Role of Sadyo Vamana in Tamaka Swasa - A Case Study

[Find the meaning and references behind the names: Sri, Raj, Vega, Ayu, Rock, Kiran, Nil, Med]

Journal of Ayurveda and Integrated Medical Sciences 2025 Volume 10 Number 1 JANUARY E-ISSN:2456-3110 Case Report Tamaka Swasa Publisher www.maharshicharaka.in Role of Sadyo Vamana in Tamaka Swasa - A Case Study Raj S 1* , Supreeth MJ 2 , Goud KM 3 DOI:10.21760/jaims.10.1.36 1* Sreelakshmi Raj, Post Graduate Scholar, Department of PG Studies in Panchakarma, Sri Kalabyraveshwaraswamy Ayurvedic Medical College and Hospital and PG Research Centre, Vijayanagar, Bengaluru, Karnatak, India 2 Supreeth MJ, Associate Professor, Department of PG Studies in Panchakarma, Sri Kalabyraveshwaraswamy Ayurvedic Medical College and Hospital and PG Research Centre, Vijayanagar, Bengaluru, Karnatak, India 3 Kiran M Goud, Professor, Department of PG Studies in Panchakarma, Sri Kalabyraveshwaraswamy Ayurvedic Medical College and Hospital and PG Research Centre, Vijayanagar, Bengaluru, Karnatak, India Swasa (Asthma) is one among Pranavaha Srothodusti Vikara. Tamaka Swasa (bronchial asthma) is one among the 5 types of Swasa. A 44-year-old female patient comes with complaints of difficulty in breathing and wheezing sounds. This case was diagnosed as Tamaka Swasa. As the Doshas are in the Utklishta Avastha (excited state), Asnehapoorvaka Vamana with Pippali (Piper longum) Saindhavajala (Rock-salt, water) in Vega Avastha was implemented and significant improvements were seen. After 1 month of follow-up no recurrence have been reported Keywords: Tamaka Swasa, Asnehapoorvaka Vamana, Pippali Saindhava Jala, Dhoomapana, Bronchial Asthma Corresponding Author How to Cite this Article To Browse Sreelakshmi Raj, Post Graduate Scholar, Department of PG Studies in Panchakarma, Sri Kalabyraveshwaraswamy Ayurvedic Medical College and Hospital and PG Research Centre, Vijayanagar, Bengaluru, Karnatak, India Email: Raj S, Supreeth MJ, Goud KM, Role of Sadyo Vamana in Tamaka Swasa - A Case Study . J Ayu Int Med Sci 2025;10(1):236-241 Available From https://jaims.in/jaims/article/view/3965 Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted 2024-12-17 2024-12-27 2025-01-07 2025-01-17 2025-01-26 Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note None Nil Not required 12.78 © 2025 by Raj S, Supreeth MJ, Goud KM and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0] J Ayu Int Med Sci 2025 ; 10 ( 1 ) 236

[Find the meaning and references behind the names: Moha, Raja, Fast, Swamy, Sama]

Introduction Tamaka Swasa is among five types of Swasa and one among the Pranavaha Srothodushti Vikara “ Tama ” means - अंधकार (darkness). During the attacks, the patients feel as if they are entering darkness. Tamaka Swasa is having symptoms such as Peenasa (Rhinitis), Gurghuraka (wheezing sound), Teevra Vega (fast breath) [1 ] , Moha (unconscious), Aruchi (anorexia), Trushna (thirst) In Swasa, there are mainly three factors Karana, Sthana, Moola. [2 ] Karana is Bahya Karana (external factor) which includes Raja (dust) , Dhooma (smoke), pollen etc These enter the respiratory tract and release mast cells. After the rupture of mast cells, surfactants will be the released. These surfactants engulf the foreign body causing the production of cough reflux and plugs the respiratory tract to produce abnormal breathing sounds. Sthana, which include Nabhyadi , can be understood in terms of cardiac, renal and pulmonary problems. Dosha can be understood in terms of predominance of Dosha . Bronchial Asthma is a chronic inflammatory disorder of the airways, associated with recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night and in the early morning [3 ] Paroxysm attacks can last for days to months which results in sleepless nights, thus disturbing the normal lifestyle of the person. The available treatment in modern medical science are bronchodilators, steroids, even in the form of inhalers and leukotrienes modifiers [4] , anti-tussive, expectorants, demulcent’s etc. can be used as instant or symptomatic relief in Bronchial asthma. The pathophysiology of lung diseases is mainly of two types namely, constrictive and restrictive. Asthma is constrictive. The disease originates from Pitta Sthana , which gets localised in Kaphasthana and is characterised by dominance of Kapha and Vata Dosha. [5] Case Report A 44-year-old female patient comes with chief complaints of difficulty in breathing and wheezing sounds for the past 6 years which aggravated in the last 10 days. It is also associated with fever, headache, tiredness and severe cough with sputum and inability to sleep in the past 10 days History of Present Illness Patient was apparently normal before 6 years. One day she got fever, running nose, difficulty in breathing and nausea. For this, she consulted a nearby physician and took some medication [details unknown] which reduced symptoms temporarily. After that she started facing breathing difficulty and cough with expectoration repeatedly which often worsens at night and during cold seasons. During those times, she took one cetirizine tablet and salbutamol syrup and managed symptoms. In November 2023, she had a severe episode of fever, cold, breathing difficulty, cough with expectoration and sleep disturbance. For these complaints, she was admitted to Kaveri hospital, Bangalore. They gave injections, nebulisations and oral medicines [details unknown] which gave some relief. For past 10 days, she has been suffering from difficulty in breathing and wheezing sounds along with fever, head ache, tiredness and severe cough with sputum and disturbed sleep. For same complaints, patient consulted at Sri Kalabyraveshwara Swamy Ayurvedic Medical College Hospital and Research Centre and was admitted on 03/10/2024 Treatment History She was taking cetirizine tablet and salbutamol syrup during the episodes in the past 6 years Past History K/c/o bronchial asthma in the last 6 years n/k/c/o diabetes, hypertension and thyroid dysfunction Personal History Occupation - self-employed [working in an airconditioned room] Diet - mixed / Sama Ahara Habits - Coffee 3-4 times/ day. No alcohol or smoking Examination Table 1: Assessment of General condition Appetite Reduced Bowel Regular, once/ day Micturition Normal Sleep Disturbed Family History All family members are healthy Sreelakshmi R et al. Role of Sadyo Vamana in Tamaka Swasa J Ayu Int Med Sci 2025 ; 10 ( 1 ) 237

[Find the meaning and references behind the names: Mala, Min]

Respiratory System Symmetry - Bilaterally symmetrical. No scar, No swelling, No discoloration. Accessory muscles - sternocleidomastoid muscle used Type of breathing - Thoraco-abdominal breathing Respiratory rate - 24/minute Tenderness - Absent Position of trachea - centrally placed Vocal fremitus - bilaterally symmetrical Resonant over lung field. Cardiac and hepatic dullness noted Wheeze - present [right upper more than left] Vocal resonance - bilaterally symmetrical Respiratory rate - 24/minute Ashtasthana Pareeksha Nadi (pulse) - 68 b/min - Vataja Mala (stool) - Once a day Mootra (urine) - 3-4 times/day Jihwa (tongue) - Liptha Shabda (speech) - Difficulty in talking Sparsha (touch) - Ushna Druk (eyes) - Doosara Varna Akruthi (built) - Madhyama Materials and Methods Source of data: Patient suffering from Tamaka Swasa approached the O.P.D of SKAMCH&RC, Bangalore. IP No: L 36915 Study design : A single case study Assessment: Assessment was done based on signs and symptoms [6 ] of the Tamaka Swasa /Bronchial Asthma Treatment Table 2: Symptoms before Treatment Criteria Present /Absent Breathlessness Present Paroxysm of breathlessness Present Wheezing/ Ronchi Present Cough Present throughout the day Expectoration of sputum Present Nasal symptoms Present Tightness in chest Present Night symptoms like waking in night Present Others 1) Body position Sitting preferably 2) Respiratory Rate 24/ min Table 3: Vamana chart Time Aushadha No of glass Time Vega Contents 6.20 am Pippali Saindhava Jala 5 6.29 am 1 Vega Pippali Saindhava Jala + Kapha 6.30 am Pippali Saindhava Jala 6 6.38 am 1 Vega Pippali Saindhava Jala + Kapha 6.41 am Pippali Saindhava Jala + 1 pinch Madana Phala Choorna 6 6.50 am 1 Upavega Pippali Saindhava Jala + Kapha 6.54 Am Pippali Saindhava Jala + 1 pinch Madana Phala Choorna 2 6.57 am 1 Upavega Pippali Saindhava Jala + Kapha 7.02 Am Pippali Saindhava Jala + 1 pinch Madana Phala Choorna 2 7.06 am 1 Upavega Pippali Saindhava Jala + Kapha 7.10 Am Saindhava Jala 4 7.16 am 1 Vega Saindhava Jala + Kapha 7.18 Am Saindhava Jala 4 7.23 am 1 Vega Saindhava Jala + Kapha Total no of Vega = 4 Total no of Upavega = 3 Result Table 4: Symptoms Before and After Treatment Criteria Before treatment After treatment (next day) Breathlessness Present Mildly present Paroxysm of breathlessness Present Absent Wheezing/ Ronchi Present Absent Cough Present throughout the day Reduced Expectoration of sputum Present Absent Nasal symptoms Present Absent Tightness in chest Present Absent Night symptoms like waking in night Present Absent Others 1) Body position Sitting preferably Comfortable with all postures 2) Respiratory Rate 24/ mint 18/ mint Sreelakshmi R et al. Role of Sadyo Vamana in Tamaka Swasa Inspection Palpation Percussion Auscultation Sthanika Abhyanga with Brihat Saindhavadi Taila for 5 days Sthanika Nadi Sweda with Dashamoola Qwatha for 5 days Sadyo Vamana with Pippali Saindhava Jala for 1 day followed by Dhoomapana with Haridra Kaanda J Ayu Int Med Sci 2025 ; 10 ( 1 ) 238

[Find the meaning and references behind the names: Guna, Eka, Main, Sun, Sneha, Leena]

Discussion The management of Swasa depends upon the Dosha predominance. Here the main Doshas are Vata and Kapha . There are 4 types of patients mentioned by Acharya Charaka like Balavan (Strong), Durbala (weak), Kaphadikya , Vatadikya [7] When the patient is Balavan along with Kaphadikya , Shodhanas like Vamana and Virechana can be administered. The available treatment in modern medical science like bronchodilators, steroids, even in the form of inhalers and leukotriene modifiers along with these anti-tussive, expectorants, demulcent’s etc. can be used for instant or symptomatic relief in Bronchial asthma. Terms mentioned by Charaka like Kapha Nissaraka can be correlated with expectorant, Khani Mardavam Ayathi or Srotho Mardavakara with demulcent. Along with that, in Tamaka Swasa, Vimokshanthe Muhurthe Labhate Sugam [8] is mentioned i.e., after expelling out Kapha , there is a sudden relief of symptoms and therefore, Sadyovamana was planned The Swasa and Kasa (cough) patient is treated with Lavana Taila Abhyanga followed by Nadi , Prasthara or Sankara Swedana [9 ] (types of Swedana ). By means of Swedana , the Grathitha Kapha Vilayana (liquification) will happen. Srothaavarodha (obstruction) is relieved and proper Vatanulomana occurs, just like the liquification of snow by the heat of sun rays in hilly regions [10 ] In this condition, Vamana can be administered with Pippali , Saindhava etc which are Vata Avirodhini [11] The patient who has Kasa along with Swasa are to be treated with Chardhana (vomiting) [12] Charaka mentioned the benefits of Lavanopahitha Sneha [13 ] ( Sneha with salt) which acts in short period of time. It also has Sookshma Guna (minuteness) and therefore it has greater penetration power. Taila is having Ushna Guna (hotness) and act on Vata Dosha without hampering Kapha . Hence Brihat Saindhavadi Taila is the best choice for Abhyanga (Oil massage). Acharya Sushrutha explains Abhyanga ’s mode of action as the Veerya (potency) of drugs absorbed by skin Swedana helps to liquify the Kapha and helps with easy evacuation Due to Swedana , the drugs will penetrate inside via capillary dilation, causing increased circulation leading to waste expulsion In Jwara Chikitsa [14] it is mentioned that, if Doshas are in Utklishta Avastha, Sadyo Vamana can be advised. According to Acharya Sushruta , the Lakshana of Utklesha Avastha is Praseka (watering of mouth) and Shteevana (spitting). By considering all these, Sadyo Vamana can be advised in Vega Kaleena Avastha (during the attack). The main aim for Snehapana (internal oleation) is to do the Utkleshana of the Dosha , but here, already Doshas are in Utklishta Avastha , therefore Snehapoorvaka Vamana is not needed here. In the same context, Chakrapani has mentioned that when Doshas are already in Utklishta Avastha , Snehana and Swedana is not needed or can be done in mild form. There is a reciprocal relationship mentioned as “ वातकृ ा कफहरं कफकृ ाऽिनलापहम् |” [15 ] So, when we need direct Kapha Harana (pacification of Kapha) effect, we can directly plan for Sadyo Vamana Dhoomapana Types Types of Yoga Prayogika Samyak yoga Vairechanika Ayoga Snehika Athiyoga Astanga Sangrahakara specifically mentions Tamboola Sevana with areca nut. It contains arecoline, arecaidine which help to prevent super infection as well as for Kapha Pitta Shamaka Khadira has the properties like antimicrobial, antibacterial and anti-inflammatory property. It balances Kapha and Pitta Sreelakshmi R et al. Role of Sadyo Vamana in Tamaka Swasa Discussion on Chikitsa Sutra Discussion on Brihat Saindhavadi Taila Discussion on Nadi Swedana Discussion on Sadyo Vamana Discussion on Paschat Karma Mukha Pani Pada Prakshalana (washing of face, hands, legs) - for Srama Haranartha (to relieve tiredness) Kavala (gargling) - to remove the Upalepa (coating) in the mouth Dhoomapana [16] (medicated smoke inhalation) - According to Acharya Charaka , to remove the Sheshsa Dosha (remaining Dosha ) and Leena Dosha (concealed Dosha ) , Dhoomapana is advised Thamboola Sevana (chewing betel leaves) - Eka Patram Dwipoogam Khadira Choorna Sammitham Discussion on Samsarjana Krama J Ayu Int Med Sci 2025 ; 10 ( 1 ) 239

[Find the meaning and references behind the names: Deepika, Green]

Peya (thin rice gruel) should be avoided here as it is Kapha Vardhaka (which increase Kapha ). Yusha (soup) is the choice eg: Kulatha Yusha [17 ] (horsegram soup) , Mudga Yushas (green-gram soup) can be advised to patient Conclusion Sadhyo Vamana is an Athyayika (emergency) line of management in Vega Avastha of Tamaka Swasa After proper understanding of Karana, Sthana and Moola , treatment has to be planned. During Vega Avastha , for the Utklishta Avastha Doshas, Sadhyo Vamana will be beneficial, but later Virechana , followed by Rasayana therapy will be more beneficial to treat the disease from the root cause. By adopting modification in diet, as well as lifestyle, will help in preventing the recurrence of the disease References 1. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2023. Chikitsasthana, 17/56. p. 535 [Crossref][PubMed][Google Scholar] 2. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2023. Chikitsasthana, 17/70. p. 536 [Crossref][PubMed][Google Scholar] 3. Walker BR, Colledge NR, Ralston SH, Penman ID, editors. Davidson’s Principles and Practice of Medicine. 22 nd edition. New York: Churchill Livingstone Elsevier; 2014. Chapter 19. p. 666 [Crossref][PubMed][Google Scholar] 4. Clinical Research Protocols for Traditional Health Sciences. Central Council for Research in Ayurveda & Siddha. Section 1, Bronchial Asthma. p. 33 [Crossref][PubMed][Google Scholar] 5. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2023. Chikitsasthana, 17/8. p. 533 [Crossref][PubMed][Google Scholar] 6. Clinical Research Protocols for Traditional Health Sciences. Central Council for Research in Ayurveda & Siddha. Section 1, Bronchial Asthma. p. 43 [Crossref][PubMed][Google Scholar] 7. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2023. Chikitsasthana, 17/88-90. p. 537 [Crossref][PubMed][Google Scholar] 8. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2021. Chikitsasthana, 17/48. p. 535 [Crossref][PubMed][Google Scholar] 9. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2021. Chikitsasthana, 17/71. p. 536 [Crossref][PubMed][Google Scholar] 10. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2021. Chikitsasthana, 17/73. p. 536 [Crossref][PubMed][Google Scholar] 11. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2021. Chikitsasthana, 17/75. p. 536 [Crossref][PubMed][Google Scholar] 12. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2021. Chikitsasthana, 17/121. p. 538 [Crossref][PubMed][Google Scholar] 13. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2021. Sutra Sthana, 13/98. p. 78 [Crossref][PubMed][Google Scholar] 14. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2021. Chikitsasthana, 3/143. p. 410 [Crossref][PubMed][Google Scholar] 15. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2021. Chikitsasthana, 17/149. p. 439 [Crossref][PubMed][Google Scholar] Sreelakshmi R et al. Role of Sadyo Vamana in Tamaka Swasa J Ayu Int Med Sci 2025 ; 10 ( 1 ) 240

[Find the meaning and references behind the names: Kalpana, Kavita, Asha]

16. Acharya Yadavji Trikamji, editor. Charaka Samhita of Agnivesha, Chakrapani Datta’s Ayurveda Deepika (sans). Reprint edition. Varanasi: Chaukambha Orientalia; 2021. Chikitsasthana, 17/77. p. 436 [Crossref][PubMed][Google Scholar] 17. Asha SA, Kavita MB. Therapeutic Applications of Various Yusha Kalpana: A Critical Review. J Ayurveda Hol Med (JAHM). 2016;4(6):15-28 [Crossref][PubMed][Google Scholar] Disclaimer / Publisher's Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of Journals and/or the editor(s). Journals and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content Sreelakshmi R et al. Role of Sadyo Vamana in Tamaka Swasa J Ayu Int Med Sci 2025 ; 10 ( 1 ) 241

Other Health Sciences Concepts:

[back to top]

Discover the significance of concepts within the article: ‘Role of Sadyo Vamana in Tamaka Swasa - A Case Study’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Mudgayusha, Bronchial asthma, Breathing difficulty, Difficulty in breathing, Vata and Kapha, Dosha predominance, Samsarjana Krama, Dhoomapana, Nadi Sweda, Sadyo Vamana, Brihat Saindhavadi Taila, Tamaka Swasa.