Prodromal symptoms of cough:
Throat and mouth as if covered with awns, itching in throat and difficulty in intake of food.
Vayu impeded from below moves to the upper channels, attains character of the udaan vayu and sticks in throat and chest. Further it advances to all the orifices of head and filling them produces breaking pain and jerking in the whole body particularly causing strain and stiffness in jaws, carotid region, orbits, eye balls, back, chest and sides. Thus dry or phlegmy cough arises. Kasa is so called because of producing the above movements and affliction.
Types of Cough: Five types of cough
- Three caused by three doshas
- The fourth caused by chest wound and
- Fifth by wasting.
When advanced they are fatal
Causative factor, Sign and Symptoms according to type of Kasa
|Vataj Kasa||Intake of rough, cold, astringent, little and deficient food, fasting, excess coitus, suppression of urges and exertion are exciting causes of vatika kasa||
Dry cough causing intense pain in cardiac region, sides, chest and head, hoarseness of voice, dryness of chest, throat and mouth, horripilation, feeling of darkness, sound like that of conch or clouds, anxious expression, debility, irritation and fainting. The paroxysm diminishes after expectorating the dry phlegm with difficulty. It gets relieved after intake of unctuous, sour, salted and hot food and drinks. After the food is digested(on empty stomach) and the wind is directed upwards, vataj kasa becomes forceful.
Excessive intake of pungent, hot, burning, sour and alkaline substances, anger and heat of fire and the Sun causes Paitik kasa.
Yellowness in sputum and eyes, bitterness in mouth, disorder of voice, fuming in chest, thirst, burning sensation, fainting, anorexia and giddiness. The patient while coughing constantly sees as if stars and expectorates phlegm mixed with pitta.
Due to intake of heavy, slimy, sweet and unctuous(food and drink), oversleep, sedentary habit kapha is aggrevated and kaphaj kasa by obstructing vayu.
It produces loss of appetite, anorexia, vomiting, coryza, excitement, heaviness, horripilation, sweetness in mouth, moistening and malaise. The patient feels his chest as if filled up and while coughing expectorates profuse, sweet, unctuous and viscous phlegm without pain.
In a rough(undernourished) patient of urahkshat(chest wound) vayu aggravated by excessive sexual indulgence, weight lifting and combat with horses and elephants reaches the site of disorder and produces cough.
In cough due to chest wound, initially the patient coughs dryly but later on expels sputum with blood having, at the same time, intense pain in throat and excruciating, piercing and breaking pain with tenderness in chest. Moreover, he is afflicted with pain in joints, fever, dyspnoea, thirst and abnormal voice and makes cooing sound like pigeon during bouts of cough.
Due to irregular meals, intake of unsuitable food, excessive sexual intercourse, suppression of urges the three doshas get vitiated in the person already affected with disgust and anxiety and consequent loss of digestive power and produce kasa caused by wasting which further leads to wasting of the body.
The patient expectorates foetid, green, red and pus-like sputum and feels while coughing as if the heart has fallen down from its normal place. He suddenly feels heat and again cold, eats too much but is weak and emaciated. His complexion and skin of face is unctuous and clean, eyes are pretty, sole of hands and feet is smooth. He is always envious and disgustful. He suffers from fever of mixed characters, pain in sides, coryza, anorexia, liquid or solid stool and hoarseness of voice without an apparent cause.
One should cure the first three types(Vatik, Paitik and kaphaj) and maintain the other two with wholesome management.
In rough(undernourished) patients, one should manage the vatika kasa first all with unctuous applications such as ghrutas, enemas, gruels, vegetable soups, milk, meat soup etc. Uncting preparations etc. processed with vata-alleviating drugs, smoking, linctus, massage, sprinkling and unctuous fomentations should also be used. The condition of retention of stool and flatus should be overcome by enemas, that of dryness of upper parts by administering gruta before meals and excess of pitta and kapha by unctuous purgation.(Ch. Chi. 16/32-34)
Vataj kasa: The patient should be kept on wholesome diet consisting of saali and shashtika rice, barley and wheat with meat soup of domestic, marshy and aquatic animals. One should take, in vatika cough, liquid gruel processed with yavani, pippali, bilva(fruit pulp), shunthi, chitraka, rasna, jirak, prushniparni, palas, shtai and pushkarmool and added with fat, sour susbstances and salt. It alleviates pain of the waist, heart, sides and belly, dyspnoea and hiccup. He may also take liquid gruel cooked with the decoction of dashmool along with panchakola and jiggery or one cooked in milk with equal quantity of sesamum or one added with rock salt. Other sweet, sour and salty substances are recommended in vatika kasa.
Paitika kasa:In paitik cough with profuse phlegm emesis with ghee or decoction of madana, kashmarya and madhuka or paste(or powder) of madhuyshti and madana mixed with the juice of vidari and sugarcane is beneficial. After evacuation of doshas, the patient should follow the cold and sweet regimen.In paitik cough with thin phlegm trivrutt mixed with sweets and that with thick phlegm with bitters should be administered as purgative.One should adopt unctuous-cold and rough-cold regimens in conditions of thin and thick phlegm respectively. The linctus prepared of sugar, chandana, draksha, honey, amalaka fruits and utpala is recommended in paitik cough. In case of association of kapaha, musta and marich and in that of vata ghee should be added to the above.
Kaphaj kasa: One should manage the patient of kaphaj kasa, if he is strong, at first with evacuation by emesis and then with food made of barley, pungent, rough and hot and other kapha-alleviating drugs and diet. The patient should take light food with vegetable soup of kulattha(horse gram) and radish containing alkalis of pippali or with meat soup of wild and burrow-dweller animals processed with pungent substances and with oils of sesame, mustard and bilva followed by drink of pure honey, sour, hot water, buttermilk or wine.
Kshataj Kasa: The management of the cough by chest wound is like that of paittik cough such as predominating in milk, ghee and honey. In case of association of these doshas, the specific treatment would be:
1) Breaking pain in body due to vata and pitta, massage with ghrita is efficacious. In condition of affliction due to vata, massage with oils alleviating vatika disorders be applied.
2) If vayu is powerful, patient pits out blood with burning sensation and has pain in heart and sides, intake of jivaniya ghrut is recommended.
3) If the patient is emaciated and requires nutrition with flesh,meat soups of common quail etc. are wholesome. For those afflicted with thirst, goat’s milk boiled with panchtrunamoola etc. If there be haemoptysis, heamatemesis or haemorrhage from other passages, ghee extracted from milk should be given as snuff or oral intake.
4) If the patient is exhausted, emaciated and with loss of digestive power, gruel should be given to him. If there be contraction or expansion, ghee in maximum dose should be taken or the measures alleviating vatika disorders not antagonistic to pitta and rakta should be adopted.
5) When the morbidity of wound is eliminated but due to aggrevation of kapha chest and head are agitated painfully during bouts of cough, the patient should take smoking of the various formulation prepared from- Meda-mahameda, madhuka, bala-atibala etc.
Kshayaj Kasa: At first, one should administer the measures promoting body-weight and digestive power. If the patient has plenty of impurity, he should be given unctuous and mild purgation. The wasted patient should take evacuative ghruta cooked with aaragvadha, trivrutta,grape juice, decoction of tilvaka and juice of vidari. When pitta and kapha are diminished and dhatus are wasted, one should take ghee cooked with karkatashrungi, milk and two types of bala. In case of discolouration of urine or dysuria ghee and milk cooked wwith vidari, kadamba and mastaka should be taken. If the patient is non-vegetarian, he should, at first, be given the meat of wild animals and gradually that of quail etc. burrow dwellers and beast or bird prey. These help following out of phlegm from the channels due to their hot and churning nature and thus after the channels are cleansed rasa circulating well nourish the body properly.
Following Ghrut and Avaleha can be given in such condition: