Introduction
Bronchial asthma is a chronic respiratory disorder characterized by inflammation and narrowing of the air passages. It remains a significant global health concern, with the World Health Organization reporting approximately 250,000 deaths due to asthma worldwide. The prevalence of asthma has increased considerably in developing countries, rising by nearly 40% every decade over the last 40 years. 1,2
Despite advances in conventional treatment, the chronic nature of the disease and the limitations associated with long-term pharmacological therapy have prompted growing interest in complementary approaches, including Ayurveda.
Conventional management and its limitations
The management of bronchial asthma commonly includes:
- Long-acting beta-2 agonists
- Corticosteroids
- Avoidance of triggering factors
- Inhalation-based therapies
Inhalation therapy is widely utilized because the lungs possess a large surface area, extensive vascularization, and high permeability, allowing rapid pharmacological action of inhaled medications. However, prolonged use of corticosteroids may be associated with adverse effects such as hypothalamic-pituitary-adrenal axis suppression, osteoporosis, infections, diabetes, hypertension, and psychological disturbances. These limitations have increased interest in safer therapeutic options with broader mechanisms of action. 3,4
Ayurvedic understanding of bronchial asthma
Bronchial asthma can be correlated with Tamakshwas, which is described by Acharya Charaka as one of the most acute and severe disease conditions.
Key Ayurvedic concepts associated with Tamakshwas include:
- Predominant involvement of Kapha and Vata Dosha
- Origin in the Aamashay (upper abdomen)
- Manifestation in the Urah (chest), Kanth (throat), and Shir (head)
- Involvement of Pranavaha Strotas, Udakavaha Strotas, and Annavaha Strotas
According to Ayurvedic principles, prolonged exposure to etiological factors leads to vitiation of Pran Vayu along with Kapha, resulting in obstruction of the channels responsible for the movement of vital breath. Prodromal manifestations include abdominal bloating, pain in the lateral chest region, a feeling of compression in the cardiac region, and disturbed respiration.
Ayurvedic therapeutic approaches
Ayurvedic management of bronchial asthma primarily focuses on Shodhana and Shamana therapies.
Commonly described interventions include:
- Virechana (purgation therapy)
- Shamana Chikitsa (pacifying treatment)
- Dhumapana (medicated fumigation therapy)
- Basti (medicated enema)
Dhumapana is an important mode of drug administration in Ayurveda, in which herbal fumes are inhaled through the nose and mouth and exhaled through the mouth. Unlike nebulization, where medicines are delivered in aerosol form, Dhumapana utilizes herbal medicines in a gaseous state to facilitate delivery into the respiratory tract. 5
Clinical relevance of Basti
Bronchial asthma is associated with elevated levels of serum ferritin, tumor necrosis factor-alpha, interleukin-6, interleukin-8, and serum cortisol. Basti therapy has been reported to reduce these parameters, suggesting its potential role in addressing inflammatory and systemic components associated with the disease.
Conclusion
Bronchial asthma remains a major respiratory disorder with substantial global burden. From an Ayurvedic perspective, it closely resembles Tamakshwas, a Kapha-Vata dominant condition involving multiple Strotas. Classical therapies such as Virechana, Shamana Chikitsa, Dhumapana, and Basti provide a structured therapeutic framework aimed at addressing the underlying pathogenesis. The growing interest in herbal inhalation and systemic Ayurvedic interventions highlights their potential relevance in the long-term management of bronchial asthma.6, 7
References:
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2. Shine S, Muhamud S, Demelash A. Prevalence and associated factors of bronchial asthma among adult patients in Debre Berhan Referral Hospital, Ethiopia 2018: a cross-sectional study. BMC Res Notes. 2019;12(1):608. Published 2019 Sep 23. doi:10.1186/s13104-019-4670-9. https://pmc.ncbi.nlm.nih.gov/articles/PMC6757354/
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5. Thatte U, Chiplunkar S, Bhalerao S, et al. Immunological & metabolic responses to a therapeutic course of Basti in obesity. Indian J Med Res. 2015;142(1):53-62. doi:10.4103/0971-5916.162099. https://pmc.ncbi.nlm.nih.gov/articles/PMC4557251/
6. Chaudhary A, Singh N, Dalvi M, Wele A. A progressive review of Sandhana kalpana (Biomedical fermentation): An advanced innovative dosage form of Ayurveda. Ayu. 2011;32(3):408-417. doi:10.4103/0974-8520.93925. https://pmc.ncbi.nlm.nih.gov/articles/PMC3326893/
7. Khobarkar P, Nakanekar A. Acute exacerbation of bronchial asthma with infective focus treated with holistic Ayurveda approach: A case report. J Ayurveda Integr Med. 2024;15(1):100824. doi:10.1016/j.jaim.2023.100824. https://pmc.ncbi.nlm.nih.gov/articles/PMC10945435/#ack0010