By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Kasa is a word used to describe ‘cough’ or act of cough in Ayurveda. Bouts of cough coming out either in dry or with phlegm is called kapha.
Kasa is both a symptom and disease
Kasaroga is a symptom and is found in many diseases. When it gets independently manifested having its own pathogenesis, it will be considered as a disease. When kasa is a disease it will have its own etiological factors, premonitory symptoms, subtypes, symptom complex, prognosis and treatment principles.
While master Sushruta has enumerated common etiological factors for cough, master Charaka has mentioned etiological factors separately for individual subtypes of cough.
- Smoke entering the mouth, nose, throat etc
- Exposure to dust
- Excessive exercise
- Excessive consumption of dry foods
- Entry of food particles into the respiratory passages
- Forcibly stopping the natural urges of the body, especially that of cough and sneeze
Premonitory symptoms of cough
The person feels as if his throat and mouth are filled with spicules. There is itching in the throat and obstruction to passage of food.
Pathogenesis of cough
The vayu obstructed below i.e. in the lower portion of the body moves upwards and gains entry into the upper channels of the body.
On reaching the upper portion of the body, the vayu gains the form and behavior of udana vata i.e. it tends to have movement in an upward direction.
Moving upwards it gets lodged in throat and chest.
It also encroaches into the channels of the head and fills up all these channels i.e. gets localized in the channels of the head also.
It breaks and seizes the body, jaws and eyes.
The vayu further bends and distorts the eyes, back, chest and flanks and also causes stiffness and immobility in these structures.
Following this the cough is produced in a dry form or along with sputum. This disease in which the bouts appear in a contemptible form is called as kasarog.
Pathogenesis as explained by Sushruta (SU.U.52)
The vitiated Prana Vata gets associated with Udana Vata produces sounds resembling that produced by broken piece of bronze when striken. These doshas also expel sputum and other morbidities through the mouth. This is called as kasarog.
The Vataja, Pittaja and Kaphaja types of cough are curable.
Kshataja and Kshayaja types of cough are manageable. They cannot be easily treated like the doshic types. Therefore they need to be manages with suitable diet and lifestyle modulations.
Even among all these coughs, the kshayaja type is said to destroy the body of an emaciated person. If the same cough occurs in a strong person it will be curable. Similarly kshataja kasa roga occurring in strong persons will be manageable whereas that which occurs in emaciated person is said to be incurable.
If all the four limbs of treatment i.e. physician, patient, medicine and caretakers are available in their best form and with optimum qualities and get involved in the treatment of cough, there is a possibility that the newly manifested kshataja and kshayaja coughs are cured sometimes.
All types of cough caused in old age, due to the effect of ageing process are manageable.
When the five types of cough are neglected, they lead to deterioration and destruction of the body i.e. may eventually lead to death.
Treatment principles in Kasam
|Type of Kasa||Treatment principles||Useful medications|
|Vataja||Oleation Sudation Oil / lubricating enemas Oral consumption of ghee after food Lubricating purgation medicines Dhumapana||Kantakari Ghrta Rasnadi Ghrta Agastya Haritaki|
|Pittaja||Drinking of emetic ghee and causing vomiting in association of kapha Purgation in lesser association of kapha||Srngatakadi Leha Pippalyadi Leha Sharadi or Sthiradi Kshirapaka|
|Kaphaja||Emesis Kapha destroying foods Medicated smoking||Katphaladi Kvatha Nagaradi Yoga Pippali Kantakari Ghrta|
|Kshataja||Medicines predominant with sweet taste Jivaniya group of medicines |
Balya group of medicines
Muscle enhancing medicines Treatment mentioned in Pittaja kasa
|Pippalyadi sneha Jivaniya Ghrta Milk, ghee and honey Use of meat|
|Kshayaja||Mild purgation Unctuous enema Wholesome diet Consumption of meat and meat juice Medicated smoking Alternative use of appetite enhancing, bulk promoting and cleansing medicines Strengthening medications and food||Dashamuladi Ghrta Guduchyadi Ghrta Haritaki Leha Jivantyadi Leha|
Treatment of wet and dry cough
Ardra Kasa – means wet cough. In this more mucus / phlegm is produced. Here food and drinks which are drying in nature should be administered. In cough caused by kapha if there is association of pitta, foods predominantly prepared with bitter things should be given.
Shushka Kasa – means dry cough. In this there is no expectoration of phlegm. Here lubricating / unctuous foods and drinks should be administered.