Bronchial asthma-Thamaka Swasa -Ayurvedic management

Bronchial asthma is a common disease affecting 10-20 per cent of the population. In the vast majority of cases, the disease is mild and often unrecognised. There is evidence that the prevalence of asthma is increasing. In spite of better understanding of the pathophysiological processes involved in this disease, mortality from asthma has not been influenced, and in our country, it has been increased!

Asthma means twitchy airways! These narrowed airways may lead to coughing, wheezing, chest tightness and shortness of breath, symptoms often being worse at night.

Invasion of allergens into our daily life is the prime cause for it. Increasing industrialisation and spreading urbanisation are the provoking factors for it. Surprisingly, in a majority of the cases, allopathic drugs such as beta-antagonists, aspirin and non-steroidal anti-inflammatory drugs often cause acute attacks of asthma. It is often aggravated by non-specific factors such as cold air, tobacco smoke, dust and acrid fumes, respiratory viral infection and emotional stress.

Asthma is a clinical condition characterised by attacks of wheezing, breathlessness and cough due to the narrowing of the air passage within the lungs. There are two types of asthma—extrinsic and intrinsic.

Extrinsic asthma occurs in the younger age group. Patients are usually sensitive to pollen, house mice, feathers, food, fur, and drugs and have a family history of similar sensitivities. Exposure to the precipitating factor causes an inflammatory allergic reaction in the mucous membrane. This type of asthma tends to be sporadic. Intrinsic asthma tends to occur in older patients. It is a chronic condition. It has no apparent allergic cause or family history. This type of asthma is precipitated by bronchial infections, chronic bronchitis, strenuous exercise, stress or anxiety.

Throughout the world, bronchial asthma is on the rise. Out of sheer desperation, sufferers readily fall for any wonder cure. Consequently, hundreds of traditional healers make tall claims of having found a permanent cure for asthma. Most of these healers are quacks. Bronchial asthma is a complex disorder, which needs to be treated by a qualified medical doctor. Instead of searching for symptomatic relief or a magical cure, it is always better to concentrate on predisposing conditions and causative factors. If you identify them, then you can avoid frequent attacks.

Ayurvedic View

Bronchial asthma is known as tamaka svassa in Ayurveda. This medical science emphasises on gastro-intestinal factors apart from the respiratory afflictions to be the cause for bronchial asthma. That is why in the preliminary stage of the disease or just before its onset, the patient complains of indigestion, constipation or diarrhoea.

It is mainly a kapha syndrome, though differentiation of humoural types also exists. In other words, bronchial asthma can be from any of the three humours—vaata, pitta or kapha. Most often, the disease is kapha in nature.

Vaata type asthma, is characterised by dry cough and wheezing. Additional symptoms are thirst, dry mouth, dry skin, constipation, anxiety and craving for warm drinks. Attacks occur predominantly at vaata time—dawn and dusk.

Pitta type asthma is characterised by cough and wheezing with yellow phlegm. Other symptoms are fever, sweating, irritability and need for cool air. Attacks are at pitta time—noon and midnight.

Kapha type asthma is characterised by cough and wheezing with abundant clear or white phlegm. The lungs are often congested producing a whistling sound.

Attacks are at kapha time—morning and evening.

Guidelines & ayurvedic remedies

The treatment of asthma consists in the employment of remedies to allay the paroxysms, and in the adoption of measures likely to prevent the recurrence.

According to Ayurveda, the asthma of recent origin can be treated effectively but if it becomes chronic, it can only be managed. It is not the drug alone that can give relief from asthma but regulation of diet and the change of conceptual thinking can also play a great role. Along with proper medication and control over eating and living, asthmatics can get better and quick results.

                During an acute attack, a hot chest and shoulder pack, repeatedly given every half an hour, will have a sedative effect upon the nerves and a relaxing influence generally, giving the quickest and most satisfactory relief.

                Hot milk or hot water when sipped little by little, provides immediate relief from the attack. The inhalation of steam-laden air may be provided by using an ordinary teakettle, attaching a funnel to the spout, and inhaling from the upper wide end of the cone. This is very effective in relieving spasms. In many acute attacks, relief will be found in a simple hot hand-bath or hot foot-bath (immersing hands or feet up to the elbows or knees).

                Concussion to the cervical vertebrae from the fourth to the seventh for six to eight minutes with half minute interruptions every minute is excellent to relieve attacks.

                A creeping plant known as somalataa (Ephedra vulgaris) is found to be highly efficacious in relieving asthma. This grows in western Himalayas in abundance and is sent in hundreds of tonnes to western countries where ephedrine is prepared from it. The powder made from the whole plant, after drying in the shade and is given in the dosage of 100 to 250 milligrams, mixed with honey or water at the intervals of 8 to 4 hours.

                At the time of a full attack, wrapping a hot brick in a rough cloth and then giving dry fomentation with it to the chest is found to be useful in asthma. Smearing chandanaadi oil and then giving heat fomentation is also good. Turmeric paste used as poultice on the chest or warming the chest with it is very soothing.

                Only the use of pippalee (Piper longum) powder along with pure honey, makes an attack of asthma subside.

                The rhizomes of turmeric are to be baked in hot sand slightly and made into fine powder. This is to be taken 3 grams twice a day with sugar. The dose can be increased up to 10 grams in due course.

                During an acute attack of asthma, drink some hot water with the juice of one clove of garlic.

                Take the juice of the whole plant of Solanum surattense (chote kateri)—7 to 14 ml as such, or with Trikatu (equal parts of dried ginger, long pepper and black pepper)—one gm twice a day. You can even take Terminalia bellirica powder (baheda)—3 to 6 grams with 4 to 6 grams honey twice a day.

                Mustard oil (sarason) is a good remedy. Take a spoonful with jaggery, twice a day.

                If you wish to use a compound formulation, then here is a medicine for you. Prepare a decoction by boiling equal parts of root of Adhatoda vasica (adoosaa), rhizome of turmeric, stem of Tinospora cordifolia (giloa), and the fruit of Solanum surattense (chote kateri). Take this decoction internally, 14 to 28 ml. with one gram of powdered black pepper twice a day.

                Smoke leaf of Datura stramonium (dhatura). This gives instant relief but needs medical supervision.

Specific Medicines

Kapha kartari: This cuts the kapha like scissors, hence the name. About 200 milligrams of this powder is to be wrapped in a betel leaf and chewed slowly. As soon as the saliva mixes with the powder and reaches the stomach, its effect will be clearly felt. Even when the attack subsides, four doses of it are to be taken for the next 24 hours.

Bhaarangee guda: It is a good remedy for asthma. It also relieves all types of coughs. A dose of 12 grams is taken together with one boiled fruit of hareetakee (harad/Termilalia chebula).

Kanakaasava: It is a proven medicine for asthma and allied-complaints like cough, tuberculosis, bronchiectasis, chronic fevers and haemoptysis. The principal ingredient in this preparation is kanaka (Datura stramonium), which has been a reliable drug for asthma. 10-30 ml of this medicine is to be taken twice a day after meals.

Chyavana praasa and Agastya rasaayana: The main ingredient of the former medicine is amla, the richest source of vitamin C in nature. A peculiarity of this fruit is that its vitamin content is not lost by exposure to heat, as is the case with other drugs and fruits. The latter preparation is indicated in cases of asthma where the patient is constipated. However, chyavana praasa is the better remedy. Both the medicines can be taken in one teaspoonful doses thrice a day, preferably before food intake. They are slow acting remedies but are surer in the efficacy. In chronic cases, their effect is evident from the increasing gap between successive attacks.

Sitopalaadi choorna: This should be taken three or four times a day in one teaspoonful dose with honey. Since the drug is likely to cause irritation of the throat, it is better when mixed with honey and taken as a linctus.

During Acute Attack

                In severe cases, any of the following medicines can be tried with the advice of the physician—Swaasakaasa chintaamanee rasa, Swaasa kuthaara rasa etc.

                In case a patient has a long history of asthma and other complications are present, the panchakarma therapy of Ayurveda gives satisfactory results.

Diet and other considerations

                Avoid foods that can aggravate asthma. Common foods, which trigger asthma, are animal foods, milk products, food items which take more than two hours to digest, mucous producing foods such as curd, bananas, sugar, sweets, black gram, etc.

                Drink plenty of liquids, 8 to 10 glasses a day, to keep secretions loose.

                Find out what triggers your asthma, and get rid of things that bother you at home and work. Upper respiratory infections, either viral or bacterial often trigger an asthmatic attack. Exposure to smoke, perfumes, paints or other strong chemical odours are common culprits.

                Change in weather, exposure to moulds, animal dander, grass or tree pollen triggers asthmatic attacks. Certain food colourings and preservatives may trigger asthma. Drugs, such as aspirin, non-steroidal anti-inflammatory drugs, beta-blockers, ACE inhibitors can precipitate an asthma attack.

                Make a special effort to keep your bedroom allergen-free. Sleep with a foam or cotton pillow, not a feather pillow.

                Use a plastic cover over the mattress. If possible, wash your mattress in hot water every week.

                Dust your room often, but not with a broomstick. Vacuum cleaning is the better option. Wear a dust filter mask when you do so.

                Avoid using perfumes.

                Wear a scarf round your mouth and nose in cold weather. Doing so will warm the air as you breathe in and will prevent cold air from reaching sensitive airways.

                Mild exercise, like swimming, is good for asthmatics. However, some asthmatics are allergic to chlorine, which rules out swimming in a public pool.

                During an asthma attack, sit up straight or bend forward. Do not lie down.

                If you have an air conditioner, change its filter regularly.

                Make a paste of rock-salt and old ghee or mustard oil. Rub it on the chest. Alternately, you can massage Saindhavaadi tailam on the chest.

                Place a hot towel over the chest. This helps to relax muscles and restore normal breathing.

                For an acute asthma attack, try steam inhalation. Add a few drops of eucalyptus oil in a bowl of hot water. Cover your head and the bowl with a towel. Be careful that the water is not so hot that the steam burns your face.

                You should not suppress natural urges like urination, thirst and cough. In addition, you must avoid smoking and moving in the sun.

                It may be useful to assess the alignment of your spine. Often the upper throacic vertebrae are not in alignment with the spine after an asthmatic attack. This ultimately puts greater pressure on the lungs and possibly precipitates another attack. Getting a professional massage, specifically between the shoulder blades with Chandana bala laakshaadi taila can reduce the frequency of attacks.

                Yoga benefits asthmatics. The integral yoga approach to asthma includes correction of distorted posture and faulty breathing habits, methods for the expectoration of mucous, teaching a system of general muscle relaxation, techniques for the release of suppressed emotion and for reducing anxiety.

                In yoga, the purpose of functional breathing exercise is to learn to engage both abdominal muscles and the diaphragm in breathing. The duration of exhalation should double the inhalation.

                During the process of breathing, you must learn to relax. Asanas such as suryanamaskaara, shashankaasana, pranamaasana, sarvangaasana, supta vajraasana, ushtraasana, hasta-uttanaasana, uttita-lolaasana, dwikonaasana, matsyaaasana are helpful. Pranaayaamas like naadi-shodhana, bhastrika, kapaala-bhaati are beneficial. If you want to try some higher range of yoga procedures, shat karmas such as vastradhauti, shankha-prakshaalana, jalaneti are considered therapeutic. Other yoga related aspects like yoga-nidra, antar-mouna, meditation and relaxation techniques are useful to remove the source of nervousness.

                The first and foremost thing is to keep the bowels regular. Constipation should not be allowed to supervene. Exposure to cold should be avoided. Edibles, which are hard to digest, should also be avoided. The supper should contain easily digestible and light food. It is better if the food is taken before sunset. Boiled water should invariably be taken. If milk increases coughing or phlegm, it may be boiled with, equal quantity of water and two or three numbers of pippalee (long pepper) crushed and ground.

                Curd, buttermilk, bananas, guavas and fried foods are to be avoided. All sour substances should be banned. Smoking—both active and passive, should be strictly prohibited.

                Allergens and other substances liable to provoke attacks of asthma are to be avoided. For example, pollen may be avoided by not being exposed to flowering vegetation and closing the bedroom windows. Mites in house dust may be prevented by cleaning mattresses and blankets with vacuum cleaners. Animal dander is best avoided if contact with dogs, cats, horses or other animals is avoided. It will be good if feather pillows are substituted with cotton pillows. Often, allergens are produced from certain foods such as fish, eggs, milk, yeast and wheat. These should be carefully identified and eliminated from diet. Exposure to chemicals is to be avoided. If it is not possible, it is better to change the profession. In addition, indiscriminate usage of chemical pain relieving drugs should be avoided. Physical and mental stress should be avoided.