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Management of Tamak Shwas (Bronchial Asthma) by Vaman Karma

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1. Conceptual Understanding

Tamak Shwas - Ayurvedic Perspective

• The disease originates in Pittasthana (small intestine/stomach region)
• It manifests in Kapha Sthana (chest/lungs)
• Pathogenesis: Aggravated Kapha causes Srothorodha (channel obstruction), which blocks the natural downward movement of Prana Vayu, pushing it upward (Pratiloma Vata), resulting in wheezing and breathlessness

• Shwasa (dyspnea with wheezing sound)
• Kasa (cough)
• Tamak (sense of darkness/suffocation during attack)
• Muhur muhur Shwasa (repeated respiratory distress)
• Vishama Shwasa (irregular breathing)
• Kantha Ghurghurak Shabda (gurgling sounds in throat)
• Pinasa (rhinitis-like symptoms)

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2. Rationale for Vaman Karma in Tamak Shwas

1. Kapha is the dominant Dosha - Vaman is the gold-standard Shodhana for excess Kapha. Since Tamak Shwas is primarily a Kapha-dominant disorder, Vaman directly addresses the root cause.
2. Srothorodha (channel obstruction) clearance - The patient craves free flow of Prana Vayu. Vaman physically expels the accumulated Kapha from the Pranavaha Srotas, Annavaha Srotas, and Rasavaha Srotas.
3. Utklesha mechanism - Vaman removes vitiated Kapha in its Utklishtavastha (liquefied/mobilized state) from the upper body channels.
4. Charaka Samhita reference - Vaman is the first-line treatment specifically for the Utkleshitavastha (acute/exacerbation phase) of Tamak Shwas.
5. Ashtanga Hridayam recommends Mrudu Vaman in Shwasa conditions after proper Sudation.

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3. The Complete Vaman Karma Protocol (Step-by-Step)

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Phase 1 - Poorvakarma (Pre-operative Procedures)

A. Deepana-Pachana (Appetizer-Digestive therapy) - Days 1-3

• Aim: To correct Agni (digestive fire), digest Ama (undigested toxins), and prepare the body
• Drug used: Trikatu Churna (Pippali + Maricha + Shunthi) - 3g, three times daily with lukewarm water after meals
• Duration: 3 days

B. Snehapana (Internal Oleation) - Days 4-10 (variable)

• Aim: To loosen vitiated Doshas from tissues and move them toward the Koshtha (gastrointestinal tract) for easy elimination
• Substance: Cow's ghee (Go Ghrita), starting 30ml on Day 4, increasing daily
• Samyaka Snigdha Lakshana (signs of adequate oleation):
  • Snigdha (oiliness/luster in stool)
  • Mrudu Koshtha (soft abdomen)
  • Kaya Laghava (lightness of body)
  • Oleation felt in skin/face
• Duration: typically 5-7 days until adequate Snehana signs appear

C. Abhyanga and Swedana (External Oleation & Fomentation) - 1-3 days

• Abhyanga: Full-body massage with Bala Taila or Sesame oil - promotes further loosening of Doshas
• Bashpa/Vashpa Swedana: Steam fomentation (whole-body) - dilates channels, further liquefies Kapha
• Done morning and evening according to patient strength

D. Samsarjana (Pre-Vaman diet preparation) - Night before Vaman

• Kapha Bahula Ahara (Kapha-enhancing diet): curd (Dadhi), milk (Dugdha), sugarcane juice, Abhishyandi foods
• Aim: To further aggravate/mobilize Kapha so it is easily expelled
• Patient avoids heavy physical activity and emotional stress

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Phase 2 - Pradhana Karma (Main Vaman Procedure)

On the day of Vaman:

Vaman Dravyas (Emetic Formulations) used in Tamak Shwas:

1. Madanaphala Churna (most commonly used) - Randia dumetorum fruit powder - the classic emetic
2. Ikshvaku Ksheera Yoga - Lagenaria siceraria (bottle gourd) seed + milk - highly effective, studied in clinical trials; described as potent for self-projecting Vega (emetic bouts)
3. Pippali Churna - used as an adjunct with Vaman
4. Madanaphaladadhi Yoga - Madanaphala + curd combination
5. Lavana Jala (salt water) - used in Sadyovamana (emergency/immediate vamana)
6. Trikatu + Honey - used in some formulations

Standard Vaman Drug Preparation (Ikshvaku Ksheera Yoga):

• Ikshvaku seed powder: 3-6g with warm milk (250-500ml)

Vega Assessment (number of emetic bouts):

Samyak Vaman Lakshanas (Signs of Adequate/Proper Vamana):

• Laghuta (lightness of body)
• Shodhana of Kapha, Pitta
• Clear emergence of Pitta (yellow bile) at the end of vomiting
• Prasanna Indriya (clarity of sense organs)
• Hridaya Shuddhi (clarity of mind/chest)
• Kanta Shuddhi (throat clarity)
• Relief in breathlessness and wheezing (immediate symptom relief)

Signs of Atiyoga (Excessive Vamana) - to be avoided:

• Rakta (blood) in vomitus
• Excessive weakness, fainting (Murcha)
• Shiro Ruja (severe headache)
• Kantha Shosha (extreme throat dryness)

Signs of Ayoga (Inadequate Vamana):

• Gurgling sounds in abdomen persist
• No lightness felt
• Cough and breathlessness not relieved
• Less bouts than expected

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Phase 3 - Paschat Karma (Post-operative Management)

A. Samsarjana Krama (graduated dietary regimen) - 3-7 days

B. Dhoomapana (Medicated smoking) post-Vaman

• Specific medicated smoking preparations are used post-Vaman in Shwasa to further clear Pranavaha Srotas
• Examples: Haridra, Vacha, Ela, Twak

C. Shamana Chikitsa (Palliative medicines) after Vaman:

• Kantakari Avaleha
• Sitopaladi Churna + honey
• Chyavanprasha (Rasayana)
• Vasavaleha
• Agastya Haritaki Avaleha
• Shwaskas Chintamani Rasa (classical formulation)
• Pushkaramoola Churna (Inula racemosa)

D. Rasayana therapy (Rejuvenation)

• Chyavanprasha
• Agastya Haritaki
• Pippali Vardhamana Rasayana

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4. Types of Vaman for Tamak Shwas

Regular Vaman (Niyata Vaman)

• Full Poorvakarma protocol (Snehapana + Swedana)
• Best for chronic/stable cases
• Pravara/Balavan patients preferred

Sadyovamana (Immediate Vaman)

• Emergency procedure - performed without full Poorvakarma
• Indicated in Vegavastha (acute asthma attack)
• Drug: Lavana Jala (salt water) or other quick-acting emetics
• Clinical studies show significant effectiveness in acute episodes
• Particularly useful when the patient presents in acute distress

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5. Patient Selection & Contraindications

Indications (Yogya - suitable patients):

• Kapha-dominant constitution (Kapha Prakriti)
• Utkleshitavastha (exacerbation phase) of Tamak Shwas
• Relatively strong patients (Bala - good physical strength)
• Age group: 16-55 years (typical range in studies)
• Disease chronicity up to 10 years (studied)

Contraindications (Ayogya - unsuitable patients):

• Durbala (very weak/debilitated patients)
• Balavriddha (very young children and very elderly)
• Garbhini (pregnant women)
• Hridaya Roga (heart disease)
• Unmada/Apasmara (psychiatric conditions, seizure disorders)
• Ati Sthula (morbidly obese) or Ati Krisha (extremely emaciated)
• Urdhvaga Raktapitta (bleeding disorders with upward tendency)

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6. Clinical Evidence

• Breathlessness scores
• Cough severity
• Rhonchi on auscultation
• Lung function parameters (FEV1, FVC, PEFR)

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7. Mode of Action - Modern Interpretation

1. Expulsion of mucus plugs - Forceful emesis physically clears mucus/sputum from bronchial tree, similar to chest physiotherapy
2. Anti-inflammatory effect - Reduced inflammatory mediators (Pitta pacification corresponds to reduction in inflammatory cytokines)
3. Vagal reflex modulation - Emesis triggers vagal activity that can reduce bronchospasm
4. Immunomodulation - Ghee used in Snehapana has demonstrated anti-inflammatory, immunomodulatory properties
5. Gut-lung axis - Cleansing the gastrointestinal tract (origin site of the disease in Pittasthana) may reduce systemic inflammation reaching the lungs
6. Microbiome modulation - Panchakarma has been postulated to positively affect gut microbiome, reducing allergic sensitization

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8. Classical Textual References

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Summary

1. Deepana-Pachana (3 days) - correct Agni, digest Ama
2. Snehapana (5-7 days) - internal oleation with cow's ghee to mobilize Kapha
3. Abhyanga + Swedana (1-3 days) - loosen and liquefy Doshas
4. Kapha Bahula Ahara (night before) - maximize Kapha for expulsion
5. Vaman Karma (procedure day) - with Ikshvaku Ksheera Yoga or Madanaphala Churna
6. Samsarjana Krama (3-7 days post) - graduated dietary rehabilitation
7. Shamana + Rasayana - long-term maintenance

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Management of Tamak Shwas by Vaman Karma - With Samhita References (Brihattrayi)

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Part I - Nidana (Etiology) as per Samhitas

Charaka Samhita - Nidana Sthana Ch. 17 / Chikitsa Sthana Ch. 17

Dhuma (smoke), Raja (dust), Ativyayama (excessive exertion), Sheeta Sthananivasa (cold dwelling), Guru Bhojana (heavy diet), Sheeta Bhojana (cold food/drinks) - these factors vitiate Vata which then vitiates Kapha, obstructing the Pranavaha Srotas.

Kapha avrtah Vayuh - "Vata is captured by the Avarana (covering/obstruction) of Kapha" - this is the fundamental mechanism. The obstructed Vata moves in Pratiloma gati (reverse/upward direction) causing breathlessness.

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Part II - Lakshana (Signs & Symptoms) as per Samhitas

Charaka Samhita - Chikitsa Sthana 17/55-62 (Sanskrit Shlokas)

प्रतिलोमं यदा वायुः स्रोतांसि प्रतिपद्यते | ग्रीवां शिरश्च संगृह्य श्लेष्माणं समुदीर्य च ||५५|| करोति पीनसं तेन रुद्धो घुर्घुरुकं तथा | अतीव तीव्रवेगं च श्वासं प्राणप्रपीडकम् ||५६||

प्रतम्यत्यतिवेगाच्च कासते सन्निरुध्यते | प्रमोहं कासमानश्च स गच्छति मुहुर्मुहुः ||५७|| श्लेष्मण्यमुच्यमाने तु भृशं भवति दुःखितः | तस्यैव च विमोक्षान्ते मुहूर्तं लभते सुखम् ||५८||

• Throat choked, unable to speak (Kricchrat Bhashitum)
• Cannot sleep lying down; gets relief in sitting posture - आसीनो लभते सौख्यम् (Aseeno Labhate Soukhyam) (17/60)
• Eyes upturned (Ucchritaksha), profuse sweating on forehead
• Prefers warm things (Ushnam Chaivabhinandati)
• Aggravated by clouds, cold water, cold breeze, and Kapha-aggravating diet
• "स यापयस्तमकश्वासः साध्यो वा स्यान्नवोत्थितः" - "Tamaka Shwasa is Yapya (palliable); it may be Sadhya (curable) if of recent origin" (Ch.S. Chikitsa 17/62)

Ashtanga Hridayam - Nidana Sthana Ch. 4/6-10

Tamaka Shwasa Lakshana - described with Ghurghuruka, Pinasa, Shirogaurava, Kricchrat Bhashitum consistent with Charaka; Vagbhata places origin at Amashaya Sambhava (Chakrapani's commentary aligns this with Pittasthana). (A.H. Nidana Sthana 4/6-10)

Sushruta Samhita & Madhava Nidana

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Part III - Vaman Karma Chikitsa - Samhita References

A. Charaka Samhita - Chikitsa Sthana 17 (Primary Reference)

Step 1 - Snehana-Swedana first (Poorvakarma):

Acharya Charaka (Ch.S. Chikitsa 17): "First of all, Snehana (oleation) and Swedana (fomentation) should be done and then Vaman Karma must be performed to remove the vitiated Kapha." (Ch.S. Chikitsa Sthana 17/8)

Step 2 - Primary Shodhana Chikitsa:

"कासश्वासग्रहण्यर्शः श्लेष्मण्युत्क्लिष्टे तु वामनम्" "When Kapha is in Utklishtavastha (aggravated/liquefied state), Vamana should be administered."

Step 3 - Vaman followed by Virechana (Charaka's unique sequence):

"कासे श्वासे स्वरभेदे च वमनं बुद्धिमान् नरः | तमके तु विरेचनम् ||१२१||" "यथा जलप्रवाहस्य रुद्धस्य महती गतिः | तथा कफनिरोधेन वायोः स्यादतिवर्धनम् | तस्मात् सर्वप्रयत्नेन वायोः पन्थाः शोधयेत् ||१२२||"

• "A wise physician should administer Vamana in Shwasa associated with Kasa (cough) and Swara Bheda (hoarseness of voice); and Virechana specifically in Tamaka Shwasa."
• "Just as the flow of a river, when obstructed, rises with great force and breaks the dam - similarly, when the path of mobile Vayu is blocked by Kapha, the Vayu gets greatly aggravated and causes harm. Therefore, with all effort, the channels of Vayu must always be cleansed." (Ch.S. Chikitsa 17/121-122)

Important Clarification: Charaka's sequence is: Vamana first (as emergency measure / Vegavastha treatment) to expel obstructing Kapha, followed by Virechana with Vata-Kaphahara dravyas for Avegavastha (inter-ictal/stable phase) to cleanse Pittasthana (the origin site).

Step 4 - Haritaki in Tamaka Shwas:

"फलत्रिकं च" - "Haritaki is indicated in Tamaka Shwasa." (Haritaki forms the base of many post-Shodhana Rasayana formulations)

Step 5 - Patient Classification for Shodhana:

Charaka divides Tamaka Shwasa patients into two categories for treatment selection:

• Kapha-dominant, Balavan (strong) patients: Vamana and Virechana (Shodhana therapy)
• Vata-dominant, Durbala (weak) patients: Tarpana (nourishing) and Shamana only; Shodhana only if absolutely essential

Final shloka of Shwasa Chikitsa (Ch.S. Chikitsa 17/91): "Brimhana (nourishing/anabolic therapy) is the best option for Tamaka Shwasa patients compared to Shamana and Karshana." (Ch.S. Chikitsa 17/91)

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B. Ashtanga Hridayam - Reference for Mrudu Vamana

Vagbhata prescribes Mrudu Vamana (mild emesis) in Shwasa conditions. After completion of proper Sudation (Swedana), the patient should be given diet with unctuous substance (Snigdha Ahara) - boar's meat (Varahamamsarasa) and the supernatant fatty layer of curd (Dadhi Santanika). (A.H. Chikitsa 4/57-58)

Vagbhata's general principle of Vamana procedure - defines Samyak (adequate) Vamana Lakshanas used in all Kaphaja disorders including Tamaka Shwasa. (A.H. Sutra Sthana 18/25)

Vagbhata's description of Tamaka Shwasa Samprapti - Amashaya Sambhava, Kapha-Vataja mechanism. (A.H. Nidana Sthana 4/3)

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C. Sushruta Samhita - Reference for Vamana Indication

In this chapter, while describing the indications for Vamana, Acharya Sushruta includes Shwasa Vyadhi (respiratory disorders) among the conditions requiring emetic therapy. However, Sushruta does not describe the detailed procedure for Vamana specifically in Tamaka Shwasa as Charaka does. Sushruta advises both Vamana and Virechana for Shwasa management broadly.

Sushruta also describes medicated Ghrita Kalpanas (ghee preparations) for Shamana Chikitsa in Shwasa, which complement post-Vaman management.

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Part IV - Samhita-Referenced Treatment Protocol Summary

Phase 1 - Poorvakarma (Charaka Ch.S. Chikitsa 17/8)

Phase 2 - Pradhana Karma (Vamana)

Phase 3 - Paschat Karma

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Part V - Shatyadi Churna and Other Formulas (Ch.S. Chikitsa 17/123-124)

शटीचोरकजीवन्तीत्वङ्मुस्तं पुष्करह्वयम् | सुरसं तामलक्येला पिप्पल्यगुरु नागरम् ||१२३|| वालकं च समं चूर्णं कृत्वाऽष्टगुणशर्करम् | सर्वथा तमके श्वासे हिक्कायां च प्रयोजयेत् ||१२४||

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Part VI - Concept of Yapya vs. Sadhya (Prognosis per Samhitas)

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Quick Reference - Key Samhita Chapters

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तामक श्वास (ब्रोंकियल अस्थमा) का वमन कर्म द्वारा प्रबंधन

संहिताओं के संदर्भ सहित

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भाग १ - तामक श्वास का परिचय एवं निदान

शब्द व्युत्पत्ति

धातु: "तमग्लानौ" (पाणिनि) - जिसका अर्थ है दुःख, घुटन, अंधकार।

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निदान (कारण) - च.सं. चिकित्सा स्थान १७

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सम्प्राप्ति (रोगोत्पत्ति)

निदान सेवन
    ↓
वात-कफ प्रकोप (पित्त स्थान / आमाशय में)
    ↓
कफ द्वारा वात का आवरण
"कफावृत वायुः"
    ↓
प्राणवह स्रोतस में अवरोध (Srothorodha)
    ↓
वात की प्रतिलोम गति (उल्टी दिशा में)
    ↓
तामक श्वास

च.सं. चिकित्सा १७: "वात कफज विकार है; उत्पत्ति स्थान - पित्त स्थान (आमाशय)" सु.सं. एवं माधव निदान: "कफ प्रधान व्याधि"

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भाग २ - तामक श्वास के लक्षण - संहिता श्लोकों सहित

चरक संहिता - चिकित्सा स्थान १७/५५-६२

प्रतिलोमं यदा वायुः स्रोतांसि प्रतिपद्यते। ग्रीवां शिरश्च संगृह्य श्लेष्माणं समुदीर्य च॥५५॥ करोति पीनसं तेन रुद्धो घुर्घुरुकं तथा। अतीव तीव्रवेगं च श्वासं प्राणप्रपीडकम्॥५६॥

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प्रतम्यत्यतिवेगाच्च कासते सन्निरुध्यते। प्रमोहं कासमानश्च स गच्छति मुहुर्मुहुः॥५७॥ श्लेष्मण्यमुच्यमाने तु भृशं भवति दुःखितः। तस्यैव च विमोक्षान्ते मुहूर्तं लभते सुखम्॥५८॥

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"स यापयस्तमकश्वासः साध्यो वा स्यान्नवोत्थितः" "तामक श्वास याप्य (नियंत्रण योग्य) है; यदि नया हो तो साध्य (ठीक होने योग्य) हो सकता है।" (च.सं. चिकित्सा १७/६२)

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अष्टाङ्ग हृदयम् - निदान स्थान ४/३, ६-१०

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भाग ३ - वमन कर्म का औचित्य (Rationale)

क्यों वमन? - संहिता प्रमाण

कासे श्वासे स्वरभेदे च वमनं बुद्धिमान् नरः। तमके तु विरेचनम्॥१२१॥ यथा जलप्रवाहस्य रुद्धस्य महती गतिः। तथा कफनिरोधेन वायोः स्यादतिवर्धनम्। तस्मात् सर्वप्रयत्नेन वायोः पन्थाः शोधयेत्॥१२२॥

• "बुद्धिमान वैद्य को कास, श्वास और स्वरभेद में वमन देना चाहिए; तामक श्वास में विरेचन देना चाहिए।"
• "जैसे रुके हुए जल-प्रवाह का वेग बढ़कर बाँध को तोड़ देता है - उसी प्रकार कफ के अवरोध से वायु अत्यंत प्रकुपित होकर हानि पहुँचाती है। इसलिए सब प्रकार से वायु का मार्ग (प्राणवह स्रोतस) शुद्ध करते रहना चाहिए।"

चरक का क्रम: पहले वमन (तीव्र/वेगावस्था में) → फिर विरेचन (अवेगावस्था में) वात-श्लेष्महर द्रव्यों से।

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वमन कर्म की उपयुक्तता के कारण:

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भाग ४ - वमन कर्म की सम्पूर्ण विधि

पूर्वकर्म (प्रारंभिक प्रक्रियाएँ)

१. दीपन-पाचन (दिन १-३)

• औषधि: त्रिकटु चूर्ण (पिप्पली + मरीच + शुण्ठी) - ३ग्राम, भोजन के बाद गर्म जल से
• उद्देश्य: अग्नि को सुधारना, आम का पाचन करना
• (च.सं. चिकित्सा १७ के अनुसार प्रथम चरण)

२. स्नेहपान (आंतरिक स्नेहन) - दिन ४-१०

• द्रव्य: गो-घृत (गाय का घी) - प्रारंभ में ३०मिली, प्रतिदिन बढ़ाते हुए
• उद्देश्य: धातुगत दोषों को कोष्ठ में लाना
• सम्यक स्निग्ध लक्षण (पर्याप्त स्नेहन के चिह्न):
  • मल में चिकनाई (स्निग्ध मल)
  • शरीर में हल्कापन (काय लाघव)
  • त्वचा पर चमक आना
  • अरुचि, उकाई आना

३. अभ्यंग + स्वेदन (दिन १-३, प्रधान कर्म से पूर्व)

• अभ्यंग: बला तैल या तिल तैल से सम्पूर्ण शरीर का मर्दन
• बाष्प स्वेदन: भाप से स्वेदन - कफ और वात को द्रवित करता है
• (अ.हृ. चिकित्सा स्थान ४/५७-५८ का अनुसरण)

४. कफ बहुल आहार (वमन से एक रात पूर्व)

• दही, दूध, गन्ने का रस, उड़द से बनी वस्तुएँ
• उद्देश्य: कफ को और अधिक उत्क्लिष्ट (mobilize) करना

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प्रधान कर्म (वमन की मुख्य प्रक्रिया)

वमन विधि (क्रमशः):

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वमन द्रव्य (च.सं. कल्प स्थान १/५ के अनुसार)

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वेग मूल्यांकन (च.सं. कल्प स्थान)

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सम्यक् वमन लक्षण (अ.हृ. सूत्र स्थान १८/२५)

• लाघव - शरीर में हल्कापन
• प्रसन्न इन्द्रिय - इंद्रियों की स्पष्टता
• हृदय शुद्धि - हृदय/छाती में स्वच्छता
• कण्ठ शुद्धि - गले की शुद्धि
• श्वास में तत्काल राहत - घरघराहट में कमी
• वमन के अंत में पित्त का आना (पीला द्रव्य)

अतियोग लक्षण (अधिक वमन - हानिकारक):

• वमन में रक्त आना
• अत्यधिक दुर्बलता, मूर्च्छा
• शिरोरुजा (तेज सिरदर्द)

अयोग लक्षण (अपर्याप्त वमन):

• पेट में गुड़गुड़ाहट बनी रहना
• शरीर में हल्कापन न आना
• श्वास और खाँसी में राहत न मिलना

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भाग ५ - पश्चात् कर्म (वमन के बाद की देखभाल)

संसर्जन क्रम (आहार पुनर्स्थापना) - च.सं. सिद्धि स्थान

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विरेचन (अवेगावस्था में) - च.सं. चिकित्सा १७/१२१

• अरग्वध (Cassia fistula) - मृदु विरेचन, कफघ्न, वातानुलोमन (च.सं. के अनुसार सर्वश्रेष्ठ मृदु विरेचन)

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धूमपान (च.सं. चिकित्सा १७)

• हरिद्रा, वचा, एला, त्वक् आदि से निर्मित धूम

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शमन चिकित्सा (वमन के बाद दीर्घकालीन नियंत्रण)

शटीचोरकजीवन्तीत्वङ्मुस्तं पुष्करह्वयम्। सुरसं तामलक्येला पिप्पल्यगुरु नागरम्॥१२३॥ वालकं च समं चूर्णं कृत्वाऽष्टगुणशर्करम्। सर्वथा तमके श्वासे हिक्कायां च प्रयोजयेत्॥१२४॥

• कण्टकारी अवलेह
• सितोपलादि चूर्ण + मधु
• वासावलेह
• अगस्त्य हरीतकी अवलेह
• च्यवनप्राश (रसायन)

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रसायन चिकित्सा (च.सं. चिकित्सा १/३३)

"फलत्रिकं च" - "हरीतकी तामक श्वास में उपयोगी है।" (च.सं. चिकित्सा स्थान १/३३)

• हरीतकी (च.सं. चिकित्सा १/३३)
• च्यवनप्राश
• अगस्त्य हरीतकी
• पिप्पली वर्धमान रसायन

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भाग ६ - सद्योवमन (आपातकालीन वमन - वेगावस्था में)

• द्रव्य: लवण जल (नमक का पानी)
• वमन कर्म अत्यंत प्रभावकारी है वेगावस्था में क्योंकि तब दोष पहले से ही उत्क्लिष्ट होते हैं

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भाग ७ - रोगी वर्गीकरण - च.सं. के अनुसार

च.सं. चिकित्सा १७/९१ (अंतिम श्लोक): "बृंहण चिकित्सा तामक श्वास में शमन और कर्षण से श्रेष्ठ मानी गई है।"

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भाग ८ - साध्यासाध्यता (रोग की प्रकृति)

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संहिता संदर्भ सारणी

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सार: चरक संहिता के चिकित्सा स्थान के १७वें अध्याय (हिक्का-श्वास चिकित्सित) में तामक श्वास का वमन कर्म द्वारा प्रबंधन सबसे विस्तृत और प्रमाणिक रूप से वर्णित है। चरक की वह अमर उपमा - "जैसे रुके हुए नदी के जल का वेग बाँध तोड़ देता है, वैसे ही कफावृत वायु हानि पहुँचाती है - इसलिए वायु का मार्ग सदा शुद्ध रखें" (१७/१२२) - वमन कर्म की अनिवार्यता का सर्वश्रेष्ठ प्रमाण है।