Cough or Kasa (कासः)

परिचयः॥ Introduction

Kasa is Pranavaha Srotasa(Respiratory and cardiovascular system) related disease. It is thoroughly explained in charak samhita. Every disease in samhita is explained after weakening of target organ or target organ related condition  of that disease,  like in charak samhita,  kasa is explained after Shwas vyadhi which is related with Phuphusa(Lungs), also  first vyadhi (Disease) of Chikitsa(Treatment) sthana is started with jwar (fever) where agnimandya (weakening of digestive fire /loss of appetite). And Agnimandya is the first cause of every disease , it’s either related with jatharagni(digestive fire) or processing agni of specific dosha/ dhatu/srotas. There are total 5 types of kasa like Vataj, Pittaj, Kaphaj, kshataj and  kshayaj.

व्युत्पत्तिः॥ Etymology

कासते इति कास:|- A condition where a person is trying to expel something from their throat is known as KASA.

संप्राप्ती ॥ Pathophysiology

• Apan vayu  being obstructed due to mutra(urination), purish (defaecation) or related other functions moves upward and afflicts the function of upper part of body in prana and udana vayu region and creates different signs of cough with variations depends on doshik combination is known as kasa vyadhi. It creates a resonating sound like bronze metal. (Cha. Chi. 18, Su. Uttar. 52)

1. Apan vayu organ-

पक्वाशयकटीसक्थिश्रोत्रास्थिस्पर्शनेन्द्रियम्|

                    स्थानं वातस्य, तत्रापि पक्वाधानं विशेषतः ||1|| AH. 12/1

Translation-Main places of Vata: Pakwashay (rectum), waist, both legs, both ears, bones and skin are said to be the places of Vata. Among all these,the rectum is the main place for food reprocessed by gastric fire.

Explanation- When any above mentioned organ when getting disturbed in their respective functions, it disturbs the apan vayu.

1. Udana vayu-

उरःस्थानमुदानस्य नासानाभिगलांश्चरेत् ॥

            वाक्प्रवृत्तिप्रयत्नोर्जाबलवर्णस्मृतिक्रियः ॥  AH. 12/5

Translation-The main place of Udana Vayu is the uras (chest). That air keeps moving in the nasika (nose), navel and throat (throat) region. Vakpravritti (outpouring of speech), effort (enthusiasm towards doing work), energy (power), strength, color and memory, all these activities are under the control of the same Vayu.

1. Prana vayu-

प्राणोऽत्र मूर्धगः ।

उरः कण्ठचरो बुद्धिहृदयेन्द्रियचित्तधृक् ॥ ४ ॥

ष्ठीवनक्षवथूद्गारनिःश्वासान्नप्रवेशकृत् ।  AH. 12/4,5

Translation- Pranavayu, circulating in the throat and upper region, sustains the intellect, heart, all the senses and the mind. It performs the functions of sthivan (spitting and salivation), sneezing, exhalation, exhalation and annapravesh (pushing food inside the mouth).

Explanation- Disturbed apan vayu when moved towards above mentioned Prana and udana vayu region/organ  with number of doshik variation, then it creates different vocal sounds. These different locations create variations in coughing sounds.

कासप्रकार:॥ Types, cause sand subtypes of kasa

Acharya Charak and acharya sushrut  have mentioned 5 types of kasa given as follows, vataj , pittaj, kaphaj, kshataj, kshayaj. Kshataj is vata- pittaj and kshayaj is trdoshaj in doshik understanding.

Types of Kasa

1. वातज (vataj)
2. पित्तज (Pittaj)
3. कफज (kaphaj)
4. क्षतज (kshataj)
5. क्षयज (Kshayaj)

वातज  कास हेतु (Vataj kasa causes)

1. Consumption of food with properties like ruksha(Dry) , sheetala(cold), kashaya (astringent).
2. consumption of food in less quantity, very less or totally avoidance of food.
3. Excessive practice of sexual intercourse
4. Suppression of adharniya vega (natural urges)
5. Excessive physical exausion

वातज कास रूपाः /लक्षणाः (Sign and Symptoms of vataj kasa)

1. The individual experiences severe pain in the upper abdominal area, sides, chest, and head.
2. They have significant difficulty speaking due to excessive hoarseness.
3. A persistent dry sensation in their chest, throat, and mouth.
4. Symptoms like goosebumps and fainting episodes occur.
5. Coughing produces a resonant sound, and the person seems despondent.
6. Weakness, restlessness, and distorted perceptions are also present.
7. Dry cough
8. Occasionally coughs up minimal phlegm with pain.
9. Cough improves when consuming oily, sour, salty, and warm foods and drinks.
10. The upward flow of energy, or vata, intensifies after the digestion of food.

पित्तज  कास हेतु (Pittaj kasa causes)

1. The excessive consumption of hot, spicy, irritating, sour
2. Alkaline foods, along with anger, discomfort
3. Exposure to high temperatures from fire and the sun

पित्तज कास रूपाः /लक्षणाः॥ (Sign and Symptoms of Pittaj kasa)

1. Yellowish sputum and eyes
2. A bitter taste in the mouth
3. Voice disturbances
4. A sensation of smoke being expelled from the chest
5. Intense thirst, burning, delusion, loss of appetite, and dizziness
6. Seeing flickering stars in front of the eyes during persistent coughing
7. Coughing up sputum tinged with pitta.

कफज  कास हेतु (Kaphaj kasa causes)

1. Impaired digestive function, loss of appetite, vomiting, runny nose, queasiness, and a sense of fullness
2. Goosebumps, a sticky and sugary taste in the mouth
3. Coughing up copious amounts of thick, sweet, slimy phlegm
4. Absence of chest pain during coughing
5. A sensation of chest fullness

कफज  कास रूपाः /लक्षणाः॥ (Sign and Symptoms of Kaphaj kasa)

1. Reduced digestive function, loss of appetite, vomiting, a runny nose, queasiness, and a sense of weight in the stomach
2. Goosebumps, a sticky and sugary sensation in the mouth
3. Coughing up abundant, thick, sweet, and viscous phlegm
4. Absence of chest pain during coughing
5. A perception of chest fullness

क्षतज कास हेतु (Kshataj kasa causes)

1. Excessive involvement in sensual activities,
2. Bearing an excessively heavy burden,
3. Covering excessively long distances on foot,
4. Indulgence in fighting,
5. Overindulgence in controlling the movements of horses and elephants.

क्षतज  कास रूपाः /लक्षणाः॥ (Sign and Symptoms of Kshataj kasa)

1. Initially, the cough starts as dry and later produces sputum tinged with blood.
2. Intense throat pain and a sensation of sharp, cracking chest pain.
3. Sharp, needle-like pains.
4. Extreme agony and discomfort when the chest is touched, resulting in a distressing appearance.
5. Joint and finger pain, fever, difficulty in breathing, thirst, and a change in voice.
6. During coughing, sounds resembling a humming pigeon.

क्षयज कास हेतु (Kaphaj kasa causes)

1. Consuming food at inappropriate times.
2. Unsuitable dietary choices.
3. Engagement in sensual activities.
4. Inhibition of natural bodily urges.
5. Feelings of Ghrina(dislike) and shoka(sorrow).

क्षयज कास रूपाः /लक्षणाः॥ (Sign and Symptoms of Kshayaj kasa)

1. Coughing up greenish, reddish, pus-filled, and foul-smelling phlegm.
2. During coughing, a sensation of heart displacement.
3. Sudden onset of both hot and cold sensations.
4. Overindulging in food consumption.
5. Feeling extremely weak and experiencing emaciation.
6. A clear and oily complexion, accompanied by a graceful facial and eye expression.
7. The hands and feet have a soft, silky texture.
8. Frequent fault-finding and the development of a strong aversion to others.
9. Experiencing conditions such as fever (with symptoms of all three doshas), nasal congestion, loss of appetite, flank pain, and voice changes.
10. Inconsistent stool consistency, alternating between hard and loose without an apparent cause.

भेषजसेवनं कालाः प्रयोजनं च॥ (Drug administration times)

Drug administration Times for kasa (Cough)

1. If  associated with constipation and flatulence- Before Breakfast, lunch and dinner.
2. In anorexia - During mid-meal.
3. For cough, dyspnoea and thirst, drug should be administered frequently. 1,2,3 hourly etc.  depends on patients condition and diseased severity.
4. In derangement of prana vayu drug should be administered between morsels.
5. In derangement of Vyana and udana, drug should be administered after breakfast, lunch and dinner.
6. Vatika disorders aggravates at the end of the day and night, Pittaj disorders aggravates in the mid of the day and night (Mid-day and Mid-Night)at the end of the day and night and kaphaj disorders in the begging of the day and night, so the prescribe the medicine according to doshaj condition. Cha. Chi. 30/299  

रूग्णानां प्रथमोपचाराय कृते॥ ( First aid Medicine)

(चेतावनी/ Disclaimer:)

Administration Time- 5 Days only/ If patient gets relief then continue for next 5 days. If patient is not getting relief then go for higher centre/vaidya. After 10 days, if a patient gets the relief but still mild /moderate symptoms are continue then take advise from vaidya to continue the same or not)

भेषजं तस्य मात्र च॥ (Medicines and their doses)

1. If  associated with flatulence- Shankh vati /Arshakuthar1 Tab. Three Times a day/ Lavan Bhaskar churna 3gm 2 times a day.
2. Churna Kalpana- Sitopaladi Churna , Talisadi churna etc. 3gm TDS.
3. Avaleha kalpana-  Vyaghri haritaki, kantakari haritaki, Agastya haritaki  10gm BD.
4. Asava- arishta - Draksharishta, Dashamularishta, vasarishta 15-30ml BD
5. Sore throat (kantashul)- Vyoshadi vati, lavangadi vati, khadiradi vati 250mg 2tablet TDS ,Laxmivilas Ras 125 mg 2Tablet TDS
6. Myalgia (angamarda)- rasnasaptak , Devadarvyarishta,Dashamulaarishta 30ml BD Ashwagandharishta,  Balarishta 15-20 ml BD
7. Nasal congestion (Pratishyay) - Haridrakhand 3-5 gm BD, Laxmivilas Ras 125 mg 2TDS
8. Nausea, vomiting- Eladi Churna- 3gm BD Sutshekhar Ras, 250mg 2BD
9. Anupan- For Dry cough (Vataj, pittaj)- Ghritam , For wet Cough (Kaphaj)- Honey (Same as churna)

वैद्यानां कृते (For vaidya's / Ayurveda Physicians)

1. मलावष्ठंभे आध्मान आटोपे च/ For disturbed Apan vayu- treat with basti. Cha. Chi. 18/32-34
2. मलावष्ठंभे आध्मान आटोपे च/ For disturbed Apan vayu-  Kantakari ghrita, Pippalyadi ghrita,Tryushanadi     ghrita, Rasna ghrita Cha. chi. 18.
3. पित्तज कासे /If  associated with pitta disturbed kasa - Mahatikta ghrita, Panchatikta ghrita any etc any pitta decreasing Ghrita.
4. कफज  कासे/ If  associated with kapha disturbed kasa- Virechana (purgation should be administered) Abhayadi modak/ Triphala kwatha.
5. Churna Kalpana- Sitopaladi Churna , Talisadi churna etc. 3gm TDS
6. Avaleha kalpana-  Vyaghri haritaki, kantakari haritaki, Agastya haritaki  10gm BD
7. Asava- arishta - Draksharishta, Dashamularishta, vasarishta 15-30ml BD
8. Sore throat (kantashul)- Vyoshadi vati, lavangadi vati, khadiradi vati 250mg 2tablet TDS                          Laxmivilas Ras 125 mg 2Tablet TDS
9. Myalgia (angamarda)- rasnasaptak , Devadarvyarishta,Dashamulaarishta 30ml BD Ashwagandharishta,  Balarishta 15-20 ml BD
10. Nasal congestion (Apinas/ Pratishyay) - Haridrakhand 3-5 gm BD  laxmivilas Ras 125 mg 2TDS
11. Nausea, vomiting- Eladi Churna- 3gm BD Sutshekhar Ras, 250mg 2BD