KASA (COUGH)

CASE STUDY: KASA (COUGH)

NIDANA (ETIOLOGICAL FACTORS)

• Vata, pitta, and kapha dosha imbalances leading to respiratory irritation
• Exposure to cold, damp, and polluted air
• Allergic reactions to environmental factors such as dust, smoke, or pollen
• Respiratory infections like the common cold, bronchitis, pneumonia, or tuberculosis
• Smoking or exposure to second-hand smoke
• Consumption of cold, dry, or heavy foods
• Overuse of the voice or excessive talking
  

(Ref: Charaka Samhita, Chikitsa Sthana 12/1-5; Ashtanga Hridaya, Chikitsa Sthana 9/1-4)

POORVARUPA (PRODROMAL SYMPTOMS)

• Mild throat irritation or dryness
• Sneezing and watery eyes
• Nasal congestion or runny nose
• Low-grade fever, fatigue, and malaise (in case of infection)
• Mild cough with or without mucus
  

(Ref: Charaka Samhita, Chikitsa Sthana 12/6-8)

LAKSHANA (SYMPTOMS)

• Persistent or intermittent cough
• Dry or productive cough with mucus (may vary depending on dosha involvement)
• Cough triggered by cold air, dust, or allergens
• Pain in the chest or throat during coughing
• Hoarseness or loss of voice in severe cases
• Wheezing or labored breathing if associated with bronchitis or asthma
• Fever, fatigue, and body aches in infectious causes (e.g., viral or bacterial infection)
  

(Ref: Charaka Samhita, Chikitsa Sthana 12/9-11; Ashtanga Hridaya, Chikitsa Sthana 9/5-7)

SYSTEMIC EXAMINATION TESTS (MODERN CLINICAL ASPECT)

1. General Examination:
• Observation of cough frequency and intensity
• General signs of infection such as fever and malaise
2. Cardiovascular Examination:
• Check for signs of heart failure if chronic cough is present
• Palpation for any chest wall tenderness
3. Pulmonary Examination:
• Inspection for labored breathing, chest retractions
• Auscultation for abnormal lung sounds like wheezing, crackles, or rhonchi
• Percussion for dullness in case of fluid accumulation (e.g., in pneumonia or pleural effusion)
4. Neurological Examination:
• Assessment for altered mental status (in severe or prolonged cough with systemic involvement)

Expected Findings:

• Cough with or without sputum production
• Wheezing or crackles in the lungs
• Abnormal chest examination in case of infections or fluid accumulation
• Cyanosis or signs of respiratory distress in severe cases

LABORATORY INVESTIGATIONS (MODERN ASPECT)

1. Complete Blood Count (CBC):
• Elevated WBC count in bacterial infections like pneumonia or bronchitis
• Normal or slightly elevated WBC in viral infections (e.g., common cold)
2. Chest X-ray:
• To identify infections (e.g., pneumonia, tuberculosis), pleural effusion, or signs of chronic lung disease
3. Sputum Culture and Sensitivity:
• To identify bacterial pathogens responsible for cough (e.g., Streptococcus pneumoniae, Haemophilus influenzae)
4. Pulmonary Function Test (PFT):
• To evaluate for obstructive lung diseases like asthma or COPD, if chronic cough is present
5. Throat Swab or PCR Testing:
• For identifying viral infections (e.g., influenza, COVID-19, respiratory syncytial virus)
6. Arterial Blood Gas (ABG):
• To check for signs of hypoxemia or respiratory acidosis in severe cases

Expected Results:

• Elevated WBC count in bacterial infections
• Chest X-ray showing lung consolidation or other abnormalities in cases of infection
• Positive sputum culture for bacterial pathogens in infective causes
• Normal or reduced PFT in obstructive conditions like asthma

DIFFERENTIAL DIAGNOSIS (MODERN CLINICAL ASPECT)

• Acute viral upper respiratory infections (e.g., common cold, influenza)
• Acute bronchitis or pneumonia
• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Tuberculosis
• Gastroesophageal reflux disease (GERD)
• Post-nasal drip (rhinosinusitis)
• Allergic rhinitis
• Heart failure (in case of chronic cough with dyspnea)

SAMPRAPTI (PATHOGENESIS)

• Vata, pitta, and kapha imbalances lead to irritation of the respiratory tract, resulting in a cough
• Vata leads to dry, non-productive cough due to excess air, while kapha results in a wet, mucus-producing cough
• Pitta excess causes an inflammatory response in the lungs, leading to a productive, sometimes blood-streaked, cough
• Infections like viral or bacterial pathogens provoke inflammation and mucus secretion, aggravating cough
• Chronic cough may result from long-standing dosha imbalances, often aggravated by allergens or irritants
  

(Ref: Charaka Samhita, Chikitsa Sthana 12/12-14; Ashtanga Hridaya, Chikitsa Sthana 9/8-10)

UPASAYA AND ANUPASAYA (PALLIATIVE & AGGRAVATING FACTORS)

Upasaya:

• Warm, herbal teas (e.g., ginger, licorice, and honey) for soothing the throat
• Inhalation of steam with turmeric or eucalyptus oil for clearing the airways
• Nasal irrigation with saline solution to relieve post-nasal drip
• Consumption of warm, easily digestible foods and avoiding cold foods
• Honey and black pepper for reducing throat irritation
• Use of warm water with a pinch of turmeric and salt for gargling

Anupasaya:

• Exposure to cold air, dust, or smoke
• Overexertion or physical activity leading to further irritation of the throat
• Consuming cold, dry, or spicy foods that increase irritation
• Sudden changes in temperature or seasonal transitions
• Strong fragrances, perfumes, or pollutants that trigger coughing
  

(Ref: Charaka Samhita, Chikitsa Sthana 12/15-18; Ashtanga Hridaya, Chikitsa Sthana 9/11-12)

SAMANYA CHIKITSA (GENERAL LINE OF TREATMENT)

• Vata and kapha shaman drugs (e.g., Vasa, Yashtimadhu, Pippali) for soothing the airways and reducing cough
• Pitta shaman drugs like Amalaki and Guduchi to reduce inflammation and excess heat
• Use of expectorants like Vasaka, Tulsi, and Pippali for clearing mucus
• Swedana (sudation) with herbal oils to reduce congestion in the chest
• Nasya with Anu taila for clearing nasal congestion and improving breathing
• Avoidance of cold air, smoke, allergens, and irritants
• Gargling with warm saline water or turmeric water for throat relief 

(Ref: Charaka Samhita, Chikitsa Sthana 12/19-21; Ashtanga Hridaya, Chikitsa Sthana 9/13-15)

VISHESHA CHIKITSA (SPECIFIC TREATMENT)

1. Dry Cough (Vata predominant):
• Vasa: 1 tsp of juice daily
• Yashtimadhu: 1 tsp with warm water for soothing the throat
2. Productive Cough (Kapha predominant):
• Vasaka: 1 tsp of juice twice daily
• Pippali: ½ tsp daily for clearing mucus
3. Inflammatory Cough (Pitta predominant):
• Amalaki: 1 tsp daily for cooling and reducing inflammation
• Guduchi: 1 tsp daily for immune support
4. Cough Due to Allergies or Irritants:
• Shatavari: 1 tsp twice daily for throat nourishment
• Triphala: 1 tsp daily to balance the doshas and reduce irritation
5. Chronic Cough (Post-Infectious or Asthma-like):
• Brahmi: 1 tsp daily for calming the respiratory system
• Trikatu: ½ tsp twice daily for improving airflow and reducing congestion

(Ref: Charaka Samhita, Chikitsa Sthana 12; Ashtanga Hridaya, Chikitsa Sthana 9)