BENGALURU: In Ayurveda, asthma is called shwaasa, and belongs to the same family as coughing, hiccups and other diseases characterised by the obstruction of prana (life force).
In today’s stressful modern urbanized living, incidence of asthma is considerably increasing. It has been stated that 15 pre cent of Indian population suffers from asthma and in developed countries like USA every year there is a 10 per cent increase of asthmatic patients. Every now and then we come across asthma patients seeking ayurvedic treatment and advice.
Ayurvedic theory holds it to be life threatening when prana cannot enter the body, provoking great fear, anxiety and even fear of death. The Charaka Samhita says : “There are many fatal diseases but they do not take away life so quickly as hiccup and laboured breathing (dyspnoea)”. It also specifies the multi-systemic aspects of the disease.
The Samhita says the condition is ruled by kapha (among other things: body phlegm) and vata (air and ether that are responsible for the movement of prana in our body) and appears from the seat of pitta (fire, responsible for all physical and mental processes), which dries the heart and tissue like rasa (plasma and other body fluids).
The book gives an accurate description of the phenomenon “When vayu is preceded by kapha obstructing the passages and itself being obstructed moves here and there, it produces shwaasa."
“The patient takes the breath off but does not bring it in, has mouth and passages covered with phlegm, is afflicted by vitiated vayu … due to vitiation of expiration, the inspiration is impeded …”.
This text describes causes for asthma similar to the causes described by Western medicine.
Environmental factors: dust, smoke, wind, cold air or water; or lifestyle: physical exertion which exhausts the system, consumption of coarse, inappropriate or badly cooked food, disorderly eating, weak digestion and failure to meet bodily needs. All these create toxins in the digestive system that transfer to the respiratory system with an upward movement of vayu, so prana vayu and apana vayu are not moving in the right direction. The book mentions further factors related to nutrition giving a list of foods that create excess kapha in the body, from inappropriate preparation (e.g. drinking uncooked milk) or excess consumption of fats that obstruct the physical and energetic channels, in turn causing airway obstruction.
In Ashtaanga Hrdayam, the description of the disease is similar, adding that the vata, moving upward, is imprisoned in the breathing channels and causes headache and pain in the neck, chest and shoulder blades that originates in toxins from the digestive system and polluting environmental conditions. The texts specify different types of the disease, for example, urdhva sawas in which the patient has difficulty bringing air into the lungs for various reasons: a weakened gastrointestinal tract may be causing congestion; weakened respiratory muscles may restrict exhalation; and anxiety about breathing could worsen it.
In conclusion, we see that ayurveda views asthma as a multi-systemic disease that includes a weakened digestive system, creating toxins that spread from the gastrointestinal tract to the lungs and respiratory tracts in the form of thick mucus. According to ayurveda, there is a differential diagnosis between asthma controlled by kapha, which has sticky, inflamed mucus and respiratory infections, where the patient will usually be characterised by a thick body and a swollen belly, and asthma controlled by vata, which will be expressed through a dry cough and dry phlegm, with the patient characterized by a slim, deficient build.
The patient’s struggle to breathe, making use of other muscles unrelated to the breathing mechanism, mainly in the neck, upper back (trapezius, rhomboids) and shoulders, creates stiffness and tension in these muscles. On the emotional-psychological level, the patient experiences anxiety and fear of suffocation. On the conscious level, awareness is concentrated in the upper body.
Remedies and Prevention
1 A few common medicines as suggested in ayurveda are sitopaladi choorna, vasavleha, swaskuthar ras etc. During asthma attacks, rasayana chikitsa is given to the patient. It is also advised that asthmatic patients go for a panchakarma, especially vaman chikitsa before the onset of monsoon.
2 Honey is one of the most effective remedies. During bouts of asthma, just holding a jug of honey beneath the nose and inhaling the air in contact with honey helps in easier breathing and provides temporary relief from asthma. When consumed internally with equal parts of dates, black raisins and pippali, it acts as a good lung tonic by thinning out the accumulated mucus and eliminating it from the respiratory system.
3 When five grams of Indian gooseberry or amla is mixed with one table spoon of honey and consumed, it acts as an expectorant, and is an effective medicine for asthma.
4 During asthmatic attacks, massaging mustard oil with camphor over the chest will loosen the mucus and help easy breathing. Simultaneously, inhaling steam with a few caraway seeds added to boiling water will help in dilation of bronchial passage.
5 Avoid external environmental factors such as dust, smoke, air pollution, cold, and dryness.
6 Follow recommendations for appropriate nutrition. A week of mono fasting, designed and monitored by a professional ayurvedic healer, is advisable.
7 Use herbal medicine including bronchodilators, moisturising, anti-inflammatory, and adaptogenic immune system fortifiers.
8 Practie yoga including all the elements: shatkarma (shatkriya) - six cleansings: (1) neti kriya (techniques of cleansing the nasal passages), (2) kunjal kriya (self-induced vomiting), (3) kapalabhati, (4) vastra (5) dhauti, (6) shanka-prakshalan (cleaning the digestive tract). These techniques are most important for asthma sufferers because they help improve their condition very quickly, but this is an extensive subject that lies beyond the scope of this essay. Asana for relaxation of stiff and rigid areas (neck, back, ribcage): movement, strengthening (mostly upper body), leading the awareness downward, strengthening and grounding the lower part. Pranayama (including the vayus) in order to bring the prana downward: cultivating apana vayu, samana vayu and prana vayu; developing respiratory capacity by moving the diaphragm and strengthening it and increasing the volume of air sacs in the lungs; increasing the flexibility of lung tissue, lung pleura and trachea.