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Chikitsa Sthana Chapter 18. Kāsacikitsitaṁ

==([[Chikitsa Sthana]] Chapter 18, Chapter on the Management of cough of various origins)==

(Management of cough of various origin)  

 

Hikka, shwasa and kasa (hiccup, 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, vyadhihara rasayana are followed as treatment.

Hikka, shwasa and kasa (hiccup, 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, vyadhihara rasayana are followed as treatment.

Key words: kasa, cough, treatment of cough, respiratory diseases,kshataja, kshayaja, Snehapana, vamana, virehna, vairechanika nasya (nasal catarrhal) dhumapana (medicated cigaretes).  

 

Introduction:

'''Keywords''': kasa, cough, treatment of cough, respiratory diseases,kshataja, kshayaja, Snehapana, vamana, virehna, vairechanika nasya (nasal catarrhal) dhumapana (medicated cigaretes).  

 

=== Introduction ===

 

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 atmospshere, 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 shwaasa, 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.  

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 atmospshere, 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 shwaasa, 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.  

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 selflimiting and curable. Paittika and kaphaj kasa involve lower respiratory tract and are productive in nature. While paittika kasa seems to be the result of inflammation, kaphaj 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, 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 selflimiting and curable. Paittika and kaphaj kasa involve lower respiratory tract and are productive in nature. While paittika kasa seems to be the result of inflammation, kaphaj 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).

Snehapana, vamana, virehna, vairechanika nasya (nasal catarrhal) dhumapana (medicated cigaretes) are indicated as treatment modalities in different types of kasa.

 

Snehapana, vamana, virehna, vairechanika nasya (nasal catarrhal) dhumapana (medicated cigaretes) are indicated as treatment modalities in different types of kasa.

 

अथातः कासचिकित्सितं व्याख्यास्यामः ||१||  

अथातः कासचिकित्सितं व्याख्यास्यामः ||१||  

इति ह स्माह भगवानात्रेयः ||२||  

इति ह स्माह भगवानात्रेयः ||२||