Charaka Kasa Chikitsa – 18th Chapter

18th chapter of Charaka Samhita Chikitsa Sthana is Kasa Chikitsa Adhyaya. It deals with causes, types, treatment and Ayurvedic medicines for cough and associated disorders.

Let us explore the chapter on the treatment of Kasa – cold, (Bronchitis)
Thus, said Atreya. [1-2]

Prologue
Lord Atreya, endowed with the power of Tapas, Yashas – fame, Dhruti – perseverance, and Dhee – intellect expound the therapies for the treatment of Kasa – cold, cough (bronchitis) [3]

Types

Types of Kasa – Kasa Bheda:

There are 5 varieties of Kasa(cold, cough) If exacerbated, they may cause cachexia.
These varieties are as follows:
1. Vataja Kasa – caused by Vata Dosha
2. Paittika Kasa – caused by Pitta)
3. Kaphaja Kasa – caused by Kapha) and
4. Kshayaja Kasa – caused by the diminution to the chest or tuberculosis) and
5. Kshataja Kasa – caused by the diminution of tissue elements i.e tissue depletion or tubercular bronchitis) [4]

Purvaroopa

Kasa Poorvaroopa: Premonitory Signs and Symptoms of Kasa – cold, cough
1. Shuka poorna galasyata – Sensation as if the throat and mouth filled with bristles (a feeling of congestion in the throat)
2. Kante kandu – Itching sensation in throat and
3. Bhojyanam avarodha – Obstruction to the movement of food in the gullet. [5]

Samprapti

Kasa Samprapti: Pathogenesis of cough:
Vata Dosha gets obstructed in the lower part of the body. It moves upwards, afflicts the channels of circulation in the upper part of the body, takes over the function of Udana Vayu (i.e the function of respiration), and gets lodged in the throat and the chest.

This Vata afflicts and fills up all the channels (cavities) of the head to cause bending (Abhanjan= breaking) and flexing(Akshipan) of the body, jaws, sides of the neck and eyes
Thereafter, this Vayu having caused contraction (Nirhujya) and stiffness (Stambhayan) of eyes, back and sides of the chest, gives rise to coughing (Kasanat) which may be dry or with phlegm because of which it is called Kasa – cough. [6-8]

Causes of variation in Pain etc

Specific varieties in the pain and sound associated with different types of Kasa – cold, cough are caused by the specific nature of the obstruction [by Kapha etc] to the forcefully moving Vayu. [9]

Vataja Kasa

The causative factors of Vatika Kasa are as follows:
1. Ruksha sheeta kashaya anna sevana – Intake of Ununctuous, cold and astringent food
2. Pramitashana – Intake of food in less quantity or much less in quantity (Pramita) or not taking food at all (Anasana)
3. Stree vegadharana – Excessive indulgence in sex
4. Vegadharana – Suppression of natural urges and
5. Aayasa – Excessive physical strain

Vatika Kasa Lakshana – signs and symptoms:
1. Hrit parshva uru shira shula – Excruciating pain in cardiac region, in the sides of the chest and in the chest, headache
2. Swara bheda – Excessive hoarseness of voice
3. Shushka ura kantha vaktra – Dryness in the chest, throat and mouth
4. Hrushtalomnah – Horripilation and fainting
5. Nirghosha dainyastanana – Resonant sound during coughing, feeling of prostration, hollow sound during coughing
6. Daurbalya, ksobha moha – Weakness, agitation and unconsciousness
7. Suska kasa – dry cough
8. Kapham sushka – The phlegm that comes out with pain is semi-solid(dry)
9. Snigdha amla lavana bhukta – The coughing gets alleviated by food and drinks that are unctuous, sour, saline and warm.
10. Urdhva vata jirne anna – The upward moving Vayu (which is the cause of this ailment) gets all the more aggravated after the digestion of food. [11-13]

Paittika Kasa

The causative factors of Pittaja Kasa are as follows:
1. Katu ushna vidahi amla kshara ati sevanam – Excessive intake of pungent, hot , Vidahi (which causes burning sensation), sour and Alkaline Food
2. Krodha – Anger and
3. Santapa agni suryajah – Exposure to the heat of the fire and Sun [14]

Pittaj Kasa Lakshana – 
The signs and symptoms of Pittaja Kasa are as follows:
1. Peeta nisthivana akshi – Yellowness of the sputum and eyes
2. Tikta aasya – Bitterness in the mouth
3. Svara amayah – impairment of voice
4. Uro dhumayanam – A feeling as if smoke is being emitted out of the chest (smoky eructation)
5. Trushna, Daha, Moha, Aruchi, Bhrama – Morbid thirst, burning sensation, unconsciousness, anorexia and giddiness
6. Jyotimshiva pashyati – Appearance of star like particles in front of the eyes with coughing continuously and
7. Sleshmanam pitta samsrstanam – The patient spits out phlegm mixed with Pitta [15-16]

Kaphaja Kasa

The causative factors of Kaphaja (shlaishmika) Kasa are as follows:
1. Guru, Abhishyandi, Madhura, Snigdha Sevana – In take of heavy, Abhisyandin (ingredients which cause obstruction to the channels of circulation), sweet and unctuous ingredients [in excess] and
2. Svapna vichesta – Excessive sleep and indolence
3. vddha lem’nila ruddhv – The Kapha gets aggravated because of the above mentioned regimens and obstructs the movement of Vayu which gives rise to Kaphaja Kasa. [17]

Kaphaja Kasa Lakshana – 
The signs and symptoms of Kaphaja Kasa are as follows:
1. Manda agni – – Suppression of the power of digestion
2. Aruchi , Chardi,Pinasa, Utklesha, Gaurava – Anorexia, vomiting, chronic rhinitis, Nausea and feeling of heaviness in the body
3. Loma harsha, madhurya, kleda samsadana , bahulam madhuram snigdha nisthivan ghana kapham -Horripilation, Sweetness and stickiness in the mouth and asthenia, spitting of thick phlegm in large quantity which is sweet in taste and unctuous
4. No feeling of pain in the chest while coughing and
5. Vaksha sampurna – Feeling of fullness in the chest. [18-19]

Kshataja Kasa

Etiology of Ksataja Kasa-
The causative factors of Kshataja Kasa – bronchitis caused by injury are as follows:
1. Ati vyavaya – Excessive indulgence in sex
2. Bharadhva – Carrying excessively heavy load
3. Walking excessively for long distance
4. Yudha asva gaja vigraha – Indulgence in fighting and excessive indulgence in restraining the movement of horses and elephants
5. The above mentioned factors cause injury to the chest (lungs) and bring about ununctuousness in the body.
This, in its turn, causes aggravation of Vayu, which gives rise to Kshataj Kasa – (bronchitis caused by injury). [20]

Kshataja Kasa lakshana-
The signs and symptoms of Ksataja Kasa are as follows:
1. In the beginning, the patient coughs without any output of phlegm, but thereafter, he spits out phlegm along with blood.
2. Kanthena rujata – He experiences excessive pain in the throat and feels as if the chest is cracking
3. Suchibhiriva tikshnaabhistudyamanena shulina – He feels pricking pain as if pricked by sharp needles
4. Dukha sparshena shulena – He gets excruciating pain and discomfort by touch
5. He feels miserable because of piercing type of pain
6. Parva bheda -He gets afflicted with pain in the joints of fingers and toes,
7. Jwara – fever,
8. Shvasa – dysponea,
9. Trushna – morbid thirst and
10. Svara bheda – hoarseness of voice and
11. Paravata iva kujan – While coughing He produces cooing sound like that of a pigeon. [21-23]

Kshayaja Kasa

The causative factors of Kshayaja Kasa are as follows:
1. Vishama satmya – Intake of Vishama or irregular (vide Cikitsa 15: 236) type of meals and unwholesome food.
2. Ati vyavaya – Excessive indulgence in sex
3. Udvega nigrahat – Suppression of natural urges
4. Ghrininam shocatam nrnam- Immensely hateful disposition and
5. Excessive worry.

Because of the above mentioned factors, the Agni (Gastric fire) gets adversely affected, and consequently, all the 3 Doshas get aggravated giving rise to Kshayaja Kasa which causes emaciation of the body. [24- ½ 25]

The first cause – Sahasa, gives rise to signs and symptoms which are similar to Kshataja Kasa which is already explained in the verse no 23 above. The remaining 3 factors give rise to Kshayaja Kasa which is being presently explained.

Kshayaja Kasa Lakshana and Upashaya
The signs and symptoms of Ksayaja Kasa are as follows:
1. Durgandham haritam raktam sthivana puyopamam – The patient spits phlegm which is foul smelling, green or red in colour, and which is like pus
2. Hrdayam manyate chyutam – While coughing, he feels as if the heart is being displaced (falling down from its normal location)
3. Akasmath ushna shita aarto – He is suddenly afflicted with both hot and cold sensations
4. He consumes food in excessive quantity
5. Bahva durbala krshi – He becomes weak and emaciated
6. Snigdha mukha varna tvak – His face, complexion and skin become clean and unctuous
7. Darshan lochana- His appearance becomes gracious with his eyes glowing
8. Slakshna pani pada tala – The soles of his hands and feet become smooth
9. He always rise to find fault with others, and develops immensely hateful disposition
10. He suffers from fever where signs and symptoms of all the aggravated Doshas are manifested.
11. Parshva ruk – He suffers from pain in the sides of the chest,
12. Pinasa – chronic rhinitis, and
13. Aruchi – anorexia
14. Even without any plausible cause, his stool becomes sometimes compact in form and sometimes loose
15. Swara bheda – His voice becomes hoarse

Prognosis of Kshayaja Kasa:
This is called Kshayaja Kasa which leads to the death of the patient if he is already very weak.
If the patient is strong, then the disease can be cured.
Kshataja Kasa [described in the verse nos. 20-23] is palliable if the patient is strong.
If these 2 ailments (Kshataja Kasa and Kshayaja Kasa) are in their initial stage, and if all the 4 limbs of treatment (viz, physician, drugs, attendants and the patient himself) are endowed with efficiency, then both of these are at times curable.
All the types of Kasa are however, Palliable if the patient is old. [25 ½ -30]

Kasa Chikitsa Sutra

The first 3 types of Kasa [viz, Vatika Kasa, Paittika Kasa, and Shleshmaj Kasa] is treated is palliated with appropriate wholesome ingredients. The treatment of different types of Kasa is spelt out hereafter. [31]

Vatika Kasa Treatment

Vatika Kasa – Line of Treatment
In the event of dryness of body of the patient suffering from Vatika Kasa, a wise physician should first of all treat with
Snehana – oleation therapy,
Anuvasana basti – Medicated enema
Peya (thin gruel),
Yusa (vegetable soup),
Ksheera – milk and Rasa (meat soup) prepared by boiling with Vayu- alleviating drugs.

The patient is given unctuous diet, Dhuma – smoking, Leha – linctus (medicated recipes), Abhyanga – massage, Pariseka (sprinkling of warm water) and unctuous fomentation appropriately.
Vataja kasa with constipation and flatulence is treated with medicated enema.
If the patient has dryness in the upper part of his body, and the ailment is associated with aggravated Pitta, then he is given medicated ghee after the intake of food (urdhva- Dhakitha).
If the patient has dryness of the upper part of the body, and the ailment is associated with aggravated Kapha, then he is given unctuous purgative. [32-34]

Kantakari Ghrita

1 Prastha (768 g) of Ghee is cooked by adding 30 Palas of each of the juice (or decoction) of
Kantakari – Yellow berried nightshade (whole plant) – Solanum xanthcarpum and
Guduchi –Tinospora cordifolia intake of this medicated ghee cures Vataja kasa. It also promotes the power of digestion. Thus ends the description of Kantakari Ghrta. [35]

Learn how to prepare this home remedy – step by step

Pippalyadi Ghrita

1 Prastha of Ghee is cooked by adding 1 Adhaka of the decoction of Dashamula, and the paste of 1 Kola of each of
Pippali – Long pepper fruit – Piper longum,
Pippali Mula – Piper longum
Chavya – Piper retrofractum
Nagara – Zingiber officinale
Dhanya
Patha – Cyclea peltata
Vacha – Acorus calamus
Rasna – Alpinia galanga
Yasti-Madhu – Glycrrhiza glabra
Ksara
Hingu
After taking 1 Chaturthika (Pala) of this medicated ghee, the patient is given Peya-manda (upper part of the thin gruel).
This recipe called Pippalayadi-Ghrta is propounded by Atreya.
It cures
Shwasa – Asthma
Kasa – cough,
Hrud roga – heart diseases,
Parshva shula – pain in the sides of the chest,
Grahani – Malabsorption syndrome, Irritable Bowel Syndrome-Dosha (sprue syndrome) and
Gulma (Phantom tumor)
Thus, ends the description of Pippalyadi ghruta. [36-38]
Read more about Pippalyadi Ghritham

Trayushanadi Ghrita

1 Prastha of Ghee is cooked by adding 4 Prasthas of milk and the paste of 1 Karsha each of
Sunthi – Zingiber officinale
Pippali – Piper longum
Maricha – Piper nigrum [taken together these three drugs are called Tryusana; hence the title of the recipe is Tryushanadya-ghrta],
Haritaki – Terminalia chebula
Bibhitaka – Terminalia bellerica
Amalaki (Indian gooseberry fruit – Emblica officinalis Gaertn)
Draksha – Vitis vinfera
Kashmarya – Gmelina arborea
Parushaka – Grewia asiatica
2 varieties of Patha – Cyclea peltata
Meda
Kakanasa – Martynia annua
Shatavari – Asparagus racemosus
Trikantaka
Vidari
This is an effective recipe for the cure of Kasa.
It also cures
Jwara – fever,
Gulma – abdominal tumor, distension (phantom tumor),
Anoxia
Pliha – splenic disorders,
Shiro shula – headache,
Hrt parshva shula – paining the cardiac region and sides of the chest,
Kamala – jaundice,
Arshas – piles,
Vataja Asthila (hard tumor),
Phthisis,
Kshaya – depletion of body tissues and
Yakshma – tuberculosis
This excellent recipe of medicated ghee is well known as Tryusanadya-ghrta.
Thus, ends the description of Tryusanadya-Ghrta [39-42]

Rasna Ghrita

In 1 Drona (12.288 liters) of water,
1 Pala (48 g) of each of
Rasna – Alpinia galangal
Bilva – Bael – Aegle marmelos
Syonaka – Oroxylum indicum
Gambhari – Gmelina arborea
Patala – stereospermum suaveolens
Ganikarika – Clerodendrum phlomidis
Shalaparni – Desmodium gangeticum
Prsni-Parni –
Brhati – Solanum indicum
Kantakari – Yellow berried nightshade (whole plant) – Solanum xanthcarpum
Goksura – Tribulus terrestris
1 Manika of each of
Kulatha – horse gram
Badara – ber

½ tula of Goat-meat is added and boiled till 1/4th of water remains.
To this decoction, 1 Adhaka of each of ghee and milk, and [the paste of] 1 Pala of each of the 10 drugs belonging to Jivaniya group [vide Sutra 4: 9] is added and cooked.
This medicated ghee is used as Nasya (inhalation therapy), Pana (as drink) and Anuvasana (a type of medicated enema) in the appropriate stage of Vata-roga.
It cures
5 types of Kasa,
Tremor of head,
Colic pain in the inguinal region and genital tract,
Diseases afflicted the whole body or only one limb of the body,
Pliha roga – Splenic disorders and
Urdhva-Vata (upward movement of vayu)
Thus, ends, the description of Rasna-Grtha. [43-46]

Vidangadi Churna

Intake of the powder of
Vidanga – False black pepper – Embelia ribes,
Nagara – Zingiber officinale
Rasna – Alpinia galangal
Pippali – Piper longum
Hingu,
Saindhava,
Bhargi and
Kshara (alkali preparation) along with appropriate quantity of ghee is useful in Vatik Kasa associated with Kapha, Asthma, Hiccup and Suppression of the power of digestion. [47 -1/2 48]

DviKsharadi Churna, Shatyadi Kalka

The ingredients used:
2 types of kshara Long pepper fruit – Piper longum,
Pippali – Long pepper fruit – Piper longum-Mula,
Chavya – Piper retrofractum,
Chitraka – Plumbago zeylanica,
Nagara – Zingiber officinale,
Saindhava-Rock salt
Sauvarcala,
Vida,
Audbhida and
Samudra are made to a powder.
Intake of this powder along with propriety quantity of ghee cures Vataja kasa.
The paste of Sati – Hedychium spicatum, Nagara and Udichya is squeezed through a cloth, and the paste got out of it is added with ghee in appropriate quantity.
Intake of this recipe cures Vatika Kasa. [48 ½ – 49]

Duralabhadi Leha

The ingredients used:
Powder of Duralabha – Fagonia cretica / Alhagi pseudalhagi,
Sati – Hedychium spicatum
Raksa,
Srngavera,
Sitopala (sugar of big crystal) and
Karkata-Srngi is mixed with oil, and made to a linctus form.
Intake of this recipe cures Vataja Kasa.

Duhsparshadi Leha

The ingredients used: Powder of
Duhsparsa — Solanum surratense
Pippali – Piper longum,
Musta – Nut grass (root) – Cyperus rotundus,
Bharangi – Clerodendrum serratum
Karkataki (Karkata- Srngi) – Rhus succedanea and
Sati – Hedychium spicatum is mixed with old Jaggery and oil, and made to a linctus form.
Intake of this recipe cures Vatika Kasa. [51]

Vidangadi Leha

The powder of Vidanga – Embelia ribes
Saindhava-Rock salt
Kustha – Sausserea lappa
Sunthi — Zingiber officinale
Pippali – Piper longum
Maricha – Piper nigrum
Hingu
Manah- Sila is added with honey and ghee, and made to a linctus form.
Intake of this recipe cures Kasa, hiccup and asthma.

Chitrakadi Leha

In ½ Tula of the decoction of Nidigdhika (Kantakari – Yellow berried nightshade (whole plant) – Solanum xanthcarpum)
Powder or paste of 1 Karsa of each of
Chitraka – Plumbago zeylanica
Pippali- Mula – Piper longum
Sunthi – Zingiber officinale
Pippali – Piper longum
Marica – Piper nigrum
Hingu
Duralabha – Fagonia cretica / Alhagi pseudalhagi
Sati – Hedychium spicatum
Puskara-mula – Inula racemosa
Sreyasi
Surasa – Holy basil – Tulsi
Vacha – Acorus calamus
Bharngi – clerodendron serratum
Chinna-Ruha –Tinospora cordifolia
Rasna – Alpinia galanga
Srngi and
Draksa – Vitis vinfera is added.
To this,
20 Palas of Matsyandika (a sugar –cane preparation) and
1 Kudava of Ghee is added and cooked.
Thereafter, when it becomes cool of its own,
1 Kudava of each
Honey and
Pippali – Long pepper fruit – Piper longum powder, and
4 palas of the powder of Tuga-Ksiri is added.
Intake of this linctus cures
Kasa
Hrud roga – heart diseases,
Shwasa – Asthma and
Gulma – abdominal tumor, distension (phantom tumor)
Thus, ends the description of Chitrakadi leh [53- 56]

Agastya Haritaki

2 Palas of each of
Bilva – Bael – Aegle marmelos
Syonaka – Oroxylum indicum
Gambhari – Gmelina arborea
Patali – Stereospermum suaveolens
Ganikarika
Shala-Parni –
Prsni-Parni – Uraria picta
Brhati – Solanum indicum
Kantakari – Solanum xanthocarpum
Goksura – Tribulus terrestris
Svayangupta
Shankha-Puspi – Convolvulus pluricaulis
Shati – Hedychium spicatum
Bala – Abution indicum
Hasti-Pippali – Long pepper fruit – Piper longum
Apamarga – Achyranthes aspera
Pippali – Long pepper fruit – Piper longum Mula
Chitraka – Plumbago zeylanica
Bharngi and
Puskara-Mula – Inula racemosa is added with
1 Adhaka of Yava and
100 fruits of Haritaki – Terminalia chebula
By adding 5 Adhakas of water, these drugs is cooked till the grains of Yava (barley) becomes soft (Svina) and then the decoction is strained out.
These 100 fruits of Abhaya – Harad – Terminalia chebula are then added with the above mentioned decoction, 1 Tula of Jaggery
1 Kudava of each of
Ghee,
Sesame oil and
Powder of Pippali – Long pepper fruit – Piper longum
The recipe is then cooked. Thereafter, when it becomes cool, 1 Kuduva of honey is added.
This is rejuvenating recipe.
Intake of 2 fruits of Abhaya – Harad – Terminalia chebula, thus processed, every day, cures
Wrinkling of the skin and graying of hair (process of aging), and
Promotes complexion, longevity as well as strength
It also cures
5 varieties of Kasa,
Kshaya—depletion of body tissues
Shwasa – Asthma,
Hikka – Hiccup,
Vishama-Jwara – fever (irregular fever),
Arshas – Piles,
Grahani – Malabsorption syndrome, Irritable Bowel Syndrome (sprue syndrome),
Hrud roga – heart diseases,
Aruchi – anorexia and
Pinasa – chronic rhinitis
This excellent rejuvenating recipe propounded by the sage Agastya is auspicious.
Thus, ends the description of Agastya-Haritaki [57-62]

Read more about Agastya hareetaki Rasayan

Recipes for Vatika Kasa

Intake of the powder of
Saindhava,
Pippali – Long pepper fruit – Piper longum,
Bharngi,
Sringavera – fresh ginger and
Duralabha along with the
Luke warm juice of sour dadima – Punica granatum or
The decoction of Bhragi or
the decoction of Nagara – Zingiber officinale (Cures Vatika Kasa] intake of Khadira – Gum acacia – Acacia catechu- Sara – laxative, promotes movement of liquids in channels (solid extract from the heart- wood of Khadira – Gum acacia – Acacia catechu) along with Madira(alcohol)or butter milk[ cures Vatikta Kasa]
Intake of the Paste of Pippali – Long pepper fruit – Piper longum fried (sizzled) with ghee and mixed with a little of Saindhava[ cures VatikaKasa] [63-64]

Dhoomapana

Dhoomapana – Smoking therapy
If there is headache, running nose and arrhythmia of the heart in a patient suffering from Kasa and Pratishyaya(Rhinitis), then the physician should administer Dhuma(smoking therapy).
A wise physician should keep the ingredients of the recipe which cause elimination of Doshas from the head (virechana) inside 2 earthen plates with their brims sealed with mud-smeared cloth (sharava samputa)a tube, 10 or 8 Angulas in length, is inserted in slightly curved from.
The patient suffering from Kasa should smoke the fume emanating from this tube through his mouth. After the smoke pervades the entire chest (lungs), it is 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 – cold; cough caused by Vayu and Kapha gets alleviated. [65-68]

Manahsiladi- Dhuma
After taking the smoke of Manahsila, Ala (Haritala) Madhuka – Madhuca longifolia, Mamsi, Musta – Nut grass (root) – Cyperus rotundus and Ingudi – Balanites aegyptiaca, the patient should take luke- warm milk added with Jaggery.
This cures Kasas caused by the 3 Doshas individually and also jointly (Sannipatika) even if such ailments were not amenable of hundreds of other recipes administered earlier. [69-70]

Prapaundarikadi Dhuma Varti:
The paste of Prapaundraika,
Madhuka – Madhuca longifolia
Sarngesta (Gunja) – Abrus precatorius
Manashila
Maricha – Piper nigrum
Pippali – Long pepper fruit – Piper longum
Draksa – raisins – Vitis vinfera
Ela – Cardamom and the inflorescence of Surasa is smeared over a silken cloth, and a varti (cigar) is prepared.
This cigar is smeared with ghee and used for smoking.
The patient should, thereafter, take milk or water mixed with jaggery.
This cures different types of Kasa mentioned in the verse no.70 above. [71-72]

Manashiladi Dhumavarti
According to the procedure laid down in the earlier recipe, smoking therapy is administered with
Manah- Sila,
Ela – Cardamom,
Maricha – Piper nigrum,
Kshara – Yavakshar
Anjana,
Kutannata,
Vamsa-lochana (Vamsa- Rocana),
Sevya,
Ala,
Ksauma,
Aalaktaka and
Rohisa (Gandha-Trna).
After taking this therapy, the patient should use the post- prandial drink as suggested
Similarly the recipes for smoking therapy can the prepared of Manah Sila, Ala, Pippali – Long pepper fruit – Piper longum and Nagara. [73-74]

Ingudi Tvagadi Dhuma
The smoking therapy with the recipe containing the
Bark of Ingudi – Balanites aegyptiaca
Brhati – Solanum indicum,
Kantakari – Yellow berried nightshade (whole plant) – Solanum xanthcarpum, Tala-Muli,
Manah-Sila,
Seeds of Karpasa – Gossypium herbaceum and
Asvagandha – Withania somnifera cures [vatika type] Kasa. [75]

Diet

Food preparation for Vatika Kasa –
Diet for Vataja Kasa:
Intake of shali type of rice , barley, wheat and swastika type of rice along with the soup of the meat of animals who are domesticated (gramya) or those who live in marshy lands(Anupa) or aquatic animals, or along with the soup (yusa) of Masa and Atma-Gupta is useful[ for the patient suffering from Vatika Kasa].
Peya (thin gruel) cooked along with
Yavani – Carum copticum,
Pippali – Piper longum,
Bilva – Bael – Aegle marmelos (pulp),
Nagara—Zingiber officinale,
Chitraka – Plumbago zeyylanica,
Rasna – Alpinia galanga,
Prthak- Parni,
Palasa – butea monosperma,
Sati – Hedychium spicatum and
Puskara-Mula – Inula racemosa is added with ghee, sour juice and salt.
Intake of this thin gruel cures
Vatika Kasa,
Hrud Shoola – pain in the lumber region, cardiac region,
Parshva shoola – Sides of the chest, and Koshta (gastro- intestinal tract), Shwasa – Asthma and
Hikka – hiccup.
Intake of the Peya prepared [by boiling rice etc] with the decoction of Dasha-Mula and added with the powder of Pancha-Kola and Jaggery is useful in Vatika Kasa.
Intake of the Peya prepared with [rice etc and] equal quantity of sesame seed, and boiled by adding milk [is useful in Vatika Kasa].
Similarly, intake of the peya prepared with [rice etc and] equal quantity of sesame seed, and added with rock –salt (saindhava) [is useful in Vataja Kasa].
Peya prepared by cooking [rice etc] with the meat of fish, chicken or pig, and by adding ghee and Saindhava is taken [by a person suffering from Vatika Kasa].
Vastuka, leaves of Vayasi (Kakamachi) – Solanum nigrum, Mulaka – Raphanus sativus, Sunisannaka, Unctuous material, Viz oil etc food preparations made of milk, sugar- cane juice and jaggery, curd, Aranala (a type of Vinegar), sour fruit, Prasanna (a type of Alcoholic drink), and ingredients which are sweet, sour and saline in taste are useful in Vatika type of Kasa. Thus, ends the description of the treatment of Vatika type of Kasa. [76-82]

Treatment of Paittika Kasa

Vamana for Pittaja Kasa:
If Paittika Kasa is associated with the aggravation of Kapha, then the patient is given emetic therapy with medicated ghee or with the decoction of Madana – Randia dumetroum, Kashmarya – Gmelina arborea and Madhuka – Madhuca longifolia or with the paste of Madhu-Yasti – Glyccrhiza glabra and Madana-Phala – Randia dumetroum mixed with the juice of Vidari – Pureria tuberosa and sugar-cane.
After the aggravated Doshas are eliminated, the patient is treated with cooling therapies, and recipes having sweet ingredients. [83-84]

Virechana

Virechana – Purgation Therapy for Pittaja Kasa
Purgation therapy:
If in Paittik Kasa,
The Phlegm is thin then the patient is given Virechana (purgation) therapy with Trivrt – Operculina turpethum mixed with sweet drugs.
If the phlegm is thick, then Trivrit – Operculina turpethum mixed with bitter drugs and given for purgation
After the administration of purgation therapy, Peya (thin gruel described above) is given followed by food preparations, medicated ghee and recipes of linctus. [85-86]

Leha yoga

Leha Yoga – linctus recipe:
The patient suffering from Paittka Kasa is given the following 5 recipes in the form of Leha (Linctus) by adding ghee and honey:
1. Sringataka, seeds of Padma, solid extract (Sara – laxative, promotes movement of liquids in channels) of Nili and Pippali – Long pepper fruit – Piper longum
2. Pippali – Piper longum, Musta – Nut grass (root) – Cyperus rotundus, Yasti-Madhu – Glyhccrhiza glabra, Draksa – Vitis vinfera, Murva – Marsedenia tenacissima and Sunthi – Zingiber officinale
3. Laja, Amalaki (Indian gooseberry fruit – Emblica officinalis Gaertn), Draksa – Vitis vinfera , Tvakksiri(Vamsa-Locana), Pippali – Long pepper fruit – Piper longum and Sugar
4. Pippali – Piper longum , Padmaka, Draksa – Vitis vinfera and the juice of fruits of Brhati – Solanum indicum and
5. Kharjura – Dates – Phoenix dactylifera, Pippali – Long pepper fruit – Piper longum, Vamsi (Vamsa-Locana) and Svadamstra. [87-89]

Sharkaradi Leha
If Kasa is caused exclusively by Pitta, then patient is given the linctus of Sarkara, Chandana – Santalum album, Draksa – Vitis vinfera, Honey, Dhatriphala and Utpala – Water Lily.
If there is association of Kapha, then the patient is given this recipe along with Musta – Nut grass (root) – Cyperus rotundus and Maricha – Piper nigrum. If however, it is associated with Vayu, then this recipe is used along with ghee. [90]
50 fruits of Mrdvika, 30 fruits of Pippali – Long pepper fruit – Piper longum and 1 Pala of sugar is added with honey and given to the patient suffering from Paittika Kasa.

The juice of cow- dung mixed with honey can also be given to the patient suffering from Paittika Kasa. While taking this recipe, the patient should drink only milk. [91]

Tvagadi Leha
The linctus prepared of
Tvak – cinnamon
Ela – cardamom,
Shunti – Zingiber officinale,
Pippali – Long pepper fruit – Piper longum,
Maricha – Piper nigrum,
Mrudvika – raisins,
Pippali – Long pepper fruit – Piper longum-Mula,
Puskara-Mula – Inula raemosa,
Laja,
Musta – Nut grass (root) – Cyperus rotundus,
Sati – Hedychium spicatum,
Rasna – Pluchea lanceolata,
Dhatri Phala – Amalaki (Indian gooseberry fruit – Emblica officinalis Gaertn)- and
Bibhitaka – Terminalia bellerica by adding Sugar, honey and ghee
Indicated in –
Kasa – cough
Hikka – Hiccup,
Kshaya – tuberculosis and
Hrud roga – heart diseases [92-93]

Pippalyadi Leha
Pippali – Long pepper fruit – Piper longum, Amalaka – Emblica officinalis, Draksa – Vitis vinfera, Laksa, Laja and Sitopala (sugar of big Crystals) is cooked by adding milk. After it becomes cool, 1/8th part of honey is added.
Intake of these recipes cures Pittaja Kasa [if the Phlegm has become thick] [94]

Intake of the juice of Vidari – Pureria tuberosa, Ikshu and Mrnala, milk and sitopala mixed with [an appropriate quantity of] honey, cures Paittika Kasa effectively. [95]

Intake of Shyamaka, Yava (barley) and Kodrava along with the Sweetened soup of the meat of the animals inhabiting Jangala (thinly forested) zone or with the soup of Mudga etc or with the vegetables having bitter taste is useful [in Paittika Kasa] [96]

Management of Thick and Thin Kapha

In the Paittika Kasa, if the phlegm is thick, then the patient is given recipes of Leha (linctus) prepared of bitter drugs along with honey.
If the phlegm is thin, then the patient is given Shali and Shashtika types of rice along with meat soup, etc. [97]

Anupana

Anupana – Post-Prandial Drinks
In the Pittaja Kasa, water mixed with sugar, grape-juice, sugar cane and milk are useful as Anupana (post Prandial drink).
All things which are sweet in taste and cooling in potency but not Vidhahi (which cause burning sensation in the abdomen) are useful in this condition. [98]

For the Pittaj Kasa, Meat-soup, medicated milk and Vegetable- soup, is prepared by adding
Kakoli – Fritillaria roylei,
Brhati – Solanum indicum
Meda – Polygonatum cirrhifolium,
Mahameda,
Vasaka – Adhatoda vasica and
Nagara – Zingiber officinale [99]

Ksheerayoga, Guda yoga

Ksheerayoga – Medicated Milk
The patient suffering from the Paittika Kasa should take milk boiled by adding decoction of either Saradi- Panca-Mula (trna-Panca –Mula) or the decoction of Pippali – Long pepper fruit – Piper longum and Draksa – Vitis vinfera, after adding honey and sugar. [100]

ksheera and Guda Yoga – Recipes of medicated Milk and jaggery
Recipes of medicated Milk and jaggery
Milk boiled with Sthira
Sita – sugar
Prsni-Parni – Uraria picta
Sravani – Mundi
Brhati – Solanum indicum
Kantakari – Yellow berried nightshade (whole plant) – Solanum xanthocarpum
Jivaka – Malaxis acuminata
Rishabaka
Kakoli – Fritillaria roylei
Tamalaki – Phyllanthus niruri
Riddhi
Is useful in the treatment of Kasa, fever, Daha – Burning sensation, Phthisis and Kshaya – depletion of body tissues
The ghee collected from the above mentioned milk is added with milk, sugarcane juice and the paste of 3 Karshas of each of the sweet drugs belonging to Jivaniya group (vide Sutra 4;9), fruits of Abhisuka etc, (Vatama,Aksoda, Mukulaka and Nikocaka-vide Sutra 27; 157) and cooked.
The ghee is then filtered out and made to cool. To this, the powder of Sarkara, Pippali – Long pepper fruit – Piper longum, Tvak-Ksiri, Maricha – Piper nigrum, Srngataka and honey is added.
This paste is added with wheat-flour, and Gudas (large size Pills) is prepared out of it.
Intake of these Gudas along with wholesome food cures
Seminal and menstrual diseases,
Kshaya – depletion of body tissue,
Kasa – emaciation and Phthisis. [101- 105]

Recipe for Pittaja Kasa

The paste of Sarkara (Sugar), Nagara – Zingiber officinale, Udicya, Kantakari – Yellow berried nightshade (whole plant) – Solanum xanthocarpum and Sati – Hedychium spicatum, taken in equal quantities, is squeezed through a cloth. This juice is sizzled with ghee this cures Paittika Kasa.
Ghee is cooked by adding the milk of buffalo, goat, sheep and cow, and the juice of Amalaki (Indian gooseberry fruit – Emblica officinalis Gaertn), all taken in equal quantities.
Intake of this medicated ghee in appropriate quantity cures Paittika Kasa
Thus, ends the treatment of Pitta-Kasa. [106- 107]

Kaphaja Kasa Chikitsa sutra

Line of treatment of Kaphaja Kasa:
If the patient suffering from Kaphaja kasa is strong, then he is given emetic therapy in the beginning. Thereafter, he is given barley and such other Kapha- alleviating is given barley and such other Kapha-alleviating ingredients as pungent, ununctuous and hot in potency, to eat.

The patient should take-
• light food with the soup of Kulattha mixed with the powder of Pippali – Long pepper fruit – Piper longum and alkalies (Yava- Ksara) or
• With the juice of Mulaka or
• With the soup of the meat of animals inhabiting arid zone (Dhanva-cari) or burrows (Bilesaya) prepared by adding pungent drugs, or
• With the oil of mustard and Bilva – Bael – Aegle marmelos.
Anupana – water, sour drinks, warm water, butter milk, or harmless alcoholic drinks.
Puskara-Mula – Inula racemosa, root of Aragvadha – Cassia fistula and Patola – Pointed Gourd – Trichosanthes dioica is kept in water for the whole night.
Next morning, the water is strained out and added with honey. This is taken before, during and after meals. [108-111]
Decoction Etc.,

Katphaladi Kashaya

Katphala
Kattrna
Bharngi – Clerodendrum serratum
Musta – Cyperus rotundus
Dhanya
Vaca – Acorus calamus
Abhaya – Terminalia chebula
Sunthi – Zingiber officinale
Parpataka
Srngi
Surahva is boiled with water.
This decoction added with honey and hingu is taken if Kasa is caused by Vayu and Kapha.
It also cures
Kanta roga – throat diseases,
Svayathu – oedema in the face,
Shvasa – asthma,
Hikka – hiccup and
Jwara – fever

Pathadi Yoga

The patient should take-
Patha – Oroxylum indicum
Sunthi – Zingiber officinale
Shati – Hedychium sicatum
Murva – Marsedenia tenacissima
Gavakshi
Musta – Cyperus rotundus
Pippali – Piper longum in paste from along with warm mixed with
Hingu – asafoetida and
Saindhava – rock salt
In the above mentioned manner, the patient should take
Nagara – Ginger – Zingiber officinale
Ativisa – Aconitum hetrophyllum
Musta – Cyperus rotundus
Karkata-Sringi – Rhus succedanea
Haritaki – Terminalia bellerica and
Sati – Hedychium spicatum
1 Aksa of the paste of Pippali – Piper longum, fried with oil is added with Sitopala (sugar having large size cerystal).
Intake of this recipe along with the soup of Kulattha – Dolichos biflorus cures kaphaja Kasa.
Intake of the juice Kasamarda – Cassia occidentalis, stool of horse, Bhrngaraja – Eclipta alba, Vartaka and black variety of Surasa along with honey cures kaphaj Kasa. [112-117]

Leham Yoga

Leham Yoga: Recipes of Linctus (Leha)

Recipes of Linctus (Leha)
Powders of these are mixed with honey and oil and this linctus cures Kaphaja kasa associated with aggravated Vayu:
Devadaru – Cedrus deodara
Shati – Hedychium spicatum
Rasna (Vanda roxburghi / Pluchea lanceolata)
Karkata-Srngi – Rhus succedanea
Duralabha – Fagonia arabica

Powders of these drugs mixed with honey cures Kaphaja Kasa:
Pippali – Long pepper fruit – Piper longum
Nagara – Zingiber officinale
Musta (Cyperus rotundus)
Pathya
Dhatri
Sitopala
These are made into a linctus by adding honey. Intake of this cures Kaphaja Kasa:
Pathya
Tamalaka
Dhatri
Bhadra- Musta (Cyperus rotundus)
Pippali – Long pepper fruit – Piper longum
Deva-Daru – Cedrus deodara
Abhaya – Terminalia chebula
Musta (Cyperus rotundus)
Pippali Visva-Bhesaja
Trivrta – Operculina turpethum
Intake of the powder of
Sauvarcala
Abhaya – Terminalia chebula
Dhatri
Pippali – Long pepper fruit – Piper longum
Kshara
Nagara alone with ghee cures Kasa caused by Vata and Kapha. [118-122]

Dashamuladi Ghrita

1 Prastha of ghee is cooked by adding 1 Adhaka of the decoction of Dasa-Mula and the paste of one karsha each of
Puskara-Mula – Inula racemosa
Sati – Hedychium spicatum
Bilva – Aegle marmelos
Surasa
Sunthi – Zingiber officinale
Pippali – Piper longum
Maricha – Black pepper fruit – piper nigrum
Hingu – Asa foetida
Post prandial drink – Peya (Thin gruel)
It cures Kasa caused by Vayu and Kapha, and all types of Asthma caused by Vata and Kapha.
Thus, ends the description of Dashamuladi- ghrita. [123-124]

Kantakari Grtha

1 Adhaka of the decoction of Kantakari – Solanum xanthocarpum along with its root, fruit and leaf, and 1 Prastha of ghee are cooked by adding the paste of
Bala – Country mallow (root) – Sida cordifolia
Sunthi – Zingiber officinale
Pippali – Long pepper fruit – Piper longum
Maricha – Black pepper fruit – piper nigrum
Vidanga – Embelia ribes
Sati – Hedychium spicatum
Chitraka – Leadword – Plumbago zeylanica
Sauvarcala
Yava – Barley (Hordeum vulgare)- Ksara
Pippali – Long pepper fruit – Piper longum mula
Puskara-Mula – Inula racemosa
Vrscira (white variety of Punarnava) – Boerhavia diffusa
Brihati – Solanum indicum
Pathya
Yavani – Carum copticum
Dadima – Pomegranate – Punica granatum
Rddhi
Draksha – Raisin – Vitis vinifera
Punarnava (red Variety) – Boerhavia diffusa
Chavya – Piper retrofractum
Duralabha – Fagonia arabica
Amlavetasa – Garcinia pedunculata Roxb. / Rheum emodi Wall
Srngi
Tamalaki – Phyllanthus niruri
Bhargi
Rasana – Alpinia galanga
Goksuraka – Tribulus terrestris
Cures:
All types of Kasa,
Hikka – hiccup and
Shwasa – Asthma.
This is called Kantakari Ghrta and it cures all types of diseases caused by Kapha.
Thus, ends the description of Kantakari grtha. [125-128]

Kulatthadi Ghrta

Ghee cooked with the decoction of Kulattha and [the paste] of Pancha-Kola is useful in Kaphaja Kasa, hiccup and asthma.
Thus, end the description of Kulatthandi Ghrta. [129]

Dhumapana

Dhumapana for Kaphaja Chikitsa:
Recipes for smoking therapy described for the treatment of Vatika Kasa (Shlokas – 65- 75) is used for the treatment of Kaphaja kasa.
This recipe containing the pulp of Kosataki and Manah- Sila is especially useful for smoking in Kaphaja- Kasa [130]
Management of Associated Complications:
If Kaphaja Kasa is associated with Tamaka (a type of asthma) caused by Pitta Then in this stage of Kasa, the therapies prescribed for Paittika type of Kasa should be administrated.
If there is association of Kapha in Vataja Kasa, then therapies for the alleviation with bitter ingredients.
Thus, ends the description of the treatment of Kaphaja –Kasa. [131-133]

Kshataja Kasa treatment

Line of treatment
Kshataja Kasa (phthisis) is a serious ailment.
Keeping this in view, the treatment of the patient is initiated instantaneously with sweet drugs and drugs belonging to Jivaniya group (vide Sutra 4: 9) which are promoters of strength and muscle tissue. [134]

Pippaladi Leha

The paste of 1 karsha of each of
Pippali – Piper longum and
Madhuka– Licorice – Glycyrrhiza glabra,
1 Karsha of
Sitopala (sugar of large size crystal)
1 prastha each of
Cow’s milk,
Goat’s milk and
Juice of sugar- cane
1 prastha each of the powders of
Yava
Godhuma – wheat – Triticum sativum and
Draksha – Raisin – Vitis vinifera and
1 Prastha each of the
Juice of Amalaka and
Sesame oil is cooked over mild fire.
Intake of this linctus along with ghee and honey cures
Ksataja Kasa (phthsis),
Asthma,
Heart diseases and
Emaciation
It is also useful for old persons and those who have less of semen. [135- 137]

Treatment of Associated Complications
The regimens prescribed for the Paittika Kasa are useful for the patient suffering from Kshataja kasa (Phthsis). Generally milk, Ghee and honey are given to such patients.
If 2 of the Doshas are involved in the pathogenesis of this ailment (samsarga), then special therapies are required.
If this ailment it associated with Vayu and Pitta and the patient has pain all over the body, then massage is given with ghee.
If Vayu is aggravated in excess causing pain, then massage is given with oil prepared by boiling with Vayu- alleviated drugs. [138-139]

Medicated Ghee

The patient suffering from Kasa along with Hrt parshva shola – pain in the cardiac region and sides of the chest associated with
Daha – burning sensation,
Rakta sthivana – hemoptysis and aggravation of Vayu should take Jivaniya grtha [described in the chapter dealing with the treatment of Vata- Rakta-vide Cikitsa 29: 61- 70 [140]

If the patient is weak and habituated to taking meat, then the soup of the meat of Lava etc is useful for him.
If the patient of phthisis is suffering from Trushna (thirst), then he is given goat’s milk boiled with the root of Sara, etc, (trna-Panca-Mula).
If there is bleeding from different channels or from the mouth, then the patient should use ghee extracted from the cream of milk for inhalation therapy and as drink.
If the patient of Phthisis is fatigued and weak, and if he has low power of digestion, then he is given Yavagu (thick gruel) to eat.
If there is stiffness and contraction of the body, then the patient of Phthisis is given ghee in large dose.
Therapies for his alleviation of vayu which do not aggravated Pitta and Rakta is given to such patients. [141-143]

Dhoomapana

Dhoomapana for Kshataja Kasa – 
Kshataja Kasa – Smoking Therapy
If the patient suffering from Kshataja Kasa is cured of the Kshata (injury or ulceration in the Uras or Lungs), but there is throbbing type of pain in the place of injury because of aggravation of kapha, then he is given smoking therapy with the recipes described below.
Meda,
Maha-Meda – Polygonatum cirrhifolium
Madhuka– Licorice – Glycyrrhiza glabra,
Bala – Country mallow (root) – Sida cordifolia and
Maha-Bala – Country mallow (root) – Sida cord folia is made to a paste and smeared over a cloth of silk.
This is then rolled in order to give it the Shape of a cigar.
After smoking this cigar, the patient should drink Jivaniya-Ghrta.
A cigar is prepared by smearing (llit. Soaking) a piece of silken cloth with the paste of
Manah- sila,
Palasa – Butea monosperma
Ajagandha,
Tvak- Ksiri and
Nagara – Zingiber officinale
After smoking this cigar, the patient should drink sugar- cane juice or water mixed with jaggery.
Manah-Sila is made in to a paste by triturating it with the green still root of vata (vata-Sunga).
To this, ghee is added. After taking the smoke of this recipe, the patient should take the soup of the meat of Tittiri.
Smoking with the silken cloth soaked with the decoction of drugs belonging to Jivaniya group (vide Syutra 4:9) and the sap of the egg of Kulinga, and thereafter, taking the milk immersed with hot iron balls are useful in Ksataja Kasa.
Thus, ends the description of Ksataja Kasa. [144-48]

Kshayaja Kasa treatment

Line of treatment for Kshayaj Kasa:
If the Kshayaja Kasa is manifested with all the signs and symptoms, and the patient is weak, then he should not be treated.
However, if the disease has recently occurred (navotithaa) and if the patient is strong, then such a patient may be treated even though the diseases is incurable (because, occasionally such a patient may be cured).
In the beginning, such a patient is given nourishing therapy, and his Agni (power of digestion and metabolism) is stimulated.
If the Doshas are over aggravated, then he may be given mild purgative along with unctuous ingredients (medicated ghee). [149- 150]

Ghrita for Mrudu Virechana: Medicated Ghee for Mild Purgation
Ghee cooked with the decoction of Sampaka (fruit-pulp of Aragvadha (Cassia fistula)) and Trivrt – Operculina turpethum, the juice of grape.
The decoction of Tilvaka, and (or) the juice of Vidari (Ipomoea paniculata / Pueraria tuberosa) is given in appropriate dose for the elimination (Sodhana of Doshas) to the patient whose body is weak.
It is useful for the prospection of the body, strength and chest of the patient [151-152]

Recipe of Medicated Ghee

When because of the administration of the above mentioned purgation therapy Pitta and kapha becomes reduced in quantity, the patient, whose tissue elements are already denuded, should take the ghee prepared by boiling it with
Karkata-Srngi – Rhus succadenea,
Milk,
Bala – Country mallow (root) – Sida cordifolia and
Atibala – Abutilon indicum [153]

Medicated Ghee and medicated Milk:
If there is discoloration of the urine or if there is dysuria, the patient is given milk and ghee boiled by adding Vidari – Ipomoea paniculata or Kadamba or the pulp of tender fruits of Tala. [154]

Anuvasana basti

Recipe for Anuvasana Basti – fat enema:
If there is swelling and pain in the phallus, Anus, hips and Pelvic region, the patient is given Anuvasana Basti (fat enema) with the scum of ghee (ghrita-Manda) or honey or with ghee and oil mixed together (Misraka). [155]

Diet after Anuvasana Therapy
After the administration of Anuvasana type of enema, the patient is given the soup of the meat of animals and birds which are Jangalas (those living in this forests), Vartaka, etc., those which are Bileshaya (those living in burrows) and meat- eating Prasahas (those eating by snatching their food) seriatim.
Because of their hot potency and Pramathi attribute (ingredients which help in the exudation of Doshas from the channels), these ingredients cause exudation of Kapha accumulated in the channels of circulation.
After the body is cleansed of this aggravated Kapha, these meat- soups, while flowing appropriately in the channels of circulation, cause nourishment of tissues [156- 157]

DviPanchaMuladi Ghruta

Decoction is prepared of
Bilva – Aegle marmelos
Syonaka – Oroxylum indicum
Gambhari — Gmelina arborea
Patala – Stereospermum suaveolens
Ganikarika
Sala-Parni – Desmodium gangeticum
Prsni-Parni
Brihati – Solanum indicum
Kantakari – Solanum xanthocarpum
Goksura – Tribulus terrestris
Haritaki – Terminalia chebula
Bibhitaka – Terminalia bellerica
Amalaki – Phyllanthus emblica
Cavika
Bhargi
Chitraka – Leadword – Plumbago zeylanica
Kulattha
Pippali Mula – Piper longum
Patha – Cyclea peltata
Kola – Ber
and
Yava – Barley (Hordeum vulgare) by boiling with water.
To this decoction, ghee and the paste of
Nagara – Zingiber officinale
Duhsparsa
Pippali – Long pepper fruit – Piper longum
Sati – Hedychium spicatum
Puskara-Mula – Inula racemosa
Karkata Srngi is added, and cooked.
After the medicated ghee is prepared,
Yava Kshara
Svarji-Kshara
Saindhava-Lavana
Samudra-Lavana
Sauvarcala Lavana
Vida-Lavana
Audbhida-Lavana is added in powder from [only in small quantity].
Intake of this medicated ghee in appropriate dose cures Kshayaja Kasa.
Thus ends the description of DviPancamuladi Ghrta [158-160]

Guduchyadi Ghrita

Guduci – Tinospora cordifolia
Pippali – Long pepper fruit – Piper longum
Murva – Marsedenia tenacissima
Haridra – Berberis aristata
Sreyasi (Rasna (Vanda roxburghi / Pluchea lanceolata))
Vacha (Acorus calamus Linn)
Nigdighika
Kasamarda
Patha – Cyclea peltata
Chitraka – Leadword – Plumbago zeylanica
Nagara is added with 4 times of water, and boiled till 1/4th remains.
To this decoction, equal quantity of ghee is added and cooked.
Intake of this medicated ghee cures
Gulma (Phantom tumour),
Asthma and
Kshayaj Kasa
Thus, ends the description of Guducyadi- Ghrta. [161- 162]

Medicated Ghee recipes

1 Prastha of ghee is cooked by adding the paste of 1 Aksa of each of
Kasamarda – Cassia occidentalis
Abhaya – Terminalia chebula
Musta (Cyperus rotundus)
Patha – Cyclea peltata
Katphala – Myrica nagi
Nagara
Pippali – Long pepper fruit – Piper longum
Katuka
Draksha – Raisin – Vitis vinifera
Kasmarya – Gmelina arborea
Surasa
1 Adhaka of milk and
1 Adhaka of Grape- Juice
This recipe of medicated ghee is auspicious, and it cures
Shosha – emaciation,
Jwara – fever,
Pliha – spleen-diseases and
All the types of Kasa
Fruits of amalaki is boiled in milk and made to powder. Ghee sprinkled with this powder is taken by the patient suffering from Kshayaja Kasa, among others.
Yava – Kshara-Ghrita prepared by cooking with double the quantity of Dadima – Pomegranate – Punica granatum-Jucice and added with powder of Sunthi, Pippali – Long pepper fruit – Piper longum and Maricha – Black pepper fruit – piper nigrum is taken at the end of the meal by the patient suffering from Kashayaja Kasa among others
Ghee cooked with the paste of Pippali – Long pepper fruit – Piper longum and Jaggery, and goat milk is similarly useful
All the above mentioned recipes of medicated ghee promote Agni (power of digestion and medicated metabolism) of the patient suffering from Kshayaja Kasa. These recipes also cleanse the Adhered Doshas from the channels of Kostha (gastro- Intestinal Tract) and Chest. [163- 167]

Haritaki Leha

20 fruits of Haritaki is boiled in 1 Adhaka of the decoction of Yava – Barley (Hordeum vulgare) (barley).
These boiled and softened fruits of Haritaki is smashed, [their seeds are removed] and the pulp is made to a paste.
In this paste,
6 Palas of old jaggery,
1 Karsa of Manah-Sila,
½ Karsa of Rasanjana (Aqueous extract of Berberis aristata) and
½ Kudava of Pippali – Long pepper fruit – Piper longum is added and cooked. This preparation of linctus cures
Asthma and
Kasa
Thus, ends the description of Haritaki-Leha. [168-169]

Churna – Leha Yoga: Recipes of powders and Linctus
Recipes of powders and Linctus
Intake of the ashes of Quills of Svavidha along with ghee, honey and sugar cures asthma and kasa.
Intake of the ashes of Pea- cock legs along with honey and ghee cures asthma and Kasa.
Intake of this linctus cures asthma and Kasa:
Eranda Kshara (alkali preparation) is added with
Sunthi – Zingiber officinale
Pippali – Long pepper fruit – Piper longum,
Maricha – Black pepper fruit – piper nigrum,
Oil and
Jaggery
The kshara of the leaves of
Surasa and
Eranda – Ricinus communis is mixed with
Sunthi – Zingiber officinale
Pippali – Long pepper fruit – Piper longum,
Maricha – Black pepper fruit – piper Nigrum,
Oil and
Jaggery intake of this linctus cures asthma and Kasa
The powder of
Draksha – Raisin – Vitis vinifera,
Vartaka and
Pippali – Long pepper fruit – Piper longum is added with honey and ghee. Intake of this linctus cures asthma and kasa.
The powder of
Sunthi – Zingiber officinale
Pippali – Long pepper fruit – Piper longum, and
Maricha – Black pepper fruit – piper nigrum is added with old jaggery and ghee.
Intake of this recipe cures Asthma and Kasa.
The powder of Chitraka – Plumbago zeylanica
Haritaki – Terminalia chebula
Bibhitaka – Terminalia bellerica
Amalaka – Phyllanthus emblica
Ajaji
Karkata-Srngi – Rhus succedanea
Sunthi
Pippali – Long pepper fruit – Piper longum
Maricha – Black pepper fruit – piper nigrum
Draksha – Raisin – Vitis vinifera is mixed with honey and ghee or with jaggery. Intake of these two recipes cures Asthma and kasa.

Padmakadi Leha
Recipes of powders and Linctus
These are taken in equal quantities (1 Part of each) are made to fine powder:
Padmaka – Prunus cerasoides
Haritaki – Terminalia chebula
Bibhitaka – Terminalia bellerica
Amalaki – Phyllanthus emblica
Sunthi – Zingiber officinale
Pippali – Long pepper fruit – Piper longum
Maricha – Piper nigrum
Vidanga – Embelia ribes
Suradaru (Cedrus deodara) (Deva- Daru)
Bala – Country mallow (root) – Sida cordifolia
Rasna (Vanda roxburghi / Pluchea lanceolata)
To this powder, equal quantities (eleven parts) each of honey, ghee and sugar is added and mixed well.
This recipe of linctus is auspicious and it cures all types of kasa.
Thus, ends the description of Padmakadi Leha. [174-175]
Jivantyadi – Leha

All these are taken in equal quantities and made to a powder:
Jivanti – Leptadenia reticulata
Madhuka– Licorice – Glycyrrhiza glabra
Patha – Cyclea peltata
Tvak-Ksiri
Haritaki – Terminalia chebula
Bibhitaka – Terminalia bellerica
Amalaki – Phyllanthus emblica
Sati – Hedychium spicatum
Musta (Cyperus rotundus)
Ela (Elettaria cardamomum Maton)
Padmaka – Prunus cerasoides
Draksha – Raisin – Vitis vinifera
Brihati – Solanum indicum
Kantakari – Solanum xanthocarpum
Itunnaka
Sariva – Indian Sarsaparilla – Hemidesmus indicus
Puskara-Mula – Inula racemosa
Karkata-Sringi – Rhus succedanea
Rasanjana (Aqueous extract of Berberis aristata)
Punarnava – Boerhavia diffusa
Loha- Rajata (bhasma)
Trayamana
Yavanika
Bhargi
Tamalaki – Phyllanthus niruri
Rddhi
Vidanga – Embelia ribes
Dhanvayasaka
Kshara (Alkali preparation)
Chitraka – Plumbago zeylanica
Chavya – Piper retrofractum
Amla-Vetasa – Garcinia pedunculata
Sunthi – Zingiber officinale
Pippali – Piper longum
Maricha – Black pepper fruit – piper nigrum and
Deva-Daru – Cedrus deodara
Dosage: 1 Panitala
Adjuvant: Honey and ghee
Cures: all the 5 varieties of Kasa [176-179]

Recipes
The powder of Maricha – Black pepper fruit – piper nigrum is mixed with ghee, honey and sugar.
This preparation of linctus is taken by the patient.
The paste of the leaves of Badari is sizzled with ghee and mixed with Saindhava (rock-salt).
This is given to the patient, suffering from hoarseness of voice (Swara- Bheda) and kasa. [180- ½ 181]

The paste of the leaves of Tilvaka is sizzled with ghee and made to an Utkarika (food preparation in paste form) by adding sugar.
Intake of this cure:
Chardi – vomiting,
Trut – morbid thirst,
Kasa and
Atisara – diarrhea associated with Ama (product of improper digestion). (181 ½- ½ 182)

These drugs are boiled with water and the decoction is prepared:
White variety of Sarshapa – Brassica campestris
Gandira
Vidanga – Embelia ribes
Sunthi – Zingiber officinale
Pippali – Piper longum
Maricha – Black pepper fruit – piper nigrum
Chitraka – Plumbago zeylanica
Abhaya
With this decoction, yavagu (thick gruel) is prepared.
To this Yavagu, some ghee and salt is added.
This medicated Yavagu is administrated to a patient suffering from
Hikka – hiccup,
Shwasa -asthma,
Pinasa – chronic Rhinitis,
Pandu – Anaemia
Kshaya – tissue depletion,
Shotha – oedema and
Karna shoola – earache [½ 182- 183]

Soup of Mudga prepared by adding the juice (decoction) of Kantakari – Solanum xanthocarpum is properly sizzled.
Intake of this soup by adding green Amalaki (Gauramalaka) and sour ingredients cures all types of kasa [184]

The patient suffering from Kshayaja Kasa is given
Ksheeram – milk,
Yusha – vegetable-soup and meat-soup prepared of the meat of birds/ animals belonging to Viskira who collect food by scratching), Pratuda (who collect food by Pricking) and Bilesaya (who dwell in burrows) groups.
These foods- preparations is made by boiling with the decoction of Vayu- alleviating drugs. [185]

Smoking therapy

Recipes for smoking therapy prescribed for the treatment of Kshataja Kasa along with the Anupanas (post- Prandial drinks) (vide verse nos. 144-148) should also be administered to patients suffering from Kshataja kasa in appropriate stages of the disease. [186]

General line of management

Management of kasa in general
To the patient suffering from Kshayaja Kasa
Dipana (digestive stimulants)
Brmhana (nourishing therapy) and
Srotas- Sodhana (therapies which cleanse the channels of circulation) is given alternatively.
All the therapies that promote strength (balya) are useful in this condition.
Kshayaja Kasa is caused by Sannipata (simultaneous aggravation of all 3 Doshas). Therefore, therapies which alleviate all the associated Doshas keeping this in view, treatment are administered.
The physician should know that among Vatika Kasa, Paittika Kasa, Kaphaja Kshataja and Kshayaja Kasa, the succeeding ones are more serious than the preceding. [187- 189]

Different Categories of Therapies:
For the treatment of Kasa the following categories of therapies are described to be administered:
1. Bhojya (food preparation)
2. Pana (drinks)
3. Sarpis (medicated ghee)
4. Leha (recipes of linctus) along with postprandial drinks
5. Ksheera (milk boiled with medicines)
6. Sarpirguda (preparation containing ghee, jaggery, etc) , which are used either in linctus from or in the form of pills and
7. Dhuma (recipes for smoking). [190]

Summary:
In this chapter, the following topics are discussed:
The number or types of kasa
Etiological factors of different types of Kasa
Signs and symptoms of different types of Kasa
Curability and incurability of different types of Kasa
Recipes for the treatment of different types of Kasa and
Comparative seriousness of different types of Kasa. [191]

Thus, ends the 18th chapter in Chikitsasthana dealing with the treatment of Kasa in the work of Agnivesa which was redacted by Charaka and supplemented by Drudhabala.