiratory Failure
•

Pulmonary Embolism

39. [email protected]
• Inflammation – infection, Rhinitis (coryza), Allergy,
laryngitis, Tracheitis, bronchitis, bronchiectasis,
bronchial asthma extrinsic/ intrinsic, emphysema, lung
collapse, pneumonia, lung abscess, TB, Anthracosis,
silicosis, asbestosis, fibrosis,
• Environmental
• Tumors – epithelial, connective tissue; benign/
malignant, Acinus (primary lobule) / secondary lobule,
macropahse
• Respiration – insufficiency, Atelectasis (Collapse of
an expanded lung), gas exchange supply /demand
• Pulmonary vascular
• Pulmonary plural
Types of diseases in PVS

40. PROTECTIVE AGENTS IN THE
EPITHELIAL LUNG FLUID
•

Defensins
•

Secretory

lactoperoxidase

A2
•

Lactoperoxidase
•

IgA
•

Lysozyme
•

Lactoferrin
•

Surfactant proteins (collectins)
•

Antiproteinases:
•

α1-antiproteinase, secretory

leucocyte

protease inhibitor (SLPI),
elafin
•

Antioxidants: glutathione

41. •

Alveolar macrophages.
Scanning electron micrograph
showing alveolar macrophages
(arrow) patrolling the alveolar
spaces of the lung

42. Methodical approach to diagnose

43. [email protected]
Examination of PVS
• MåüÍcÉcNûUÏUÉmÉaÉiÉÉÈ

vÉoSÉÈ

xrÉÑxiɧÉ

´ÉÉå§ÉåhÉ

mÉUϤÉåiÉç
cÉ.ÌuÉ. 4/7
Auscultation of the PVS is most important
• uÉhÉï

xÉÇxjÉÉlÉ

mÉëqÉÉhÉÉcNûÉrÉÉÈ

vÉUÏUmÉëM×ü ÌiÉÌuÉMüÉUÉæ, cɤÉëÑUçuÉæwÉÌrÉMüÉÍhÉ

rÉÉÌlÉ

cÉÉlrÉÉlrÉÑ£üÉÌlÉ

iÉÉÌlÉ

cɤÉÑwÉÉ

mÉUϤÉåiÉ

| cÉ. ÌuÉ. 4/7
The colour changes viz. Cyanosis, because O
2
deprivation or
Anemia is noticed as generalized symptom. The edema –
shotha is observed and conformed by sparsha.
• xmÉzÉïÇ

cÉ

mÉÉÍhÉlÉÉ

mÉëM×üÌiÉ

ÌuÉM×üÌiÉrÉÑ£üqÉç|| cÉ. ÌuÉ. 4/7

44. [email protected]
Areas of
examination
•

Major Points
–

Shape of the chest
–

Tracheal position
–

Apical position
–

Respiratory movement
•

Additional Points
–

Spine
–

Shape & contour of chest
–

Pulsations
–

Veins
–

Respiratory sounds like
•

cough, wheeze, stridor, grunt

45. Ayurvedic
• lÉÉQûÏ

= zsÉåwqÉåMüÉxÉå

ÎxjÉUÉ

qÉlSÉ

μÉÉxÉå

iÉÏuÉëaÉÌiÉpÉïuÉåiÉç

–
UÉuÉhÉlÉÉÌQû
• qÉÔ§ÉÇ

= oÉ®qÉÔ§ÉÇ

/ AsmÉqÉÔ§ÉqÉç

MåüÍcÉiÉç

EwhÉqÉÔ§ÉqÉç
• qÉsÉqÉç

= oÉ®uÉcÉïxÉç
• ÎeÉÀûÉ

= zsÉåwqÉÉuÉ×iÉ

qÉÑZÉ

/ sÉåmÉ

/ ÌlÉUÉSìï

ÎeÉÀûÉ

/ÌuÉzÉÑwMüÉxrÉ
• zÉoS

= ÌuÉzÉÏhÉïuÉÉMçü

/ xÉzÉoS

EcduÉÉxÉ
• xmÉzÉï

= SåWû

zÉÏiÉ

xmÉzÉï

/ mÉëlɹ¥ÉÉlÉqÉç
• SØMçü

= iÉqÉÉåpÉÉuÉÇ

/ ÌuÉpÉëÉliÉsÉÉåcÉlÉqÉç

/ FkuÉïSØ̹

/
• AÉM×üÌiÉ

= SÏlÉ

/ AÉxÉÏlÉÉå

sÉpÉiÉå

xÉÑZÉÇ
Diagnostic tools

46. Management principles
•

Methods of
Management
–

Eliminative
–

Suppressive
–

Palliative
–

Reductive
•

Should under go
either Volatile or
Stable medicament
management
•

Internal Environment
–

Ushna

vs

Sheeta
–

Snigdha

vs

Rooksha
•

Lung Disease is
Suggested as
Sheeta-Rooksha
Vyadhi requires
Ushna-Snigdha
chikitsa

47. [email protected]
MüÉxÉ
NˇÁÃ

“zoÏ

-
áÓ™ÁzúVÁoÁ¸ÃoÀos{ƒ

√ÆÁÆÁ™øqÁãåuå zƒmÁXY

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u“

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ƒzTÁzú∫ÁzáÁo‚

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@@1@@
Dhoomopaghata
Anna Vimarga gamana
Ama Rasa
Rookshanna sevana
Kshaya
Vegadharana
Vyayama
MüxÉÌiÉ

MühPûÉSÕ²ïÇ

aÉcNûiÉÏÌiÉ

CÌiÉ

MüÉxÉ
-

uÉÉiÉeÉ
-

ÌmɨÉeÉ
-MüTüeÉ
-

¤ÉiÉeÉ
-¤ÉrÉeÉ

48. [email protected]
NˇÁÃ

éú¿Áuõo

-
ú¿ÁmÁz

—ÆÏtÁåÁåÏTo: ú¿tÏ…b: à ußãåNˇÁÊÀÆÀƒåoÏ¡ÆVÁz : @
uå∫zuo

ƒMfiÁnÓÃÁ

ÃtÁz Áz

™åyu uß: NˇÁÃ

Fuo

ú¿ut…b: @@2@@
M×üiÉblÉÉå

eÉÉrÉiÉå

qÉirÉï: MüTüuÉÉlÉç

μÉÉxÉMüÉxÉuÉÉlÉç

– uÉæ±ÍcÉÇiÉÉqÉÍhÉ
AjÉ: mÉëÌiÉWûiÉÉå

uÉÉrÉÑÃkuÉïçÇxÉëÉåiÉ:xÉqÉÉÍ´ÉiÉ:
ESÉlÉpÉÉuÉqÉÉmɳÉ: (FkuÉïaÉÌiÉxuÉpÉÉuÉqÉÉmɳÉ)

MühPåû

xÉiMüxiÉjÉÉåUÍxÉ
AÉÌuÉzrÉ

ÍzÉUxÉ: ZÉÉÌlÉ

xÉuÉÉïÍhÉ

mÉëÌiÉmÉÔUrÉlÉç
AÉpÉÉgeɳÉͤÉmÉlÉç

SåWÇû

WûlÉÑqÉlrÉå

iÉjÉÉÅͤÉhÉÏ
lÉå§É

mÉ׸qÉÑU:mÉÉ μÉåï

ÌlÉpÉÑïerÉ

xiÉqpÉrÉÇxiÉiÉ:
z
É
Ñ
w
Mü
Éåu
ÉÉxÉMü
T
å
üuÉÉÅÌmÉ

M
üxÉlÉÉiMüÉxÉ

EcrÉiÉå

–
cÉ. ÍcÉ

18/6-8
MüÉxÉ

49. Cough reflex

50. [email protected]
Acute Bronchitis
ICD 10 = J20 & J21
•

Include:
•

bronchitis: · NOS, in those
under l5 years of age
· acute and subacute (with):
· bronchospasm
· fibrinous
· membranous
· purulent
· septic
· tracheitis
•

tracheobronchitis, acute
Exclude:
•

bronchitis: · NOS, in those 15
years of age and above ( J40)
· allergic NOS ( J45.0)
· chronic:
· NOS ( J42)
· mucopurulent ( J41.1)
· obstructive ( J44.-)
· simple ( J41.0)
•

tracheobronchitis: · NOS ( J40)
· chronic ( J42)
· chronic obstructive ( J44.-)
ICD-9CM CODES = 466.0 Acute bronchites

51. [email protected]
Chronic Bronchitis

52. [email protected]
Bronchiectasis

53. [email protected]

54. [email protected]
54
Kasa Chikitsa sutra
qÉÑWÒûqÉÑïWÒû
ÌuÉïwÉcNûÌSïÌWïûkqÉÉiÉ×Oèû

μÉÉxÉMüÍxÉwÉÑ

– A.WØû. xÉÔ. 13/-
MåüuÉsÉÉÌlÉsÉÇ

MüÉxÉÇ

xlÉåWæûUÉSÉæmÉÉcÉUåiÉç

– A WØû

ÍcÉ

3/1
mÉæ̨ÉMåü

xÉMüTåü

MüÉxÉå

uÉqÉlÉÇ

xÉÌmÉïwÉÉ

ÌWûiÉÇ

– cÉ. ÍcÉ. 18/83
mÉëcNûkÉïlÉÇ

MürÉÍzÉUÉåÌuÉUåMüÉxiÉjÉæuÉ

kÉÔqÉÉ: MüuÉsÉaÉëWû¶É
EwhɶÉ

sÉåWûÉ: MüOÒûMüÉ

ÌlÉWûliÉÑ: MüTÇü

ÌuÉzÉåwÉåhÉ

MüTüzÉÉåwÉhÉÇ

cÉ

– xÉÑ.E.52/28
MüÉxÉqÉÉirÉÌrÉMÇü

qÉiuÉÉ

¤ÉiÉeÉÇ

iuÉUrÉÉ

eÉrÉåiÉç
qÉkÉÑUæeÉÏïuÉlÉÏrÉæ¶É

oÉsÉqÉÉÇxÉÌuÉuÉkÉïlÉæ: -

cÉ

ÍcÉ

18/138
SÏmÉlÉÇ

oÉ×ÇWûhÉqÉåuÉÉSÉæ

MÑürÉÉïSalÉå¶É

SÏmÉlÉqÉç
urÉirÉÉxÉÉiÉç

¤ÉrÉMüÉÍxÉprÉÉå

oÉsrÉÇ

xÉuÉïÇ

ÌWûiÉÇ

pÉuÉåiÉç

– cÉ. ÍcÉ

18/187
AaêrÉ

– ÌuÉSÎaSMüÉ

-

MülOûMüËU

(Solanum xanthocarpum)
MüxÉWûU

uÉaÉï

:-

SìɤÉpÉrÉÉqÉsÉMü

ÌmÉmmÉsÉÏSÒUÉsÉpÉÉ

zÉ×…¡ûÏMühOûMüËUMüÉ

uÉ׶ÉÏUmÉÑlÉlÉïuÉÉiÉÉqÉsÉYrÉÉ

CÌiÉ

SzÉåqÉÉÌlÉ

MüxÉ

WûUÉÍhÉ

pÉuÉÎliÉ

– cÉ. xÉÔ.4/16

55. A total 1238 compounds for
treating Kasa in Ayurveda
342 Rasa aushadhi
•

Talisadi

churna

–

srungyadi

churna
•

Abhraka

bhasma

–

Shrungi

bhasma
•

Trijatakadi

vati –

Lavangadi

vati
•

Dashamoolarista

–

Vasarista
•

Amrutaprasha

ghruta

–

Vasa

ghruta
•

Vasakantakari

Avaleha

–

Agastya

Rasayanam
•

Mahalaxmivilasa

Ras

-

Agni kumara ras
•

Hemagarbha

pottali

–

Hemabhra

sindhura

-

Swarnamalivi

vasantam

56. Kasa Yoga
•

Kadaliphala yoga = kadali +
Maricha (Basava Rajiya)
•

Swarna Bhupati Ras =
Sarva Kasaharam (Vaidya
chintamani)

57. [email protected]
Hikka- Swasa
u“MNˇÁ≈ƒÁÃ

“zoÏ

-
uƒtÁu“TϪuƒ…bu©ßøqÁuß…ÆuãtßÁz\å{: @
∆yoúÁåÁ∆åÀsÁå∫\ÁzáÓ™ÁoúÁuå¬{: @@1@@
√ÆÁÆÁ™Nˇ™îßÁ∫Á܃ƒzTÁVÁoÁúoúîm{: @
u“MNˇÁ

≈ƒÁÃ≈Y

NˇÁÃ≈Y

åwmÁÊ

ÙÏú\ÁÆoz

@@2@@
• Ahara = Vidahi, Vistambhi, Abhishyandi, Vidruddha,
Vishamashana, Amapardosha, Anaha,
• Guna = Guru, Rooksha, sheeta
• Bahya = rajas, Dhooma, Atapa, anila,
• Other = Vyayama, Bharadhwa, Vegarodha, Apatarpana,
Gramyadharma, Dourbalya, Marmabhighata, Shodana
viparyaya,
• Nidanarthakara roga = Atisara, Jwara, Chardi, Peenasa,
Urahkshata, Raktapitta, Udavarta, Vishuchi, Alasaka,
Pandu, Visha

58. [email protected]
Swasa
≈ƒÁÃ

éú¿Áuõo

-
ÆtÁ

ÿÁzoÁÊuÃ

ÃʪÜÆ

™Áªo: Nˇ¢ˇúÓƒîNˇ: @
uƒ…ƒSƒ¿\uo

Ãʪt‚áÀotÁ

≈ƒÁÃÁå‚

Nˇ∫Ázuo

Ã: @@17@@
Nidana
Vata
• Prana vaha,
Udana vaha,
Annavaha
Srotoroodha
Kapha Ruddhopagamana
= obliterated by it self

59. [email protected]
Tamaka swasa
•

Normalcy of Pranavata suggests health in the
body, abnormality indicates disease
•

Pranavata and Prana vikruti leads to the Swasa,
which is an emergency condition, leads to death
even.
•

WHO 1998 estimates asthma as 155 millions
which increases 50% every decade worldwide.
•

India has an estimated 15-20 million asthmatics.
•

Tamaka - is derived from “Tamyati iti Tamaka”-
means; to choke, darkness, be suffocated.
•

Dalhana and Chakrapani commented Tamah
praveshana which refers to the darkness or black
curtains in front of the eyes.

60. [email protected]
Tamaka Swasa Nidana
•

Either Bahya or Abhyantara Nidana
(etiological factors) cause Bronchial
asthma which is heterogeneous
disease.
•

Aggravating factors like
meghambu(rainy season) sheeta
sthana(cold place) and preceding
factors like peenasa (common cold)
kasa(cough) are clearly explained in
the pathology of Tamaka Swasa.

61. [email protected]
Tamaka Swasa
o™Nˇ≈ƒÁÃ

-
ú¿uo¬Áz™Ê

ÆtÁ

ƒÁÆÏ: ÿÁzoÁÊuÃ

ú¿uoú˘oz

@
T¿yƒÁÊ

u∆∫≈Y

ÃÊTw—Æ≈¬z…™ÁmÊÙÏtyÆîÊ

Y @@27@@
Nˇ∫Ázuo

úyåÃÊ

ozå

ªt‚áÁz

VÏVîÏ∫NÊˇ

osÁ

@
EoyƒÊ

oyƒ¿ƒzTÊ

Y ≈ƒÁÃÊ

ú¿Ámú¿úygNˇ™‚

@@28@@
ú¿oÁ©Æuo

à ƒzTzå

ow…Æoz

ÃuãåªÜÆoz

@
ú¿™Áz“Ê

NˇÁÙÁå≈Y

à TXZuo

™ÏÛ™ÏîÛ: @@29@@
≈¬{…™lÆ™ÏXÆ™Áåz

o
Ï

ß
w∆Ê

߃uo

tÏ:uQo: @
oÀ
Æ
{
ƒY
uĪ
Á
z
q
Áão
z™
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˜
o
î
ʬ
ßo
zÃ
Ï
Q
™
‚
@@30@
@
osÁDÀÆÁzt‚܃ÊÃoz

Nˇle:
NwˇXZ~ÁXZMåÁzuo

ßÁu oÏ™‚

@
å

YÁuú

§oz

uå¸ÁÊ

∆ÆÁå: ≈ƒÁÃúyugo: @@31@@
úÁ≈ƒzî

oÀÆÁƒTw—mÁuo

∆ÆÁåÀÆ

Ùy∫m: @
EÁÃyåÁz¬ßozÃ
Á
{
P
Æ
™
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…
m
ÊY
{
ƒ
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@
GuXZ~oÁqÁz

¬¬Ábzå

u
Àƒ˘oÁ

ßw∆™Áuoî™Áå‚

@
uƒ∆Ï…NˇÁÀÆÁz

™Ï“Ï: ≈ƒÁÃÁz

™ÏÛ≈YƒÁƒá©Æoz

@@33@@
™zVÁ©§Ï∆yoú¿ÁSƒÁo{: ≈¬z…™¬{≈Yuƒƒáîoz

@
à ÆÁõÆÀo™Nˇ: ≈ƒÁÃ: ÃÁÜÆÁz

ƒÁ

ÀÆÁãåƒÁzunso: @@34@@
•

Asthma is defined as intermittent,
reversible airway obstruction in
association with increased
nonspecific bronchial reactivity.
These physiologic changes are
now known to exist in the context
of airway inflammation. The
addition of inflammation to the
definition has shifted the
understanding of asthma from a
disease of airway nerves and
smooth muscle to one that
identifies inflammation as the
driving force for the symptoms
associated with the disease. This
realization has led to a dramatic
shift in the treatment of the
disease in the past 10 years.

62. [email protected]
Nidana Sevana (Diet, Regimen & Climate)
Vatadushti Kaphadushti
Agnimandhya
Ama
Kapha vridhi Rasadushti
Pranavaha Sroto Avarodha
Vimarga gamana Sanga of Pranavata
Kloma Nalika Shaka
Tamaka Shwasa

63. [email protected]
Asthma

64. [email protected]
J45-Asthma
Excludes:
acute severe asthma ( J46)
chronic asthmatic (obstructive) bronchitis ( J44.-)
chronic obstructive asthma ( J44.-)
eosinophilic asthma ( J82)
lung diseases due to external agents ( J60-J70)
status asthmaticus ( J46)
J45.0 Predominantly allergic asthma
Allergic:
· bronchitis NOS
· rhinitis with asthma
Atopic asthma
Extrinsic allergic asthma
Hay fever with asthma
J45.1 Nonallergic asthma
Idiosyncratic asthma
Intrinsic nonallergic asthma
J45.8 Mixed asthma
Combination of conditions listed in J45.0 and J45.1
J45.9 Asthma, unspecified
Asthmatic bronchitis NOS
Late-onset asthma
J46 Status asthmaticus = Acute severe asthma

65. [email protected] of management interest in
Tamaka Swasa
Swasahara
Deepaneya & Hrudya
Kasahara
Parshwashoolahara
Shothahara

66. Swasa / Tamaka swasa Chikitsa
• MüÉUhÉ

xjÉÉlÉ

qÉÔsÉæYrÉÉSåMüqÉåuÉ

ÍcÉÌMüÎixÉiÉqÉç

– cxÉç.ÍcÉ.17/70
• xlÉåWûuÉÎxiÉÇ

ÌuÉlÉÉ

MåüÍcÉSÕ²ïcÉÉkɶÉ

zÉÉåkÉlÉqÉç

qÉ×SÒmÉëÉhÉuÉiÉÉÇ

´Éå¹Ç

μÉÉÍzÉlÉÉqÉÉÌSzÉÎliÉ

– xÉÑ.E.51/15
• rɲÌmÉ

μÉÉxÉå

xlÉåWûuÉÎxiÉ

mÉëÉÍgÉÌwÉ®: -

QûsWûhÉ
• iÉmÉïrÉåSåuÉ

zÉqÉlÉæ: xlÉåWûrÉÔwÉUxÉÉÌSÍpÉ: -

cÉ. ÍcÉ. 17/90
• rÉÎiMÇüÍcÉiÉç

MüTüuÉÉiÉblÉqÉÑwhÉÇ

uÉÉiÉÉlÉÑsÉÉåqÉlÉqÉç
• pÉåwÉeÉÇ

mÉÉlÉqɳÉÇ

uÉÉ

iÉήiÉÇ

μÉÉxÉÌWûÌ‚ülÉå

– cÉ. ÍcÉ. 17/147
• xÉuÉåïwÉÉÇ

oÉ×ÇWûhÉÉå½smÉ: zÉYrɶÉ

mÉëÉrÉzÉÉåpÉuÉåiÉç

-

-

-
iÉxqÉÉcNÒû®ÉlÉ

zÉÑ®ÉǶÉ

zÉqÉlÉæoÉ×ïÇWûhÉæUÌmÉ

– cÉ.ÍcÉ. 17/149-150
• mÉÉhQÒûUÉåaÉåwÉÑ

zÉÉåkÉåwÉÑ

LrÉÉåaÉÉ: xÉqmÉëMüÐÌiÉïiÉÉ:
• μÉÉxÉMüÉxÉÉmÉWûliÉåÅÌmÉ

MüxÉblÉÉrÉåcÉ

MüÐÌiÉïiÉÉ

– xÉÑ.E. 51/43-44
• ÌuÉUåcÉlÉ

xuÉåSlÉ

kÉÔqÉëmÉÉlÉ

mÉëcNûSïlÉÉÌlÉ

xuÉmÉlÉÇÌSuÉÉlÉç

– uÉæ±ÍcÉliÉÉqÉÍhÉ

67. [email protected]
Swasa yoga
Karpuradi chrna (SY)
Shatyadi churna (VC)
Vidangadi churna (VC)
Shrungyadi churna
Dashamoola katutrayadi kwatha
Vasadi kwatha
Vasaghruta
Trushana ghruta
Talisa ghruta
Bharngi guda haritaki (VC)
Abhraka bhasma
Swasa kuthara ras
Swasakasa chintamani
Swasa kaleshwara ras (VC)
Sameerapannaga ras
Rasamanikya
Aswagandha kshara
Mayurapincha bhasma
•

962 yogas for Swasa Hikka Chikitsa
•

102 Ghruta yoga
•

283 rasa yoga
•

Vasa
•

Pushkaramoola
•

Bharangi
•

Kantakari
•

Sunthi – Haritaki (BR)
•

Gandhaka + Maricha (BR)

68. Vasa

Ghruta

yoga
• oÉëͼ

bÉ×iÉ
• aÉÑSÕcrÉÉÌS

bÉ×iÉ
• aÉÑaaÉÑsÉÑmÉÇcÉÌiÉ£üMüqÉç

bÉ×iÉ
• aÉÑaaÉÑsÉÑ

ÌiÉ£üMü

bÉ×iÉ
• MülOûMüÉËU

bÉ×iÉ
• sÉzÉÑlÉ

bÉ×iÉ
• ÌlÉÇoÉÉÌS

bÉ×iÉ
• ÍxÉÇWûÉqÉ×iÉ

bÉ×iÉ
• qÉWûÉMÔüwqÉÉlQûMü

bÉ×iÉ
• iÉÉÍVûxÉÉÌS

bÉ×iÉ
• uÉÉxÉÉ

bÉ×iÉ
• ÌuÉSÉËU

bÉ×iÉ
Panchatikta

ghruruta

of
Yogaratnakara

has Vasa

and
Pushkaramoola

that are
swasahara

and the Brumhana -

Ghruta

69. pÉUÎlaÉ

bÉ×iÉ

rÉÉåaÉ
cÉÇaÉåËU

bÉ×iÉ
MülOûMüÉËU

bÉ×iÉ
MÑüÍsÉjÉwÉOèTüsÉ

bÉ×iÉ
lÉÉaÉUɱÇ

bÉ×iÉ
mÉÇcÉaÉurÉÇ

bÉ×iÉ
AqÉ×iÉmÉëÉzÉ

bÉ×iÉ
kÉluÉliÉUÇ

bÉ×iÉ
oÉ×WûiÉç

MülOûMüÉËU

bÉ×iÉ

70. Pushkara

Moola

Ghruta

Yoga
MülOûMüËU

bÉ×iÉ
mÉlcÉÌiÉ£ü

bÉ×iÉ
SzÉqÉÔsÉ

bÉ×iÉ
mÉlcÉaÉurÉÇ

bÉ×iÉ
zÉPûɱÇ

bÉ×iÉ
μÉSl·íÉÌS

bÉ×iÉ
kÉluÉliÉUÇ

bÉ×iÉ
iÉåeÉÉåuÉirÉÉÌS

bÉ×iÉ
uÉ×WûMülOûMüÉËU

bÉ×iÉ

71. Tamaka Swasahara rasa Aushadhi
• ¤ÉrÉMÑüsÉÉliÉMü

UxÉ
• sÉbÉÑÍzÉuÉ

aÉÑÌOû
• ÍzÉsÉÎeÉiÉÑ

uÉÌOûMü
• xÉÔrÉïmÉëpÉ

aÉÑÌOûMü

72. Points to observe at PVS Management •

Transport of oxygen and carbon dioxide
(Ambara peeyusha)
•

Regulation of Acid base balance
(Niramleekarana – Nirlavaneekarana)
•

Control of breathing (Kumbhaka – Rechaka
Pranayama)
•

Regulating the water balance in the body
(Ambu)

73. [email protected]
Note
This is
Not an end
But a big start !
•

Dr. K. Shiva Rama Prasad
•

[email protected]