2,062
edits
Changes
Jump to navigation
Jump to search
Line 1:
Line 1: + + Line 11:
Line 13: − + − + − + Line 19:
Line 21: − + − + − + − + − + Line 42:
Line 44: − + Line 48:
Line 50: − + Line 73:
Line 75: − + Line 83:
Line 85: − + Line 94:
Line 96: − + Line 107:
Line 109: − + Line 119:
Line 121: − + Line 130:
Line 132: − + Line 153:
Line 155: − + − + Line 174:
Line 176: − + − + − + − + − + − + − + Line 221:
Line 223: − + − + − + Line 261:
Line 263: − + Line 287:
Line 289: − +
→Case reports
'''Diagnosis and management of kasa(cough)'''
'''Diagnosis and management of kasa(cough)'''
==Diagnostic codes==
National Ayurveda Morbidity Code: EA-3
National Ayurveda Morbidity Code: EA-3
*Excessive intake of dry, cold and astringent food
*Excessive intake of dry, cold and astringent food
*Excess fasting
*Excess fasting
*Taking food in less quantity [Cha.Sa.Chikitsa Sthana 18/10]
*Taking food in less quantity [Cha.Sa.[[Chikitsa Sthana]] 18/10]
*Excessive intake of hot, spicy, sour foods [Cha.Sa.Chikitsa Sthana 18/14]
*Excessive intake of hot, spicy, sour foods [Cha.Sa.[[Chikitsa Sthana]] 18/14]
*Intake of heavy to digest, slimy, sweet and oily foods [Cha.Sa.Chikitsa Sthana 18/17]
*Intake of heavy to digest, slimy, sweet and oily foods [Cha.Sa.[[Chikitsa Sthana]] 18/17]
'''Lifestyle:'''
'''Lifestyle:'''
*Excessive indulgence in sex
*Excessive indulgence in sex
*Excessive physical strain
*Excessive physical strain
*Suppression of natural urges [Cha.Sa.Chikitsa Sthana 18/10]
*Suppression of natural urges [Cha.Sa.[[Chikitsa Sthana]] 18/10]
*Excessive exposure to heat [Cha.Sa.Chikitsa Sthana 18/14]
*Excessive exposure to heat [Cha.Sa.[[Chikitsa Sthana]] 18/14]
*Excessive sleep and inactivity [Cha.Sa.Chikitsa Sthana 18/17]
*Excessive sleep and inactivity [Cha.Sa.[[Chikitsa Sthana]] 18/17]
*Carrying a hefty load
*Carrying a hefty load
*Walking excessively long distance
*Walking excessively long distance
*Chest injury
*Chest injury
*Indirect trauma due to excessive heavy exertional work like in bullfight, controlling mighty animals like horses and elephants as in occupational fieldworks [Cha.Sa.Chikitsa Sthana 18/20]
*Indirect trauma due to excessive heavy exertional work like in bullfight, controlling mighty animals like horses and elephants as in occupational fieldworks [Cha.Sa.[[Chikitsa Sthana]] 18/20]
'''Psychological:'''
'''Psychological:'''
*Anger and grief [Cha.Sa.Chikitsa Sthana 18/14]
*Anger and grief [Cha.Sa.[[Chikitsa Sthana]] 18/14]
'''Acute exacerbating causes:'''
'''Acute exacerbating causes:'''
#[[Kapha]][[dosha]] predominance
#[[Kapha]][[dosha]] predominance
#Traumatic injury (kshataja)
#Traumatic injury (kshataja)
#Depletion of body tissues (kshayaja) [Cha.Sa.Chikitsa Sthana 18/3-4]
#Depletion of body tissues (kshayaja) [Cha.Sa.[[Chikitsa Sthana]] 18/3-4]
==Premonitory features==
==Premonitory features==
*Thorny feeling in mouth and throat
*Thorny feeling in mouth and throat
*Itching in throat
*Itching in throat
*Obstruction in deglutition [Cha.Sa.Chikitsa Sthana 18/4]
*Obstruction in deglutition [Cha.Sa.[[Chikitsa Sthana]] 18/4]
*Coating of mucous or sticky secretions in throat and palate
*Coating of mucous or sticky secretions in throat and palate
*Low raspy voice
*Low raspy voice
*Painful coughing with scanty expectoration
*Painful coughing with scanty expectoration
*Cough gets alleviated by the food and drinks that are unctuous, hot, salty and sour
*Cough gets alleviated by the food and drinks that are unctuous, hot, salty and sour
*Increases after digestion of food [Cha.Sa.Chikitsa Sthana 18/10-13]
*Increases after digestion of food [Cha.Sa.[[Chikitsa Sthana]] 18/10-13]
====[[Pitta]] dominant kasa====
====[[Pitta]] dominant kasa====
*Morbid thirst, burning, illusive, anorexia and giddiness
*Morbid thirst, burning, illusive, anorexia and giddiness
*Appearance of twinkling stars in front of the eyes while coughing continuously
*Appearance of twinkling stars in front of the eyes while coughing continuously
*Expectoration of sputum mixed with [[pitta]] [Cha.Sa.Chikitsa Sthana 15-16]
*Expectoration of sputum mixed with [[pitta]] [Cha.Sa.[[Chikitsa Sthana]] 15-16]
====[[Kapha]] dominant kasa====
====[[Kapha]] dominant kasa====
*Expectoration of thick, sweet, slimy phlegm in large quantity
*Expectoration of thick, sweet, slimy phlegm in large quantity
*Painless coughing and smooth release of sputum is differentiating feature of [[kapha]] dominance
*Painless coughing and smooth release of sputum is differentiating feature of [[kapha]] dominance
*Feeling of fullness in the chest [Cha.Sa.Chikitsa Sthana 18/18-19]
*Feeling of fullness in the chest [Cha.Sa.[[Chikitsa Sthana]] 18/18-19]
In a study, [[kapha]]kasa is compared with chronic bronchitis.<ref name=shilpals>Shilpa L.S., Prashanth A.S. A Critical Review on the Etiopathogenesis and Treatment of KaphajaKasa (Chronic Bronchitis). J Ayurveda Integr Med Sci 2016;4:118-122. http://dx.doi.org/10.21760/jaims.v1i4.6928</ref>
In a study, [[kapha]]kasa is compared with chronic bronchitis.<ref name=shilpals>Shilpa L.S., Prashanth A.S. A Critical Review on the Etiopathogenesis and Treatment of KaphajaKasa (Chronic Bronchitis). J Ayurveda Integr Med Sci 2016;4:118-122. http://dx.doi.org/10.21760/jaims.v1i4.6928</ref>
*Miserable appearance.
*Miserable appearance.
*Pain in joints and fingers, fever, labored breath, thirst, and altered voice
*Pain in joints and fingers, fever, labored breath, thirst, and altered voice
*While coughing, sounds humming like a pigeon. [Cha.Sa.Chikitsa Sthana 18/20-23]
*While coughing, sounds humming like a pigeon. [Cha.Sa.[[Chikitsa Sthana]] 18/20-23]
====Kasa due to depletion of body tissues (kshayaja)====
====Kasa due to depletion of body tissues (kshayaja)====
*The person always finds fault with others and develops an immensely hateful disposition
*The person always finds fault with others and develops an immensely hateful disposition
*The person suffers from diseases like [[jwara]] (having signs and symptoms of all [[dosha]]s), nasal congestion, anorexia, painful flanks, and altered voice
*The person suffers from diseases like [[jwara]] (having signs and symptoms of all [[dosha]]s), nasal congestion, anorexia, painful flanks, and altered voice
*Frequent hard or loose stools without apparent cause [Cha.Sa.Chikitsa Sthana 18/25-28]
*Frequent hard or loose stools without apparent cause [Cha.Sa.[[Chikitsa Sthana]] 18/25-28]
==Pathogenesis==
==Pathogenesis==
*Site of origin: amashaya (stomach)
*Site of origin: amashaya (stomach)
*Site of manifestation/clinical presentation: Throat (kantha) and chest (uras)
*Site of manifestation/clinical presentation: Throat (kantha) and chest (uras)
*Type of pathogenesis: Obstruction (sanga), Movement of [[dosha]] in the wrong direction (vimargagamana)[Cha.Sa.Chikitsa Sthana 18/6-8]
*Type of pathogenesis: Obstruction (sanga), Movement of [[dosha]] in the wrong direction (vimargagamana)[Cha.Sa.[[Chikitsa Sthana]] 18/6-8]
==Clinical examination==
==Clinical examination==
*[[Vata]], [[pitta]] and [[kapha]] dominant kasa are curable.
*[[Vata]], [[pitta]] and [[kapha]] dominant kasa are curable.
*Cough due to trauma (kshataja) and cough due to depletion of body tissues (kshayaja) are curable initially and in strong individuals. In the chronic stage, they can be controlled and palliated with appropriate drugs and diet. [Cha.Sa.Chikitsa Sthana 18/29-31]
*Cough due to trauma (kshataja) and cough due to depletion of body tissues (kshayaja) are curable initially and in strong individuals. In the chronic stage, they can be controlled and palliated with appropriate drugs and diet. [Cha.Sa.[[Chikitsa Sthana]] 18/29-31]
'''Poor prognostic features:'''
'''Poor prognostic features:'''
If the patient is weak, cough due to depletion of body tissues (kshayaja kasa) may cause death. All types are palliable in old patients.[Cha.Sa.Chikitsa Sthana 18/29-30]
If the patient is weak, cough due to depletion of body tissues (kshayaja kasa) may cause death. All types are palliable in old patients.[Cha.Sa.[[Chikitsa Sthana]] 18/29-30]
==Management==
==Management==
*Unctuous therapies ([[snehana]])
*Unctuous therapies ([[snehana]])
*Dietary supplements like gruels, milk, meat etc. processed with [[vata]] alleviating medicines can be used. [Cha.Sa.[[Chikitsa Sthana]] 18/32-33]
*Dietary supplements like gruels, milk, meat etc. processed with [[vata]] alleviating medicines can be used. [Cha.Sa.[[Chikitsa Sthana]] 18/32-33]
*Therapeutic enema ([[basti]]) [ref ??]
*Therapeutic enema ([[basti]]) [Cha.Sa.[[Chikitsa Sthana]] 18/32]
*In association [[kapha]] or [[pitta]], [[dosha]]-specific measures shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/132] When [[vata]] dominant kasa is associated with [[pitta]], medicated ghee and milk after food is indicated. [A.Hr.Chikitsa Sthana 3/2]<ref name= Hridaya > Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>
*In association [[kapha]] or [[pitta]], [[dosha]]-specific measures shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/132] When [[vata]] dominant kasa is associated with [[pitta]], medicated ghee and milk after food is indicated. [A.Hr.Chikitsa Sthana 3/2]<ref name= Hridaya > Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>
====[[Pitta]] predominance====
====[[Pitta]] predominance====
*Therapeutic purgation ([[virechana]]) [??]
*Therapeutic purgation ([[virechana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/85]
*Other purification therapies as per quantity of [[dosha]]
*Other purification therapies as per quantity of [[dosha]]
*Unctuous electuaries [Cha.Sa.[[Chikitsa Sthana]] 18/86]
*Unctuous electuaries [Cha.Sa.[[Chikitsa Sthana]] 18/86]
====[[Kapha]] predominance====
====[[Kapha]] predominance====
*Therapeutic emesis ([[vamana]]) [??]
*Therapeutic emesis ([[vamana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/108]
*Dry and light to digest foods
*Dry and light to digest foods
*The oil exuding out from burning log of Cedrus deodara (devadaru) is used in treatment. It is mixed with powders of Piper longum, Piper nigrum and Zingiber officinale (trikatu), and ash of Hordeum vulgare (yavakshara) as a first line of treatment. [A.Hr.Chikitsa Sthana 3/41]<ref name=Hridaya/>
*The oil exuding out from burning log of Cedrus deodara (devadaru) is used in treatment. It is mixed with powders of Piper longum, Piper nigrum and Zingiber officinale (trikatu), and ash of Hordeum vulgare (yavakshara) as a first line of treatment. [A.Hr.Chikitsa Sthana 3/41]<ref name=Hridaya/>
*Medicated smoke/fumigation (dhuma): It is indicated in case of headache and coryza associated with [[vata]] and [[kapha]][[dosha]]. [Cha.Sa.[[Chikitsa Sthana]] 18/65-68]
*Medicated smoke/fumigation (dhuma): It is indicated in case of headache and coryza associated with [[vata]] and [[kapha]][[dosha]]. [Cha.Sa.[[Chikitsa Sthana]] 18/65-68]
*Therapeutic emesis ([[vamana]]): In [[pitta]] dominant kasa associated with [[kapha]][[dosha]], therapeutic emesis ([[vamana]]) is advised with decoction (kashaya) prepared out of Catunaregam spinosa (madana), Gmelina arborea (kashmari), Glycyrrhiza glabra (madhuka) etc. [Cha.Sa.[[Chikitsa Sthana]] 18/83] In [[kapha]] dominant kasa and strong person, therapeutic emesis shall be done first. [Cha.Sa.[[Chikitsa Sthana]] 18/108]
*Therapeutic emesis ([[vamana]]): In [[pitta]] dominant kasa associated with [[kapha]][[dosha]], therapeutic emesis ([[vamana]]) is advised with decoction (kashaya) prepared out of Catunaregam spinosa (madana), Gmelina arborea (kashmari), Glycyrrhiza glabra (madhuka) etc. [Cha.Sa.[[Chikitsa Sthana]] 18/83] In [[kapha]] dominant kasa and strong person, therapeutic emesis shall be done first. [Cha.Sa.[[Chikitsa Sthana]] 18/108]
*Intra nasal drug administration ([[nasya]]): If bleeding is present in kasa (as a result of trauma), trinapanchamula ghee is used for [[nasya]]. It is prepared from milk processed with herbs of trinapanchamoola (combination of Desmostachyabi pinnata, Saccharum spontaneum, Phragmites karka, Imperata cylindrical, Saccharum officinarum etc.). [Cha.Sa.[[Chikitsa Sthana]] 18/142] In [[kapha]] dominant kasa, nasal instillation with medicines having purificatory properties (shirovirechana nasya) is advised. [Su.Sa.Uttara Sthana 52/28]
*Intra nasal drug administration ([[nasya]]): If bleeding is present in kasa (as a result of trauma), trinapanchamula ghee is used for [[nasya]]. It is prepared from milk processed with herbs of trinapanchamoola (combination of Desmostachyabi pinnata, Saccharum spontaneum, Phragmites karka, Imperata cylindrical, Saccharum officinarum etc.). [Cha.Sa.[[Chikitsa Sthana]] 18/142] In [[kapha]] dominant kasa, nasal instillation with medicines having purificatory properties (shirovirechana nasya) is advised. [Su.Sa.Uttara Sthana 52/28]<ref name=Susruta/>
*Decoction enema (niruha [[basti]]): Therapeutic enema with decoction is indicated [Su.Sa.Uttara Sthana 52/27]<ref name=Susruta/> in vata dominant [[kasa]] with constipation and flatulence. [A.Hr. Chikitsa Sthana 3/2]<ref name=Hridaya/>
*Decoction enema (niruha [[basti]]): Therapeutic enema with decoction is indicated [Su.Sa.Uttara Sthana 52/27]<ref name=Susruta/> in [[vata]] dominant kasa with constipation and flatulence. [A.Hr. Chikitsa Sthana 3/2]<ref name=Hridaya/>
*Medicated unctuous enema (anuvasana [[basti]]): Medicated unctuous enema (anuvasana) is advised if pain and swelling in loin, groin, anus or penile region are present in kasa (due to depletion of body tissue) patient. [Cha.Sa.[[Chikitsa Sthana]] 18/155]. It is indicated in [[vata]] dominant kasa. [Su.Sa.Uttara Sthana 52/27]
*Medicated unctuous enema (anuvasana [[basti]]): Medicated unctuous enema (anuvasana) is advised if pain and swelling in loin, groin, anus or penile region are present in kasa (due to depletion of body tissue) patient. [Cha.Sa.[[Chikitsa Sthana]] 18/155]. It is indicated in [[vata]] dominant kasa. [Su.Sa.Uttara Sthana 52/27]<ref name=Susruta/>
===Medicines used in current practice===
===Medicines used in current practice===
==Contemporary views==
==Contemporary views==
===case reports===
===Case reports===
'''Solanum xanthocarpum'''
'''Solanum xanthocarpum'''
In another study conducted on 60 patients with pulmonary tuberculosis (TB), administration of Bhrigarajasava along with the standard treatment was found effective in reducing the cough. The cough progressively diminished and became occasional and non-productive within 15 days of treatment.<ref>Dornala SN, Dornala SS. Clinical efficacy of Bhringarajasava as Naimittika Rasayana in Rajayakshma with special reference to pulmonary tuberculosis. Ayu. 2012 Oct;33(4):523-9. doi: 10.4103/0974-8520.110536. PMID: 23723670; PMCID: PMC3665204.</ref>
In another study conducted on 60 patients with pulmonary tuberculosis (TB), administration of Bhrigarajasava along with the standard treatment was found effective in reducing the cough. The cough progressively diminished and became occasional and non-productive within 15 days of treatment.<ref>Dornala SN, Dornala SS. Clinical efficacy of Bhringarajasava as Naimittika Rasayana in Rajayakshma with special reference to pulmonary tuberculosis. Ayu. 2012 Oct;33(4):523-9. doi: 10.4103/0974-8520.110536. PMID: 23723670; PMCID: PMC3665204.</ref>
'''Vyaghri-haritakiavaleha in chronic bronchitis'''
'''Vyaghri-haritaki avaleha in chronic bronchitis'''
A study on 66 patients with chronic bronchitis reported that Vyaghri-haritaki avaleha effectively reduced the productive cough, which is the cardinal feature of chronic bronchitis.<ref>Ram J, Baghel MS. Clinical efficacy of Vyaghriharitaki Avaleha in the management of chronic bronchitis. Ayu. 2015 Jan-Mar;36(1):50-5. doi: 10.4103/0974-8520.169009. PMID: 26730139; PMCID: PMC4687240.</ref>
A study on 66 patients with chronic bronchitis reported that Vyaghri-haritaki avaleha effectively reduced the productive cough, which is the cardinal feature of chronic bronchitis.<ref>Ram J, Baghel MS. Clinical efficacy of Vyaghriharitaki Avaleha in the management of chronic bronchitis. Ayu. 2015 Jan-Mar;36(1):50-5. doi: 10.4103/0974-8520.169009. PMID: 26730139; PMCID: PMC4687240.</ref>