Shwasa Roga – Dyspnoea: Types, Symptoms As Per Ayurveda

Article by Dr Raghuram Y.S. MD (Ay)
Dyspnoea or shortness of breath can be compared to ‘Shwasa Roga’ or ‘Shwasa Krichrata’ explained in Ayurveda. Both mean to say ‘difficulty in breathing’. Generally we use the word Shwasa to describe this condition.

According to Ayurveda, Shwasa (dyspnoea), Kasa (cough) and Hikka (hiccough) are inter-related conditions. They have identical aetiological factors and site of origin. We often find them to be associated with each other.

Shwasa is independently explained as a disease in Ayurveda. In some texts, it shares its space with Hikka.

Swasa forms

Shwasa can occur in 2 forms –
Swatantra Shwasa – Primary Shwasa, wherein Shwasa will get manifested as an independent entity (disease). The disease will have its own set of aetiological factors (nidana), pathogenesis (samprapthi) and symptoms (lakshanas). The treatment lies in prompt diagnosis of the condition and strategically attacking it with suitable set of medicines, treatment, and diet and lifestyle changes.

Paratantra Shwasa – Secondary Shwasa occurs as an effect of some other disease. Here, Shwasa will be a symptom, premonitory symptom, complication or sign of bad prognosis of another disease. Here, the treatment depends on the treatment of the disease (primary) which is at the backdrop shwasa.

Shwasa can be found in the below said conditions –
As Purvarupa (premonitory symptom) in – Rajayakshama (tuberculosis)

Shwasa as Lakshana

Shwasa is seen As Lakshana (symptom) in

• Vataja Apasmara – Epilepsy caused by morbid vata
• Apatantraka – tremors
• Kaphaja and Vataja Arshas – piles or haemorrhoids caused by vitiated kapha and vata
• Pureeshaja anaha – flatulence caused by constipation or obstruction of faeces
• Amashaya gata vata – stomach afflicted by vitiated vata
• Kaphaja udara – abdominal disorder caused by vitiated kapha
• Aharaja udavarta – retrograde or upward movement of vata caused by food
• Udgara nirodhaja udavarta – retrograde or upward movement of vata caused by forcible obstruction of belching
• Kantha shundi – bulging or swelling of palate
• Kshataja kasa – cough caused by chest injury and bleeding within the chest organs
• Vataja grahani – intestinal disorder or sprue caused by vitiated vata (irritable bowel syndrome)
• Tridoshaja chardi – vomiting caused by vitiation of all the 3 doshas
• Antarvega jwara – fever manifested within the body
• Asthigata jwara – fever afflicting and located in the bones
• Gambhira jwara – deep rooted / chronic fevers
• Pachyamana jwara – progressive fevers
• Majjagata jwara – fever afflicting and located in the bone marrow
• Sannipataja jwara – typhoid fever
• Talu shosha – dryness of palate
• Balasa – throat disorder
• Vataja madatyaya – alcoholic intoxication caused by vitiated vata
• Medo roga – errors of fat metabolism
• Pratinaha – nasal congestion
• Nasa shosha – dryness of nasal cavity
• Mutraghata (kundalini) – obstruction of urine
• Raktaja murcha – fainting or unconsciousness caused by vitiated blood or sight of blood
• Rajyakshma – tuberculosis
• Pliha vidradhi – abscess occurring in spleen
• Yakrut vidradhi – liver abscess
• Visha – poisoning
• Agni visarpa – erysipelas or herpes caused by vitiated vata and pitta
• Granthi visarpa – erysipelas or herpes caused by vitiated kapha and pitta
• Tridoshaja nadi vrana – sinus ulcers caused by vitiation of all the 3 doshas
• Swaraghna – throat disorder leading to loss of voice

Shwasa as Upadrava

Shwasa is seen as as upadrava (complication) in

• Atisara – diarrhoea
• Chardi – vomiting
• Trishna – thirst
• Vataja prameha – urinary disorders / diabetes caused by vitiated vata
• Raktapitta – bleeding disorders
• Vatarakta – gout
• Vrana –ulcers,

Shwasa as Asadhya Lakshana

Shwasa is mentioned as Asadhya Lakshana (sign of bad prognosis) in

• Atisara – diarrhoea
• Kumbha kamala – complicated jaundice
• Galaganda – goitre
• Gulma – abdominal tumours
• Chardi – vomiting
• Jwara – fever
• Masurika – small pox
• Rajayakshma – tuberculosis
• Vidradhi – abscess
• Visha – poisoning
• Tridoshaja nadi vrana – sinus ulcer caused by vitiation of all 3 doshas
• Shotha – swelling

Swasa Roga

ShwasaRoga (Primary dyspnoea)
Below mentioned are the important causes for dyspnoea –

• Raja – exposure to dust
• Dhooma – Exposure to fumes and smoke
• Vata – exposure to breeze
• Sheeta Sthana – living in cold places
• Sheeta ambu sevana – excessive consumption of cold water
• Ati hima ambu – chilled or frozen water
• Vyaayaam – excessive physical exercise
• Graamya dharma – Excessive indulgence in sexual activities
• Adhwa – Excessive walking
• Rooksha anna – Excessive consumption of dry foods
• Vishama ashana – consumption of incompatible foods
• Aaama pradosha – excessive accumulation of ama (essence of improperly digested food, immature nutrition in circulation which by virtue of its stickiness tends to block the channels of the body and deplete the body of its nutrients and essential things)
• Aanaha – flatulence
• Roukshyat – excessive dryness of the body
• Ati apatarpanaat – Excessive fasting
• Dourbalya – long standing debility
• Marma ghata – injury to vital areas of the body
• Shuddi ati yoga – excessive administration of cleansing treatments Atisara – diarrhoea
• Jwara – fever
• Chardi – vomiting
• Pratishyaya – cold, congestion, flu
• Kshata – chest injury
• Kshaya – depletion of body tissues
• Raktapitta – Haemorrhagic disorders
• Udavarta – upward movement of vitiated Vayu
• Visuchika – cholera
• Alasaka – lazy stomach
• Pandu – Anaemia, liver disorders
• Visha – poisoning
• Nishpava – consumption of flat beans in excess
• Masha – excessive consumption of black grams
• Pinyaka – residue left out after extracting oil from sesame seeds
• Tila Taila – excessive intake of sesame oil
• Pishta – taking flours in excess
• Shaalooka – Nymphaea alba
• Vishtambhi – excess intake of foods tending to cause constipation
• Vidaahi – foods which are corrosive in nature
• Guru bhojana – foods which are heavy to digest
• Jalaja ahara – meat of aquatic animals
• Aanupa ahara – flesh of animals living in marshy regions
• Dadhi – excess intake of curds
• Ama ksheera – consumption of unprocessed milk
• Abhishyandi ahara – foods which are sticky in nature which tend to obstruct the channels
• Kantha-Ura pratighata – Obstruction or block in throat or chest
• Kasa Vriddhi – aggravation of cough, chronic cough

Poorvarupa

Shwasa Roga Purvaroopa: Premonitory symptoms
Anaha – flatulence, distension of the abdomen
Paarshwa shoolam – pain in the sides / flanks of the body
Hrudaya peeda – heart pain, pain in chest
Pranasya vilomatvam – the vayu running abnormal or retrograde (upward direction)

Bheda

Shwasa bheda: Types of Swasa
Shwas Rog is of 5 types. They are –

• Maha Shwasa
• Urdhwa Shwasa
• Chinna Shwasa
• Tamaka Shwasa
• Kshudra Shwasa

Maha Shwasa

Maha Shwas:
This type of shwasa is marked by strenuous, painful inspiration with loud noises or sounds which are audible. Due to the vitiated vayu moving haphazardly blocking the channels in the body, the person breathes in with difficulty throughout the day and night.

Symptoms –

• Matta rishabha iva – The breathing pattern is compared to the hissing of an intoxicated bull. The person breathes the air with severe discomfort and pain.
• Pranashta gnana vignana – Since the vayu gets blocked, the body is depleted of aeration. The person loses gnana (knowledge) and vignana (skill of differentiation).
• Vibhranta lochana – improper perception or deceptive perception of vision
• Vikruta akshi – abnormalities / deviations in eye
• Vikruta anana – abnormalities / deviations in face
• Badda mutra – obstruction of urination
• Badda varcha – constipation
• Visheerna vaak – split voice, hoarseness of voice
• Deena – helplessness
• Doorat vignayate – the breathing is heard to a long distance
• Kshipra marana – death in quick time

Urdhwa Shwasa

Urdhwa Shwas Rog:
This is a type of shwasa in which there is an imbalance between the input and output of air i.e. inspiration and expiration. The kapha blocks the channels. As a result the vayu gets aggravated and causes Urdhwa Shwasa.

Symptoms

• Deergham shwasati, na pratyaharati dhaha – deep and prolonged inspiration with difficulty in expiration or throwing out the air
• Urdhwa drishti – eye deviated upwards
• Vibhranta aksha – irregular eye movements
• Pramuhyan vedanaartaha cha – fainting or loss of consciousness due to pain
• Shushka asya – dryness of mouth
• Arati – nonspecific pains, discomfort, confusion
• Moha – unconsciousness
• Tamyati – feeling as if in darkness
• Hanta asoon – death in quick time

Chinna Shwasa

Chinna Shwasa
This type of Shwasa manifests with obstructed type of breathing which is severely distressing and painful. When all the prana (life elements) have been blocked and choked in the body due to obstruction of channels, the person breathes interruptedly in splits and parcels.

Symptoms

• Shwasati vichchinnam – split and obstructed breathing
• Na va shwasati – total breathlessness
• Dukhartaha – person in deep grief and distress
• Marma cheda ruk arditaha – the person is afflicted with severe distress and pain as if all his vital organs have been split and damaged
• Aanaaha – flatulence, distension of abdomen
• Sweda – excessive perspiration
• Murcha – fainting
• Basti daha – burning sensation in the urinary bladder
• Vipluta aksha – deviated and fluctuating eye
• Pariksheena – debility, loss of tissues and nutrition
• Rakta eka lochanaha – blood shot eye (single eye)
• Vichetaha – loss of consciousness
• Pari shushka asya – severe dryness of mouth
• Vivarna – discolouration of the body
• Pralaapa – delirium
• Sheeghra mrityu – death in quick time

Kshudra Shwasa

Kshudra Shwasa
This type of Shwasa is characterised by short spells of dyspnoea which is not troublesome. It generally is an accompaniment of strenuous exercises and will pacify after a brief span of rest.
The Vayu vitiated in small proportions following consumption of ruksha ahara (dry foods) or aayasa (exercise or physical activities) afflicts the upper channels of respiration (breathing passages) and cause kshudra shwasa.
Symptoms

• Dyspnoea, which lives for a short period
• The kshudra shwasa will not produce any discomfort in the body parts. It will also not produce any harmful effects / symptoms. The functioning of the body is also not disturbed.
• It doesn’t cause obstruction to the intake of foods or liquids
• It doesn’t cause any trouble to the sense organs or sensory functions (perception)
• This is said to be easily curable and many times doesn’t require any treatment

Tamaka Shwasa

Tamaka Shwasa, Asthma – one of the leading causes of dyspnoea
When the vayu gets vitiated, it starts moving haphazardly in the upward direction (quite unnatural of its behaviour). This abnormally moving vayu occupies and invades all the srotases (channels of transportation in the body). On reaching the head region, the vayu grips the head and neck and also provokes the kapha located in these regions. The provoked kapha along with vayu causes peenasa (cold, congestion). The kapha being blocked in these channels produces sounds. In due course of progression, the kapha blocks the srotases and causes serious dyspnoea of life taking proportions.

Symptoms of Tamaka Shwasa, dyspnoea caused by Asthma

• Pratamyati – When the block in the channels get increased, the dyspnoea gets severe; the person unable to breathe properly would lose consciousness feeling darkness in front of his eyes
• Kasate – cough, severe in nature
• Pramoham – due to persistent cough, the person suffers from loss of consciousness again and again, repeatedly
• Dukhitaha – When the dyspnoea progresses and when the patient is not able to expectorate the phlegm, he finds himself in severe distress
• Kapha vimokshante sukham – But due to repeated coughing, if he is able to expectorate the kapha or blocked phlegm, the person feels relieved
• Kantha udhwamsa – the person, due to repeated cough and dyspnoea would have soreness of throat or loss of voice, it becomes difficult to speak
• Anidra – when the patient suffering from tamaka shwasa sleeps, the dyspnoea becomes severe and he is not able to sleep
• Parshva graham – catch in the flanks due to vitiated vayu
• Aaseeno labhate soukhyam – the person feels better if he changes his position from sleeping to sitting position
• Ushna abhinandati – the person feels better with warm or hot comforts
• Uchrita aksha – elevation of eyes
• Lalata sweda – sweating of forehead
• Vishushka asya – dryness of mouth
• Bhrusha arti – severe discomfort
• Muhuhu shwasa, muhuhu avadhamanam – episodes of breathlessness get severe and suppressed in repeated cycles
• Agravating factors – the breathlessness gets severe in cloudy environment (megha), due to exposure to water (ambu), exposure to cold breeze (sheeta), winds or breeze coming from east (prak vata) and any causes which vitiate kapha (shleshmala)
• Nature and prognosis of Tamaka Shwasa – Tamaka shwasa is said to be yapya (maintainable), it is said to be curable when it is nava utthita (newly manifested or acute)

Yogas Mentioned in Sahasra Yoga Text Book

Shleshma Jvarahara Kashaya
Sannipata Jvaradihara Kashaya
Atisarahara Kashaya
Swasa Kasahara Kashaya
Hikkadihara Kashaya
Panduhara Kashaya
Kaushikokta Rasnadi Kwatha
Kasaswasahara Yavagu
Panchatiktaka Guggulu ghrita
Vrisha Ghrita
Dhanantari Ghrita
Mahakushmanda Ghrita
Lakshadi Taila
Bhringalarkadi Taila
Maha Lakshadi Taila
Amrutadi Taila
Bala Taila
Sudarsana Choorna
Sitopaladi Choorna
Lavangadi Choorna
Maha Khandava Choorna
Swasakasadihara Choorna
Jivantyadi Choorna
Trikatvadi Choorna
Talisapatradi Choorna
Jati Lavangadi Choorna
Hinguvachadi Choorna
Bala Soolari Choorna
Kalyanaka Kshara
Sudha Kandadi Kshara
Draksharishta
Dasamoolarishta
Dhatryarishta
Kumaryasava
Bilwadi Lehya
Kusmanda Rasayana
Manibhadra Guda
Agasthya Rasayana
Chyavanaprasavalehya
Brihadvasavalehya
Bharngyadi Lehya
Punarnavadi Lehya
Vyaghryadi Lehya
Dasamoola Hareetaki Lehya
Gudardraka
Matala Rasayana (Dadima)
Suryaprabha Gutika
Kittadi Gutika
Sarvarogakulantaka Rasa
Neelakanta Rasa
Gaganeshwara Rasa
Jatilingadi Gutika
Dhanvantari Gutika
Bala Kuvaladi Kashaya
Bilwa Dhanyadi Kashaya
Cherupayaradi Kashaya
Panal Veradi Kashaya
Ramacchadi Kashaya
Karimkuringyadi Kashaya
Jariladi KAshaya
Kulatthadi Kashaya
Adalotadi Kashaya
Nayopaya Kashaya
Puvankurunthaladi Eranda Taila
Swasari Taila
Mamsa Sarpi
Amritaprasa Ghrita
Maha Mayura Ghrita

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