INTRODUCTION

svasqasya svaasqya rXaNama\ |

Aataursya ivakxar pa`Samanama\ ca ||
(ca. sau. 30/26)
The purpose of Ayurveda is to maintain health of healthy person
and cure the disease. The science of Ayurveda is divided into 8
faculties.

kxayabaalaga`haoQvaa_MgaSalyadMYT
^ajaravaRYaana\ | (A.=. 1/5)
The faculty dealing with ‘Kaumaras’ or Children is called
‘Kaumarabhritya Tantra.’

kxaOmaarBaRtyaM naama kuxmaarBarNa

Qaa~aIXaIrsaMSaaoQanaaqa_ |
duYTstanyaga`hsamautqaanaaM ca vyaaQaInaaM
{paSamanaaqa_ma ||
(sau.saU. 1/8)
Kaumarabhritya is branch which deals with the growth and
development of infant and child.
We live in modern and technologically advanced environment
where we are surrounded by artificial and chemical substances,
pollution and over population that create a number of causes which
attribute to ill health. Human respiratory system mostly gets exposed
to the environment which leads to various respiratory tract disease
and among them Kasa is the foremost symptom.
Acharya Charak explained in Viman sthan (8/122) about Balak
Avastha that Apairpakva Datu, Akleshsah, Asampurna Bala
Soukomaryata, Alpakayata, Sarvananaupasavata, Asamatvagata
Prandosha, Dhatu, Bala, Ojasa, shleshma Dhatu so that Balak is
more prone to get exposed to Pranvaha srotas.Pranvaha strotas is

1
directly related with the external environment, and is vulnerable for
allergens and droplet infections. Factors like air pollution, dust and
urbanization leads to the manifestation of Kasa.
It is a very burning problem, approximately 20-30% of the world
suffered from Kasa Vyadhi. Hence we are to study of kasa vyadhi in
the children age 1 to 5 years.

Aqa pa`itahtaao . . . . . . . . . |
. . . . . . . . . kxasanaatkxasa {ccatao || 8 ||
(ca. ica. 18/8)
Being vitiated in the lower region of the body, vayu reverts its
path and affect the normal channel of circulation of its self in the
upper part of the body arugments the function of udan vayu. It
occupies the space in the head and the upper torso causing spasms in
muscle of the area causing a specific sound called Kasa which may be
dry or with phegner.
In Ayurved samhita many drugs and specific therapy are
advised for Kasa vyadhi management. Acharya Kashyap has
specifically advised to give all kind of medicine to the children in the
form of Leha. Another aspect of treatment is Madhur Rasatmak,
Saumya, Bala Vardhak, acceptability and palatability due to Guda
and Til Tail. So Dusparshadi leha selected from Ashtang Hrudaya &
Charak Chikitsa Sthan is used in Aparipakavata of Dhatu,
Soukaumaryata, Akleshsah, Asampurna Bala, Alpakayata, of Balak
and Madhur Satmyata fo Balak.
The contents of Dusparshadi Leha are

duspaSaa_ ipappalaI maustaaM BaagaI_

kxk_xTkxI SaTIma\ || 14 ||
pauraNagauDtaOlaaByaaM
cauiNa_taanyavalaohyaota\ |

2
 (A.=. ica. 3/15), (ca. ica.
18/51)
Kantakari, Pippali, Musta, Bharangi, Karkataki & Shati these
authentified drug will be taken in equal quantity for the preparation of
Churna, along with in equal quantity of guda and double quantity of
Til taila by mixing them in Leha form which be given to the patient at
the time of drug administration.According to Sharandhar Samhita
(Sha.sa.8/48-51) the dose of drug is decided.
Hence we are to study the efficacy of Dusparshadi Leha on the
kasa in the children age 1 year to 5 year.

AIMS AND OBJECTIVES

1) To study of efficacy of Dusparshadi leha on Kasa in children

(1-5 years) by given clinical trial.

2) To study of Kasa vyadhi in detail.

3) To study the contents of Dusparshadi leha and its possible

mode of action on the Kasa.

3
4
 REVIEW OF RECENT RESEARCH WORKS
Ayurveda with its time tested principles and ancient wisdom
has the potential to come out with solutions where the modern
science has failed to provide answers. Some efforts have been done
in this direction are as follows:
Researches Pertaining to Kasa Roga
 Upaddhyaya sachchidanand – Study of kasa roga L-29(JM-622),
1960
 Tewari Jagdish-Kas roga Evam lakshana Vimarsha L-119 (JM-
655), 1963
 Ananthraman N-Harita Manjari and its effects on Kaphaja kasa
(BL-01)-1977
 Kulkarni E.G-The effect of Nidigdhika (kantkari) kwath on
Kaphaja kasa (NA-17) 1984.
 Ranjan Ashutosh – Role of Shati and Swasa kutara rasa on
Vatika kasa (BU-512), 2000.
Researches Pertaining to Kasa in Children
Mishara K – Ayurvedic management of Kasa roga in Children
(BU-70) 1969.
Sharma S.K-Balyavastha men Kasa roga ke pariprekshya men
kasaghna yoga ki karmukata (JP-806) 1969.
Rao Venkatakaram V-Pharmacological study of Tulasi and its
different preparations in Kaphaja kasa of children, 1984.
Sharma S.K-Balyavstha men Kasa roga Ke Pariprekshya men
Kasaghna yoga Ki Karmukata (JP-806)-1992.
Tiwari R.P-A clinical study on kasa roga in childhood (JM-2342)
1994.
Deshmukh UP – Role of Kantakari avalehya in Kaphaja kasa
(Chronic Bronchitis) (NS-701), 1998.
Raju C.M.M - The Effect of Drakashadichurna in Kasa – An
observational study (HA-303), 2002.

5
 Nitin S.A. – Management of Kasa in children with Pushkaradi
choorna (HA-311), 2003.

LITERARY REVIEW

HISTORICAL REVIEW:-
History of any particular subject is the root to understand the
origin, progress and other aspects of that subject. Ayurveda, the
science of longevity is considered as Upaveda of Atharvaveda, one
among Chaturvedas orated by Lord Brahma, who has explained the
health sciences in eight branches. The reference of Kasa is available
from Vedic period to modern era. The Historical reviews of Kasa
from various literatures are described below in chronological order.
1. Vedas 4. Sangra
2. Puranas has
3. Samhita 5. Adhuni
s ka Kala
The references regarding the disease “Kasa” are as follows.
1) VEDAKALIN:
In Atharva Veda references of Kasa Vyadhi are mentioned in
Kanda – 6 and Sukta – 105. Vedas are the foundation of mankind’s
information and provides complete details. Among the four Vedas;
Health and disease related matter are much available in Atharva
Veda where, Kasa is mentioned in the context of Tamaka-Jwara as
an Upadrava (complication). Holy mantras have been advised in this
context for the cure of Kasa.
2) PURANKALIN:
In Agni Puran line of treatment of kasa Vyadhi was
mentioned.Garuda Purana, a renowned sacred treatise, has
described and documented about the disease Kasa and its varieties
with their individual Lakshanas and management.
i. Abhrata Kasa
ii. Vataja Kasa

6
 iii. Summa Kasa
3) SAMHITAKALIN:
The disease as a whole with Hetu, Lakshana, Samprapti and
descriptive line of treatment is mentioned in:
I. Bruhatrayee:-
 Charaka Samhita Chkitsa Sthana Adhyaya 18
Panchavidha Kasa along with their Poorva roopa, Samanya
samprapti, Vishesha nidana and Samprapti, Lakshanas,
Sadhyasadhyata, Shodhana and Shamana chikitsa had been
explained elaborately in Charaka Samhita written in 8 th
century B.C.
 Sushruta Samhita Uttartantra Prakaran 52
Susrutha Acharya during the period of 600-700 B.C had
described Kasa as a symptom as well as a disease in his
Susrutha Samhitha. The book describes Bhedas, Nidana,
Samprapti, Poorva roopa, Lakshana, Samanya and Vishesha
chikitsa of Kasa.
 Ashtanga Hridaya Nidan Sthana Adhyaya 3 as “Rakta Pitta
Kasa Nidan”. (400 A.D.)
 Asthtanga Hridaya chikitsa Sthana Adhyaya 3.
 Ashtanga Sangraha Nidan Sthana Adhyaya 3,2
 Asthtanga Sangraha chikitsa Sthana Adhyaya 4
In these samhitas detailed description on Nidana, Bheda,
Samprapti, Lakshana, Sadhyasadhyata and Chikitsa of Kasa
compared to Charaka and Susrutha Samhita.
II. Laghutrayee:
 Madhav Nidan Adhyay 12 (800 A.D.)
Madhavakar, has described the Nidana aspect of Kasa and
also the commentators Vijayarakashita and Shreekantadutta
have commented on Nidana, Samprapti, Purvaroopa and
varieties of Kasa with their prognosis.
 Bhav Parkash(Kasarogadhikar Adhyay) 15

7
4) OTHER SAMHITA:
 Harita Samhita Adhyay 12
 Bhel Samhita Adhyay 5
 Sharangdhar Samhita (Kasadhikar)
 Kashyap samhita:
In the important chapter name (Vedanadhyaya), the
symptoms of a child who will get attack of shwasa is mentioned as
exhalation of hot air.While describing the treatment of pregnant
woman, Acharya mentions about the chikitsa of tamakashwas later
in khilastana.

5) OTHER REFERENCES:
 Yoga Ratnakara Purva Khanda: Sarvakasa Chikitsa Adhyay
24/1.
 Bhaishjaya Ratnavali Adhyay-15
 Bharat Bhaisajya Rantnakar Kasarogadhikar

AYURVEDIC RACHANA SARIR

In samprathi of kasa vyadhi Pravaha strotas & Rasvaha
strotasdusti takes place.The sthan of Kapha dosha is Ura & the
Kasa Vyadhi is seen in Kapha Vrudhi. (Ast. Hya)
In Kasa,
Udbhava sthan - Amashya,
Adhishtan- Urapradesha,
Vyaktha Sthana –Mukha
So that, we are consider the Sharir of Pranvaha Srotas.
The signs and symptoms of vitiation of prana vaha srothas re-
confirm that pranavaha srotas is nothing other than the airway, or
the respiratory system.
Achaarya Charaka mentioned signs and symptoms of its dushti,

8
 iÉjÉ |ÉÉhɴɽýÉxÉÉÆ »ÉÉäiɺÉÉÆ ¾ýnüªÉÆ
¨ÉÚ™Æü ¨É½ýÉ»ÉÉäiÉõÉ, |ÉnÖüŸüÉxÉÉÆ iÉÖ
Jɱ´Éä¹ÉÉʨÉnÆü ʴɶÉä¹ÉÊ´ÉYÉÉxÉÆ ¦É
´ÉÊiÉ; iÉtlÉÉ-- +ÊiɺÉÞŸü¨ÉÊiɤÉrÆü
EÖúÊ{Éiɨɱ{Éɱ{ɨɦÉÒIhÉÆ ªÉÉ
ºÉ¶É¤nü¶ÉÚ™ü¨ÉÖS‡üºÉxiÉÆoü«üÉ |ÉÉhÉ
´É½ýÉxªÉºªÉ »ÉÉäiÉÉÆ漃 |ÉnÖüŸüÉxÉÒÊiÉ Ê
´ÉtÉiÉÂ* (ca.iva. 5/8)
Acharya Sushruta also explains the viddhalakshana of
pranavahasrotas: Kroshan (cry), Vinaman (forward bending of body),
Mohana (syncope), Bhramana (vertigo), Vepanani (tremors),
Maranam (death).This indicates the organ damage of respiratory
system.
Therefore, It can be certainly supposed that description of
pranavahasrotas in Ayurvedic text is may be correlated with the
Respiratory system as described in modern medical science.
The Strotas causing Prana (Life) is to called Pranavaha
Strotas. Kasa vadhy is vadhi of Pranavaha Strotas.The difference in
number laid down in difference classics is only due to
Interpretation.The mula of Pranavaha Strotas are Hridaya &
Mhahastrotas.
According to Sushruta,

ta~a pa`aNavaho Óo taqaaomaU_M laM=dyaM rsa

vaaihnyaSca Qamanya: |
ta~a ivaQdsyaak`xaoSanaivanamana maaohna Ba`maNa
vaopanaaina marNaM vaa Bavaita ||
(sau. Saa. 9/12)

9
 The mula of of Pranavaha Strotas are Hridaya & Rasvahini
Dhamani.
AVAYAVA OF SHWANA SANSTHANA
 NASA  PHUPPHUS
 KANTHA  PHUPPUSAVARANKALA
 KANTHANADI  HRIDAYA
 APASTHAMBA  MAHASTROTAS

 NASA
Nasa is one of the shirapratyang. It is said adhisthan of
ghranendriya, in Charaka samhita. Charak has said the praman
as four anguli. Nasa is said to be the dwara of shir. In Asthang
Hridya nasika is said to be the sanchar sthan of Udana Vayu.
 KANTHA
The parth of shwasa which at the end of mukha (oral cavity) is
called as the kantha. The passage in which food particles doesn’t
enter and is a posterior part of jivha is called as the Kantha.

 KANTHANADI
The references of kanthanadi in Asthanga Sangraha indicate as
Trachea.Kanthanadi is described as having 4 dhamanis on
either side of which 2 are & 2 are manya. Any injury over this
dhamanis leads to mukhata and Swaravikruti.
 APASTHAMBHA (BRONCHI)

AvastaMBaa {r: paaEvao_ naaD\yaa Ainala vaaihnaI

rWtaona paUNa_ kxaoYzao Anna Svaasaata
kxasaaScya naSyaita ||
(A.=.Saa. 4/15)
Kantha-nadi gets divided into two rights & left (bronchi)
Apastambha at the level of 5ththoracic vertebra. It carries Vata-
dosa. It is named so because it contains a marma called

10
 Apastambha, if it gets traumatised, patient dies due to swasa &
kasa.Vagbhata adds to this srotas a structural entity called
Apastambha which is located in Ura Sthana and while giving
details of its location has mentions it to be on Parshwa or a tube
like structure on the Parshwa of Ura which carries Vayu. This is
the first reference of its kind where Urasthana is directly
considered to play majar part in Kasa.
Vagbhata has mention that the traumatized Apastambha causes
blood accumulation, improper respiration and deglutition along
with Kasa where as Charaka Samhita has mentioned about
sashadha and abnormalities of phelgum in vitiation of
Pranavaha Srotas which can be considered as Kasain broad
context not only Shwas.

 PHUPPHUS
Phupphus is said to be one organ of urasthana development of
phupphus is from shonitphena.shaeangadhara has said
phupphus as udana vayu aadhar.

 PHUPPHUSAVARANKALA
This shleshmashaya can be considered as
phupphusavaarankala is phuera which are two in nature, which
enclose both the phupphus.
 HRUDAYA
Hrudaya is one of avayava of urasthana. Its uitpati is from the
praasadbhoot bhag of shonita & kapha the dhamanis concerned
with it do the function of pranvahanam Charak has included
hridaya in Dashapranayahana & Panchdash kasatangam.
 MAHASTROTAS (Ch.Vi. 5/8, Ah.Hr.Su. 12/46, Ch Su. 11/48)
Mahastrotas, Sharid Madya, Mahanimna, Amapakvashaya are
the synonyms mentioned of koshtha ‘Abhyantar’ rogamarga.

11
 Annavaha mahastrotas includes Mukha, Oshtha, Danta,
Upajivhika, Lalagranthi, Gala, Annanalika, Urdhva Amashya,
Grahani-Purva, Madhya and utta bhaga. Also includes
Pakvashyaya and Guda.

AYURVEDIC SHWASAN KARMA

Pranapavan originating from the Nabhi sthana vitiated
upward (urdhvadisha) touching Hritakamal; it escapes
through the kantha marga & reaches vishnupaad where,
Ambarpiyush Prakashan takes place & kanthanadi.This
Amrut is responsible for prenana karma of the whole body &
pradeepan of jathar agni. This sharir sanchari vayu via
sira & Dhamanis travels to the whole body where all the
dhatu pushti is achieved
 SWASANA PRAKRIYA
1] Prana vayu:-

pa`aNaao#~a maUQa_ga: |
{r: kxNzcarao bauQdI=dyaoMid`yaicattaQaRkx |
YzIvana Xavaqau {d\gaar inaSvaasa Anna
pa`vaoSakRxta || (vaa. saU. 12/4)
Prana-Vayu present in the sira-pradesa, gives
stimulation to the muscles related to 'swasa-patha' & muscles
in the Urah-Pradesa (Diaphragm & intercostals muscles) Due
to this dimension of the chest as well as lung increases & air
with important 'Prana-dravya' i.e. oxygen enters in the lungs.
This Prana-dravya strengthens the internal Prana. So
Susruta describes 'Prana-Vayu' as

‘pa`aNaaMScapyaavalaMbatao |’
sqaanaM pa`aNasya maUQaao_r:
kxNzija=asyanaaisakxa:

12
 YzIvanaXavaqaUgdarEvaasaaharaid kxma_ca || 6
|| (ca. ica. 28/6)
Swasan or respiration is the basic of life and is related
to Pranavaha srotas specifically Pranavayu and along with
that Agni and thus it becomes a necessisity to understand
the constituents and a process of respiration in the context of
Kasa.
Pranavayu is said to be situated at the ‘Moordha’ which
better should be considered ‘Shirastha Moordha’ rather than
the’ Mukhastha Moorda’.The functions of these are along with
others Stheevana (expectoration), Nishwasa (inhalation) and
degludation, which shows Urdhwa and Adhogati of
Pranavayu. This has been more elaborated by Sharangdhar
while explaining the process of Swasana.

2] Udana-Vayu:-

{rsqaanama\ {danasya
naasaanaaiBagalaaMEcarota |
BaaiYatagaItaaitairita AivaSabdad\
{cCvaasaidivaSaoYa |
(A. =. saU.DlhNa TIkxa)
Niswasa i.e. Inspiration is the function of Prana-Vayu.
Ucchavasa i.e. Expiration is the function of Udana-Vayu.
Suksma-Mala produced during Respiration if not get expelled,
it causes ill health; this expulsion of mala (Vayaviya) is done
by Udana-Vayu.

1) =nüÉxɺªÉ {ÉÖxÉ: ºlÉÉxÉÆ xÉɦªÉÖ®: Eúh`ü B

´É SÉ *

13
 ´ÉÉC|É´ÉÞÊkÉ: |ɪɋÉÉèVÉÉæ¤É™ü
´ÉhÉÉÇÊnü Eú¨ÉÇ SÉ ** (ca. ica. 28/7)
2) naaiBasqa: |ÉÉhÉ{É´ÉxÉ: ºpRYzvaahR
%kmalaantar ma\ |
Eúh`üÉtabaihinaOya_aÊtapaatau\Ê
´ÉYhau{ÉdamaRtama\ ||
paItvaa caaMbarÊpayauYaMpaUUnaraªÉita
vaogata\: |
|ÉIhÉtamaÊKalaM dohMInaama\ jaIvaM ca
jaazraxÉlama\ || Saa.saM.{ÉÖ´ÉÇKÉÆD
The another part of Swasana Prakriya i.e Uchawas i.e
expiration or exalation is the function of Udana
Vayu.Vimargaman of Udan Vayu take place and thus
samprapti of Kasa which has been denoted by abnormality of
sound and speech as lakshanas of Kasa.
3] Apana-Vayu:-

|ÉÉhÉÉ{ÉÉxɺɨÉÉxÉèºiÉÖ ºÉ´ÉÇiÉ: {É
´ÉxÉèÊÛÉʦÉ: **
v¨ÉɪÉiÉä {ÉɱªÉiÉä SÉÉÊ{É º´ÉÉÆ º´ÉÉÆ
MÉÊiɨɴÉκlÉiÉè: ** (sau.saU 35/28)
Commentory by Dalhan on this Sholka
Apana-Vayu has an Adhogati, a gati totally opposite to
that of Udana and partially against that of Prana. The friction
between Prana and Apana has been considered to be
responsible for formation of Agni. Brahat Aranya Upanishad
which has been accepted by ayurveda and mentioned by
Gangadhar Rai by his commentary on Charaka Samhita in
Jala Kalpa Tantra. So a change in the normal gati in these
courses of Vayu is going to affect on Agni and the Swasana
14
 prakriya which then going to the Rasa Vahini i.e Maha
Srotasa. This later has been denoted as production of
abnormal sound and abnormal expulsion of air in the form of
either Shwas or Kasa.

MODERN ANATOMY & PHYSIOLOGY

The respiratory system consists of the nose, pharynx
(throat), larynx, trachea, bronchi and lungs, structurally; the
respiratory system consists of two portions –
 The term upper respiratory system refers to the nose, pharynx
and associated structures.
 The lower respiratory system refers to the larynx, trachea,
bronchi and lungs.
 The conducting portion - consists of a series of inter connecting
cavities and tubes nose, pharynx, trachea, bronchi bronchioles
and terminal bronchioles - that conduct air into the lungs.
 The respiratory portion consists of those portions of the
respiratory system where the exchange of gases occurs -
respiratory bronchioles, alveolar ducts, alveolar sacs, and alveoli.
 NOSE –
The nose has an external and internal portion inside
the skull. The external portion consists of a supporting
framework of bone and hyaline cartilage covered with muscle
and skin and lined by mucous membrance.
The interior structures of the nose are specialized for
three functions -
1) Incoming air is warmed, moistened and filtered.
2) Olfactory stimuli are received
3) Large, hollow resonating chambers modify speech sounds.
When air enters the nostril, it passes first through
vestibule, which is lined by skin containing coarse hairs that
filter out large dust particles.

15
 Mucous membrance lines the cavity and superior,
middle & interior conchae. The mucous membrance contains
capillaries and pseudostratified ciliated columnar epithelium
with many goblet cells. As the air whirls around the conchae
and meatuses, blood capillaries warm it. Mucus secreted by
the goblet cells moistens the air and traps dust particles.
Drainage from the nesolacrimal duct & secretions from
paranasal sinuses also help moisten the air. The cilia move
the mucus - dust particles towards the pharynx so they can
be eliminated from the respiratory tract by swallowing or
expectoration (spitting)

 PHARYNX –
Or throat is a somewhat funnel shaped tube about 13
km long starts at internal nares to the larynx. The pharynx
functions as a passage way for air and food, provides a
resonating chamber for speech sound.
 LARYNX –
Or a voice box, is a short passage way that connects
the laryngo pharynx with the trachea.It lies in the midline of
the neck anterior to the fourth through sixth cervical
vertebrae.
When small particles, such as dust, smoke, food or
liquids pass into the larynx, cough reflex occurs to expel the
material.
 TRACHEA -
The trachea or windpipe is a tubular passage way for
air about 12 cm (5 in) in lenth and 2 ½ cm in diameter. The
layers of the trachea from deep to superficial are -
(i) a mucosa (ii) submucosa (iii) hyaline cartilage (iv)
adventitia,

16
 composed of areolar connective tissue. The mucosa of the
trachea consists of an epithelial layer of pseudostratified
ciliated columnar epithelium and an underlying layer of
lamina propria that contains elastic and reticular fibers. The
epithelium consists of ciliated columnar cells and goblet cells
thatreach the luminal surface plus basal cells that do not
reach the luminal surface. The epithelium provides the same
protection against dust as the membrane lining the nasal
cavity and larynx.
 BRONCHI -
At the superior border of the fifth thoracic vertebra, the
trachea divides into a right primary bronchus, which goes
into the right lung and a left primary bronchus, which goes
into the left lung. On entering the lungs, the primary bronchi
divide to form smaller bronchi - the secondary bronchi, one
for each lobe of the lung. (The right lung has three lobes and
the left lung has two). The secondary bronchi continue to
branches, forming still smaller bronchi, called tertiary
(segmental) bronchithat divide into bronchioles. Bronchioles,
in turn branch repeatedly and the smallest bronchioles
branch into even smaller tubes called terminal bronchioles.
 LUNGS -
The Lungs are paired cone - shaped organs lying in the
thoracic cavity. Two layers of serous membrane, collectively
called the pleural membrane, enclose and protect each lung.
Layer lines the wall of the thoracic cavity and is called the
parietal pleura. The deep layer, the visceral pleura cover the
lungs themselves.
The right lung has three lobes and the left lung has
two.There are ten tertitary bronchi in each lung.The segment
of lung tissue that each supplies is called bronchopulmonary
segment.Each bronchopulmonary segment of the lungs has
many small compartments called lobules.

17
 RESPIRATORY UNIT -
Respiratory unit is the terminal portion of respiratory
tract. The exchange of gases occurs only in this part of the
respiratory tract.
 STRUCTURE OF RESPIRATORY UNIT -
The respiratory unit starts from the respiratory
bronchioles. Each respiratory bronchiole divides into alveolar
ducts. Each alveolar duct enters and enlarged structure
called the alveolar sac. The space inside the alveolar sac is
called antrum.The wall of the alveolar sac contains the
alveoli. The epithelial lining of the alveolar consists of two
types of cells called type I and type II alveolar cells.Type-I
alveolar cells are squamous epithecial cells forming about
95% of the cells in alveolar epithelium. These cells form the
site of gas exchange between the alveolus and blood. Type-II
alveolar cells are cuboidal in nature and form about 5% of
alveolar cells. Type-II alveolar cells secrete the alveolar fluid
and surfactant.
 RESPIRATORY MEMBRANE -
The blood vessels in the lungs form a capillary network
beyond the terminal bronchiole i.e. in the respiratory unit.
The capillaries are formed by endothelial cells.The alveolar
membrane and capillary membrane together form respiratory
membrane. The exchange of gases (O2 and CO2) between the
lungs and blood takes place by diffusion across alveolar and
capillary walls.
 PULMONARY CIRCULATION -
The right atrium receives deoxygenated blood from
various parts of the body. From right atrium blood flows into
the right ventricle, which pumps It into the pulmonary trunk.
The pulmonary trunk divides into a right and left
pulmonary artery each of which carries blood to one lung. As
blood flows through pulmonary capillaries, it loses CO 2 and

18
 takes on O2. This blood called oxygenated blood, returns to
the heart via the pulmonary veins that empty into the left
atrium. The blood then passes into the left ventricle, which
pumps the blood into the ascending aorta; Branches of the
arch of the aorta and descending aorta (thoracic aorta and
abdominal aorta) deliver blood to systemic arteries, which
lead into systemic capillaries. In systemic capillaries blood
loses O2 and gains CO2. This blood called deoxygenated blood
returns to the right side of the heart through superior vena
cava, inferior vena cava & coronary sinus.
 PULMONARY VENTILATION -
Pulmonary ventilation (breathing) in the process by
which gases are exchanged between the atmosphere and lung
alveoli. Air moves into the lungs when the pressure inside
the lungs is less then the air pressure in the atmosphere. Air
move out of the lungs when the pressure inside the lungs is
greater than the pressure in the atmosphere.
 INSPIRATION -
Breathing in is called inspiration (inhalation) Just
before each inspiration, the air pressure inside the lungs
equals the pressure of the atmosphere, which is about
760mm Hg, or 1 atmosphere (atm), at sea level for air to flow
in to the lungs the pressure inside the alveoli must become
lower than the pressure in the atmosphere. This condition is
achieved by increasing the volume of the lungs. The first step
in expanding the lungs involves contraction of the principal
inspiratory muscles - the diaphragm and external
intercostals. Air always flows from a region of higher
pressure to a region of lower pressure and inspiration takes
place. Air continues to flow into the lungs as long as the
pressure difference exists.
 EXPIRATION -

19
 Breathing out called expiration (exhalation) is also
achieved by a pressure gradient, but in this case the gradient
is reversed; the pressure in the lungs is greater than the
pressure of the atmosphere. Normal expiration during quiet
breathing, unlike inspiration, is a passive process because no
muscular contractions are involved. It results from elastic
recoil of the chest wall and lungs. The lung volume decreases
and the alveolar pressure increases to 762 mm Hg. Air then
flows from the area of higher pressure in the alveoli to the
area of lower pressure in the atmosphere.
During heavy breathing, however the elastic forces are
not powerful enough to cause the necessary rapid expiration,
so this is achieved by contraction of the abdominal muscles
which forces the abdominal contents upward against the
bottom of the diaphragm.

BALAK VICHAR:
This Research Study done in OPD of Kaumarbhritya
Tantra according assessment criteria i.e.age group of 1 year
to 5 years.
According to charak: also states this Avastha of baalak
with special symptoms,

ta~a baala ApairpaWva QaataU................||

(ca.iva.8ó122)
In Apairpakva Datu Avastha–rasa raktaadi dhatauare
not developed completely secondary sexual characters are not
formed, Sharir is sukumaar without klesha sahanan properly
kapha pradantva is there to low strength this Avastha is from
birth up at 16 years of age.
The Health problems of children are different from
those of adults because of the following aspects.

20
1) Soukomaryata: Children are highly vulnerable due to
sukumaaratwam
2) Alpakayata: Lower body mass index in comparisons to adults.
3) Sarvananaupasavata: Children can not consume all types of food.
4) Aparipakva dhatu: Immature dhaatu sataters of children
5) Dosha dushyamataalpata: Quantitatively and qualitatively
doshas and dushyas are alpata.
6) Asamatvagata Prandosha, dhatu, bala, ojasa: Equilibrium of
functional and structural entities of children.
7) Ajata yanjana: Children have cant developed secondary sexul
characters.
8) Aahar sankarat aniyat vanhi: The status of Agni in children is
unstable as they are not acclimatized with different status of food
materials (solid, liquid, semi solid)
9) Madhur satmya: children are more food of madhura rasa and it
yiekds through language and action.
10) Vaka cheshtayora samartha: Children can’t properly express their
needs through language and action.
The character of human being is moulded pick from the
childhood by the interaction to pediatrician, parents, teachers
and society. Among them, the pediatrician plays an important
role as he deals to health of the child, which is considered as

wealth for a life time i.e.SarIrmaaÒM Kalau

Qama_saaQanama\ |

21
 KASA

In the classics of Ayurveda, Kasa was described under

various categories such as an independent disease,
prodromal symptom, complication and sequel of diseases.
Acharya has stated that, Lakshanas of the Vyadhi appears as
independent disease some times as long as they exist
secondarily, and should be called as Lakshanas and should
not be considered as Vyadhi.
It is justified to study the Vyutpatti, Paribhasha, and
Paryaya of the word Kasa. In Ayurveda, Kasa is explained as
a separate disease entity with the explanation of specific
Nidana panchaka and Chikitsa. It is significant to study the
Vyutpathi, Paribhasha and Paryaya of the word Kasa before
going through the disease proper.

VYUTPATTI
Two derivations are available for the word Kasa in
Shabda anushasana of Panini.
1. Kasa is derived from the root “Kasri” i.e. “shabda kutsanyam”
which means “unpleasant sound”.
Gangadhara, the commentator describes kasa from the dhatu
“kasri”, which means“bhinnaswara”.
2. Second derivation is from the root ‘kas’ meaning
Kas + gathou  movement
Commentator Chakrapani derived the word kasa from the root
‘kas’ i.e. “gati-shatanayoh” which means “falling movement”.

NIRUKTI
 Acharya Caraka defines kasa as;
“Shushko Va Sa Kapho Va Kasanath Kasaha”

22
 Release of obstructed vayu resulting in the production
of abnormal sound in the process which may be productive or
dry is termed as Kasa.
In Kanta both reflex activities of Prana and Udana
vayu, require co-ordinate action. When the reflex activity of
Prana vayu is in action such as while swallowing food,
initiation of the action of Udana vayu by way of talking brings
a collusion between the two reflexes; and then the obstructed
Prana vayu takes a deviation by imitating or following the
Udana vayu in its action and comes out through oro or naso
pharynx with a sound resulting in cough.
 Chakrapani dutta has commented on the word Kasa as
“Uraprabuthi shatanayo kasa ethi anavastha saamya
uchyate”
Which means, in drawing of chest wall (Ura) during
coughing.
 Acharya Sushruta defines kasa as
“Sambhinna kaansyaswana tulya ghosha”
The disease associated with a typical sound obtained from
broken bronze vessel.
 In madhukosha kasa is defined as
“Kasti shirokantath urdhva gachahati vayu
riti”
The disease where the vayu attains upward movement and
moves above kanta and shira is called as Kasa.
 Dalhana in his commentary writes
“Sagoshastaddigvidha prananirgamanottha swara yukta -
sa prana vayu kasa ityudahruta”
The vitiated prana vayu leaves the body through the urdhwa
bhaga with a loud noise. This condition is termed as kasa.
According Sanskrit, English dictionary by Sir. Monier Monier
Williamskasa means “cough”.

23
 PARYAYA
Paryaya of kasa are as follows,
1. Kasaha.
2. Kasa.
3. Kasika-, Means it is a Roga vishesha, which produces a
peculiar sound i.e., kas shabda.
According to Amarakosha:
“kasa” and “kshavatu” are the synonyms. Though they
are different entities, their pathogenesis could be the same.

NIDAN PANCHAK:
There are five factor that describe the nidan in
details.They are known as vyadhi dnyana upaya or
panchanidana.There are,
1) Nidan 2) Purvarupa 3) Rupa 4) Upasaya 5) Samprati
Amoong these Nidan hetu, It describes the root cause of
that particular diseases.Purvarupa & Roop explain the sign &
symptom of the diseases in details. Upasaya explain the
relieving factors. Samprati explains the whole pathogenesis of
the disease.To get the through knowledge kasa vyadhi the
nidan panchka should be studied in details.
Nidana or Etiology of Kasa
Kasa is one among the most common disease occurring
due to Pranavaha srotho dushti. Cordial relationship between
Prana and Udana vayu is very much responsible for normal
functions of Pranavaha srotas. Pranavaha srotas is one of the
exposed srotasas of our body which is directly related with
the external environment, and is vulnerable for allergens and
droplet infections. Factors like air pollution, dust and
urbanization leads to the manifestation of Kasa. Immunity
factor or Deha prakruthi is responsible for disease

24
 manifestation in children. Like other diseases, Nidana of Kasa
is categorized broadly into two main divisions,
1. Samanya nidana (General causative factor)
2. Visesha nidana (Specific causative factor)
General etiological factors are responsible for the
manifestation of all varieties of Kasa where as the specific
etiological factors are responsible for the particular variety of
Kasa.

A. SAMANYA NIDANA
Samanya nidanas of Kasa as per various Acharyas can
be classified as follows.
1) Aharaja nidanas 3) Manasika nidanas
2) Viharaja nidanas 4) Vyadhijanya nidanas
Table 1 :Showing the Nidanas of Vataja Kasa
Sr. Nidanas
M.N

G.N

B.R

H.S
S.U
C.S

B.S
Y.R

B.P
A.S

No
.
Aharaja
1 Rooksha ahara sevana + + + + + + + + + -
Ati kashayarasa ahara
2 + + - - - - - - - -
sevana
3 Sheeta ahara sevana + + - - - - - - - -
4 Asatmya ahara sevana - + - - - - - - + +
5 Alpa ahara sevana + - - - - - - - - -
Bhojanasya
6 - + - + + + + + - -
Vimargagamana
Viharaja
7 Dhoomopagata - + - + + + + + + -
8 Rajasevana - + - + + + + + - +
9 Shrama + + + + + + + + + +
10 Vegavarodha + + + + + + + + + -
11 Hasyapraharshya - - - - - - - - - +
12 Anila sannirodha - - - - - - - - - +
13 Vega Udeerana - - + - - - - - - -
14 Ratri jagarana - - + - - - - - - -
15 Kshavathu dharana - + - + + + + + + -

VATAJ KASA NIDANA:-

25
 1) °ÿIɶÉÒiÉEú¹ÉɪÉɱ{É|ÉʨÉiÉÉxɶÉxÉÆ
ÊÛɪÉ: *
´ÉäMÉvÉÉ®hɨÉɪÉɺÉÉä ´ÉÉiÉEúɺÉ|É
´ÉiÉÇEúÉ: **10**(ca. ica. 18/10)
2) Ê´ÉnüÉʽýMÉÖ¯þÊ
´ÉŸüΨ¦É°ÿIÉÉʦɹªÉÎxnü¦ÉÉäVÉxÉè: **
¶ÉÒiÉ{ÉÉxÉɺÉxɺlÉÉxÉ®VÉÉävÉÚ¨ÉÉÊxÉ™ü
ÉxÉ™èü: **3**
´ªÉɪÉɨÉEú¨ÉǦÉÉ®Év´É
´ÉäMÉÉPÉÉiÉÉ{ÉiÉ{ÉÇhÉè: **
+ɨÉnüÉä¹ÉÉʦÉPÉÉiÉÛÉÒIɪÉnüÉä¹É|
É{ÉÒbüxÉè: **4**
ʴɹɨÉɶÉxÉÉvªÉxɶÉxÉèºiÉlÉÉ
ºÉ¨É¶ÉxÉè®Ê{É **
ʽýDúÉ ·ÉɺÉõÉ EúɺÉõÉ xÉÞhÉÉÆ
ºÉ¨ÉÖ{ÉVÉɪÉiÉä **5** (sau.{.50/3-5)
3) kxYaayaivajjalaasaatmyakxT\vamlalavaNaaoYaNaO : |
r]XaSaItagaur]isnagQaaotWlaoidpayau_iYataaSanaO : ||
22 ||
QaarNaaodIrNaayaasara~yah: svapnajaagarO: |
AnyaOEcataiÓQaOQaa_tauXayaavarNakxairiBa: || 23 ||
(A.=.ina. 3/22-23)

26
 4) hasyaatpa`hasyarjasaainalasainnaraoQaaiÓmaaga_gatvaac
ca ih Baaojanasya |
vaogaavaraoQaatXavaqaaostaqaOva saÉjaayatao#ipa
manaujaaM pa`itaQaama kxasa: || 2 ||
saMsaovanaanmaQauripacClajaagaroNa
svapnaOid_vaaitadiQagaaOlyaihmaaSanaona ||
saÉjaayatao madnataOlamaaqaalpakxndao maÒona vaa
Baaiva janau: kxfxsya || 3 || (h.saM.12/2)

Table 2 : Showing the Nidana Pattaj Kasa

Sl. M.N

G.N

H.S
B.R
S.U
C.S

B.S
Y.R

B.P
A.S

Nidanas
No.
Aharaja

1 Katu ahara sevana + - - - + - + - + -

Amla ahara
2 + - - - - - - - + -
sevana
Ushna ahara
3 + - - - - - - - + -
sevana
Vidhahi ahara
4 + - - - - - - - - +
sevana
5 Kshara sevana + - - - - - - - - -
Tila, Lashuna,
6 - - - - - - - - + -
Kulatha sevana
Manasika

7 Krodha + - - - - - - - - -

8 Santhapa + - - - - - - - + -

Sl.
M.N

G.N

H.S
B.R
S.U
C.S

B.S
Y.R

B.P
A.S

Nidanas
No.
Aharaja

1 Guru ahara + - - - - - - - + -
Abhishyandi ahara
2 + - - - - - - - + -
sevana

27
 Madhura ahara
3 + - - - - - - - + -
sevana
Snigdha ahara
4 + - - - - - - - - -
sevana
Picchila ahara
5 + - - - - - - - - -
sevana
6 Dadhi sevana + - - - - - - - - -
Guda vikara
7 + - - - - - - - - -
sevana
Manasika
Hima (ambu)
8 + - - - - - - - - -
snana
9 Divaswapana + - - - - - - - - -

KAPHAJ KASA NIDANA:-

1) ¨ÉxnüÉÊMÉíi
´ÉɯþÊSÉSUüÌnü{ÉÒxɺÉÉäiKäú¶ÉMÉÉè®
´Éè: *
™üÉä¨É½ý¹ÉÉǺªÉ¨ÉÉvÉÖªÉÇKäúnüºÉƺÉ
nüxÉèªÉÖÇiɨÉ **18**
¤É½Öý™Æü ¨ÉvÉÖ®Æ Ê×ÉMvÉÆ ÊxÉ¢Ò
´ÉÊiÉ PÉxÉÆ Eú¡ú¨É *
EúɺɨÉÉxÉÉä Á¯þMÉ ´ÉIÉ:
ºÉÆ{ÉÚhÉÇÊ¨É´É ¨ÉxªÉiÉä **19** (ca.ica. 18/18-
19)

Acharaya Charaka is the only author who has mentioned

separate etiological factors for different varities of kasa. Rest of the
authers viz. sushruta, vagbhata, bhavmishra, madavakara,
yogaratnakara have explained general nidana for all the varieties of
kasa.

28
 Broadly nidana of kasa can be classified into:

(1) Abhyantara nidana :

Tridosha and ama can be considered and other pathological
conditions like adhijiwha and galasundika can be considered.
(Ch.S.Ni.1)

(2) Bahya nidana : (All the other nidanas explained in nidana can be
considered)
For the better understanding of nidanas they can be broadly grouped
into four groups(Ch.S.Ni.1)
(1) Aharaja nidana (3) Manasika
(2) Viharaja nidana (4) Vyadhijanya nidana

Aharaja nidana
(1) Bhojya manavarodha
(2) Vimargagamana of ahara
(3) Rooksha ahara sevana
(4) Atikashaya rasa ahara sevana
(5) Atisheetha ahara sevana
(6) Alpa ahara sevana
(7) Katu,ushna,amla,ahara atisevana
(8) Guru, singdha, madhara ahara atisevana

Viharaja nidana
(1) Dhooma sevana
(2) Raja sevana
(3) Shrama
(4) Vegavarodha
(5) Ratri jagarana
(6) Vega uderana
(7) Ayasa
(8) Ati samsarga of surya and agni
(9) Divaswapana

29
(10)Alpa chestana

30
Depending upon mode of action, nidana can be divided into three
groups as below.
(1) Agnimandyakara nidana (3) Khavaigunyakara nidana
(2) Vataprakopakara nidana
Agnimandyakara nidanas
Diwa swapna
Snigdha ahara &
Kledhakara ahara
Khavigunyakara nidana :
Where as dhoomapagata, rajasevana and bhojyamana
vimargagamana.
Bhojyamana vimargagamana
Here the food while in the process of swallowing goes to the
shwasa nalika instead of annalika due to urgency taking in it
obstructs the vayu sanchara producing cough due to defense
mechanism.(M.Ni.1)
Ruksha anna sevana
Consumption of ruksha ahara vitiates vata dosha with its
samana guna especially prana vayu and udana vayu causing the
disease kasa and it produces rukshata in pranavaha srotas.
Atikashaya rasa
Consumption of Kashaya rasa ahara in excess vitiates vata
dosha and is held responsible for the manifestation of vataja kasa by
vitiating prana and udana vayu. Even Sheeta ahara sevana causes
vataja kasa by vitiating vata dosha, which is a predominating factor in
this disease. Alpa ahara sevana and sustenance of adharaneeya vega
results in vata prakopa and this affecting the normal course of vayu
in turn results in kasa production. Shram, Ratri jagarana, vega
uderana, anila sannirodha and ati vyayama also increases vata dosha
and prakopa of vayu affects the normal Dhooma sevana, raja sevana
deals about local irritation of mucous membrane of the pranavaha
srotas and exerts unpleasant action of the jatargni, there by causing
kasa.

31
B. VISHESHA HETU:
Table No. 4 : Hetu is one of the “Triskandha” mentioned in Ayurveda
and can be divided into the following:

VATAJA KASA PITTAJA KASA KAPHAJA KASA

Aharaja
1 Rookshaahaara Katu ahara Guru aahaara
Abhishyandhi
2 Sheetaahaara Ushnaahaara
aahaara
3 Kashaayaahaara Vidaahi aahaara Snigdhaahaara
Amla kshara
4 Alpaahaara sevana
aahaara
5 Pramitaashana
6 Anashana
Viharaja
Kshavatu Swapna
7
vegadharana vicheshta

POORVA ROOPA
Poorva roopa are the early manifested signs and symptoms which
appear before the onset of actual disease and which gives information
about theforthcoming disease. Dosha dooshya sammurchana is the
stage of manifestation of Poorva roopa.
Poorva roopas mentioned by almost all our Acharyas are
identical in the context of Kasa. They are as follows,

1) {ÉÚ´ÉÇ°ÿ{ÉÆ ¦É´ÉäkÉä¹ÉÉÆ
¶ÉÚEú{ÉÚhÉÇMÉ™üɺªÉiÉÉ *
Eúh`äü EúhbÚüõÉ ¦ÉÉäVªÉÉxÉɨɴɮÉävÉõÉ
VÉɪÉiÉä **5**(ca.ica. 18/5)

2) ¦ÉʴɹªÉiɺiɺªÉ iÉÖ
Eúh`üEúhbÚü¦ÉÉæVªÉÉä{É®ÉävÉÉä
32
 MÉ™üiÉÉ™Öü™äü{É: **
º´É¶É¤nü´Éè¹É¨ªÉ¨É®ÉäSÉEúÉä%ÊMÉíºÉÉnüõÉ
Ê™üƒûÉÊxÉ ¦É´ÉxiªÉ¨ÉÚÊxÉ **7** (sau.{. 52/7)

3) taoYaaM BaivaYyataaM r]paM kxNzo

kxNDUrraocakx: || 18 ||
SaUkxpaUNaa_BakxNztvama\ ||(A.=.ina. 3/7)
1) shooka poorna galaasyata 5) Sashabdha Vaishamya
2) kante kandu 6) Agnisad
3) Bhojyanam avarodha 7) Gala lepa
4) Aruchi 8) Thalu lepa.

Hridaya aswastha has been mentioned by Vagbhata as Poorva roopa

of Kasa in Astanga Sangraha.

Shookapurna Gala, Kanta, Aasya: Prodominal symptoms are seen

when there is Dosha – Dushya sammurchana occurring in the
process of development of a disease. In case of kasa the doshas are
Vata and Kapha, where as dushya is pranava strotas. When Dosha –
Dushya sammurchana is in process Shukapurna galasyata is seen
i.e. a feeling as if gala bhaga is filled with shuka graules are formed
due to dosha prokop which are described as kantakvat leading to
shukavata vedana.
Kanta kandu: Kandu is said to be as lakshan of Kapha Vikruti. In
kaphaja kasa there is vikrut vruddhi of kapha dosha. This vikrut
kapha develops vyadhi into pranavaha strotas. During development
kasa, this vikrut kapha develops kandu into the kantabhaga which is
one of the part of pranavaha strotas.
Bhojyanam avarodha: Increased kapha gets coated into the
galabhaga where it produces shotha. Due to this lipta kapha and
shotha avrodha develops to the bhojya padartha.
33
Aruchi: The vitiated Vata causes dryness of the mouth and throat
region initially and later the increased Kapha dosha does the Lepa
over these regions causing impairment in taste perception leading
Aruchi.
Sashabdha Vaishamya: A change in normal voice is noticed as a
result of vitiation of Udana vayu. It can also occur due to the dryness,
irritation, and itching sensation in the throat region, which in turn
causes hoarseness of voice.
Agnisada: The vitiated Vata and Kapha dosha results in Vaishamyata
of Agni and becomes responsible for Mandagni.
Gala talu lepa : Due to the excess intake of Guru, Abhishyandi,
Madhura and Snigdha aharas causes increase in Kapha Dosha leads
to the coating in the region of Gala and Talu, which is predominantly
seen in Kasa.

Table 5 : Showing Poorvarupa of Kasa

Sl.
Poorvarupa C.S S.S A.S A.H M.N B.P G.N
No.
Shooka purana
1 + - + + + + +
gala
Shooka purana
2 + - - - + + +
asya
3 Kanthe kandu + + + + + + +
Bhojyanamavarodh
4 + + - - + + +
a
5 Arochaka - + + + - - -
6 Sashabdha - + - - - - -
7 Vaishamya - + - - - - -
8 Agnisada - + - - - - -
9 Gala lepa - + - - - - -
10 Talu lepa - + - - - - -
Hridaya
11 - - + - - - -
Aswasthata
kavala galane
12 - - - - - + -
vyadhi

ROOPA

34
 The actual signs and symptoms of the disease will be seen in
the vyakta avastha where dosha dooshya sammoorchana takes
place43. With the help of roopa, a disease can be diagnosed and
confirmed. The samprapti ghatakas can be studied with the help of
roopa only.

Roopa is of two types. Namely,

 Samanya Roopa
 Vishishta Roopa
The general signs and symptoms of the disease will be explained
under samanya roopa, where as specific or cardinal signs and
symptoms of the disease are described under vishishta roopa.
Table 6 Showing the Samanya lakshanas of kasa
Vataja Samanya Pittaja Samanya Kaphaja Samanya
Lakshanas Lakshanas Lakshanas
Kasa Kasa Kasa
Deha Kshepana Bhrama Aruchi
Parshwa Shoola Daha Asya Madhurata
Prista Shoola Moha Sharira Guruta
Urah Shoola Trushna Vamana
Urodhooma Loma harsha
Table 7 Showing theVishishta lakshanas of of vataja, pittaja
and kaphaja kasa
Vataja Pittaja Kaphaja
Bahula, madhura,
Peeta ghana kapha
Shushka kasa snigdha sandra
nishteevana
kapha nishteevana
Kruchrena alpa
Tiktasyata Peenasa
kapha shteevana
Shushka – ura,
kanta, vaktra

1) ¾ýi{ÉÉ·ÉÉæ®:ʶɮ:¶ÉÚ™üº´É®¦ÉänüEú®Éä
¦É޶ɨÉ *

35
 ¶ÉÖ¹EúÉä®:Eúh`ü´ÉCjɺªÉ ¾ýŸü™üÉä¨Éí: |ÉiÉɨªÉiÉ:
**11**

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%±{ÉiÉÉÆ µÉVÉäiÉ **12**
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ɶÉɨªÉÊiÉ *
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¦É´ÉäiÉ **13** (ca. ica. 18/11-13)

2) ¾ýSUü‚û¨ÉÚvÉÉænü®{ÉÉ·ÉǶÉÚ™üÒ IÉɨÉÉxÉxÉ:
IÉÒhɤəüº´É®ÉèVÉÉ: **
|ɺÉHú¨ÉxiÉ: Eú¡ú¨ÉÒ®hÉäxÉ EúɺÉäkÉÖ ¶ÉÖ¹EÆú º
´É®¦ÉänüªÉÖHú: **8** (sau.{. 52/8)

3) kuxipataao vaatalaOvaa_yau:
SauYkxaor:kxNzvaW~ataama\ |
=tpaaEvaao_r: iSar: SaUlaM maaohXaaoBasvarXayaana\
|| 29 ||
kxaraoitaSauYkxkxasaM mahavaogar]jaasvanama\ |
saao#ÈgahYaI_ kxfMx SauYkMx
kRxcC^anamuWtvaalpataaM va`jaota\ ||30|| (A.=.ina. 3/29-30)
Table 8 :Showing Roopa of Vataja Kasa in different classics

36
Sl. M.
ROOPA C.S S.S A.S B.P Y.R B.S A.H
No N
1 Shushka kasa + + + + + + + +
2 Prasakta vega + + + + + + + +
3 Shira shoola + + + + + + + +
4 Hrit shoola + + + + + + + -
5 Parshwa shoola + + + + + + + -
6 Urah shoola + + + + + + + +
7 Kanta shoola - - + - - - - -
8 Ksheena oja - + - + + + + -
9 Ksheena bala - + - + + + + +
10 Ksheena swara - + + + + + + -
11 Swara bheda + + - + + + + -
12 Shushka urah + + - + + + + -
13 Shushka vaktra - + + + + + + -
14 Shushka kanta + - + - - - - -
Snigdha, amla, lavana
15 Bhukta peetai + - + - - - - -
prashamyati
16 Moha + - + - - - - -
17 Kshobha + - + - - - - -
18 Anga harsha + - + - - - - -
19 Dourbalya + - + - - - - -
20 Ruja + - + - - - - -
21 Paravata ivakujana - - - - - - + -
22 Shankashoola - + - + + - - -

1) {ÉÒiÉÊxÉ¢Ò´ÉxÉÉÊIÉi´ÉÆ ÊiÉHúɺªÉi´ÉÆ º
´É®É¨ÉªÉ: *
=®ÉävÉÚ¨ÉɪÉxÉÆ iÉÞ¹hÉÉ nüɽýÉä ¨ÉÉä½ýÉä
%¯þÊSɧÉǨÉ: **15**
|ÉiÉiÉÆ EúɺɨÉÉxÉõÉ VªÉÉäiÉÓ¹ÉÒ´É SÉ {ɶªÉÊiÉ *
ö乨ÉÉhÉÆ Ê{ÉkɺÉƺÉÞŸÆü ÊxÉ¢Ò´ÉÊiÉ SÉ
{ÉèÊkÉEäú **16** (ca. ica. 18/15-16)

2) =®ÉäÊ´ÉnüɽýV´É®
´ÉCjɶÉÉä¹É讦ªÉÌnüiÉκiÉHú¨ÉÖJɺiÉÞ¹ÉÉiÉÇ: **

37
 Ê{ÉkÉäxÉ {ÉÒiÉÉÊxÉ ´É¨ÉäiÉ Eú]ÚüÊxÉ EúɺÉäiÉÂ
ºÉ {ÉÉhbÖü: {ÉÊ®nüÁ¨ÉÉxÉ: **9** (sau.{. 52/9)

3) ipa$aata\ paItaaiXakxfxtaa ita$a]syaatvaM jvarao Ba`ma: |

ipa$aasaRgvamanaM taRYNaa vaOsvaya_M
QaUmakxao: mad: || 31||
pa`tataM kxasavaogaona jyaaoitaYaaimava dSa_nama\ |
(A.=.ina. 3/31)

Table 9 :Showing Roopa of Pittaja kasa in different classics

Sl.
C. S. A. A. B. B. M.
No Lakshanas
S S S H P S N
.
Peetha nishteevana and
1 + + + + + - -
peetha netra
2 Tikta asyata + + + + + - +
3 Urodoomayana + - + - - + +
4 Trushna + + + + + - +
5 Daha + + - - + - +
6 Moha + - + - - - -
7 Aruchi + + - - - - -
8 Bhrama + - + + - - -
9 Pratatam kasa + - + + - - -
Shleshmana pitta
10 + - - - - - -
samsrustam
11 Gruhitwa hridyam - - - - + + -
12 Jwara - + + + + + +
13 Pandu varna shareera - + + - + - +
14 Pitta & rakta vamana - + + + + - +
15 Mukha shosha - - - + + - +

1) ¨ÉxnüÉÊMÉíi
´ÉɯþÊSÉSUüÌnü{ÉÒxɺÉÉäiKäú¶ÉMÉÉè®´Éè: *
38
™üÉä¨É½ý¹ÉÉǺªÉ¨ÉÉvÉÖªÉÇKäúnüºÉƺÉnüxÉèªÉÖÇiɨÉÂ
**18**
¤É½Öý™Æü ¨ÉvÉÖ®Æ Ê×ÉMvÉÆ ÊxÉ¢Ò´ÉÊiÉ
PÉxÉÆ Eú¡ú¨É *
EúɺɨÉÉxÉÉä Á¯þMÉ ´ÉIÉ: ºÉÆ{ÉÚhÉÇʨɴÉ
¨ÉxªÉiÉä **19**(ca.ica. 18/18-19)

2) |É(Ê´É)Ê™ü{ªÉ¨ÉÉxÉäxÉ ¨ÉÖJÉäxÉ ºÉÒnüxÉÂ

ʶɮÉä¯þVÉÉiÉÇ: Eú¡ú{ÉÚhÉÇnäü½ý: **
+¦ÉÚHú¯þMMÉÉ讴ɺÉÉnüªÉÖHú: EúɺÉäiÉ xÉÉ
ºÉÉxpüEú¡Æú Eú¡äúxÉ **10**(sau.{. 52/10)

3) kxfxadurao#lpar]È\maUQa_=dyaM istaimataM gaur] || 32

||
kxNzaopalaopa: sadnaM paInasacCÒ_raocakxa: |
raomahYaao_ GanaisnagQaEvaotaElaoYmapa`vata_nama\
|| 33 || (A.=.ina.3/32-33)

Table 10 :Showing Roopa of Kaphaja Kasa from different classics

Sl. M.
Lakshanas C.S S.S A.S A.H B.P B.S
No. N
Bahula, Madhura,
1 Snigdha, Ghana, Sandra + - - - - - -
kapha
2 Urah alpa rujatwa - + - - + + -
3 Hridaya stimitha - - + - - - -
Vaksha Kapha
4 + - - - - - -
Sampurnamiva Manyate

39
 5 Kanthe kandu - - - - - - +
6 Swara bheda - - - - - + -
7 Peenasa + - + - - + -
8 Utklesha + - - - - - -
9 Chardi + - + - - - -
10 Aruchi + + + - - - +
11 Asya madhuryata + - - - - - +
12 Shira shoola - + - - + - +
13 Mandagni + - - - - - -
14 Gourava + - + - + - -
15 Angasada - + - - - - -
16 Romaharsha + - + - - - -
17 Mukhalepa - + - - - - -
18 Kledata - - + - - - -

ROOPA OF VATAJA KASA

Shuska kasa: The aggravated vata moves in the ura, kantha, gala and
talu pradesha and does the shoshana of kapha which is present there
leading to shushka kasa.
Prasakta Vega: The increase in laghu and chala gunas of vata result
in continuous cough.
Parshwa shoola, Shirashoola, Urahshoola and Hruthshoola:
Shoola is the main feature of aggravated vata. The seats of prana and
udana vayu are urah, hrudaya, kantha and shira regions. So due to
the vimarga gamana of vata and obstructed flow, pain is seen in the
above mentioned regions.
Ksheena bala and Daurbalya: Anna praveshakruth is the main
function of Udana vayu is lost along with the mandagni which is
caused due to vitiated vata and kapha. Due to Kasa vega and reduced
intake of food makes a person more tired causing decreased bala of
shareera.
Snigdha, amla, lavana bhukta peetaihi prashamyati:. Snigdha,
amla and lavana rasa dravyas are capable of reducing vata dosha that

40
in turn becomes responsible for the reduction in duration and
intensity of kasa.
Ksheena swara: Udana vayu, which is responsible for the production
of normal voice.In kasa vyadhi samprapti Udan vayu will be impaired
so change in normal voice in baby this called swarabhedha.

ROOPA OF PITTAJA KASA

Peetha nishteevana: Prakruta guna of peetha of pittavruddhi causes
peetha Nishteevana of kapha.
Tikta asyata: Pitta is having tikta rasa, due to pitta vriddhi patient
feels tiktasyata.
Trushna: Shosana of dravamsha by increased metabolic activity by
pitta vitiation causes trushna.
Pratatam kasa: continuous flow of thin secretions causes a less
severe and continuous cough.
Urodoomayana, Daha, Jwara and Bhrama: These are the Nanatmaja
Doshalakshanas in vitiation of pitta and hence could be seen in any
disorder where pitta gets vitiated, so also in pittaja kasa.
Aruchi: Due to its innate qualities pitta produces tikta ashyata, which
in turn causes aruchi in the mouth. The patient has no desire to take
food.
Pitta and Rakta vamana: In advanced cases of kasa, rakta along
with pitta vamana may be observed, as there is very close relation
between pitta and rakta.
Mukha shoshana: Pitta causes dryness of all jaliya dhatus because of
its ushna guna leading to Mukha shoshana.
ROOPA OF KAPHAJA KASA
Bahula, Madhura, Snigdha, Ghana, Swetha kapha nishteevana:
In kapha is predominant and is present along with the dravyatmaka
vridhi of kapha Dosha in the disease kasa. So patient having qualities
of kapha like Snigdha, Sandra, Ghana & Madhura, Kapha stheevana
will be seen.

41
Kanthe kandu: Kandu is said to be as lakshan of Kapha Vikruti. In
kaphaja kasa there is vikrut vruddhi of kapha dosha. This vikrut
kapha develops vyadhi into pranavaha strotas. During developent
kaphaja kasa, this vikrut kapha develops kandu into the kantabhaga
which is one of the part of pranavaha strotas.
Urashoola: In kaphaja kasa pain in chest persists during coughing &
the intensity of pain is mild. Urashoola is one of the symptoms of
pranavaha sroto dushti. The ruksha & sheeta gunas are responsible
for shoola.
Peenasa: In Kaphaja Kasa Prakupit Kapha and Vayu Travels to shira
pradesh, Ghanamoola and Nasa Pradesha. Here Kapha attains
Styanata and leads to Pratikshaya.
Swarabheda: The gala talu lepa by the aggravated kapha and vitiation
of Udana vayu is responsible for the swarabhedha.
Mukhalepa: It is due to picchila guna vridhi of kapha.Which does the
coating in the mukha pradesha.

SAMPRAPTI
Samprapti helps us to understand the pathological process of the
disease manifested after Nidana sevana, which are responsible for
clinical signs and symptoms of the disease. As far as the treatment of
diseases are concerned much importance has been given towards the
Samprapti vighatana because the treatment mainly aims to
disintegrate the pathological process i.e

“Samprapti Vighatanameva Chikitsa”.

SAMANYA SAMPRAPTI OF KASA:

The explanation of general samprapti of kasa by Acharaya
Charaka state that due to pressure on the vayu especially prana &
udana vayu, move and gets filled up in the channels present in the
upper region i.e. throat, brain (shira) & thoracic region. Vitiation of
prana & udana vayu & blocking of srotasas result in increased

42
pressure inside the channels of eyes, nose, ear and throat. In turn
there will be severe painful contraction of muscles in the areas like
mandibular joint, cervical region, resulting in forceful expulsion of air
producing a typical sound in the presence or absence of sputum
called kasa.The seat of prana vayu is shira i.e. brain & its areas of
movement are chest, & neck, it controls hearts beats & respiratory
action. Whereas seat of udana vayu is thoracic region, trunk, nose &
throat region & it plays an important role in producing sound and
speech. Since vataja kasa is a pranavaha sroto dusti vikara, these two
vayus (prana & udana) gets vitiated predominantly causing
abnormality resulting in forceful expulsion of vayu from various
srotasas where it is temporarily obstructed producing an abnormal
sound. (ch.chi.18/6)
Acharya Susrutha narrates the Samprapti of Kasa as, due to
Nidana sevana vitiation of Prana vayu takes place and this gets mixed
with Udana vayu and further moves upwards and gets filled in the
channels of Kanta and Shira pradesha. The Prakopa of these two
Vayus increases pressure inside the Srotasas causing abnormal,
forceful expulsion of Vayu creating a peculiar sound similar to that of
sound produced by broken bronze vessel.
Acccording to Vagbhata, due to Nidana sevana vitiation of
Prana and Udana vayu takes place which moves upwards and gets
filled up in the channels of throat and head. Due to increased
pressure inside the channels Vayu expels out with a forceful forward
bending of Urah pradesha and even feeling of eyeballs getting
protruded out along with little pain. This creates a typical sound
which is similar to the sound produced by a broken bronze vessel is
called as Kasa.
VISHESH SAMPRAPTI

According to bhedaj prakara of Kasa Vyadhi Vishesh Samprapti

explain as below,

Figure 1 showing the samprapti of vataja kasa

43
 VATAJA KASA SAMPRAPTI

Vataprakopaka Vataprokopaka Khavigunyakara

Ahara VATAJA KASAVihara
SAMPRAPTI Nidana

Kashayarasa atisevana
Ratrijagarana Dhooma &
Vataprakopaka
Rookshaahara sevana Vataprokopaka
Ativyayama Khavigunyakara
Rajasevana
Asatmyaahara sevana
Ahara Vihara Nidana

Vata Vriddi
Kashayarasa atisevana
(Prana & Udana)
Ratrijagarana Dhooma &
Rookshaahara sevana
Ativyayama Rajasevana
Asatmyaahara sevanaAgnidusti

Dosha Sroto
Prasara dusti

Vata Vriddi
(Prana & Udana) (Sanga)

Urah Kanta Pradesha

Srotas Vikar

Agnidusti Shuska kasa

PITTAJA KASA SAMPRAPTI

Dosha Sroto
Prasara
Pitta Prakopaka Nidana
Pitta
dusti
Vriddhi Agnidusti

Pittaja Pitta Prakopaka Vihara Dosha

Kasa Prasara

Urahkanta
Khavigunyakara (Sanga)
Srotodusti & Pradesha
Nidana Dourbalya Srotadusti

Urah Kanta Pradesha Pittaja

kasa
Srotas Vikar

Shuska kasa
Figure 2 showing the samprapti of pittaja kasa

PITTAJA KASA SAMPRAPTI

Pitta Prakopaka Nidana

Pitta Agnidusti
Vriddhi

Pittaja Pitta Prakopaka Vihara Dosha

Kasa Prasara

Urahkanta
Khavigunyakara Srotodusti & Pradesha
Nidana Dourbalya Srotadusti

Pittaja
kasa

Figure 3 showing the samprapti of Kaphaja kasa Kaphaja kasa

samprapti

44
 Khavaigunya Nidanarthakara Kapha Prakopaka
Utpadaka Nidana Karan Nidana

Kaphavridhi

Agnimandya

Amarasa

Khavaigunya Prakupita Dusti

kapha Rasadhatu

Malarupi kapha
vridhi

Sanga
Vata vriddhi

Vata Avarodha

Kaphaja kasa

SAMPRAPTI
1) +vÉ:|ÉÊiɽýiÉÉä ´ÉɪÉÖ°ÿv´ÉÇ»ÉÉäiÉ:ºÉ¨ÉÉʸÉiÉ: *
=nüÉxɦÉɴɨÉÉ{ÉzÉ: Eúh`äü ºÉHúºiÉlÉÉä®ÊºÉ **6**
+ÉʴɶªÉ ʶɮºÉ: JÉÉÊxÉ ºÉ´ÉÉÇÊhÉ |
ÉÊiÉ{ÉÚ®ªÉxÉ *
+ɦɉÉzÉÉÊIÉ{ÉxÉ näü½Æý ½ýxÉÖ¨ÉxªÉä iÉlÉÉ
%ÊIÉhÉÒ **7**
xÉäjÉä {ÉÞ¢¨ÉÖ®:{ÉÉ·Éæ ÊxɦÉÖÇVªÉ
ºiɨ¦ÉªÉƺiÉiÉ: *

45
 ¶ÉÖ¹EúÉä ´ÉÉ ºÉEú¡úÉä ´ÉÉ%Ê{É EúºÉxÉÉiEúɺÉ
=SªÉiÉä **8** (ca.ica. 18)
2) |ÉÉhÉÉä ÁÖnüÉxÉÉxÉÖMÉiÉ: |ÉnÖüŸü:
ºÉÆʦÉzÉEúÉƺªÉº´ÉxÉiÉÖ±ªÉPÉÉä¹É: **
ÊxÉ®äÊiÉ ´ÉCjÉÉiÉ ºÉ½ýºÉÉ ºÉnüÉä¹É: EúɺÉ: ºÉ Ê
´ÉuüÊ‘ü¯þnüɾýiɺiÉÖ **5** (sau.{. 52)
3) ta~aaQaao ivahtaao#inala: |
{Qva_o pa`vaR$a: pa`apyaaorstaismana\ kxNzo ca
saMsajana\ || 19 ||
iSar: s~aaotaaMisa sampaUya_
tataao#ÈgaanyauitXapainnava |
iXapainnavaaiXaNaI paRYzmaur: paaEvao_ ca paIDyana\
|| 20 ||
pa`vata_tao sa vaW~aoNa iBannakxaMsyaaopamaQvaina:
|
hotauBaodatpa`taIGaataBaodao baayaao: sarMhsa: || 21 ||
yad`ujaaSabdvaOYamyaM kxasaanaaM jaayatao tata: |
(A.=. 3)
4) {dana {]Qva_gaitavaOparaotyaatkxfoxna
pa`aNaanaugataona dIGa_:|
=dM inarotya kxfxkxasakxNzo kxraoita taonaaipa ca
kxasa saM&aama\ ||4||(h.saM. 12)

BHEDHA
In Garuda purana three types of kasa are mentioned.
 Abhrata kasa

46
 Vataja kasa and
 Summa kasa
Authors of Charaka, Sushruta, Vagbhata, Bhavapraksha,
Sharngadhara, Yogaratnakara, Madhava nidana, Gada Nigraha and
Bhela samhita mentioned Kasa as five types. They are as follows,

1) ´ÉÉiÉÉÊnüVÉÉÛɪÉÉä ªÉä SÉ IÉiÉVÉ:

IɪÉVɺiÉlÉÉ *
{ɈÉèiÉä ºªÉÖxÉÞÇhÉÉÆ EúɺÉÉ ´ÉvÉǨÉÉxÉÉ:
IɪÉ|ÉnüÉ: **4**(ca.ica. 18)
2) ºÉ ´ÉÉiÉÊ{ÉkÉ|ɦɴÉ: Eú¡úÉcÉ IÉiÉÉkÉlÉÉ%xªÉ:
IɪÉVÉÉä%{É®õÉ **
{ɈÉ|ÉEúÉ®: EúÊlÉiÉÉä ʦɹÉÎM¦ÉÌ´É´ÉÌvÉiÉÉä
ªÉI¨ÉÊ´ÉEúÉ®EÞúiÉ ºªÉÉiÉ **6**(sau.{. 52)
3) paÉca kxasaa: smaRtaa vaataipa$aElaoYmaXataXayaO: ||
17 ||
XayaayaaopaoiXataa: savao_ bailanaEcaao$arao$arma\ |
(A.saM. 3)

1. Vataja kasa 4. Kshataja kasa

2. Pittaja kasa 5. Kshayaja kasa
3. Kaphaja kasa

47
Haritha Samhitha has mentioned eight types kasa. they are namely;
 Vataja kasa.  Sleshma pittaja kasa.
 Pittaja kasa.  Sannipataja kasa.
 Kaphaja kasa.  Raktaja kasa.
 Vata pittaja kasa.  Kshayaja kasa.

Harita has excluded Kshataja kasa and has included vata

pittaja, sleshma pittaja, sannipataja and Raktaja kasa. The lakshanas
mentioned for raktaja kasa is more or less similar to the kshataja
kasa explained by other authors.
In the management of Kasa while discussing the chiktsa
aspects Caraka, Sushruta and Vagbhata explains
 Kaphanubandhi pittja kasa
 Vatanubandhi pittaja kasa and
 sannipataja kasa
In Basavarajeeyam we get 14 different varieties of kasa
explained. Even though the author mentions only five types of kasa
while classifying the disease, other classifications are found in the
context of management.
1. Shukti kasa 8. Upajihwika kasa
2. Shleshma kasa 9. Urdhva kasa
3. Ama kasa 10. Kushta kasa
4. Pandu kasa 11. Kanta jiwhika kasa
5. Krishna kasa 12. Jara kasa
6. Dadhi kasa 13. Kasa jwara
7. Shleshmajihwika kasa 14. Kasatisara
Based on sadhyasadhyata, the disease can be classified into
 Sadhya Kasa
 Asadhya Kasa
On the basis of occurrence, kasa can be classified into two groups,
namely
 Nija Kasa
 Agantuja Kasa

48
On the basis of kapha nishteevana seen in kasa, the disease can be
classified into two varieties i.e.
 Shushka Kasa ( Dry cough)
 Ardhra Kasa ( Productive cough)

UPASHAYA
Vataja Kasa:Food having snigdha, amla, lavana, ushna and vatahara
properties are to be administered in vataja kasa for upashaya.
Pittaja Kasa:Sneha, sheeta, tikta and pittahara ahara can be used as
Upashaya in pittaja kasa.
Kaphaja Kasa:For upashaya Katu, ruksha, ushna and kaphahara
ahara can be administered in kaphaja kasa. If kaphaja kasa is
associated with pitta then, tikta rasa dravya will act as upashaya.

ANUPASHAYA(A.H.Ni.5/37)
Vataja Kasa:Ruksha, sheeta, kashaya dravya sevana, alpa bhojana,
pramitha bhojana, vegadharana, parishrama, all act as anupashaya.
If vataja kasa is associated with pitta and kapha, snehana dravyas
may act as anupashaya.
Pittaja Kasa:Katu, ushana, Vidhahi, amla, Kshara ahara etc., hot
climate and weather act as anupashaya factors in pittaja kasa.
Kaphaja Kasa:Guru, snigdha, abhishyandi and madhura, dravyas
may act as Anupashaya for Kaphaja Kasa.

UPADRAVA
Any disease if neglected or treated improperly or adopting
abnormal diet and behaviour during the treatment period can
progress to secondary stage known as Upadrava i.e. Complication of
the disease.In Bhavaprakasha, it is explained that if Kasa is neglected
without following proper treatment it can lead to Upadravas like
Jwara, Arochaka, Swasa, Swarabheda and Kshaya.
In Astanga hridaya as well as in Yogaratnakara it is mentioned
that if Kasa is neglected then it leads to Swasa, Kshaya, Chardi and
Swarabheda.

49
ARISHTA LAKSHANA(Ch.In.6)
1. When a Kasa rogi develops the symptoms of Mamsa ksheena, Bala
ksheena Romaharsha, Shotha, Sandramutrata and Jwara it
becomes Asadhya for treatment and patient may go for death.
2. When a patient with Kasa produces large quantities of sputum
having the colour of blue, yellow or red, it suggests definite sign of
death.
3. When a Kasa rogi exhibits the prodromal symptoms like Hikka and
Chardi then the death can happen.
4. A person suffering from Kasaif exhibits associated problems like
Jwara, Chardi, Trushna, Atisara and Shopha then it becomes
Asadhya.
5. A patient suffering from Kasa develops Jwara, Hikka, Chardi and
Shotha in Medra as well as Vrushana is considered as fatal.
6. Persistent vomiting in a patient of Kasa suggests a definite sign of
death.
7. Kasa patientshowing extreme Dhatukshaya and Balakshaya
getting violent coughis mentioned as Arishta lakshana in the texts
of Ayurveda.

SADHYASADHYATHA
Before the start of treatment physician should decide whether
the patient should be included for treatment and to decide the line of
treatment as well as the prognosis of the disease, Sadhyasadhyatha is
helpful.
According to Caraka & Vagbhata the kasa, which is manifested
by a single dosha is sadhya. So Vataja kasa, Kaphaja kasa and Pittaja
kasa are sadhya to treat. In case of aged persons it will be yapya.
Even in Bhavaprakasha It is stated that all type of kasa in old
age come under yapya. Kasa of newly origin, due to vitiation of single
dosha and if chikitsa chatushpada are in good condition, it is sadhya
and kasa accompanied with upadravas like shwasa, kshaya, vamana

50
and swara bhanga will kill the patient at the earliest. So without
neglecting the disease and before manifestation of upadravas it
should be treated.
The disease kasa will be sadhya for chikitsa if,
 It is navotpanna.
 It is devoid of complications. The patient is affordable for the
treatment and
 All the four chikitsa chatushpada are in good condition.
 It is associated with very minimal or milder degree of nidana,
poorva roopa and roopa.
 The prakruti of the patient and the dosha vitiated in the disease
are different.
 The kala and the desha are not similar to the dosha involved in
the disease.

Kasa in other Systemic Disorders

The disease Kasa can be also seen as Poorvarupa, Upadrava,
Asadhya lakshana and also associated symptom of any respiratory or
other systemic disorders.

Table No. 11:Kasa as Poorvaroopa, Upadrava and Asadhya

lakshanas

As Poorva roopa As Upadrava As Asdhya lakshana

Rajayakshma Atisara Atisara
Chardi Apachi
Trushna Kumbhakamala
Prathishyaya Gulma
Vataja Prameha Rajayakshma
Kaphaja Prameha Vrana
Rakta pitta Kshataksheena
Vrana

51
Table No. 12 :Kasa as associated symptom
As Associated symptom
Arsha Vataja Arsha
Kaphaja Arsha
Amashayastithavata
Udara Vathodara
Kaphodara
Jalodara
Urakshata
Galashundi
Gulma
Grahani Vataja
Kaphaja
Vataja chardi
Jwara Kaphaja
Kapha pittaja
Kapha vataja
Gambhira jwara
Majjagatajwara
Sannipataja jwara
Parigarbhika
Masurika
Rajayakshma
Vidradihi
Granthivisarapa
Shoola Amaja
Kaphaja
Swasa
Bala Grahas Nigamesha
Swagraha
Andhaputhana
Revathi

CHIKITSA VIVECHANA
Chikitsa is the procedure, which normalizes the structural and
functional impairment (vikara) which are manifested during disease
process by counter acting upon them.The treatment is planned for
kasa according to the division i.e. subtype; which includes the
significant factors mentioned in Ayurvedic classics viz. Severity,
strength of the patient. Anubandha(i.e.predominant condition of dosh)
with proper evaluation of the clinical features. The divisions as per
classics are Vataja, Pittaja, Kaphaja, Kshayaja and Kashtaja kasa.

52
 Choice of different treatment modalities like Shodana, Shamana
etc. depends upon the roga and rogibala. If a patient with the
condition of the disease is suitable for Shodana then one should go
for Vamana, Virechana, Basti etc, depending upon Dosha its
anubanda dosha and avastha of the patient.
If the patient is contraindicated for Shodhana or the clinical
condition of the disease doesn’t require the same then one should go
for suitable means of shamana line of treatment. Shamana can be
either Abyantra viz. Sneha, Churn, Avalehya, kashya etc. or Bahya
like Dhoomapana, parisheka etc.

SAMANYA CHIKISTA:-
During treatment of Kasa first we have to treat the causative
factor.Along with Doshaprakop the sthana of Pranavaha Srotas viz
Kantha, Phuphusa should undergo treatment. The Kanthya Medicines
should be used to treat Kasa.For that Gandush, Dhumpan, And
Avaleha should be used. According to Dosha involvement the medicine
used for treatment should be changed.

VATAJ KASA CHIKISTA:-

°ÿIɺªÉÉÊxÉ™üVÉÆ EúɺɨÉÉnüÉè
×Éä½èý¯þ{ÉÉSÉ®äiÉ *
ºÉÌ{É̦ɤÉÇκiÉʦÉ:
{ÉäªÉɪÉÚ¹ÉIÉÒ®®ºÉÉÊnüʦÉ: **
´ÉÉiÉPÉîʺÉrèü: ×Éä½ýÉtèvÉÚǨÉè™æü½èýõÉ
ªÉÖÊHúiÉ: *
+¦ªÉƒèû: {ÉÊ®¹ÉäEèúõÉ Ê×ÉMvÉè: º´ÉänèüõÉ
¤ÉÖÊrü¨ÉÉxÉ **
¤ÉκiÉʦɤÉÇrüÊ´ÉbÂü´ÉÉiÉÆ ¶ÉÖ¹EúÉäv´ÉÈ
SÉÉäv´ÉǦÉÊHúEèú: *
53
 PÉÞiÉè: ºÉÊ{ÉkÉÆ ºÉEú¡Æú VɪÉäiÉ ×Éä½ýÊ
´É®äSÉxÉè: ** ca.ica. 18/32,33,34
During treatment of Kasa there is dryness in mouth due to dry
cough so Snehan is mostly useful.Basti with Sneha Dravyas.
Alongwith snehan the Basti can be used which is preapared with
Vataghna Dravyas. After Abhang Parishek or Avagaha swade is
helpful. When there is Anubhandha of Pitta and Kapha then Mrudu
Virechan is useful.
PITTAJ KASA CHIKISTA:-

{ÉèÊkÉEäú ºÉEú¡äú EúɺÉä ´É¨ÉxÉÆ ºÉÌ{ɹÉÉ

ʽýiɨÉ *
iÉlÉÉ
¨ÉnüxÉEúɶ¨ÉªÉǨÉvÉÖEúFúÊlÉiÉèVÉÇ™èü: **
¾ýiÉnüÉä¹ÉºiÉiÉ: ¶ÉÒiÉÆ ¨ÉvÉÖ®Æ SÉ Gú¨ÉÆ
¦ÉVÉäiÉ **
{ÉèkÉä iÉxÉÖEú¡äú EúɺÉä ÊjÉ´ÉÞiÉÉÆ
¨ÉvÉÖ®èªÉÖÇiÉɨÉ *
nütÉòüxÉEú¡äú ÊiÉHèúÌ´É®äEúÉlÉæ ªÉÖiÉÉÆ
ʦɹÉEÂú **
Ê×ÉMvɶÉÒiɺiÉxÉÖEú¡äú °ÿIɶÉÒiÉ: Eú¡äú
PÉxÉä *
Gú¨É: EúɪÉÇ: {É®Æ ¦ÉÉäVªÉè:
×Éä½èý™æü½èýõÉ ¶ÉºªÉiÉä **

¶ÉEÇú®ÉSÉxnüxÉpüÉIÉɨÉvÉÖvÉÉjÉÒ¡ú™üÉäi{É™è
ü: *

54
 {ÉèkÉä, ºÉ¨ÉÖºiɨÉÊ®SÉ: ºÉEú¡äú, ºÉPÉÞiÉÉä
%ÊxÉ™äü **
ºÉ´ÉÈ SÉ ¨ÉvÉÖ®Æ ¶ÉÒiɨÉÊ´ÉnüÉʽý |
ɶɺªÉiÉä ** ca.ica. 18/81 tao 84
In Pittaj Kasa there Kaphanubandha so first we have to give
Grutapan and then go for Vaman. When Kapha Dosha throws out of
body then for Shaman Upchar Shita and Madhur dravyas are
used.When Kapha is Ghana then shita And Ruksha Upchar should be
done.

KAPHAJ KASA CHIKISTA:-

¤ÉÊ™üxÉÆ ´É¨ÉxÉè®ÉnüÉè ¶ÉÉäÊvÉiÉÆ

Eú¡úEúÉʺÉxɨÉ *
ªÉ´ÉÉzÉè: Eú]Öü°ÿIÉÉä¹hÉè:
Eú¡úPÉîèõÉÉ{ªÉÖ{ÉÉSÉ®äiÉ ** ca.ica. 108

In Kaphaj Kasa when Patient is strong then start with Vaman.

For Vaman Procedure Madan Phal, Vacha, Yastimadhu these
aushadhi dravyas are used. Other procedures like Virechana, Nasya,
Dhum, Kaval Dharan and Gandush is mostly useful.

Management of Vataja Kasa

The line of treatment of vataja kasa includes,
 Abhyanga  Basti
 Parisheka  Dhooma
 Swedana  Avaleha
Caraka mentioned different treatment modalities to treat Kasa
by using sneha like ghrtha, peya, yoosha, ksheera, mamsa rasa
etc. that are prepared with the vataghna dravyases mentioned
above.

55
Management of Pittaja Kasa
 Avaleha is also indicated.
 Rooksha and sheetala ahara should be used.
 If the involvement of kapha is very minute, the virechana
should be the choice of treatment.
 If kapha is associated with the pitta in pittaja kasa, vamana
has to be performed.
Management of Kaphaja Kasa
In the management of kaphaja kasa, initially vamana has to be
performed followed by pathya consisting of kaphanashaka katu,
rooksha and ushna ahara.

PATHYAPATHYA
Acharya Charaka has considered the word ‘Pathya’ as a
synonym of Chikitsa. Treatment procedure for any disease with out
Pathya diet will not be complete. It plays a very important role in
combating the disease as well as in keeping doshas under control.
In some instances, following only Pathyapathyas in its primary
stage the disease can be treated or arrested or weakened.
The pathya and apathya mentioned in the classics for kasa
roga are given below.
APATHYA(B.R.15)
Table 13 :showing the Apathya
Ahara Vataja Pittaja Kaphaja
Kashaya & tikta rasa Madhura
Rasa Katu, amla ahara
yukta ahara rasa
Snigdha,
Laghu, rooksha, Ushna, vidhai, guna
Guna guru, picchila
sheeta guna ahara ahara
ahara
Ati vyayama Sheeta
Vihara Working in hot climate Divaswapna
jala Snana
PATHYA(B.R.16)
Table 14 :showing the Pathya
Ahara Vataja Pittaja Kaphaja
Shali Godhuma Shastikashali
Shukavarga Godhuma Yava Yava

56
 Tandulia Shali Laja
Yava Godhuma
Shastikashali
Laja
Purana shali
Mudga Masha Mudga
Shimbi varga Kulatha Kulatha
Masha Masha
Gramya prani mamsa Jangala Grama
mamsa with mamsa
Desert animal flesh mudga and Jangala
Mamsa varga yusha mamsa
Anupa prani mamsa Bileshaya
mamsa
Birds flesh
Ksheera Ghritha Ksheera
Gorasa varga Dadhi Ghritha
Cows milk Takra
Gomutra
Ghritha
Aranala Ushnodaka Ushnodaka
Jalavarga Ushnodaka
Vasthuka Draksha Bimbi
Phalavarga/ Amra Phala Bala Bijapura
Shakha varga
Beejapura, Rasna Pippali
Makshika, Draksha Triphala
Devadaru, Bala
Yavakshara
Matulunga
Pippali, Triphala
Kadaliphala
Vidanga, Dashamula
Lashuna
Madhu varga Madhu Madhu Madhu
Ikshu rasa Ikshu rasa Guda
Ikshuvarga Sharkara Sharkara padartha
Guda
Tila taila
Taila varga Sarshapataila
Bilvataila

MODERN REVIEW
COUGH
Cough is a sudden noisy expiration that provides a protective
mechanism for clearing the Tracheobronchial tree of secretions and
foreign material because of forceful contraction of the expiratory

57
muscles. As per modern medicine cough is considered as a
symptom but not a disease as such. Persistent cough interferes
with sleep and feeding also fatigues the child and may result in
vomiting. Generally cough is considered as defence mechanism of
Respiratory System.
DEFINITION
A cough is a sudden, often involuntary, forceful release of air
from the lungs.Cough is a sudden explosive forcing of air through
the glottis, excited by an effort to expel mucus or other matter from
the bronchial tubes or larynx or it is to force the air through the
glottis by a series of expiratory efforts.
COUGH REFLEX:
Cough is a protective reflex occurs due to the irritation of
the mucus membrane of the larynx or Tracheobronchial tree. The
centre in the medulla controls the cough reflex.

PHYSIOLOGY OF COUGH REFLEX

The bronchi and the trachea are so sensitive that any foreign matter
or other cause of irritation initiates the cough reflex. The larynx and
carina (the point where the trachea divides into the bronchi) are
especially sensitive to corrosive chemical stimuli, such as sulphur
dioxide gas andchlorine.

Afferent impulses pass from the

respiratory passages mainly through
the vagus nerve to the medulla. There
the neuronal circuits of the medulla Figure No. 4
causing the following effects integrate
an automatic sequence of events.
 First, about 2.5 litres of air is
inspired.
 Second, the epiglottis closes and the vocal cords shut tightly to
entrap the air within the lungs.

58
 Third, the abdominal muscles contract forcefully pushing
against the diaphragm while other expiratory muscles such as
the internal intercostals also contract forcefully. Consequently
the pressure in the lungs rises usually to 100mm of Hg. or more.
 Fourth, the vocal cords and the epiglottis suddenly open widely
so that the air under pressure in the lungs explodes outward.
Indeed this air is sometimes expelled at velocities as high as 75
to 100 miles an hour. The rapidly moving air usually carries with
it any foreign matter that is present in the bronchi or trachea.

Figure No.5 :Physiology of cough reflex

Sensors stimulated due to irritation

Pleura transmits the afferent impulses in setting up of reflex

Relaxation of Diaphragm + Violent contraction of expiratory

Muscles + Closure of Glottis

Vocal cords closed & air can’t escape – pressure within lungs build up

Forceful opening of glottis

Air escapes violently with high speed & sound

COUGH
Unwanted material in the lungs expelled

TYPES OF COUGH
Cough is divided into two types based on association of
mucus along with the cough. They are
 Productive cough
 Dry cough
Cough may be associated with profuse mucus secretion of
bronchial mucosa. The cough that is associated with such type of

59
mucus expectoration is termed as productive cough.
Minor irritations in the throat can start the cough reflex even
when there is no mucus secretion in the bronchial tree. Such type
of cough which is devoid of expectoration is named as dry cough.

SEVERITY:
Cough ranks among the top 10 reasons for visiting family
physicians. Cough is the fifth most common symptom for which
patients seek care. Americans spend more than $600 million
annually on over-the-counter sale and prescription sale of
medications for cough.

COUGH IN CHILDREN
Cough is one of the most frequent symptoms of childhood
illness, and although they can sound awful at times they usually
are not a symptom of anything dangerous. Occasionally though not
rare can be a cause for a visit to the pediatrician.

TYPES OF COUGH IN CHILDREN

1) "Barking" Cough 7) Night time Cough
2) "Whooping" Cough 8) Cough with Cold
3) Cough with Wheezing 9) Cough with Fever
4) Stridor 10) Cough with Vomiting
5) Sudden Cough 11) Persistent Cough
6) Day time Cough 12) Cough in Young Infants
CAUSES AND SYMPTOMS
In majority of the cases cough is caused by
respiratory infection including,
- Cold or influenza, the most common causes of coughs.
- Bronchitis, an inflammation of the mucus membrane of the
bronchial tubes.
- Croup, a viral inflammation of the larynx, windpipe and
bronchial passages that produces barking like cough in children.

60
- Whooping cough, a bacterial infection accompanied by the high
pitched cough where deep inspiration and stridor are
characteristic.
- Pneumonia, a potentially serial bacterial infection that produces
discoloured or bloody mucus.
- Tuberculosis, another serious bacterial infection that produces
bloody sputum and productive cough.
- Fungal infections, such as aspergellosis, histoplasmosis and
Cryptococcus.
- Environmental pollutants, such as cigarette smoke, dust or
smoke
- Post-nasal drip (the irritating trickle of mucus from the nasal
passages into the throat caused by allergies or sinusitis)
- Some chronic conditions such as asthma, chronic bronchitis,
emphysema and cystic fibrosis.
- Condition in which stomach acid backs up into the esophagus
(Gastro esophageal reflex) can cause coughing, especially when a
person is lying down.
- Cough can also be a consequence of medications that are
administered via an inhaler (It can also be a side effect of beta-
blockers or ACE inhibitors).

ACUTE COUGH
1. Upper respiratory tract infection – Common cold, postnasal
discharge due to sinusitis (in older children), rhinitis,
hypertrophied tonsils and adenoids, pharyngitis, laryngitis and
tracheobronchitis.
2. Nasobronchial allergy and asthma.
3. Bronchiolitis, pneumonia, empyema and pulmonary suppuration
4. Measles and whooping cough.
5. Foreign body in the air passages
6. Non-pulmonary cause: CHF

61
 Cough as a symptom is seen in other systemic
disordersand are listed below
Respiratory System Disorders
 Acute Bronchitis - painful cough, coughing up pus in sputum.
 Asthma - cough worse at night, coughing, persistent cough
 Bronchiectasis - paroxysmal coughing, morning cough, coughing
foul-smelling sputum, coughing blood, coughing green or yellow
sputum, chronic cough and mucus settles in layers on standing.
 Bronchiolitis - hacking cough
 Bronchitis - productive cough, persistent winter cough that
disappears in summer, painful cough, coughing up pus in
sputum, cough with sputum, persistent cough
 Bronchopulmonary dysplasia - cough
 Chronic Bronchitis - persistent productive cough.
 Chronic Obstructive Pulmonary Disease - frequent coughing,
severe cough from respiratory infection, sputum, daily morning
cough, occasional coughing, chronic cough
 Common cold - cough
 Croup - cough, characteristic crowing-sound breathing, barking
cough, night coughing.
 Cystic Fibrosis - coughing, chronic cough with thick sticky
mucus.
 Emphysema - cough with sputum
 Epiglotitis - cough
 High altitude pulmonary edema - cough
 Idiopathic Pulmonary Fibrosis - dry cough
 Lung abscess -productive cough, coughing pus, coughing blood,
foul-smelling cough
 Pneumococcal pneumonia - cough

62
 Para influenza - cough, croup
 Pneumonia - productive cough, cough with rust-coloured
sputum, cough with thick yellow-green mucus, dry cough.
 Pneumonic plague - cough
 Pneumothorax - barking cough, dry cough
 Pulmonary edema - cough, dry cough, pink-stained sputum
cough
 Pulmonary embolism - cough followed by hemoptysis
 Sinusitis - cough, coughing
 Tracheitis - dry cough
 Upper Respiratory Infection - cough
Digestive System Disorders
 Acute Appendicitis - abdominal pain on coughing
 Gastro oesophageal reflux disease - coughing, dry cough
Cardiovascular System Disorders
 Heart failure - persistent coughing, cough, coughing up blood
 Pulmonary valve stenosis - cough, cough with pink frothy
sputum
Allergic Diseases
 Allergies - Coughing
 Dust mite allergies - coughing
 Mild allergies – coughing
Infectious Diseases
 Adenoviruses - Croup
 Allergic bronchopulmonary aspergillosis - coughing brown-
flecked masses of mucus
 Alveolar Hydatid Disease - cough, coughing blood
 Ascariasis - coughing followed by swallowing movements of
larvae.

63
 Blastomycosis - productive cough
 Chlamydia pneumonia - gradual onset of cough
 Dengue hemorrhagic fever - cough
 Flue - dry cough
 Hay fever - Coughing
 Histoplasmosis - cough, dry cough, non-productive cough
 HIV/AIDS - coughing
 Hookworm - coughing
 Measles - cough, hacking cough
 Mycoplasma pneumonia - non-productive cough
 Plague - cough
 Q fever - non-productive cough
 Respiratory syncytial virus - cough
 SARS - dry non-productive cough
 Strongyloidiasis - coughing
 Tuberculosis - coughing up bloody sputum, persistent cough
 Whopping cough - mild cough, dry racking cough, coughing
spasms, cough, whoop – like cough may recur due to other
respiratory infections, mild dry cough
Environmental Health Hazards
 Asbestosis - coughing blood, persistent cough
 Carbon monoxide poisoning - Persistent cough
Cancer
 Cancer - Persistent cough
 Esophagus Cancer - Coughing up blood, chronic cough
 Larynx Cancer - persistent cough
 Lung cancer - chronic coughing, worsening cough, coughing up
blood

64
 Immunological Disorders
 Chronic Granulomatous Disease - persistent cough
 Myeloidosis - cough
Congenital anomalies
 Esophageal atresia … excessive coughing, coughing when trying
to swallow
Rheumatic Diseases of Children
 Sarcoidosis - persistent cough
Pathological condition of the Sputum
 Serous – Thin, watery, often blood stained. Indicates edema of
the lungs.
 Mucoid – The sputum is jelly like and sticky. Seen in acute or
chronic bronchitis, pneumoconiosis, early stage of pulmonary
tuberculosis.
 Muco purulent – Contains lump of muco-pus, looks like
‘nummular’ form or coin like when collected in a conical glass.
Such sputum is seen in bronchiectasis, abscess, putrid
bronchitis and where an empyema ruptures into the air
passages.
 Purulent – Contains pus and hence offensive in smell, occurs in
Lung abscess, Gangrene of Lung, bronchiectasis and when an
empyema ruptures into the air passages. Sputum is thick and
yellow. Even green and non sticky.
 Frothy – Copious, frothy, often blood stained indicates
pulmonary edema.
 Fibrinous – Clear, tough and sticky and may be ‘rusty’ in colour
occurs in lobar pneumonia.
 Prune-juice coloured – Amoebic liver abscess bursting into the
lungs.
 Red currant jelly – Seen in bronchogenic carcinoma.
 Anchovy – Sauce coloured seen in amoebic liver abscess
bursting into the lungs.

65
 Black sputum – Common in coal miners. May occur when there
is breaking down of lung tissue.
 Green Sputum – Occurs as a result of disintegration of
leucocytes when there is retention of purulent sputum as in
bronchiectasis and lung abscess when the infected sputum is
not easily expectorated.
 Creamy yellow sputum – Seen in staphylococcus infection.

Therefore cough is considered as the major symptom

of respiratory disorders and it is highly significant in the
diagnosis of respiratory diseases. In all the above reasons
the manifestation of the disease related with cough may be
considered as an important symptom.

Diagnostic Modalities
It is important to notice details about cough such as
type of cough, does it bring up mucus or pus etc., which in
turn helps in tracing the cause and proper diagnosis.
A cough may occasionally indicate a serious condition such
as
 When blood is coughed up
 When it is accompanied by chest pain
 When there is difficulty in breathing or shortness of breath
 If there is also unintentional weight loss

History
In 70% of cases the history is much useful in
diagnosing the cause of cough.

66
 Table No.15: Clues to common causes of cough that may
be apparent by history
Findings Possible diagnosis
Infant with cough Congenital malformations
Patient is a smoker Tobacco-induced bronchitis
Purulent sputum Pneumonia, bronchitis
Patient is taking an ACE inhibitor ACE inhibitor induced cough
High risk for tuberculosis exposure Tuberculosis
Wheezing Asthma
Asthma, congestive heart
Nocturnal wheezing
failure
Occupational environment
Cough is worse at work
cause
Cough following upper respiratory
Postnasal drip
infection or exposure to allergen
Sensation of postnasal drip Postnasal drip, asthma
Facial pain, tooth pain Sinusitis
Gastro esophageal reflux
Heartburn or sour taste in mouth
disease
History of weight loss Cancer, tuberculosis
Table No.16: Diagnosis of cough on the basis of type of cough
Types of Cough Responsible condition
1.Discontinuous productive cough
Bronchitis
Asthmatic bronchitis
Cystic fibrosis
Bronchietiasis
2.Brassy cough Tracheitis, Habit cough
3.Paroxysmal (with or without Cystic fibrosis
gurgling and vomiting) Pertussis syndrome
Foreign body
4. With Stridor Laryngeal obstruction
Pertussis
5.Nocturnal cough Upper or lower respiratory
tract allergic reaction or both
SINUSITIS
6. Cough most severe on Cystic fibrosis
awakening in morning Bronchiectasis
Chronic bronchitis
7. With vigorous exercise Exercise induced asthma
CYSTIC FIBROSIS
Bronchiectasis
8. Disappears with sleep Habit cough
Mild hyper secretary states in
cystic fibrosis and asthma

67
Table No.17:Diagnosis of cough on the basis of Physical
examination
1.Cough with onset from
birth
2. Cough starting in 1st
month of life
3.Cough in early infancy
4. Cough during late infancy
5. Cough in pre-school age
6. At all ages
Laryngeal webs, vascular rings or H-
type tracheo esophageal fistula
Congenital infection (rabies, CMV)
leading to interstitial pneumonia
Gastro esophageal reflux leading to
vomiting and aspiration of milk
saliva or gastric contents.
Bronchiolitis, Bronchitis, asthma,
cystic fibrosis, Whooping cough
Recurrent bronchitis, Allergic
bronchitis, Asthma, Foreign body,
Chronic suppuration, Lung disease,
Pulmonary eosinophilia
Asthma, whooping cough, Viral
bronchitis, tuberculosis, Foreign
body aspiration

INVESTIGATIONS
Laboratory investigations help the pediatrician to
confirm the diagnosis. Though mainly the diagnosis is
based on the clinical signs and symptoms for the
confirmation Laboratory investigations are helpful.
1. Routine blood investigations like TLC, DLC, Hb%, ESR helps to
rule out anaemia, esinophilia, etc.
2. Serological examination, immunoglobulin can be measured in
suspected case of immunodeficiency.
3. Sputum, nasal and throat secretions can be cultured to detect
bacterial growth and antibiotic sensitivity pattern.
4. Pulmonary function tests (PFTs), Spirometry is the most
important test of lung mechanics.
5. Chest Radiograph may help to indicate the presence and extent
of inflammation.
6. Procedures like Transillumination, Bronchoscopy, laryngoscopy
and polygraphic monitoring may be used to inspect the interior
of bronchi and larynx.

68
 TREATMENT
Treatment of cough mainly consists of treating the
underlying cause. A productive cough serves to drain the
airway. Its suppression is not desirable, may even be
harmful except if the amount of expectoration achieved is
small compared to the effort of continuous coughing. Non
productive cough should be suppressed.
Apart from specific remedies (antibiotics etc), cough
may be treated as a symptom (non specific therapy) with,
 Pharyngeal demulcents
 Expectorants
 Antitussives
 Antihistamines
 Bronchodilators
Pharyngeal demulcents
Pharyngeal demulcents soothens the throat and
reduce afferent impulses from the inflamed/irritated
pharyngeal mucosa thus provide symptomatic relief in dry
cough arising from throat.
E.g.: Lozenges, cough drops, linctuses containing
syrup, Glycerine, Liquorice.
Expectorants (Mucokinetics)
These are the drugs which increase bronchial secretion or
reduce its viscosity, facilitating its removal by coughing. They are
believed to loosen cough that becomes less tiring and more
productive. There are different varieties of expectorants namely,
1. Directly acting: Sodium and Potassium citrate or acetate,
Potassium iodide, Guaiacol, Guaiphenesin, Vasaka, Terpin
hydrate.
2. Reflexly acting: Ammonium chloride or carbonate, Potassium
iodide, Ipecacuanha (Ipecac).
3. Mucolytics: Bromhexine, Acetyl cysteine, Carbocisteine.
Antitussives:

69
 These are cough center suppressants. They act in
the CNS to raise the threshold of cough center or act
peripherally in the respiratory tract to reduce tussal
impulses, or both these actions. It should be used only for
dry unproductive cough or if cough is unduly tiring
disturbs sleep or is hazardous (hernia, piles, cardiac
disease, ocular surgery).
The antitussives are of two types,
 Centrally acting
 Peripherally acting

Centrally acting antitussives

Centrally acting Antitussives inhibits or suppress
the cough reflex by depressing the medullary cough centre
or associated higher centers. E.g.Dextromethorphan and
codeine.

Peripherally acting Antitussives:

Peripherally acting Antitussives may act on either
the afferent or the efferent side of the cough reflex.
On the afferent side, an antitussive may reduce the
input of stimuli by acting as mild analgesic or anaesthetic
on the respiratory mucous, by modifying the output and
viscosity of the respiratory tract fluid or by relaxing the
smooth muscle of the bronchi in the presence of
bronchospasm.
On the efferent side, an antitussive may make
secretion easier to cough up by increasing the efficiency of
the cough mechanism.
Eg.Benzocaine,hexylcaine hydrochloride, Lidocaine,
Humidifying, aerosols and steam inhalation.
Antihistamines:

70
 Antihistamines afford relief in cough due to their sedative
and anticholinergic actions but lack selective action for the
cough center. They have no expectorant action may even
reduce secretions by anticholinergic action. They have
been specially promoted for cough in respiratory allergic
states.Eg:Chlorpheniramine, Diphenhydramine and
Prometnazine.
Bronchodilators:
Bronchospasm can induce or aggravate the cough.
Bronchodilators cause an increase in calibre of bronchus
or bronchial tube, so that the effectiveness of cough in
clearing secretions by increasing superficial velocity of
cough. They should be used only when an element of
bronchoconstriction is present and not routinely.

COMPLICATION OF COUGH
Though cough is an effective defence mechanism it can cause
many complications in both adults and children. Prolonged
coughing can reduce venous blood flow thus cerebral deoxygenation
and results in syncope. So complications may be related to
Cardiovascular, Central nervous, Gastrointestinal, Respiratory or
Musculo skeletal system.
The most common complications of cough are:
 Excessive perspiration
 Exhaustion from prolonged coughing
 Hoarseness
 Insomnia
 Life-style change imposed by coughing
 Musculoskeletal pain from prolonged severe coughing
 Semi-consciousness due to prolonged coughing
 Urinary incontinence

71
 Subconjunctival haemorrhage in eyes or such haemorrhages in
brain.

72
 DRUG REVIEW

Medicines are equivalent to Nectar. Drugs play a

very significant and prominent role in the clinical study.

Applicability, richness of quality, abundance and

utility in multipurpose are said to be the best qualities of a
drug. Therefore the drug is kept in second position among
the padachatustaya because of its great role in treatment.

W. H. O. also stresses the importance of drug and

defines it as “a substance or product that is used or
intended to be used to modify or explore physiological
system or pathological status for the benefit of the
recipient.”

According to Ayurveda, there is nothing in the world

which is not having medicinal value but its beneficial or
harmful utilization depends upon the skill of the
physician. So selection and rationality are the two
parameters to judge and use any substance as medicines.

Ayurvedic literature speaks, drug or diet article that

reverses or breaks the samprapti is ideal. It is often the
total effect of all the ingredients in the formula rather than
the action of individual drugs that plays a vital role in
therapeutics. Drug combinations are envisaged to severe
synergistic action, combined action and toxicity
neutralizing action and specific function. So looking to the
urgent need of finding a suitable remedy for Kasa it is
proposed to study the effect of certain indigenous drug
compound from Ayurvedic wealth. It is composed of
following Drugs.

73
74
1) KANTAKARI:

Figure : Kantakari plant photo

Latin Name -Solanum xanthocarpum Sch. & Wendl.

Family – Solanaceae
Synonyms – Duhsparsha, Kshudra,
Vyaghri,Nidigdhika, etc.
Vernacular Names –
Gujarati - Bhoya Ringani
Hindi - Bhatkataiya, Chhoti Kateri
English - Yellow berried nightshade or Wild egg plant
Marathi – Bhuiringani
Classification –
Cha.Sa.-Kasahara,Kanthya,Shothahara,Hikkanigrahana,
Shitaprashamana
Su.Sa. - Brihatyadi, Virtarvadi, Laghupachumula
Officinal Part – Panchanga
Gunakarma –
Rasa - Tikta, Katu
Guna - Laghu, Ruksha, Tikshna
Virya - Ushna
Vipaka – Katu
Doshaghnata -Kapha-Vatahara
Karma - Kashghna, Shwasaghna, Pachana,
Javaraghna, Pinasahara, Krimihara,
Kapha-Nihsaraka
Upayoga - Shwasa, Kasa, Jvara, Pinasa,
Parshvapida, Hridamaya

75
Chemical constituents: Solacarpidine, Potassium nitrate,
PotassiumChloride.
Therapeutic use: Inflammation, Dyspepsia, Anorexia, Fever,
CoughAsthma, Bronchitis, Pharyngitis, Hiccough, Catarrh and
Cardiac disorders.
Properties/Action:Antihistaminic, Thermogenic, Anti
inflammatory,Digestive, Carminative, Stomachic, Expectorant.

2) PIPPALI:-

Figure :Pippali

Botanical Name : Piper Longum

Family Name : Piperaceae
Common Name : Long Papper, Pipli
Part Used : Fruit, Root, Stem
Habitat : Most deciduus to evergreen forests
Product offered : Seeds, Roots, Fruit, Stem
Bio energetics:
Rasa - Katu
Guna - Laghu ,Snigdha ,Teekshna
Veerya - Anushnasheeta
Vipaka- Madhur
Effect on Tridosha (Three bio humors):-
Pippali pacifies Kapha and Vata Doshas i.e. useful in
management of diseases having their origin in aggravated
Kapha/ Vata or Both.

76
Qualities:- laghu, snigda, tiksna.
Bio chemistry of Pippali:
Pippali contains less essential oil than its relatives (about 1%),
which consists of sesquiterpene hydrocarbons and ethers
(bisabolene, β-caryophyllene, β-caryophyllene oxide, each 10
to 20%; α-zingiberene, 5%), and, surprisingly, saturated
aliphatic hydrocarbons: 18% pentadecane, 7% tridecane, 6%
heptadecane.
ActivePrinciple:
Pepper contains volatile oil, the crystalline alkaloids:
piperine, piperidine and piperettine, and a resin. Long
pepper contains the alkaloid piperine (about 6%), which is
slightly higher than that in black pepper.
Actiona according to Ayurveda:
Shwas-kasahara- Pippali is useful in respiratory discomfort
(including asthmatic condition) and cough, Hikkanighrana,
Shirovirechana, Vamana, Triptighna, Deepana,
Shoolaprashamana,Vrishya,Rasayana, Kushthahara,
Pramehahara, Meda vinashini, Krimiroganut, Pleehaghna.
Medicinal value:
Primarily used for cold, wet and ‘mucusy’ conditions of
the lungs. Pippali encourages vasodilation and therefore
increases circulation, specifically to the lungs. Used with
honey in asthma, bronchitis, pneumonia and compromised
immunity in the respiratory system.
Clinical studies show that that piperine increases the
absorption of curcumin in Turmeric root .Its anthelmintic
qualities are used as part of a formula to kill worms,
amoebas and parasites. It helps to treat diarrhoea from cold
symptoms and constipation.Pippali has a hepatoprotective
effect that may benefit fibrosis.
Expectorant, bronchodilator, respiratory stimulant,
respiratory tonic, kaapha vata pitta samaka digestive,

77
 carminative, mild diuretic, antihelmintic, alterative.
Uses: obesity, bronchitis, chronic cold, cough, congestion,
chronic asthma, juvenile asthma, v, k type bronchial
asthma, cough, chronic bronchitis, chest affections, asthma.
Active-substances-: piperine
Useful parts:-Fruits, root
Some useful combinations
of Pippali:Guda pippali, Pippali khanda,
Pippalyaasava,Vardhamana pippali,Causasti
pippali,Sitopaladi curna

3) MUSTAKA

Figure : Musta

Latin name :Cyprus rotondus Linn.

Family : Cyperaceae
Gunkarma:-
Rasa :Tikta, Katu, Kashaya
Guna :Laghu, Ruksha
Virya :Shita
Vipaka :Katu
Doshakarmata :Kapha Pitta Shamak
Karma :Deepana, Pachana, Sangrahaka
Rogaghnata :Trishana, Jwara, Aruchi, Atisara
Chemical constituent : 0.5-0.9% of essentail oils like amphene,
limonene,cyperol, rotundone, cyperene, patchoulenone &

78
 triterpenes like B-sitosterol,oleanolic ,glycerol, linolenic, linoleic,
oleic, myristic and possibly stearic acids. The oil contains 2.7%
characteristics of a neutral waxy substance.
Therapeutic use : Colds, flu, malabsorption, fever, indigestion,
colic,diarrhea, dysentery etc.
Properties / Action : Antihelmintic, antiinflammatory,
carminative,stomachic, diuretic, emmenagogue and stimulant
properties.

4) BHARANGI :

Figure : BHARANGI

Latin Name -Clerodendrum Serratum Linn.

Family – Verbenaceae
Synonyms - Angarvalli, Bhargavi, Bhargi,
Bramhani,Padma,Bhrigubhava,Bramhanayashtika
Vernacular Names –
Gujarati - Bharang
Hindi – Bharangi
Classification –
Su.Sa. - Pipplyadi
Bha. Pra. – Haritakyadi
Botanical Description :
Perennial herbs or shrubs, 0.9-2.4 m high leaves
sessile or nearlyso, opposite or sometimes ternate, passing
upwards into bracts, narrowlyabovate - oblong or sub-

79
 elliptic, acute or acuminate, usually coarsely andsharply
serrate. Flowers many, blue purple or white, arranged in
dichotomous cymes, the whole forming a lax, sub pyramidal
panicle. Drupes 6 mm long, broadly obovoid, rather
succulent, dark purple when ripe.
Distribution :
More or less throughout India, in forests upto 1500 m
altitude.
Reported to be rare and in endangered in Gujarat.
Officinal Part - Stem bark, Root
Gunakarma –
Rasa - Katu, Tikta
Guna - Laghu, Ruksha
Virya - Ushna
Vipaka - Katu
Doshaghnata - Kapha-Vataghna
Parts used - Root, Leaf
Actions and Uses :
The roots are bitter, acrid, thermogenic, anti-
inflammatory,digestive carminative, stomachic, anthelmintic,
depurative, expectorant,sudorific, antispasmodic, stimulant
and febrifuge and are useful in inflammations, dyspepsia,
anorexia, colic, flatulence, helminthiasis,cough, asthma,
bronchitis, hic-cough, tumours, tubercular glands, dropsy,
consumption, chronic inflammation of the nose, skin
diseases,leucoderma, leprosy and fever. Leaves are useful as
an external application for cephalagia and opthalmia. The
root increases appetite, lessens expectoration. Seeds bruised
and boiled in buttermilk are used as aperients and in
dropsy.
Rogaghnata :Kasa,Shwasa,Gandamala, Vrana, Visarpa, Aruchi,
Agnimandya, Gulma, Raktavikara,Shotha, Rajakshma,
Pratishyaya, Nashtartava, Jvara.

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Karma :Kasaha,kaphagna Shwasahara, Jvaraghna,
Svedajanana.Shothahara, Vranapachana, Deepana,
Pachana, Anulomana,Raktashodhaka.
Chemical Constituents :Serratagenic acid, queretaroic acid,
some phytosterols, saponins,two iridiod glycosides, feralic
acid, arabinose, scutellarein, baicalein aresome important
chemical constituents reported.Alcoholic extract and
Saponin isolated from root bark caused release of histamine
from lung tissue (J. Pharm. Pharmacol. 1968) Glucose and
D-(-) mannitol from root bark, Hydrolisis of crude saponin
from bark yielded oleanolic acid, queretaroic acid and
serratagenic acid (Tetrahedron 1969,25,370).
New Compound :HOOCCOOHHO Serratagenic Acid Saponins
caused disruption of mast cells of rat mesentery, which was
proportional to dose upto 40 g and maximum disruption
effect was exerted in 30 min (Indian J. Med. Sci. 1971,
25,29).
Pharmacological Activities :Spermicidal, CNS depressant,
antihistaminic, hypotensive, bronchoconstrictor, antiallergic,
antiasthmatic, antibiotic, antifertility, stomachic.
Substitutes and Adulterants :Clerodendrum serratum and C.
indicum (L) Kuntze both are used as Bharangi. C. indicum is
known in Bengal as Bamanhatti and in Telgu it is known as
Bharangi. The bark of Garderia turgida Raxb.is reported to
be sold as Bharangi bark.Picrasma quassioides Benn. is
used as Bharangi in Bengal. Bharangi root is sometimes
substituted by Ringani Root (Solanum surattense Burmf).

5) KARKATSHRINGI

81
 Figure :Karkatshringi plant

Latin name :Pisticia intgerrima Stewart.

Family : Anacardiaceae

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 Gunkarma:-
Rasa :Kashaya, Tikta
Guna :Laghu, Ruksha
Virya :Ushna
Vipaka :Katu
Doshakarmata :Vata Kapha Shamak
Rogaghnata :Kasa, Kshaya, Jwara, Swasa, Trishna, Aruchi,Hikka
Chemical constituents: Tannins (20-75%), an essential oil, and a
resin(5%), two isomeric triterpenic acids designated pistacienoic
acid A and pistacienoic acid B, a triterpene alcohol probably
tirucallol, ß- sitosterol and a waxy compound. The two
triterpenic acids are ketocarboxylic and appear to be identical
with the α - and ß- acids.
Therapeutic use : Imflammation, cough, asthma, indigestion,
fever,general body weakness, loss of appetite, nose bleeding,
snake bites & scorpion stings.
Properties / Action : Antiimflammatory, carminative,
expectorant,antispasmodic, weak antibacterial, antiprotozoal,
CNS depressant activity.

6) SHATI

Figure : Shati
Latin Name : Hedychium Spicatum
Hamilt.ex.Smith
Family : Zingiberaceae

83
 Vernacular names :
English -Spiked ginger lily.
Hindi -Kapurkachari
Kannada -Gandhasati,Kachora.
Telugu -Gandha Kachuralu
Synonymn :Palasi,Gandhamoolika.
Gunkarama
Rasa :Katu, Tiktha, Kashaya.
Guna : Laghu, Tikshna
Veerya : Ushna
Vipaka : Katu
Doshagnatha : Kapha vata hara
Rogagnatha : Kasa, Swasa, Shula, Hikka.
Pryojya Anga : Rhizome (Kanda)
Chemical composition:Hedychenone, 7-
hydroxyhedychenone.
Research: - Crude power of Shati showed good eosinopenic,
antitussive and cough sedative property (Medicine and surgery
September, 1974- P.V Tewari et. al)

7) GUDA (JAGGERY) :

Figure : Guda

Jaggery is a dark, course, unrefined sugar, sometimes

referred toas "palm sugar:" It can be made either from the

84
 sap of various palm trees or from sugar-cane juice. It is
primarily used in India, where many categorize sugar made
from sugar-cane as jaggery and that processed from palm
trees as "gur". Jaggery has a sweet, wine-like fragrance
andflavor that lends distinction to whatever food it
embellishes.
a. Ayurvedic Review :
Sweetening substances used in the Ayurvedic
formulations for thepurpose to increase it’s palatability, for
preservation and also to have,tonic effect. They are
responsible for the generation of alcohol in Asavarishtas and
serve as base in Avaleha Kalpana. Besides this, sweetening
substances, which are important ingredients of Asavarishta,
have unavoidable role in the process of fermentation. In our
Ayurvedic formulation, various sweetening agentsused are
Guda, Sita, Sharkara etc. Among these Guda (Jaggery), Sita
(Purified sugar candy), Sharkara (sugar) are very commonly
used the preparation of different Kalpanas i.e. Avaleha,
Gutika, Asava-Arishta, Sharkara, Panaka, etc. But in Asava-
Arishta, percentage of Jaggery (Guda) found is more in
comparison to others.
Jaggery is explained under the heading of “Ikshuvarga”
in all
Samhitas and Nighantus. It is prepared by the juice of
sugarcane.
When sugarcane juice is heated upto thick and
somewhat hard then it is termed as Guda.
According to Cha.Su. 27/239 –
Before formation of Jaggery, the sugarcane juice
undergoes four stages i.e.
(i) Chaturbhagavasheshita - 1/4th remain
(ii) Tribhagavasheshita - 1/3rd remain
(iii) Ardhabhagavasheshita - ½ remain

85
 All these three varieties are called “Kshudraguda” and they are light for
digestion in their ascending order.
(iv) Dhauta Guda : The finally formed Guda will be clean and of
goodquality, it is called as Dhauta Guda and used for medicinal
purpose as well as dietetic purpose.

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Vernacular Names :
Gugrati - Gola
Hindi - Guda
English - Treacle/Jaggery
Marathi - Gula
Gunakarma :
Rasa - Madhura
Guna - Natishita, Snigdha
Virya - Ushna
Vipaka - Madhura
Doshaghnata – Tridoshashamaka (with different Anupana)
Properties :Deepana, Pachana, Anulomana, Vrishya, Hridya,
Mutra- Raktashodhaka, Increase Medodhatu, Kapha and
Krimi, Pittaghna,Vatashamaka and its efficacy is considered
to increase after one year (Su. Su.45/160-161).

Properties of Navaguda (New Jaggery) :

Newly prepared jaggery is Kapha, Shwasa-Kasakrita,
Krimikaraand Agnideepaka.
Properties of Purana Guda (Old Jaggery) :
It is Laghu, Pathya, Anabhishyandi, Agnivardhaka,
Vata Pittaghna,Madhura, Vrishya, Raktaprasadana.Guda
with different Anupana having Trisodhashashamaka
activity.With Ardraka – Kaphaghna Haritaki –
Pittaghna,Sunthi - Vatghna
b. Modern Review :
Jaggery is nutritious. It improves digestion, prevents
fatigue,purifies blood and provides strength to the
muscles.Jaggery is rich in minerals, iron and instant
glucose. It is not onlyeasily digestible but has various
minerals and vitamins in right proportion,which is extremely
useful for our body.Jaggery and sugar not only differ in their
composition but also in their effect on the human

87
 metabolism.Carbohydrate, which is prominently present in
sugar, need B-vitamins for their proper utilization by the
body and the nature has so arranged it that, in their natural
states, both cereals and natural sugar items (like, cane-juice,
fruits, nuts etc.), and also protein foods, have more than
enough of the B-vitamins needed for the assimilation of all
the carbohydrate present. If excess of refined sugar is eaten,
it is likely to lead to some degree of B-vitamin deficiency.
Symptoms of B-vitamin deficiency include irritability,
nervous exhaustion, sleeplessness, heart trouble, digestive
disorders and mental trouble.On the other hand, one
hundred gm. of jaggery provides 200 calories and so requires
about 0.1 mg of vitamin B and, it contributes many times
this amount itself.
NUTRIENT CONTENT OF JAGGERY (PER 100 GMS.)
 Moisture 3.80 gm  Iron 11.4 mg
 Protein 0.40 gm  Total Minerals 0.60 gm
 Fat 0.10 gm  Carotine 168 mcg
 Carbohydrate 95.00 gm  Thiamine 0.02 mg
 Energy 183 k. cals  Riboflavin 0.05 mg
 Calcium 80.20 mg  Vitamin C 0.50 mg
 Phosphorous 40.20 mg
Pharmacological Characters of Guda :
A work was carried out regarding the identification of
fermentingorganism in Asava - Arishtas. The organism was isolated
from jaggery.According to this study Bacillus Sp. was present in both
the new and old jaggery. Among the Bacillus Sp. B. acetoethylicus
and B. Polymyxa are reported to bring about alcohol production
(Prescott and Runn, 1959). Old and new jaggery yield almost equal
percentage of alcohol.

8) TILA TAILA

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Latin Name :Sesamum indicum
Natural Order :Pedaliceae
Classical Name :Tila
Parts Used :Root, leaf, seed, oil
Ayurvedic Properties :
Rasa :Madhura, Katu, Tikta, Kashaya
Guna :Guru, Snigdha
Virya :Ushna
Vipaka :Madhura
Doshaghnata :Vatashamaka, Kapha-pittashamaka,
Rogaghnata :Vatashula, Amavata, Indralupta, Vrana.
Karma :Snehana, Sandhaniya, Vranashodhana, Vranaropana,
Keshya,Medhya, rasayana, Shulaprashamana, Balya, Vrishya.
Actions &Uses :
The seeds are astringent, emollient, demulcent, aphrodisiac,
laxative, useful in haemorrhoids, ulces, buns, dysentery,
diarrhea, polyuria,amenorrhea, baldness, strangury,
dermatopathy, migraine, alopecia and obesity. The oil is bitter,
astringent and emollient.
Chemical Constituents :
Neutral lipids, glycolipids and phospholipids, arginine,
cystine,histidin, isoleucine, leucine, lysine, methionine,
threonine, tryptophan,tyrosine, ualine, α &β-globuline, folic
acid.
Pharmacological Activities :Cholesterolemic, antioxidant.

89
 MATERIALS & METHODS

The present clinical study entitled “To study the efficacy of

Dusparshadi Leha on Kasa in Children (Age 1 to 5 years)” was
carried out with the following objectives.

OBJECTIVES OF THE STUDY

1. Detail literary study of kasa.
2. To study the individual contents of ‘DUSPARSHADI LEHA’ and the
formulation as whole.
3. Possible mode of action of ‘DUSPARSHADI LEHA’ on Kasa.

TYPE OF STUDY
Open study
STATISTICAL ANALYSIS
The collected data analyzed using paired ‘t’ test.

Table No. A-1 :INGREDIENTS OF “DUSPARSHADI LEHA”

The contents of Dusparshadi Leha are ,

duspaSaa_ ipappalaI maustaaM BaagaI_ kxk_xTkxI

SaTIma\ || 14 ||
pauraNagauDtaOlaaByaaM cauiNa_taanyavalaohyaota\ |
(A.=. ica. 3/15), (ca. ica. 18/51)
Sr. No. Sanskrit Name Latin Name
1 Dusparsha (Kanthkari) Solanum Xanthocarpus
2 Pippali Piper Longum
3 Musta Cyperus Rotundus
4 Bharangi Clerodendeun Serratum
5 Karkataki Pistacia Integermina
6 Shati Hedychium Spicatium
7 Guda Saccharum officinarum L.

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 8 Til Taila Sesamum indicum L.
METHOD OF PREPARATION
Drug:-
DUSPARSHAYADI LEHA:-
 Method of Preperation of drug:-
Kanthkari, Pippali, Musta, Bharangi, Karkataki& Shati
authentified drug will be taken in equal quantity for the preparation
of Churna, along with in equal quantity of guda and double
quantity of Til Taila by mixing them in Leha form which be given to
the patient at the time of drug administration.
Table No. A-2 :DOSE
Drug 1 Year 2 Year 3 Year 4Year 5 Year
Churna 1.5 gm. 3 gm. 4.5 gm. 6 gm. 7.5 gm.
Guda 1.5 gm. 3 gm. 4.5 gm. 6 gm. 7.5 gm.

Til Taila 3 ml. 6 ml. 9 ml. 12 ml. 15 ml.

Saa.saM.pauva_ KaMD 8/48-51.

TIME :- Every 6 hours
SOURCE OF DATA
15 patients with complaints of Kasa with many associated
symptoms as explained in classics under Kasa Rogadhyaya were
selected randomly from Kaumarbhritya O.P.D of B.V.U Ayurvedic
Hospital Pune.
METHOD OF COLLECTION OF DATA
Patients who fulfilled the diagnosis and inclusion criteria were
selected for the study. Selected children were thoroughly examined;
both objective and subjective manifestations were recorded.
INFORMED CONSENT FROM PARENTS
The present study includes a sample size of 20 children in and
around Pune. All of them and their guardian were made to
understand about the study and the informed consent was obtained.

91
Only after getting the informed consent, they were included in the
study.
INCLUSION CRITERIA
1) Patient with kasa as major symptom with a history of not more
than 3 days.
2) Patient Age group : 1 year to 5 years.
3) Patient with weight between : 10 th to 90th percentile for that specific
age.
4) Patient with vataja, pittaj, kaphaj, kasa lakshana.
5) Patient with mild to moderate respiratory track infection.

EXCLUSION CRITERIA
1) Patients with chronic debilitating disease or disorder.
2) Patients on any other medication.
3) Kasa not of respiratory origin.
4) Patient with kshataj, kshayaj, kasa lakshan.

COLLECTION AND ANALYSIS OF DATA

Initially the vital data like name, age, sex, religion, occupation,
habitat, diet, socio economic status, type of family was recorded.
Education of the father and mother as well as their occupation was
also noted down.
While taking the history of present illness (nidan panchak),
every patient was enquired for various etiological factors described for
vataj, pittaj and kaphaj Kasa.
All the patients were enquired for the presence of symptoms of
Poorva roopa mentioned for Kasa like, Kanta kandu, Shookapoorna
galaasyata etc. An effort was made to evaluate the status of
Lakshanas of different type kasa with the help of performed table
before and after the treatment.The mode of onset of Kasa, duration,
frequency, occasional variation in the pattern and periodicity was
noted down.With the help of relevant history, the time of occurrence of
Kasa, nature of cough were recorded before and after the treatment.

92
Under rogi pareeksha relevant data such as kula vrittanta, jatamatra
vrittanta were noted.
Samhanana, Satwa, Sara, Agni, Bala, Deha bala, Ahara shakti
and Koshta of the patients were ascertained and recorded in the
Performa.Pramana of the patients like height and weight were
recorded by using necessary instruments.
Under Vikruti pareeksha, effort was made to evaluate the
Doshas with the help of Ashtavidha pareeksha. Using a thermometer,
the temperature of the patients was noted before and after the
treatment.
All the Srotas were examined using available Ayurvedic and
modern Para meters before and after the treatment.
Under Sthanika pareeksha, Shira, Greeva, Koshta, Hasta and
Pada were examined mainly to observe for enlargement of lymph
nodes before and after the treatment.
Detailed evaluation of Respiratory system was made to diagnose
the disease and to know the severity of the disease to assess the
improvement in the condition of the patient before and after
treatment.
Under Inspection, the shape of the chest was noted for its
symmetry. Type of breathing, respiratory rate, respiratory rhythm and
movement of chest were recorded to know the severity of the disease
as well as to exclude the underlying diseases such as Pneumonia,
Pleural effusion etc.
Palpation was done to confirm the centralization or deviation of
Trachea, symmetrical movement of chest wall.
On percussion, it was examined to note the abnormalities like
resonant, hyper resonant, dull or stony dull areas over the chest wall
to evaluate the other under lying signs.
Type of breath sounds was recorded on auscultation. It was also
noted for the presence of added sounds like wheeze or crepitations.
The diagnosis of kasa was made on the presence of two or more
lakshanas mentioned under specific variety of Kasa.

93
94
ASSESSMENT CRITERIA
1. Assessment was made by observing the improvements in the
clinical features based on the gradation before and after the
treatment.
2. Assessment was made on the following schedule
a. 1st assessment on the registration day.
b. 2nd assessment on 3rdday,3rd assessment on 5th day, and
finally 4th assessment on the last day of treatment i.e. on 7 th
day.
3. Patients were assessed the following parameters and the sign
and symptoms were graded from 0 to 3 by the patients/Relative
and examination done onMODIFIED VISUAL ANALOG SCALE.

GRADATION OF CLINICAL FEATURES:-

1) KASA VEGA:- For simple Kasa vega of cough was noted in each
patient and graded as follows;
Grade 3-Severe Kasa Vega 15-20 times in Days
Grade 2-moderate Kasa Vaga 10-15 times in Day
Grade 1-mild Kasa Vega 5-10 times in Day
Grade 0-No Kasa Vega
2) KAPHA NISHTEEVANA- For Kapha Nishteevana was noted in
each patient and graded as follows;
Grade 3-Severe Kapha nishteevana
Grade 2-moderate Kapha nishteevana
Grade 1-mild Kapha nishteevana
Grade 0-No Kapha nishteevana
3) KAPHAPURNA VAKSHATA- For Kaphapurna vakshata was
noted in each patient and graded as follows;
Grade 3-Severe Kaphapurna vakshata
Grade 2-moderate Kaphapurna vakshata
Grade 1-mild Kaphapurna vakshata
Grade 0-No Kaphapurna vakshata

95
 4) JWAR:-The Temp measured on thermometer and graded as
follows.
Grade 3- Temp above 102 degree
Grade 2-Temp in bet 100.4degree to 102degree
Grade 1-Temp in bet 99 degree to 100.4degree
Grade 0- Temp in bet 99 degree & below.
5) SHOOL:- Shool is noted and graded as below
Grade 3-severe Shool
Grade 2-moderate Shool
Grade 1-mild Shool
Grade 0-No Shool
6) KANTHOPALEPA:- Throat pain noted and graded as below
Grade 3- severe Throat pain
Grade 2- moderate Throat pain
Grade 1- mild Throat pain
Grade 0- No Throat pain.
7) SWARBHEDA:- Throat congestion is noted and graded as below
Grade 3-severe Throat congestion
Grade 2-moderate Throat congestion
Grade 1-mild Throat congestion
Grade 0-Normal Throat.
8) PRATISHAY (Post Nasal Discharge):-
Grade 3-severe cold
Grade 2-moderate cold
Grade 1-mild Cold
Grade 0-No cold (Cold =Running nose or nasalcongestion)
OVERALL ASSESSMENT:
The overall assessment of the patient was made based on the
following criteria.
Absence of signs & symptoms Cured
Reduction in the signs & symptoms Improved
No change in signs & symptoms No Improvement

96
 OBSERVATIONS & STATISTICAL ANALYSIS

In this chapter the analysis of observations of clinical study are

done by using the appropriate statistical data.
GENERAL DISTRIBUTION OF THE STUDY GROUP
Fifty children suffering from Kasa were selected for the clinical
trial, by considering the inclusion and exclusion criteria. These
children were taken in a single group. Five children were not included
in the study because of their discontinuation of the treatment in the
middle. Thus the complete clinical trial was completed on Fifty
children diagnosed of Kasa.
The observations made were graded and tabulated as follows.
Table No. B-1 Age distribution of the study group
Age distribution
Age No. of children
1 Years 2
2 Year 2
3 Years 6
4 Years 2
5 Years 3

Age (years)
6
6

4
Number of patients

3
3 No. of children
2 2 2
2

0
1 Years 2 year 3 Years 4 Years 5 Years
Age

Among 15 children 2were of the age group 1 years, 2 were of the age
group of 2 years,6 were of the age group 3 year,2 were of the age
group of 4 year and 3 children were of the age group of 5 years. Kasa
is common in all age group children.

97
Table No. B-2 :GENDER WISE DISTRIBUTION OF PATIENTS.

Number Gender
Gende Percentage
of
r (%)
patients

Male 7 46.7
Male
47% Female
53%
Female 8 53.3

Total 15 100.0

Out of 15 children, 7 were male i.e 46.7% male and 8 were female
i.e53.3% female as shown in Table.

Table No. B-3 :DISTRIBUTION OF PATIENTS WITH RESPECT TO

SOCIO ECONOMIC CLASSIFICATION.

Socio SocioNumber
economic class Percentage
economic of
(%)
class patients
7%

Lower 7 46.7
Lowe
Middle
Middle 47%7 46.7
Upper
47%
Upper 1 6.7

Total 15 100.0

Children were divided in to 3 categories on the basis of their

socio-economic status. Out of 15 children almost equal number of
children belongs to i.e. 7 were from middle class (46.7%) and 7 were
from lower class i.e. 46.7 % and only 1 children i.e.6.7 % were from
upper class.

98
Table No. B-4 :DISTRIBUTION OF PATIENTS WITH RESPECT TO
LOCATION.

Number Location
Percentage
Location of
(%)
patients
7%
Rural 7 46.7
Semi
7 46.7 47%
urban Rural Semi Urban Urban
47%
Urban 1 6.7

Total 15 100.0

Children were divided in to 3 categories on the basis of their habitat.

Out of 15 children 7 (46.7%) were from rural area 7(46.7%) children
were from semi-urban area and 1(6.7%) were from urban area.

Table No. B-5 :DISTRIBUTION OF PATIENTS WITH RESPECT TO

DIET.

Number
Diet
Percentage
Diet of
(%)
7%
patients

Mixed 14 93.3
Mixed
Vegetarian

Vegetarian 1 6.7

Total 93% 15 100.0

Children were divided in to 2 categories on the basis of their

respectively Diet status. Out of 15 children almost equal number of
children belongs to i.e. 14 were from Mixed Diet (93.3%) and 1 were
from Veg Diet i.e. 6.7 % in this study

99
Table No. B-6 :DISTRIBUTION OF PATIENTS WITH RESPECT TO

NumberPrakruti Percentage
Prakruti of
(%)
patients
Vataprad
13%
han 9 60.0
kapha
Kaphapra Vatapradhan kapha Kaphapradhan vata
dhan 4 26.7
27%
vata
60% Pittapradhan kapha
Pittaprad
han 2 13.3
kapha

Total 15 100.0

It was seen that out of children, 9 children (60%) belonged to

Vatapradhan kapha prakruti. 4 (26.7%) children belonged to
Kaphapradhan vata prakruti and 4 (13.3%) children were belonged to
Pittapradhan kapha prakruti.

Table No. B-7 :DISTRIBUTION OF PATIENTS WITH RESPECT TO

IMMUNIZATION.
Number
Immunization of
Percentage( Immunization
%)
patients
No
immunization
1 6.7 13% 7% No immuniza-
tion
Partially
12 80.0 Partially im-
immunization
munization
Complete
2 13.3
immunization 80% Complete
immunization
Total 15 100.0

Immunization status of 15 children of study group showed that

2(13.3%) children were completely immunized, 12(80%) children were
partially immunized and 1 (6.7%) children were no immunized in the
study.

100
Table No. B-8 :DISTUBUTION OF PATIENTS FOUND ACCORDING
TO TYPES OF KASA.
No of patients Cured and Improved:-

1) Bhed
Kaphaja kasa 4
Pittaja kasa 2
Vataja kasa 9

No of Improved
Cured Cure rate Improved
patients rate
Vataj Kasa 7 77.78 2 22.22
Pittaj Kasa 0 00.00 2 100.0
Kaphaj Kasa 2 50.0 2 50.0

Bhed
7
7

5
Number of patients

Cured
4 Improved
3
2 2 2 2
2

1
0
0
Vataj Kasa Pittaj Kasa Kaphaj Kasa

It was seen that out of 15 children, 9 children belonged to Vataj kasa

in that 7 were cure & 2 were improved. 4 children belonged to Kaphaj
Kasa in that 2 were cure & 2 were improved and 2 children were
belonged to Pittaj kasa in that 2 were improved.

101
Table No. B-9 :DISTRIBUTION OF AHARA SAMBANDHI NIDANA IN
THE STUDY GROUP
Ahara sambandhi nidana in the children
Ahara sambandhi nidana No. of children Percentage
Ruksha ahara 9 60.00
Sheeta ahara 8 53.33
Guru ahara 5 33.33
Madura ahara 7 46.67
Katu-Amala ahara 6 40.00
Tila,Lashuna,Kulatha ahara 2 13.33
Ati Ushna 3 20.00
Abhishyandi ahara 11 73.33
Asatmya ahara 8 53.33
Vidhahi ahara 4 26.67

No. of children
12
10
8
6
4
Number of patients

2
0
a
ara
ara
ara

ara
ara

ara
hn
ara

ara
ara
ah

Us
ah
ah

ah
ah

ah
ah

ah
ah
ru

Ati
ta
a

ra

hi
ya
la

di
ksh

ee

ha
Gu

du

tha

atm
ma

an
Sh

Vid
Ru

Ma

hy
ula
A

As
tu-

his
a,K
Ka

Ab
un
ash
a,L
Til

Aahar

While considering Ahara sambandhi nidana for the disease of

kasa, it was found that in maximum number of children 11(73.33%)
Abhishyandi ahara & 9 (60%)Ruksha ahara were found to be the
cause. Sheeta ahara&Asatmya ahara was found as the cause in 8
(53.33%) children, Guru ahara were found in 5 (33.33%) and Madhura
ahara as Nidana were found in 7 (46.67%) children where as Katu-
Amala sevana in 6 (40%), Vidhahi ahar in 4 (26.67%),Ati ushana in
3(20%) and Tila-Lashuna,kulatha ahara in 02 (13.33%) children
respectively.While Considering all Ahar sambandhi nidan factors
responsible in the manifestation of Vataj Kasa , Kaphaj Kasa & Pittaj
Kasa bhad.

102
Table No. B-10 :DISTRIBUTION OF VIHARA SAMBANDHI NIDANA
IN THE STUDY GROUP
Vihara sambandhi nidana in the children
Vihara sambandhi
No. of children Percentage
nidana
Divaswapana 12 80.00
Vega Udeerana 8 53.33
Dhoomopaghata 3 20.00
Sheeta vihara 3 20.00
Krodha santhapa 2 13.33
Ratri jagarana 3 20.00
Himaambu snana 2 13.33

Vihar
14

12

10
Number of patients

0
Divaswapana Vega Udeerana Dhoomopaghata Sheeta vihara Krodha santhapa Ratri jagarana Himaambu snana

Vihar

In connection with Vihara sambandhi nidana it was observed that

Diwaswapana vihara as Nidana for kasa in 12 children (80%)Vega
Udeerana wereobserved as nidan in 8(53.33%) where as
Dhoomopaghat,Sheeta Vihar and Ratri jagarana were the cause in
equal number of children 3 (20%). In 2 (13.33%) children the cause
was Krodha Santhapa and Himaambu snana of children
respectively.While consider all Vihar sambandhi nidan factors
responsible in the manifestation of Vitaj Kasa,Kaphaj Kasa & Pittaj
kasa.

103
Table No. B-11 :DISTRIBUTION OF POORVA ROOPA AMONG
STUDY GROUP

Poorva roopa in the children

No. of
Poorva roopa Percentage
children
Shooka poorna galaasyata 4 26.66%
Kantakandu 12 80%
Bhojyanam avarodha 2 13%
Gala lepa 5 33.33%
Agnisaada 2 13%
Aruchi 13 86.66%
Soshabdha Vaishamya 11 73.33%

Poorva roopa

14 13
12
12 11

10
Number of patients

6 5
4
4
2 2
2

0
Shooka Kantakandu Bhojyanam Gala lepa Agnisaada Aruchi Soshabdha
poorna avarodha Vaishamya
galaasyata

Kanta kandu was evidently seen in 12 children (80%) as the Poorva

roopa. Next evident Poorva rupa was Aruchi found in 13 (86.66%) of
children followed by Soshabdha Vaishamya in11 (73.33%), Gala Lepa
5 (33.33%), Talu lepa in 12 (40%) of children and Shooka poorna
galaasyata was seen in 4(26.66%)in childern. Bhojyanam avarodha
and Aganisaada was seen in 2 children (13%).

104
Table No. B-12 :DISTRIBUTION OF ROOPA OF KASA
Incidence of Roopa among the children
Roopa No. of children Percentage
Kasa Vega 15 100.00
Kapha nishteevana 15 100.00
Kapha purna vashata 5 33.33
Jwara 9 60.00
Shoola 12 80.00
Kanthoplepa 9 60.00
Swarabheda 12 80.00
Pratishaya 13 86.67

Roop
16
14
12
10
8
Number of patients

6
4
2
0
ara

ola
ga

aya
a
a

ed
lep
a

Jw
Ve

ata

o
van

h
Sh

bh
op

tis
sa

ash
tee

ara

Pra
Ka

nth
av

Sw
ish

Ka
urn
an

ap
ph
Ka

ph
Ka

Roop

Regarding the clinical features,Kasa Vega & Kapha Nishteevana

Lakshana were observed in 15 children (100%) children each,
Pratishaya Lakshana was seen in 13 children (86.66%), Shoola &
Swarabheda Lakshana were observed in 12 children (80%), Jwara &
Kanthooplepa Lakshana were seen in 9 children (60%) and Kapha
Purna vashata was observed in 5 children (33.33%).

105
Table No. B-13 :COMPARISON OF PATIENTS AT BEFORE
TREATMENT AND AFTER TREATMENT DAY1, DAY 3, DAY 5,
DAY7, AFTER TREATMENT FOR KASA VEGA.

Before Negative Positive p-

Ties
treatment Rank rank value
Day 1 0 0 15 0.999
Day 3 11 0 4 0.001
<
Day 5 15 0 0
0.001
Day 7 15 0 0 0.001

Conclusion :- By using Wilcoxon Sign rank test p-value < 0.05

therefore there is significant difference between before treatment and
day 3, day 5, day 7 for Kasa vega..It suggests that Dusparshadi Leha
has statistically significant effect in reducing the Kasa Vega.

Distributon of patients with respect to severity of Kas Vega

14

12

10
0
Number of patients

8 1
2
3
6

0
Before treatment Day 1 Day 3 Day 5 Day 7

Kasa Vega was found in all the 15 patients, 7 suffered Grade 2 type of
Kasa Vega and 8 patients suffered Grade 3 type of Kasa Vega. 9
patients got relief at the end of 7th day of treatment (% relief is
66.66%).

106
Table No. B-14 :COMPARISON OF PATIENTS AT BEFORE
TREATMENT AND AFTER TREATMENT DAY1, DAY 3, DAY 5, DAY
7, AFTER TREATMENT FOR KAPHA NISHTEEVANA.
Before Negative Positive p-
Ties
treatment Rank rank value
Day 1 0 0 15 0.999
Day 3 8 0 7 0.005
<
Day 5 14 0 1
0.001
<
Day 7 15 0 0
0.001

Conclusion :- By using Wilcoxon Sign rank test p-value < 0.05

therefore there is significant difference between before treatment and
day 3, day 5, day 7 for Kapha nishteevana.It suggests that
Dusparshadi Leha compound has statistically significant effect in
reducing the Kapha nishteevana.

Distributon of patients with respect to severity of Kapha nishteevana

12

10

8
Number of patients

0 1
6

2 3
4

0
Before treatment Day 1 Day 3 Day 5 Day 7

Kapha nishteevana was found in all the 15 patients, 4 suffered

Grade 2 type of Kapha nishteevana and 11 patients suffered Grade 3

107
type of Kapha nishteevana. 11 patients got relief at the end of 7 th day
of treatment (% relief is 73.33%).
Table No. B-15 :COMPARISON OF PATIENTS AT BEFORE
TREATMENT AND AFTER TREATMENT DAY1, DAY 3, DAY 5, DAY
7, AFTER TREATMENT FOR KAPHAPURNA VAKSHATA.
Before Negative Positive
Ties p-value
treatment Rank rank
Day 1 0 0 15 0.999
Day 3 2 0 13 0.157
Day 5 5 0 10 0.025
Day 7 5 0 10 0.038

Conclusion :-By using Wilcoxon Sign rank test p-value < 0.05
therefore there is significant difference between before treatment and
day 5, day 7 for Kapha purna vakshata.This data indicates that
Dusparshadi Leha compound provides good result in reducing the
kaphaPurna Vakshata.

Distributon of patients with respect to severity of Kapha purna

vakshata
16

14

12

10
Number of patients

0 1
8
2 3
6

0
Before treatment Day 1 Day 3 Day 5 Day 7

Kapha Purna Vakshata was found in all the 5 patients, 2

suffered Grade 1 type of Kapha Purna vakshata and 3 patients

108
suffered Grade 1 type of Kapha purna vashata. 5 patients got relief at
the end of 7th day of treatment (% relief is 100%).
Table No. B-16 :COMPARISON OF PATIENTS AT BEFORE
TREATMENT AND AFTER TREATMENT DAY1, DAY 3, DAY 5, DAY
7, AFTER TREATMENT FOR JWARA.
Before Negative Positive p-
Ties
treatment Rank rank value
Day 1 0 0 15 0.999
Day 3 2 0 13 0.157
Day 5 9 0 6 0.003
Day 7 9 0 6 0.004

Conclusion :- By using Wilcoxon Sign rank test p-value < 0.05

therefore there is significant difference between before treatment and
day 5, day 7 for Jwara.This data indicates that Duspashadi Leha
compound provides good result in reducing the Jwara

Distributon of patients with respect to severity of Jwara

12

10

8 0
1
Number of patients

6 2
3

0
Before treatment Day 1 Day 3 Day 5 Day 7

Jwara was found in all the 9 patients, 4 suffered Grade 1 type of

Jwara and 5 patients suffered Grade 2 type of Jwara. patients got
relief at the end of 7th day of treatment (% relief is 55.55%).

109
110
Table No. B-17 :COMPARISON OF PATIENTS AT BEFORE
TREATMENT AND AFTER TREATMENT DAY1, DAY 3, DAY 5, DAY
7, AFTER TREATMENT FOR SHOOLA.
Before Negative Positive p-
Ties
treatment Rank rank value
Day 1 0 0 15 0.999
Day 3 10 0 5 0.002
Day 5 12 0 3 0.001
Day 7 12 0 3 0.002

Conclusion :-By using Wilcoxon Sign rank test p-value < 0.05
therefore there is significant difference between before treatment and
day 3, day 5, day 7 for Shoola. It suggests that Dusparshadi Leha
compound has statistically significant effect in reducing the Shoola.

Distributon of patients with respect to severity of Shoola

16

14

12

10 0
Number of patients

1
8 2
3
6

0
Before treatment Day 1 Day 3 Day 5 Day 7

Shoola was found in all the 12 patients, 6 suffered Grade 1

type of Shoola and 6 patients suffered Grade 2 type of shoola. 11
patients got relief at the end of 7th day of treatment (% relief is
91.66%).

111
Table No. B-18 :COMPARISON OF PATIENTS AT BEFORE
TREATMENT AND AFTER TREATMENT DAY1, DAY 3, DAY 5, DAY
7, AFTER TREATMENT FOR KANTHOPALEPA.
Before Negative Positive p-
Ties
treatment Rank rank value
Day 1 0 0 15 0.999
Day 3 12 0 3 0.001
<
Day 5 15 0 0
0.001
<
Day 7 15 0 0
0.001

Conclusion :- By using Wilcoxon Sign rank test p-value < 0.05

therefore there is significant difference between before treatment and
day 3, day 5, day 7 for Knthoplepa. It suggests that Dusparshadi Leha
compound has statistically significant effect in reducing the
Kanthopalepa.

Distributon of patients with respect to severity of Kanthopalepa

16

14

12

0
Number of patients

10
1
8 2
3
6

0
Before treatment Day 1 Day 3 Day 5 Day 7

112
 Kanthoplepa was found in all the 15 patients, 9 suffered Grade
2 type of Kanathoplepa and 6 patients suffered Grade 1 type of
Kanthopalepa. 14 patients got relief at the end of 7 th day of treatment
(% relief is 93.33%).

113
Table No. B-19 :COMPARISON OF PATIENTS AT BEFORE
TREATMENT AND AFTER TREATMENT DAY1, DAY 3, DAY 5, DAY
7, AFTER TREATMENT FOR SWARBHEDA.
Before Negative Positive
Ties p-value
treatment Rank rank
Day 1 0 0 15 0.999
Day 3 8 0 7 0.005
Day 5 15 0 0 < 0.001
Day 7 15 0 0 < 0.001

Conclusion:-By using Wilcoxon Sign rank test p-value < 0.05

therefore there is significant difference between before treatment and
day 3, day 5, day 7 for Swarbheda. This data indicates that
Dusparshadi Leha compound provides good result in reducing the
Swarabheda.

Distributon of patients with respect to severity of Swarbheda

14

12

10
0
8 1
2
3
6

0
Before treatment Day 1 Day 3 Day 5 Day 7

Swarabheda was found in all the 15 patients, 12 suffered Grade

1 type of Swarabheda and 3 patients suffered Grade 1 type of
Swarabheda. 12 patients got relief at the end of 7 th day of treatment
(% relief is 80%).

114
Table No. B-20 :COMPARISON OF PATIENTS AT BEFORE
TREATMENT AND AFTER TREATMENT DAY1, DAY 3, DAY 5, DAY
7, AFTER TREATMENT FOR PRATISHAYA.
Before Negative Positive
Ties p-value
treatment Rank rank
Day 1 0 0 15 0.999
Day 3 5 0 10 0.025
Day 5 13 0 2 < 0.001
Day 7 15 0 0 < 0.001

Conclusion :- By using Wilcoxon Sign rank test p-value < 0.05

therefore there is significant difference between before treatment and
day 3, day 5, day 7 for Pratishaya. This data indicates that
Dusparshadi Leha compound provides good result in reducing the
Pratishaya.

Distributon of patients with respect to severity of Pratishaya

14

12

10
0
Number of patients

8 1
2
3
6

0
Before treatment Day 1 Day 3 Day 5 Day 7

Pratishaya was found in all the 15 patients, 2 suffered Grade 1

type of Pratishya and 13 patients suffered Grade 2 type of Pratishaya.
9 patients got relief at the end of 7th day of treatment (% relief is 60%).

115
Table No. B-21 :OVERALL IMPROVEMENT OF CHILDREN IN THE
STUDY GROUP

Overall improvement No. of children Percentage

Cured 9 60.0
Improved 6 40.0
No Change 00 00.00

Outcome

40%
Cured
Improved

60%

By considering the overall results of the treatment, 10 children of the

study were fully cured and 05 children got improved.

116
 DISCUSSION

After Creative and critical discussion based on the observations

and analysis. Discussion is the important part in any scientific
research which links the theory and practice of medicine. The present
work comprises the study of the efficacy of Dusparshadi Lela in 15
children of kasa, where the findings derived from the data analysis are
subjected to discussion. The interpretation of the facts observed based
on the clinical study will throw more light into the subject and thereby
helping in formulating the solutions.
Kasa is a symptom and also disease, the references of which
procured from the Vedic period onwards till date it is mentioned in
Atharva Veda and Garuda Puran, though in different names as
compared to today, confirms its dual identity existence as a symptom
and as a disease, though detail description can be obtain and studied
from the texts of Samhita kala. All the measure Samhita’s available on
date give a detail description Kasa as a separate disease and also as a
secondary disease/symptom to underline pathology. Most of the
Samhita have subdivided Kasa in five types; Where Harita and
Basavrajeeyam have divided it in to eight types.
Cough as a symptom has been studied in modern medicine and
not as a separate disease. It always is a symptom arising secondary to
some underline pathogenesis. It again has been classified on the basis
of its chronicity more it is difficult in treatment and also affect the
growth of a child, different types of cough has been mentioned which
most of the type indicate a specific disease like whooping cough
indicates pertusis, a cough with wheeze indicates bronchiolitis. A
persistent cough indicates asthma and allergies, night time cough
indicates nasal congestion and so on. Similarly the onset of cough
indicates a specific disease like a persistent cough in infant is
indicative of GERD or other congenital malformations or cough in
work time indicates occupational diseases or cough during the change
of season indicates allergic cough and so on. These are some

117
indication for easy diagnosis of disease though not 100% correct, but
certainly gives direction towards probable diagnosis.
Management of cough as a symptom include drugs from the
groups like pharyngeal demulcents which sooth the throat reducing
irritation, like Mukokinetic which increase the Cilliary action of
trachea-bronchial mucosa adding in removal of foreign particulate
which causes cough, the third group is an Antitussive either
peripherally acting which prevent the impulse either efferent or
afferent, centrally acting which suppress the cough centre in the
medulla. The others are antihistaminic and bronchodilator which
reduce the secretion and add in the expectoration.
The Clinical study was conducted on children between the age
group of 1 to 5 years from both sexes. The drug compound consists of
Dusparshadi, Pippali, Musta, Bharangi, Karkatashringi i& Shati equal
quantity of Churna with Guda &Til Taila,which was considered as
good remedy for the diseases Kasa and Swasa in children by Acharya
Charak & Ashtang Hrudaya. By looking into the properties of
individual drugs in the Churna, Guda & Til Taila, it appears that the
combination which is named as Dusparshadi Leha is expected to be
good effective in bringing normalcy of Kapha and Vata Doshas. As
Vathik aggravation is the main cause in the manifestation of Kasa
Roga. Hence this formulation was chosen to evaluate its efficacy
clinically in Kasa of Vataj, Pittaj & Kaphaj origin.
Patients with kasa as major symptom with a history of not more
than 3 days given in the study as they may respond quickly to the
treatment and there will be no chance of complications, more over the
patients can be managed in the OPD level itself.
As study group consists of 1 to 5 years children, for them the
drug was administered four times (qid) a day in the dosage according
to Sharandhar Samhita. Compound in form of Leha so Duspardhadi
Leha which easy to prepared and palatable in small children.
The patients were assessed on the clinical features using
modified Visual analogue scale on the symptoms of Kasa Vega, Kapha

118
nishteevana, KaphaPurna Vakshata, Jwara, Shool, kanthoplepa,
Swarbheda and Pratishya on day 1 i.e. regstration day and
subsequently on day 2, 3, 5 and day 7. The patients were given only
requisite amount of drug so they turn up for follow up.
The whole of data was collected on the basis of examination and
questioning and interaction with patients and parents so that even
minute observations are not left out. The observation was subjected to
statistically analysis applying a paired t test and results were drawn.
At the end and overall assessment of cure and improvement was also
done.
1-Age Distribution-
Among 15 children 2were of the age group 1 years, 2 were of the
age group of 2 years,6 were of the age group 3 year,2 were of the age
group of 4 year and 3 children were of the age group of 5 years. Kasa
is common in all age group children.
2-Gender Distribution-
Out of 15 children, 7 were male i.e 46.7% male and 8 were
female i.e 53.3% female as shown in Table. The observation shows
nearly equal distribution of disease, thus concluding that the sex has
no influence on the affection of disease, thus confirms that Kasa in
has more of an external origin rather than the physiology of body
which differs in male and females.
3-Socioeconomic Status-
Children were divided in to 3 categories on the basis of their
socio-economic status. Out of 15 children almost equal number of
children belongs to i.e. 7 were from middle class (46.7%) and 7 were
from lower class i.e. 46.7 % and only 1 children i.e.6.7 % were from
upper class.
High prevalence in lower class and middle class and lower
prevalence in upper class.
4-Habitate-
Children were divided in to 3 categories on the basis of their
habitat. Out of 15 children 7 (46.7%) were from rural area 7(46.7%)

119
children were from semi-urban area and 1(6.7%) were from urban
area. This may be because the area where the study was conducted is
semi urban & rural area type.
5-Immunization Status-
Immunization status of 15 children of study group showed that
2(13.3%) children were completely immunized, 12(80%) children were
partially immunized and 1 (6.7%) children were no immunized in the
study.
6-Prakruti-
It was seen that out of children, 9 children (60%) belonged to
Vatapradhan kapha prakruti. 4 (26.7%) children belonged to
Kaphapradhan vata prakruti and 4 (13.3%) children were belonged to
Pittapradhan kapha prakruti.
7-Distribution of Patients With Respect To Diet-
Children were divided in to 2 categories on the basis of their
respectively Diet status. Out of 15 children almost equal number of
children belongs to i.e. 14 were from Mixed Diet (93.3%) and 1 were
from Veg Diet i.e. 6.7 % in this studyThis may be because of usage of
more oily, fried and chilly foodstuffs as well as unwhole some food by
the mixed diet children.
8-Type of Kasa-
It was seen that out of 15 children, 9 children belonged to Vataj
kasa in that 7 were cure & 2 were improved. 4 children belonged to
Kaphaj Kasa in that 2 were cure & 2 were improved and 2 children
were belonged to Pittaj kasa in that 2 were improved.
9-Distribution of Ahara sambandhi nidana in the study group-
While considering Ahara sambandhi nidana for the disease of
kasa, it was found that in maximum number of children 11(73.33%)
Abhishyandi ahara & 9 (60%)Ruksha ahara were found to be the
cause. Sheeta ahara&Asatmya ahara was found as the cause in 8
(53.33%) children, Guru ahara were found in 5 (33.33%) and Madhura
ahara as Nidana were found in 7 (46.67%) children where as Katu-
Amala sevana in 6 (40%), Vidhahi ahar in 4 (26.67%), Ati ushana in

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3(20%) and Tila-Lashuna,kulatha ahara in 02 (13.33%) children
respectively. While Considering all Ahar sambandhi nidan factors
responsible in the manifestation of Vataj Kasa, Kaphaj Kasa & Pittaj
Kasa Bhed.
10-Distribution of vihara sambandhi nidana in the study group:
In connection with Vihara sambandhi nidana it was observed
that Diwaswapana vihara as Nidana for kasa in 12 children (80%)Vega
Udeerana were observed as nidan in 8(53.33%) where as
Dhoomopaghat ,Sheeta Vihar and Ratri jagaran were the cause in
equal number of children 3 (20%). In 2 (13.33%) children the cause
was Krodhasantapa and Himaambu snana of children respectively.
While consider all Vihar sambandhi nidan factors responsible in the
manifestation of Vitaj Kasa, Kaphaj Kasa & Pittaj kasa.
11-Distribution of poorva roopa among study group:
Kantakandu was evidently seen in 12 children (80%) as the
Poorva roopa. Next evident Poorva rupa was Aruchi found in 13
(86.66%) of children followed by Soshabdha Vaishamya in11 (73.33%),
Gala Lepa 5 (33.33%), Talu lepa in 12 (40%) of children and Shooka
poorna galaasyata was seen in 4(26.66%) in childern. Bhojyanam
avarodha and Aganisada was seen in 2 children (13%). Kantakandu
(80%) and Aruchi (86%) were the main Poorva roopa observed in major
number of children and they were persistent even after manifestation
of actual signs and symptoms.
12-Distribution of roopa of kasa:
Regarding the clinical features, Kasa Vega & Kapha Nishteevana
Lakshana were observed in 15 children (100%) children each,
Pratishaya Lakshana was seen in 13 children (86.66%), Shoola&
Swarabheda Lakshana were observed in 12 children (80%), Jwara &
Kanthooplepa Lakshana were seen in 9 children (60%) and Kapha
Purna vashata was observed in 5 children (33.33%).
At the end of treatment relief in signs and symptoms of the
patient were noted .Total general symptoms of each patient were

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calculated before and after treatment and percentage of relief was also
calculated.
 Of the total 15 cases majar symptom KasaVega found in all case,in
that 9 patient got relief at on 7 th day of treatment. i.e. % relief is
66.66%.
 Of the total 15 cases majar symptom Kapha Nishteevana found in
all case ,in that 11 patient got relief at on 5 th day of treatment.i.e.
relief is 73.33%.
 Kapha Purna Vakshata was seen in 5 Patients which pratically
disappeared on 5th day of treatment.i.e.relief is 100%.
 Most of the 13 patients presence of Jwara, in that 11 patient got
relief at 5rd day of treatment.i.e.relief is 73.33%.
 Shoola was seen in 12 patients in that 11 patients got relief on the
5th day of treatment.i.e. relief is 91.66%.
 Kanthopalepa was seen in 15 patients in that 14 patients got relief
on the 3rd day of treatment.i.e. relief is 93.33%.
 Swarbheda was seen in 15 patients in that 12 patients got relief on
the 5th day of treatment.i.e. relief is 80%.
 Pratishya was seen in 15 patient in that 9 patients got relief on the
7th day of treatment.i.e.relief is 60%.

All subject showed statistically significant improvement in the

symptom. It was seen from the trail that maximum patient showed
(70-80%) significant relief of the symptoms after seven days of the
treatment.

13-Overall improvement of children in the study group:

By considering the overall results of the treatment, 10 children
of the study were fully cured and 05 children got improved

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SAMPRAPTIBHANGA:
Samprapti is termed as the process in which the Prakruti dosha
gets Sthanasnashraya where there is Strotodushti. It is also defined
as the process in which Dosha – Dushya – Sammurchana leads to
Vyadhi.
In the Samprapti of Kasa there is Vikruti of Vata and Kapha
dosha. In this Samprapti even if there is dominance of Vata dosha,
Kapha Vikruti should also be given more importance.
Strotodushti develops due to Kapha dosha and the prakrut gati
of Vayu is disturbed / obstructed. Apana Vayu changes its normal
path i.e. It gets Urdhvagat therefore, the normal gati of Udana Vayu
increases.
Angaharsha is developed since the Urdhva gati of Udan Vayu
and Anuloma Gati of Prana Vayu gets Prtiloima leading to the
samprapti of Kasa.
The treatment given in Kasa has Dusparshadi Leha drugs,
which are Hetu Virodhi i.e. the rasa Katu, and Tikta are Kapha
Shamak. The dravyas uses are ushna Viryatmak which act on the
shita guna of Kapha Dosha. The Ruksha, Tikshna, Laghu and Sara
gunas are Kapha guna virodhi i.e. Snighdha, Manda, Guru and
Sthira.
The drugs / Dravyas used in Duspashadi Leha are Kapha
Vilayak and Kapha Shoshak. Some decrease the Styanta of Kapha
dosha, Tikshana guna does Chhedhan Karma and some act as Kapha
Nissarak. In this way they act as Kapha Shamak, which leads to
decrease in strotorodha. As Strotorodha is relieved, the Vikrut Gati of
Vayu is turned Prakrut. I.e. Apana and Prana Vayu gets Anuloma gati
and Vighatan of Kasa Vyuadhi take place.

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 CONCLUSION

 Kasa has been known since time and antiquity and has been
described in detail in all major samhitas of Ayurveda, as a
symptom and as a disease.
 By most of the samhitas Five types of Kasa have been accepted.
 Vataj, Pittaj, Kaphaj and Kshayaj are Nija(indigenous) in origin and
Kshataj kasa is exception which is Agantuj in origin.
 Abhishyandi & Asatmya ahara, Sheeta & Ruksha ahara, Madhur &
Guru ahara, Vega Udeerana, Dhoomopaghat, Sheeta sevan, Ratri
Jagarana, Himaambu Snana are common factors (nidan)
responsible in the manifestation of Kasa.
 Shookapurana galasyata, Kanthakandu, Gala-Talu lepa and
Sashabda vaishamya are the common purva roopa of Kasa vyadhi.
 Kasa Vega, Kapha Nishteevana, Kapha Purna Vakshata, shool,
Swarbheda, Jwara,Kanthoplepa & Pratishya are common
Lakshana of Kasa Vyadhi was found.
 Dusparshadi Leha are Kapha Vilayak,Kapha Shosha, Kapha
Nissarak and Kapha Sharma, which leads to decrease in
strotorodha so Vikrut Gati of Vayu is turned Prakrut. I.e. Apana
and Prana Vayu gets Anuloma gati and Vighatan of Kasa
Samprapti take place.
 In Dusparshyadi Leha,Guda is works as Deepana, Pachana,
Anuloman& Balya. In Dusparshyadi Leha,Til Tail works as Snehan
and Kapha Nissaran.
 The action of Dusparshadi Leha compound is effective in relieving
the symptoms of kasa in children in general within the duration of
5 to 7 days.
 Dusparshadi Leha has high nutritive value in terms of
carbohydrates and micronutrients like Iron, Potassium, and
Calcium.

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 The compound was found to be effective in all three types of Doshaj
Kasa predominantly in Vataj Kasa followed by Kaphaj Kasa and
Pittaj Kasa.
 Dusparshyadi Leha relieves multiple Lakshana of Kasa Vyadhi and
has no side effect therefore It fits in the category of Ideal medicine
as described in Ayurvedic texts.

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 SUMMARY

The reference of kasa is available since antiquity i.e. from Vedic

period to modern era and the references of this disease available in
various literatures.
We get an elaborate description of the disease kasa, its
aetiology, pathogenesis, complication and its treatment in different
samhitas.Charak Samhita had the detailed description of kasa like its
bhedas, nidana of Kasa, samprapti, lakshana, sadhyasadhyata and
chikitsa have been mentioned.Sushruta samhita mentioned kasa as a
symptom as well as a disease. Sushruta Samhita also describes
bhedas, individual lakshanas, samprapti and chikitsa of kasa.
Kasa is derived from the root ‘ksa’
kasa + gatao  movement
Commentator Chakrapani has derived the word Kasa from the root
‘kas’
For the better understanding of nidanas they can be broadly
grouped into four groups i.e. Aharaja nidana, Viharaja nidana,
Manasika and Vyadhijanya nidana. Abhishyandi (60%) & Asatmya
(53.33%) ahara, Sheeta (53.33%) & Ruksha (60%) ahara, Madhur
(46.67%) & Guru (33.33%) ahara, Vega Udeerana (53.33%),
Dhoomopaghat (20%), Sheeta sevan (20%), Ratri Jagarana (20%),
Himaambu Snana (13.33%) are common factors(nidan) responsible in
the manifestation of Kasa.
Samprapti is once again divided into two types i.e. Samanya
Samprapti and Vishesh Samprapti. According to Acharya the
Samanya samprapti of Kasa is upward movement of vitiated Vayu
afflicting the channels present in the Shira, Ura and Greeva pradesha.
Vitiation of both Prana & Udana vayu together blocking of Srotasas
results in increased pressure inside the channels of the head causing
painful contraction of muscles in the areas like mandibular joint and

126
cervical region, gives rise to cough with the presence or absence of
sputum called as Kasa.
Poorva roopa denotes the symptoms that manifest before the
actual (or main) symptoms occur. They are manifested during the
stage of doshadushya sammurchana. As there is no mention of
specific Poorva roopa only general Poorva roopas explained in the
context of kasa can be considered. It is observed that most of the
Poorva roopa of the disease Kasa described in Bruhatrayis and other
important classics are identical. They are Shookapurana galaasyata,
kantha kandu, Bhojyamanovarodha and Aruchi. Apart from these
sushruta has mentioned few more in poorvaroopa like Sashabda
Vaishamya, Agnisada and Gala talu lepa. In the clinical trail
Shookapurana galasyata, Kanthakandu, Gala-Talu lepa and
Sashabda vaishamya are the common purva roopa of Kasa vyadhi was
found.
Roopa of vataja kasa are Shuska kasa, Parshwa shoola,
Sheerashoola, Urahshoola, Ksheena bala, Prasakta Vega, Snigdha
Guru Lavana Bhukta Preeta, prashamyati, Swarabheda.Roopa of
pittaja kasa are, Peetha nishteevana, Tikta asyata, Mukha shoshana,
Trushna, Pratatam kasa (continuous cough), Urodoomayana, Jwara,
Bhrama and Aruchi.Roopa of kaphaja kasa are Bahula Snigdha
Sandra Ghana Shweta, Madhura Stivanayukta kasa, Urashula,
Pinasa, Kantha kandu, Swarabheda and Mukalepa. In the clinical trial
Kasa Vega (100%),Kapha Nishteevana(100%) , Kapha Purna Vakshata
(33%),shool (80%),Swarbheda (80%), Jwara (60%),Kanthoplepa(60%)
& Pratishya (86.66%) are common Lakshana of Kasa Vyadhi was
found.
Any disease if neglected i.e. in the absence of proper
treatment,progresses further owing to abnormal diet behavior etc.
leading to secondary disease known as upadrava i.e. Bhedavasta of
the disease.
In Bhavaprakasha, it is explained that Rajayakshma, Jwara,
Arochaka, Shwasa, Swarabheda, kshaya like disorders will manifest if

127
kasa is neglected without proper treatment. So it should not be
neglected and should be treated at the earliest.
According to Charaka & Vagbhata the kasa which is manifested
by single doshaj is sadhya so Vataj kasa, Kaphaj kasa and Pittaj kasa
are sadhya diseases. In our classics it is mentioned that disease
process nidana, poorva rupa, rupa are in minimal quantity, if the
patients prakruti is different from the dosha vitiated, Season and the
desha are not equal to the particular dosha, if it is navotpanna,
without complications, if the patient is capable of taking medicine and
chikitsa chatushpada are in good condition it will be a sadhya
disease.
A cough is a sudden, often involuntary, forceful release of air
from the lungs. Cough is a sudden explosive forcing of air through the
glottis, excited by an effort to expel mucus or other matter from the
bronchial tubes or larynx or it is to force the air through the glottis by
a series of expiratory efforts. Cough ranks among the top 10 reasons
for visiting family physicians. Cough is the fifth most common
symptom for which patients seek care. Cough is one of the most
frequent symptoms of childhood illness. Even though it might not be a
symptom of serious disease, but becomes one of the important
reasons to attend paediatrician.
Depending upon production of phlegm cough is devided in to
two types. They are Productive cough and Dry cough. Apart from this
types of Cough are Barking Cough, Whooping Cough, Cough with
Wheezing, Day time Cough, Night time Cough, Persistent Cough and
Coughs in Young Infants.
Treatment of cough mainly consists of treating the underlying
cause. A productive (useful) cough serves to drain the airway. Its
suppression is not desirable, may even be harmful, except if the
amount of expectoration achieved is small compared to the effort of
continuous coughing. Non productive (useless) cough should be
suppressed.

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 Apart from specific remedies (antibiotics etc), cough may be
treated as a symptom (non specific therapy) with, Pharyngeal
Demulcents, Expectorants (Mukokinetics), Antitussives,
Antihistamines and Bronchodilators.
In Ayurved samhita many drugs and specific therapy are
advised for Kasa vyadhi management. Acharya Kashyap has
specifically advised to give all kind of medicine to the children in the
form of Leha. Another aspect of treatment is Madhur Rasatmak,
Saumya, Bala Vardhak, acceptability and palatability due to Guda
and Til Tail. So Dusparshadi leha selected from Ashtang Hrudaya &
Charak Chikitsa Sthan is used in Aparipakavata of Dhatu,
Soukaumaryata, Alpakayata, Ksheen Bal of Balak and Madhur
Satmyata fo Balak.
The present clinical study entitled “TO STUDY OF EFFICACY OF
DUSPARSHADI LEHA ON KASA IN CHILDREN (1-5 YEARS) ”was
carried out with the following objectives.
Objectives of the study are detail literary study of Kasa, study
the individual contents of ‘DUSPARSHADI LEHA’ and formulation as
whole and the possible mode of action of ‘DUSPARSHADI LEHA’ on
Kasa.
The type of study is open and the collected data analyzed using
paired ‘t’ test.
Kanthkari, Pippali, Musta, Bharangi, Karkataki & Shati these
authentified drug will be taken in equal quantity for the preparation of
Churna, along with in equal quantity of guda and double quantity of
tiltaila by mixing them in Leha form which be given to the patient at
the time of drug administration.
The dose of DUSPARSHADI LEHA given in 4 equal divided doses
according to Sharandhar Samhita.
15 patients with complaints of kasa with many associated
symptoms as explained in classics under kasa Rogadhyaya were
selected randomly from Kaumarabhritya O.P.D of B.V.U Ayurvedic
Hospital Pune.

129
 Patients who fulfilled the diagnosis and inclusion criteria were
selected for the study. Selected children were thoroughly examined;
both objective and subjective manifestations were recorded.
The present study includes a sample size of 15 children in and
around Pune. All of them and their guardian were made to
understand about the study and the informed consent was obtained.
Only after getting the informed consent they were included in the
study.
The inclusion criteria are patient with kasa as a symptom with a
history of not more than 3 days, age patient group i.e. 1-5 years,
patient with weight between 10th to 90th percentiles for that specific
age and patients were selected irrespective of sex i.e. male or female.
The exclusion criteria’s are patient with chronic debilitating
diseases/disorder, patient on any other medication. , Patient without
Kshataj Kasa and Kshayaj Kasa.
Assessment was made by observing the improvements in the
clinical features based on the gradation before and after the
treatment. Assessment was made on the initial assessment before the
commencement of treatment, 2nd assessment on 3rd day, 3rd
assessment on 5th day and finally 4th assessment on the last day of
treatment on day 7th day. Patients were assessed the following
parameters and the signs and symptoms were graded from 0 to 3 by
the patients/Relative and examination done on MODIFIED VISUAL
ANALOGUE SCALE.
Among 15 subjects register, the maximum (08) were the age
group of 1-5 yrs female and (07) were male of the total patients. Kasa
is common in all age group children. A small study was done on these
children to find out the immunization status. One kid was left off from
immunization program but it was seen that most of them were not
completely immunized for that ages however primary vaccination was
complete. High prevalence in lower class and middle class and lower
prevalence in upper class was found. Out of 15 children 7 (46.7%)
were from rural area 7(46.7%) children were from semi-urban area

130
and 1(6.7%) were from urban area. This may be because the area
where the study was conducted is semi urban &Rural area type.
It was seen that out of 15 children, 9 children belonged to Vataj
kasa in that 7 were cure & 2 were improved. 4 children belonged to
Kaphaj Kasa in that 2 were cure & 2 were improved and 2 children
were belonged to Pittaj kasa in that 2 were improved.
Of the total 15 cases majar symptom KasaVega found in all
case,in that 9 patient got relief at on 7th day of treatment. (i.e. % relief
is 66.66%). Of the total 15 cases majar symptom Kapha Nishteevana
found in all case,in that 11 patient got relief at on 5th day of
treatment (i.e. relief is 73.33%). Kapha Purna Vakshata was seen in 5
Patients which pratically disappeared on 5th day of treatment
(i.e.relief is 100%). Most of the 13 patients presence of Jwara, in that
11 patient got relief at 5rd day of treatment (i.e. relief is 73.33%).
Shoola was seen in 12 patients in that 11 patients got relief on the
5th day of treatment (i.e. relief is 91.66%).Kanthopalepa was seen in
15 patients in that 14 patients got relief on the 3rd day of treatment
(i.e. relief is 93.33%). Swarbheda was seen in 15 patients in that 12
patients got relief on the 5th day of treatment (i.e. relief is 80%).
Pratishya was seen in 15 patient in that 9 patients got relief on the
7th day of treatment (i.e.relief is 60%).
In Dusparshyadi Leha,Guda is Deepana,Pachana, Anuloman &
Balya; Til Tail does function of Liquification of Kapha due to its Sneha
guna & also does function of Kapha Nissaran by its TIkta,Katu,Ushna
gunas.
Kanthakari,Pippali,Bharangi are Kapha Vilayak and Kapha
Shoshak due to katu tikta rasa, katu in vipaka and ushna in veerya.
Kanthakari,Pippali & Shati are decrease the Styanyata of Kapha
dosha and its Tikshna guna does Chhedhan Karma. Also Karkataki,
Musta & Kanthkari are act as Kapha Nissarak.So Dusparshadi leha
leads to decrease in strotorodha. As Strotorodha is relieved, the Vikrut
Gati of Vayu is turned Prakrut. i.e. Apana and Prana Vayu gets
Anuloma gati and Vighatan of Kasa Vyadhi take place.

131
 The cure rate of the patient was about 60% and the rest showed
improvement in general health and symptoms.It was found that about
77.78% were cured and 22.22 % of Vataj Kasa patient were
improved,50% were cured and 50% of kaphaj Kasa Patient were
improved & 100% of Pittaj kasa Patient were improved but not cured.
The compound was found to be effective in all three types of
Doshaj Kasa predominantly in Vataj Kasa followed by Kaphaj Kasa
and Pittaj Kasa.

132
 ABBREVIATIONS

 A.H. - Astanga Hridaya

 A.S. - Astanga Samgraha
 Ak - Amarakosha
 Ar - Arunadutta
 B.M - Bhavamishra
 B.N - Brihath Nighantu
 B.P - Bhavaprakasha
 B.R. - Bhaisajya Ratnavali
 Bas.R - Basavarajeeyam
 Ba.Ro - Bala Roga
 C.S - Charaka Samhita
 Chi. - Chikitsa Sthana
 Ck - Chakrapani
 D.N - Dhanwantari Nighantu
 Da - Dalhana
 Dic - Dictionary
 Dr. - Doctor
 etc. - etceteras
 G.N - Gadanigraha
 H.S. - Haritha Samhita
 i.e. - that is
 Id - Indu
 Ind - Indriya Sthana
 K.B. - Kaumarabhritya
 K.S. - Kashyapa Samhita
 K.N. - Kaiyadeva Nighantu
 Ltd. - Limited
 M.K - Madhukosha
 M.N. - Madhava Nidana

133
  Med - Medical
 Ni. - Nidana Sthana
 No. - Number
 P.G. - Post Graduation
 Prof. - Professor
 R.N - Raja Nighantu
 S.S - Sushruta Samhita
 Sh.S. - Sharangadhara Samhita
 Sr. No. - Serial Number
 Sha - Shareera Sthana
 Su - Sutra Sthana
 Ut. - Uttara Tantra
 viz. - namely
 Y.R.. - Yoga Ratnakara

Symbols used in Master Chart

 A.T. : After treatment
 B.T. : Before treatment
 D.T. : During treatment
 d.f. : Degree of freedom
 F : Female
 M : Male
 p : Probability
 SD : Standard deviation
 SE : Standard Error
 t : Test of significance
 > : More than
 < : Less than
 % : Percentage
 0, 1, 2, 3 : Grades of severity
 & : And

134
  yrs : years

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139
 ANNEXURE
BHARATI VIDYAPEETH UNIVERSITY COLLEGE OF AYURVEDA
DHANKAWADI, PUNE : 411 043.
Efficacy of Dusparshadi Leha on Kapha in Children (Age 1 to 5
years)

CASE PAPER
Name of Patient : Date of Examination :
Fathers Name : Sex :
Age :
Permanent Address : Phone No.
Present Address : Informant :
Relation of Informant
with patient :
OPD No. :
Date of Admission : Date of Discharge :
Immunization :
Vedana Vishesh :

Vartaman Vyadhi Vritta :

Poorvotpanna Vyadhi :

Kulavrittanta :

Garbhakalin Vritta :

Jaat Matra Vritta :

140
Maasanumasik Vikas Karma :

Prakruti Parikshana :

Aahar Shakti : i. Abhyavaharan

ii. Jaran

Samanya Parikshana :

Nadi : Temperature :

Mala : Pulse :

Mutra : Respiration :

Jivha : BP :

Shabda : Weight :

Sparsha :

Drik :

Aakriti :

Nidra :

Bala :

Agni :

Strotas Parikshan

1) Pranavaha Strotas
Nasa Kantha Shwashanvega
Phuphus Hrudaya

141
2) Annavaha Strotas
Mukha Danta Jivha
Amashaya Grahani Agni
Koshta
3) Udakavaha Strotas
Jivha Talu Trushna

4) Rasavaha Strotas
Nadi Twacha Rasavahini
Hrudaya

5) Raktavaha Stroatas
Yakrut Pleeha Mukha
Nakha Raktavahini

6) Mansavaha Strotas
Akruti Sahanan Dehabhar
Snayu Twacha

7) Medovaha Strotas
Vakka Udarkati Sphik
Sweda

8) Asthivaha Strotas
Asthi Sandhi Dant
Kesha Nakh

9) Majjavaha Strotas
Netra Sandhi Akshivitsneha
Buddhi

10) Purishvaha Strotas

11) Mutravaha Strotas

142
12) Manovaha Strotas
Nidra Smruti Buddhi
Dharanshakti

PRANAVAHA STROTAS VISHESH

1) Nasaparikshan Darshan Sparshan Prashna

Nasaguha :

Nasajavanika :

Nasastrava :

2) Kanthaparikshan
Kantha :

Gilayu :

Galashundika :

3) Kanthanadi Parikshan

4)a) Hrudayaparikshan
Darshan :
Hrudaya Sthan :
Hruda Spanda :
Sparshan
Hruda Spanda :
Akothan
Shravan
Heart Sound :

143
b) Phuphusa Parikshan
Darshan :

Sparshan :

Akothan :

Shravan :
Phuphus Dhwani :

Examination of Respiratory System

Observation

Palpation

Purcussion

Auscultation

NIDAN PANCHAK
Hetu

Purvaroopa

Roopa

Upashayanupashaya

Samprapti

Bhed
SAMBHAVYA VYADHI

VYADHI VINISCHAYA

144
UPADRAVA

NIDAN PARIKSHAN

Kapha Penus/
Sympto Kas Jwa Shoo Kantoplep Swarbhe
Nishteevan Pratishay
m a r l a d
a a

Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7

Chikitsa :

Chikitsa Fala :

145
 BHARATI VIDYAPEETH DEEMED UNIVERSITY
COLLEGE OF AYURVED
PUNE : 411043.

INFORMED CONSENT

I, Mr/Mrs. ..........................................................................................
hereby give my consent for the Ayurvedic treatment given by Dr.
Prashant S. Pawar under guidance of Dr. J.A. Nandgaonkar for his
studies. I have been fully informed about the nature, duration, dose of
the said treatment. I am ready for the full treatment and follow-up. If
any untoward side effect or complications occur regarding this
treatment, I am ready to treat them at Bharati Vidyapeeth’s Ayurved
Hospital.

Parent’s Sign : Date :

saMmataIpa~a
maI/AamhI KaalaIla sahI kxrNaar
saaO./Ea`ImataI/kux. ...............................................
vaya ....... vaYao_ ilahUna dotao kxI DaV. pa`SaaMta
sauroSa pavaar yaaMcyaa saMSaaoQana
pa`kxlpaamaQyao svata:huna sahBaagaI haota Aaho. tarI
maaJyaa maulaalaa/maulaIlaa doNyaata yaoNaa%yaa
AaOYaQaaMcao fxayado va taaoTo DaVWTraMnaI
malaa samajaavaUna saaMigatalao Aahota.

146
DaVWTraMnaI saaMigatalaolao sava_ paqya va
inayama paaLNao maaJyaavar baMQanakxarkx Aaho.
kxaoNatyaahI AimaYaalaa ikMxvaa dDpaNaalaa
baLI na paDtaa maaJyaa paalyaasa saMSaaoQana
pa`kxlpaata saamaIla kxr]na GaoNyaasa parvaanagaI
dota Aaho.

paalakxacaI sahI
idnaaMkx

147
148
149