1

LAKSHANA

1. Durgandhamharitamraktamsthivanapuyopamam – The patient spits phlegm which is foul smelling, green or red in colour, and which is like pus

2. Hrdayammanyatechyutam – While coughing, he feels as if the heart is being displaced (falling down from its normal location)

3. Akasmathushnashitaaarto – He is suddenly afflicted with both hot and cold sensations

4. He consumes food in excessive quantity

5. Bahvadurbalakrshi – He becomes weak and emaciated

6. Snigdhamukhavarnatvak – His face, complexion and skin become clean and unctuous

7. Darshanlochana- His appearance becomes gracious with his eyes glowing

8. Slakshnapanipadatala – 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. Parshvaruk – 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. Swarabheda – His voice becomes hoarse 

2

NIDANA

1. Vishamasatmya – Intake of Vishama or irregular (vide Cikitsa 15: 236) type of meals and unwholesome food.

2. Ativyavaya – Excessive indulgence in sex

3. Udveganigrahat – Suppression of natural urges

4. Ghrininamshocatamnrnam- 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 KshayajaKasa which causes emaciation of the body. [24- ½ 25]

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

3

PURVARUPA

1. Shukapoornagalasyata – Sensation as if the throat and mouth filled with bristles (a feeling of congestion in the throat)

2. Kantekandu – Itching sensation in throat and

3. Bhojyanamavarodha – Obstruction to the movement of food in the gullet. 

4

SAMPRAPTI

1)nidana sevana->

pranavayu shrotas me khavegunya-> sanga(vataprakopa->rasa dusti-> mulabhuta kaphoutpatti)->

kasa-> adra kasa

2) nidana sevana->vataprakopa->rasa dusti-> mulabhuta kaphoutpatti-> kapha stivana

3) nidana sevana-> vata prakopa-> vayumarga dusti-> pranavayu ka udanagata -> pranavaha srtotas me vega purvaka gaman-> visista dhuvani-> suska kasa 

5

SAMPRAPTI GHATAKA

DOSHA-vata-kahpha

DUSHYA-rasa,svara,anna

SHROTAS-rasavaha,pranavaha

ADHISTHAN-ama-pakvasyoth vyadhi,pranavaha, ura & kantha

SVABHAV-ashukari

SADHYA ASADHYATA-

This is called KshayajaKasa 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.

KshatajaKasa [described in the verse nos. 20-23] is palliable if the patient is strong.

If these 2 ailments (KshatajaKasa and KshayajaKasa) 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. 

6

CAUSES OF VARIATION IN PAIN 

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 Kaphaetc] to the forcefully moving Vayu

7

PRICIPAL OF CHIKITSA 

If the KshayajaKasa 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). 

8

SODHANA CHIKITSA 

GHRITA FOR MRUDUVIRECHANA: MEDICATED GHEE FOR MILD PURGATION

Ghee cooked with the decoction of Sampaka (fruit-pulp of Aragvadha (Cassia fistula)) and Trivrt – Operculinaturpethum, the juice of grape.

The decoction of Tilvaka, and (or) the juice of Vidari (Ipomoea paniculata / Puerariatuberosa) 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 

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 – Rhussuccadenea,

Milk, Bala – Country mallow (root) – Sidacordifolia 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]

Anuvasanabasti

Recipe for Anuvasana Basti – fat enema:

If there is swelling and pain in the phallus, Anus, hips and Pelvic region, the patient is given AnuvasanaBasti (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  

9

SAMANYA KASA CHIKITSA

Management of kasa in general

To the patient suffering from KshayajaKasa

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.

KshayajaKasa 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 VatikaKasa, PaittikaKasa, KaphajaKshataja and KshayajaKasa, 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).  

PRANAYAMA

- Pranayam

DIET AND LIFESTYLE

Pathya(DO):

Shali rice, santhi rice, wheat, java, anup mamsa rasa, purana ghrita, aja milk, bathuya, bringal, parval, choti muli, draksha, ela, go-mutra, lehsuna, warm water, harad, trikatu, madhu.

Divaswapna, swedana,virechana, niyamita bhojana

Apathya(DON’T):

Guru, vistanbhi, vidahi anna sevana, fish, jamikanda, aalu, sarso saag, sheetal jala, sheetal anna,ruksha anna

Basti karma, nasya, raktamokshana, vyayam, daton, vagadharana, dhula,dhuma sevana  

RECIPES

A. 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.

B. 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]

C. 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)

4. These drugs are boiled with water and the decoction is prepared:

White variety of Sarshapa – Brassica campestris

Gandira, Vidanga – Embeliaribes, Sunthi – Zingiberofficinale, Pippali – Piper longum, Maricha – Black pepper fruit – piper nigrum, Chitraka – Plumbagozeylanica, 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 andKarna shoola – earache [½ 182- 183]

5. Soup of Mudga prepared by adding the juice (decoction) of Kantakari – Solanumxanthocarpum is properly sizzled.

Intake of this soup by adding green Amalaki (Gauramalaka) and sour ingredients cures all types of kasa [184]

6. The patient suffering from KshayajaKasa 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] 

DVI PANCHA MULADI GHRUTA

Decoction is prepared of Bilva – Aegle marmelos, Syonaka – Oroxylumindicum, Gambhari — Gmelinaarborea, Patala – Stereospermumsuaveolens, Ganikarika, Sala-Parni – Desmodiumgangeticum, Prsni-Parni, Brihati – Solanumindicum, Kantakari – Solanumxanthocarpum, Goksura – Tribulusterrestris

Haritaki – Terminalia chebula, Bibhitaka – Terminalia bellerica, Amalaki – Phyllanthusemblica, Cavika, Bhargi, Chitraka – Leadword – Plumbagozeylanica, Kulattha, PippaliMula – Piper longum, Patha – Cycleapeltata, Kola – Ber and Yava – Barley (Hordeumvulgare) by boiling with water.

To this decoction, ghee and the paste of Nagara – Zingiberofficinale, Duhsparsa, Pippali – Long pepper fruit – Piper longum, Sati – Hedychium spicatum, Puskara-Mula – Inularacemosa, KarkataSrngi is added, and cooked.

After the medicated ghee is prepared,

YavaKshara, 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 KshayajaKasa.

Thus ends the description of DviPancamuladiGhrta [158-160]

GUDUCHYADI GHRITA

Guduci – Tinosporacordifolia, Pippali – Long pepper fruit – Piper longum, Murva – Marsedeniatenacissima, Haridra – Berberisaristata, Sreyasi (Rasna (Vanda roxburghi / Pluchealanceolata)), Vacha (Acoruscalamus Linn), Nigdighika, Kasamarda, Patha – Cycleapeltata, Chitraka – Leadword – Plumbagozeylanica, 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

KshayajKasa

MEDICATED GHEE RECIPES

A. 1 Prastha of ghee is cooked by adding the paste of 1 Aksa of each of

Kasamarda – Cassia occidentalis, Abhaya – Terminalia chebula, Musta (Cyperusrotundus), Patha – Cycleapeltata, Katphala – Myricanagi, Nagara, Pippali – Long pepper fruit – Piper longum, Katuka, Draksha – Raisin – Vitisvinifera, Kasmarya – Gmelinaarborea, 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

B. Fruits of amalaki is boiled in milk and made to powder. Ghee sprinkled with this powder is taken by the patient suffering from KshayajaKasa, among others.

C. Yava – Kshara-Ghrita prepared by cooking with double the quantity of Dadima – Pomegranate – Punicagranatum-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 KashayajaKasa among others

D. 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 KshayajaKasa. 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 (Hordeumvulgare) (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 Berberisaristata) and ½ Kudava of Pippali – Long pepper fruit – Piper longum is added and cooked. This preparation of linctus cures Asthma and Kasa

CHURNA – LEHA YOGA: RECIPES OF POWDERS AND LINCTUS

RECIPES OF POWDERS AND LINCTUS

A. 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:

B. ErandaKshara (alkali preparation) is added with Sunthi – Zingiberofficinale, Pippali – Long pepper fruit – Piper longum,, Maricha – Black pepper fruit – piper nigrum, Oil and Jaggery

C. The kshara of the leaves of Surasa and Eranda – Ricinuscommunis is mixed with ,Sunthi – Zingiberofficinale, Pippali – Long pepper fruit – Piper longum,, Maricha – Black pepper fruit – piper Nigrum, Oil and

Jaggery intake of this linctus cures asthma and Kasa

D. The powder of Draksha – Raisin – Vitisvinifera, Vartaka and Pippali – Long pepper fruit – Piper longum is added with honey and ghee. Intake of this linctus cures asthma and kasa.

E. The powder of Sunthi – Zingiberofficinale, 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.

F. The powder of Chitraka – Plumbagozeylanica, Haritaki – Terminalia chebula, Bibhitaka – Terminalia bellerica, Amalaka – Phyllanthusemblica

Ajaji, Karkata-Srngi – Rhus succedanea, Sunthi, Pippali – Long pepper fruit – Piper longum, Maricha – Black pepper fruit – piper nigrum, Draksha – Raisin – Vitisvinifera is mixed with honey and ghee or with jaggery. Intake of these two recipes cures Asthma and kasa.

PADMAKADI LEHA

These are taken in equal quantities (1 Part of each) are made to fine powder:

Padmaka – Prunuscerasoides, Haritaki – Terminalia chebula, Bibhitaka – Terminalia bellerica, Amalaki – Phyllanthusemblica, Sunthi – Zingiberofficinale, Pippali – Long pepper fruit – Piper longum, Maricha – Piper nigrum, Vidanga – Embeliaribes, Suradaru (Cedrusdeodara) (Deva- Daru), Bala – Country mallow (root) – Sidacordifolia, Rasna (Vanda roxburghi / Pluchealanceolata)

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 PadmakadiLeha. [174-175]

JIVANTYADI – LEHA

All these are taken in equal quantities and made to a powder:

Jivanti – Leptadeniareticulata, Madhuka– Licorice – Glycyrrhizaglabra, Patha – Cycleapeltata, Tvak-Ksiri, Haritaki – Terminalia chebula, Bibhitaka – Terminalia bellerica, Amalaki – Phyllanthusemblica, Sati – Hedychium spicatum, Musta (Cyperusrotundus), Ela (ElettariacardamomumMaton), Padmaka – Prunuscerasoides, Draksha – Raisin – Vitisvinifera, Brihati – Solanumindicum, Kantakari – Solanumxanthocarpum, Itunnaka, Sariva – Indian, Sarsaparilla – Hemidesmusindicus, Puskara-Mula – Inularacemosa, Karkata-Sringi – Rhus succedanea, Rasanjana (Aqueous extract of Berberisaristata), Punarnava – Boerhaviadiffusa, Loha- Rajata (bhasma)

Trayamana, Yavanika, Bhargi, Tamalaki – Phyllanthusniruri, Rddhi, Vidanga – Embeliaribes, Dhanvayasaka, Kshara (Alkali preparation), Chitraka – Plumbagozeylanica, Chavya – Piper retrofractum, Amla-Vetasa – Garcinia pedunculata, Sunthi – Zingiberofficinale, Pippali – Piper longum

Maricha – Black pepper fruit – piper nigrum and, Deva-Daru – Cedrusdeodara

Dosage: 1 Panitala

Adjuvant: Honey and ghee

Cures: all the 5 varieties of Kasa

RASODHI/BHASMA/PISTI-(120-250MG WITH MADHU/USHNODAKA)

- Praval pisti

- Mukta pisti

- Basant malti rasa-(svarna,mukta,kharpara,marich)

- Chandra mrit rasa-(parad,gandhak,loh,tankan,triphala,trikatu,chavya)

VATI-(250-500MG WITH USHNA JALA)

- Haritkyadi gutika-(haritaki,sunthi,mustak)

- Haritkyadi modaka-(haritaki,pipper,sunthi,marich,guda)

CURNA-(3-6GM WITH MADHU/USHNODAKA)

- Yavani sadav curna-(ajwain,sunthi,kacchi ber,amlavet,anardana,pipper,dalcheeni)

- Sitopaladi curna-(sita,vanshlochana,pippali,trigashiri)

- Talisadicurna-(talisa,maricha,sunthi,pippali,vanshlochana,mishri)

- Krishna maricha curna-(kali mirch)

- Samsarkar curna-(lavanga,jayphala,pippal,marich,sunthi,mishri)

KAVATH/ASAV/ARISHTA-(20-40ML WITH SAMABHAG WATER)

- Kankasava-(dhattur,dashmula)

- Vasarista-(vasa panchang,trikatu,dhataki)

GHRITA(20-30ML WITH USHNODAKA)

- Dvipanchmuladi ghrita-(laghu & bhrit panchmula,pipper)

- Gudichyadi ghrita-(guduchi,amlaki,pipper,ghrita)

- Rasnadhya ghrita-(rashna,panchmula,trikatu,pippali mula,katkari,ghrita)