Chapter LI - Symptoms and Treatment of Asthma (Shvasa)

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of Asthma (Shvasa-Pratishedha). 1.

Ætiology:—

To the same group of exciting factors which bring in an attack of hiccough should be attributed the origin of that voilent disease which is known as Svasa (asthma). The vital Vayu known as the Prana-Vayu foregoing its normal function rises upward in unison with the deranged Kapha of the body and produces that gasping and laboured breathing which is called Shvasa (asthma). This dreadful disease though virtually one in its nature and origin is divided into five specific types, vis., Kshudra-Shvasa, Tamaka-Shvasa, Cinna-Shvasa, Maha-Shvasa and Urddhva-Shvasa. 2–4.

Premonitory Symptoms:—

Pain in the region of the heart and at the sides, aversion to food as well as to all other pursuits, suppression of stool and urine and a bad taste in the mouth, may be regarded as the premonitory symptoms of the disease. 5.

Specific Symptoms:—

The type in which the least movement or exertion brings on an aggravation of the disease, and a distinct amelioration or relief is restored in a sitting posture, is called Kshudra-Shvasa The type which is accompained by such symptoms as thirst, perspiration, vomiting and a rattling sound in the throat and finds aggravation specially in foul weather is called Tamaka-Shvasa. In a case of Tamaka-Shvasa the patient is weak and has a loud (wheezing) sound in the throat, as also cough, the symptoms of (bronchial) catarrh and an aversion to food. He is oppressed with difficult breathing even in sleep which abates only when the cough subsides and is aggravated when the patient sleeps. If a case of Tamaka-Svasa be attended with fever and fainting fits, it is then called Pratamaka. 6—9.

The case wherein the patient pants for breath and has tympanites and a burning sensation in the bladder, and wherein the breaths are painful, detached and intermittent, is known as Chinna-Shvasa. The case wherein the patient breathes heavily lying unconscious and with a loud rattling sound in his throat and with cramps at his sides, the lips and the throat being parched and the eyes riveted in a fixed gaze or stare, is known as Maha-Shvasa. The case wherein a patient breathes hurriedly, lies unconscious with choked voice and upturned eyes and with his Marmans stretching out fully with each stroke of breath is called Urddhva-Shvasa. 10—12.

Prognosis:—

Of these (five) types the one known a Kshudra-Shvasa is easily curable, while the one known as Tamaka-Shvasa is hard to cure, and the three remaining ones, as well as Tamaka, ocurring in a weak or enfeebled patient are regarded as incurable. 13.

General Treatment:—

Several authorities aver that mild emetics and purgatives (lit. upward and downward cleansing—Shodhana—of the system) with the exception of the application of Sneha-vasti would be the chief remedies in cases of asthma, if the patient possesses sufficient vitality. Old and matured clarified butter duly cooked with Abhaya, Vit -salt and Hingu or with Sauvarchala, Abhaya and Vilva would be beneficial in cases of cough, asthma, hiccough and heart-disease. Similarly old and matured clarified butter duly cooked with the pulverised drugs of the Pippalyadi group as Kalka and with (the decoction of) the drugs of the first i.e. the Vidarigandhadi group and with the five officinal kinds of salt added to it by way of an after-throw, relieves both cough and asthma. 14—15.

Himsradi Ghrita:—

Clarified butter should be duly cooked with a Kola (D. R. Karsha) weight each of^[1] Himsra, Vidanga, Putika, Tri-phala, Vyoska and Citraka, and with milk twice as much and water four times as much as clarified butter. A draught of this mediated Ghrita relieves both cough and asthma and proves curative in cases of piles, aversion to food, Gulma, diarrhea and consumption (Kshaya). 16.

A quantity of clarified butter, duly cooked with four times as much of the decoction of all the parts (viz.—leaves, branches, barks, flowers and roots) of Vasaka and with its roots and flowers as Kalka, should be used with honey when cold (in cases of asthma). 17.

Shringyadi-Ghrita:—

A Prastha measure of clarified butter duly cooked with Shringi, Madhurika, Bhargi, Shunthi, Rasanjana, sugar, Ambuda, Haridra and Yashti-madhu all taken in equal parts and as Kalka and with four times of water, would cure cases of cough, asthma and hiccough. 18.

Suvahadi Ghrita:—

A Prastha measure of clarified butter should be duly cooked with twice as much of water and with a Kola (one Tola. D. R.—Karsha) weight each of Suvaha, Kalika, Bhargi, Shukanasa, fruits of Nichula, Kakadani, Shringavera, Varshabhu and the two kinds of Vrihati. Taken hot after being made pungent (by the addition of some pungent drug e. g., Pippali), it would cure all forms of asthma. 19.

Calrified butter duly cooked with the admixture of Sauvarchala, Yava-kshara, Katuka, Vyosha, Citraka, Vaca, Abhaya, and Vidanga, proves curative in a case of asthma. Similarly clarified butter duly cooked with the decoction of Gopa-valli (Sariva) weighing twice as much as the clarified butter is also prescribed. Physicians prescribe these five medicated Ghritas in cases of asthma and cough^[2] 20–21

Talisadi-Ghrita:—

Clarified butter mixed with Hingu weighing a quarter part of its own weight and duly cooked in combination with four times as much of water and with Talisha, Tamalaki and Ugra, Jivanti, Kushtha, Saindhava, Bilva, Pushkara, Putika, Sonvarchala, Kana (Pippali), Agni (Citraka), Pathya, (Hari-taki) and Tejovati as Kalka proves curative in all forms of asthma. The medicated Ghrita known as Vasa- Ghrita^[3] and Shatpala-Ghrita^[4] would likewise prove beneficial. 22.

The proper use of oil duly cooked in combination with the expressed juice of Bhringa-raja weighing ten times as much, would relieve cough and asthma. 23.

Meat as Diet:—

Essence of any bird of the Vishkira species (e.g. chicken, Lava, etc.) charged with the juice of any acid fruit (e.g., pomegranate, Vijapura, etc.) and with clarified butter and salted with a profuse quantity of Saindhava, or the soup of Kulattha cereals, properly cooked with the heads of Ena deer, etc., as well as milk duly cooked with (Anti-asthmatic and Vayu-subduing) drugs (e.g. Panca-mula) would destroy cough and asthma. 24.

The five Lambatives:—

A lambative composed of any of the following five groups of drugs mentioned in a hemistich each, viz, Tinisha-seeds, Karkata-Shringi and Shuvarchika (Jatuka-creeper), or Dura-labha, Pippali, Katuka and Haritaki,; or porcupine’s hair, peo-cock’s feather, Kola (Cavya) Magadhika, and Kana,^[5] or Bhargi, Tvak, (cardamom), Shringavera, Sharkara (sugar) and Shallaka -bark, or the well-pounded seeds of Tri-kantaka alone, should be licked with honey and clarified butter by a patient suffering from cough and asthma. 25.

Powders of sapta-cchada -flowers and Pippali should be taken with curd-cream (Mastu) or powders of fried barley grains (?) previously soaked for several times in the expressed juice of tender Arka -twigs together with honey should be taken. As an alternative, a patient suffering from asthma would drink the Tarpana (cordial) prepared with the above-mentioned barley-powder (by mixing it with a copious quantity of water and) with honey. 26.

A potion prepared with the flowers of Shirisha, Kadali and of Kimda and with Magadhika and dissolved in the washings of rice would completely cure all forms of asthma. The pith or inner pulp of Kola- stone, roots of Tala (palm) tree (D. R.—Tala-muli) and the burnt skin^[6] of a deer of the Rishya species, should be taken with honey; or Bhargi with honey and clarified butter, or Kadamba -seeds and Nimba in combination with honey and the washings of rice. 27—28.

Draksha, Haritaki, Krishna, Karkata-shringi and Duralabha in combination with honey and clarified butter, should be licked by a patient whereby he would get rid even of a violent attack of asthma. A lambative composed of the equal parts of Haridra Marica, Draksha, treacle, Rasna, Kana and Shathi. should be given to be licked with oil by an asthma-patient, conforming to the regimen of wholesome diet. 29—30.

The expressed liquid of cow-dung and horse-dung should be licked by the patient with honey and powdered Pippali in cases of cough and asthma. The medicinal remedies or compounds mentioned in connection with Pandu-roga, and edema (Shotha) or cough, may be employed with efficacy both in cough and asthma. A compound made of Bkargi, Tvak, Tryushana, oil, Haridra, Katu-rokini, Pippali, Marica, Chanda and the expressed liquid of cow-dung should be given (to be licked). Utkarika should be prepared with Tala-kīta-vija^[7]. Taken internally, it instantaneously subdues even a violent attack of asthma. 31—34.

Articles recommended:—

Matured clarified butter, Pippali, soups of Kulattha, or of the flesh of any Jangala animal, Sura, Souviraka (fermented rice-boilings), Hingu, the expressed juice of Matulunga, honey, Draksha, Amalaki and Bilva are recommended (as diet) in cases of asthma and hiccough. 35.

Application of Sveda:—

Oily fomentation (Snigdha-Sveda) with the help of oil and salt should be applied to the patient suffering from asthma and hiccough, whereby the hardened Kapha (accumulated in the channels) would be liquefied and the deranged bodily Vayu pacified. If the Vayu and Kapha be not thereby pacified, the patient should be first treated with Sneha and then with a diet consisting of boiled rice cooked with meat-soup. Application of Dhuma-inhalation should then be resorted to. 36A.

Application of Dhuma:—

The stick (Varti) to be used in the process should be duly made of Manah-shila, Deva-daru, Haridra, Patra, Guggidu, Laksha and Eranda-roots made into a paste. Compounds made of clarified butter, fresh wax and resin; or of cow’s horn, hairs, hoof, tendon and skin; or of Turashka (Shila-rasa), Shallaki (Moca-rasa), Guggulu and Padniaka, should be pounded together (and made into sticks) with the addition of clarified butter. An intelligent physician should use these (sticks) for the purpose of smoke-inhalation in the disease. 36.

Purging and vomiting should be induced in a patient overwhelmed with the action of the deranged Kapha, while Tarpana measures with the administration of a potion of the well-cooked soup of mutton or of the flesh of any Jangala or Anupa animal, should be prescribed in the case of a weak or enfeebled patient, or in respect of one suffering from an internal parched condition of the body. 37.

A lambative should be prepared with Nidigdhika paste of the weight of an Amalaka, mixed with half as much of powdered Hingu and with a copious quantity of honey. Duly taken, it would per force conquer a paroxysm of asthma within three days. 38.

Irresistible is an attack of asthma like that of a fire fed with heaps of fuel (D. R. fauned by the wind) or like that of the thunderbolt hurled by the wrathful Indra, the king of the gods. 39.

 

Thus ends the fifty-first chapter in the Uttara-Tantra of the Sushruta-Samhita which deals with the (symptoms and) treatment of asthma.

Footnotes and references:

[1]:

Some prescribe the Kalkas to be taken in the ordinary way and say that the dose would be one Kola weight.

[2]:

Some editors add this sentence after the next (Tālisādi) Ghrita.

[3]:

Vāsā-Ghrita is mentioned in the treatment ‘of Rakta-pitta (Ch. XLV, 20, Uttara-Tantra). It should be prescribed in cases of asthma when Pitta predominates.

[4]:

Shatpala-Ghrita is mentioned in the treatment of Vāta-Vyādhi. It should be prescribed if Vāyu prevail.

[5]:

Maghadhikā and Kanā arc synonyms and mean Pippali. Some, therefore, prescribe two parts of Pippali in the compound. Others prescribe one part of Pippali, and one of Gaja-pippali.

[6]:

The skin of the deer should be burnt in a covered earthen pitcher and the black contents should be used.

[7]:

We do not know what ‘Tala-kīta’ is. Some printed editions read “Talpa-kīla” which would evidently mean a “bug”. Dallana is silent on the point.