Shwas (dyspnoea)

• Introduction
• Hetu (causes)
• Roopa (clinical Features)
• Treatment
• Commonly used drugs

Introduction
Dysnopea is afatal disease as loss of life is very much possible inthis ailment. It is not necessary that this disease arises from its root cause in any person but can also arise as a compkication side effect of some other ailment. Hetu (causes)

• Increase of cough
• Diarrhoea due to indigestion
• Vomiting
• Poisons
• Anemia
• Fever
• Exposure to dust, smoke, breeze
• Injury to vital organs
• Drinking of very cold water

Following are the types of this disease

• Kshudra
• Tamaka
• Chinna
• Mahan
• Urdhva

Purvaroopa (premonitory signs)

• Pain in region of heart & flanks
• Upward movement of prana (respiration)
• Flatulence
• Splitting pain in the temples (sides of the forehead)

Roopa (clinical Features)

• Kshudra Shwasa
  • When Maruta (Vata) on being aggravated by exertion & overeating, produces Kshudra Shwasa which subsides by itself (without any medication) i.e. heavy breathing on exertion, passes of soon by rest & is thus not very troublesome.
  
  
  
• Tamaka Shwasa
  • Pain in head, neck, chest & flanks, cough accompanied with cracking sound
  • Delusion
  • Loss of taste, appetite
  • Running nose
  • Thirst Forceful bouts of respiration
  • Feeling of going into darkness (i.e.losing conciouseness of the surrounding) momentary comfort after expectoration
  • Inability to breathe on lying
  • Comfortable on sitting
  • Eyes wide open
  • Perspiration on forehead
  • Dry mouth
  • Desire for hot comforts
  
  
  
• Chhinna Shwasa
  • Patient breathes with interruptions
  • Cutting pain in the vital organs
  • Sweating
  • Fainting
  • Flatulence
  • Burning sensation
  • Obstruction in the urinary bladder
  • Eyes are unsteady ( full of tears)
  • Delusion (or coma)
  • One eye is angry - (red in colour)
  • Dryness of mouth
  • Irrelevant talks
  • Feeling of helplessness (inability to do anything)
  • Loss of chhaya (complexion)
    Loss of conciousness
  
  
  
• Maha Shwasa
  • Heavy breathing
  • Helplessness (unable to withstand the trouble)
  • Respiration is accompanied with sounds resembling those of high pitch sounds from the nose, resembling that of a bull in heat
  • Common sense & intelligence are lost
  • Eyes & face are unsteady
  • Chest constricted
  • Obstruction of urine & feces
  • Broken voice
  • Dryness of throat
  • Frequent delusions
  • Severe pain in ears, temples & head
  
  
  
• Urdhva Shwasa
  • Prolonged upward breathings (expiration) but difficult respiration
  • Obstructed movement of vata
  • An upward gaze
  • Rolling eye balls
  • Terrified look
  • Severe pain as though his vital organs are being cut
  • Speech choked.

Treatment

• Snehan - Svedana (Oleation and Sudation)
  • Snehan (Sudation) anointing the body with oil mixed with salt.
  • After sudation, the patient should be made to eat ricemess, mixed with ghee or with dadhi (curds). Then, a mild emesis therapy should be given, especially for those who have cough, vomiting, catching pain in the region of the heart and diminution of voice, by using Pippali, Saindhava and honey, which is not opposed to Vata (which does not aggravate vata).
  • Rice-mess mixed with matulunga, amlavetasa, hingu, pilu and bida should be consumed, this acts as anulomana (laxative).
  • Next, a purgative drug mixed with saindhava and any sour fruit followed by warm water should be administered to produce purgation.
  • It is advisable to have administration of purifactory therapy of both the upper and lower parts of the body.
  • If by the treatment the disease does not subside, the kapha dosha adherent deep inside should be removed out by inhalation of smoke (of drugs) after purifying the patient by emesis and puragation therapies.
  • Leaves of haridra, root of eranda, laksha, manasshila, devadaru, elaa, and mansi , are made into a paste and a cigarette prepared. It should be lubricated with ghee and smoked; or smoke of yava mixed with ghee; or smoke of madhucchista, sarjarasa and mixed with ghee; or smoke of aguru or of chandana or guggulu, of manohva or of resin of sala, sallaki, guggulu, aguru or padmaka-each one lubricated with ghee.
  
  
• Svedana (sudation therapy)
  • This is essential for those who are fit for it and even those who are unfit, should be given sudation for a short duration either by pouring warm milk mixed with sugar, or oil; or by utkarika and upanaha (warm poultices) especially over the chest and throat.
  • Decoction of dashamula, shathi, raasana, bharangi, bilva, riddhi, pushkara, tamalaki, amruta and nagara should be consumed; after it is digested peya (thin gruel) processed by the same drugs should be partaken.
  • A mud pot smeared inside with ghee should be coated (inside) with the paste of pippali, pippalimula, pathya, jantughna and chitraka. After the paste dries up; the pot is filled with takra (buttermilk) and kept undisturbed for a month; this is carminative and cures dyspnoea and coughs.
  • Jivanti, musta, surasa, tvak, eladvaya, pushkara, tamalaki, aguru, bharangi, nagara, karkata, shathi, krishna, nagakeshara, are made into nice powder and mixed with sugar, double its quantity.

Commonly used drugs

• Churna
  • Shatayadi Churna- Bhaishajya- Ratnavali Shwas Chikitsa
  • Haridradi Churna- Bhaishajya Ratnavali Shwas Chikitsa
  • Shrungyadi Churna- Bhaishajya Ratnavali Shwas Chikitsa
  
  
• Lauha
  • Pippaladya Lauha- Bhaishajya Ratnavali- Shwas Chikitsa
  
  
• Rasa Kalpa
  • Shwas Kuthar- Bhaishajya Ratnavali- Shwas Chikitsa
  • Shwas Kaasa Chintamani Rasa- Bhaishajya Ratnavali - Shwas Chikitsa
  • Swarnavasant Malati- Bhaishajya Ratnavali
  
  
• Aasav
  • Kanakasav- Bhaishajya Ratnavali- Shwas Chikitsa
  
  
• Ghrita
  • Tejovatyadya Ghrita- Bhaishajya Ratnavali- Shwas Chikitsa
  
  
• Bhasma
  • Abhrak- Ras Raj Sunder
  • Raupya- Rasendra Saar Sangraha
  • Shrung Bhrama- Ras Tarangini
  • Suvarna Bhrama- Siddhayog Sangraha
  • Moti Bharma- Ras Tarangini & Rasendra Saar Sangraha
  
  
• Arishtha
  • Draksharishtha- Bharat Bhaishajya Ratnakar
  
  
• Pishthi
  • Praval Pishthi- Ayurved Saar Sangraha
  • Moti Pishthi- Ayurved Saar Sangraha