RESPIRATORY DISEASES

DR. Shekhar Annambhotla BAMS, MD (Ayurveda), CMT, RYT

FACILITATOR

Dr. Shekhar Annambhotla, B.A.M.S., M.D.(Ayurveda), R.Y.T. – 500, CMT

Director & Founder

Ojas, LLC Ayurveda Wellness Center

567 Thomas Street, Coopersburg, PA 18036email: doctorshekhar@gmail.com

Website: www.ojas.us

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LordDhanvantari

God of Ayurveda

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“Namāmi dhanvantari mādi dēvamsurā surair vandita pāda padmam

loke jara ruk bhaya mrutyu nāsham dātaramēsham vividoushadēnām”

I bow and humbly request Lord Dhanvantari, who is the embodiment of perfect health -- respected by

great seers and evil people -- to remove old age, disease, fear and death through His divine presence

in all natural herbal medicines.

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DeviSaraswati

God of Education

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“ Saraswati namastubhyam varade kāma roopini vidyārambham karishyāmi

siddhirbhatatu mānasa”

I offer deepest respect and great reverence to divine mother Saraswati, who fulfills my desires

and provides perfection in my education.

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Pranavaha Srotas – Respiratory system

Main locations – Nose, Trachea, Lungs

Etiology of vitiation:

• Dust, pollen, polluted air, sun, cold weather,

• injury to the chest,

• excessive intake and exposure to cold substances,

• excessive exertion,

• suppression of natural urges, malnutrition,

• Ama, krimi (bacteria, parasites, fungi etc.)

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Vata imbalance –

• Dryness, roughness, pain in nose, throat and trachea;

• anemia,

• hoarseness of voice, aphonia (loss of speech);

• lightness, pain, cavitations,

• inflated with air of lungs, dilatation of bronchii, emphysema, pneumothorax

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Pitta imbalance –

• Foul discharge from nose, throat, trachea

• ulcerations, suppuration

• hemorrhage, burning sensation

• inflammation

• abscess formation in lungs

• cancer

• hemothorax

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Kapha imbalance –

• Excessive, thick, mucous secretions from nose, throat, trachea, obstruction, itching, edema, polyp, tumors

• disorders of smell

• consolidation of lungs, tumors, edema, and hydrothorax

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Important diseases of the Pranavaha Srotas –• Nose, nasal passages – Common cold, rhinitis, nasal obstruction,

nasal dryness, nasal ulcerations, nasal polyp, tumors, cancer, epistaxis

• Throat – Tonsillitis, enlarged uvula, inflammation of the throat, adenoids, tumors, cancer, diphtheria, pharyngitis, laryngitis, hoarseness, and aphasia

• Trachea, bronchi – Tracheal obstruction, trachiitis, bronchitis, bronchial asthma

• Lungs – Pneumonia, tuberculosis, abscess, pulmonary edema, embolism, corpulmonale, emphysema, cancer, whooping cough, dyspnea

• Pleurae – Pleurisy, hydrothorax, hemo-thorax, emphysema

• Respiratory disorders are considered “Swasa Roga” in Ayurveda

• Aggravated and vitiated Kapha-Vata accumulates in upper respiratory tract, lungs, sinuses, leading to several respiratory disorders

• In general, Kapha-Vata pacifying measures such as food, herbs, behavior help to alleviate respiratory problems

• Even though respiratory disorders are of Kapha-Vata type, its revelations starts from the Stomach (Pitta location)

• The several srotas involved are:–Pranavaha srotas - The channels that

carry Prana,the breath or life-force

• Udakavaha srotas - The channels that carry water or regulate water metabolism

• Annavaha srotas - The channels that carry food

• Raktavaha srotas - The channels that carry blood

ETIOLOGICAL FACTORS

• Foods - Aharaja Hetu• Regimen - Viharaja Hetu• Cause of other diseases - Nidanarthakara

Hetu

FOODS

• Dry, rough diet• Irregular diet• Taking large quantities of foods very

frequently• Fasting• Excessive intake of cold and/or hot foods• Constipating foods, i.e.,tubers

• Intake of sesame oil• Irritant foods• Pungent, sour, salty, foods• Beans, black gram (maasha)• Starchy preparations• Heavy foods• Aquatic meat

• Marshy meat• Yogurt• Raw milk• Channel blocking foods• Kapha increasing foods• Unctuous, oily foods

REGIMEN

• Exposure to dust, smoke, wind, fire• Residing in cold places• Over exercise• Excessive sexual intercourse• Excessive evacuation• Walking long distances• Injury to the chest

• Lifting or carrying heavy weights• Suppression of natural urges• Injury to vital organs (marmas)• Night vigil• Excessive heat• Day sleep

Cause of other diseases

• Accumulation of gas• Ama disorders• Weakness• Diarrhea• Fever• Vomiting

• Coryza • Surgery to the chest• Upward movement of flatus• Gastroenteritis• Intestinal torpor• Anemia

• Constipation• Hemorrhagic disorders• Edema• Wasting• Abdominal disorders

Commonly Used Ayurvedic Herbs

• Anti asthmatics & Broncholytics:–Vasa - Adhatoda vasica–Bramhi - Bacopa monniera– Shallaki - Boswellia serrata–Haridra - Curcuma longa–Dugdhika - Euphorbia hirta

–Ashwattha - Ficus religiosa–Tulasi - Ocimum sanctum–Kutki - Picorrhiza kurroa–Pippali - Piper longum–Kantakari - Solanum xanthocarpumAtitussive:– Shatavari - Asparagus racemosus

VASA (Adhatoda vasica)

• Ayurvedic properties:–Taste (Rasa) - Bitter, Astringent–Quality (Guna) - Light, Dry–Potency (Veerya) - Cooling–Post digestive effect (Vipaka) - Pungent–Dosha action - Pacifies Kapha, Pitta–Part used - Leaves

• Bronchodilatory and antiasthmatic activity:–Vasicine showed bronchodilatory activity

both in vitro and in vivo, the activity being comparable to that of theophlline.• Gupta OP, et.al 1977 Pharmacological investigations of vasicine

and vasicinone - the alkaloids of Adhatoda vasica. IJMR 66(4):680

–Vasicine, however, showed bronchodilatory activity in vitro but bronchoconstriction in vivo. The two alkaloids in combination had a more potent brochodilatory activity and the combination of vasicinone with aminophylline also had an additive effect• Bhalla HL, et.al 1982 Preformulation studies III. Vasicinone, a

brochodilatory alkaloid from Adhatoda vasica Nees (absorption, potency and toxicity studies). Drug Dev. Indian.Pharm 8(6):833

–Adhatoda vasica reduced ovalbumin and: PAF-induced allergic reactions. A fraction containing the minor alkaloid vascinol and about 20% vasicine inhibited ovalabumin -induced allergic reactions by about 37% at a concentration of 5 mg.• Mullar A. et. Al 1993 Chemistry and pharmacology of the

antiasthmatic plants. Galpinia glauca, Adhatoda vasica, Picrorrizha kurroa. Planta Medica 59S:A586

Bramhi (Bacopa monneri)

• Ayurvedic properties:–Taste (Rasa) - Bitter–Qualities (Guna) - Light, Unctuous–Potency (Veerya) - Ushna–Post digestive effect - Pungent–Dosha effect - Pacifies Kapha and Vata–Part used - Leaves

– Effects - Nerve tonic, diuretic, anti anxiety agent, cardiotonic, –Beneficial in - • Bronchial asthma• Hoarseness of voice• Epilepsy• Insanity• Intellect promoter• Anti anxiety agent

• Bronchodilatory activity:– An ethanol extract dilated the bronchial smooth

muscles of anaesthetized rats, counteracting bronchoconstriction induced by carbachol. This property reduced expiratory pressure, resembling salbutamol rather than isoprenaline in manner. The action may be mediation through both adrenoceptor dependent and independent mechanisms.• Dar A, et. Al 1999 Calcium antagonistic activity of Bacopa

monniera on vascular and intestinal smooth muscles of rabbit and guinea pig. Journal of Ethnopharmacology 66 (2): 167

SHATAVARI (Asparagus racemosus)

• Ayurvedic properties:–Taste (Rasa) - Sweet, Bitter–Quality (Guna) - Heavy, Unctuous–Potency (Veerya) - Cooling–Post digestive effect (Vipaka) - Sweet–Dosha effect - Pacify Pitta and Vata and

promotes Kapha

• Antitussive activity:– The methanolic extract of the root, at a dose

of 200 and 400 mg/kg PO, showed significant antitussive activity in sulphur dioxide-induced cough in mice. The cough inhibition of 40% and 58.5%, respectively, was comparable to that of 10-20 mg/kg of codeine phosphate, where the inhibition observed was 36% and 55.4%, respectively.• Mandal SC et.al 2000 Antitussive effect of Asparagus

racemosus root against sulfur dioxide-induced cough in mice. Fitoterpaia 71(6):686

SHALLAKI (Boswellia serrata)

• Ayurvedic properties:–Taste (Rasa) - Astringent, Bitter, Sweet–Qualities (Guna) - Light, Dry–Potency (Veerya) - Hot–Post digestive effect (Vipaka) - Pungent–Dosha action - Balances Kapha, Pitta–Part used - Oleo-gum resin, bark

• Antiasthmatic activity:– In a double-blind, placebo-controlled study,

40 patients of both sexes in the age range 18-75 years, and with a mean duration of bronchial asthma of 9.58 years, were treated with a preparation of gum resin (300 mg thrice daily) for a period of 6 weeks. Seventy percent of patients should some improvement as evidenced by their disappearance of physical symptoms such as dyspnoea and number of attacks.

– There was an improvement in biochemical parameters including a decrease in eosinophil count and ESR. The control group of 40 patients were treated with lactose (300 mg thrice daily) for 6 weeks and of these, 27% showed some improvement.• Gupta I, et.al 1998 Effects of Boswellia serrata gum resin in

patients with bronchial asthma: the of a double-blind, placebo-controlled, 6 week clinical study. European Journal of Medical Research 3(11):511

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Questions & Answers

PIPPALI (Piper longum)

• Ayurvedic properties:–Taste (Rasa) - Pungent–Qualities (Guna) - Light, Unctuous,

Sharp–Potency (Veerya) - Slight cold–Post digestive effect (Vipaka) - Sweet–Dosha action - Pacifies Kapha, Vata–Part used - Fruit

• Antiasthmatic activity:– Studies have been carried out to validate the

traditional claims of Ayurveda for antiasthmatic activity of piper longum. An extract of the fruits in milk reduced passive cutaneous anaphylaxis in rats and protected guinea pigs against antigen-induced bronchospasm.• Kulashreshta VK et. al. 1969 A study of central stimulant

effect of Piper longum, Indian Journal of Pharmacology 1(2):8

• Kulashreshta VK et.al. 1971 Analysis of central stimulant activity of Piper longum. Journal of Research into Indian Medicine 6(1):17

KUTKI (Picrorrhiza kurroa)

• Ayurvedic properties:–Taste (Rasa) - Bitter–Quality (Guna) - Light, Dry–Potency (Veerya) - Cold–Post digestive effect - Pungent–Dosha effect - Pacifies Kapha, Pitta–Part used - dried root

• Antiasthmatic activity:– P.kurroa has been studied extensively for its

antiasthmatic activity.• Kulkarni ED et. Al 1976 Studies of antiasthmatic potentials of

P.kurroa in comparison with disodium chromoglycate. Aspects of Allergy and Applied Immunology 9:231

• Rajaram D 1975 A preliminary clinical trail of P.kurroa in

bronchial asthma. Indian Journal of Pharmacology 7:95

– The activity has been attributed to compounds such as androsin and apocynin, which have been shown to inhibit allergen- and PAF-induced broncho constriction.• Wagner H. 1994 New potent anti-asthmatic constituents

from higher plants. Second International Symposium on Innovations in Pharmaceutical Sciences and Technology. Ahmedabad, Feb 25-27

• Stuppner H. 1991 Antiasthmatic effects of P. kurroa: inhibition of allergen and PAF induced bronchial obstruction in guinea pigs by androsin, apocynin and structurally related

compounds. Planta Medica 57(2):A-60

– The antiallergic and antianalphylactic activity of Picroliv has also been investigated in vitro and in vivo. A dose of 25 mg/kg inhibited passive anaphylaxis in mice and rats and protected mast cells from degranulation, but bronchospasm induced by histamine could not inhibited.• Baruah CC et. Al 1988 Anti-allergic and antianalphylactic

activity of Picroliv, as standardized iridoid glycoside fraction of Picrorrhiza kurroa. Pharmacology Research 38 (6):487

– A pilot study of 10 patients with acute bronchial asthma given a dose of 160 mg powder twice daily produced evidence of objective and subjective improvement.• Shah BK, et. Al 1977 Preliminary report of use of P. kurroa

root in bronchial asthma. Journal of Postgraduate Medicine 23(3):118

– In another study in 20 patients, the crude extract of P. kurroa roots reduced the frequency and severity of asthmatic attacks and the need for regular bronchodilators.• Yegnanarayana R. et.al., Study of Picrorrhiza kurroa in cases

of bronchial asthma. Bombay Hospital Journal 24(2):15

ASHWATHA (Ficus religiosa)

• Ayurvedic properties:– Taste (Rasa) - Astringent– Qualities (Guna) - Heavy, dry– Potency (Veerya) - Cold– Post digestive effect (Vipaka) - Pungent– Dosha effect - Pacifies Kapha, Pitta– Part used: Bark

• Parasympatholytic and antiasthmatic activity: A 95% ethanolic extract of the bark relaxed the intestines of the rat, guinea pig, rabbit and dog and their uterus of the rat. It antagonised the spasmolytic effect of acetylcholine (Ach), histamine, barium chloride and serotonin, blocked the cardiovascular effects of Ach and protected guinea pigs against Ach and histamine induced asthma.– Malhotra CL, et. Al. 1960 Parasympatholytic activity of Ficus

religiosa. Indian Journal of Medical Research 48:734

• When tested on the blood pressure of anaesthetised dog, it had vagolytic activity and antagonised Ach, but not histamine. The extract also relaxed the bronchial musculature and antagonised Ach induced spasm in tracheal chain of the dog.– Malhotra CL. et.al. 1960 Effects of Ficus religiosa on smooth

muscles. Indian Journal of Physiology and Pharmacology 4:130

• The dried, powdered interior bark of Ficus religiosa has been suggested as a treatment for they symptoms of bronchial asthma in humans.– Patel JR. et al. 2000 Compositions for treatment of asthma

containing Ficus religiosa bark admixed with rice pudding. US Paten No. 6149914

HARIDRA (Curcuma longa)

• Ayurvedic properties:– Taste (Rasa) - Bitter, pungent– Qualities (Guna) - Light, dry– Potency (Veerya) - Hot– Post digestive effect (Vipaka) - Pungent– Dosha action - Balances Tridosha– Part used - Root powder

• Anti allergic activity:– Antiallergic activity in curcuma extract has

been reported.• Yano S. et. Al. 1996 Proceedings of the 2nd International

Congress on Phytomedicine, Munich, September 11-14.

Antiasthmatic activity:• Oral administration of the volatile oil was found

to be clinically effective in cases of bronchial asthma.– Jain JP, et al 1990 A clinical trail of volatile oil of Curcuma longa

Linn. (haridra) in cases of bronchial asthma (Tamak Swasa). Journal of Research in Ayurveda and Siddha 11(1-4): 20

• A protective effect by curcumin (200 mg/kg for 7 days) on rat lung, against toxicity induced by cyclophosphamide, has been observed.– Venkatesan N, et.al. 1995 Modulation of cyclophosphamide-

induced early lung injury by curcumin, an anti-inflammatory antioxidant. Molecular and Cellular Biochemistry 142:79

• Ayurvedic properties:– Taste (Rasa) - Sweet– Qualities (Guna) - Unctuous– Potency (Veerya) - Cold– Post digestive effect (Vipaka) - Sweet– Dosha effect - Pacifies Pitta– Part used - Whole plant

Anti asthmatic activity:– The drug is reported to have a relaxation

effect on the bronchial tubes and a depressant action on respiration.• Chopra RN. Et. Al 1994. Indigenous drugs of India, Academic

Publishers, Calcutta

TULASI (Ocimum sanctum)

Ayurvedic properties:– Taste (Rasa) - Pungent, Bitter– Qualities (Guna) - Light, Dry– Potency (Veerya) - Hot– Post digestive effect (Vipaka) - Pungent– Dosha action - Pacifies Kapha and Vata– Part used - Leaves, seeds

Anti asthmatic activity:• A 50% hydro alcoholic extract and the volatile oil

extracted from fresh leaves were evaluated against histamine and Ach induced pre-convulsive dyspnoea in pigs. Both the extract and the oil exhibited a significant dose-dependent anti-asthmatic activity, with the percentage protection shown by 200 mg/kg of ethanol extract of fresh leaves equivalent to 0.5 ml of volatile oil.

The volatile constituents of the fresh leaves were thought to be the main factor responsible for the activity.– Singh S et. Al. 1991 Anti-asthmatic and anti-inflammatory

activity of Ocimum sanctum, International Journal of Pharmacognosy 29(40):306

• Anti-stress activity of Ocimum Sanctum– The plant Ocimum sanctum has been found to

posses adaptogenic (anti-stress) properties when tested against a battery of tests in mice and rats. The drugs increased the physical endurance (increased survival time) of swimming mice, prevented stress induced ulcers in rats, protected mice and rats against carbon tetra chloride induced hepatotoxicity, prevented milk induced leucocytosis in mice.

The result of the study indicated that O. sanctum induces a state of non-specific increased resistance against a variety of stress induced biological changes in animals.

“ K.P. Bhargava et.al. Indian J. Medical Research March 1981 page 443-451”

KANTAKARI(Solanum xanthocarpum)

Ayurvedic properties:– Taste (Rasa) - Pungent, bitter– Qualities (Taste) - Light, sharp, dry– Potency (Veerya) - Hot– Post digestive effect (Vipaka) - Pungent– Dosha action - Pacifies Kapha and Vata– Part used - Whole plant

Anti asthmatic and respiratory activity:– A whole plant extract of Solanum

xanthocarpum produced a significant improvement in certain parameters of pulmonary functions in asthmatic subjects.• Govindan S, et.al. 1999 A pilot study on the clinical efficacy

of Solanum xanthocarpum and Solanum trilobatum in bronchial asthma. Journal of Ethnopharmacology 66 (2): 205

– Clinically the herb has also proved to be useful in treating individuals with cough and bronchial asthma.• Vector NP et.al. 1971 Solanum xanthocarpum (Kantakari) in

chronic bronchitis, bronchial asthma and non-specific unproductive cough (an experimental and clinical co-relation). Journal of the Association of Physicians of India 19(10):741

ALLERGIES

• Affect 37 million people• Ayurvedic Samprapti (pathogenesis),

allergies are doshic reaction to specific allergens

• Spring, later summer very reactive

• Common allergens are- Germination of trees, grasses and ragweed, chemicals on rug, walls, dust, smoke, fire, sun, strong chemical smell

• Common complaints - Sneezing, itching, red eyes, swelling, obstruction of the nose, fever

• Allergic reaction leads to imbalance of either Vata, or Pitta or Kapha

VATA ALLERGIESSigns & Symptoms

• Flatulence• Gastric discomfort• Intestinal colic• Sudden wheezing

• Sneezing• Headache• Tinnitus• Insomnia– Predominant in Winter & Autumn/Fall seasons

Management• Herbal compound:– Ashwagandha (Withania somnifera) - 2 parts– Bala (Sida cordifolia) - 1 part– Vidari Kanda (Ipomoea digitata) - 1 part– Yastimadhu (Glycyrrhiza glabra) - 1 part– Haritaki (Terminalia chebula) - 1 part• 1/4 teaspoon TID with warm water before meals

• For severe wheezing -– 1/4 teaspoon ginger (Zingiber officinale)– 1/4 teaspoon Yastimadhu (Glyceriza glabra)– 1/4 teaspoon Pippali (Piper longum)– 1 cup hot water – 1 pinch salt– 1/2 teaspoon Mahanarayana oil or plain

sesame oil• Panchakarma: Basti (Enema) -– Dashamoola decoction

PITTA ALLERGIESSigns & Symptoms

• Rash• Itching, Hives• Urticaria• Allergic dermatitis• Eczema– Predominant in Summer season

Management• Blood cleansing: Equal portions of:– Manjishta (Rubia cordifolia) - 3 parts– Nimba (Azadirachta indica) - 1 part – Turmeric (Curcuma longa) - 2 part– Amalaki (Phyllanthus emblica) - 2 parts– Guduchi (Tinospora cordifolia) - 1 part• Beneficial for Allergic skin problems

(dermatitis, eczema)

• Blood purification:– Burdock tea - three times daily

• For excessive Pitta: Herbal compound:– Avipattikara - 4 parts– Shatavari (Asparagus racemosus) - 4 parts– Guduchi (Tinospora cordifolia)- 2 parts– Bhumyamalaki (Phyllanthus niruri) - 2parts• 1/2 teaspoon powder with warm water before

meals three times daily

• Dermotological problems - – Dermatitis, eczema, hives, rash, urticaria• Apply liberally Neem oil externally on the skin.• Rose water for cooling effect on the skin

• Panchakarma: – Raktamokshana • (Blood letting / blood donation): Donate 1/2 pint or

100 cc blood to blood bank.

• Virechana (Purgation therapy):• 2 tablespoons Castor oil or Flax seed oil or Olive

oil • 1/4 teaspoon dry ginger powder • 1 cup hot milk / soy milk / rice milk

– Bed time for 3 consecutive days

KAPHA ALLERGIESSigns & Symptoms

• Hay Fever• Colds• Congestion• Cough• Sinus infection• Asthma– Predominant in Spring season

Management• Herbal compound: – Sitopaladi - 4 parts– Tulasi (Ocimum sanctum) - 2 parts– Yastimadhu (Glycyrrhiza glabra) - 2 parts– Kantakari (Solanum xanthocarpum) - 1part– Vasa (Adhothoda vasica) - 1 parts– Bibhitaki (Terminalia belerica) - 1part • 1/2 teaspoon three times daily with honey before

meals– Upper respiratory problems - Cough, cold, congestion,

asthma, hay fever

• Panchakarma: Vamana (Vomiting therapy)– Licorice tea with rock salt, drink full stomach– Rub or irritate the back of the tongue to induce

vomiting reflux– Can be done in Kapha period (6:00 am - 10:00 am)– In west it is not well accepted, where in India well

practiced.• Avoid in people - history of heart problems, surgeries,

high blood pressure, low blood pressure, hiatal hernia, inguinal hernia, pregnancy

Tri-dosha Allergies

– Triphala - Combination of three fruits• Haritaki - Balances Vata• Amalaki - Balances Pitta• Bibhitaki - Balances Kapha

Dietary Regimen

– Vata allergy - Vata pacifying foods– Pitta allergy - Pitta pacifying foods– Kapha allergy - Kapha pacifying foods

Viruddha Ahara (Contradictory/Incompatible foods)

Avoid combination of:– Milk with - Yogurt, fish, sour fruits, bread

with yeast– Meat, Poultry with Diary products– Honey & Ghee in equal proportions– Corn with dates, raisins, bananas– Nightshades (potato, tomato, eggplant) with

yogurt, milk, melon, cucumber– Fruits, Melons with Starches, Grains

e.g.: banana milk shakes, fruit smoothies etc.

Avoid causative factors:– Common allergens - pet hair, pollen, mold,

dust, smoke, fire, sun etc.,– Synthetic fibers - polyester, rayon

Arrest Allergens:– Nasal drops - Ghee / Sesame oil– Application of neem oil on the skin

• Breathing exercises– Sukha Pranayama - Alternative nostril

breathing - hay fever, wheezing, sneezing– Bhastrika Pranayama - Congestion– Ujjayi Pranayama - Improve immunity

• Yoga Postures– Surya Namaskar (Sun salutations) - Kapha,

Vata problems– Chandra Namaskar (Moon salutations) - Pitta

problems

• Stress Management– Meditation

COMMON COLD, FLU

• Kapha - Vata disorder• Predisposing seasons– Winter, Spring

• Signs & Symptoms– Runny nose, cough, congestion, headache, body

aches, loss of appetite, poor digestion, chills, occasional fever

Management• Herbal compound:– Dry ginger powder - 1 part– Cinnamon - 1 part– Amalaki - 1 part• Steep 1 teaspoon in 1 cup of hot water for about

10 minutes, strain, mix in 1 teaspoon honey, drink several times a day

• For enhancing digestion:– Fennel seed powder - 1 part– Natural sugar - 1 part• 2-3 times daily with warm water before meals

• Nasal decongestant tea:– Turmeric 1 part– Ginger - 2 part– Cinnamon - 3 parts– Cardamom - 1 pinch• Make tea with honey and drink several times a

day.

• Decongestant inhalation:– 1 teaspoon ginger or 10 drops eucalyptus oil

in 1 a pint of hot boiling water. Inhale steam

• Herbal compound:– Sitopaladi - 1 part– Mahasudarshan choorna - 1 part– Amalaki - 2 parts• 1/2 teaspoon powder with warm water before

meals, three times daily

Septilin (HimalayaUSA) in Pharyngitis:• A double blind, placebo controlled clinical trial was

conducted in 50 patients with chronic non-specific pharyngitis as assess the efficacy of Septilin in comparison to Actifed, an antihistamine-decongestant formula. Based on the clinical assessment and patient’s score at the end of three months. Septilin was found effective in 68% of the cases compared to Actifed, which was effective in 40% of the cases. Septilin was well tolerated and no side effects were observed.– Nehru V. Septilin Versus Actifed in Chronic Non-Specific

Pharyngitis. Ind.Pract.2001: 54(7):501-505

• Nasal drops:– Liquid ghee (clarified butter) 3- 4 drops in

each nostril • for lubrication, relieving irritation, sneezing

• Sipping hot water several times a day– helps to remove toxins

• Completely avoid dairy products• Take sufficient rest, relaxation

• Pranayama: Breathing exercises:– Bhastrica – Alternative nostril breathing

• Mild exercises– Sun salutations– Inverted & Forward bend postures - • Paschimothana Asana (Shoulder stand)• Hasta Pada Asana (Hands leg pose)

– Removes postnasal drip, helps to drain mucous from the nose

SINUSITIS• Signs & Symptoms:– Aggravated Kapha blocks sinuses, leads to:• Sinus headaches• Snoring • Difficulty breathing• Ear infections• Sleep apnea• Post nasal drip• Brain infection• Meningitis

MANAGEMENTHerbal Compound:– Sitopaladi - 4 parts– Mahasudharshan - 3 parts– Trikatu - 2 parts– Tulasi - 2 parts• Take 1/2 teaspoon of mixture with warm water

three times daily, before meals, for 3 months

Herbal Decongestant:– Fresh ginger juice - 1 teaspoon– Lemon juice - 2 teaspoons– Honey - 3 teaspoons

Herbal Antibiotic:– Talisadi - 3 parts– Haridra (Curcuma longa) - 2 parts– Pippali - 1 part– Yastimadhu - 2 parts• 1/2 teaspoon with warm water three times daily,

before meals

Sinus Headache:– External application of 1/2 teaspoon

cinnamon with enough water to make a paste, twice daily

Sinus congestion & Pain:– Fresh garlic juice nasal drops - 2 drops in each

nostril twice daily in the morning & evening.

Avoid:– Dairy products - cheese, yogurt, ice cream– Ice cold drinks– Leftover foods– Exposure to cold weather– Smoking cigarettes

Favor:– Instill 2 drops of melted Ghee in each nostril– Pungent, bitter, astringent tastes– Sipping warm/hot water throughout the day– Light dinner

BRONCHIAL ASTHMACausative factors:• Allergens - pollen, dust, animal hair,

various foods• Increase of Kapha in entire body• Cold• Congestion• Cough• Hay fever

• Increased Kapha in stomach, moves to lungs, trachea, and bronchi, thereby blocking the natural flow of air, creating spasms in the bronchial tree and resulting in bronchial asthma and wheezing.

• Ayurvedic management for bronchial asthma is to move the excessive Kapha located in the lungs and bronchi back to the stomach, from which it can be easily eliminated through Vamana and Virechana programs.

ManagementHerbal Compounds:– For excessive mucus in the mouth, throat,

stomach:• Ginger powder - 1 part• Yastimadhu - 1 part

– 1/2 teaspoon with warm water twice daily, before meals

For Excessive wheezing, difficulty in breathing:Recipe 1:- Trikatu - 1 part- Shallaki - 1 part- Haridra - 1 part- Yastimadhu - 1 part- Cinnamon - 4 parts• 1/2 teaspoon powder with 1 teaspoon honey twice

daily, before meals

Recipe 2:- Onion juice - 1 part- Honey - 2 parts

Take 1 teaspoon 3-4 times daily

Recipe 3:– Shatavari - 2 parts– Kantakari - 2 parts– Dugdhika - 2 parts– Bramhi - 2 parts– Tulsi - 2 parts• 1/2 teaspoon powder with honey 3-4 times daily

Acute Dyspnoea:– Sitopaladi - 4 parts– Pippali - 1 part– Kutki - 1 part– Vasa - 4 parts• 1/2 teaspoon mixed with honey and 1/2 cup

spinach juice 3-4 times daily, before meals

• External application on chest:– Massaging warm mustard oil with pinch of

salt into chest• Broncho-dilation effect, relieves congestion

• Kapha reducing tea:–Mustard seed powder - 1 part–Pippali powder - 1 part• 1/4 teaspoon with 1/2 teaspoon honey and

1 cup warm water 3-4 times daily

Home Remedy:– Organic red apple - 1– Cloves - 10• Insert cloves into apple and bake for 10-15

minutes, until it becomes soft and peel the skin of the apples and mash well, take 2 tablespoons 2-3 times daily after meals.– Helps to remove excess Kapha in lungs and stomach.

Respicare (HimalayaUSA)• A placebo-controlled clinical trial was conducted in

patients with chronic asthma using E-721B, a polyherbal formulation. E-721B was administered at a dose of 2 tablets, twice daily, for 12 weeks. A gradual reduction in severity of cough, a dyspnoea, wheezing and rhonchi and relief from bronchospasm was seen in a majority of patients after treatment with E-721 B

• E-721B (Respicare) contains Albizzia lebbeck, Tylophora indica, Glycyrrhiza glabra, Solanum xanthocarpum and Rhus succedanea.

– Albezzia lebbeck posses mast cell stabilizing properties

– Glycyrrhiza glabra effective in chronic bronchitis, chronic cough, antihistamnic and expectorant properties

– Solanum xanthocarpum has anti-inflammatory activity, useful in inhibiting bronchial hyperactivity and mucosal oedema.

– Tylophora indica has anti-allergic activity along with membrane stabilizing and bronchodilator effects.

– Rhus succedanea has been used in the treatment of cough, fever and chronic asthma• S.C. Agarwal, R.H. Singh, Indian Journal of Clinical Practice

Vol.12 N.5, October 2001

Avoid:– Dairy products - cheese, milk etc.– Kapha aggravating foods - salt, cucumber,

tuna fish– Junk foods with lots of sugar– Saturated fats, trans-fatty acids– Consumption of meats, margarine, fried

foods, commercial popcorn, commercial baked goods

– Unsaturated vegetable oils - corn, safflower– Smoked, cured, barbecued, and grilled foods– Mushrooms, peanuts, walnuts, other nuts,

yeast– Dusty books, moldy basements, some

chemicals.

YOGA ASANAS FOR RESPIRATORY SYSTEM

General: Shiva Asana (Relaxing pose)Bhujanga Asana (Cobra pose)Shalabha Asana (Grasshopper pose)Sarvanga Asana (Shoulder stand pose)

Vital capacity of lungs:Bhujanga Asana (Cobra pose)Shalabha Asana (Grasshopper pose)

Asthma, Bronchitis, Allergies, Hay fever: • Sarvanga Asana (Shoulder stand pose)• Shalabha Asana (Grasshopper pose)• Bhujanga Asana (Cobra)• Vajra Asana (Diamond)

Throat, Tonsils: • Bhujanga Asana (Cobra pose)

Quick reference Ayurvedic Medicines for Common Respiratory Disorders

Bronchial Asthma• RespiCare - Himalaya - 1-2 tablet/twice daily

• Lung Formula - Banyan - 1-2 tablet/twice daily• Protection Plus Respiratory system - MAPI• Nasya oil - Banyan - 2-3 drops in each nostril

Constipation

Triphala - Banyan - 2 tab / bedtimeVegelax - Himalaya - 2 tab / bedtimeElim-Tox - MAPI - 2 tab / bedtimeHerbal Cleanse - MAPI / 2 tab / bedtime

Immunity

ImmuneCare / Jr - Himalaya - 1-2 tab with meals/twiceBio-Immune - MAPIImmune Support - BanyanChavanprash - Banyan

Allergies, Hay Fever, Common cold

Flu Season Defense - MAPISeptilin - HimalayaSniffle Free - MAPIAller-Tabs - MAPI

Sinusitis

Protection Plus Sinuses - MAPISeptilin - Himalaya

Cough, Pharyngitis

Koflet - Himalaya - 1-2 lozenges/thrice dailyThroat Ease - MAPI - 1-2 lozenges/thrice dailySeptilin - Himalaya - 1-2 tablet/twice daily

Digestion, Flatulence, GasGastrim - HimalayaDigest Ease - BanyanTricot - BanyanHerbal Di-Gest - MAPI - 1-2 tab/twice/with mealsHingwastak - Banyan - 1-2 tab/twice/with meals

Stress, Insomnia

Geriforte - Himalaya - 1-2 tab/twice/with mealsStress Ease - Banyan - 1-2 tab/twice/with mealsTranquil Mind - Banyan - 1-2 tab/twice/with meals

REFERENCE BOOKS

• Elizabeth M. Williamson, Major herbs of Ayurveda, Churchill Livingstone publication 2002.

• Sairam TV 1999 Home remedies, Penguin India, New Delhi

• Sivarajan VV, Balachandran 1994 Ayurvedic drugs and their plant sources, Oxford and IBH Publishing, New Delhi

• Kapoor LD 1990 Handbook of Ayurvedic medicinal plants, CRC Press, Boca Raton

• Ministry of Health and Family Welfare 1989 Ayurvedic pharmacopoeia of India, Government of India, New Delhi

• Ross 1 1999 Medicinal plants of the World, Humana Press, Totowa, New Jersey

• Rastogi RP, Mehrotra BN 1993 Compendium of Indian medicinal plants, PID, New Delhi

• Bharatiya Vidya Bhavan’s Swami Prakashananda Ayurveda Research Center 1992 Selected medicinal plants of India, Chemexcil, Mumbai

• Thakur RS, Puri HS, Husain A 1989 Major medicinal plants of India, CIMAP, Lucknow

• Nadkarni AK 1976 Indian materia medica. Popular Prakashan Pvt. Ltd. Bombay

• Chopra RN et.al 1994 Indigenous drugs of India. Academic publishers, Calcutta

• Pandey GS (ed) 1998 Bhavaprakash Nighantu. Chaukhambha Bharati Academy, Gokul Bhawan, Varanasi