Madhava Nidana Chapter 11 Kasa Nidanam

This article explains Madhava nidaana 11th chapter “Kasa Nidanam”. Causes, pathology and symptoms of Kasa (cough) are explained in this chapter.

Read – Acharya Madhavakara: His Work ‘Madhava Nidana’, Legacy, Amazing Facts

Table of Contents

Kasa Nidana, Samprapti

Etiological factors of Kasa

Smoke entering the nose, mouth and throat and harming these organs
Dust entering the nose, mouth and throat and harming these organs
Excessive indulgence in exercises (strenuous physical activities)
Excessive consumption of foods which are dry in nature
Entry of the consumed food into wrong passages (respiratory passages – trachea etc.)
Suppression of natural urges of the body
Suppression / forcibly controlling the sneezing urge

Pathogenesis of Kasa
The prana vata aggravated due to the above said etiological factors gets mixed (associated) with udana vata and comes out of the mouth suddenly, along with the other doshas (pitta and kapha), producing a sound resembling that made by obstructing (or hitting against) a broken piece of bronze. This disease is called kāsa. (1-2)
Read – Kasa – Causes, Pathogenesis, Types, Treatment

Kasa Bheda

Types of coughs
Kāsa is of five kinds –

Vataja kasa – caused by predominant vitiation of vata
Pittaja kasa – caused by predominant aggravation of pitta
Kaphaja kasa – caused by predominant aggravation of kapha
Kshataja kasa – caused due to the chest injury
Kshayaja kasa – caused due to loss of tissues

The first four types of kasa if neglected will lead to kshaya (dhātukshaya-wasting of the tissues). These five types of kasa are stronger (dangerous, damaging, harmful) in the successive order. (3)

Note – Going with strength of kasa as mentioned in the above said context –
Pittaja Kasa is stronger than Vataja Kasa.
Kaphaja Kasa is stronger than Pittaja Kasa.
Kshataja Kasa is stronger than Kaphaja Kasa.
Kshayaja Kasa is stronger than Kshataja Kasa.
Therefore, Kshayaja Kasa is more powerful and troublesome amongst all the kasa and Vataja Kasa is the least troublesome one. The prognosis of kasa also will follow the same chronology.
Read – Charaka Kasa Chikitsa – 18th Chapter

Purvarupa

Premonitory symptoms of cough
Premonitory symptoms (of cough) are – feeling as if the throat and mouth are filled with thorns / spikes and (pricking inside these organs), itching sensation inside the throat and obstruction to inward movement of food (swallowing). (4)

Vataja Kasa symptoms

In Vatika Kasa, the person suffers from – pain in the region of the heart, temples, head, abdomen and flanks; dry face (mouth), loss of strength, voice and ojas. The person will have continuous bouts of husky (small) and dry cough, and cracked voice due to aggravation of vata. (5)
Read – Vataja Kasa – Causes, Symptoms, Treatment

Pittaja Kasa symptoms

In pittaja kasa, the person will have a burning sensation in the chest, fever, dryness of the mouth, bitter taste in the mouth, severe thirst, and bitter taste in the mouth, severe thirst, vomiting with the contents appearing yellow in colour and bitter in taste, anaemia and burning sensation inside the body. (6)

Kaphaja Kasa symptoms

The symptoms of kaphaja kasa are – inside of the mouth is coated with thick secretions (saliva), weakness, headache, accumulation of kapha in the entire body, anorexia / tastelessness, heaviness, itching, heavy cough along with expectoration of thick sputum. (7)

Kshataja Kasa causes, symptoms

Etiological Factors – Excessive indulgence in sexual intercourse, carrying heavy weights, walking long distances, wrestling, taming or fighting with horses and elephants (forcibly trying to stop the running of horses and elephants) etc. are the causative factors of kshataja kasa.
Pathogenesis – The above-mentioned etiological factors cause injury in the chest (tear in the lungs) in a person who is dry (weak). The aggravated vata reaches the site of injury and produces cough.

Symptoms
Initially the person suffers from dry cough. Later this is followed by expectoration of blood mixed sputum.

The other symptoms include –

Severe pain in the throat
Severe pain in the chest
The person feels as if he is pricked by sharp needles in the chest (and throat) / cutting or gnawing pain
Intolerance to touch (the patient resists others from touching the afflicted area, painful area) / tenderness,
Splitting pain and pain associated with burning sensation
Splitting pain in the small joints of the hands and feet (interphalangeal joints),
Fever
Dyspnoea
Severe thirst
Hoarseness (change of) of voice
Makes sounds from the throat resembling that of a pigeon (8-11)
Read – Kshataja Kasa – Causes, Symptoms, Treatment

Kshayaja Kasa causes, symptoms

Etiological factors – Indulgence in irregular and untimely meals, unaccustomed foods, indulgence in excessive sex, suppression of bodily urges, too much jealousy, grief, etc.
Pathogenesis – Due to the above said etiological factors, the digestive fire gets contaminated. This fire in turn causes aggravation of all the three doshas. These aggravated dosas produce kshayaja kasa which would cause destruction of the body (wasting of body tissues).
Symptoms – Kshayaja Kasa would present with symptoms including pain in the body parts (all over the body), fever, burning sensation, delusion & threat to life. There occurs severe dryness / wasting of the body, extreme weakness, deterioration (destruction) of strength and muscles, and the patient expectorates blood with pus as he coughs. This form of cough having all the symptoms (symptoms caused by all three doshas) and is difficult to cure is called by the name Kshayaja Kasa by the clinical experts who are well versed in the knowledge of treatment principles (of Ayurveda). This cough would kill the weak ones. (12-14)
Read – Kshayaja Kasa – Causes, Symptoms, Treatment

Prognosis

In strong people this cough (kshayaja) is sometimes curable and sometimes manageable.
Similarly, the kshataja kasa caused by chest injury is curable in weak and emaciated patients. It is sometimes curable and sometimes manageable in strong patients.
Kshayaja or Kshataja Kasa of recent origin are sometimes curable if the four limbs of treatment (physician, patient, medicines and attendants) are bestowed with good qualities and are operational towards cure of the disease.
All kinds of kasa caused due to ageing (and natural depletion of tissues occurring in the old age) are manageable in older persons if the four limbs of treatment are bestowed with good qualities.
The first three kinds of kasa (i.e., vataja, pittaja and kaphaja) are easily curable. Therefore, they shall be treated. The manageable kinds (chronic) of kasa shall be controlled by using a suitable diet etc. (15)