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{{#seo:
|title=Kasa Chikitsa
|titlemode=append
|keywords=kasa, cough, treatment of cough, respiratory diseases, kshataja, kshayaja, Snehapana, vamana, virehna, vairechanika nasya (nasal catarrhal), dhumapana (medicated cigarettes),Ayurveda, Indian system of medicine, charak samhita.
|description=Chikitsa Sthana Chapter 18. Management of Kasa (Cough of various origins)
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=charak samhita
|type=article
}}
<big>'''[[Chikitsa Sthana]] Chapter 18. Management of Kasa (Cough of various origins) </big>'''
{{Infobox
{{Infobox
|title = Kasa Chikitsa
|title = Kasa Chikitsa
|label5 = Other Sections
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|header3 =
|data6 = Nesari T., Mallya S., [[Yogesh Deole|Deole Y. S.]]
|label7 = Reviewer
|data7 = Prasad B.S., Mali P.
|label8 = Editors
|data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
|label9 = Year of publication
|data9 = 2020
|label10 = Publisher
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]
|label11 = DOI
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.019 10.47468/CSNE.2020.e01.s06.019]
}}
}}
<big>'''Abstract </big>'''
<p style="text-align:justify;">''Hikka, shwasa'' and ''kasa'' (hiccups, dyspnea and cough) are the three main diseases of ''pranavaha srotas'' (respiratory system). There are similarities in clinical presentation and management of these three. Therefore, these are described in sequence. ''Kasa'' is categorized in to five types based on its dominance of dosha and etiology. The vata dominant, pitta dominant and kapha dominant kasa are curable with proper medication. The other two types originating due to kshata (injury) and depletion of body constituents (kshaya) are palliable (yapya). Avoiding etiological factors (Nidana parivarjana), purification therapy ([[shodhana]]), pacification therapy ([[shamana]]), disease specific treatment (vyadhiahara [[rasayana]]) are principles of management for all types of ''kasa''. Administration of [[shodhana]] therapy is important. The reduction in persistent nature of illness with episodic exacerbation and the severity is possible if all modalities are followed in sequence.
=== Abstract ===
<br/><br/>
'''Keywords''': ''kasa'', cough, treatment of cough, respiratory diseases, kshataja, kshayaja, snehapana, [[vamana]], [[virechana]], vairechanika [[nasya]] (nasal catarrhal), [[dhumapana]] (medicated cigarettes).
''Hikka, shwasa'' and ''kasa'' (hiccups, dyspnea and cough) are the three main diseases of ''pranavaha srotas'' (respiratory system). There are clinical and treatment similarities between these three disease conditions that is why these diseases are being described together. ''Kasa'' is categorized in to five kinds as ''vataja, pittaja, kaphaja, kshataja'' and ''kshayaja''. The former three are curable with proper medication while the remaining two are ''yapya'' (palliable). ''Nidana parivarjana'' (avoidance of etiological factors), ''shodhana'' (purificatory therapy), ''shamana'' (palliative drugs), ''vyadhiahara rasayana'' (disease specific treatment) are the principles of treatment for all types of ''kasa''. Administration of ''shodhana'' has been given importance. The reduction in persistent nature of illness with episodic exacerbation and the severity is possible if all modalities of management like ''shodhana, shamana'', and ''vyadhihara rasayana'' are followed as treatment.
</p>
'''Keywords''': ''kasa'', cough, treatment of cough, respiratory diseases, ''kshataja, kshayaja, Snehapana, vamana, virehna, vairechanika nasya'' (nasal catarrhal), ''dhumapana'' (medicated cigarettes).
''Pranavaha srotas'' is a vital system of the body and although this ''srotas'' is more susceptible to abuse from little amount of smoke, allergens, adulterants, petrochemicals and many pollutants in atmosphere, there are a variety of disorders and diseases that are temporary and harmless, while others can be life threatening. In literature, ''pranavaha srotas'' disorders are elaborated under the heading of ''shwasa, kasa, hikka, rajayakshma'' and ''urakshata'' (''kshata-kshina''). Cough, expectoration, breathlessness, sore throat, chest pain are common clinical features of respiratory diseases. ''Kasa'' is one such disease, which is identified by the hoarse phonetic sound, produced due to the pathological process of ''doshadushti'' (vitiation of ''dosha''), ''vimarga gamana'' (diverted movement) of ''pranavata'' and ''avarana'' (occlusions) of ''vayu'' by the ''kapha''. The main pathology is in chest region with reduced functioning of the respiratory system.
== Introduction ==
<div style="text-align:justify;">
''Pranavaha srotas'' is a vital system of the body and although this ''srotas'' is more susceptible to abuse from little amount of smoke, allergens, adulterants, petrochemicals and many pollutants in atmosphere, there are a variety of disorders and diseases that are temporary and harmless, while others can be life threatening. In literature, ''pranavaha srotas'' disorders are elaborated under the heading of ''shwasa, kasa, hikka, rajayakshma'' and ''urakshata'' (''kshata-kshina''). Cough, expectoration, breathlessness, sore throat, chest pain are common clinical features of respiratory diseases. ''Kasa'' is one such disease, which is identified by the hoarse phonetic sound, produced due to the pathological process of [[dosha]] dushti'' (vitiation of [[dosha]]), ''vimarga gamana'' (diverted movement) of ''pranavata'' and ''avarana'' (occlusions) of [[vayu]] by the [[kapha]]. The main pathology is in chest region with reduced functioning of the respiratory system.
Smoke, dust, and over exertion (''dhumopaghata, raja, vyayama'') are largely considered as causative factors (''samanya nidana''). These may cause direct damage to the harmony of the ''pranavaha srotas'' which occurs in all respiratory disorders. Apart from above said causative factors some in particular like ''guru'' (heavy), ''snigdha'' (unctuous), ''madhura'' (sweet), ''asatmya'' (unhabituated), ''paryushita ahara'' (rotten food) will cause vitiation of ''dosha'', more specifically ''vata'' and ''kapha'' which will in turn have its impact on ''pranavaha srotas'' to cause structural and functional impairments (''kha vaigunya''). Improper diet will result in the improper digestion and absorption of ''ahara rasa'' which will in turn produce ''kasa''. These can be considered as intrinsic factors for the pathogenesis.
Smoke, dust, and over exertion (''dhumopaghata, raja, vyayama'') are largely considered as causative factors (''samanya nidana''). These may cause direct damage to the harmony of the ''pranavaha srotas'' which occurs in all respiratory disorders. Apart from above said causative factors some in particular like ''guru'' (heavy), ''snigdha'' (unctuous), ''madhura'' (sweet), ''asatmya'' (unhabituated), ''paryushita ahara'' (rotten food) will cause vitiation of [[dosha]], more specifically [[vata]] and [[kapha]] which will in turn have its impact on ''pranavaha srotas'' to cause structural and functional impairments (''kha vaigunya''). Improper diet will result in the improper digestion and absorption of ''ahara rasa'' which will in turn produce ''kasa''. These can be considered as intrinsic factors for the pathogenesis.
Prodromal symptoms (''purvarupa'') are irritation of throat with pricking sensation, itching (''kantha kandu'')and inability to swallow (''bhojyanam avarodha''). These are very much similar with upper respiratory tract infection leading to condition of pharyngitis or pharyngotonsillitis and persistence of such upper respiratory tract infection will further spread to lower respiratory tract.
Prodromal symptoms (''purvarupa'') are irritation of throat with pricking sensation, itching (''kantha kandu'')and inability to swallow (''bhojyanam avarodha''). These are very much similar with upper respiratory tract infection leading to condition of pharyngitis or pharyngotonsillitis and persistence of such upper respiratory tract infection will further spread to lower respiratory tract.
There are five types of ''kasa'' namely, ''vataja, pittaja, kaphaja, kshataja'' and ''kshayaja''. ''Vatika kasa'' is more related to upper respiratory tract with ''swarabheda'' (hoarseness of voice) as its diagnostic feature and is unproductive. It resembles more to allergic rhinobronchitis, which may be self-limiting and curable. ''Paittika'' and ''kaphaja kasa'' involve lower respiratory tract and are productive in nature. While ''paittika kasa'' seems to be the result of inflammation, ''kaphaja kasa'' is due to mucosal hypertrophy of bronchial lining or chronic bronchitis. ''Kshyaja kasa'' is a state of chronic cough associated with emaciation. Charaka has mentioned that the disturbance in the action of ''jatharagni'' all the three ''doshas'' get vitiated, which causes emaciation of ''dhatus'' of the body either due to ''anulomana kshaya'' or ''pratiloma kshaya'' (Ch. Chi. 18/24). That makes it different from ''shosha'', which is a ''tridoshaja'' disease manifests as a group of several diseases. ''Kshataja kasa'' is associated with break in integrity of lung parenchyma with ''shonita darshana'' (blood tinged mucous) as a symptom. There may or may not be ''shosha'' (emaciation).
There are five types of ''kasa'' namely,[[vata]]ja, [[pitta]]ja, [[kapha]]ja, kshataja and kshayaja. ''Vatika kasa'' is more related to upper respiratory tract with ''swarabheda'' (hoarseness of voice) as its diagnostic feature and is unproductive. It resembles more to allergic rhinobronchitis, which may be self-limiting and curable. ''Paittika'' and [[kapha]]ja kasa'' involve lower respiratory tract and are productive in nature. While ''paittika kasa'' seems to be the result of inflammation, [[kapha]]ja kasa is due to mucosal hypertrophy of bronchial lining or chronic bronchitis. ''Kshyaja kasa'' is a state of chronic cough associated with emaciation. Charak has mentioned that the disturbance in the action of ''jatharagni'' all the three [[dosha]] get vitiated, which causes emaciation of [[dhatu]] of the body either due to ''anulomana kshaya'' or ''pratiloma kshaya'' [Cha.Sa. [[Chikitsa Sthana]] 18/24]. That makes it different from ''shosha'', which is a tri[[dosha]]ja disease manifests as a group of several diseases. ''Kshataja kasa'' is associated with break in integrity of lung parenchyma with ''shonita darshana'' (blood tinged mucous) as a symptom. There may or may not be ''shosha'' (emaciation).
Snehapana, [[vamana]], [[virechana]], vairechanika [[nasya]] (nasal catarrhal), [[dhumapana]] (medicated cigaretes) are indicated as treatment modalities in different types of ''kasa''.
</div>
== Sanskrit Text, Transliteration and English Translation ==
<div class="mw-collapsible mw-collapsed">
अथातः कासचिकित्सितं व्याख्यास्यामः ||१||
अथातः कासचिकित्सितं व्याख्यास्यामः ||१||
इति ह स्माह भगवानात्रेयः ||२||
इति ह स्माह भगवानात्रेयः ||२||
<div class="mw-collapsible-content">
athātaḥ kāsacikitsitaṁ vyākhyāsyāmaḥ||1||
athātaḥ kāsacikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
</div></div>
<div style="text-align:justify;">
Now we shall expound the chapter "Kasa chikitsa"(Management of cough of various origins). Thus said Lord Atreya.[1-2]
=== Types ===
<div class="mw-collapsible mw-collapsed">
तपसा यशसा धृत्या धिया च परयाऽन्वितः |
तपसा यशसा धृत्या धिया च परयाऽन्वितः |
वातादिजास्त्रयो ये च क्षतजः क्षयजस्तथा |
वातादिजास्त्रयो ये च क्षतजः क्षयजस्तथा |
पञ्चैते स्युर्नृणां कासा वर्धमानाः क्षयप्रदाः ||४||
पञ्चैते स्युर्नृणां कासा वर्धमानाः क्षयप्रदाः ||४||
<div class="mw-collapsible-content">
tapasā yaśasā dhr̥tyā dhiyā ca parayā'nvitaḥ|
tapasā yaśasā dhr̥tyā dhiyā ca parayā'nvitaḥ|
vAtAdijAstrayo ye ca kShatajaH kShayajastathA|
vAtAdijAstrayo ye ca kShatajaH kShayajastathA|
pa~jcaite syurnRuNAM kAsA vardhamAnAH kShayapradAH||4||
pa~jcaite syurnRuNAM kAsA vardhamAnAH kShayapradAH||4||
</div></div>
Atreya, endowed with power of penance, fame and perseverance and super-intellect expounded the infallible therapies for the treatment of ''kasa''. There are five types of ''kasa''. If exacerbated they may cause ''kshaya''. These five types are ''vataja, pittaja, kaphaja, kshataja'' and ''kshayaja''. [3-4]
Atreya, endowed with power of penance, fame and perseverance and super-intellect expounded the infallible therapies for the treatment of ''kasa''. There are five types of ''kasa''. If exacerbated they may cause kshaya. These five types are [[vata]]ja, [[pitta]]ja, [[kapha]]ja, kshataja and kshayaja. [3-4]
=== Premonitory signs ===
<div class="mw-collapsible mw-collapsed">
पूर्वरूपं भवेत्तेषां शूकपूर्णगलास्यता |
पूर्वरूपं भवेत्तेषां शूकपूर्णगलास्यता |
कण्ठे कण्डूश्च भोज्यानामवरोधश्च जायते ||५||
कण्ठे कण्डूश्च भोज्यानामवरोधश्च जायते ||५||
<div class="mw-collapsible-content">
pūrvarūpaṁ bhavēttēṣāṁ śūkapūrṇagalāsyatā|
pūrvarūpaṁ bhavēttēṣāṁ śūkapūrṇagalāsyatā|
pUrvarUpaM bhavetteShAM shUkapUrNagalAsyatA|
pUrvarUpaM bhavetteShAM shUkapUrNagalAsyatA|
kaNThe kaNDUshca bhojyAnAmavarodhashca jAyate||5||
kaNThe kaNDUshca bhojyAnAmavarodhashca jAyate||5||
</div></div>
Following are the premonitory signs and symptoms of ''kasa'':
Following are the premonitory signs and symptoms of ''kasa'':
#Sensation as if throat and mouth are filled with ''shooka'' (thorns).
#Sensation as if throat and mouth are filled with ''shooka'' (thorns).
#Itching sensation in the throat.
#Itching sensation in the throat.
#Inability to swallow food.[3-4]
#Inability to swallow food.[3-4]
=== Pathophysiology ===
<div class="mw-collapsible mw-collapsed">
अधःप्रतिहतो वायुरूर्ध्वस्रोतःसमाश्रितः |
अधःप्रतिहतो वायुरूर्ध्वस्रोतःसमाश्रितः |
नेत्रे पृष्ठमुरःपार्श्वे निर्भुज्य स्तम्भयंस्ततः |
नेत्रे पृष्ठमुरःपार्श्वे निर्भुज्य स्तम्भयंस्ततः |
शुष्को वा सकफो वाऽपि कसनात्कास उच्यते ||८||
शुष्को वा सकफो वाऽपि कसनात्कास उच्यते ||८||
<div class="mw-collapsible-content">
adhaḥpratihatō vāyurūrdhvasrōtaḥsamāśritaḥ|
adhaḥpratihatō vāyurūrdhvasrōtaḥsamāśritaḥ|
netre pRuShThamuraHpArshve nirbhujya stambhayaMstataH|
netre pRuShThamuraHpArshve nirbhujya stambhayaMstataH|
shuShko vA sakapho vA~api kasanAtkAsa ucyate||8||
shuShko vA sakapho vA~api kasanAtkAsa ucyate||8||
</div></div>
[[Vata]] being obstructed in the lower region of the body, moves upwards, afflicts the channels of circulation in the upper part of the body, takes over the function of udana vayu and gets localized in the throat and chest. Then entering all the cavities in the head, fills them up and causes hunching and convulsive movements of the body, jaws, sides of the neck and eyes. Thereafter this obstructed [[vata]] causes contraction and stiffness of the eyes, back, chest and sides of the chest, gives rise to ''kasa'' which may be dry or with phlegm because of which it is known as ''kasa''.[6-8]
=== Specific features of ''kasa'' ===
<div class="mw-collapsible mw-collapsed">
प्रतिघातविशेषेण तस्य वायोः सरंहसः |
प्रतिघातविशेषेण तस्य वायोः सरंहसः |
वेदनाशब्दवैशिष्ट्यं कासानामुपजायते ||९||
वेदनाशब्दवैशिष्ट्यं कासानामुपजायते ||९||
<div class="mw-collapsible-content">
pratighātaviśēṣēṇa tasya vāyōḥ saraṁhasaḥ|
pratighātaviśēṣēṇa tasya vāyōḥ saraṁhasaḥ|
pratighAtavisheSheNa tasya vAyoH saraMhasaH|
pratighAtavisheSheNa tasya vAyoH saraMhasaH|
vedanAshabdavaishiShTyaM kAsAnAmupajAyate||9||
vedanAshabdavaishiShTyaM kAsAnAmupajAyate||9||
</div></div>
Specific variations in the pain and sound associated with different types of ''kasa'' are caused by the specific nature of the obstruction (by ''kapha'', etc.) to the force fully moving ''vayu''.[9]
Specific variations in the pain and sound associated with different types of ''kasa'' are caused by the specific nature of the obstruction (by [[kapha]], etc.) to the force fully moving [[vayu]].[9]
==== Etiological factors, clinical features of ''vataja kasa'' ====
==== Etiological factors, clinical features of [[Vata]]ja kasa ====
<div class="mw-collapsible mw-collapsed">
रूक्षशीतकषायाल्पप्रमितानशनं स्त्रियः |
रूक्षशीतकषायाल्पप्रमितानशनं स्त्रियः |
स्निग्धाम्ललवणोष्णैश्च भुक्तपीतैः प्रशाम्यति |
स्निग्धाम्ललवणोष्णैश्च भुक्तपीतैः प्रशाम्यति |
ऊर्ध्ववातस्य जीर्णेऽन्ने वेगवान्मारुतो भवेत् ||१३||
ऊर्ध्ववातस्य जीर्णेऽन्ने वेगवान्मारुतो भवेत् ||१३||
<div class="mw-collapsible-content">
rūkṣaśītakaṣāyālpapramitānaśanaṁ striyaḥ|
rūkṣaśītakaṣāyālpapramitānaśanaṁ striyaḥ|
snigdhAmlalavaNoShNaishca bhuktapItaiH prashAmyati|
snigdhAmlalavaNoShNaishca bhuktapItaiH prashAmyati|
UrdhvavAtasya jIrNe~anne vegavAnmAruto bhavet||13||
UrdhvavAtasya jIrNe~anne vegavAnmAruto bhavet||13||
</div></div>
Following are the causative factors of ''vatika'' type of ''kasa'':
Following are the causative factors of ''vatika'' type of ''kasa'':
#Intake of ''ruksha'' (dry), ''sheeta''(cold), ''kashaya'' (stringent) type of food.
#Intake of ''ruksha'' (dry), ''sheeta''(cold), ''kashaya'' (astringent) type of food.
#Intake of food in less quantity or much less quantity or not taking food at all.
#Intake of food in less quantity or much less quantity or not taking food at all.
#Excess indulgence in ''vyavaya''.
#Excess indulgence in ''vyavaya''.
#Expectorate scanty phlegm with pain.
#Expectorate scanty phlegm with pain.
#The ''kasa'' gets alleviated by the food and drinks that are ''snigdha, amla, lavana'' and ''ushna''.
#The ''kasa'' gets alleviated by the food and drinks that are ''snigdha, amla, lavana'' and ''ushna''.
#The upward movements increases ''vata'' after digestion of food.[10-13]
#The upward movements increases [[vata]] after digestion of food.[10-13]
==== ''Pittaja kasa'' ====
==== Etiological factors, clinical features of [[Pitta]]ja kasa ====
<div class="mw-collapsible mw-collapsed">
कटुकोष्णविदाह्यम्लक्षाराणामतिसेवनम् |
कटुकोष्णविदाह्यम्लक्षाराणामतिसेवनम् |
प्रततं कासमानश्च ज्योतींषीव च पश्यति |
प्रततं कासमानश्च ज्योतींषीव च पश्यति |
श्लेष्माणं पित्तसंसृष्टं निष्ठीवति च पैत्तिके ||१६||
श्लेष्माणं पित्तसंसृष्टं निष्ठीवति च पैत्तिके ||१६||
<div class="mw-collapsible-content">
kaṭukōṣṇavidāhyamlakṣārāṇāmatisēvanam|
kaṭukōṣṇavidāhyamlakṣārāṇāmatisēvanam|
pratataM kAsamAnashca jyotIMShIva ca pashyati|
pratataM kAsamAnashca jyotIMShIva ca pashyati|
shleShmANaM pittasaMsRuShTaM niShThIvati ca paittike||16||
shleShmANaM pittasaMsRuShTaM niShThIvati ca paittike||16||
</div></div>
Excessive intake of ''ushna, katu, vidahi, amla'' and ''kshara'' type of ''ahara; krodha, santapa'' , exposure to the heat of the fire and sun are the causative factors of ''pittaja kasa''.
Excessive intake of ''ushna, katu, vidahi, amla'' and ''kshara'' type of ''ahara; krodha, santapa'' , exposure to the heat of the fire and sun are the causative factors of [[pitta]]ja kasa''.
Signs and symptoms of ''pittaja kasa'' are as follows:
Signs and symptoms of [[pitta]]ja kasa'' are as follows:
#Yellowish sputum and eyes
#Yellowish sputum and eyes
#Bitter taste in mouth
#Bitter taste in mouth
#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''. [14-16]
#Expectoration of sputum mixed with [[pitta]]. [14-16]
==== ''Kaphaja kasa'' ====
==== Etiological factors, clinical features of [[Kapha]]ja kasa ====
<div class="mw-collapsible mw-collapsed">
गुर्वभिष्यन्दिमधुरस्निग्धस्वप्नाविचेष्टनैः |
गुर्वभिष्यन्दिमधुरस्निग्धस्वप्नाविचेष्टनैः |
बहुलं मधुरं स्निग्धं निष्ठीवति घनं कफम् |
बहुलं मधुरं स्निग्धं निष्ठीवति घनं कफम् |
कासमानो ह्यरुग् वक्षः सम्पूर्णमिव मन्यते ||१९||
कासमानो ह्यरुग् वक्षः सम्पूर्णमिव मन्यते ||१९||
<div class="mw-collapsible-content">
gurvabhiṣyandimadhurasnigdhasvapnāvicēṣṭanaiḥ|
gurvabhiṣyandimadhurasnigdhasvapnāvicēṣṭanaiḥ|
bahulaM madhuraM snigdhaM niShThIvati ghanaM kapham|
bahulaM madhuraM snigdhaM niShThIvati ghanaM kapham|
kAsamAno hyarug vakShaH sampUrNamiva manyate||19||
kAsamAno hyarug vakShaH sampUrNamiva manyate||19||
</div></div>
Intake of heavy to digest, slimy, excessive sweets and oily foods ; excessive sleep and habitual inertia leads to aggravation of ''kapha'' and thereby obstructs the movement of ''vata'' which gives rise to ''kaphaja'' type of ''kasa''.
Intake of heavy to digest, slimy, excessive sweets and oily foods ; excessive sleep and habitual inertia leads to aggravation of [[kapha]] and thereby obstructs the movement of [[vata]] which gives rise to [[kapha]]ja type of ''kasa''.
The signs and symptoms of ''kaphaja'' type of ''kasa'' are as follows:
The signs and symptoms of [[kapha]]ja type of ''kasa'' are as follows:
#Lowered digestion process, anorexia, vomitng, nasal discharge, nausea and heaviness
#Lowered digestion process, anorexia, vomitng, nasal discharge, nausea and heaviness
#Horripilation, stickiness and sweetness of the mouth
#Horripilation, stickiness and sweetness of the mouth
#Feeling of fullness in the chest [17-19]
#Feeling of fullness in the chest [17-19]
==== ''Kshataja kasa'' ====
==== Etiological factors, clinical features of ''Kshataja kasa'' ====
<div class="mw-collapsible mw-collapsed">
अतिव्यवायभाराध्वयुद्धाश्वगजविग्रहैः |
अतिव्यवायभाराध्वयुद्धाश्वगजविग्रहैः |
पर्वभेदज्वरश्वासतृष्णावैस्वर्यपीडितः |
पर्वभेदज्वरश्वासतृष्णावैस्वर्यपीडितः |
पारावत इवाकूजन् कासवेगात्क्षतोद्भवात् ||२३||
पारावत इवाकूजन् कासवेगात्क्षतोद्भवात् ||२३||
<div class="mw-collapsible-content">
ativyavāyabhārādhvayuddhāśvagajavigrahaiḥ|
ativyavāyabhārādhvayuddhāśvagajavigrahaiḥ|
parvabhedajvarashvAsatRuShNAvaisvaryapIDitaH|
parvabhedajvarashvAsatRuShNAvaisvaryapIDitaH|
pArAvata ivAkUjan kAsavegAtkShatodbhavAt||23||
pArAvata ivAkUjan kAsavegAtkShatodbhavAt||23||
</div></div>
Excessive indulgence in ''vyavaya'', carrying excessive heavy load, walking excessively long distance, indulgence in fighting, excessive indulgence in restraining the movement of horses and elephants etc factors cause injury to the chest and bring about ''rukshata'' in the body and in turn causes aggravation of ''vata'' there by results in the manifestation of ''kshataja kasa''.
Excessive indulgence in ''vyavaya'', carrying excessive heavy load, walking excessively long distance, indulgence in fighting, excessive indulgence in restraining the movement of horses and elephants etc. factors cause injury to the chest and bring about ''rukshata'' in the body and in turn causes aggravation of [[vata]] there by results in the manifestation of ''kshataja kasa''.
Signs and symptoms of ''kshataja kasa'' are as follows:
Signs and symptoms of ''kshataja kasa'' are as follows:
#The cough will be dry in the beginning followed by blood tinged sputum
#The cough will be dry in the beginning followed by blood tinged sputum
#Excessive pain in the throat and feeling of cracking pain in the chest
#Excessive pain in the throat and feeling of cracking pain in the chest
#While coughing, sounds humming like pigeon. [20-23]
#While coughing, sounds humming like pigeon. [20-23]
==== ''Kshayaja kasa'' ====
==== Etiological factors, clinical features of ''Kshayaja kasa'' ====
<div class="mw-collapsible mw-collapsed">
विषमासात्म्यभोज्यातिव्यवायाद्वेगनिग्रहात् |
विषमासात्म्यभोज्यातिव्यवायाद्वेगनिग्रहात् |
नवौ कदाचित् सिध्येतामेतौ पादगुणान्वितौ |
नवौ कदाचित् सिध्येतामेतौ पादगुणान्वितौ |
स्थविराणां जराकासः सर्वो याप्यः प्रकीर्तितः ||३०||
स्थविराणां जराकासः सर्वो याप्यः प्रकीर्तितः ||३०||
<div class="mw-collapsible-content">
viṣamāsātmyabhōjyātivyavāyādvēganigrahāt|
viṣamāsātmyabhōjyātivyavāyādvēganigrahāt|
navau kadAcit sidhyetAmetau pAdaguNAnvitau|
navau kadAcit sidhyetAmetau pAdaguNAnvitau|
</div></div>
Intake of ''vishamashana'' and ''asatmya ahara'', indulgence in ''vyavaya'', suppression of ''vega, ghrina'' and ''shoka'' etc factors leads to vitiation of ''agni'' thereby aggravation of ''tridosha'' giving rise to ''kshayaja kasa''.
Intake of ''vishamashana'' and ''asatmya ahara'', indulgence in ''vyavaya'', suppression of ''vega, ghrina'' and ''shoka'' etc factors leads to vitiation of [[agni]] thereby aggravation of tri[[dosha]] giving rise to ''kshayaja kasa''.
Signs and symptoms of ''kshayaja kasa'' are as follows:
Signs and symptoms of ''kshayaja kasa'' are as follows:
#Expectoration of the ''kapha'', which is greenish, red in colour, associated with pus and bad odor.
#Expectoration of the [[kapha]], which is greenish, red in colour, associated with pus and bad odor.
#While coughing person feels as if the heart is displaced.
#While coughing person feels as if the heart is displaced.
#Feels suddenly afflicted with both hot and cold sensations.
#Feels suddenly afflicted with both hot and cold sensations.
#Soft silky touch of hands and foot.
#Soft silky touch of hands and foot.
#Person always finds fault with others and develops immensely hateful disposition.
#Person always finds fault with others and develops immensely hateful disposition.
#Person suffers from diseases like ''jwara'' (having signs and symptoms of all ''doshas''), nasal congestion, anorexia, painful flanks, altered voice.
#Person suffers from diseases like ''jwara'' (having signs and symptoms of all [[dosha]]), nasal congestion, anorexia, painful flanks, altered voice.
#Feces hard or loose frequently without apparent cause stool.
#Feces hard or loose frequently without apparent cause stool.
''Kshataja kasa'' is palliable if the patient is strong. If these two diseases(''kshataja'' and ''kshayaja'') are in their initial stage and if all four ''chikitsa chatushpada'' are endowed with efficiency, then both of these are curable. All types of ''kasa'' are however palliable if the patient is old. [24-30]
''Kshataja kasa'' is palliable if the patient is strong. If these two diseases(''kshataja'' and ''kshayaja'') are in their initial stage and if all four ''chikitsa chatushpada'' are endowed with efficiency, then both of these are curable. All types of ''kasa'' are however palliable if the patient is old. [24-30]
=== Prognosis ===
<div class="mw-collapsible mw-collapsed">
त्रीन्साध्यान्साधयेत्पूर्वान् पथ्यैर्याप्यांश्च यापयेत् |
त्रीन्साध्यान्साधयेत्पूर्वान् पथ्यैर्याप्यांश्च यापयेत् |
चिकित्सामत ऊर्ध्वं तु शृणु कासनिबर्हिणीम् ||३१||
चिकित्सामत ऊर्ध्वं तु शृणु कासनिबर्हिणीम् ||३१||
<div class="mw-collapsible-content">
trīnsādhyānsādhayētpūrvān pathyairyāpyāṁśca yāpayēt|
trīnsādhyānsādhayētpūrvān pathyairyāpyāṁśca yāpayēt|
trInsAdhyAnsAdhayetpUrvAn pathyairyApyAMshca yApayet|
trInsAdhyAnsAdhayetpUrvAn pathyairyApyAMshca yApayet|
cikitsAmata UrdhvaM tu shRuNu kAsanibarhiNIm||31||
cikitsAmata UrdhvaM tu shRuNu kAsanibarhiNIm||31||
</div></div>
The first three types of ''kasa'' (''vataja, pittaja, kaphaja'') should be treated as these are ''sadhya vyadhi''. Whereas other two types (''khataja'' and ''kshayaja'') should be palliated with appropriate drugs and diet.
The first three types of ''kasa'' ([[vata]]ja, [[pitta]]ja, [[kapha]]ja) should be treated as these are ''sadhya vyadhi''. Whereas other two types (''khataja'' and ''kshayaja'') should be palliated with appropriate drugs and diet.
Treatment of different types of ''kasa'' has been described here after.[31]
Treatment of different types of ''kasa'' has been described here after.[31]
==== Treatment ====
=== Management ===
=== Management of [[vata]] [[dosha]] dominant kasa ===
<div class="mw-collapsible mw-collapsed">
रूक्षस्यानिलजं कासमादौ स्नेहैरुपाचरेत् |
रूक्षस्यानिलजं कासमादौ स्नेहैरुपाचरेत् |
बस्तिभिर्बद्धविड्वातं शुष्कोर्ध्वं चोर्ध्वभक्तिकैः |
बस्तिभिर्बद्धविड्वातं शुष्कोर्ध्वं चोर्ध्वभक्तिकैः |
घृतैः सपित्तं सकफं जयेत् स्नेहविरेचनैः ||३४||
घृतैः सपित्तं सकफं जयेत् स्नेहविरेचनैः ||३४||
<div class="mw-collapsible-content">
rūkṣasyānilajaṁ kāsamādau snēhairupācarēt|
rūkṣasyānilajaṁ kāsamādau snēhairupācarēt|
bastibhirbaddhaviDvAtaM shuShkordhvaM cordhvabhaktikaiH|
bastibhirbaddhaviDvAtaM shuShkordhvaM cordhvabhaktikaiH|
ghRutaiH sapittaM sakaphaM jayet snehavirecanaiH||34||
ghRutaiH sapittaM sakaphaM jayet snehavirecanaiH||34||
</div></div>
As dryness (rukshata) will be more prominent in [[vata]]ja type of ''kasa'', it should be treated with unctuous therapies (snehika upacharas). Ghrita pana,[[basti]], peya, yusha, ksheera, mamsa rasa etc. should be prepared with [[vata]]ghna dravya and is to be administered properly.
[[Abhyanga]], [[parisheka]] (sprinkling or pouring), snigdha sweda etc. should be followed appropriately.
If it is associated with constipation and flatulence should be treated with [[basti]]. If the person has dryness in the upper part of the body, and is associated with aggravated [[pitta]], then he should be given medicated [[ghrita]] after intake of food.
If the person has dryness of the upper part of the body associated with [[kapha]] aggravation, then he should be treated with snigdha [[virechana]].[32-34]
==== ''Kantakari ghrita'' ====
==== Kantakari ghrita ====
<div class="mw-collapsible mw-collapsed">
कण्टकारीगुडूचीभ्यां पृथक् त्रिंशत्पलाद्रसे |
कण्टकारीगुडूचीभ्यां पृथक् त्रिंशत्पलाद्रसे |
इति कण्टकारीघृतम् |
इति कण्टकारीघृतम् |
<div class="mw-collapsible-content">
kaṇṭakārīguḍūcībhyāṁ pr̥thak triṁśatpalādrasē|
kaṇṭakārīguḍūcībhyāṁ pr̥thak triṁśatpalādrasē|
iti kaNTakArIghRutam|
iti kaNTakArIghRutam|
</div></div>
Thirty ''pala'' of ''kantakari'' and ''guduchi kashaya'' each is to be boiled with ''ghrita'' to prepare 1 ''Prastha'' of ''ghrita''. This particular ''ghrita'' is beneficial in ''vatika kasa''. It promotes the power of digestion. Thus ends the description of ''kantakari ghrita''.[35]
Thirty ''pala'' of ''kantakari'' and ''guduchi kashaya'' each is to be boiled with ''ghrita'' to prepare 1 ''Prastha'' of ''ghrita''. This particular ''ghrita'' is beneficial in ''vatika kasa''. It promotes the power of digestion. Thus ends the description of ''kantakari ghrita''.[35]
==== ''Pippalyadi ghrita'' ====
==== Pippalyadi ghrita ====
<div class="mw-collapsible mw-collapsed">
पिप्पलीपिप्पलीमूलचव्यचित्रकनागरैः |
पिप्पलीपिप्पलीमूलचव्यचित्रकनागरैः |
इति पिप्पल्यादिघृतम् |
इति पिप्पल्यादिघृतम् |
<div class="mw-collapsible-content">
pippalīpippalīmūlacavyacitrakanāgaraiḥ|
pippalīpippalīmūlacavyacitrakanāgaraiḥ|
iti pippalyAdighRutam|
iti pippalyAdighRutam|
</div></div>
One ''prastha'' of ''ghrita'' is to be cooked by adding one ''adhaka'' of the decoction of ''dashamoola'' and the paste of one ''kola'' of each ''pippali, pippali-moola, chavya, chitraka, nagara, dhanyaka, patha, vacha, rasna, yashtimadhu, kshara'', and ''hingu''. Intake of one ''chaturthika'' (''pala'') of this ''ghrita'' along with ''peya, manda'' is beneficial in ''shwasa, kasa, hridroga, parshwashoola, grahani'' and ''gulma''. This particular formulation is known as ''pipplyaadi ghrita'' and is propounded by Atreya.
One ''prastha'' of ''ghrita'' is to be cooked by adding one ''adhaka'' of the decoction of ''dashamoola'' and the paste of one ''kola'' of each ''pippali, pippali-moola, chavya, chitraka, nagara, dhanyaka, patha, vacha, rasna, yashtimadhu, kshara'', and ''hingu''. Intake of one ''chaturthika'' (''pala'') of this ''ghrita'' along with ''peya, manda'' is beneficial in ''shwasa, kasa, hridroga, parshwashoola, grahani'' and ''gulma''. This particular formulation is known as ''pipplyaadi ghrita'' and is propounded by Atreya.
Thus ends the description of ''pipplyadi-ghrita''.[36-38]
Thus ends the description of ''pipplyadi-ghrita''.[36-38]
==== ''Tryushanadi ghrita'' ====
==== Tryushanadi ghrita ====
<div class="mw-collapsible mw-collapsed">
त्र्यूषणं त्रिफलां द्राक्षां काश्मर्याणि परूषकम् |
त्र्यूषणं त्रिफलां द्राक्षां काश्मर्याणि परूषकम् |
इति त्र्यूषणाद्यं घृतम् |
इति त्र्यूषणाद्यं घृतम् |
<div class="mw-collapsible-content">
tryūṣaṇaṁ triphalāṁ drākṣāṁ kāśmaryāṇi parūṣakam|
tryūṣaṇaṁ triphalāṁ drākṣāṁ kāśmaryāṇi parūṣakam|
dvē pāṭhē dēvadārvr̥ddhiṁ svaguptāṁ citrakaṁ śaṭīm||39||
dvē pāṭhē dēvadārvr̥ddhiṁ svaguptāṁ citrakaṁ śaṭīm||39||
iti tryUShaNAdyaM ghRutam|
iti tryUShaNAdyaM ghRutam|
</div></div>
One ''prastha'' of ''ghrita'' should be cooked by adding four ''prasthas'' of milk and the paste of one ''karsha'' each of ''tryushana, triphala, draksha, kashmari, parushaka, dve patha'' (''patha, raja patha''), ''devadaru, rddhi, swagupta, chitraka, shati, brahmi, tamalaki, meda, kakanasa, shatavari, trikantaka, vidari''. This is an effective ''kasahara'' formulation. It also cures ''jwara, gulma, aruchi, pleeha, shirah shoola, hrit shoola, parshwa shoola, kamala, arshas, ashtheela, kshata, shosha, kshaya''. This well known formulation is named as ''tryushanadi ghrita''.
One ''prastha'' of ''ghrita'' should be cooked by adding four ''prasthas'' of milk and the paste of one ''karsha'' each of ''tryushana, triphala, draksha, kashmari, parushaka, dve patha'' (''patha, raja patha''), ''devadaru, rddhi, swagupta, chitraka, shati, brahmi, tamalaki, meda, kakanasa, shatavari, trikantaka, vidari''. This is an effective ''kasahara'' formulation. It also cures ''jwara, gulma, aruchi, pleeha, shirah shoola, hrit shoola, parshwa shoola, kamala, arshas, ashtheela, kshata, shosha, kshaya''. This well known formulation is named as ''tryushanadi ghrita''.
Thus ends the description of ''tryushanadi ghrita''. [39-42]
Thus ends the description of ''tryushanadi ghrita''. [39-42]
==== ''Rasna ghritam'' ====
==== Rasna ghritam ====
<div class="mw-collapsible mw-collapsed">
द्रोणेऽपां साधयेद्रास्नां दशमूलीं शतावरीम् |
द्रोणेऽपां साधयेद्रास्नां दशमूलीं शतावरीम् |
इति रास्नाघृतम् |
इति रास्नाघृतम् |
<div class="mw-collapsible-content">
drōṇē'pāṁ sādhayēdrāsnāṁ daśamūlīṁ śatāvarīm|
drōṇē'pāṁ sādhayēdrāsnāṁ daśamūlīṁ śatāvarīm|
iti rAsnAghRutam|
iti rAsnAghRutam|
</div></div>
In one ''drona'' of water, one ''pala'' of each of ''rasna, dashamoolas,'' one ''manika'' of each of ''kulattha, badara, yava'' and half ''tula'' of ''ajamamsa'' should be added and boiled till one fourth of water remains. To this decoction, one ''adhaka'' of each of ''ghrita, ksheera'' and one ''pala'' of each of ten drugs belonging to ''jivaneeya'' (''dashemani'') should be added and cooked. This prepared ''ghrita'' should be used in the form of ''nasya, pana'' and ''anuvasana'', after proper assessment of the stages of ''vataroga''. This cures five types of ''kasa, shirahshoola, kamparoga, vankshna'' and ''yoni roga'', diseases afflicting whole body or only one limb of the body, ''pleeha roga, urdhwa vata''.
In one ''drona'' of water, one ''pala'' of each of ''rasna, dashamoolas,'' one ''manika'' of each of ''kulattha, badara, yava'' and half ''tula'' of ''ajamamsa'' should be added and boiled till one fourth of water remains. To this decoction, one ''adhaka'' of each of ''ghrita, ksheera'' and one ''pala'' of each of ten drugs belonging to ''jivaneeya'' (''dashemani'') should be added and cooked. This prepared ''ghrita'' should be used in the form of [[nasya]], pana and ''anuvasana'', after proper assessment of the stages of [[vata]]roga. This cures five types of ''kasa, shirahshoola, kamparoga, vankshna'' and ''yoni roga'', diseases afflicting whole body or only one limb of the body, pleeha roga, urdhwa [[vata]].
Thus ends the description of ''rasna- ghrita''.[43-46]
Thus ends the description of ''rasna- ghrita''.[43-46]
==== Various formulations ====
<div class="mw-collapsible mw-collapsed">
विडङ्गं नागरं रास्ना पिप्पली हिङ्गु सैन्धवम् |
विडङ्गं नागरं रास्ना पिप्पली हिङ्गु सैन्धवम् |
विडङ्गं सैन्धवं कुष्ठं व्योषं हिङ्गु मनःशिलाम् |
विडङ्गं सैन्धवं कुष्ठं व्योषं हिङ्गु मनःशिलाम् |
मधुसर्पिर्युतं कासहिक्काश्वासं जयेल्लिहन् ||५२||
मधुसर्पिर्युतं कासहिक्काश्वासं जयेल्लिहन् ||५२||
<div class="mw-collapsible-content">
viḍaṅgaṁ nāgaraṁ rāsnā pippalī hiṅgu saindhavam|
viḍaṅgaṁ nāgaraṁ rāsnā pippalī hiṅgu saindhavam|
viDa~ggaM saindhavaM kuShThaM vyoShaM hi~ggu manaHshilAm|
viDa~ggaM saindhavaM kuShThaM vyoShaM hi~ggu manaHshilAm|
madhusarpiryutaM [1] kAsahikkAshvAsaM jayellihan||52||
madhusarpiryutaM [1] kAsahikkAshvAsaM jayellihan||52||
</div></div>
Intake of the powder prepared out of ''vidanga, nagara, rasna, pippali, hingu, saindhava lavana, bharangi'' and ''kshara'' along with appropriate quantity of ''ghrita'' is beneficial in ''vataja kasa, kaphaja kasa, shwasa, hikka'' and suppression of digestion power.
Intake of the powder prepared out of ''vidanga, nagara, rasna, pippali, hingu, saindhava lavana, bharangi'' and ''kshara'' along with appropriate quantity of ''ghrita'' is beneficial in [[vata]]ja kasa, [[kapha]]ja kasa, shwasa, hikka and suppression of digestion power.
Fine ''vastragalita'' powder prepared out of ''dwou kshara''(''yava kshara'' & ''sarja kshara''), ''pancha kola, pancha lavana, shati, nagara'' and ''udichya'' , taken along with appropriate quantity of ''ghrita'' cures ''vatika'' type of ''kasa''.
Fine ''vastragalita'' powder prepared out of ''dwou kshara''(''yava kshara'' & ''sarja kshara''), ''pancha kola, pancha lavana, shati, nagara'' and ''udichya'' , taken along with appropriate quantity of ''ghrita'' cures ''vatika'' type of ''kasa''.
Intake of the powder prepared out of ''duralabha, shati, draksha, shringavera, sitopala, karkata shringi'' along with mixed with ''taila'' and its licking will cure ''vataja kasa''.
Intake of the powder prepared out of ''duralabha, shati, draksha, shringavera, sitopala, karkata shringi'' along with mixed with ''taila'' and its licking will cure [[vata]]ja kasa.
The powder of ''dusparsha, pippali, musta, bharangi, karkataki,'' and ''shati'' should be mixed with ''purana guda'' and ''taila''.
The powder of ''dusparsha, pippali, musta, bharangi, karkataki,'' and ''shati'' should be mixed with ''purana guda'' and ''taila''.
==== ''Chitrakadi leha'' ====
==== ''Chitrakadi leha'' ====
<div class="mw-collapsible mw-collapsed">
चित्रकं पिप्पलीमूलं व्योषं हिङ्गु दुरालभाम् |
चित्रकं पिप्पलीमूलं व्योषं हिङ्गु दुरालभाम् |
इति चित्रकादिलेहः |
इति चित्रकादिलेहः |
<div class="mw-collapsible-content">
citrakaṁ pippalīmūlaṁ vyōṣaṁ hiṅgu durālabhām|
citrakaṁ pippalīmūlaṁ vyōṣaṁ hiṅgu durālabhām|
iti citrakAdilehaH|
iti citrakAdilehaH|
</div></div>
In half ''tula'' of the decoction of ''nidigdhika''(Solanum xanthocarpum), the powder or paste of one ''karsha'' of each of ''chitraka, pippalimula, vyosha, hingu, duralabha, shati, pushkaramoola, shreyasi, surasa, vacha, bharangi, chinnaruha, rasna, shringi, draksha'' should be added. To this twenty ''palas'' of ''matsyandika'' and one ''kudava'' of ''ghrita'' should be added and cooked, There after when it becomes cool, one ''kudava'' of each of ''madhu, pippali'' powder, four ''palas'' of the powder of ''tugakshiri'' should be added. This ''leha'' will cure ''kasa, hridroga, shwasa, gulma''.
In half ''tula'' of the decoction of ''nidigdhika''(Solanum xanthocarpum), the powder or paste of one ''karsha'' of each of ''chitraka, pippalimula, vyosha, hingu, duralabha, shati, pushkaramoola, shreyasi, surasa, vacha, bharangi, chinnaruha, rasna, shringi, draksha'' should be added. To this twenty ''palas'' of ''matsyandika'' and one ''kudava'' of ''ghrita'' should be added and cooked, There after when it becomes cool, one ''kudava'' of each of ''madhu, pippali'' powder, four ''palas'' of the powder of ''tugakshiri'' should be added. This ''leha'' will cure ''kasa, hridroga, shwasa, gulma''.
Thus ends the description of ''chitrakadi leha''.[53-56]
Thus ends the description of ''chitrakadi leha''.[53-56]
==== ''Agastya haritaki'' ====
==== Agastya haritaki ====
<div class="mw-collapsible mw-collapsed">
दशमूलीं स्वयङ्गुप्तां शङ्खपुष्पीं शटीं बलाम् |
दशमूलीं स्वयङ्गुप्तां शङ्खपुष्पीं शटीं बलाम् |
इत्यगस्त्यहरीतकी |
इत्यगस्त्यहरीतकी |
<div class="mw-collapsible-content">
daśamūlīṁ svayaṅguptāṁ śaṅkhapuṣpīṁ śaṭīṁ balām|
daśamūlīṁ svayaṅguptāṁ śaṅkhapuṣpīṁ śaṭīṁ balām|
agastyavihitaM shreShThaM rasAyanamidaM shubham||62||
agastyavihitaM shreShThaM rasAyanamidaM shubham||62||
ityagastyaharItakI|
ityagastyaharItakI|
</div></div>
Two palas of each among ''dashamoola, swayamgupta, shankahpushpi, shati, bala, hasti pippali, apamarga, pippalimoola, chitraka, bharangi, pushkaramoola'' should be added with one ''adhaka'' of water, these drugs should be cooked till the grains of ''yava'' becomes soft. And then decoction should be strained out. These hundred fruits of ''abhaya'' should be added with above mentioned decoction, one ''tula'' of ''guda'', one ''kudava'' of ''ghrita, taila'' and powder of ''pippali''. This is to be cooked and after attaining coldness one ''kudava'' of ''makshika'' is to be added.
Two palas of each among ''dashamoola, swayamgupta, shankahpushpi, shati, bala, hasti pippali, apamarga, pippalimoola, chitraka, bharangi, pushkaramoola'' should be added with one ''adhaka'' of water, these drugs should be cooked till the grains of ''yava'' becomes soft. And then decoction should be strained out. These hundred fruits of ''abhaya'' should be added with above mentioned decoction, one ''tula'' of ''guda'', one ''kudava'' of ''ghrita, taila'' and powder of ''pippali''. This is to be cooked and after attaining coldness one ''kudava'' of ''makshika'' is to be added.
Intake of two fruits of ''haritaki'' along with ''leha'' daily is considered as ''rasayana''. It removes ''vali, phalita''; increases ''varna, ayu'' and ''bala''. Beneficial in ''panchakasa, kshaya, shwaasa, hikka, vishamajwara, arshas, grahani, hridroga, aruchi, pinasa''. This excellent formulation is propounded by Agastya and is auspicious.
Intake of two fruits of ''haritaki'' along with ''leha'' daily is considered as [[rasayana]]. It removes ''vali, palita''; increases [[varna]], [[ayu]] and [[bala]]. Beneficial in ''panchakasa, kshaya, shwaasa, hikka, vishamajwara, arshas, grahani, hridroga, aruchi, pinasa''. This excellent formulation is propounded by Agastya and is auspicious.
Thus, ends the description of ''Agastya-haritaki''.[57-62]
Thus, ends the description of ''Agastya-haritaki''.[57-62]
==== Other formulations ====
<div class="mw-collapsible mw-collapsed">
सैन्धवं पिप्पलीं भार्गीं शृङ्गवेरं दुरालभाम् |
सैन्धवं पिप्पलीं भार्गीं शृङ्गवेरं दुरालभाम् |
पिबेत् खदिरसारं वा मदिरादधिमस्तुभिः |
पिबेत् खदिरसारं वा मदिरादधिमस्तुभिः |
अथवा पिप्पलीकल्कं घृतभृष्टं ससैन्धवम् ||६४||
अथवा पिप्पलीकल्कं घृतभृष्टं ससैन्धवम् ||६४||
<div class="mw-collapsible-content">
saindhavaṁ pippalīṁ bhārgīṁ śr̥ṅgavēraṁ durālabhām|
saindhavaṁ pippalīṁ bhārgīṁ śr̥ṅgavēraṁ durālabhām|
pibet khadirasAraM [1] vA madirAdadhimastubhiH|
pibet khadirasAraM [1] vA madirAdadhimastubhiH|
athavA pippalIkalkaM ghRutabhRuShTaM sasaindhavam||64||
athavA pippalIkalkaM ghRutabhRuShTaM sasaindhavam||64||
</div></div>
Intake of the powder of ''saindhava, pippali, bharangi, shringavera'' and ''duralabha'' along with lukewarm juice of sour ''dadima'' or the decoction of ''nagara'' cures [[vata]]ja kasa.
Intake of the powder of ''saindhava, pippali, bharangi, shringavera'' and ''duralabha'' along with lukewarm juice of sour ''dadima'' or the decoction of ''nagara'' cures ''vataja kasa''.
Intake of ''khadira saara'' along with ''madira'' or ''takra''; intake of ''pippali'' fried with ''ghrita'' mixed with ''saindhava'' is beneficial in [[vata]]ja kasa. [63-64]
==== [[Dhumapana]] (medicated smoke inhalation) formulations ====
<div class="mw-collapsible mw-collapsed">
शिरसः पीडने स्रावे नासाया हृदि ताम्यति |
शिरसः पीडने स्रावे नासाया हृदि ताम्यति |
स ह्यस्य तैक्ष्ण्याद्विच्छिद्य श्लेष्माणमुरसि स्थितम् |
स ह्यस्य तैक्ष्ण्याद्विच्छिद्य श्लेष्माणमुरसि स्थितम् |
निष्कृष्य शमयेत् कासं वातश्लेष्मसमुद्भवम् ||६८||
निष्कृष्य शमयेत् कासं वातश्लेष्मसमुद्भवम् ||६८||
<div class="mw-collapsible-content">
śirasaḥ pīḍanē srāvē nāsāyā hr̥di tāmyati|
śirasaḥ pīḍanē srāvē nāsāyā hr̥di tāmyati|
sa hyasya taikShNyAdvicchidya shleShmANamurasi sthitam|
sa hyasya taikShNyAdvicchidya shleShmANamurasi sthitam|
niShkRuShya shamayet kAsaM vAtashleShmasamudbhavam||68||
niShkRuShya shamayet kAsaM vAtashleShmasamudbhavam||68||
</div></div>
If there is pain in the ''shiras, nasa srava, arrhythmia'' of ''hridaya'' and ''pratishyaya'' in ''kasa'' then the physician should administer ''dhuma''. A wise physician should keep the ingredients of the recipe which cause elimination of ''doshas'' from the head inside two earthen plates with their brims sealed with mud-smeared cloth. In the upper plate there should be a hole to which a tube, ten or eight ''angulas'' in length, should be inserted in slightly curved form. The patient suffering from ''kasa'' should smoke the fume emanating from this tube through his mouth. After the smoke pervades the entire chest, it should be smoked out through the mouth. Because of the sharpness of the ingredients used in this recipe, the phlegm located in the chest gets detached and forcibly thrown out as a result of which ''kasa'' caused by ''vayu'' and ''kapha'' gets alleviated. [65-68]
If there is pain in the ''shiras, nasa srava, arrhythmia'' of ''hridaya'' and ''pratishyaya'' in ''kasa'' then the physician should administer ''dhuma''. A wise physician should keep the ingredients of the recipe which cause elimination of [[dosha]] from the head inside two earthen plates with their brims sealed with mud-smeared cloth. In the upper plate there should be a hole to which a tube, ten or eight ''angulas'' in length, should be inserted in slightly curved form. The patient suffering from ''kasa'' should smoke the fume emanating from this tube through his mouth. After the smoke pervades the entire chest, it should be smoked out through the mouth. Because of the sharpness of the ingredients used in this recipe, the phlegm located in the chest gets detached and forcibly thrown out as a result of which ''kasa'' caused by [[vayu]] and [[kapha]] gets alleviated. [65-68]
<div class="mw-collapsible mw-collapsed">
मनःशिलालमधुकमांसीमुस्तेङ्गुदैः पिबेत् |
मनःशिलालमधुकमांसीमुस्तेङ्गुदैः पिबेत् |
त्वगैङ्गुदी बृहत्यौ द्वे तालमूली मनःशिला |
त्वगैङ्गुदी बृहत्यौ द्वे तालमूली मनःशिला |
कार्पासास्थ्यश्वगन्धा च धूमः कासविनाशनः ||७५||
कार्पासास्थ्यश्वगन्धा च धूमः कासविनाशनः ||७५||
<div class="mw-collapsible-content">
manaḥśilālamadhukamāṁsīmustēṅgudaiḥ pibēt|
manaḥśilālamadhukamāṁsīmustēṅgudaiḥ pibēt|
tvagai~ggudI bRuhatyau dve tAlamUlI manaHshilA|
tvagai~ggudI bRuhatyau dve tAlamUlI manaHshilA|
kArpAsAsthyashvagandhA ca dhUmaH kAsavinAshanaH||75||
kArpAsAsthyashvagandhA ca dhUmaH kAsavinAshanaH||75||
</div></div>
Intake of lukewarm milk along with guda after the ''dhumapana'' using ''manahshila, ala''(''haritala''), ''madhuka, jatamansi, ingudi'' cures ''kasa'' of ''prthakdosha'' (three ''doshas'' individually) or ''sannipatika''. This can cure such ailments which were not cured even after the treatment with hundred other recipes.
Intake of lukewarm milk along with guda after the ''dhumapana'' using ''manahshila, ala''(''haritala''), ''madhuka, jatamansi, ingudi'' cures ''kasa'' of ''prthakdosha'' (three [[dosha]] individually) or ''sannipatika''. This can cure such ailments which were not cured even after the treatment with hundred other recipes.
The paste prepared out of ''prapoundarika, madhuka, sharangeshta, manhashila, maricha, pippali, draksha, ela'' and ''surasa manjari''(inflorescence of Ocimum sanctum), should be smeared on silk cloth and a ''varti'' should be prepared. This ''varti'' smeared with ''ghrita'' should be used for ''dhumapana'', followed by intake of milk or jaggery mixed with water cures both ''ekadoshaja'' and ''sannipatika kasa''.
The paste prepared out of ''prapoundarika, madhuka, sharangeshta, manhashila, maricha, pippali, draksha, ela'' and ''surasa manjari''(inflorescence of Ocimum sanctum), should be smeared on silk cloth and a ''varti'' should be prepared. This ''varti'' smeared with ''ghrita'' should be used for ''dhumapana'', followed by intake of milk or jaggery mixed with water cures both ''ekadoshaja'' and ''sannipatika kasa''.
''Dhuma'' therapy using bark of ''ingudi, brihati, kantakari, talamuli, manahshila, karpasasthi'' (Seeds of ''karpasa''), ''ashwagandha'' cures ''kasa''. [69-75]
''Dhuma'' therapy using bark of ''ingudi, brihati, kantakari, talamuli, manahshila, karpasasthi'' (Seeds of ''karpasa''), ''ashwagandha'' cures ''kasa''. [69-75]
=== Diet recipes ===
<div class="mw-collapsible mw-collapsed">
ग्राम्यानूपौदकैः शालियवगोधूमषष्टिकान् |
ग्राम्यानूपौदकैः शालियवगोधूमषष्टिकान् |
इति वातकासचिकित्सा |
इति वातकासचिकित्सा |
<div class="mw-collapsible-content">
grāmyānūpaudakaiḥ śāliyavagōdhūmaṣaṣṭikān|
grāmyānūpaudakaiḥ śāliyavagōdhūmaṣaṣṭikān|
iti vAtakAsacikitsA|
iti vAtakAsacikitsA|
</div></div>
Intake of ''shashtikashali, shali, yava, godhuma'' along with the ''mamsa rasa'' or ''yusha'' prepared out of ''masha'' or ''Atmagupta'' is beneficial in ''vataja kasa. Peya'' prepared out of ''yavani, pippali, bilwa, nagara, chitraka, rasna, ajaji, prithakparni, palasha, shati'' and ''pushkaramoola'' by adding ''snigdha, amla'' and ''lavana dravyas'' is beneficial in ''vataja kasa''. This particular ''peya'' is helpful in curing ''vataja kasa'' associated with ''shoola'' in ''kati, parshwa, koshta, hikka'' and ''shwasa''.
Intake of ''shashtikashali, shali, yava, godhuma'' along with the ''mamsa rasa'' or ''yusha'' prepared out of ''masha'' or ''Atmagupta'' is beneficial in ''vataja kasa. Peya'' prepared out of ''yavani, pippali, bilwa, nagara, chitraka, rasna, ajaji, prithakparni, palasha, shati'' and ''pushkaramoola'' by adding ''snigdha, amla'' and ''lavana dravyas'' is beneficial in ''vataja kasa''. This particular ''peya'' is helpful in curing ''vataja kasa'' associated with ''shoola'' in ''kati, parshwa, koshta, hikka'' and ''shwasa''.
Intake of ''peya'' prepared with ''dashamoola kashaya'' by adding the powder of ''panchakola'' and ''gud'' is specifically useful in ''vataja kasa''. Similarly the ''peya'' prepared by adding equal quantity of ''tila'' and boiled by adding ''ksheera'' is also useful in this ''kasa''.
Intake of ''peya'' prepared with ''dashamoola kashaya'' by adding the powder of ''panchakola'' and ''gud'' is specifically useful in [[vata]]ja kasa. Similarly the ''peya'' prepared by adding equal quantity of ''tila'' and boiled by adding ''ksheera'' is also useful in this ''kasa''.
''Peya'' prepared out of ''matsya, kukkuta, varaha mamsa'' by adding ''ghrita'' and ''saindhava lavana'' should be taken by a person suffering from ''vataja kasa''. Vegetables like ''vastuka, vayasi, mulaka, sunishannaka'' should be used in ''vataja kasa'' along with adequate quantity of ''sneha, kshera, ikshurasa'' and ''gud''. ''Aranala, amla phala, prasanna'' etc foods and drinks which are ''madhura, amla, lavana'' in nature are useful in ''vataja kasa''.[76-82]
''Peya'' prepared out of ''matsya, kukkuta, varaha mamsa'' by adding ''ghrita'' and ''saindhava lavana'' should be taken by a person suffering from ''vataja kasa''. Vegetables like ''vastuka, vayasi, mulaka, sunishannaka'' should be used in ''vataja kasa'' along with adequate quantity of ''sneha, kshera, ikshurasa'' and ''gud''. ''Aranala, amla phala, prasanna'' etc foods and drinks which are ''madhura, amla, lavana'' in nature are useful in ''vataja kasa''.[76-82]
=== Management of [[pitta]] [[dosha]] dominant kasa ===
<div class="mw-collapsible mw-collapsed">
पैत्तिके सकफे कासे वमनं सर्पिषा हितम् |
पैत्तिके सकफे कासे वमनं सर्पिषा हितम् |
इति पित्तकासचिकित्सा |
इति पित्तकासचिकित्सा |
<div class="mw-collapsible-content">
paittikē sakaphē kāsē vamanaṁ sarpiṣā hitam|
paittikē sakaphē kāsē vamanaṁ sarpiṣā hitam|
sarpiH siddhaM pibedyuktyA pittakAsanibarhaNam||107||
sarpiH siddhaM pibedyuktyA pittakAsanibarhaNam||107||
iti pittakAsacikitsA|
iti pittakAsacikitsA|
</div></div>
If ''pittaja kasa'' is associated with the aggravation of ''kapha'', then ''vamanakarma'' is to be advised with ''ghrita'' or using the ''kashaya'' prepared out of ''madana, kashmari, madhuka''. ''Vamana'' can also be induced by using the ''klaka'' of ''madanaphal'' and ''madhuyashti'' along with ''vidari'' and ''ikshurasa''. Once after the elimination of aggravated ''doshas'' he should be treated with ''sheeta'' and ''madhura aharas''.
If [[pitta]]ja kasa is associated with the aggravation of [[kapha]], then [[vamana]] karma is to be advised with ''ghrita'' or using the ''kashaya'' prepared out of ''madana, kashmari, madhuka''. [[Vamana]] can also be induced by using the ''klaka'' of ''madanaphal'' and ''madhuyashti'' along with ''vidari'' and ''ikshurasa''. Once after the elimination of aggravated ''doshas'' he should be treated with ''sheeta'' and ''madhura aharas''.
If in ''pittaja kasa'' the phlegm is thin then ''virechana'' is to be advised using ''trivrita'' mixed with ''madhura dravyas'', followed by ''snigdha'' and ''sheeta ahara''. Whereas if the phlegm is thick then ''trivrita'' is to be mixed with ''tiktha dravyas'', followed by ''ruksha'' and ''sheeta dravyas''.
If in [[pitta]]ja kasa the phlegm is thin then [[virechana]] is to be advised using ''trivrita'' mixed with ''madhura dravyas'', followed by ''snigdha'' and ''sheeta ahara''. Whereas if the phlegm is thick then ''trivrita'' is to be mixed with ''tiktha dravyas'', followed by ''ruksha'' and ''sheeta dravyas''.
After proper ''shodhana'' therapy person should be treated with ''snigdha leha kalpanas''.
After proper ''shodhana'' therapy person should be treated with ''snigdha leha kalpanas''.
Following five formulations have been advised for ''pittaja kasa'' along with ''ghrita'' and ''kshoudra'' and made into the form of ''leha'':
Following five formulations have been advised for [[pitta]]ja kasa along with ''ghrita'' and ''kshoudra'' and made into the form of ''leha'':
#''Shringataka, padma beeja, sara'' of ''nili,'' and ''pippali''
#''Shringataka, padma beeja, sara'' of ''nili,'' and ''pippali''
#''Pippali, musta, yashtimadhu, draksha, murva, mahoushadha''
#''Pippali, musta, yashtimadhu, draksha, murva, mahoushadha''
#''Kharjuara, pippali, vamshalochana, shwadamshtra''
#''Kharjuara, pippali, vamshalochana, shwadamshtra''
If ''kasa'' is exclusively of ''pitta'', then the patient should be given the combination of ''sharkara, chanadana, draksha, madhu, dhatriphala'' and ''utpala''. If there is association of ''kapha,'' then he should administer this along with ''musta'' and ''maricha.'' If however, it is associated with ''vata'', then it should be used with ''ghrita''.
If ''kasa'' is exclusively of ''pitta'', then the patient should be given the combination of ''sharkara, chanadana, draksha, madhu, dhatriphala'' and ''utpala''. If there is association of [[kapha]], then he should administer this along with ''musta'' and ''maricha.'' If however, it is associated with [[vata]], then it should be used with ''ghrita''.
Fifty fruits of ''mridvika,'' thirty fruits of ''pippali'' and one ''pala'' of sugar should be added with ''madhu'', and given to the patient suffering from ''pittaja kasa''.
Fifty fruits of ''mridvika,'' thirty fruits of ''pippali'' and one ''pala'' of sugar should be added with ''madhu'', and given to the patient suffering from ''pittaja kasa''.
Administration of ''madhu'' either with cows milk or urine is beneficial in ''pittaja kasa''. But during this therapy patient should drink only milk. The ''leha'' prepared out of ''twak, ela, shunthi, pippali, maricha, mridvika, pippalimula, pushkaramula, laja, musta, shati, rasna, dhatriphala'' and ''bibhitaka'' along with ''sharkara, madhu'' and ''ghrita'' cures ''kasa, shwasa, hikka, kshaya, hridroga. Pippali, amalaki, draksha, lakshai, laja'' and ''sitopala'' should be cooked by adding milk. When it becomes cool , one eighth part of ''madhu'' should be added. This is indicated in ''kasa''. Intake of the liquid prepared out ''vidari, ikshu, mrinala, ksheera'' and ''sitopala'' mixed with ''madhu'' cures ''pittaja kasa'' effectively. Intake of ''yusha'' prepared out of ''shyamaka, yavaka, kodrava, mudga'' along with sweet ''jangal mamsa rasa'' along with ''tiktha shaka'' is beneficial in ''pittaja kasa''. If the phlegm is thick then the patient should be administered with ''lehas'' prepared out of ''tiktha rasa dravyas'' along with ''madhu''. If the phlegm is thin, then the patient should be given with ''shali'' and ''shashtika shali'' along with ''mamsa rasa''.
Administration of ''madhu'' either with cows milk or urine is beneficial in [[pitta]]ja kasa. But during this therapy patient should drink only milk. The ''leha'' prepared out of ''twak, ela, shunthi, pippali, maricha, mridvika, pippalimula, pushkaramula, laja, musta, shati, rasna, dhatriphala'' and ''bibhitaka'' along with ''sharkara, madhu'' and ''ghrita'' cures ''kasa, shwasa, hikka, kshaya, hridroga. Pippali, amalaki, draksha, lakshai, laja'' and ''sitopala'' should be cooked by adding milk. When it becomes cool , one eighth part of ''madhu'' should be added. This is indicated in ''kasa''. Intake of the liquid prepared out ''vidari, ikshu, mrinala, ksheera'' and ''sitopala'' mixed with ''madhu'' cures [[pitta]]ja kasa effectively. Intake of ''yusha'' prepared out of ''shyamaka, yavaka, kodrava, mudga'' along with sweet ''jangal mamsa rasa'' along with ''tiktha shaka'' is beneficial in ''pittaja kasa''. If the phlegm is thick then the patient should be administered with ''lehas'' prepared out of ''tiktha rasa dravyas'' along with ''madhu''. If the phlegm is thin, then the patient should be given with ''shali'' and ''shashtika shali'' along with ''mamsa rasa''.
In this ''pittaja kasa'' drink prepared out of ''sharkara, draksha, ikshurasa'' and milk are beneficial. All things which are ''madhura, sheeta'' and ''avidahi'' should be used.
In this [[pitta]]ja kasa drink prepared out of ''sharkara, draksha, ikshurasa'' and milk are beneficial. All things which are ''madhura, sheeta'' and ''avidahi'' should be used.
Dishes like ''mamsa rasa, ksheera, yusha'' etc prepared out of ''kakoli, brihati, meda, mahameda, vasa'' and ''nagara'' are to be used in ''pittaja kasa''. Similarly milk boiled with ''sharadi panchamoola''(Trinapanchamoola), ''pippali, draksha'' along with ''madhu'' and ''sharkara'' should be taken in ''pittaja kasa'' .
Dishes like ''mamsa rasa, ksheera, yusha'' etc prepared out of ''kakoli, brihati, meda, mahameda, vasa'' and ''nagara'' are to be used in [[pitta]]ja kasa. Similarly milk boiled with ''sharadi panchamoola''(Trinapanchamoola), ''pippali, draksha'' along with ''madhu'' and ''sharkara'' should be taken in [[pitta]]ja kasa.
Milk boiled with ''sthira, sita, prashniparni, sharavani, brihati, kantakari, jivaka, rshabhaka, kakoli, tamalaki, rddhi'' and ''jivaka'' is useful in the treatment of ''kasa, jwara, daha, kshata'' and ''kshaya''.
Milk boiled with ''sthira, sita, prashniparni, sharavani, brihati, kantakari, jivaka, rshabhaka, kakoli, tamalaki, rddhi'' and ''jivaka'' is useful in the treatment of ''kasa, jwara, daha, kshata'' and ''kshaya''.
The ''ghrita'' collected from the above mentioned should be added with milk, ''ikshu rasa'' and the paste of three ''karsas'' of each of the ''madhura dravya'' belonging to ''jivaneeya'' group, fruits of ''abhishuka'' etc and cooked. The ''ghrita'' should then be filtered out and made to cool. To this the powder of ''sharkara, pippali, tvak-kshiri, maricha , shringatak'' and ''madhu'' should be added. This paste should be added with wheat-flour and ''gud'' (''sarpi gud'') should be prepared out of it. Intake of this cures ''shukra'' and ''asrig dosha, shosha, kasa , kshataksheena'' etc.
The ''ghrita'' collected from the above mentioned should be added with milk, ''ikshu rasa'' and the paste of three ''karsas'' of each of the ''madhura dravya'' belonging to ''jivaneeya'' group, fruits of ''abhishuka'' etc and cooked. The ''ghrita'' should then be filtered out and made to cool. To this the powder of ''sharkara, pippali, tvak-kshiri, maricha , shringatak'' and ''madhu'' should be added. This paste should be added with wheat-flour and ''gud'' (''sarpi gud'') should be prepared out of it. Intake of this cures ''shukra'' and ''asrig dosha, shosha, kasa , kshataksheena'' etc.
Fine paste of ''sharkara, nagara, udeechya, kantakari, shati'' should be prepared and is to be filtered through a cloth. This liquid is to be used for the ''ghrita murchana''. This ''murchita ghrita'' cures ''pittaja kasa''.
Fine paste of ''sharkara, nagara, udeechya, kantakari, shati'' should be prepared and is to be filtered through a cloth. This liquid is to be used for the ''ghrita murchana''. This ''murchita ghrita'' cures [[pitta]]ja kasa.
''Ghrita'' should be cooked with ''mahisha, aja'' and cows milk, along with ''dhatri phala rasa'', all taken in equal quantity. Intake of this ''ghrita'' in appropriate quantity cures ''pittaja kasa''.
''Ghrita'' should be cooked with ''mahisha, aja'' and cows milk, along with ''dhatri phala rasa'', all taken in equal quantity. Intake of this ''ghrita'' in appropriate quantity cures [[pitta]]ja kasa.
Thus ends the description of ''pittaja kasa''. [83-107]
Thus ends the description of [[pitta]]ja kasa. [83-107]
=== Management of [[kapha]] [[dosha]] dominant kasa ===
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बलिनं वमनैरादौ शोधितं कफकासिनम् |
बलिनं वमनैरादौ शोधितं कफकासिनम् |
पौष्करारग्वधं मूलं पटोलं तैर्निशास्थितम् |
पौष्करारग्वधं मूलं पटोलं तैर्निशास्थितम् |
जलं मधुयुतं पेयं कालेष्वन्नस्य वा त्रिषु ||१११||
जलं मधुयुतं पेयं कालेष्वन्नस्य वा त्रिषु ||१११||
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balinaṁ vamanairādau śōdhitaṁ kaphakāsinam|
balinaṁ vamanairādau śōdhitaṁ kaphakāsinam|
pauShkarAragvadhaM mUlaM paTolaM tairnishAsthitam|
pauShkarAragvadhaM mUlaM paTolaM tairnishAsthitam|
jalaM madhuyutaM peyaM kAleShvannasya vA triShu||111||
jalaM madhuyutaM peyaM kAleShvannasya vA triShu||111||
</div></div>
If the person suffering from ''kaphaja kasa'' is strong, then he should follow ''shodhana'' procedure by means of ''vamana''. There after he should be given with ''yava'' and such other ''kaphaghna'' food which are ''katu, ruksha'' and ''ushna'' in nature.
If the person suffering from [[kapha]]ja kasa is strong, then he should follow ''shodhana'' procedure by means of [[vamana]]. There after he should be given with ''yava'' and such other [[kapha]]ghna food which are ''katu, ruksha'' and ''ushna'' in nature.
The person should take ''laghu ahara'' with the ''yusha'' prepared out of ''kulattha, pippali, kshara, mulaka'' or with the ''mamsa rasa'' of animals of arid zone/ ''bilehsya'' etc. mixed with ''katu rasadravya, srashapataila'' and ''bilva''.
The person should take ''laghu ahara'' with the ''yusha'' prepared out of ''kulattha, pippali, kshara, mulaka'' or with the ''mamsa rasa'' of animals of arid zone/ ''bilehsya'' etc. mixed with ''katu rasadravya, srashapataila'' and ''bilva''.
Drinks such as ''madhu, amala rasa,'' warm water, butter milk or harmless ''madya'' are preferred in ''kaphaja kasa''. Roots of ''pushkaramoola, argwadha, patola, tinisha'' should be kept in water for whole night. Next morning water should be strained out and added with ''madhu''. This should be taken before, during and after food. [108-111]
Drinks such as ''madhu, amala rasa,'' warm water, butter milk or harmless ''madya'' are preferred in [[kapha]]ja kasa. Roots of ''pushkaramoola, argwadha, patola, tinisha'' should be kept in water for whole night. Next morning water should be strained out and added with ''madhu''. This should be taken before, during and after food. [108-111]
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कट्फलं कत्तृणं भार्गीं मुस्तं धान्यं वचाभये |
कट्फलं कत्तृणं भार्गीं मुस्तं धान्यं वचाभये |
दशमूलाढके प्रस्थं घृतस्याक्षसमैः पचेत् |
दशमूलाढके प्रस्थं घृतस्याक्षसमैः पचेत् |
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kaṭphalaṁ kattr̥ṇaṁ bhārgīṁ mustaṁ dhānyaṁ vacābhayē|
kaṭphalaṁ kattr̥ṇaṁ bhārgīṁ mustaṁ dhānyaṁ vacābhayē|
sauvarcalAbhayAdhAtrIpippalIkShAranAgaram|
sauvarcalAbhayAdhAtrIpippalIkShAranAgaram|
cUrNitaM sarpiShA vAtakaphakAsaharaM pibet||122||
cUrNitaM sarpiShA vAtakaphakAsaharaM pibet||122||
</div></div>
Decoction prepared by boiling drugs such as ''katphala, kuttrana, bharangi, musta, dhanyaka, vacha, abhaya, shunthi, parpata, shrungi'' and ''surahva'' is to be used in ''kasa'' associated with ''vata'' and ''kapha'' along with ''madhu'' and ''hingu''. This is also beneficial in ''kantharoga, mukha roga, shoola, shwasa, hikka'' and ''jwara''.
Decoction prepared by boiling drugs such as ''katphala, kuttrana, bharangi, musta, dhanyaka, vacha, abhaya, shunthi, parpata, shrungi'' and ''surahva'' is to be used in ''kasa'' associated with [[vata]] and [[kapha]] along with ''madhu'' and ''hingu''. This is also beneficial in ''kantharoga, mukha roga, shoola, shwasa, hikka'' and ''jwara''.
''Patha, shunthi, shati, murva, gavakshi, musta'' and ''pippali'' paste taken along with hot water by adding ''hingu'' and ''saindhava'' cures ''kasa''. Similarly administration of ''nagara, ativisha, musta, karkatashringi, haritaki'' and ''shati'' is also beneficial.
''Patha, shunthi, shati, murva, gavakshi, musta'' and ''pippali'' paste taken along with hot water by adding ''hingu'' and ''saindhava'' cures ''kasa''. Similarly administration of ''nagara, ativisha, musta, karkatashringi, haritaki'' and ''shati'' is also beneficial.
One ''aksha'' of the paste of ''pippali'', fried with oil should be added with ''sitopala''. Intake of this recipe along with ''kulattha yusha'' cures ''kaphaja kasa''. The ''swarasa'' extracted out of ''kasamarda'', stool of horse, ''bhringaraja, vartaka'' and black variety of ''surasa'' along with honey cures ''kaphaja kasa''.
One ''aksha'' of the paste of ''pippali'', fried with oil should be added with ''sitopala''. Intake of this recipe along with ''kulattha yusha'' cures [[kapha]]ja kasa. The ''swarasa'' extracted out of ''kasamarda'', stool of horse, ''bhringaraja, vartaka'' and black variety of ''surasa'' along with honey cures [[kapha]]ja kasa.
Powder prepared out of ''devadaru, shati, rasna, karkatashringi, duralabha'' taken along with ''madhu'' and ''taila'' is effective in ''vatanuga kaphajakasa''.
Powder prepared out of ''devadaru, shati, rasna, karkatashringi, duralabha'' taken along with ''madhu'' and ''taila'' is effective in [[vata]]nuga [[kapha]]ja kasa.
''Pippali, nagara, musta, haritaki, amalaki'' and ''sitopala'' is to be taken along with ''madhu'' and ''taila'' is effective in ''vatanuga kaphajakasa''.
''Pippali, nagara, musta, haritaki, amalaki'' and ''sitopala'' is to be taken along with ''madhu'' and ''taila'' is effective in [[vata]]nuga [[kapha]]ja kasa.
''Pippali, pippalimula, chitraka'' and ''gaja pippali'' should be made into ''leha'' form by adding ''madhu''. Intake of this cures ''kaphajakasa.''
''Pippali, pippalimula, chitraka'' and ''gaja pippali'' should be made into ''leha'' form by adding ''madhu''. Intake of this cures [[kapha]]ja kasa.
Similarly ''pathya, tamalaki, dhatri, bhadra-musta'' and ''pippali'' combination taken along with ''madhu'' cures ''kaphajakasa''.
Similarly ''pathya, tamalaki, dhatri, bhadra-musta'' and ''pippali'' combination taken along with ''madhu'' cures ''kaphajakasa''.
''Vishala, pippali, musta, trivrit'' should be taken along with honey in ''kaphajakasa''.
''Vishala, pippali, musta, trivrit'' should be taken along with honey in [[kapha]]ja kasa.
Intake of the powder prepared out of ''souvarchala, abhaya, dhatri, pipplai, kshara'' and ''nagara'' taken along with ''ghrita'' cures ''kasa'' caused by ''vata'' and ''kapha''. [112-122]
Intake of the powder prepared out of ''souvarchala, abhaya, dhatri, pipplai, kshara'' and ''nagara'' taken along with ''ghrita'' cures ''kasa'' caused by [[vata]] and [[kapha]]. [112-122]
==== ''Dashamuladi ghritam'' ====
==== Dashamuladi ghritam ====
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पुष्कराह्वशटीबिल्वसुरसव्योषहिङ्गुभिः ||१२३||
पुष्कराह्वशटीबिल्वसुरसव्योषहिङ्गुभिः ||१२३||
इति दशमूलादिघृतम् |
इति दशमूलादिघृतम् |
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daśamūlāḍhakē prasthaṁ ghr̥tasyākṣasamaiḥ pacēt|
daśamūlāḍhakē prasthaṁ ghr̥tasyākṣasamaiḥ pacēt|
iti dashamUlAdighRutam|
iti dashamUlAdighRutam|
</div></div>
One ''prastha'' of ''dashamoola'' should be cooked by adding one ''adhaka'' of the decoction of ''dashamoola'' and the paste of one ''aksha'' each of ''pushkar-moola, shati, bilva, surasa, shunthi, pippali, maricha'' and ''hingu''. Administration of this ghee followed by ''peya'' as ''anupana'' cure ''vatakaphaja kasa, shwasa roga''.
One ''prastha'' of ''dashamoola'' should be cooked by adding one ''adhaka'' of the decoction of ''dashamoola'' and the paste of one ''aksha'' each of ''pushkar-moola, shati, bilva, surasa, shunthi, pippali, maricha'' and ''hingu''. Administration of this ghee followed by ''peya'' as ''anupana'' cure [[vata]] [[kapha]]ja kasa, shwasa roga.
Thus ends the description of ''dashamooladi ghrita''. [123-124]
Thus ends the description of ''dashamooladi ghrita''. [123-124]
==== ''Kantakari ghritam'' ====
==== Kantakari ghritam ====
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समूलफलपत्रायाः कण्टकार्या रसाढके |
समूलफलपत्रायाः कण्टकार्या रसाढके |
कण्टकारीघृतं ह्येतत् कफव्याधिनिसूदनम् ||१२८||
कण्टकारीघृतं ह्येतत् कफव्याधिनिसूदनम् ||१२८||
इति कण्टकारीघृतम् |
इति कण्टकारीघृतम् |
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samūlaphalapatrāyāḥ kaṇṭakāryā rasāḍhakē|
samūlaphalapatrāyāḥ kaṇṭakāryā rasāḍhakē|
iti kaṇṭakārīghr̥tam|
iti kaṇṭakārīghr̥tam|
samUlaphalapatrAyAH kaNTakAryA rasADhake|
samUlaphalapatrAyAH kaNTakAryA rasADhake|
ghRutaprasthaM balAvyoShaviDa~ggashaTicitrakaiH||125||
ghRutaprasthaM balAvyoShaviDa~ggashaTicitrakaiH||125||
iti kaNTakArIghRutam|
iti kaNTakArIghRutam|
</div></div>
One ''adhaka'' of ''kantakari kashaya'' should be prepared using its root, fruit and leaves. This is to be processed with one ''prastha'' of ''ghrita'' by adding the paste of ''bala, shunthi, pippali, maricha, vidanga, shati, chitraka, sauvarchala, yavakshara, pippalimula, pushkarmoola, vrischira, brihati, pathya, yavani, dadima, riddhi, draksha, punaranava, chavya, duralabha, amlavetasa, shringi, tamalaki, bharangi, rasna'' and ''gokshuara''. This is beneficial in all types of ''kasa, hikka'' and ''shwasa''. This is known as ''kantakari ghrita'' and it cures all types of ''kaphaja'' diseases.
One ''adhaka'' of ''kantakari kashaya'' should be prepared using its root, fruit and leaves. This is to be processed with one ''prastha'' of ''ghrita'' by adding the paste of ''bala, shunthi, pippali, maricha, vidanga, shati, chitraka, sauvarchala, yavakshara, pippalimula, pushkarmoola, vrischira, brihati, pathya, yavani, dadima, riddhi, draksha, punaranava, chavya, duralabha, amlavetasa, shringi, tamalaki, bharangi, rasna'' and ''gokshuara''. This is beneficial in all types of ''kasa, hikka'' and ''shwasa''. This is known as ''kantakari ghrita'' and it cures all types of [[kapha]]ja diseases.
Thus ends the description of ''kantakari-ghrita''.
Thus ends the description of ''kantakari-ghrita''.
==== Kulatthadi ghritam ====
<div class="mw-collapsible mw-collapsed">
Thus ends the description of ''kulatthadi- ghrita''. [125-129]
कुलत्थरसयुक्तं वा पञ्चकोलशृतं घृतम् |
पाययेत् कफजे कासे हिक्काश्वासे च शस्यते ||१२९||
इति कुलत्थादिघृतम् |
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kulattharasayuktaṁ vā pañcakōlaśr̥taṁ ghr̥tam|
pāyayēt kaphajē kāsē hikkāśvāsē ca śasyatē||129||
iti kulatthādighr̥tam|
kulattharasayuktaM vA pa~jcakolashRutaM ghRutam|
pAyayet kaphaje kAse hikkAshvAse ca shasyate||129||
iti kulatthAdighRutam|
</div></div>
''Ghrita'' cooked with the decoction of ''kulattha'' or with that of ''panchakola'' is useful in [[kapha]]ja kasa, hikka and ''shwasa''.
Thus ends the description of ''kulatthadi- ghrita''. [125-129]
==== [[Dhuma]] (medicated smmoke) formulations ====
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धूमांस्तानेव दद्याच्च ये प्रोक्ता वातकासिनाम् |
धूमांस्तानेव दद्याच्च ये प्रोक्ता वातकासिनाम् |
कोशातकीफलान्मध्यं पिबेद्वा समनःशिलम् ||१३०||
कोशातकीफलान्मध्यं पिबेद्वा समनःशिलम् ||१३०||
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dhūmāṁstānēva dadyācca yē prōktā vātakāsinām|
dhūmāṁstānēva dadyācca yē prōktā vātakāsinām|
dhUmAMstAneva dadyAcca ye proktA vAtakAsinAm|
dhUmAMstAneva dadyAcca ye proktA vAtakAsinAm|
koshAtakIphalAnmadhyaM pibedvA samanaHshilam||130||
koshAtakIphalAnmadhyaM pibedvA samanaHshilam||130||
</div></div>
''Dhuma yogas'' which have been mentioned at the context of [[vata]]ja kasa can also be administered in [[pitta]]ja kasa. Specifically ''manshilla'' kept inside the ''koshataki phala majja'' is useful in the form of ''dhupana'' in [[kapha]]ja-kasa. [130]
=== Principles of treatment in various states of [[dosha]] ===
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तमकः कफकासे तु स्याच्चेत् पित्तानुबन्धजः |
तमकः कफकासे तु स्याच्चेत् पित्तानुबन्धजः |
इति कफजकासचिकित्सा |
इति कफजकासचिकित्सा |
<div class="mw-collapsible-content">
tamakaḥ kaphakāsē tu syāccēt pittānubandhajaḥ|
tamakaḥ kaphakāsē tu syāccēt pittānubandhajaḥ|
iti kaphajakAsacikitsA|
iti kaphajakAsacikitsA|
</div></div>
If ''kaphajakasa'' is associated with ''tamaka''(a type of ''shwasa'') then at this stage of ''kasa'', therapies prescribed for ''pittaja kasa'' should be administered.
If [[kapha]]ja kasa is associated with ''tamaka''(a type of ''shwasa'') then at this stage of ''kasa'', therapies prescribed for [[pitta]]ja kasa should be administered.
If there is association ''kapha'' in ''vatajakasa'' the ''kaphahara'' measures should be administered.
If there is association [[kapha]] in [[vata]]ja kasa the [[kapha]]hara measures should be administered.
If ''pitta'' is associated with ''vataja'' and ''kaphaja kasa'' then ''pittahara'' measures should be followed.
If [[pitta]] is associated with [[vata]]ja and [[kapha]]ja kasa then [[pitta]]hara measures should be followed.
If ''vataja'' and ''kaphaja kasa'' are associated with expectoration of phlegm, then ''rukshana'' therapy should be followed, whereas if not associated with phlegm then ''snigdha'' therapy should be administered.
If [[vata]]ja and [[kapha]]ja kasa are associated with expectoration of phlegm, then ''rukshana'' therapy should be followed, whereas if not associated with phlegm then ''snigdha'' therapy should be administered.
If ''kaphaja kasa'' is associated with ''pitta,'' then the patient should be given food and drinks mixed with ''tikta dravyas''.
If [[kapha]]ja kasa is associated with [[pitta]], then the patient should be given food and drinks mixed with ''tikta dravyas''.
Thus ends the description of ''kaphaja kasa''.[131-134]
Thus ends the description of [[kapha]]ja kasa.[131-134]
=== Management of kshataja kasa (due to injury) ===
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कासमात्ययिकं मत्वा क्षतजं त्वरया जयेत् |
कासमात्ययिकं मत्वा क्षतजं त्वरया जयेत् |
पचेल्लेहं घृतक्षौद्रयुक्तः स क्षतकासहा |
पचेल्लेहं घृतक्षौद्रयुक्तः स क्षतकासहा |
श्वासहृद्रोगकार्श्येषु हितो वृद्धेऽल्परेतसि ||१३७||
श्वासहृद्रोगकार्श्येषु हितो वृद्धेऽल्परेतसि ||१३७||
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kāsamātyayikaṁ matvā kṣatajaṁ tvarayā jayēt|
kāsamātyayikaṁ matvā kṣatajaṁ tvarayā jayēt|
pacellehaM ghRutakShaudrayuktaH sa kShatakAsahA|
pacellehaM ghRutakShaudrayuktaH sa kShatakAsahA|
shvAsahRudrogakArshyeShu hito vRuddhe~alparetasi||137||
shvAsahRudrogakArshyeShu hito vRuddhe~alparetasi||137||
</div></div>
''Kshatajakasa'' is a serious ailment. Keeping this in view the treatment of the patient should be initiated instantaneously with ''madhura'' and ''jivaniya dravyas'', which are promoters of ''bala'' and ''mamsa''.
''Kshatajakasa'' is a serious ailment. Keeping this in view the treatment of the patient should be initiated instantaneously with ''madhura'' and ''jivaniya dravyas'', which are promoters of ''bala'' and ''mamsa''.
The paste of one ''karsha'' of each of ''pippali, madhuka,'' one ''karsha'' of ''sitopala'', one ''prastha'' of each of cows milk, goats milk and ''ikshurasa'', one ''prastha'' of the powder of ''yava, godhuma, draksha'' and one ''prastha'' of each of the juice of ''amalaka'' and ''tilataila'' should be cooked over ''mridu agni''. Intake of this ''leha'' along with ''ghrita'' and ''madhu'' cures ''kshataja kasa, shwasa, hridroga'' and ''kshata''. It is also useful for old persons and those who have less semen.[134-137]
The paste of one ''karsha'' of each of ''pippali, madhuka,'' one ''karsha'' of ''sitopala'', one ''prastha'' of each of cows milk, goats milk and ''ikshurasa'', one ''prastha'' of the powder of ''yava, godhuma, draksha'' and one ''prastha'' of each of the juice of ''amalaka'' and ''tilataila'' should be cooked over mridu [[agni]]. Intake of this ''leha'' along with ''ghrita'' and ''madhu'' cures ''kshataja kasa, shwasa, hridroga'' and ''kshata''. It is also useful for old persons and those who have less semen.[134-137]
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क्षतकासाभिभूतानां वृत्तिः स्यात् पित्तकासिकी |
क्षतकासाभिभूतानां वृत्तिः स्यात् पित्तकासिकी |
इति क्षतजकासचिकित्सा |
इति क्षतजकासचिकित्सा |
<div class="mw-collapsible-content">
kṣatakāsābhibhūtānāṁ vr̥ttiḥ syāt pittakāsikī|
kṣatakāsābhibhūtānāṁ vr̥ttiḥ syāt pittakāsikī|
iti kShatajakAsacikitsA|
iti kShatajakAsacikitsA|
</div></div>
The medicaments prescribed for the ''pittajakasa'' are also useful for ''kshatajakasa''. Generally milk, ghee and honey should be given to such patients. If two ''doshas'' are involved in the pathogenesis of this ailment then special therapies are required.
The medicaments prescribed for the [[pitta]]ja kasa are also useful for ''kshatajakasa''. Generally milk, ghee and honey should be given to such patients. If two [[dosha]] are involved in the pathogenesis of this ailment then special therapies are required.
If this ailment is associated with ''vata'' and ''pitta'' and the person has pain all over the body then ''abhyanga'' should be given with ghee. If there is excessive ''vata aggravation'', causing pain, then ''abhyanga'' should be given with ''taila'' prepared out of ''vatahara dravya''.
If this ailment is associated with [[vata]] and [[pitta]] and the person has pain all over the body then ''abhyanga'' should be given with ghee. If there is excessive [[vata]] aggravation, causing pain, then ''abhyanga'' should be given with ''taila'' prepared out of [[vata]]hara dravya.
The person suffering from ''kasa'' along with pain in ''hridaya'' and ''parshwa'' associated with burning sensation, hemoptysis and aggravation of ''vata'' should take ''jivaniya siddha ghrita.''
The person suffering from ''kasa'' along with pain in ''hridaya'' and ''parshwa'' associated with burning sensation, hemoptysis and aggravation of [[vata]] should take jivaniya siddha ghrita.
If the person weak and habituated to take ''mamsa'' then the ''mamsarasa'' prepared out of lava is beneficial for him.
If the person weak and habituated to take mamsa then the ''mamsarasa'' prepared out of lava is beneficial for him.
If he is suffering from ''trishna'' then he can take goats milk processed with ''trinapanchamoola''.
If he is suffering from ''trishna'' then he can take goats milk processed with ''trinapanchamoola''.
If there is bleeding then he should take the ghee extracted out of this milk. Or this ghee can be administered in the form of ''nasya'' or as a drink.
If there is bleeding then he should take the ghee extracted out of this milk. Or this ghee can be administered in the form of [[nasya]] or as a drink.
If the patient of ''kshata'' is fatigued and weak, and if he has low power of digestion, then he should be given ''yavagu'' to eat.
If the patient of ''kshata'' is fatigued and weak, and if he has low power of digestion, then he should be given ''yavagu'' to eat.
If there is ''stambha'' and ''ayama'' then the patient should be given ghee in large quantity.
If there is ''stambha'' and ''ayama'' then the patient should be given ghee in large quantity.
Thus all therapies which alleviate the ''vata'', simultaneously which do not aggravate ''pitta'' and ''rakta'' should be followed in such persons.
Thus all therapies which alleviate the [[vata]], simultaneously which do not aggravate [[pitta]] and [[rakta]] should be followed in such persons.
After ''khsataja kasa'' treatment, after complete relief, still person is complaining of pain at the place of injury due to aggravation of ''kapha'', should be given ''dhumapana chikitsa'' with following combination.
After ''khsataja kasa'' treatment, after complete relief, still person is complaining of pain at the place of injury due to aggravation of [[kapha]], should be given ''dhumapana chikitsa'' with following combination.
''Meda, mahameda, madhuka, bala'' and ''mahabala'' should be made into paste and smeared over silk-cloth and ''varti'' is to be prepared. After the ''pana'' of this ''dhumavarti'' should be prepared by smearing a piece of silk cloth with the paste of ''manahshila'', ''palasha, ajagandha, tavksheeri,'' and ''nagara''. After ''dhumapana'' the person should drink ''ikshurasa'' and water mixed with jaggery.
''Meda, mahameda, madhuka, bala'' and ''mahabala'' should be made into paste and smeared over silk-cloth and ''varti'' is to be prepared. After the ''pana'' of this ''dhumavarti'' should be prepared by smearing a piece of silk cloth with the paste of ''manahshila'', ''palasha, ajagandha, tavksheeri,'' and ''nagara''. After ''dhumapana'' the person should drink ''ikshurasa'' and water mixed with jaggery.
''Manhashila'' should be made into a paste by tritrating it with the ''vatashrunga''. To this ghee should be added. After ''dhuma'' the person should be given ''tittiri pakshi mamsa rasa''.
''Manhashila'' should be made into a paste by tritrating it with the vatashrunga. To this ghee should be added. After ''dhuma'' the person should be given ''tittiri pakshi mamsa rasa''.
The silk cloth should be soaked with ''jivaniya gana dravyas'' or with egg yolk of ''kulinga''. With this ''varti'' should be prepared and after ''dhumapana'', the person should take the milk soaked with hot iron balls. This is beneficial in ''kshataja kasa''.[138-148]
The silk cloth should be soaked with ''jivaniya gana dravyas'' or with egg yolk of ''kulinga''. With this ''varti'' should be prepared and after ''dhumapana'', the person should take the milk soaked with hot iron balls. This is beneficial in ''kshataja kasa''.[138-148]
=== Management of kshayaja kasa (due to depletion)===
<div class="mw-collapsible mw-collapsed">
सम्पूर्णरूपं क्षयजं दुर्बलस्य विवर्जयेत् |
सम्पूर्णरूपं क्षयजं दुर्बलस्य विवर्जयेत् |
औष्ण्यात् प्रमाथिभावाच्च स्रोतोभ्यश्च्यावयन्ति ते |
औष्ण्यात् प्रमाथिभावाच्च स्रोतोभ्यश्च्यावयन्ति ते |
कफं, शुद्धैश्च तैः पुष्टिं कुर्यात्सम्यग्वहन्रसः ||१५७||
कफं, शुद्धैश्च तैः पुष्टिं कुर्यात्सम्यग्वहन्रसः ||१५७||
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sampūrṇarūpaṁ kṣayajaṁ durbalasya vivarjayēt|
sampūrṇarūpaṁ kṣayajaṁ durbalasya vivarjayēt|
auShNyAt pramAthibhAvAcca srotobhyashcyAvayanti te|
auShNyAt pramAthibhAvAcca srotobhyashcyAvayanti te|
kaphaM, shuddhaishca taiH puShTiM kuryAtsamyagvahanrasaH||157||
kaphaM, shuddhaishca taiH puShTiM kuryAtsamyagvahanrasaH||157||
</div></div>
If ''kshayaja kasa'' is manifested with all the signs and symptoms, and if the patient is weak, then he should not be treated. However if the disease has recently occurred and if the patient is strong enough, then he may be treated even though the disease is incurable. In the beginning the person should be given ''brihmana'' therapy along with ''agni deepana''. If ''dosha'' aggravation is more, then he can be given mild purgation therapy along with ''snigdha dravyas''.
If ''kshayaja kasa'' is manifested with all the signs and symptoms, and if the patient is weak, then he should not be treated. However if the disease has recently occurred and if the patient is strong enough, then he may be treated even though the disease is incurable. In the beginning the person should be given [[brihmana]] therapy along with [[agni]] [[deepana]]. If [[dosha]] aggravation is more, then he can be given mild purgation therapy along with ''snigdha dravyas''.
Ghee cooked with the decoction of ''shamapaka''(fruit pulp of ''aragwadha''), ''trivrit, mridvika rasa, tilvaka kashaya'' and ''vidari swarasa'' should be given in appropriate dosage for the ''shodhana'' of ''ksheena'' person. It protects the body as well as gives strength for the ''uras''.
Ghee cooked with the decoction of ''shamapaka''(fruit pulp of ''aragwadha''), ''trivrit, mridvika rasa, tilvaka kashaya'' and ''vidari swarasa'' should be given in appropriate dosage for the ''shodhana'' of ''ksheena'' person. It protects the body as well as gives strength for the ''uras''.
When ''pitta'' and ''kapha'' are reduced in quantity, along emaciation of ''dhatu'', then the person should take the ''ghrita'' prepared out of ''karkatashringi'', milk, ''bala'' and ''atibala''.
When [[pitta]] and [[kapha]] are reduced in quantity, along emaciation of [[dhatu]], then the person should take the ''ghrita'' prepared out of ''karkatashringi'', milk, ''bala'' and ''atibala''.
If there is association of ''mutra vaivarnyata'' or ''krichchchrata'', then he should be given the milk boiled with ''vidari, kadamba'' or with tender fruits of ''tala''.
If there is association of ''mutra vaivarnyata'' or ''krichchchrata'', then he should be given the milk boiled with ''vidari, kadamba'' or with tender fruits of ''tala''.
If there is swelling and pain in the ''medhra, payu, shroni'' and ''vankshana'', then the person should be given the ''anuvasana'' prepared out of ''ghritamanda, madhu'' or with ''mishraka sneha''.
If there is swelling and pain in the ''medhra, payu, shroni'' and ''vankshana'', then the person should be given the ''anuvasana'' prepared out of ''ghritamanda, madhu'' or with ''mishraka sneha''.
After ''anuvasana'' the person should be fed with ''mamsa rasa'' prepared out of ''jangala, prasaha, bileshaya,'' and ''vartakas''. Because of their ''ushnata, pramathi bhava'' these move properly in all ''srotas'' and cause dryness of ''kapha'' and simultaneously they nourish the ''srotas''.[149-157]
After ''anuvasana'' the person should be fed with ''mamsa rasa'' prepared out of ''jangala, prasaha, bileshaya,'' and ''vartakas''. Because of their ''ushnata, pramathi bhava'' these move properly in all ''srotas'' and cause dryness of [[kapha]] and simultaneously they nourish the ''srotas''.[149-157]
==== ''Dvi-panchamuladi ghritam'' ====
==== Dvi-panchamuladi ghritam ====
<div class="mw-collapsible mw-collapsed">
द्विपञ्चमूलीत्रिफलाचविकाभार्गिचित्रकैः |
द्विपञ्चमूलीत्रिफलाचविकाभार्गिचित्रकैः |
इति द्विपञ्चमूलादिघृतम् |
इति द्विपञ्चमूलादिघृतम् |
<div class="mw-collapsible-content">
dvipañcamūlītriphalācavikābhārgicitrakaiḥ|
dvipañcamūlītriphalācavikābhārgicitrakaiḥ|
iti dvipa~jcamUlAdighRutam|
iti dvipa~jcamUlAdighRutam|
</div></div>
Decoction should be prepared out of ''bilva, shyonaka, gambhari, patala, ganikarika, shalaparni, prashanaparni, brihati, kantakari, gokshuara, haritaki, bibhitaka, amalaki, chavika, bharangi, chitraka, kulattha, pippali moola, patha, kola'' and ''yava''. To this decoction ghee and the paste prepared out of ''nagara, dusparsha, pippali, shati, karkatashringi'' and ''pushkara'' should be added and ''ghritapachana'' should be done. After proper ''paka'' powder prepared out of ''yavakshara, sarjakshara, saindhava-lavana, samudra-lavana, sauvarchala-lavana, vida-lavana'' and ''audbhida-lavana'' is to be added. Intake of this cures ''kshayajakasa''.
Decoction should be prepared out of ''bilva, shyonaka, gambhari, patala, ganikarika, shalaparni, prashanaparni, brihati, kantakari, gokshuara, haritaki, bibhitaka, amalaki, chavika, bharangi, chitraka, kulattha, pippali moola, patha, kola'' and ''yava''. To this decoction ghee and the paste prepared out of ''nagara, dusparsha, pippali, shati, karkatashringi'' and ''pushkara'' should be added and ''ghritapachana'' should be done. After proper ''paka'' powder prepared out of ''yavakshara, sarjakshara, saindhava-lavana, samudra-lavana, sauvarchala-lavana, vida-lavana'' and ''audbhida-lavana'' is to be added. Intake of this cures ''kshayajakasa''.
Thus ends the description of ''dwi-pancha-mooladi-ghrita''.[158-160]
Thus ends the description of ''dwi-pancha-mooladi-ghrita''.[158-160]
==== ''Guduchyadi ghritam'' ====
==== Guduchyadi ghritam ====
<div class="mw-collapsible mw-collapsed">
गुडूचीं पिप्पलीं मूर्वां हरिद्रां श्रेयसीं वचाम् |
गुडूचीं पिप्पलीं मूर्वां हरिद्रां श्रेयसीं वचाम् |
इति गुडूच्यादिघृतम् |
इति गुडूच्यादिघृतम् |
<div class="mw-collapsible-content">
guḍūcīṁ pippalīṁ mūrvāṁ haridrāṁ śrēyasīṁ vacām|
guḍūcīṁ pippalīṁ mūrvāṁ haridrāṁ śrēyasīṁ vacām|
iti guDUcyAdighRutam|
iti guDUcyAdighRutam|
</div></div>
''Guduchi, pippali, murva, haridra, shreyasi, vacha, nidigdhika, kasmarda, patha, chitraka'' and ''nagara'' are to be boiled with four times of water, till the quantity of water reduces to one-fourth. To this decoction equal quantity of ''ghrita'' should be added and cooked. Intake of this cures ''gulma, shwasa'' and ''kshayajakasa''.
''Guduchi, pippali, murva, haridra, shreyasi, vacha, nidigdhika, kasmarda, patha, chitraka'' and ''nagara'' are to be boiled with four times of water, till the quantity of water reduces to one-fourth. To this decoction equal quantity of ''ghrita'' should be added and cooked. Intake of this cures ''gulma, shwasa'' and ''kshayajakasa''.
Thus ends the description of ''guduchyaadi-ghrita''.[161-162]
Thus ends the description of ''guduchyaadi-ghrita''.[161-162]
<div class="mw-collapsible mw-collapsed">
कासमर्दाभयामुस्तपाठाकट्फलनागरैः |
कासमर्दाभयामुस्तपाठाकट्फलनागरैः |
एतान्यग्निविवृद्ध्यर्थं सर्पींषि क्षयकासिनाम् |
एतान्यग्निविवृद्ध्यर्थं सर्पींषि क्षयकासिनाम् |
स्युर्दोषबद्धकोष्ठोरःस्रोतसां च विशुद्धये ||१६७||
स्युर्दोषबद्धकोष्ठोरःस्रोतसां च विशुद्धये ||१६७||
<div class="mw-collapsible-content">
kāsamardābhayāmustapāṭhākaṭphalanāgaraiḥ|
kāsamardābhayāmustapāṭhākaṭphalanāgaraiḥ|
etAnyagnivivRuddhyarthaM sarpIMShi kShayakAsinAm|
etAnyagnivivRuddhyarthaM sarpIMShi kShayakAsinAm|
syurdoShabaddhakoShThoraHsrotasAM ca vishuddhaye||167||
syurdoShabaddhakoShThoraHsrotasAM ca vishuddhaye||167||
</div></div>
One ''prastha'' of ''ghrita'' should be cooked by adding the paste of one ''aksha'' of each of ''kasamarda, abhaya, musta, patha, katphala, nagara, pippali, katuka, draksha, kashmarya'' and ''surasa''; one ''adhaka'' of milk and one ''adhaka'' of grape juice. Thus prepared ''ghrita'' is considered as auspicious, and cures ''shosha, jwara, pleeha'' and ''kasa''.
One ''prastha'' of ''ghrita'' should be cooked by adding the paste of one ''aksha'' of each of ''kasamarda, abhaya, musta, patha, katphala, nagara, pippali, katuka, draksha, kashmarya'' and ''surasa''; one ''adhaka'' of milk and one ''adhaka'' of grape juice. Thus prepared ''ghrita'' is considered as auspicious, and cures ''shosha, jwara, pleeha'' and ''kasa''.
All the above mentioned ''ghrita'' will promote agni of the patient suffering from ''kshayajakasa''. These also cleanse the adhered ''doshas'' from the ''srotas'' of ''koshtha'' and ''uras''.[163-167]
All the above mentioned ''ghrita'' will promote agni of the patient suffering from ''kshayajakasa''. These also cleanse the adhered ''doshas'' from the ''srotas'' of ''koshtha'' and ''uras''.[163-167]
==== ''Haritaki leha'' ====
==== Haritaki leha ====
<div class="mw-collapsible mw-collapsed">
हरीतकीर्यवक्वाथद्व्याढके विंशतिं पचेत् |
हरीतकीर्यवक्वाथद्व्याढके विंशतिं पचेत् |
इति हरीतकीलेहः |
इति हरीतकीलेहः |
<div class="mw-collapsible-content">
harītakīryavakvāthadvyāḍhakē viṁśatiṁ pacēt|
harītakīryavakvāthadvyāḍhakē viṁśatiṁ pacēt|
iti harItakIlehaH|
iti harItakIlehaH|
</div></div>
Twenty fruits of ''haritaki'' should be boiled with one ''adhaka'' of ''yava kashaya''. These boiled and soft fruits of ''haritaki'' are to be smashed. To this paste, six ''palas'' of ''purana gud'', one ''karsha'' of ''rasanjana'', half ''kudava'' of ''pippali'' should be added and cooked. This particular ''leha'' cures ''shwasa'' and ''kasa''.
Twenty fruits of ''haritaki'' should be boiled with one ''adhaka'' of ''yava kashaya''. These boiled and soft fruits of ''haritaki'' are to be smashed. To this paste, six ''palas'' of ''purana gud'', one ''karsha'' of ''rasanjana'', half ''kudava'' of ''pippali'' should be added and cooked. This particular ''leha'' cures ''shwasa'' and ''kasa''.
Thus ends the description of ''haritaki-leha''. [168-169]
Thus ends the description of ''haritaki-leha''. [168-169]
==== ''Padmakadi leha'' ====
==== Padmakadi leha ====
<div class="mw-collapsible mw-collapsed">
श्वाविधः सूचयो दग्धाः सघृतक्षौद्रशर्कराः |
श्वाविधः सूचयो दग्धाः सघृतक्षौद्रशर्कराः |
इति पद्मकादिलेहः |
इति पद्मकादिलेहः |
<div class="mw-collapsible-content">
śvāvidhaḥ sūcayō dagdhāḥ saghr̥takṣaudraśarkarāḥ|
śvāvidhaḥ sūcayō dagdhāḥ saghr̥takṣaudraśarkarāḥ|
iti padmakAdilehaH|
iti padmakAdilehaH|
</div></div>
Quills of ''svavit'' should be burnt. Intake of these ashes along with ghee, honey and ''ikshurasa'' cure ''kasa'' and ''shwasa''.
Quills of ''svavit'' should be burnt. Intake of these ashes along with ghee, honey and ''ikshurasa'' cure ''kasa'' and ''shwasa''.
''Jivanti, madhuka, patha, tavaksheeri, triphala, shati, musta, ela, padmaka, draksha, brihati, kantakari, vitunnaka, sariva, pushkara, karkatashringi, rasanjana, punaranava, loha, rajatha, trayamana, yavanika, bharangi, tamalaki, riddhi, vidanga, dhanvayaasa, kshara, chitraka, chavya, amlavetasa, vyosha'', and ''devadaru'' should be taken in equal quantity and a fine powder should be prepared. Intake of this powder in one ''panitala matra'' along with ''madhu'' and ''ghrita'' cures all five types of ''kasa''.[170-179]
''Jivanti, madhuka, patha, tavaksheeri, triphala, shati, musta, ela, padmaka, draksha, brihati, kantakari, vitunnaka, sariva, pushkara, karkatashringi, rasanjana, punaranava, loha, rajatha, trayamana, yavanika, bharangi, tamalaki, riddhi, vidanga, dhanvayaasa, kshara, chitraka, chavya, amlavetasa, vyosha'', and ''devadaru'' should be taken in equal quantity and a fine powder should be prepared. Intake of this powder in one ''panitala matra'' along with ''madhu'' and ''ghrita'' cures all five types of ''kasa''.[170-179]
<div class="mw-collapsible mw-collapsed">
लिह्यान्मरिचचूर्णं वा सघृतक्षौद्रशर्करम् |
लिह्यान्मरिचचूर्णं वा सघृतक्षौद्रशर्करम् |
क्षतकासे च ये धूमाः सानुपाना निदर्शिताः |
क्षतकासे च ये धूमाः सानुपाना निदर्शिताः |
क्षयकासेऽपि तानेव यथावस्थं प्रयोजयेत् ||१८६||
क्षयकासेऽपि तानेव यथावस्थं प्रयोजयेत् ||१८६||
<div class="mw-collapsible-content">
lihyānmaricacūrṇaṁ vā saghr̥takṣaudraśarkaram|
lihyānmaricacūrṇaṁ vā saghr̥takṣaudraśarkaram|
kShatakAse ca ye dhUmAH sAnupAnA nidarshitAH|
kShatakAse ca ye dhUmAH sAnupAnA nidarshitAH|
kShayakAse~api tAneva yathAvasthaM prayojayet||186||
kShayakAse~api tAneva yathAvasthaM prayojayet||186||
</div></div>
The powder of ''maricha'' should be given with ''ghrita, madhu'' and ''sharkara''. ''Badara'' leaves should be fried with ghee and this given with ''saindhava lavana''. Both these formulations are beneficial in ''kasa'' and ''swarabheda''.
The powder of ''maricha'' should be given with ''ghrita, madhu'' and ''sharkara''. ''Badara'' leaves should be fried with ghee and this given with ''saindhava lavana''. Both these formulations are beneficial in ''kasa'' and ''swarabheda''.
''Mudga yusha'' should be prepared by using ''kantakari'' decoction. Intake of this ''yusha'' along with ''goura amalaka'' and other ''amla dravyas'' cure all types of ''kasa''.
''Mudga yusha'' should be prepared by using ''kantakari'' decoction. Intake of this ''yusha'' along with ''goura amalaka'' and other ''amla dravyas'' cure all types of ''kasa''.
''Ksheera, yusha, mamsa rasa'' are preferred in ''kshayajakasa'' persons. For the preparation of ''mamasarasa vishkira, pratuda'' and ''bileshaya mamsa'' should be added. Always these food preparations should be prepared by ''vataghna'' drugs.
''Ksheera, yusha, mamsa rasa'' are preferred in ''kshayajakasa'' persons. For the preparation of ''mamasarasa vishkira, pratuda'' and ''bileshaya mamsa'' should be added. Always these food preparations should be prepared by [[vata]]ghna drugs.
''Dhumapana'' formulations mentioned in reference to ''kshatajakasa'' can also be administered to the patients suffering from ''kshayajakasa''.[180-186]
''Dhumapana'' formulations mentioned in reference to ''kshatajakasa'' can also be administered to the patients suffering from ''kshayajakasa''.[180-186]
==== Principles of management ====
<div class="mw-collapsible mw-collapsed">
दीपनं बृंहणं चैव स्रोतसां च विशोधनम् |
दीपनं बृंहणं चैव स्रोतसां च विशोधनम् |
भोज्यं पानानि सर्पींषि लेहाश्च सह पानकैः |
भोज्यं पानानि सर्पींषि लेहाश्च सह पानकैः |
क्षीरं सर्पिर्गुडा धूमाः कासभैषज्यसङ्ग्रहः ||१९०||
क्षीरं सर्पिर्गुडा धूमाः कासभैषज्यसङ्ग्रहः ||१९०||
<div class="mw-collapsible-content">
dīpanaṁ br̥ṁhaṇaṁ caiva srōtasāṁ ca viśōdhanam|
dīpanaṁ br̥ṁhaṇaṁ caiva srōtasāṁ ca viśōdhanam|
bhojyaM pAnAni sarpIMShi lehAshca [1] saha pAnakaiH|
bhojyaM pAnAni sarpIMShi lehAshca [1] saha pAnakaiH|
kShIraM sarpirguDA dhUmAH kAsabhaiShajyasa~ggrahaH||190||
kShIraM sarpirguDA dhUmAH kAsabhaiShajyasa~ggrahaH||190||
</div></div>
[[Dipana]], [[brihmana]] and ''srotoshodhana'' therapies should be followed alternatively in the patient suffering from ''kshyajakaasa''. All such therapies which are ''balya'' are preferred in this condition.
''Kshayajakasa'' is caused by ''sannipata''. Therefore therapies which alleviate ''tridosha'' are to be administered for the treatment.
''Kshayajakasa'' is caused by ''sannipata''. Therefore therapies which alleviate tri[[dosha]] are to be administered for the treatment.
But still ''bala'' (strength) and ''abalata'' (weakness) of the disease is determined by the nature of aggravation of associated ''dosha''. Keeping this in view, treatment should be administered.
But still ''bala'' (strength) and ''abalata'' (weakness) of the disease is determined by the nature of aggravation of associated [[dosha]]. Keeping this in view, treatment should be administered.
The physician should know that among these five kasa, the succeeding ones are more serious than the preceding.
The physician should know that among these five kasa, the succeeding ones are more serious than the preceding.
''Bhojya, pana, sarpi, leha, panaka, ksheera, sarpiguda'' and ''dhuma''.[187-190]
''Bhojya, pana, sarpi, leha, panaka, ksheera, sarpiguda'' and ''dhuma''.[187-190]
=== Summary ===
<div class="mw-collapsible mw-collapsed">
तत्र श्लोकः-
तत्र श्लोकः-
सङ्ख्या निमित्तं रूपाणि साध्यासाध्यत्वमेव च |
सङ्ख्या निमित्तं रूपाणि साध्यासाध्यत्वमेव च |
कासानां भेषजं प्रोक्तं गरीयस्त्वं च कासिनः ||१९१||
कासानां भेषजं प्रोक्तं गरीयस्त्वं च कासिनः ||१९१||
<div class="mw-collapsible-content">
tatra ślōkaḥ-
tatra ślōkaḥ-
sa~gkhyA nimittaM rUpANi sAdhyAsAdhyatvameva ca|
sa~gkhyA nimittaM rUpANi sAdhyAsAdhyatvameva ca|
kAsAnAM bheShajaM proktaM garIyastvaM ca kAsinaH||191||
kAsAnAM bheShajaM proktaM garIyastvaM ca kAsinaH||191||
</div></div>
''Sankhya'' (types of ''kasa''), ''nimitta'' (etiological factors), ''rupa'' (signs and symptoms), ''sadhya-asadhyata'' (curability and incurability), ''kasa bheshaja'' (medicinal formulations), ''gariyastva'' (comparative seriousness of the disease) – have been discussed under this chapter. [191]
''Sankhya'' (types of ''kasa''), ''nimitta'' (etiological factors), ''rupa'' (signs and symptoms), ''sadhya-asadhyata'' (curability and incurability), ''kasa bheshaja'' (medicinal formulations), ''gariyastva'' (comparative seriousness of the disease) – have been discussed under this chapter. [191]
<div class="mw-collapsible mw-collapsed">
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते
चिकित्सास्थाने कासचिकित्सितं नामाष्टादशोऽध्यायः ||१८||
चिकित्सास्थाने कासचिकित्सितं नामाष्टादशोऽध्यायः ||१८||
<div class="mw-collapsible-content">
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē
cikitsAsthAne kAsacikitsitaM nAmAShTAdasho~adhyAyaH||18||
cikitsAsthAne kAsacikitsitaM nAmAShTAdasho~adhyAyaH||18||
</div></div>
Thus ends the eighteenth chapter in [[Chikitsa Sthana]] dealing with treatment of ''kasa'' in the work of Agnivesha which was redacted by Charaka and because of non-availability supplemented by Dridhabala.
Thus ends the eighteenth chapter in [[Chikitsa Sthana]] dealing with treatment of ''kasa'' in the work of Agnivesha which was redacted by Charak and because of non-availability supplemented by Dridhabala.
=== ''Tattva Vimarsha'' ===
== Tattva Vimarsha (Fundamental Principles) ==
*''Vata'' being obstructed in the lower region of the body, moves upwards, afflicts the channels of circulation in the upper part of the body, takes over the function of ''udana vayu'' and gets localized in the throat and chest, then enters and fills up all the cavities in the head.
*[[Vata]] being obstructed in the lower region of the body, moves upwards, afflicts the channels of circulation in the upper part of the body, takes over the function of udana [[vayu]] and gets localized in the throat and chest, then enters and fills up all the cavities in the head.
*''Udanavata'' plays key role in ''kasa''. It is located in sinuses, throat and upper respiratory tract. Its main function is to exude out secretions from head and upper respiratory tract, effortlessly.
*Udana[[vata]] plays key role in ''kasa''. It is located in sinuses, throat and upper respiratory tract. Its main function is to exude out secretions from head and upper respiratory tract, effortlessly.
*Due to one group of etiological factors, sinuses and bronchial tree gets filled with secretions. Another group of factors like over exertion, weaken the functions of ''udanavata'' by over consuming it.
*Due to one group of etiological factors, sinuses and bronchial tree gets filled with secretions. Another group of factors like over exertion, weaken the functions of udana[[vata]] by over consuming it.
*Since ''udanavata'' is not available, the physiological mechanism of ''kasa'' (cough reflex) starts to work causing forceful, frictionful expectoration with sound.
*Since udana[[vata]] is not available, the physiological mechanism of ''kasa'' (cough reflex) starts to work causing forceful, frictionful expectoration with sound.
*In order to prevent damage to delicate mucosa and avoid friction, treatment with good amount of ghee after meal is best.
*In order to prevent damage to delicate mucosa and avoid friction, treatment with good amount of ghee after meal is best.
*In contrast to ''hikka'' and ''shwasa, pitta'' is not involved ''kasa'' except ''paittic kasa''.
*In contrast to ''hikka'' and shwasa, [[pitta]] is not involved ''kasa'' except ''paittic kasa''. </div>
== Vidhi Vimarsha (Applied Inferences) ==
=== Diagnostic codes===
National Ayurveda Morbidity Code: EA-3<ref>Avaialable from http://namstp.ayush.gov.in/#/Ayurveda accessed on 10/06/2021</ref>
ICD code: R05
=== Causes of kasa ===
'''Dietary:'''
*Excessive intake of dry, cold and astringent food
*Excess fasting
*Taking food in less quantity [Cha.Sa.[[Chikitsa Sthana]] 18/10]
*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]
'''Lifestyle:'''
*Excessive indulgence in sex
*Excessive physical strain
*Suppression of natural urges [Cha.Sa.[[Chikitsa Sthana]] 18/10]
*Excessive exposure to heat [Cha.Sa.[[Chikitsa Sthana]] 18/14]
*Excessive sleep and inactivity [Cha.Sa.[[Chikitsa Sthana]] 18/17]
*Carrying a hefty load
*Walking excessively long distance
*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]
'''Psychological:'''
*Anger and grief [Cha.Sa.[[Chikitsa Sthana]] 18/14]
'''Acute exacerbating causes:'''
*Exposure to smoke and dust
*Entry of food into respiratory tract [Su.Sa.Uttara Sthana 52/4]<ref name= Susruta> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>
===Classification===
#[[Vata]] [[dosha]] predominance
#[[Pitta]] [[dosha]] predominance
#[[Kapha]] [[dosha]] predominance
#Traumatic injury (kshataja)
#Depletion of body tissues (kshayaja) [Cha.Sa.[[Chikitsa Sthana]] 18/3-4]
===Premonitory features===
*Thorny feeling in mouth and throat
*Itching in throat
*Obstruction in deglutition [Cha.Sa.[[Chikitsa Sthana]] 18/4]
*Coating of mucous or sticky secretions in throat and palate
*Low raspy voice
*Anorexia
*Low digestive capacity [Su.Sa.Uttara Sthana 52/7]<ref name=Susruta/>
===Clinical features===
====General clinical features====
The voice of patient resembles the sound that comes out of a broken bronze vessel. [Su.Sa.Uttara Sthana 52/5]<ref name=Susruta/>
====[[Dosha]] specific clinical features====
======[[Vata]] dominant kasa======
*Excruciating pain in the epigastric region, flanks, chest, and head
*Excessive hoarseness of the voice
*Dryness in the chest, throat and mouth
*Horripilation and fainting
*Resonant sound during coughing, looks hopeless, hollow sound during coughing
*Weakness, agitated, illusive perceptions
*Dry cough
*Painful coughing with scanty expectoration
*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]
======[[Pitta]] dominant kasa======
*Yellowish sputum and eyes
*Bitter taste in mouth
*Abnormal voice or inflammation of vocal apparatus as in pharyngitis, laryngitis
*A feeling of smoke is being vomited out of the chest
*Morbid thirst, burning, illusive, anorexia and giddiness
*Appearance of twinkling stars in front of the eyes while coughing continuously
*Expectoration of sputum mixed with [[pitta]] [Cha.Sa.[[Chikitsa Sthana]] 15-16]
======[[Kapha]] dominant kasa======
*Poor digestion
*Anorexia, vomiting, nausea
*Nasal discharge
*Heaviness
*Horripilation, stickiness, and sweetness of the mouth
*Expectoration of thick, sweet, slimy phlegm in large quantity
*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]
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 Kaphaja Kasa (Chronic Bronchitis). J Ayurveda Integr Med Sci 2016;4:118-122. http://dx.doi.org/10.21760/jaims.v1i4.6928</ref>
====== Kasa as a result of trauma (kshataja)======
*Initial dry cough followed by blood-tinged sputum
*Excessive pain in the throat
*Cracking pain in the chest
*Sharp pricking pain
*Excruciating pain and discomfort on touching the chest
*Miserable appearance.
*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]
======Kasa due to depletion of body tissues (kshayaja)======
*Expectoration of greenish, reddish sputum, associated with pus and bad odor.
*While coughing, the person feels as if the heart is displaced.
*Feels suddenly afflicted with both hot and cold sensations
*Weakness and emaciation even after taking food in excessive quantity
*The clean and unctuous complexion of the face, associated with the gracious appearance of face and eyes.
*The soft silky touch of hands and foot
*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]]), nasal congestion, anorexia, painful flanks, and altered voice
*Frequent hard or loose stools without apparent cause [Cha.Sa.[[Chikitsa Sthana]] 18/25-28]
===Pathogenesis===
[[File:Kasa_Samprapti.JPG|500px|'''Image 1: Samprapti of Kasa'''|thumb]]
*[[Dosha]]: [[Vata]], [[Kapha]]
*[[Dushya]]: [[Rasa]]
*Srotasa: pranavaha, rasavaha
*Site of origin: amashaya (stomach)
*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]
===Clinical examination===
*Respiratory rate
*Pulse examination
*Chest examination by auscultation, palpation and percussion
===Investigations===
'''Radiological examinations:'''
*Chest X-Ray
*C.T.Scan of chest and thoracic region
'''Laboratory investigations:'''
*Sputum examination
*Absolute Eosinophil count
===Prognosis===
*[[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]
'''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]
===Management===
====Principles of management====
*Avoidance of etiological factors
*Purification therapy (shodhana) as per dominance of [[dosha]]
*Pacification therapy (shamana) as per dominance of [[dosha]]
*Disease-specific rejuvenation treatment (vyadhiahara [[rasayana]])
====[[Dosha]] specific treatment principles====
======[[Vata]] predominance======
*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]
*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>
======[[Pitta]] predominance======
*Therapeutic purgation ([[virechana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/85]
*Other purification therapies as per quantity of [[dosha]]
*Unctuous electuaries [Cha.Sa.[[Chikitsa Sthana]] 18/86]
======[[Kapha]] predominance======
*Therapeutic emesis ([[vamana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/108]
*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/>
====Disease-specific treatment principles====
=====Cough due to traumatic injury =====
*This acute condition should be treated immediately with drugs promoting strength and improving muscle tissues ([[mamsa dhatu]]). Sweet and life-promoting (jivaniya) drugs shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/134]
*Kerria lacca (laksha) mixed with honey with milk is advised. [A.Hr.Chikitsa Sthana 3/73]<ref name=Hridaya/>
*Medicines used for [[pitta]] dominant kasa are indicated.
*Milk, ghee, and honey are given in such patients. [Cha.Sa.[[Chikitsa Sthana]] 18/138]
*All therapies which alleviate [[vata]][[dosha]], and do not aggravate [[pitta]] and [[rakta]] should be followed in such persons.
*Ghee prepared with life-promoting (jivaniya) medicines.
*Meat, meat soup prepared out of common quail (lava)
*Goat’s milk processed with trinapanchamoola (combination of Desmostachyabipinnata, Saccharum spontaneum, Phragmites karka, Imperata cylindrical, Saccharum officinarum etc.) in case of morbid thirst (trushna)
*Ghee in the form of nasal administration ([[nasya]]) or as a drink in case of bleeding.
*In case of stiffness of body, ghee in larger quantity should be given.[Cha.Sa.[[Chikitsa Sthana]] 18/139-143]
===== Cough due to depletion of body tissues or degenerative conditions =====
In the initial stage, nourishing therapy ([[brimhana]]) with [[deepana]] (therapies that increase digestive capacity) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/150] These therapies and purification therapies (srotoshodana) shall be done alternatively. As all three [[dosha]]s are vitiated in this type of kasa, the therapies aim to pacify and balance all three [[dosha]]s. [Cha.Sa.[[Chikitsa Sthana]] 18/187-88]
If the amount of [[pitta]] and [[kapha]] are less, and associated with emaciation, then ghee processed with Pistacia chinensis (karkatakasringi), Sida cordifolia (bala), Sidarhombifolia (atibala) and milk should be given.
If kasa is associated with discoloration or difficulty in urination, then milk processed with Pueraria tuberose (vidari), Neolamarckia cadamba (kadamba) or with tender fruits of Flacourita jangomas (tall) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/153-54]
==== [[Panchakarma]] procedures with safety precautions ====
*Internal administration of unctuous substances (snehapana): In [[vata]]kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33]
*Oil massage (abhyanga): It is indicated in [[vata]] dominant kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] and cough due to chest injury associated with [[vata]] and [[pitta]]. [Cha.Sa.[[Chikitsa Sthana]] 18/139]
*Fomentation: Unctuous fomentation is indicated in [[vata]] dominant kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33]
*Therapeutic enema ([[basti]]): It is indicated in [[vata]] dominant kasa associated with constipation and flatulence [Cha.Sa.[[Chikitsa Sthana]] 18/32-33]
*Therapeutic purgation ([[virechana]]): Purgation with unctuous substance (like castor oil) shall be given in case of dryness and aggravation of [[kapha]]. [ [Cha.Sa.[[Chikitsa Sthana]] 18/34] In case of thin phlegm, then Operculina turpethum (trivrit) mixed with sweet substances is advised for purgation. In case of thick phlegm, Operculina turpethum (trivrit) mixed with bitter substances is advised for purgation. [Cha.Sa.[[Chikitsa Sthana]] 18/85] Mild purgation is advised to reduce aggravated [[dosha]] in kasa due to depletion of body tissues. [Cha.Sa.[[Chikitsa Sthana]] 18/150]
*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]
*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/>
*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====
=====Herbs=====
Piper longam (pippali), Piper nigrum (maricha), Flacourtia jangomas (talisapatra), Solanum virginianum (kantakari), Inula racemosa (pushkaramula).<ref name=Ranades>Ranade S. Pranavaha srotas (Respiratory sysytem). In: Kayachikitsa Vol 2. Delhi: Chaukhamba Sanskrit pratishthan; 2014: 212-24</ref>
=====Herbal formulations=====
Agastya Haritaki [Cha.Sa.[[Chikitsa Sthana]] 18/ 57-62], Kushmandarasayana [A.Hr.Chikitsa Sthana 3/114-117]<ref name=Hridaya/>, Vyaghriharitaki [B.R.15/169-172]<ref name=Ratnavali> Govindadas. Bhaishajyaratnavali. Translated from Sanskrit by Kanjiv Lochan. Reprint. Varanasi: Chaukhambha Sanskrit sansthan;2008.</ref>, Talisadichurna [B.R 15/36-40]<ref name=Ratnavali/>, Vasa arishta<ref name=shilpals/>, Vasa avaleha [B.R.15/179-181]<ref name=Ratnavali/>, Sitopaladi churna<ref name=shilpals/>, Lavangadivati [B.R.15/35]<ref name=Ratnavali/>, Khadiradi vati<ref name=Ranades/>, Kanakasava.<ref name=Ranades/>
=====Herbo-mineral formulations=====
Laxmivilasa rasa [B.R 15/130-37]<ref name=Ratnavali/>, Kasakuthara rasa, Svachandabhairava rasa<ref name=shilpals/>, Hema garbha potalirasa<ref name=shilpals/>, Rudraparpati, Bhutankusha rasa<ref name=Ranades/>, Amritarnava rasa[B.R 15/60-61]<ref name=Ratnavali/>
====Wholesome diet====
Meat soup along with wheat, barley, rice etc. and sweet, sour and salty foods are wholesome in kasa with [[vata]] predominance.[Cha.Sa.[[Chikitsa Sthana]] 18/76-82]
Dysphania ambrosioides (vastuka), Solanum americanum (vayasi), Senna occidentalis (kasaghna), fruits and leaves of Solanum virginianum (kantakari), dried tender Raphanus raphanistrum (mulaka), Sesamum indicum (tila) oil, edibles prepared from milk, sugarcane juice and jaggery, whey of curds, juice prepared from sour fruits and fermented beverages are wholesome in [[vata]]kasa. [A.Hr.Chikitsa Sthana 3/23-24]<ref name=Hridaya/>
In kasa with [[pitta]] predominance, sweet and cold things are advised. Shyamaka, Hordeum vulgare (yava), Paspalum scrobiculatum (kodrava), bitter vegetables etc. are wholesome. [B.R 15/8]<ref name=Ratnavali/> [Cha.Sa.[[Chikitsa Sthana]] 18/98]
Hot and spicy food materials are wholesome in kasa with [[kapha]] predominance. [Cha.Sa.[[Chikitsa Sthana]] 18/108]
Drinks such as honey (madhu), warm water, buttermilk etc. are preferred in kasa with [[kapha]] predominance. [Cha.Sa.[[Chikitsa Sthana]] 18/110]
Piper longum, Piper nigrum and Zingiber officinale (trikatu)[Su.Sa.Uttara Sthana 52/29]<ref name=Susruta/>, barley, green gram, horse gram etc. are wholesome in [[kapha]]kasa.[A.Hr.Chikitsa Sthana 3/43]<ref name=Hridaya/>
Goat’s milk is good in all types of kasa.<ref name=shilpals/>
===Complications===
If kasa is not appropriately treated, it leads to consumption (rajayakshma) due to aggravation of all three [[dosha]] and depletion of body tissues.[Su.Sa.Uttara Sthana 52/6]<ref name=Susruta/>
===Contemporary views===
====Case reports====
=====Solanum xanthocarpum=====
The whole plant (panchanga) of Solanum xanthocarpum showed significant anti-tussive activity when compared to its roots. Administration of 10 gms of powder of drug for 10 days in 30 patients reported better action over [[kapha]] dominant kasa. The drug might be suppressing the central cough center by stimulating opioid receptors in the brain. It may be acting through protective ciliary activity in the respiratory tract. The action as demulcent can relieve cough.<ref name=mansukh>Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. & Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamnagar</ref>
=====Tribulus terrestris=====
An experimental study reported anti-tussive activity of root powder of Tribulus terrestris (laghu gokshura) in sulphur dioxide induced cough models. The number of cough episodes was significantly less in Tribulus terrestris (laghu gokshura) root administered group. While root of Pedalium murex (brihat gokshura) showed insignificant decrease in number of cough episodes. In a clinical study, administration of powder of Tribulus terrestris (laghu gokshura) root and root of Pedalium murex (brihat gokshura), 3gm twice a day in 28 patients of kasa is observed. It reported better effect in group administered with Tribulus terrestris. The effect was better in reducing [[vata]]kasa. This study also suggested effect of drug on central nervous system and its anti-inflammatory activity.<ref name=chandrika>Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghu gokshura (Tribulus terrestris Linn.) and Brihat gokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamanagar</ref>
=====Combination of terminalia chebula and rock salt=====
In a study conducted on 19 patients, Terminalia chebula (haritaki) with Rock salt (saindava lavana) was found effective in reducing the symptoms of [[kapha]]kasa. There was 92.3% relief in cough with sputum and itching in throat. The action of haritaki on [[vata]] and [[kapha]][[dosha]] due to its hot potency is observed as reason behind efficacy.<ref name=rout>Rout AK, Dwivedi RR. A clinical study of Haritaki and Saindhava Lavana in Kaphaja Kasa with special reference to Samyoga Guna. Ayu. 2011 Jul;32(3):357-60. doi: 10.4103/0974-8520.93914. PMID: 22736910; PMCID: PMC3326882.</ref>
=====Kantakari-maricha leha=====
In a study, kantakari-marichaleha (ayurvedic formulation) was administered for 7 days in 30 children with symptoms of [[kapha]]kasa. It was found effective in reducing the signs and symptoms.<ref name=sawant>Sawant S, Nandgaonkar J A, Gujarathi R H. Efficacy of kantakari maricha leha on kaphaja kasa in children of age group 1 to 5 years. WJPR. 2018 Mar;7(7):1250-55. doi: 10.20959/wjpr20187-11693</ref>
=====Samasharkara powder formulation=====
In another study on 60 patients with [[kapha]]kasa, 10gms of Samasarkarachurna for 15 days is found effective in reducing the signs and symptoms.<ref name=dighe>Dighe P M. Efficacy of Samsharkara Churna in Kaphaj Kasa. Ijam. 2013, 4(1), 36-42</ref>
=====Bhrigarajasava as adjunct to anti tubercular treatment=====
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-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>
In another study conducted on 25 patients of kasa, administration of vyaghri-haritaki avaleha for four weeks showed highly significant results signs and symptoms.<ref>Suhas A. Chaudhary, Patel KS, Kori VK , Rajagopala S. Management of doshika kasa in subacute and chronic stage with Vyaghri haritaki avaleha in children. Ayurpharm Int J Ayur Alli Sci. 2014;3(4):97-111.</ref>
=====Unctuous enema in pertussis=====
Administration of unctuous enema (sneha[[basti]]) in pertussis patients of pediatric age group ( n=2) was studied. It was found very effective in reducing dry cough. Sesame oil in a dose of 10 - 20ml is used in [[basti]] for 14 days along with antimicrobial therapy. Initially, the intensity of cough was reduced, followed by a reduction in the frequency of cough episodes. Unctuous enema acts directly over the colon to restore normal functions of [[vata]][[dosha]].<ref>Gujarathi RH, Gokhale VM, Tongaonkar JN. Effect of Basti (oil enema) therapy for the management of cough in pertussis. Ayu. 2013 Oct;34(4):397-400. doi: 10.4103/0974-8520.127722. PMID: 24696577; PMCID: PMC3968703.</ref>
=====Kasahara dashemani tablets=====
In 40 children with kasa, administration of Kasahara Dashemani vati for 60 days showed relief in all symptoms of kasa. Reduction in acute eosinophil count (AEC) and erythrocyte sedimentation rate (ESR) levels are noted. The decrease in IgE levels indicates the drug’s action against allergy. It is found effective in [[vata]] and [[pitta]] predominant kasa.<ref>Subrahmanya NK, Patel KS, Kori VK, Shrikrishna R. Role of Kasahara Dashemani Vati in Kasa and Vyadhikshamatva in children with special reference to recurrent respiratory tract infections. Ayu. 2013 Jul;34(3):281-7. doi: 10.4103/0974-8520.123124. PMID: 24501524; PMCID: PMC3902595.</ref>
=== List of research works done ===
#Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. & Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamnagar
#Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghugokshura (Tribulus terrestris Linn.) and Brihatgokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamanagar
=== Abbreviations ===
Cha. = Charak, Su. = Sushruta, A. = Ashtanga, Hr. = Hridayam, Sa. = Samhita, B.R = Bhaishajya ratnavali
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