Shwas Vyadhi/Dyspnoea

Shwas Vyadhi/Dyspnoea

  • Preface-

There are many fatal diseases but they do not take away the life so quickly as dyspnoea! Moreover, in the person suffering from various other disorders severe dyspnoea arises at the end.

Dyspnoea is predominanat in kapha and vata, arise from the seat of pitta and dry up the heart and the dhatus such as rasa etc. Hence it is regarded as very difficult to overcome and if managed badly it get aggrevated further and kill the patient like serpants.

  • Causative factor:
  1. Dust, wind, smoke, residing in cold places and using cold water
  2. Excessive physical exertion
  3. Excessive sexual intercourse
  4. travelling on foot
  5. Intake of rough food, irregular meals
  6. Vitiation of ama
  7. Distension of bowels
  8. Roughness, Oversaturation
  9. Debility, injury to vital parts
  10. Use of duals(cold and hot etc.) together
  11. Excessive evacuation
  12. Diseases like diarrheoa, fever, vomitting, coryza, chest injury with wasting, internal heamorrhage, upward movement of Vayu, visuchika, alasak, pandurog and poisoning.
  13. Intake of food articles like Nishpava, black gram, oil ckake, sesamum and oil, flour preparations, tubers, distending, burning and heavy food, aquatic and marshy meat, curd, unboiled milk, channel blocking regimens and use of Kapha aggrevating things leading to obstruction in throat and chest and various other sorts of retention.
  • Pathogenesis:

Vayu situated in chest entering into the channels carrying vital breath is vitiated and enforcing the kapha further give rise to dyspnoea of five types which are severe in nature and impede the vital breath in living creaturs.

  • Prodromal sign and symptoms:
  1. Hardness in bowels
  2. Pain in sides
  3. Compression in cardiac region
  4. Mis-passage of vital breath
  •  Types of Shwas:

Mahashwas-The patient with upward force of vayu respires highly  with obstruction, sound and discomfort constantly like a mad bull. He loses all sorts of knowledge, has rolling eyes, abnormal eyes and face, retention of urine and feaces, fallen voice, anxious expression and excessive respiration known from distance. This is a case of mahashwasa which is highly fatal.

Urdhwa shwas-the patient takes the breath off but does not bring it in, has mouth and passages covered with plegm, is afflicted by vitiated vayu, gazes abnormally with eyes up and rolling eyeballs, has fainting, pain, dryness of mouth and restlessness, due to vitiation of expiration, the inspiration is impeded, the patient again and again faints and becomes unconscious and finally dies.

Chinna-shwas- One who afflicted in entire vital breath respires intermittently or does not respires at all and has pain particularly cutting one in vital parts. Besides, he has hardness in bowels, sweating and fainting, burning sensation in pelvis, with rolling eye balls, is extremely emaciated, panting, having redness in one eye, detraction of mind, dryness of mouth, abnormal complexion and delirium. Cut off by the itermittent respiration he leaves his life instantly.

Tamak-shwas-When vayu taking severe course reaches(respiratory) passages seizing neck and head and aggravating(secretion of) phlegm it produces coryza which creates obstruction and troublesome dyspnoea. The patient due to severe paroxysms faints, coughs with obstruction, while coughing becomes unconsciuos frequently, in abscence of expectoration becomes too much distressed and after expectoration gets temporarily releif. He suffers from hoarseness of voice and can speak with difficulty. In lying posture dyspnoea is aggrevated and he cant sleep beacuse in that position vayu seizes his sides of chest. He feels comfortable while sitting and welcomes hot things.His eyes are elevated, forehead persspiring; he has severe pain, dried mouth and suffers frequently from paroxysms of dyspnoea which aggrevates by cloud, water, cold, easterly wind and kapha-increasing things. This is tamaka shwas(bronchial astma) which can be maintained or can be cured if it is newly arisen.

Pratamak-Santamak Shwas-

  • If shwas is associated with fever and uncosciousness it is known Pratamak
  • One which is caused by udavarta(reverse movement of Vayu), dust, indigestion, humidity and suppression of natural urges, aggrevtes severly in darkness and subsides quickly by cold things is known as santamak because the patient feels as if sinking in darkness.

Treatment Principles:

  • The patient of dyspnoea should at first, be managed with unctous sudation by the tubular, bed and bolus methods after he is massaged with salted oils. By this his inspissated plegm into the channles gets dissolved and thereby the passages become soft and vayu returs to its normal course. 
  • As on hilly forests the snow is liquified by the heat of sun-rays, the sticky phlegm in the body gets dissolved by the heat of sudation. After full sudation the patient should be given the diet consisting of rice with uncting substance along with meat soup of fish or boar or with the supernatant fatty layers of curd. In this way when kapha is increased, he should be advised to take emesis mixed with pipplai, rock salt and honey and which is not antagonistic to  vata. On elimination of deranged phlegm he gets relief and vayu also starts moving unimpeded after the channels are cleansed.
  • If some pathogenic material still remains hidden, it should be eliminated by smoking. Sudation should not be applied to those suffering from pitta, burning sensation, profuse heamorrhage or seating, loss of dhatus and strength and those who are roughened, pregnanat women or of pitta constitution.
  • In case of acute fever and ama dosha, rough sudation and ligghtening or emesis with salt water should be advised according to condition.
  • If vata is aggrevated due to excessive application of these regimens, it should be brought to normalcy by administrating vata-alleviating regimens, meat soup etc. with moderate heat and massages.
  • In condiion of reverse movement of vayu and tympanitis food mixed with matulunga and amlavetas or hingu, pilu and bida(salt) should be taken. This acts carminative.
  • whatever drug or diet alleviates kapha and vata, is hot and carminative is wholesome for the one suffering from dyspnoea. 

Churna:

  • Shatyadi Churna
  • Muktadi churna

Ghrut:

  • Tejovatyaadi ghrut
  • Manah-sheeladi ghrut

Tamak shwas Treatment-

physician should administer emesis to patients of cough as well as hoarseness of voice and purgation added with the drugs alleviating vata and kapha to those of tamakshwas. As the flowing water is spilled over excessively due to obstruction in its passage so is vayu. Hence its passage should be cleaned regularly.