The Nidanam dyspapsea ||150||

1DhanvantarI said: -Now I shall discourse on the Nidanam of Dyspnea. Svasa. A case of chronic or aggravated cough may run into one of Dyspnea, or the enraged morbific principles of the body may likewise give rise to this diseased condition.
2-3Difficult breathing may also mark the sequel of Amatisara (mucous dysentery), vomiting, chlorosis, fever, or poisoning, or may be produced as the effect of an exposure to dust storm, smoke, cold wind, or of a blow: on any of the vulnerable amestomoses of nerves, arteries, etc., (Marmas), Dyspnoea may be divided into five different kinds such as Ksudraka, Tamaka, Chinna, Malian, and Urdha Svasa.
4The Vayu (nerve-force), that courses all through the organism, affects the channels of food-carrying, water carrying and breath carrying ducts in the event of its own vessels being obstructed by the deranged Kapham (mucous deposits); and remains incarcerated in the cardiac region, producing dyspnea from the lower end of the stomach.
5An aching pain about the heart and the sides, contrary direction of the breath-wind, long drawn breaths, pain at the temporal bones, and tympanites are the premonitory symptoms of this disease.
6The Vayu, enraged and aggravated by the toils of overeating, and over fatiguing physical labour, obstructs the vessels by enraging and aggravating the deranged Kapham, coursing through them in a contrary direction, and produces the form of difficult breathing known as Kshudra Svasa.
7The enraged Vayu, by exciting the deranged Kapham, lies catching at the head, neck and cardiac region, and produces and aching pain at the sides. A wheezing sound is heard in the throat, and catarrh with fits of fainting and a no relish for food supervene.
8-9The aggravated Vayu · increases the difficulty of breathing, and the patient is seized with a violent fit of cough, feeling a little relief when a little mucous is coughed, or belched out. He is obliged to sit tip, as a liying or recumbent posture tends to aggravate the pain and difficulty of breath. The eyes are turned upward and beads of perspiration break out on the forehead of the patient, testifying to the intense agony be suffers from in this form of disease.
10The lining membrane of the cavity of the mouth gets dry and parched up by constant drawing in of the breath-wind, and the patient evinces a strong desire for hot drinks or food. Winter, rain, east wind, and partaking of phlegm generating food, are set down as the aggravating factors of Asthma.
11The type known as Tamaka Svasa is curable only in a strong patient, but the paroxysm does not speedily abate in the event of there being fever, epileptic fits, rigor, etc., in its company.
12In this type both cough and dyspnea are marked by their virulence. The patient becomes emaciated and complains of a cutting pain at the chest and the Marinas. Perspiration, fainting its, and tympanites with a burning sensation in the bladder are its further characteristics.
13The eyes become red, swollen, and glossy, and are turned downward. The patient complains of a dryness in the throat, and drops down unconscious, moaning in a slow; piteous voice.
14In the type known as Maha-Svasa (Cerebral dyspnea) the patient breathes very hard and upward (with upturned nose) like an infuriated bull.
15The breathing is hard, rapid and hurried and the patient Eyes senseless and almost speechless with is turned upward and stool and urine, are entirely suppressed.
16The throat is dry and parched, respiration becomes hard and rapid, drops of perspiration appear on the forehead, and the patient complains of an excruciating pain at the head and the temples. All chance of recovery should be given up if the patient is found to continue in the state for a while.
17In this type the mouth and ears of the patient are found to be stuffed with mucous, and the eyes under the influence of the aggravated Vayu, are found to roll about in their sockets or are fixed in an upward state. The heart seems as if being tom asunder, and the patient moans for a while and then lies speechless in death.
18Medical treatment t may be useful in this type of dyspnea until the preceding symptoms appear, in which case the physician should think it prudent to retire.