28 Prevention, Yoga And Lifestyle Tips For Dyspnoea

Dyspnoea depends on the disease or cause which is causing or triggering it. Management of those conditions or causes in the backdrop will take care of dyspnoea. Thus, prevention of dyspnoea can be achieved by preventing the primary conditions causing the shortness of breathe from recurrence and keeping away the causes which are responsible for dyspnoea.
Attend dyspnoea – Try to address breathlessness as soon as the distress becomes apparent. Do not wait until it gets well established. If neglected, symptoms may add up quickly.

Detect Cause – Try to find and establish a cause or causes of the dyspnoea. It may be a specific type of food allergy, pollen grains, pollution etc.

Dyspnoea due to psychological causes – Breathing difficulties may arise due to fear, anxiety, phobia etc. Talk to your doctor and get to know the cause. If anxiety is the reason, learn the tips to manage anxiety
Explore – Try to find out about the ongoing fears a patient has, like fears of suffocation, choking, dying in sleep etc.Stay close – Staying close to an acutely distressed patient will help. One can use reassurance and distraction as tools for betterment of the patients.

Call bell – Make sure you have someone to call quickly. An attender’s presence during an attack of breathing difficulty will be very useful.

Positioning – Sitting upright with support is the most comfortable position for those suffering from dyspnoea

Room temperature – keep the room cool. It should neither be too cold nor be too warm. Asthma related dyspnoea may worsen if the room is too cold.

Move air – Moving air from a fan (hand-held or stationary) or open window helps provide psychological relief. Make sure that your home, especially your room has good ventilation.

Inhaler – people with asthma may use inhalers before going for an exercise or whenever they feel the early symtpoms.

Humidifier – is beneficial especially in winter. Dry air thickens mucus and can make breathing difficult.

Avoid warm rooms – Avoid sitting for long hours or sleeping in overly warm room. Warmth can worsen shortness of breath. Try changing your position to help relieve shortness of breath. Some positions are comfortable.

Rest – When you feel breathless, stop whatever you are doing, Rest until your breathing returns to normal.

Distract yourself – When you have dyspnoea, try to distract your mind and focus on something else instead of focussing on your breathing. This helps your subconscious mind take control of your breathing again.

Breathing exercises – The patients should be taught with breathing exercises and relaxation methods. They should be done by specialists. Breathing retraining, taught by physiotherapists or clinical nurse specialists come in handy. Try to learn Pranayama

Lifestyle modification – should be encouraged. Patients should be helped in knowing non-essential activities and in reducing them as far as possible. This should be achieved whilst trying to maintain mobility and independence as far as possible.

Encourage exertion – Exertion should be encouraged to the point of breathlessness to build tolerance and maintain fitness. Pulmonary rehabilitation appears to be well tolerated and to provide symptomatic relief in many patients with severe COPD.

Dietary modifications – should be done with small frequent drinks and meals being best tolerated.

Oral hygiene – Mouth breathing dries the mouth and oxygen will be very dry unless it has been humidified. So, attention to oral hygiene is important.

Complementary therapies – such as aromatherapy, hypnosis and acupuncture may be helpful to some patients

Diary or journal – keep a journal and write details about the episodes and timing of shortness of breath and also its quality. Also describe what makes it better and worse. This will help you and your doctor to take proper call on the management.

Sleep propped up – If you have difficulty sleeping, try to sleep propped up with many pillows or in a recliner. Try to lie on your side with a pillow between your legs and your head elevated with pillows.

Breaks – Take short breaks at regular intervals while doing strenuous activities to avoid shortness of breath.

Avoid chemicals and irritants – Avoid exposure to toxic chemicals at home or work. Also avoid any household or any work which is known to trigger your dyspnoea. Avoid all the known allergens which cause shortness of breath. Make a note if something suddenly causes dyspnoea.

Wholesome diet – Prefer taking a diet full of fruits and vegetables

Avoid stress and anxiety – stress, anxiety and panic attacks may cause or worsen shortness of breath. Therefore they should be kept away as far as possible.

Lose weight – obesity is one of the causes of shortness of breath. Loss of weight can cure shortness of breath. Proper diet, exercises and weight losing programs under guidance of qualified doctor will help to shed excess weight.

Hydration – drink plenty of water to keep your body hydrated. This helps thinning your mucus, making it easier to expel.
Do not – take any supplement or medicine without consulting your doctor.

Breathing techniques:
Diaphragmatic breathing (abdominal breathing, deep breathing) –
This is useful especially in shortness of breath due to COPD (chronic obstructive pulmonary disease)
How to do?

Lie down on your back
Put your hands on your abdomen and relax your muscles
Breathe in deeply through your nose, expanding your abdomen and then filling your lungs with air
Hold your breath for couple of seconds
Breathe out slowly through your mouth, empty your lungs completely
Repeat this for 5-10 minutes
Do this breathing exercise for 2-3 times a day
Pursed-lip Breathing
This technique quickly slows your pace of breathing. It also helps you to restore your normal breathing. It also helps relieve stress and anxiety.
How to do?

Sit comfortably
Relax your neck and shoulder muscles
Keep your lips pressed together tightly, except at the centre
Inhale through your nose for a couple of seconds
Exhale slowly while counting to 4, through your pursed lips
Continue to inhale and exhale for another 10 minutes
Quit Smoking
Smoking cigarette can cause dyspnoea and many other respiratory (breathing) problems. It also triggers the already persisting dyspnoea. It is immaterial if you are an active smoker or passive smoker. Therefore quitting smoking will help in getting rid of dyspnoea.
Quitting smoking also will reduce the risk of getting lung cancer.

Walking
Walking has immense benefits in curing shortness of breath. Dyspnoea or shortness of breath is common in overweight / obese people. Regular walking helps in weight reduction, improves stamina and reduces episodes of breathlessness.

Walking also will provide distractions of mind and help your subconscious mind restore your normal breathing. Walk for 30-60 minutes at a moderate pace, at least for 5 times a week. This boosts your metabolism, increases your stamina and helps get rid of dyspnoea.

Relaxation therapies
Yoga and meditation are best relaxation therapies which help you deal with your breathing difficulties associated with dyspnoea. They help in enhancing blood and oxygen flow throughout the body. They can slow down your heart rate and helps in normal breathing. They help in reducing stress and anxiety.
If possible, try doing Yoga and meditation in an open area where you can breathe fresh and pure air.
Yoga and meditation should be done on a regular basis and in correct way, under the guidance of an expert to obtain optimum results.

Pranayama (Deep Breathing) –
This is essentially a breathing exercise which moves the breath in unique ways allowing for different effects on the nervous system. At night, practicing calm breathing, even breathing in a 1:1 ratio and then eventually building up to 1:2 allowing the exhale to lengthen more than the inhale. You can also try inhaling while blocking one nostril and alternating nostrilwith each breathe, which can help calm the nervous system.

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31 Easy And Effective Home Remedies For Dyspnoea

Dyspnoea – breathing difficulties can occur due to asthma, heart disorders, psychological issues such as anxiety, phobia and even in some cases of gastritis and bloating. Here are a few easy home remedies for dyspnoea.
Black Coffee
A cup of black coffee is useful in alleviating shortness of breath. Caffeine present in coffee helps reduce respiratory muscle fatigue and improves airway functions. It may also reduce asthma symptoms
One has to take 1-2 cups of strong, black coffee to get relieved from shortness of breath and to have normal breathing back
Excess coffee is also not good. It may raise your heart rate and BP.
Steam Inhalation
Steam inhalation is a good option if breathlessness is due to a respiratory problem. It decongests the nasal passages and helps to breathe easily. The heat and moisture coming from the steam will help break up and dissolve the mucus. This dissolved and liquefied mucus will be easily eliminated from the system.

How to do?

Heat the water on the stove
Fill a bowl with hot water
Add few drops of essential oil, such as eucalyptus or peppermint oil
Place your face over the bowl
Cover your head with a blanket or towel such that the bowl with hot water and your face are enveloped by the cloth
Inhale the steam; keep taking deep breaths for several minutes
Take care to close your eyes while doing this procedure
Do this whenever you have nasal congestion
Alternatively a facial sauna may be used
Ginger
Ginger is a time tested expectorant. It helps treat chest and nasal congestion. When the congestion is removed, the breathing naturally becomes normal and easy. Ginger also fights against throat and respiratory tract infection.
Ginger, Amla, Raisin And Honey Home Remedy For Asthma And Cough
How to take ginger for dyspnoea?
Ginger can be used to season or top foods, prepare soups or tea
Take 2-3 cups of ginger tea daily. For this, add 1 tsp freshly chopped fresh ginger to 2 cups of boiling water. Cover the simmer for 5-10 minutes. Strain and add a little honey. Sip the tea slowly.
Small pieces of ginger can be chewed. Ginger candies are also handy.
Beetroot
Beetroots are good for anaemia. Anaemia is one of the causes for dyspnoea. If your shortness of breath is due to anaemia caused by iron deficiency, beetroots will help to improve your condition. Beetroot has high iron content. It also comprises fibre, calcium, potassium and vitamins.

How to take?
Beetroot juice – Extract juice of 1 medium size beetroot, 3 carrots, handful of spinach and ½ sweet potatoes in a juicer. Drink it once in a day.
Alternatively, roast 1-2 beetroots along with their peels on the stove. Allow them to cool, peel and then eat them with salt and pepper.
Beetroot salad is also beneficial.

Fennel
Fennels are good remedies for dyspnoea. It is a good expectorant. It helps break up the phlegm and is useful in treating congestion, bronchitis and cough. Fennel is a rich source of iron. Thus it can be used in breathlessness caused by anaemia.
Fennel Tea – Add 1 teaspoon of fennel seeds to a cup of hot water. Cover and steep for 5-10 minutes. Strain the contents. Add raw honey. Drink this fennel tea 2-3 times a day.
Chewing – You can simply chew a spoonful of dry roasted fennel seeds.
Fennel Seed Health Benefits, Dose, How To Use – Ayurveda Details

Garlic
Garlic is an important immune-modulator and antioxidant. It maintains healthy blood circulation. The important active compound in garlic is the sulphur component called allicin. It is a very strong antibiotic. It helps the body to inhibit the ability of germs to grow and reproduce. It helps in relieving the constriction caused to the airways.

How to take?
Garlic juice – Crush few garlic pieces, make their juice, add 10-12 drops of garlic juice in warm water and drink once a day.
Garlic can be chewed (2-3 pieces) 2-3 times per day
Garlic juice ½ spoons should be taken with 1 spoon honey
Dyspnoea – Difficulty in breathing: Causes, Pathophysiology, Diagnosis

Chilli pepper (capsicum)
It acts as an anti-inflammatory medicine. It contains a substance called Capsaicin. It acts as a bronchodilator that stimulates the saliva and other fluids present in the mouth, nose, throat and lungs. It helps in decreasing the secretion of mucus and breaking down its formation as well.
It can be used in the diet and in the form of salads, curries etc.

Gooseberries
The fruits of gooseberry are rich in Vitamin C. They also have astringent, cooling and anti-oxidant effect. Vitamin C boosts up the immune system and reduces the severity and episodes of dyspnea.
Gooseberries help in reducing the inflammation of lungs owing to its anti-inflammatory properties.
How to use?
Amla powder ½ spoons mixed in 1 spoon honey, 2-3 times daily
Amla juice ½ – 1 spoons mixed in 1 spoon honey, 2-3 times daily
Note, in some people, taking amla may increase cold and cough. If you have experienced such a thing, then avoid amla.

Pomegranate juice
Pomegranates are powerful anti-inflammatory agents owing to rich content of ascorbic acid and flavonoides. It is helpful in difficulty in breathing. Pomegranate juice should be used for drinking on daily basis or alternative days.

Mullein
Being one of the best effective remedies for breathing difficulty, mullein is used as a respiratory tonic. It has good antispasmodic, antiseptic, antibiotic and expectorant properties. It is effective in breathlessness associated with asthma.
It promotes expulsion of mucus so as to clear the respiratory passages.

Cayenne Pepper Tea
Capsaicin, the active ingredient of cayenne pepper is good for respiratory and cardiovascular health. It is beneficial in curing the dyspnoea caused by heart or lung problem. It can be used in the form of cayenne tea.

Gingko Biloba
It is a good bronchodilator used in treatment of dyspnea (caused by asthma and other lung disorders). It dilates the blood vessels and improves blood circulation in the blood vessels. It can be consumed as Gingko tea.

Hyssop Tea
Hyssop herb clears the lungs off the phlegm and congestion. It keeps the lungs free from respiratory infections owing to its antiseptic and antibacterial properties. Hence it is useful in combating shortness of breath.

Hyssop herb can be consumed in the form of Hyssop tea. Care should be taken that this herb or its tea should be taken for short duration as it may cause toxicity.

Grindelia
It is an excellent antispasmodic, antiseptic and anti-inflammatory herb. It helps clear the mucus from the bronchial passages.
Grindelia can be consumed in the form of Grindelia tea

Elecampane Tea
It is a good expectorant. Roots of Elecampane have highest medicinal value. Therefore its roots are used to prepare tea. Inulin is the active ingredient of Elecampane root which is highly effective in combating dyspnoea.

Wild Cherry Bark
It is a good expectorant, antiseptic, antitussive and sedative. It decreases the intensity of cough reflex, thereby facilitating increased respiration. It shall be used for short time as it may cause toxicity on long run. It can be consumed in the form of infusion.

Mustard Oil
This oil shall be used to massage over the chest and back areas of the person afflicted with dyspnoea. This helps in relieving the symptoms of breathlessness very effectively.

Figs
They are effective in improving the overall health of the lungs and respiratory passage. Regular consumption of figs prevents breathlessness. Figs should be soaked in water overnight. In the morning the soaked figs and water should be taken on empty stomach.

Eucalyptus oil
It is highly effective in relaxing the congested air passage and promotes breathing effectively. Few drops of eucalyptus should be added to hot water and the vapours coming from it should be inhaled for at least 15 minutes

Honey
Honey has decongestant properties that helps in facilitating the breathing properly and provides relief from breathlessness. Honey should be mixed in warm water and be consumed on daily basis.

Bitter Gourd
It is highly effective in breathlessness associated with asthma. The paste of biter gourd should be added with honey. Consume this paste 3-4 times in a day.

Onion
They have anti-inflammatory property and are highly useful for dyspnoea. Regular consumption of fresh onion juice helps in decongesting the blocked respiratory passage and provides relief from breathlessness.

Liquorice
It is highly effective in treating asthma and bronchitis. Some pieces of liquorice roots should be boiled in water, strained and this tea should be consumed 3-4 times in a day. It reduces shortness of breath.

Lemon juice
It has rich antioxidants. They are helpful in providing relief from asthma and bronchitis.

Mint leaves tea
Tea made from mint leaves is highly effective in asthma and bronchitis and reduces the dyspnoea caused by them. Regular consumption of tea prevents the attacks of breathlessness.

Boswellia
It is highly useful in dyspnoea caused by asthma.

Holy Basil –
Tulasi or Holy Basil and its tea, when taken on regular basis will keep the respiratory airways free from mucus and free from inflammation and infections
Turmeric –
It has powerful anti-inflammatory and warming action. It can remove bacterial and viral infections and can clear the excess mucus from the respiratory tract.
How to take?
Mix 1 teaspoon of turmeric powder into a glass of hot milk and drink at bedtime
|Mix ½ – 1 teaspoon of turmeric powder in 1 spoon honey and take it once or twice a day

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Shwasa Roga – Dyspnoea: Types, Symptoms As Per Ayurveda

Dyspnoea or shortness of breath can be compared to ‘Shwasa Roga’ or ‘Shwasa Krichrata’ explained in Ayurveda. Both mean to say ‘difficulty in breathing’. Generally we use the word Shwasa to describe this condition.According to Ayurveda, Shwasa (dyspnoea), Kasa (cough) and Hikka (hiccough) are inter-related conditions. They have identical aetiological factors and site of origin. We often find them to be associated with each other.

Shwasa is independently explained as a disease in Ayurveda. In some texts, it shares its space with Hikka.

Shwasa can occur in 2 forms –
Swatantra Shwasa – Primary Shwasa, wherein Shwasa will get manifested as an independent entity (disease). The disease will have its own set of aetiological factors (nidana), pathogenesis (samprapthi) and symptoms (lakshanas). The treatment lies in prompt diagnosis of the condition and strategically attacking it with suitable set of medicines, treatment, and diet and lifestyle changes.

Paratantra Shwasa – Secondary Shwasa occurs as an effect of some other disease. Here, Shwasa will be a symptom, premonitory symptom, complication or sign of bad prognosis of another disease. Here, the treatment depends on the treatment of the disease (primary) which is at the backdrop shwasa.
Shwasa can be found in the below said conditions –
As Purvarupa (premonitory symptom) in – Rajayakshama (tuberculosis)

Shwasa is seen As Lakshana (symptom) in

Vataja Apasmara – Epilepsy caused by morbid vata
Apatantraka – tremors
Kaphaja and Vataja Arshas – piles or haemorrhoids caused by vitiated kapha and vata
Pureeshaja anaha – flatulence caused by constipation or obstruction of faeces
Amashaya gata vata – stomach afflicted by vitiated vata
Kaphaja udara – abdominal disorder caused by vitiated kapha
Aharaja udavarta – retrograde or upward movement of vata caused by food
Udgara nirodhaja udavarta – retrograde or upward movement of vata caused by forcible obstruction of belching
Kantha shundi – bulging or swelling of palate
Kshataja kasa – cough caused by chest injury and bleeding within the chest organs
Vataja grahani – intestinal disorder or sprue caused by vitiated vata (irritable bowel syndrome)
Tridoshaja chardi – vomiting caused by vitiation of all the 3 doshas
Antarvega jwara – fever manifested within the body
Asthigata jwara – fever afflicting and located in the bones
Gambhira jwara – deep rooted / chronic fevers
Pachyamana jwara – progressive fevers
Majjagata jwara – fever afflicting and located in the bone marrow
Sannipataja jwara – typhoid fever
Talu shosha – dryness of palate
Balasa – throat disorder
Vataja madatyaya – alcoholic intoxication caused by vitiated vata
Medo roga – errors of fat metabolism
Pratinaha – nasal congestion
Nasa shosha – dryness of nasal cavity
Mutraghata (kundalini) – obstruction of urine
Raktaja murcha – fainting or unconsciousness caused by vitiated blood or sight of blood
Rajyakshma – tuberculosis
Pliha vidradhi – abscess occurring in spleen
Yakrut vidradhi – liver abscess
Visha – poisoning
Agni visarpa – erysipelas or herpes caused by vitiated vata and pitta
Granthi visarpa – erysipelas or herpes caused by vitiated kapha and pitta
Tridoshaja nadi vrana – sinus ulcers caused by vitiation of all the 3 doshas
Swaraghna – throat disorder leading to loss of voice
Shwasa is seen as as upadrava (complication) in

Atisara – diarrhoea
Chardi – vomiting
Trishna – thirst
Vataja prameha – urinary disorders / diabetes caused by vitiated vata
Raktapitta – bleeding disorders
Vatarakta – gout
Vrana –ulcers,
Shwasa is mentioned as Asadhya Lakshana (sign of bad prognosis) in

Atisara – diarrhoea
Kumbha kamala – complicated jaundice
Galaganda – goitre
Gulma – abdominal tumours
Chardi – vomiting
Jwara – fever
Masurika – small pox
Rajayakshma – tuberculosis
Vidradhi – abscess
Visha – poisoning
Tridoshaja nadi vrana – sinus ulcer caused by vitiation of all 3 doshas
Shotha – swelling
ShwasaRoga (Primary dyspnoea)
Below mentioned are the important causes for dyspnoea –

Raja – exposure to dust
Dhooma – Exposure to fumes and smoke
Vata – exposure to breeze
Sheeta Sthana – living in cold places
Sheeta ambu sevana – excessive consumption of cold water
Ati hima ambu – chilled or frozen water
Vyaayaam – excessive physical exercise
Graamya dharma – Excessive indulgence in sexual activities
Adhwa – Excessive walking
Rooksha anna – Excessive consumption of dry foods
Vishama ashana – consumption of incompatible foods
Aaama pradosha – excessive accumulation of ama (essence of improperly digested food, immature nutrition in circulation which by virtue of its stickiness tends to block the channels of the body and deplete the body of its nutrients and essential things)
Aanaha – flatulence
Roukshyat – excessive dryness of the body
Ati apatarpanaat – Excessive fasting
Dourbalya – long standing debility
Marma ghata – injury to vital areas of the body
Shuddi ati yoga – excessive administration of cleansing treatments Atisara – diarrhoea
Jwara – fever
Chardi – vomiting
Pratishyaya – cold, congestion, flu
Kshata – chest injury
Kshaya – depletion of body tissues
Raktapitta – Haemorrhagic disorders
Udavarta – upward movement of vitiated Vayu
Visuchika – cholera
Alasaka – lazy stomach
Pandu – Anaemia, liver disorders
Visha – poisoning
Nishpava – consumption of flat beans in excess
Masha – excessive consumption of black grams
Pinyaka – residue left out after extracting oil from sesame seeds
Tila Taila – excessive intake of sesame oil
Pishta – taking flours in excess
Shaalooka – Nymphaea alba
Vishtambhi – excess intake of foods tending to cause constipation
Vidaahi – foods which are corrosive in nature
Guru bhojana – foods which are heavy to digest
Jalaja ahara – meat of aquatic animals
Aanupa ahara – flesh of animals living in marshy regions
Dadhi – excess intake of curds
Ama ksheera – consumption of unprocessed milk
Abhishyandi ahara – foods which are sticky in nature which tend to obstruct the channels
Kantha-Ura pratighata – Obstruction or block in throat or chest
Kasa Vriddhi – aggravation of cough, chronic cough
Shwasa Roga Purvaroopa: Premonitory symptoms
Anaha – flatulence, distension of the abdomen
Paarshwa shoolam – pain in the sides / flanks of the body
Hrudaya peeda – heart pain, pain in chest
Pranasya vilomatvam – the vayu running abnormal or retrograde (upward direction)

Shwasa bheda: Types of Swasa
Shwas Rog is of 5 types. They are –

Maha Shwasa
Urdhwa Shwasa
Chinna Shwasa
Tamaka Shwasa
Kshudra Shwasa
Maha Shwas:
This type of shwasa is marked by strenuous, painful inspiration with loud noises or sounds which are audible. Due to the vitiated vayu moving haphazardly blocking the channels in the body, the person breathes in with difficulty throughout the day and night.

Symptoms –

Matta rishabha iva – The breathing pattern is compared to the hissing of an intoxicated bull. The person breathes the air with severe discomfort and pain.
Pranashta gnana vignana – Since the vayu gets blocked, the body is depleted of aeration. The person loses gnana (knowledge) and vignana (skill of differentiation).
Vibhranta lochana – improper perception or deceptive perception of vision
Vikruta akshi – abnormalities / deviations in eye
Vikruta anana – abnormalities / deviations in face
Badda mutra – obstruction of urination
Badda varcha – constipation
Visheerna vaak – split voice, hoarseness of voice
Deena – helplessness
Doorat vignayate – the breathing is heard to a long distance
Kshipra marana – death in quick time
Urdhwa Shwas Rog:
This is a type of shwasa in which there is an imbalance between the input and output of air i.e. inspiration and expiration. The kapha blocks the channels. As a result the vayu gets aggravated and causes Urdhwa Shwasa.

Symptoms

Deergham shwasati, na pratyaharati dhaha – deep and prolonged inspiration with difficulty in expiration or throwing out the air
Urdhwa drishti – eye deviated upwards
Vibhranta aksha – irregular eye movements
Pramuhyan vedanaartaha cha – fainting or loss of consciousness due to pain
Shushka asya – dryness of mouth
Arati – nonspecific pains, discomfort, confusion
Moha – unconsciousness
Tamyati – feeling as if in darkness
Hanta asoon – death in quick time
Chinna Shwasa
This type of Shwasa manifests with obstructed type of breathing which is severely distressing and painful. When all the prana (life elements) have been blocked and choked in the body due to obstruction of channels, the person breathes interruptedly in splits and parcels.

Symptoms

Shwasati vichchinnam – split and obstructed breathing
Na va shwasati – total breathlessness
Dukhartaha – person in deep grief and distress
Marma cheda ruk arditaha – the person is afflicted with severe distress and pain as if all his vital organs have been split and damaged
Aanaaha – flatulence, distension of abdomen
Sweda – excessive perspiration
Murcha – fainting
Basti daha – burning sensation in the urinary bladder
Vipluta aksha – deviated and fluctuating eye
Pariksheena – debility, loss of tissues and nutrition
Rakta eka lochanaha – blood shot eye (single eye)
Vichetaha – loss of consciousness
Pari shushka asya – severe dryness of mouth
Vivarna – discolouration of the body
Pralaapa – delirium
Sheeghra mrityu – death in quick time
Kshudra Shwasa
This type of Shwasa is characterised by short spells of dyspnoea which is not troublesome. It generally is an accompaniment of strenuous exercises and will pacify after a brief span of rest.
The Vayu vitiated in small proportions following consumption of ruksha ahara (dry foods) or aayasa (exercise or physical activities) afflicts the upper channels of respiration (breathing passages) and cause kshudra shwasa.
Symptoms

Dyspnoea, which lives for a short period
The kshudra shwasa will not produce any discomfort in the body parts. It will also not produce any harmful effects / symptoms. The functioning of the body is also not disturbed.
It doesn’t cause obstruction to the intake of foods or liquids
It doesn’t cause any trouble to the sense organs or sensory functions (perception)
This is said to be easily curable and many times doesn’t require any treatment
Tamaka Shwasa, Asthma – one of the leading causes of dyspnoea
When the vayu gets vitiated, it starts moving haphazardly in the upward direction (quite unnatural of its behaviour). This abnormally moving vayu occupies and invades all the srotases (channels of transportation in the body). On reaching the head region, the vayu grips the head and neck and also provokes the kapha located in these regions. The provoked kapha along with vayu causes peenasa (cold, congestion). The kapha being blocked in these channels produces sounds. In due course of progression, the kapha blocks the srotases and causes serious dyspnoea of life taking proportions.

Symptoms of Tamaka Shwasa, dyspnoea caused by Asthma

Pratamyati – When the block in the channels get increased, the dyspnoea gets severe; the person unable to breathe properly would lose consciousness feeling darkness in front of his eyes
Kasate – cough, severe in nature
Pramoham – due to persistent cough, the person suffers from loss of consciousness again and again, repeatedly
Dukhitaha – When the dyspnoea progresses and when the patient is not able to expectorate the phlegm, he finds himself in severe distress
Kapha vimokshante sukham – But due to repeated coughing, if he is able to expectorate the kapha or blocked phlegm, the person feels relieved
Kantha udhwamsa – the person, due to repeated cough and dyspnoea would have soreness of throat or loss of voice, it becomes difficult to speak
Anidra – when the patient suffering from tamaka shwasa sleeps, the dyspnoea becomes severe and he is not able to sleep
Parshva graham – catch in the flanks due to vitiated vayu
Aaseeno labhate soukhyam – the person feels better if he changes his position from sleeping to sitting position
Ushna abhinandati – the person feels better with warm or hot comforts
Uchrita aksha – elevation of eyes
Lalata sweda – sweating of forehead
Vishushka asya – dryness of mouth
Bhrusha arti – severe discomfort
Muhuhu shwasa, muhuhu avadhamanam – episodes of breathlessness get severe and suppressed in repeated cycles
Agravating factors – the breathlessness gets severe in cloudy environment (megha), due to exposure to water (ambu), exposure to cold breeze (sheeta), winds or breeze coming from east (prak vata) and any causes which vitiate kapha (shleshmala)
Nature and prognosis of Tamaka Shwasa – Tamaka shwasa is said to be yapya (maintainable), it is said to be curable when it is nava utthita (newly manifested or acute)

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Pranavaha Srotas: Channels Carrying Vital Life Element – Oxygen

According to Sushruta – Pranavaha Srotas are 2 in number. They have their roots of origin in Hrudaya (heart) and Rasa vahini dhamanis (the vessels or channels or terminal branches of arteries which transport nutrition to various parts of the body) Symptoms of injury to Pranavaha Srotas:

Aakroshana – Screaming
Vinamana – Bending of body
Mohana – Perplexing
Bhramana – Giddiness
Vepana – Tremors
Maranam – Death
All these symptoms are those of low oxygenation or low nutrition. When there is total blockage of supply of oxygen and nutrients, it ultimately leads to death. This is also the earliest explanation available to show that the oxygen, which is the prime element representing the life and rasa or essential nutrients are transported in the same passage.According to Charaka – The roots of Pranavaha Srotas are located in
Hrudaya – Heart and
Maha Srotas – Greater srotas which is the abode of Amashaya and Pakwashaya (stomach, small intestines and large intestines)The explanation of Charaka also is almost similar to Sushruta. He too has pointed towards the heart which supplies the nutrient Rasa to all the parts of the body being connected to the stomach and intestines.This shows that the stomach produces the Ahara Rasa and the small intestine absorbs it. This is called Poshaka Rasa or nutrient essence of food. This Poshaka Rasa comes to the heart and is pumped through various dhamanis (arteries) to all parts of the body to provide the nutrition.

Pakwashaya or large intestine eliminates the waste products of digestion and keeps the body clean and sterile. This Stomach – Small intestine – Heart – Tissues – Large Intestine axis should be in perfect rhythm for the body functions to take place smoothly.

Symptoms of vitiation of Pranavaha srotas –

Ati srushta shwasam – too long (prolonged) breathing
Ati baddham – too short breathing (short of breathe)
Kupitam shwasam – difficult breathing
Alpam alpam shwasam – frequent and interrupted / intermittent breathing
Abheekshnam shwasam – highly disturbed breathing patterns looking scary
Sa shabda shwasam – abnormal sounds during breathing
Sa shula shwasam – painful breathing
Both Charaka and Sushruta have included Hridaya or heart as the site of Pranavaha srotas. This also includes the lung and the whole respiratory apparatus entangled with heart. Thus the heart and lung disorders manifest with shwasa as one of the symptoms.

The mention of Rasavahini dhamanis by Sushruta points towards the nutritional imbalances causing Shwasa.

The mention of mahasrotas points towards the digestive imbalances and errors of metabolism causing pranavaha sroto dushti, shwasa being one of its complaints.

Thus treating pranavaha sroto dushti combats dyspnoea caused due to lung and heart pathology, nutritional impairment and errors of metabolism.

Causes of Pranava Srotas vitiation:
Ref – Charaka Vimana 5/10

Kshaya – depletion of tissues
Sandhaaranaat – forcibly withholding the natural body reflexes or urges Example, those of stools, urine etc
Roukshyaat – intake of dry foods
Vyaayaamaat Kshudhitasya – excessive exercise in presence of hunger
Anya daaruna kaarya – doing many such activities which are beyond ones physical capacityManagement of vitiation of Pranavaha Srotas –
The vitiation of Pranavaha Srotas should be managed on the lines of treatment of Hridroga (heart diseases), Kasa (cough) and Shwasa (breathing disorders, dyspnoea). When the symptoms of gastrointestinal tract like loss of appetite, indigestion, bloating, anorexia, regurgitation, constipation etc are found on the backdrop of vitiation of Pranavaha srotas or if those symptoms are associated with respiratory symptoms, the alimentary tract also should be effectively treated.

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Pandu Roga: Causes, Pathophysiology, Symptoms, Treatment

Pandu Roga is generally considered as anemia as per Ayurveda.

When the pitta predominant doshas get aggravated in the tissues, the tissues undergo inflammation and get weak and lax. Heaviness also develops in the tissues of the body. This pathological process leads to deterioration of varna (colour), bala (strength and immunity), sneha (unctuousness of the body, the protective fat buffer) and other qualities of ojas (ojas is the essence of all the tissues and hence represents immunity).
The qualities of ojas go on deteriorating due to the complicated amalgamation of doshas and tissues (dhatus) in a disease complex. The person in whom this pathology sets in will be left out with less blood tissue in the body (anaemia), less fat (less insulation and protection to the body), less tissue essence and will suffer from weakness of the sense organs. The person ultimately gets vaivarnya (discoloured, mainly pallor) and such a condition is called Pandu Roga.-Cha. Chi. 16

Causes and pathogenesis of Pandu Roga
Kshaara amla lavana ati ushna viruddha asaatmya bhojanaat
Nishpaava maasha pinyaaka tila taila nishevanaat
Vidagdhe anne diva swapnaad vyaayaamaat maithunaat tathaa
Pratikarma rutu vaishamyaat vegaanaam cha vidhaaranat
Kaama chintaa bhaya krodha shoka upahata chetasaha
Samudeernam yadaa pittam hrudayae samanvitam
Vaayunaa balinaa kshiptam sampraapya dhamaneehi dasha
Prapanne kevalam deham twak maamsaantara samaashritam
Pradooshya kapha vaata asruk twak maamsaani karoti tat
Paandu haaridra haritaan varnaan bahu vidhaam twachi
Sa paandu roga ityuktaha……… (Ref – Charaka Chikitsa 16/7-11)
Below mentioned are the causative factors of Pandu Roga –
Kshaara – excessive consumption of alkalis
Amla – excessive consumption of sour things
Lavana – excessive consumption of salt or salty stuff
Ati ushna – excessive consumption of hot substances / foods
Viruddha ahara – mutually incompatible foods
Asaatmya aahara – incompatible foods
Nishpaava – Flat bean
Maasha – black grams
Pinyaka – paste of sesame
Tila taila – sesame oil
Vidagdha anna – corrosive foods
Diwa swapna – sleeping during day time
Vyaayaam – excessive physical exercise
Maithuna – excessive indulgence in sex
Pratikarma – doing any activities out of proportions
Rutu vaishamya – seasonal incompatibility
Vega dhaaranam – forcible suppression of natural body urges / reflexes
Kaama – keeping attached to things
Chinta upahata cheatas – mind afflicted by worries
Bhaya upahata cheatas – mind afflicted by fear, panic,
Krodha upahata cheatas – mind afflicted by anger
Shoka upahata cheatas – mind afflicted by grief
Due to the above said factors, the pitta located in the Hrudaya (Sadhaka) gets vitiated. This pitt which has got aggravated is thrown into the circulation through the 10 dhamanis (main arteries) by the vitiated vata. This pitta being propelled by vata reaches all the corners of the body. It finally gets lodged between skin and muscles and further contaminates kapha, vata, rakta (blood), twacha (skin) and mamsa (muscles). The pitta imparts turmeric, pale (earthen) and green colours on the skin and causes pandu roga.

The above said aetiological factors are those which cause vitiation of pitta, which leads to the manifestation of inflammation in all parts of the body which come into contact with the vitiated pitta in circulation. The immunity deteriorates henceforth and causes autoimmune response. Since these causes afflicts the liver mainly and damage it, the inflammatory process first begins in the liver causing autoimmune hepatitis. Thus it can be said that the causes and pathogenesis of pandu roga and the symptoms (mentioned ahead) point towards autoimmune hepatitis or an autoimmune inflammatory process taking place in the liver, anaemia and jaundice being the chief by-products and chief manifestations of this process.

Symptoms of Pandu Roga
Sambhoote asmin bhavet sarvaM karna kshwedee hata analaha
Durbalaha sadano anna dwit shrama bhrama nipeeditaha
Gaatra shoola jwara shwaasa gourava aruchimaan naraha
Mruditaihi iva gaatraihi cha peedita unmathitaihi iva
Shoona akshi kooto haritaha sheerna lomaa hata prabhaha
Kopanaha shishira dweshee nidraaluhu shteevano alpa vaak
Pindika udweshtana kati ooru paada ruk sadanaani cha
Bhavanti aarohana aayasaihi visheshaha cha asya vakshyate (Ref – Charaka Chikitsa 16/13-16)

Karna kshweda – sounds in the ears, tinnitus
Hata analaha – low metabolism, indigestion
Durbala – weakness, fatigue
Sadana – laxity of the body, lethargy
Anna dwesha – aversion towards the food
Shrama – tiredness
Bhrama – giddiness
Gaatra shula – body pains
Jwara – fever
Shwasa – dyspnoea, shortness of breath
Gourava – heaviness of the body
Aruchi – tastelessness
Mruditaihi iva gaatra – the patient feels as if he has been beaten up
Peedita – feels as if the body has been compressed
Unmathita – feeling as if the body has been churned
Shuna akshi kuta – swelling around the eye sockets (orbit)
Sheerna lomaha – falling or shedding of body hairs
Hata prabhaha – lack lustre
Kopanaha – feeling angry for simple causes, irritable nature
Shishira dweshi – aversion towards cold
Nidraaluhu – sleepiness
Shteevana – excessive expectoration, spitting
Alpa vaak – speaks less
Pindika udweshtana – painful cramps in the calf muscles
Kati ruk, sadana – low back pain and weakness
Uru ruk, sadana – thigh pain, weakness
Pada ruk, sadana – foot pain, weakness
Arohana ayasa – feels breathless while climbing steps or going uphill.
Types of Pandu Roga –

Pandu Roga again is of 5 types

Vataja Pandu Roga (Pandu Roga caused due to predominant vitiation of Vata) –

Causes – caused due to vata aggravating food and activities

The vitiated Vata produces black and pale / blackish brown or whitish yellow colour in the skin, dryness and redness in the body parts and organs, liver in this condition.

Symptoms –

Angamarda – body pains
Jwara – fever
Toda – pricking pain
Kampa – tremors
Parshwa ruja – pain in flanks
Shiro ruja – headache
Varcha shosha – dryness of faeces
Asya vairasya – manifestation of odd and abnormal tastes in the mouth
Shopha swelling
Anaha – distension of abdomen, flatulence
Bala kshaya – deterioration of strength
Pittaja Pandu Roga –
Causes – The pitta vitiating food and activities lead to excess vitiation and accumulation of pitta in the system which on contaminating rakta etc tissues causes pittaja pandu.

Symptoms –

Peeta haritabha – body colour becomes yellow or green
Jwara – fever
Daha – burning sensation
Trushna – thirst
Murcha – fainting
Pipasa – excessive thirst, depletion of water
Peeta mutra – yellow discolouration of urine
Peeta shakrut – yellow discolouration of faeces
Swedana – excessive sweating
Sheeta kama – liking towards cold things (food, comforts etc)
Na annam abhinandati – dislike or aversion towards food
Katuka asya – pungent taste in the mouth
Ushna anupashaya – discomfort towards heat
Amla anupashaya – discomfort towards sour foods
Amla udgara – sour belching (due to incomplete digestion)
Vidaha – severe burning sensation all through the body
Dourgandhyam – foul smell from the body
Bhinna varchastwam – diarrhoea
Dourbalyam – weakness
Tama – feeling of darkness before the eyes
Kaphaja Pandu Roga (Pandu Roga caused due to predominant vitiation of Kapha) –

Causes – The kapha vitiating food and activities lead to excess vitiation and accumulation of kapha in the system which on contaminating rakta etc tissues causes kaphaja pandu.

Symptoms –

Gouravam – heaviness of the body
Tandra – sleapiness
Chardi – vomiting
Shwetavabhasata – feeling as if the body has become white in colour
Prasekam – excessive salivation, nausea
Lomaharsham – horripulation
Saadam – lethargy, slowing down of body activities, lack of interest in doing any type of activities
Murcha – fainting, loss of consciousness
Bhrama – giddiness
Klama – fatigue
Shwasam – dyspnoea, shortness of breath
Alasya – lethargy, laziness
Aruchi – tastelessness
Vak graham – obstruction of speech
Swara graham – obstruction of voice
Shukla mutra – whitish discolouration of urine
Shukla aksha – whitish discolouration of eyes
Shukla varchastwam – whitish discolouration of stools
Katu-ruksha-ushna-kamatam – liking towards pungent taste, dry and hot foods, drinks and comforts
Shwayathu – swelling, inflammation
Madhura asya – feeling of sweet taste in the mouth
Tridoshaja Pandu –

Tridoshaja Pandu is caused by the simultaneous vitiation of all the 3 doshas due to the consumption or exposure of food and lifestyle activities which aggravate all the doshas. The symptoms of tridoshaja pandu will be a mixture of the symptoms said in the types of pandu manifested due to vitiation of individual doshas. This is said to be a complicated type of pandu, difficult to treat.

Mrittikajanya Pandu –
This is a peculiar type of Pandu caused due to the consumption of mud.

Causes – Consumption of mud in excess leads to the vitiation of all the 3 doshas, which further vitiate the rakta etc tissues and cause Mrid bhakshanajanya Pandu or Mrittika janya Pandu. The mud doesn’t get digested by the metabolic fire. This mud which is not metabolised will fill up the channels of circulation in the body and deplete the cells and organs from nutrition, causes dryness and damage of the system.

Symptoms –

Indriya bala nasha – destruction of strength of sense organs
Tejo nasha – destruction of the heat element of the body or destruction of metabolic fire
Veerya nasha – destruction of the potency of the body
Ojo nasha – destruction of the essence of tissues
Bala nasha – destruction of strength
Varna nasha – destruction of colour
Agni nashanam – destruction of digestion capacity
Ganda shuna – swelling of cheeks
Akshi shuna – swelling around eyes
Bhru Shuna – swelling around the eyebrow
Pada Shuna – swelling of the feet
Nabhi Shuna – swelling of the navel region
Mehana Shuna – swelling of penis
Krimi koshta – worms in the gut
Atisara – diarrhoea
Sakapha mala – stools with phlegm
Sa rakta mala – blood mixed stools
Signs of bad prognosis in Pandu –

Chirotpanna Pandu – chronic pandu
Kharibhuta – deep rooted disease which has caused extreme dryness of all the tissues of the body
Shuna, peetani pashyati – swelling all over the body due to chronicity and the patient sees everything around him or her yellow
Baddha vit – constipation
Alpa vit – less faeces
Sakapha vit – stools with phlegm
Harita atisara – diarrhoea with green coloured stools
Shwetatwa – whiteness of the body due to excessive blood loss


Principles of treatment for Pandu
Vamana (therapeutic emesis) and Virechana (therapeutic purgation) are ideal choices

Classical medicines and home remedies for Pandu

Loha Bhasma (ash of iron) – with honey and ghee
Shunti churna (ginger powder) with Loha Bhasma
Loha bhasma with Gomutra (urine of cow)
Powders of Ela (cardamom), Jeeraka (cumin seeds), Bhumyamalaki (Phyllanthus niruri) and Sita (sugar) – taken in equal quantities and mixed with ghee should be taken early in the morning
Haridra churnam (turmeric powder) with curds early in the morning
Best medicines for Pandu and Shotha

Guluchyadi Kashayam
Drakshadi Kashayam
Ardhavilwam Kashayam
Patolakaturohinyadi Kashayam
Punarnavadi Kashayam
Mahatiktakam Kashayam
Vasaguluchyadi Kashayam
Lohasavam
Lodhrasavam
Drakshasavam
Draksharishtam
Rohitakarishtam
Mridwikasavam
Punarnavasavam
Pippalyasavam
Parthadyarishtam
Dantyarishtam
Chavikasavam
Kumaryasavam
Ayaskrity
Loha bhasma
Mandura Bhasma
Punarnava Mandura
Loha Mandura
Shotari Mandura
Madhu mandura
Yakritpleehari Lauha
Navayasa Lauham
Svarnamakshika bhasma
Rasasindhoora
Mandura Vataka
Arogyavardhini Vati
Trailokyanatha Rasa
Chandraprabha Vati
Giloy Satwa
Chinchadi leham
Danti haritaki leham
Drakshadi leham etc
Herbs beneficial for Pandu and Shotha:

Bhumyamalaki – Phyllanthus niruri
Amalaki – Emblica officinalis
Sharapunka – Tephrosia purpurea
Katuki – Picrorrhiza kurroa
Punarnava – Boerhavia diffusa
Kakamachi – Solanum nigrum
Kalamegha – Andrographis paniculata
Loha – Iron
Kumari – Aloe vera
Guduchi – Tinospora cordifolia
Yashtimadhu – Glycyrrhiza glabra
Haridra – Curcuma longa
Bhringaraja – Eclipta alba
Vasa – Adhatoda vasica
Kiratatikta – Swertia chirayata
Daruharidra – Berberis aristata etc

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Shwasa Roga Chikitsa: Ayurvedic Treatment, Medicines

Article by Dr Raghuram Y.S. MD (Ayu)
Among the 5 types of Shwasa, Maha, Urdhwa and Chinna Shwasa are said to be incurable.
Kshudra Shwasa either needs no treatment (because it settles down on its own after a period of rest) or subsides with little treatment, basically correction of food and lifestyle practices. If kshudra shwasa is a chronic one, we need to look at some disorder at its backdrop (like anaemia etc). Treating the concerned disease will give relief from kshudra shwasa.

Tamaka Shwasa – asbronchial asthma or bronchitis is the only type of Shwasa which needs a prompt and timely management. Though it is said to be yapya (maintainable), treatment in the early conditions will help. In severe tamaka shwasa or chronic tamaka shwasa, regular periodic treatment in the form of cleansing treatments like vamana (therapeutic emesis), virechana (therapeutic purgation), disease modifying medicines and rasayanas (rejuvenators and immunmodulators) will be needed at various stages of the disease. Maintenance of the achieved relief is essential. Stringent dietetic and lifestyle protocols followed sincerely will help keep away the disease. Careless and negligent nature from the patient will evidently result in relapses and complications. A holistic approach is needed to cure Tamaka Shwasa.

To keep it simple, Shwasa treatment mainly covers the treatment of Tamaka Shwasa. Tamaka Shwasa is one of the leading cause of dyspnoea or shortness of breath.

Personal experience:
Ayurvedic management of Shwasa not only covers the treatment line up of asthma but also is a remedy for wide array of disorders which present with dyspnoea. I have seen that the medicines and treatments advised for tamaka shwasa are also applicable as efficient remedies in many types of dyspnoea associated with other systemic disorders. Thus Shwasa Chikitsa is not limited to ‘cure asthma’. The treatment line up and concept of tamaka shwasa treatment shall be looked from a different platform and broader horizon. There is no harm in prescribing the medicines mentioned in Tamaka Shwasa in any case of dyspnoea. This will take care of symptomatic relief until we have made a proper diagnosis. When we find that the dyspnoea is secondary to another disease, we shall also implement the treatments and medicines (disease modifying) specified for the primary disease leading to dyspnoea. But as per my experience, even if the primary disease (causing dyspnoea) is not diagnosed accurately, there is no harm in prescribing the medicines advised to relieve shwasa. I have found many patients getting relief from this approach, which is the key to treatment of any condition.

Giving reason for this gross approach, I would like to credit the skill of Ayurveda scholars and teachers of ancient era for wonderfully combining the herbs in such a way that they are not only symptom specific or disease specific, but are also multi-directional and multi-dimensional, targeting many diseases or symptoms at a time.
Principles of management of Shwasa (Tamaka Shwasa) and best Panchakarma options
Snehana and Swedana
Snehana (oleation, intake of metered quantities of medicated ghee or oil) and Swedana (sudation, steaming therapy, sweating therapy, and fomentation) should be initially administered for the patient suffering from shwasa. Before swedana, abhyanga (massage with herbal oils) should be conducted.

Snehana and Swedana is given as pre-treatment procedures (purva karma) when shodhana (cleansing treatments) in the form of Vamana (therapeutic emesis) and or Virechana (therapeutic purgation) has been planned. These procedures shall be avoided if vamana or virechana is not in the treatment plan.

Shwasa with feeble symptoms or acute exaggeration of chronic shwasa, can be managed with small quantities of disease modifying medicines prescribed for short-duration. In these cases, snehana, swedana or shodhana (panchakarma measures) might not be necessary.

For abhyanga or massage, lavana taila (oils processed with salt and other medicinal herbs) is used. Following Abhyanga, Swedana is administered by one of the below mentioned methods (types) of swedana –

Nadi Sweda – tubular fomentation (steam or vapours coming out of a tube in a streamed way)

Prastara – slab fomentation (medicinal herbs, grains etc are boiled and spread over the slab of the dimension of the body of a person, the person who is subjected to abhyanga is made to lie on the slab on which herbs are spread and sudation given, the herbs shall be brought to tolerable temperature before providing fomentation)

Sankara Sweda – bolus fomentation (medicines made tolerably hot are tied in boluses and these boluses are used to provide fomentation to the massaged body

Benefits of Snehana and Swedana in Swasa Chikitsa:
Snehana will help in provoking the doshas (kapha and pitta, in shwasa) which are stagnant in the cells and channels, increases them proportionally and prepare them to move out of the cells and channels. Swedana, owing to its heat and penetrating property, further liquefies the doshas bulged by snehana and aid their flow towards koshta (gut, stomach). When the liquefied doshas reach the koshta, it becomes easy to eliminate them through cleansing measures i.e. Vamana or Virechana.

Due to the effect of snehana and swedana, the grathita shleshma sticking to the walls of the channels (consolidated phlegm) gets broken and liquefied, flows out of the channels. The channels, as a result get cleansed and the blocks are removed. The vayu, whose movements are blocked by vitiated kapha is set free. The vayu starts moving freely and gets eliminated from the body.

Preparation for shodhana –
After proper administration of snehana and swedana the patient is prepared for shodhana or cleansing treatments (panchakarma treatments, mainly vamana and virechana).

For this, the patient after having undergone swedana, is given snigdha bhojana (unctuous or oil food). Fish, meat of pig, curds is given in large quantities so as to provoke and increase the kapha in the body. The kapha which has liquefied by snehana, swedana gets provoked further on intake of these foods and gets ready to get eliminated from the body.

Administration of Vamana (therapeutic emesis) –
After confirming that the kapha has been increased on administration of snehana, swedana and snigdha bhojana, after making the patient drink stomach full of milk, sugarcane juice or gruels or meat soup (on the day of administering vamana), and after learning that the patient is having vomiting reflexes , Vamana is administered by giving medicines which induce vomiting. For this, the paste of Pippali (Long pepper), Saindhava (rock salt) and Kshaudra (honey) is given.

Benefits of Vamana in Shwasa
Once the morbid kapha has been eliminated by administration of Vamana, the person starts feeling better and the shortness of breath gets relieved. The person starts breathing easily due to the removal of morbid kapha and the blocks in the channels. The free and unobstructed movements of vayu in the body (after the channels have been cleansed through vamana) further help the establishment of normal breathing process and providing relief from dyspnoea.

Dhumapana (medicated smoking) –
Even after the administration of Vamana, small quantities of kapha might still be stagnant in the channels of the body. The kapha adhering in the channels of the body may proportionally increase in due course of time and trigger shwasa yet again. To avoid this remaining kapha which is sticking in the walls of the channesl has to be eliminated. For this to happen, medicated smoking or dhumapana is administrated.

The medicinal herbs are made into paste and wicks are prepared from it. The wicks are smeared with ghee, kept in the smoking instrument (dhumapana yantra), and lit with fire. At the other end of the instrument the smoke is emitted through a long nozzle. The person is asked to intake the smoke.

Any one of the below mentioned dhumapanas can be used –

Haridradi Dhumavarti – Wick is prepared from the paste of Haridra (turmeric), Yava (barley), Eranda mula (roots of castor plant), laksha (lac), Manashila (purified realgar), Devadaru (Cedrus deodara), Haratala (Orpiment), Jatamamsi (Nardostachys jatamansi)
Yava dhumavarti – Wick prepared with Yava (barley) and ghee
Madhuchishtadi varti – Wick prepared with Madhuchista (wax), Sarjarasa (resin of Shorea robusta) and ghee
Sringadi dhumavarti – wick prepared from Go sringa (cow horn), baalam (hairs of cow) and snayu (ligaments of cow)
Shyonakadi varti – wick made from shyonaka (Oroxylum indicum), eranda naadi (hollow stem of castor plant) and shushka kusha (dry grass) and ghee
Padhmakashtadi varti – wick prepared from padhma kashta (stem of lotus), guggulu (Commiphora mukul), Agaru (Aquilaria agallocha), Shallaki (Boswellia serrata) and ghee
Virechana (therapeutic purgation) for Shwasa Roga:
Treatment of dyspnoea vis-à-vis shwasa will be incomplete without the administration of virechana. Shwasa is said to have its origin from Pitta sthana (location of pitta, gut, stomach or small intestine). Virechana is the best treatment for pitta and diseases manifested due to vitiated pitta or diseases having their origin from pitta sthana.

The Virechana can be administered in one or the other of the below mentioned forms –

Krama Virechana – After the administration of Vamana, samsarjana krama is administered. Samsarjana krama is a planned dietetic schedule planned to bring back the digestive fire which has become weak after vamana, to normalcy. Following this, snehana and swedana is administered. After proper snehana and swedana, virechana is administered.

Nitya Virechana – Virechana is administered in small metered doses on daily basis. In this, herbal laxatives are administered. This doesn’t need snehana and swedana as in krama virechana.

Types of shwasa patients –
Patients suffering from Shwasa are of 2 types. They are –

Balavan / Kaphadhika rogi (strong patients in whom there is excessive vitiation or morbidity of kapha) – In these patients, shodhana can be readily given because the cleansing methods of treatment are well tolerated by patients who have good strength. Presence of excessive kapha in the system is another indication of shodhana. These patients naturally tend to vomit. Administration of Vamana helps in initiating that process of vamana to perfection.

For these patients, administration of Vamana, Virechana, Dhuma and Avaleha (confections) is an ideal choice.

Durbala / Vatadhika rogi (weak patients in whom there is excessive vitiation or morbidity of vata) – In these patients dryness naturally prevails owing to the dry and rough nature of Vayu. Shodhana in the form of Vamana and or virechana should never be administered to these patients as they have low tolerance. Shodhana can also produce complications in these people.

For these patients tarpana (nourishing or nutritional therapies) in the form of sneha (medicate oils or ghee which are disease modifying in terms of dyspnoea i.e. shwasa), yusha (soups), mamsa rasa (meat soups) etc shall be administered skilfully.

Brimhana (bulk promoting) treatments, medicines and foods are highly beneficial in this category of patients. The meat of animals and birds living in desert areas (jangala desha) like peacock, cock etc should be processed with decoction of Dashamula (10 roots) or Kulattha (horse gram) and given to the patient.

Beneficial yusha, yavagu and peya (soups, gruels) in shwasa
Nidagdhikadi yusha – Soup prepared with Nidagdhika (Solanum xanthocarpum), Bilwa majja (pulp of fruit of Aegle marmelos), Karkatasringi (Pistacia integerrima), Duralabha (Fagonia cretica), Gokshura (Tribulus terrestris), Guduchi (Tinospora cordifolia), Kulattha (horse gram) and Chitraka (Plumbago zeylanica)

Hingwadi yavagu – Gruel made up of Hingu (asafoetida), sauvarchala lavana (sauchal salt), jeeraka (cumin seeds), vida lavana (black salt), Pushkaramula (Inula racemosa) and Chitrakamula (roots of Plumbago zeylanica)

Effective formulations for Shwasa from treatises
Sauvarchaladi churna – powder prepared from Sauvarchala lavana (sauchal salt), shunti (ginger), bharangi (Clerodendrum serratum), Sharkara (sugar) should be taken with hot water

Bharangyadi kalka – Paste of Bharangi (Clerodendrum serratum), Shunti (ginger), Maricha (pepper), Yava kshara (alkali derived from the whole plant of barley), Daruharidra (Berberis aristata), Chitrakamula (Roots of Plumbago zeylanica), Sariva (Hemidesmus indicus) and Murva (Argyreia nervosa)

Shatyadi churna – Powder of Shati (Hedychium spicatum) and Pushkaramula (Inula racemosa) should be taken with honey
Amalaki churna – powder of Emblica officinalis should be taken with honey
Kala loha churna – ash or powder of iron should be taken with honey
Kulattadi Kwatha – Decoction of Kulatta (horse gram), shunti (ginger), vyaghri (Solanum xanthocarpum) and Vasa (Adhatoda vasica)

Dashamuladi Kwatha – decoction of Dashamula (10 roots) mixed with powder of Pushkaramula (Inula racemosa)
Vasadi Kwatha – Decoction of Vasa (Adhatoda vasica), Haridra (turmeric), Dhanyaka (coriander), guduchi (Tinospora cordifolia), Bharangi (Clerodendrum serratum), Pippali (long pepper), Shunti (ginger) and Kantakari (Solanum xanthocarpum)

Gudavaleha – confection prepared using purana guda (old jaggery), katu taila (mustard oil)
Vardhamana Pippali – Long pepper treatment in which the powder, decoction or paste of long pepper (pippali) is given in an ascending way (increasing the dose gradually) and later tapered (gradually decreasing the dose and ending with the dose with which the treatment was started).

Management of Secondary Shwasa
If Shwasa or dyspnoea is due to some other primary disease at its backdrop, it can be treated by addressing the primary issue. Here in most cases, we might not require symptomatic treatment for dyspnoea. When the main disease causing dyspnoea goes away, the dyspnoea too would subside.

Other strategies of treatment –
Shwasa can be treated on the lines of treatment of –
Pranavah sroto dushti chikitsa – Shwasa or dyspnoea is a symptom of vitiation of Pranavaha Srotas (channels responsible for transportation of air in the body).

Pandu Roga Chikitsa (Anaemia and liver disorders) – Since shortness of breath is an essential part of anaemia most of the times, prompt treatment of anaemia would address the issue.

Shotha Chikitsa (swelling and inflammation) – Swelling and inflammation or airways is one of the chief causes of dyspnoea. Treatment and medicines advised in Shota chikitsa would reduce the swelling (inflammation or oedema) in the airways and relieve dyspnoea.
Pathya (beneficial and wholesome things) in Shwasa

Vamana – therapeutic emesis
Virechana – therapeutic purgation
Swedana karma – sudation, fomentation, sweating/steaming treatment
Dhumapana – herbal smoking
Diwa swapna – sleeping during the day time
Puratana shali – old rice / paddy
Rakta shali – red rice
Kulattha – horse gram
Godhuma – wheat
Yava – barley
Mamsa – flesh / meat of rabbit, peacock, cock, parrot etc
Dwija or andaja mamsa – meat of birds
Purana ghrita – old ghee
Aja dugdha – goat milk
Aja ghrita – ghee derived from goat’s milk
Sura – fermented alcoholic herbal drink
Madhu – honey
Patola – pointed gourd
Vaartaaka – brinjal
Lashuna – garlic
Bimbi – Ivy gourd
Jambeera – Citron fruit
Tanduleeya – Amaranthus spinosus
Vaastuka – Chenopodium album
Draksha – raisins
Ela – Cardamom
Apathya (non-beneficial and unwholesome things) in Shwasa

Raktamokshana – bloodletting
Purva vata – wind or breeze blowing from the east
Purva bhojana – taking food facing east
Purva pana – taking liquids facing east
Mesha dugdha – sheep milk
Mesha ghrita – ghee extracted from sheep milk
Dushta jala – contaminated water
Matsya – fish
Kanda – tubers
Sarshapa – mustard
Ruksha annapana – dry foods
Sheeta – cold things, foods and comforts
Guru – foods which are heavy to digest
Single herbs useful in Shwasa vis-à-vis dyspnoea

Vasa – Adhatoda vasica
Pushkaramula – Inula racemosa
Kantakari – Solanum xanthocarpum
Pippali – Long pepper / Piper longum
Maricha – Black pepper
Shunti – Ginger
Bharangi – Clerodendron serratum
Chitraka – Plumbago zeylanica
Dashamula – 10 roots
Twak – Cinnamon
Talisapatra – Abies webbiana
Haritaki – Terminalia chebula
Draksha – raisins
Musta – Cyperus rotundus
Karkatasringi – Pistacia integerrima
Katuki – Picrorrhiza kurroa
Shati – Hedychium spicatium
Haridra – Turmeric
Daruharidra – Berberis aristata
Rasna – Alpinia galangal
Ela – cardamom
Vacha – Acorus calamus
Kulattha – horse gram
Jeeraka – Cumin seeds
Yava kshara – alkali of the full plant of barley
Amalaki – Emblica officinalis
Loha – iron
Guduchi – Tinospora cordifolia
Duralabha – Fagonia cretica
Classical Ayurvedic medicines for Shwasa
Kashayam (herbal decoction) –

Vyaghryadi Kashayam
Dashamula Kashayam
Dashamula Katutrayadi Kashayam
Nayopayam Kashayam
Elakanadi Kashayam
Punarnavadi Kashayam
Asava Arishtam (fermented herbal drinks) –

Vasarishtam
Vasakasavam
Kanakasavam
Dashamularishtam
Duralabharishtam
Draksharishtam
Punarnavasavam
Parthadhyarishtam
Leham / Rasayanam (confections, immune modulators) –

Kantakari avaleham
Talisapatradi leham
Mridvikadi leham
Agastya haritaki rasayanam
Kushmanda rasayanam
Chitraka haritaki leham
Dashamula rasayanam
Ela dashamula rasayanam
Churnam / Vatakam (herbal powders, granules) –

Talisadi churnam
Sitopaladi churnam
Yashtimadhu churnam
Haridra khandam
Vyoshadi vatakam
Vati, Gulikas, Bhasmas and Rasa aushadhas (tablets, pills, ashes and herbo-mineral preparations) –

Shwasananda gulika
Kasa-shwasa chintamani rasa
Shwasa kutara rasa
Eladi vati
Rasa sindura
Malla sindura
Vyoshadi Guggulu
Shringa bhasma
Abhraka bhasma
Loha bhasma
Proprietary medicines –

AJ-Rasayana (Kumar)
Cap Branchozen (ZEN)
Cap Broncap (Capro)
Tab / Syrup Bronto (Anuja)
Chandramrit Rasayana (Nanjangud)
Tab Desma (J & J)
Tab Ephenin (Sandu)
Cap Fizzle (Ayulabs)
Kanaka Lepa (Nanjangud)
Kankushtasav liquid (Rajashree)
Powder Pankajakasturi (Pankajakasturi)
Cap Pulmoflex (Envin)
Liquid Pushkaramrith (Swadeshi)
Tab / Syrup Respidac (Cadila)
Granules Rhinex (Pentacare)
Tab Shwas Kalp (Baidyanath)
Cap Shwasankush (Pavaman)
Cap Shwasi (Dhanwantri)
Syrup Somakalpa (Unjha)
Syrup Spasma (Charak)
Syrup Tussnil (KAPL)
Syrup Adulsa (Arya)
Syrup Crux (BAN)
Syrup Kofend (Gufic)
Syrup Kofex (Nanjangud)
Syrup Zeal (Vasu)
Chaitanya Rasayana (Chaitanya)
My clinical experience with Dyspnoea
In my 20 years of clinical practice I have encountered many cases of dyspnoea and breathlessness. Majority of them were cases of asthma or asthmatic bronchitis.

The next in the list are anaemia, nutritional disorders, obesity, cardiac disorders, anxiety neurosis, few cases of hysteria and some due to ageing. I have found shortness of breath also presenting as associated complaint of some acute diseases also including fever, acute bronchitis, cold congestion, etc. These conditions respond to the treatment given to the primary condition.

Asthma and anaemia topped the list because the people having dyspnoea associated with other conditions came for treatment of some primary diseases, wherein dyspnoea was not presented as chief compliant. In these cases, the treatment of the main diseases for which the patients were seeking help would take care of shortness of breath associated with them.

Panchakarma – Yes!! Whenever we deal any case in Ayurveda, Panchakarma or cleansing set of treatments come as the first line of choice of management. It is a boon especially in chronic cases. An Ayurvedic doctor would definitely not put away his thoughts from these highly effective treatments. But I am little conservative about using Panchakarma treatments and pushing my clients into the treatments when things can be handled by efficient medicines. I have always kept Panchakarma as my final weapon. It is also true that the corporate patients find it difficult to allot their time for shodana / panchakarma schedules (unless pressed by doctors).

Having said that, I would still state that Panchakarma is the best option especially if the condition demands. If the patient can fit into the treatment protocol, there is no harm in giving a small course of vamana and or virechana. Later it shall be followed up by administration of disease modifying medicines and immune-modulators.

I have taken to Panchakarma in very chronic and stubborn cases of dyspnoea (related with asthma, anaemia or obesity). In kapha predominant cases, I have preferred advising Vamana, but has always ended my treatment with Virechana. I would suggest that the treatment shall be concluded with virechana or nitya virechana for better results. In people fit for vamana and or virechana, the treatment shall be given once or twice in a year, even though they are symptom free. This will help in overcoming the problem and developing immunity to the disease.

I have always taken care about vata predominant people and have kept Panchakarma options away from these people. Snigdha type of virechana (purgation with medicated oils or ghee) to take control of the vitiated vayu and administration of rasayanas (immune modulators) and brimhana (bulk promoting) and balya (strengthening) medicines in the later period has worked.

I always felt double confident handling even worst of dyspnoea cases. In cases of Pandu vis-à-vis anaemia, a just focussed on enhancing the quality and quantity of blood. In hridroga (heart disease induced dyspnoea), I have always concentrated on medicines strengthening the heart and it’s functioning. In either case, virechana in one or the other form was the secret of my success in handling these cases.

Asthma or bronchial problems causing dyspnoea were always easier to handle. I would confess to have got very good results in managing asthma (with or without Panchakarma). The wide range of herbs and classical formulations has made the doctor’s job easy. The key is to diagnose the cause of dyspnoea.

I have focussed my suggestions on lifestyle modifications, avoiding trigger and causative factors, diet corrections, developing seasonal compatibility and regular intake of immune-modulating medicines so as to prevent recurrences.

One more interesting thing that I have found out in my clinical practice is that lot of ama (metabolic toxins or intermediate products of digestion in circulation) is the cause of many diseases and also dyspnoea. Medicines which correct the metabolic process and aid proper digestion relieve dyspnoea related to diseased gut.

Constipation is another common accompaniment of dyspnoea. Snigdha virechanas and correction of apana vayu functions have come in handy to relieve constipation and related dyspnoea.

Limitations of Ayurveda in handling Shwasa
Options and success rates of treating Shwasa with Ayurvedic treatments and medicines is unlimited. This statement of mine and whatever I discussed in the ‘My experience’ section would make little sense of me trying to explain the limitations of Ayurveda in handling shwasa. Ayurvedic medicines have been successfully been administered in shwasa patients of all ages, including infants.

Care should be taken while administering medicines to infants, pregnant women and feeding woman.

Some medicines may have stronger ingredients which are intolerable in these sensitive groups. Many formulations consists of herbs which are ‘micro-cleansing’ in nature, have some laxatives which keep detoxifying on daily basis. This may be inconvenient in the mentioned set of patients. Old age group of patients are another set which need to be looked at caution.

Acute, sudden, severe and complicated types of dyspnoea are anyhow out of equation of Ayurveda management because the patients any how would opt out for emergency medicines and immediate attention. Ayurveda too has lot of emergency medicines towards handling complicated dyspnoea cases including heart related shortness of breath. But it would be a risk factor to take chances when some other system would provide good relief and equipped better towards emergency management.

 Dyspnoea should be promptly diagnosed and the cause behind it should be found out in right time. This helps in early intervention. This article provides you a wide array of options to get rid of your dyspnoea.
Breathe naturally and easily with the help of Ayurvedic remedies!!

Check in at Zama Ayurveda wellness centre in Kerala, for the best panchakarma treatments

Acharya Agnivesha – Legend, Works, Samhita

Agnivesha was an ancient Ayurveda teacher and an author of a famous treatise called by the name ‘Agnivesha Tantra’ which in the later period came to be popularly called by the name ‘Charaka Samhita’.

Life –
Agnivesha was the disciple of Acharya Punarvasu Atreya. Punarvasu Atreya himself was the disciple of Sage Bharadwaja.

Atreya had learnt Ayurveda, the science of life and the most ancient medical science from Sage Bharadwaja and had imparted the same to his disciple Agnivesha. The other students of Atreya and colleagues of Agnivesha were Bhela, Jatukarna, Parashara, Harita, Ksharapani and others. All these went on to become stalwarts of Ayurveda and had contributed towards Ayurveda in the form of documented science, which they had heard, learnt and practiced from their Gurus (teachers).

Best student – Agnivesha was considered to be the most intelligent disciple among the above mentioned 6 disciples of Punarvasu Atreya. He was also the first among the lot to have composed a treatise. It was named after him and called ‘Agnivesha Tantra’.

Agnivesha Tantra’ was also considered as the best among the treatises composed by the disciples of Punarvasu Atreya.
Other names and references of Agnivesha
Below mentioned are the other names of Agnivesha –

Vahnivesha
Hutashavesha
Hutasha
Hutasa
Vahni
All the above mentioned names are synonyms of ‘Agni’ i.e. fire

In Madhavanidana, 44th chapter which deals with fractures and their pathology (Bhagna Nidana), one can observe that Agnivesha was called by the name ‘Hutasa’
In Charaka Samhita, Siddhi Sthana, Chapter 12, verse 53, Agnivesha is referred by the name Vahnivesha

Acharya Chakrapanidatta, while starting the commentary on Charaka Samhita, in Mangalacharana (intro), refers to Agnivesha as Hutavesha
Dowson, in his classical mythology has quoted that Agnivesha was the son of ‘Agni, the God of fire’, hence the name. Sage Bharadwaja gave him the ‘Agneyastra – the weapon of fire’, which was in turn possessed by Dronacharya, the preceptor of Pandavas.

Time Period of Agnives
One can find that the name of Atreya being mentioned in ‘Aswadi Gana’ of Panini’s Sanskrit work on grammar named Ashtadhyayi. Panini’s date was fixed at 7th century BC. With this reference it can be inferred that Atreya and Agnivesha were quite renowned during that period, i.e. 7th century BC.

As Atreya’s teachings are mentioned in Charaka Samhita, which belongs to the period of Upanishads, it is said that Ayurveda is more attached to Atharvana Veda.

Thus, the time period of Agnivesha and Atreya may be fixed between the period of Atharva Veda (1500BC) and Panini’s period (7th BC) i.e. 1000BC i.e. in the age of Upanishads.

Works of Master Agnivesh:
Agnivesha Tantra is the most popular work of Acharya Agnivesha. Below said are the works of Agnivesha –

Agnivesha Tantra – present day Charaka Samhita
Anjana Nidana – a treatise on the diseases of the eye
Nidana Sthana – a book on pathology
Ramayana Rahasya
Ramayana Shatashloki
Among these, the first 3 are the works on Ayurveda.

Agnivesha Tantra –
Acharya Agnivesha composed Agnivesha tantra, a treatise comprising of compilation of Ayurveda and topics related to it.
Originally Agnivesha Tantra comprised of 12000 verses. Unfortunately the original work is not available at present.

In the later period, this treatise was redacted by Acharya Charaka. Thereafter Agnivesha Tantra became popular as Charaka Samhita and has been called by that name ever after.

In total 41 chapters (i.e. 17 chapters from Chikitsa Sthana, 12 chapters from Kalpa Sthana, 12 chapters from Siddhi Sthana) which were originally composed by Agnivesha and revised by Charaka, were lost.
Later on those works were redacted by Acharya Dridhabala.

Charaka Samhita is considered as one of the most important reference for learning and practicing Ayurveda. Whenever there is a mention of Ayurvedic treatises, the name of Charaka Samhita always stands tall and qualifies as the best reference.

Charaka Samhita adorns the first place in the list of the elite ‘Greater Trio’ or ‘Greater Trilogy’ of Ayurveda i.e. Brihat Trayees. The other two treatises which share the respect and status in this group are Sushruta Samhita (composed by Acharya Sushruta) and Ashtanga Samhita (Ashtanga Hridaya and Ashtanga Sangraha composed by Acharya Vagbhata).

Formulations in the name of Agnivesha –
Some formulations can be seen in Gadanigraha in the name of Agnivesha. They are supposed to be formulated by him or named after him. They are –

Changeri Ghritam
Shatpala Ghritam
Mahatiktaka Ghritam
Vasadyam Ghritam
Tiktaka Ghritam
Trushanadyam Ghritam
Summing up –
Charaka Samhita is a great treatise and the ‘numero-uno’ reference for Ayurveda. But it is always the ‘brain child’ of Acharya Agnivesha. It is supposedly the first ‘methodically documented’ work on Ayurveda. He is undoubtedly the pioneer of Ayurveda. His work Agnivesha Tantra paved way and foundation for many future works on Ayurveda.

Check in at Zama Ayurveda wellness centre in Kerala, for the best panchakarma treatments

Acharya Atreya – legacy, works, contribution to Ayurveda

There were many great ancient Ayurvedic legendary persons who have composed excellent treatises, but they all learnt under some great Guru (teacher). Acharya Atreya was one of the greatest teachers of Ayurveda who preached, taught and spread the fragrance of this natural healing system. Life –
Atreya was the son of sage Atri.
He learned the science of life, Ayurveda, from his teacher, sage Bharadwaja.
He in turn taught Ayurveda to his disciples.

Agnivesha (the author of the famous Charaka Samhita, one among the greater trio of Ayurveda or Brihat Trayees), Bhela, Jatukarna, Harita and Ksharapani were some of his reputed students. All these students went ahead to write important treatises related to Ayurveda and thus kept alive the chain of propagation of this holistic science of health and life. Other names and designations of Lord Atrey
Atreya was also addressed by other names. They are, Bhagawan Athreya, Punarvasu Athreya, Krishna Atreya and Chandrabhaga. Bhagawan, literarily means ‘professor or God of knowledge of creation and dissolution of the world; birth and death of creatures and also both material and spiritual sciences’. As Atreya possessed all the above said qualities, he was rightly called aas Bhagawan Atreya.
Since Atreya was born during the dominance of ‘Punarvasu Nakshatra’ or Punarvasu star (one among the stars in the Hindu calendar), he was called as Punarvasu Atreya.

The words ‘Punarvasu’ and ‘Atreya’ are used together in Charaka Samhita and Kashyapa Samhita.

Krishna Atreya or Krishnatreya is his popular title. We can find a reference in Mahabharata quoting Krishnatreya as the ‘famous teacher of medicine’.

Even in Charaka Samhita, Atreya is often called by the name Krishna Atrey, probably because he belongs to Krishna Yajurveda Sakha (clan) or for having Krishna Varna (dark colour).
Atreya was also called as Chandrabhaga (son of Chandrabhagi), being the resident on the banks of river Chandrabhagi.

Bhikshu Atreya and Punarvasu Atreya –
We come across another name called Bhikshu Atreya, related to Ayurveda. He was a Buddhist and was a reputed teacher. Bhikshu Atreya was the teacher of Jivaka, who worked as a professor of medicine at the University of Takshashila. He was not the preceptor of Agnivesha, Bhela etc. we cannot find any references in the history of Jivaka which explains that Jivaka and Agnivesha studied together. Thus we can conclude that Bhikshu Atreya and Punarvasu Atreya are not synonyms of the same persons. They both were different teachers, not one and the same.

Atreya’s school of teaching (Atreya Sampradaya)
Atreya was the best teacher of Ayurveda and was highly qualified in the branch of Kayachikitsa (general medicine of Ayurveda), which happens to be one of the elite branches among the Ashtanga Ayurveda (8 branches of Ayurveda).

His teachings were more of medicines and less of surgical implications. The treatment principles were framed on systematic understanding of the disease and its process which was dependant on strong and comprehensive theoretical and practical knowledge of Ayurveda basics.

His school of medicinal teaching was known as ‘Atreya Sampradaya’ or ‘Kaya Chikitsa Sampradaya’.

Punarvasu Atreya was adjudged as the best teacher from the methods he adopted to instruct his disciples. He is also known for his unparalleled methodology of ‘arranging and classifying the subjects’.

Specialties of Atreya’s teachings –
Discussion of each topic takes place like an interaction between the teacher and disciples – At the beginning of each lesson, Punarvasu Atreya announces the definite subject he proposes to expand and detail in the ongoing chapter. Following the pledge of his teacher, Agnivesha, the most brilliant disciple of Atreya puts questions in order to spotlight the salient features of the subject proposed. Afterwards, the teacher while expanding these salient points covers the whole field of the proposed subject. Occasionally there are intelligent interjections by Agnivesha asking for clarification on certain points.

Example, While Atreya is explaining the types of Vaidyas (doctors) as Pranabhisara and Rogabhisara, Agnivesha intervenes and asks a question, ‘How can we distinguish a real physician from a quack?’. Then Atreya delineates the differences between the quack and real physician in a most impressive manner.

Call for views – The disciples were given the liberty to express and put forth their views. After proposing the subject to be expounded and detailed the disciples and other contemporary scholars are invited to offer their individual views. Example, discussions on the subject Vata (12th chapter of Sutra Sthana of Charaka Samhita) and Rasa (26th chapter of Sutra Sthana of Charaka Samhita) are the best examples for such deliberations.

The summary – The expertise inputs and the brief summary of proceedings and deliberations was ultimately put forth by Atreya after having listened to the views of each of the learned persons and disciples present in the discussion. Atreya used to announce his final opinion on the topic of discussion at the end.

Different from Socratic Method – Atreya’s teaching methodology is somewhat different from Socratic Method, known as teacher-disciple dialogues. It is in its form more ancient and related to the Brahmanical method of discussion.

Spirit of teaching and learning – In the discussions of Atreya and his students, an element of spirit of teaching from the teacher’s side and learning from the student’s side is clearly visible. There is a true spirit of inquiry and desire for discovering and accepting the truth on a subject without hostility and prejudices.

Methodical and scientific way of teaching – Atreya taught ‘medical science and its basics’ and regarding the ‘herbs and medicines’ in a methodical and scientific way. The stage of rational medicine began with Atreya.

Scientific detailing of basics – Atreya explained in detail, the concepts of Tridoshas (basic components or humors of the body namely, Vata, Pitta and Kapha) and Pancha Mahabhutas (5 basic elements of nature). The theory of Rasa and its influences on metabolic and physiological functions and its application in therapeutics was propounded. The concept of Rasa (taste of medicine), Guna (quality of medicine), Virya (potency of medicine), Vipaka (post digestion effect of the medicine) and Prabhava (gross effect or impact of the medicine) was explained scientifically in a comprehensive way. With the above concepts the ‘science of medicine’ passed on from the empirical stage to the scientific stage.

Concept of Unmada or insanity – Prior to Atreya, it was believed that insanity or Unmada may have to a religious or demoniac origin. While explaining insanity Atreya observes that neither the Gods nor the Demons had anything to do with it and it results due to the irregular diet and regimen and must be corrected by suitable remedies. Hippocrates of Greece also opined that the cause of insanity was no longer divine but human. To sum up –
If you have a good teacher who can put seeds of ‘comprehensive and reasoning learning’ in your minds, you would conquer the world with that knowledge. Teachers like Punarvasu Atreya were pioneers of Ayurveda. Ayurveda, as a science and system took wings under their patron. They not only propagated Ayurveda, but also made sure that it fell into the hands of right disciples like Agnivesha who could carry ahead the legend of Ayurveda. Hence Atreya can be called as ‘the father of scientific medicine’ and the first preceptor to teach medicine in a scientific and methodical way.

Check in at Zama Ayurveda wellness centre in Kerala, for the best panchakarma treatments

Pakwashaya Shodhana Basti: Medicated Enemas For Colon Cleanse

Basti is said to be ‘Ardha Chikitsa’ i.e. ‘half of all the treatments available in the creation’. This statements signifies the authority of Vasti in the management of wide array of psycho-somatic diseases. Among these, Vasti (including Niruha and Anuvasana) is the best treatment to combat morbid Vata and to cure all disorders caused by vitiated Vata. Vasti also effectively combats the Pitta and Kapha vitiation, and depends on the herbs with which the vasti medicine is formulated.

Vata, the control mechanism of all the activities in the body –
Vata is the main controlling force of all the activities of the body.

Pitta and Kapha are inert elements. They are incapable of producing a disease or disease process unless they are motivated, provoked and mobilized by vitiated Vata. Their natural functions also depend on the motivation provided by normal vayu.Similarly the functions of all the tissues and organs, the functions of mind, sense organs, motor organs, all the discharges and movements in the system is carried over by the governance of Vata.
The expulsion of wastes from the body is also under its control.In short, Vata is the remote control of all the activities of the body, mind and senses. If this Vata gets vitiated, it will start controlling the body in an undesired way and cause lot of diseases and deformities.

Vata being the superior dosha, needs a stronger treatment and attention when it is a in a state of vitiation.
Nothing can control a ‘Vata’ which is ‘out of control’ as is done effectively by Basti treatment.Pakwashaya Shodhana Vastis (Effective enemas to cleanse the colon)

Need of colon cleanse – Pakwashaya Shodhana
Pakwashaya or colon is said to be one of the sites of Vayu. Apart from this, it is also the predominant site or control station of Vayu. The Vayu is located predominantly (though it is all pervading) in the lower portion of the body, especially pakwashaya, from where it controls all the activities of the body.

Vitiation of Vata Dosha also means that its sites too are disturbed. Pakwashaya will invariably be disturbed, including its normal functioning, when vayu gets morbid. Thus, vitiation of Vayu is reflected in terms of disturbed activities in the seats of Vayu, predominantly pakwashaya vis-à-vis colon. A contaminated or vitiated pakwashaya in turn becomes a bad home for Vayu.

On the contrary the reverse is also true. If Pakwashaya is contaminated for a long time, the Vayu too will be vitiated and unsettled. Its control over the body functions become disturbed and we are exposed to wide array of diseases.

The Vastis which are helpful in expelling the morbid Vayu will help in recovery of pathology in pakwashaya and make it healthy. The other way is also true. The vastis given to purify or cleanse Pakwashaya or colon, will combat vata vitiation, get it to normalcy and relieve one of all the disorders which have been caused by vitiated Vayu.Thus Pakwashaya Shodhana Vastis are helpful in –

Removing colon pathology
Cure the diseases of large intestine
Control and balance vayu
Cure diseases caused by morbid vayu
To enhance health and immunity of the most important seat of Vata, which is also a remote control for all the activities of the body
Below mentioned are the important Pakwashaya Shodhana Vastis –
Reference of all Vastis mentioned below – Charaka Siddhi Sthanam, Chapter 10, verses 25-27

Madanaphaladi Niruha Vasti
Ingredients

Madanaphala – Randia dumetorum
Jeemutaka – Luffa echinata
Ikshwaku – Lagenaria siceraria
Dhaamargava – Luffa cylindrica
Krutavedhana – Luffa acutangula
Vatsaka – Holarrhena antidysenterica (Kutaja)
The decoction of the above said ingredients is mixed with Gomutra (urine of cow) and administered as vasti.

Shyamadi Niruha Vasti
Ingredients

Shyama Trivrit – Operculina turpethum
Haritaki – Terminalia chebula
Bibhitaki – Terminalia bellirica
Amalaki – Emblica officinalis
Shalaparni – Desmodium gangeticum
Danti – Baliospermum montanum
Dravanti – Croton tiglium
The decoction of the above said ingredients is mixed with Gomutra (urine of cow) and administered as vasti.

Prakeeryadi Niruha Vasti
Ingredients

Prakeerya (Karanja) – Pongamia pinnata
Udakeerya (Puti karanja) – Caesalpinia bonducella
Neelini – Indigofera tinctoria
Ksheerini – Ipomoea digitata
The decoction of the above said ingredients is mixed with Gomutra (urine of cow) and administered as vasti.

Saptaladi Niruha Vasti
Ingredients

Saptala – Acacia concinna / Acacia sinuata
Shankini – Canscora decussata
Lodhra – Symplocus racemosa
Kampillaka – Mallotus phitippinensis
The decoction of the above said ingredients is mixed with Gomutra (urine of cow) and administered as vasti.

Note – In all the above said Niruhas (decoction or evacuation enemas), the essential ingredients of Vasti i.e. Saindhava lavana (rock salt), Makshika (honey), Sneha (medicated oil or ghee), Kalka (paste of the herbs with which kashaya or decoction is prepared), Kashaya (decoction of the mentioned herbs) and other ingredients like milk etc are added.

Gomutra or urine of cow is added to all the preparations to make the formulations strong, intense acting and effective. Gomutra along with other herbs help in scraping of the morbidity from Pakwashaya, hence cleansing it.Just before finishing –
The health of gut, especially colon is often an indication and reflection of body’s health, mind health too. It also reflects the magnitude with which the body is cleansing itself. Healthy colon means healthy vata. Healthy Vata means proper functioning of all aspects of body and mind, a good health and immunity. Colon and vata are remote controllers of the body. Their health is mutually dependant on each other. The above mentioned vastis help in cleansing the pakwashaya or colon of its morbidity and impurities, restores normal functioning of Pakwashaya and the Vata therein and helps the body to keep itself healthy.

Check in at Zama Ayurveda wellness centre in Kerala, for the best panchakarma treatments