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According to Vagbhat, "Prana vaha srotas' chief organs are hridaya (the heart) and mahasrotas (alimentary tract), it gets vitiated by dryness and depletion, suppression of thirst, hunger and other urges. Respiration being increased, decreased, difficult or interrupted, accompanied by pain or sound, are the chief signs of vitiation" (1). Nowadays the respiratory tract is seen as synonymous with the marga or pathway of pranavahasrotas, its root being in the left side of the heart, which receives oxygenated blood from the lungs.
Conditions of prana vaha srotas may occur in either the upper or respiratory tract and may be either easily curable, curable with difficulty, chronic incurable (yapya) or fatal.
Easily curable conditions of prana vaha srotas
Easily curable conditions of prana vaha Srotas include the common cold, hay fever, pharyngitis and laryngitis as well as many forms of influenza. Essentially these conditions fall into the category of abhaisaja sadhya or curable without medicine, since they are typically self-limiting viral infections which resolve within a few days to three weeks to allergies which dissipate when the allergen is absent. However, it is advisable to treat these conditions for two reasons; firstly, to help them resolve more quickly since they cause discomfort and inconvenience and secondly, to prevent complications. Easily curable conditions of prana vaha srotas may invade into deeper dhatus, as when rhinosinusitis localizes into asthi dhatu to create sinusitis proper. They may also move from the upper to the lower respiratory tract to cause conditions such as bronchitis. And they may progress through the stages of samprapti all the way to bheda, to create a dangerous condition such as a lung abscess.
Easily curable conditions of prana vaha srotas can often be managed with the use of home remedies, localized treatments and simple Ayurvedic medicines. Provide your patients with a checklist of products they should have on hand and ways to use them.
(If you are pregnant, diabetic, have high blood pressure or are taking blood thinners, please consult your practitioner before using these remedies)
Nsal Rinse Cup: use for colds, sinus infections and allergies
Neem Soap: Use for hand washing especially during flu season
Natural mineral salt:
· Use in tub to relieve coughs and colds
· Use in neti pot for sinus conditions and allergies
· Use with turmeric as gargle
· Use in steam for coughs
· Use with hot water and salt as gargle for sore throats
· Mix with honey and eat for allergies
· Use with ginger and tulsi as a tea for coughs, colds and flus
Tulsi: Use with ginger and turmeric as tea for coughs, colds and flus
· Use with turmeric and tulsi as a tea for coughs, colds and flus
· Use with baking soda in tub to promote sweating and relieve aches
Licorice: Use as tea for sore throat
Sitopaladi: Use for coughs, colds and flus, half a teaspoon three times daily.
Chyavanprash: Take to aid recovery after colds and flus; or as a preventative to support immunity
Conditions of Prana vaha srotas curable with difficulty
Many acute conditions of prana vaha srotas fall into the bhaisaja sadhya (curable with medicine) category. They can be cured completely but require the intervention of a practitioner to avoid serious complications or even the onset of life-threatening situations. One example is tonsillitis. Once the upper respiratory infection localizes in the tonsils, it may progress rapidly to the vyakti stage, with visibly enlarged and inflamed tonsils. The tonsils and tonsillar fauces (the passage from the mouth to the pharynx) may show either vesicles or yellow spots. Typically vesicles indicate a viral tonsillitis, which usually resolves harmlessly, whereas a high fever, thickly coated tongue and yellow dots may point to a streptococcal throat infection (colloquially known as strep throat). Strep throat may have serious complications at the bheda level ranging from abscessed tonsils to septicemia, organ failure and death. Long-term complications of untreated streptococcal infections may include rheumatic fever (ama vata), rheumatic heart disease and renal disease (glomerulo-nephritis). Use a surgical mask when examining the throat with a tongue depressor. Tonsillitis should be referred to the primary care physician for a throat swab to determine whether there is a streptococcal infection. If so, antibiotics will be prescribed and Ayurvedic herbal therapies can be resumed after completion of the course of antibiotics. Ayurvedic herbs that are active against streptococcus include turmeric (2), ginger (3), and tulsi (4), rendering "Trinity Tea" -turmeric, tulsi and ginger--a good combination for strep throat as well as for viral tonsillitis. For added effectiveness, neem can also be used (5). Mahasudarshan will help clear Ama from the system, as will triphala. After the langhana phase of clearing toxins, Chyavanprash can be used to rejuvenate prana vaha srotas.
Another condition of prana vaha srotas classified as difficult to treat is pneumonia. Suspect pneumonia if a patient comes to you complaining of cough, fever, fatigue, malaise and difficulty breathing. Take careful notes of the respiratory rate. If it is elevated above the normal rate of 15 breaths per minute (in adults), pneumonia may be suspected and a medical referral made. Atypical pneumonia or walking pneumonia may be more difficult to detect since its onset is insidious. I t should be suspected in a patient with malaise and a worsening non-productive cough. In general, pneumonia will initially be managed with Western medical treatments such as antibiotics and may possibly even require a hospital stay to manage respiratory distress. The work of the Ayurvedic practitioner will begin after the patient has been discharged and antibiotics have been discontinued.
To give an example: Patient A is a sixty one year old pitta-kapha woman (V1 P3 K3) with a previous history of smoking, who was admitted to hospital with pneumonia following an overseas vacation where she was exposed to a lot of second hand smoke. She spent 24 hours in intensive care for respiratory distress and three additional days in hospital. After discharge and cessation of antibiotics she sought out Ayurvedic support as she was still fatigued and coughing. She was given a formula that included punarnava as dosha pratyanika (against the dosha) for kapha, tulsi and pippali as vyadhi pratyanika (against the disease) for cough and cinnamon as an adjuvant for kindling prana vaha sroto-agni. She was placed on a kapha soothing and langhana regime but was encouraged to eat easily digestible soups, stews and kitcheris to soothe her provoked vata. After her cough resolved she was till feeling fatigued and drained and at this point was placed on a more rejuvenative regime for prana vaha srotas including twice daily Chyavanprash. As the weather was warming, her formula was changed to include shatavari as a strengthening and building herb as well as punarnava and licorice as lung strengtheners. She was also given an ojas drink which included raisins, well known as lung rejuvenatives.
Non-dairy Ojas drink
- 10 raw almonds
- 2 cups pure water
- 20 raisins
- 1 tsp ghee (rejuvenative)
- 1/32 tsp saffron (increases digestion and rejuvenative)
- 1/8 tsp ground cardamom (increases digestion)
- pinch of black pepper (helps control the Kapha)
- Soak almonds in 1 cup of water overnight, and soak raisins in 1 cup of water either overnight or for several hours
- In the morning, drain off the almond water and rub the skins off the almonds
- In a blender, add the raisins AND their soaking water with the drained and peeled almonds
- Add ghee, saffron, cardamom, black pepper
- Blend until smooth
Drink 3-4 times a week as directed.
Following this period of more intensive rejuvenation she took Lung Formula regularly for some months to continue to strengthen her lungs.
As we have seen, Ayurvedic therapies and home remedies are valuable in easily curable upper respiratory conditions to help speed recovery and return to normal life as well as to prevent complications. In conditions like tonsillitis and pneumonia that are curable with difficulty, Ayurvedic management can be used following the recommended Western medical treatments, to help ensure optimal recovery. Following a serious lung infection requiring hospitalization, some months of treatment may be required to help the patient feel like themselves again. Next month, we will consider chronic conditions of prana vaha srotas and will also consider how to notice and refer potentially fatal respiratory conditions.
1. KR Srikantha Murthy, tr, Asthanga hridayam vol 1 pg 403 Chowkhamba Krishnadas Academy, Varanasi 2004 edition. (Excerpt from Asthanga Sangraha quoted in translator's notes)
2. Nadia Gul ; Talat Y. Mujahid ; Nayyar Jehan ; Samia Ahmad Studies on the Antibacterial Effect of Different Fractions of Curcuma longa Against Urinary Tract Infection Isolates Pakistan Journal of Biological Sciences 20047 12 p 2055-2060
3. Gur, S
Turgut-Balik, D Gur, N Antimicrobial Activities and Some
Fatty Acids of Turmeric, Ginger Root and Linseed Used in the Treatment of
World Journal of Agricultural Sciences [World J. Agric. Sci.]. Vol. 2, no. 4, pp. 439-442. 2006.
5. Vanka, A : Tandon, S : Rao, S R : Udupa The effect of indigenous Neem (Adirachta indica) mouth wash on Streptococcus mutans and lactobacilli growth. Author: Indian-J-Dent-Res. 2001 Jul-Sep; 12(3): 133-44
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