A critical review on dhoomupahat-understanding smoke inhalation injury

Dhoomupahat is a condition described in classical Ayurvedic literature, refers to pathological effects arising from exposure to inhaled smoke (Dhooma), particularly when used improperly or encountered in toxic environments. In the current era of increasing air pollution, industrial hazards, and fire-related injuries, this concept holds significant clinical relevance. According to different Ayurvedic texts, such as Charaka Samhita, Sushruta Samhita, and AshtangaHridaya, Acharyas have elaborately described the etiological factors, clinical manifestations, and complications associated with improper inhalation of smoke. Especially Acharya Charaka and Acharya Vagbhatta emphasizes on the role of Mithya Dhoomapana and its systemic effects, whereas AcharyaSushruta provides a more clinically oriented description, highlighting acute respiratory compromise and features resembling asphyxiation. The pathogenesis of Dhoomupahat primarily involves vitiation of Pranavaha Srotas, leading to obstruction, impaired gaseous exchange, and systemic hypoxia. These descriptions show strong parallels with modern concepts of smoke inhalation injury and acute respiratory distress syndrome (ARDS), including airway inflammation, alveolar damage, and oxygen deprivation.