Kshayaja Kasa – Causes, Symptoms, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Kshayaja Kasa means cough produced by destruction of tissues in the body. It is one among the five types of cough. This condition is said to be caused by aggravation of all three doshas and is dreadful in nature.

Table of Contents

Causative factors

Eating unequal foods
Eating incompatible foods
Excessive indulgence in sexual activities
Forcibly controlling the natural urges of the body
Always thinking about disgusting things

Pathogenesis

The digestive fire becomes disturbed when the person gets exposed to one or more of the above said etiological factors. Following this all three doshas get aggravated and causes cough which destroys the body of the patient. This cough is called kshayaj kas.
Read – Charaka Kasa Chikitsa – 18th Chapter

Signs and Symptoms

Patient expectorates phlegm which smells foul, resembles pus and is green or red in color.
While coughing, the patient feels as if his heart has been displaced from its place.
Eats food in excess but still remains weak and emaciated.
Skin, color and face become clear and unctuous.
Eyes are attractive and lustrous.
Palms and foot are always unctuous.
They find wrong doings in others works always. He also hates everything around.
Fever, generally caused by two doshas.
Pain in the ribs, stuffy nose and anorexia.
Sometimes the patient has diarrhea and other times he suffers from constipation.
Loss of voice or hoarseness without any obvious reason, suddenly.

Aggravating and pacifying factors

Sometimes the patient is troubled on consuming hot things and sometimes he is suddenly troubled by taking cold things.
Read – Understanding Digestion Process From An Ayurveda View

Prognosis of Kshayaja Kasa

Kshayaja Kasa is said to destroy the body of an already emaciated person. So in these people it is incurable or life threatening in nature.

If the same cough due to depletion of tissues happens in a strong person, it is treatable.

Newly manifested kshayaja cough is curable sometimes when there is proper synchronization of all the four limbs of treatment i.e. physician, patient, medicines and attendants and they work as a team in a methodical way towards curing the disease.

This cough and all other coughs manifested in the old age, due to ageing are manageable.

Sanskrit Verses

Treatment of Kshayaja Cough

If in a weak person kshayaja type of cough is manifested with complete clinical symptoms, the patient should not be treated.

If in a strong patient kshayaja type of cough is newly manifested, the patient should be explained about the complicated nature of the disease and then treated promptly.

Brimhana and Deepana – In fresh cases of kshayaja type of cough firstly brimhana i.e. bulk promoting treatments and medicines which kindle the digestive system should be administered.

Mrdu Virechana – if there is severe accumulation of doshas, the patient should be given with mild purgation using unctuous purgatives.

Newly manifested kshataja kasa in debilitated / emaciated patients purgation should be administered with one of the below mentioned formulations –

Ghee prepared with

fruit pulp of Aragwadha – Cassia fistula
juice of Mrdvika – Vitis vinifera mixed with Paste of Trivrit – Operculina turpethum
decoction of Tilvaka – Symplocos racemosa or
juice / decoction of Vidarikanda – Pueraria tuberosa

Principles of treatment in nutshell

Patients of kshayaja Kasa should be treated with the below mentioned measures used alternatively with each other –

digestive fire / power enhancing medicines
bulk promoting medicines and measures
medicines to cleanse / purify the channels of the body

All medicines and food inclusions which are strengthening in nature shall be used in the treatment of cough caused by depletion of tissues.
Read – Ghee Home Remedy For Dry Cough

Sannipata Chiktsa –

Kshayaja type of cough is very dangerous and life threatening condition. This condition is caused by vitiation of all three doshas. Therefore treatment, medicines and measures which cure the vitiation of all three doshas should be included in the treatment of these types of cough.

Treatment of commonly associated conditions

Treatment of predominantly vitiated vata in Kshayaja Kasa

In the patient of Kshayaja Kasa, if there is decrease of pitta and kapha and subsequent increase of vata, and if the tissues have got depleted ghee processed with the below mentioned herbs should be given for drinking –

Karkatashringi – Pistacia integerrima
Milk
Bala – Sida cordifolia
Mahabala – Sida rhombifolia
Read – Symptoms Of Vata Dosha Increase And Imbalance – Vata Vruddhi Lakshana

Treatment of urinary disorders associated with Kshayaja Kasa

When the kshayaj cough is associated with discoloration of urine and difficulty in passing urine, the patient should be given with ghee or milk processed with paste / decoction of one of the below mentioned –

Vidari – Pueraria tuberosa
Kadamba – Neolamarckia cadamba
Tala – Borassus flabellifer

Treatment of swelling associated with Kshayaja Kasa

If in Kshayaja Kasa swelling occurs in the genitals, anus / rectum, pelvis or groins along with pain, Ghrta Manda – supernatant layer of ghee mixed with honey should be given. Ghrta Manda or Mishraka Sneha i.e. mixture of ghee and sesame oil should be used for giving enema.

Use of meat

Food should be served with meat juice of animals and birds living in desert like regions to the patients of kshayaja cough who are habituated to eating meat. Such food should be served after administering unctuous / oil enema.

After this, meat juice of quail bird, animals living in burrows and bird of prey should be consumed in that order along with wholesome foods.

The meat and juice of these animals and birds are hot in nature and pramathi (tearing) in nature. Therefore they remove the kapha stuck in the channels and cleanse them. This will relieve the cough.

When the channels get cleansed, the nutritive juices flow easily throughout the body and nourish all the tissues which have got depleted in the process of the disease.

Formulations

Ghee preparations

1. Amalaki Ghrta – Ghee prepared with juice of Amalaki – Emblica officinalis and milk, sprinkled with powder of Emblica officinalis is ideal.

2. Dadimadi Ghrta – Ghee should be prepared with twice its quantity of juice of Dadima – Punica granatum. It should be served for drinking after food, mixed with the powder of –

Ginger – Zingiber officinale
Marica – Piper nigrum
Pippali – Piper longum

3. Pippali Ghrta – Ghee prepared with Pippali – Piper longum, jaggery and goat’s milk should be given to drink.

Other classical ghee formulations (Cha.Chi.18)

Dvipanchamulyadi Ghrta
Guduchyadi Ghrta
Kashmaryadi Ghrta
Read – Ghee Benefits, Usage, Side Effects, Contra Indications

Leha – confections

1. Erandapatra Kshara Leha – prepared using –

Eranda Patra Kshara – alkali of leaves of Ricinus communis
Trikatu Churna – powder of Piper longum, Piper nigrum and Zingiber officinale
Sesame oil
Jaggery

2. Surasadi Leha – prepared with –

Surasa patra – leaves of Ocimum sanctum
Eranda Patra Kshara – alkali of leaves of ricinus communis
Trikatu Churna – powder of Piper longum, Piper nigrum and Zingiber officinale
Sesame oil
Jaggery

3. Drakshadi Leha – prepared with –

Draksha – Vitis vinifera
Padma – Nelumbo nucifera
Vartaka – Solanum indicum
Pippali – Piper longum
Honey
Ghee

4. Chitrakadi Leha – prepared with –

Chitraka – Plumbago zeylanica
Amalaki – Emblica officinalis
Haritaki – Terminalia chebula
Bibhitaki – Terminalia bellirica
Cumin – Cuminum cyminum
Karkatashringi – Pistacia integerrima
Shunti – Zingiber officinale
Maricha – Piper nigrum
Pippali – Piper longum
Raisins – Vitis vinifera
Honey
Ghee

5. Shuntyadi Leha – prepared with –

Ginger – Zingiber officinale
Pippali – Piper longum
Maricha – Piper nigrum
Old jaggery
Ghee

6. Marichavaleha – prepared with –

Pepper – Piper nigrum
Ghee
Honey
Sugar

7. Badaripatra Leha – prepared by frying paste of fresh leaves of Badara – Ziziphus mauritiana in ghee added with rock salt.

Other classical Leha preparations (Cha.Chi.18)

Haritakyadi Leha
Padhmakadi Leha
Jivantyadi leha

Yavagu & Yusha – gruels and soups

1. Sarshapadi Yavagu

Gruel is prepared using water prepared / processed with below mentioned ingredients –

Sarshapa – Brassica juncea
Gandira – Coleus forskohlii
Vidanga – Embelia ribes
Shunti – Zingiber officinale
Maricha – Piper nigrum
Pippali – Piper longum
Chitraka – roots of Plumbago zeylanica
Haritaki – Terminalia chebula

This gruel should be mixed with ghee and rock salt and served.

2. Kantakari siddha Yusha

Soup of green gram is prepared with juice or decoction of Kantakari – Solanum xanthocarpum. It should be added with paste of Sarshapa – Brassica juncea and Amalaki – Emblica officinalis and juice of sour pomegranate.

Other measures

Foods prepared with vata mitigating herbs

Milk, soup and meat juice of gallinaceous birds, pecker birds and animals living in burrows should be processed with decoction of vata mitigating herbs and served.

Dhumapana – medicated smoking

Medicated smoking and the after drinks explained in the context of kshataja kasa are beneficial in kshayaja kasa also.

Yogas for Kasa Mentioned in Sahasra Yoga Text Book
Atisarahara Kashaya
Swasa kasahara Kashaya
Hikkadihara Kashaya
Koushikokta Rasnadi Kwatha
Kasa swasahara Yavagu
Panduhara Kashaya
Sannipata Jwaradihara Kashaya
Panchatiktaka Guggulu Ghrita
Vrisha Ghrita
Nirgundyadi Ghrita
Dasanga Ghrita
Sasa Vasadi Ghrita
Dhanvantari Ghrita
Maha kushmanda Ghrita
Balashwagandhadi taila
Tekaraja Rasa
Bhringalarkadi Taila
Amrutadi Taila
Bala Taila
Sudarsana Choorna
Sitopaladi Choorna
Pridhu Nimba Panchaka Choorna
Maha Khandava Choorna
Lavangadi Choorna
Tugadi Choorna
Swasakasadihara Choorna
Jivanthyadi Choorna
Trikatwadi Choorna
Yavanyadi Choorna
Talisapatradi Choorna
Jati Lavangadi Choorna
Karpooradi Choorna
Hingu Vachadi Choorna
Bala Soolari Choorna
Narasimha Choorna
Kalyana Kshara
Sudha kandadi Kshara
Draksharishta
Dasamoolarishta
Dhatryarishta
Bhringarajasava
kumaryasava
Kushmanda Rasayana
Manibhadra Guda
Agasthya Rasayana
Chyavanaprasavaleha
Bharngyadi Leha
Punarnavadi lehya
Vyaghryadi Lehya
Gudardraka
Matala Rasayana (Dadima)
Kasattinutiri (Kasahari Vati)
Suryaprabha Gutika
Neelakantha Rasa
Gaganeshwara Rasa
Jatilingadi Gutika
Dhanvantari Gutika
Bala Kuvaladi Kashaya
Cherupayaradi Kashaya
Ramacchadi Kashaya
Swasari Taila
Mamsa Sarpi
Amritaprasa Ghrita
Maha Mayura Ghrita
Ajamamsa Rasayana