Cause And Etiology

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

Classification

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

Premonitory Symptoms

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

Specific Symptoms

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

Symptoms Of Kshataja Kasa

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

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

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

General Treatment

A compound consisting of Srhigi, Vacha, Kat-phala, Ka-trina, Musta, Dhanyaka, Abhaya, Bhargi, Deva-daru, Viswa and Hingu taken in hot water would rapidly cure a case of long-standing cough. A lambativc composed of the equal quantity of Tri-phala, Vyosha, Vidanga, S'ringi, Ra'sna, Vacha, Padmaka and Deva'-daru pounded together and mixed with a copious quantity of honey, sugar and clarified butter, would speedily conquer a serious attack of cough. 13 -14.

A patient afflicted with cough should use a lamba-tive composed of Patha, sugar, Amalaka, fried paddy, Magadhi, and S'unthi pounded together and mixed with honey and clarified butter, or take Krishna and Saindhava salt with warm water. He should use Nagara and Pippali in combination with treacle, or use a lambative of the paste of Draksha mixed with honey and clarified butter. A compound composed of the equal parts of Draksha, sugar and Magadhika, or of S'rwga-zera, Yashti-madhu, and Titga (Vams'a-lochana) should be licked with honey and clarified butter ; or a compound consisting of S'itopala (sugar) and an equal quantity of Maricha should be licked with honey and clarified butter. A compound consisting of Dhatri, Kana, Vis'va and S'itopala (sugar) should be taken with curd-cream (Dadhi-manda). A person suffering from an attack of cough should use Harenuka and Magadhika taken in equal parts and pounded together through the medium of curd. The two kinds of Haridra, Deva-daru, Sunthi and the pith of a Gayatri-tree pounded and mixed in equal parts should be taken with the urine of a goat, or a pulverised compound consisting of Danti, Dravanti and Tilvaka should be taken. Leaves of Vadara pasted with Saindhava salt and fried in clarified butter should be taken ; or a Kola (two tolas) weight of Hingu should be taken with fermented rice-boilings (Souviraka) or with the juice of acid fruit.

Powdered Markka should be likewise licked with honey. 15.