Chapter LII - Symptoms and Treatment of Cough (Kasa)

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of cough. (Kasa Pratishedha). 1.

Cause and Etiology:—

Cough has its origin in the same sets of causes, which excite or usher in an attack of hiccough or asthma. The vital Vayu of the body known as the Prana-Vayu combined with other Doshas (Pitta and Kapha) is deranged by such causes as the entrance of smoke or of particles of dust (into the larynx and nostrils), over-fatiguing physical exercise, inordinate use of any dry or parched (Ruksha) food, any food going wrong way, voluntary repression of sneezing or of any natural propulsion of the body. Thus deranged, it is suddenly pressed upward and emitted through the mouth in unison with the deranged Udana-Vayu (situated in the trachea) producing a peculiar sound resembling that of broken Indian bell-metal. This is called Kasha (cough) by the learned. 2—3.

Classification:—

This disease is divided into five types according as it is originated through the action of the deranged Vayu, or Pitta or Kapha of the body, or is due to the presence of any ulcer (Kshata) or to any wasting process (Kshayaja) in the organism. These five types of cough are recognised by the physicians (in practice), which, when fully developed, (i.e., if neglected) would tend to produce phthisis (Yakshma). 4.

Premonitory Symptoms:—

Itching in the throat, a sense of obstruction in eating (difficulty of deglutition), a sticky feeling in the throat and in the palate, changed voice, aversion to food, and dulness of the digestive fire are the symptoms which usher in an attack of cough. 5.

Specific Symptoms:—

A person affected with a cough of the Vataja type, complains of an aching pain in the region of his heart, in his temples, head, stomach and the sides and has dry and frequent coughs (unattended with mucous expectorations), with a pale face, a weak and hoarse voice and diminished strength and vigour (Ojas). A burning feeling in the region of the heart, fever, sense of dryness, and a bitter taste in the mouth, thirst, yellow and pungent expectoration, paleness of complexion and a burning sensation in the body, are the indications of the Pittaja type of Kasa. A sticky sense in the mouth, a sense of physical lassitude, headache, aversion to food, a sense of heaviness in the body, itching, frequent fits of cough and thick mucous expectorations are the features which distinguish the Kaphaja type. 6—8.

Symptoms of Kshataja Kasa:—

Ulceration in the Vakshas (chest?) caused by loud reading, over-fatiguing physical exercise or carrying loads of excessive weight, or incidental to any blow or hurt dealt thereon, affects the locality and gives rise constant fits of cough accompained by blood-spitting. The disease is called Kshatja Kasa or cough of ulcerated chest. 9.

Sexual excess, carrying heavy loads, excessive toils of journey, over-exertion in battle, forcible controlling of horses and elephants and such other fatiguing feats tend to produce parchedness of the system and ulcers in the Uras (chest) whereby the bodily Vayu is deranged and cough is produced. The patient is afflicted only with a sort of dry cough at the outset but begins to spit blood with the progress of the disease. The patient feels an excessive pain in the throat and his Uras (chest) seems to be broken and pricked into with sharp needles, and cannot bear the least touch on account of the pressure of an intolerable aching pain (Sula) in the locality. Breaking pain in the joints, fever, asthma, thirst, and loss of voice are the symptoms which mark the Kshataja type of the disease and the patient lies moaning like a pigeon. 10.

Kshayaya-Kasa:—

The fire of digestion in a person who is addicted to the habit of taking unwholesome and incongenial food or of taking it at improper time and quantity or who is given to sexual excesses or who indulges in grief or disgust or abhorrence (of food) in his mind, or who voluntarily represses any natural urging of his body, becomes affected and diminished. It (thereby) aggravates all the three Doshas of the body, which, in their turn, give rise to a type of cough attended with a gradual emaciation of the body. The disease is called Kshayaja Kasa. Cramps in the limbs, fever, burning sensation in the body, fainting fits (Moha), loss of strength (Prana) and of flesh, emaciation of the body, spitting blood streaked with pus, and weakness are the symptoms of this type of Kasa known as Kshayaja Kasha. It is said by medical experts to be due to the concerted action of all the three Doshas and to be included within the category of diseases which are very hard to be cured. A case of cough (in an old man) due to his declining years is only susceptible of palliation. 11—12.

General Treatment:—

A compound consisting of Shringi, Vaca, K at-phala, Ka-trina, Musta, Phanyaka, Abhaya, Bhargi, Deva-daru, Vishwa and Hingu taken in hot water would rapidly cure a case of long-stand ing cough. A lambative composed of the equal quantity of Tri-phala, Vyostia, Vidanga, Shringi, Rasma, Vacci, Padmaka and Deva-daru pounded together and mixed with a copious quantity of honey, sugar and clarified butter, would speedily conquer a serious attack of cough. 13–14.

A patient afflicted with cough should use a lambative composed of Pathya, sugar, Amalaka, fried paddy, Magadhi, and Shunthi pounded together and mixed with honey and clarified butter, or take Krishna and Saindhava salt with warm water. He should use Nagara and Pippali in combination with treacle, or use a lambative of the paste of Draksha mixed with honey and clarified butter. A compound composed of the equal parts of Draksha, sugar and Magadhika, or of Shringa-vera, Yashti-madhu, and Tuga (Vamsha-locana) should be licked with honey and clarified butter; or a compound consisting of Shitopala (sugar) and an equal quantity of Marica should be licked with honey and clarified butter. A compound consisting of Dhatri, Kana, Vishva and Shitopala (sugar) should be taken with curd-cream (Dadhi-manda). A person suffering from an attack of cough should use Harenuka and Magadhika taken in equal parts and pounded together through the medium of curd. The two kinds of Haridra, Deva-daru, Shunthi and the pith cf a Gayatri- tree pounded and mixed in equal parts, should be taken with the urine of a goat, or a pulverised compound consisting of Danti, Dravanti and Tilvaka should be taken. Leaves of Vadara pasted with Saindhava salt and fried in clarified butter should be taken; or a Kola (two tolas) weight of Hingu should be taken with fermented rice-boilings (Sauviraka) or with the juice of acid fruit. Powdered Marica should be likewise licked with honey. 15.

Inhalation of Dhuma:—

The patient should be made to inhale the smoke of a burning Varti (medicinal stick) composed of Bhargi, Vaca and Hingu, pounded together and mixed with clarified butter, or of the scrapings of (green) bamboo,^[1] Ela and Lavana mixed with clarified butter. Similarly, a patient suffering from an attack of cough due to Vata and Kapha should inhale the smoke of a Varti prepared with Musta, bark of Ingudi, Yashti-madhu, Mansi, Manah-shila and Haritala pasted together with goat’s urine and then take a draught of milk. 16.

In the alternative, Sidhu (a kind of wine) should be taken in combination with Marica, whereby a fit of cough would be instantaneously subdued. Milk duly boiled and cooked with the admixture of Draksha, Ambu (Valaka), Manjishtha and Pura^[2] should be taken with honey. Well-boiled Mudga pulse should be taken with powdered Kanta-Karika, Nagara and pippali mixed with honey^[3]. Utkaraka (a kind of confection) prepared with clarified butter, Mula^[4], Truti (Ela), leaves of Vadara and a copious quantity of powdered Nagara should be used. A thin Peya prepared with the preceding drugs may be taken cold in combination with honey. 17–19.

Treatment of Vataja Kasa:—

The medicated clarified butter mentioned in connection with the medical treatment of Plihodara (enlargement of spleen) and known as Shadanga-Ghrita^[5] proves equally curative in cases of Vataja-Kasa. Clarified butter duly cooked with the drugs of the Vidari-gandhadi group, or with the expressed juice of Vasaka, would also prove beneficial. Applications of purgatives with any Sneha, as well as those of Asthapana or Anuvasana-Vasti are recommended. Inhalation of Snaihika (oleaginous) Dhuma as well as potions of lukewarm clarified butter, gruels duly cooked with meat-essence, milk and lamba-tives saturated with clarified butter, may be taken with advantage in such a case. 20.

Treatment of Kaphaja Kasa:—

Cases of Kaphaja-Kasa readily yield to the use of emetics, purgatives, medicinal head-purgatives, medicinal gargles, hot and pungent lambatives as well as the inhalation of smoke (Dhuma). Any articles of food which are emaciating (i.e., light, percifying and small in quantity and even fasting) should more particularly be beneficial. A case of cough due to the action of the deranged bodily Kapha is relieved by the use of Tri-katu^[6], or of clarified butter duly cooked with the expressed juice of Krimighna^[7] (Vidanga) or with the expressed juice of the leaves of Nirgundi. 21.

A clarified butter duly cooked in combination with twice as much juice of Nidigdhika (Kantikari) and with the Kalka of Patha, Vit-salt, Vyosha, Vidanga, Sain-dhava , Tri-kantaka (Gokshura), Rasna, Citraka, Vala, Shringi, Vaca, Musta, Deva-daru, Duralabha, Bhargi, Abhaya and Shathi, proves curative in asthma, dulness of digestion, hoarseness, as well as the violent attacks of the five different types of cough. 22.

Pittaja and Kshayaja Kasa:—

A case of cough of the Pittaja -type, as well as the one due to the wasting (Kshaya) brought about by sexual excess, yields to the use every morning of the clarified butter, duly cooked with the decoction of the drugs of the Vidari-gadhadi, Utpaladi, Sarivadi and the Madhura (i.e. Kakolyadi) groups and with the expressed juice of sugar-cane, water, milk and with the drugs of the Kakolyadi group as Kalka and with the addition of sugar as an after-throw. The three cases viz., Pittaja, Kshataja (ulcer-orignied) and Kshayaja (due to any wasting process in the system) of Kasa are relieved by the use of the compound prepared with Kharjura, Bhargi, Pippali, Piyala, Madhulika. Ela and Amalaka mixed in equal parts, and taken with a copious quantity of clarified butter, honey and sugar. 23—24.

Cases of the Kshataja (ulcerated) or Kshayaja (consumptive) Kasa, would become amenable to the use of a compound consisting of the equal parts of Rakta (Manjishtha), Haridra, Anjana (antimony), Citraka, Patha, Murva and Pippali pounded together and taken with honey, or of clarified butter duly cooked with the expressed juice of sugar-cane. Amalaka powder duly cooked with milk and taken in combination with clarified butter would prove efficacious. Persons afflicted with the three types of cough may take with benefit the fine powders of wheat, barley as well as of the drugs of the Kakolyadi group, with milk and clarified butter. Treacle boiled with water should be taken, when cold, with honey and with Marica taken at intervals by biting it. 25—28

Kalayana-Guda:—

Three Prastha measures of the expressed juice of Amalaka and half a Tula measure (six seers and a half) of treacle should be duly cooked with eight-Pala-weight of powdered Trivrit (lightly fried) with eight-Pala measures of oil. Powdered Granthika (Pippali-roots), Cavya, Jiraka, Vyosha, Gaja-pippali, Havasha, Ajamoda, Vidanga, Saindhava, Tri-phala, Yamani, Patha, Citraka and Dhanya, each weighing a Pichu weight (two Tolas) should then be added to it as an after-throw and the whole compound should be scented with the three scented drugs (Tvak, Ela and Patra). The patient should take an Aksha (two Tola) weight of this preparation. The medicine thus prepared is called Kalyanaka Guda and it proves curative in cases of Grahani, cough, asthma, hoarseness of voice and phthisis. It serves to improve appetite, increase the semen of males and remove sterility in females. There is no special restriction about the regimen of diet and conduct when it is used. 29.

Agastya-Leha:—

Two Palas each of the drugs known as Dasha-mula, Gaja-pippali, Atma-gupta, Bhargi, Shathi, Pushkara-roots, Shunthi, Patha, Gulanca, Granthika (Pippali-roots), Shamkha-pushpi, Rasna, Citraka, Apamarga, Vala and Duralabha, and one Adhaka (half a seer) of Yava together with one hundred large-sized Haritaki should be boiled with one Drona measure of water and taken down from the oven with its three-quarter part evaporated in the process. It should then be filtered through a piece of linen. A Tula weight of treacle should be dissolved in the above decoction and duly cooked with the addition of a Kudava measure each of oil and clarified butter. When the cooking is finished, powdered Pippali should be added as an afterthrow and honey should be mixed with it, when cooled. One Karsha weight of this elixir Leha should be licked every day in combination with two Abhayas. It conquers cases of phthisis, Grahani edema, dulness of appetite, hoarseness of voice, cough, Pandu, asthma, head-ache (Shiroroga), Hrid-roga (diseases of the heart), hiccough and Vishama Jvara. A regular use of this elixir improves strength and memory, imparts vigour of mind and energy of action and removes disinclination to work. It was first concocted by the holy sage, Agastya. 30.

Clarified butter duly cooked with the decoction made by boiling the drugs of the Madhura or any other suitable group with the essence of Kulira (crab), Sukti, Chataka, Ena-decr and Lava proves curative in the case of cough due to the presence of any ulcer (in the lungs) or to any wasting process in the system. The use of clarified butter duly cooked with Shatavari, Naga-vala and Vala proves beneficial to a person afflicted with cough. 31—32.

 

Thus ends the fifty-second chapter of the Uttara Tantra in the Sushruta Samhita which deals with the (symptoms and) treatment of cough.

Footnotes and references:

[1]:

Dallana explains as (leaves of bamboo).

[2]:

Pura means Śallaki (gum) or Guggulu. —Dallana.

[3]:

Dallana reads as a variant and explains that the powders of Tri-katu should be added in a large quantity in place of honey.

[4]:

By the term some mean (raddish', while others take it to mean the drugs of the Panca-mula-group.

[5]:

For Shadānga-ghrita, see chapter XIV, Para 18. It is belter known as Shatpalaka-Ghrita.

[6]:

According to Vāgbhata the clarified butter should be duly cooked with the Kalka of Tri-katu and with the decoction (Rasa) of Vidanga.

[7]:

Some lake ‘Krimighna’ to mean Vidanga, others take it to mean any antiparasitic drug, viz., the drugs of the Surasādi-gana:—Dallana. The infusion or decoction of Vidanga should be used if its expressed juice be not available.—Ibid.