ISSN: 2456-6640

International Journal of of Ayurveda

(A Monthly Scientific Journal of Kiban Research Publications)
www.kibanresearchpublications.com

REVIEW ARTICLE

A Literary Review of Kshayaja Kasa

Aarif Khan *1, Prashant Saini2, Archana Singh3
1Ph.D. Schlor, P.G.Dept. of Roga Evam Vikriti Vigyan, National Institute of Ayurveda, Jaipur (Raj.),
India.
2Ph.D. Schlor, P.G.Dept. of Shalya Tantra, National Institute of Ayurveda, Jaipur
3P.G. Schlor, P.G.Deptt. of Roga Evam Vikriti Vigyan, National Institute of Ayurveda, Jaipur (Raj.),
India.

*Corresponding Author: Aarif Khan

Abstract

Now a day the life style of human being is broadly changed. Due to lack of knowledge of rule and
regulation or for avoidance of dinacharya and ritucharya, some disgusting habit like smoking etc. people
suffer from many chronic diseases like chronic bronchitis which can be correlated with Kshayaja Kasa.
Not only habit but also the environmental pollution is responsible for such diseases, mainly such habit
and environmental pollution affect the pranavahasrotas and produce the diseases, Kshayaja Kasa is one
of them. Here it is mentioned that due to dhatukshaya kshayaja kasa occur. Dhatuis loosely translated
as tissue and represents the constituents of the body that are not eliminated. The dhatus are the basic
varieties of tissues, which compose the human body. Due to lack of proper nutrition to the body, the
process of formation of all these Dhatus gets decreased. These decreased Dhatus causes Vata prakopa,
which is most important Samprapti ghataka in the pathogenesis of Kshayaja Kasa. In modern system of
medicine, anti-biotics, anti-histamines etc. are commonly used for the management of Chronic
Bronchitis .Although, they all are suppressing the symptoms, yet, none of these modalities of
treatments provide a permanent cure, and have limitations owing to their effects. In other way of
treatment ayurvedic drugs have no side effects and widely used in the management of Kshayaja Kasa.

Keywords: Pranavahasrotas, Dhatukshaya, Samprapti, Vata, Chronic bronchitis.

Introduction
The illness characterized by the act of Definition of Kasa
‘Kasana’ is known as Kasa [1]. The word
Kasais a forced exptration against a closed
Kasais derived from the root ‘kasagathou’,
glottis. It is usually an expression of disease
meaning course. Pathologically speaking the
in the Pranavaha Strotas. It may be either a
morbid Vata Dosa either alone or in
voluntary act or a reflex response to
combination with morbid Kapha Dosa
irritation of Pranvaha Strotas. By the
constricting the body parts like sirah,
association of the Udanavayu, Pranavayu
Kantha, etc. and then escapes from the
assumes an abnormal upward course and
mouth. This abnormal course of vayuis
spontaneously escapes from the mouth
referred as Kasa [2]. Authors of Charaka
generating the sound similar to the one
Samhita, Sushruta Samhita, Ashtanga
produced by the broken bronze vessel, and
Sangraha and Hridaya, Bhavaprakasha,
this illness is known as Kasa [3-5].
Sharngadhara Samhita, Madhava Nidana,
mentioned Kasaas five types. Definition of Kshayaja Kasa
Chronologically, they are strong one by one. A type of Kasa Roga in which patients
They are as follows: expectorates offensive, greenish, sanguinous
 Vataja Kasa PittajaKasa or purulent sputum and during the fit of
 Kaphaja Kasa Kshataja Kasa coughing, he feels as though his heart were
 Kshayaja Kas displaced is known as Kshayaja Kasa.
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Definition of Chronic Bronchitis
Presence of chronic productive cough on
most days for 3 months, in each of 2
consecutive years [6].
Nidana of Kshayajakasa
These are the specific causative factors
responsible for the production of individual
verities of Kshayaja Kasa-Visama Ahara,
Asatmya Ahara, Ativyavaya, Veganigraha,
Jaraa etc [7]. As Acharya Charaka says
“Vayordhatukshayaat kopo
maargasyaavarnenacha” means dhatu
kshaya leads to Vata prakopa and prakupita
vata is responsible for Kshayaj a Kasa.
Hence dhatu kshaya is also the most
important cause for pathogenesis of
Kshayaja Kasa.
Dhatu
Body is nothing but the combination of all
dosa, dhatu and malas. If these body
constituents are in the equilibrium body will
be in the healthy state. (Su.su.15/3)
Functions of the Seven Tissues [8]
 Rasa dhatu (plasma) provides satisfaction,
nutrition and supplies nourishment to
raktadhatu (blood).
 Rakta (blood) bestows color, nourishment
to mamsa (muscle) and maintains life
activities.
 Mamsa (muscle) furnishes nourishments
to the body and also to medas (fat).
 Medas (fat) bestows lubrication, sweating,
stability and nourishment to asthi (bone).
 Asthi (bone) provides support to the body
and nourishment to majja (bone marrow).
 Majja (bone marrow) provides lubrication,
strength, filling of the bones and
nourishment of sukra.
 Sukra (semen/reproductive tissue) bestows
courage, ejaculation, lust, strength of the
body, pleasure, love (affection) and the
purpose of seed (formation of embryo).
General Causes of Dhatu
(Wasting)
Over-exercise, fasting, worries, taking dry
&scanty and limited meals ,exposure to
wind and sun ,fear ,grief ,dry beverages
,excessive waking excessive discharge of
mucus ,blood, semen and excretion, season
or age and possession by spirits are to be
known as the cause of wasting [9].
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Symptoms of Dhatu Kshaya According
to Charaka [10].

he symptoms of loss of nutrient body fluid
are restlessness, intolerance to loud
sounds, acceleration of flow, tachycardia
pain and distress even on the slightest
exertion.

he symptoms of loss of blood are
roughness, cracks, withering and dryness
of skin.

he symptoms of loss of flesh are thinning
in general & specially on hips, neck &
belly.

he symptoms of loss of fat are the
cracking of the joints, lassitude in the
eyes, exhaustion and thinning of the
abdomen.

he symptoms of the atrophy of ostio-tissue
are the falling of hair, nail and teeth,
fatigue and looseness of joints.

he symptoms of the atrophy of the
marrow are the atrophy of bone-tissue
which becomes weak and light, and the
patient is afflicted with chronic vata
disorders.

he symptoms of wasting of semen are
debility, dryness of the mouth, pallor,
asthenia, fatigue, impotency and non-
emission.
Causes of Chronic Bronchitis
The two most important etiologic factors
responsible for majority of cases of chronic
bronchitis are: cigarette smoking and
atmospheric pollution .Other contributory
factors are occupation, infection, familial
Kshaya and genetic factors [11].
The "Wear and Tear" Theory
Dr. August Weismann, a German biologist,
first introduced this theory in 1882. He
believed that the body and its cells were
damaged by overuse and abuse. The organs,
liver, stomach, kidneys, skin and so on are
worn down by toxins in our diet and in the
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environment; by the excessive consumption durbal krsa, Snigdha mukha, varna, tvaca,
of fat, sugar, caffeine, alcohol and nicotine; Dusro ke guno me dosa nikalna, Jvara,
by the ultra-violet rays of the sun and by the Parsvashula, Pinasa, Aruci , Daurbalya etc.
many other physical and emotional stresses
Clinical Features Chronic Bronchitis
to which we subject our bodies. Wear and
tear is not confined to our organs, however;  Persistent cough with copious
it also takes place on the cellular level. Of expectoration of long duration; initially
course even if you've never touched a beginning in a heavy smoker with ‘morning
cigarette or had a glass of wine, stayed out catarrh’ or ‘throat clearing’ which worsens in
of the sun and eaten only natural foods, winter.
simply using the organs that nature
endowed you is going to wear them out.  Recurrent respiratory infections are
Abuse will only wear them out more quickly. common.
Likewise as the body ages our very cells feel  Dyspnoea is generally not prominent at
the effect, no matter how healthy our life rest but is more on exertion.
style.  Patients are called ‘blue bloaters’ due to
cyanosis and oedema.
When we are young the body's own
maintenance and repair systems keep  Features of right heart failure
compensating for the effects of both normal (corpulmonale) are common.
and excessive wear and tear. (That's why  Chest X-ray shows enlarged heart with
young people can more easily get away with prominent vessels.
a night of heavy drinking or a binge of pizza
or sweets.) With age the body loses its Upashaya and Anupashaya of
ability to repair damage caused by diet, Kshayajakasa
environmental toxins, bacteria or a virus. Upashayafor a disease is considered to be
Thus many elderly people die of diseases Satmya for that disease and should be
that they could have resisted when they practiced by the patient. Anupashayais
were younger [12]. Asatmya (harmful) for the disease and
Poorvaroopa of Kshayaja KASA patient has to avoid those. The causative
factors which leads to irritation of bronchial
Poorvaroopaare those signs and symptoms tree, like that of dust, smoke, pollens, cold
which appear prior to the manifestation of breeze, fog, polluting gases, etc. leads to
actual disease. They appear during Sthana aggravation of the illness. The Dosa
Samshraya, the stage of localization at the producing products as stated in Nidana as
site of Khavaigunya [13] and considered as well as the behaviors inducing Vat and
the first indicators of future disease. Kaphapra kopa because of divasvapna,
There is much similarity among the ratrijagarana, etc. prolongs the Kasa. Living
Poorvaroopa of Kasa explained in the in an environment which is free of dust and
classics of Ayurveda. Those are as follows - pollution, are considered as upasaya.
Shooka Poorna Galaasyata, Kanthe Kandu, [15,16].
Bhojyanaam Avarodha, Aruchi, Sashabdha Samprapti of Kshayajakasa
Vaishamya, Agnisada, Gala Lepa & Thalu
Lepa. The gastric fire being vitiated in squeamish
or mournful persons as the result of
Roopa of Kshayaja Kasa unbalanced or unwholesome diet, excessive
The actual signs and symptoms of fully sexual indulgence and suppression of
evolved disease along with the cardinal natural urges, the three humors become
features will be seen in Vyakta Avastha provoked and produce the cough, born of
where Dosha-Dooshya Sammoorchana takes wasting ,which in turn leads to the
place [14]. With the help of Roopa, a disease consumption of the body [17].
can be diagnosed with confirmation and Pathogenesis [18]
management can be planned accordingly.
 Chronic bronchitis and emphysema occur
Roopa of Kshayaja Kasa explained in the as a result of an inflammatory process
classics of Ayurveda are as follows involving the airways and distal
Daurgandha harit rakta puyavata kapha airspaces.
sthivana, Hrtchyuti anubhuti at the time of  Increased activity of oxidants combined
attack, Akasmat usnashitarta, Bahvasi with reduced activity of antioxidants has

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 Available online at:http://ija.kibanresearchpublications.com/index.php/IJA
been implicated in the development of
inflammation and COPD.
treatment, it can lead to Upadra vas like
 Cigarette smoke, produce high Jwara, Arochaka, Swasa, Swarabheda and
concentration of oxygen free radicals Kshaya.
(reactive oxygen species-ROS) including
Complications
superoxide, hydrogen peroxide and
Mucopurulent relapses, Respiratory failure,
hypochlorous acid. These are responsible
pulmonary hypertension and right
for tissue damage and activation of
ventricular failure (corpulmonale).
eosinophils and neutrophils.
Chikitsa of Kshayaja Kasa
 Inflammatory response is initiated
through the activation of transcription Chikitsa Sidhanta of Kshayaja Kasa
factors (nuclear factor-kB {NF-kB} and The measures that are promotive of the
activator protein-1(AP-1), and gene gastric fire and roborant, as well as the
expression of pro-inflammatory measures predicative of the channels are
mediators. administered alternately, they will become
 Further, cigarette smoke, various strength giving and beneficial [22].
oxidants and activated neutrophils A general principle of management of any
damage alpha-antitrypsin that is disorder in Ayurveda is divided into three
required to prevent degradation of parts [23].
elastin. All these result in various
changes seen in patients with chronic  Nidana
bronchitis and emphysema. Parivarjana
 Samshodhana
 Various inflammatory mediators involved  Samshamana
in COPD include leucotriene B4 (which
amplify inflammatory response and may Management
be responsible for systemic effects) and Regular exercise, nutritional management,
transforming growth factor-beta (which Reduction of bronchial irritation like-
may induce fibrosis in small airways). smoking, dusty and smoke-laden
 Pulmonary hypertension develops due to atmospheres, antibiotics, bronchodilator and
vascular remodelling in COPD, which steroid therapy.
results from combined effects of hypoxia, Pathyapathya
inflammation, and in severe emphysema,
loss of capillaries. Acharya Charaka has considered the word
“Pathya” as a synonym of Chikitsa.
Upadrava Treatment procedure for any disease
Charaka in the context of Nidanarthakara without Pathya diet will not be complete. It
Roga tells, untreated or partially treated playsa very important role in combating the
Kasawill land up in Kshaya [19]. In Astanga disease as well as in keeping Doshas under
Hridaya [20] and as well as in control. In some instances, following only
Yogaratnakara, it is mentioned that if Pathya pathyas in its primary stage the
Kasais neglected then it leads to Swasa, disease can be treated or arrested or
Kshaya, Chardi and Swarabheda. In weakened.
Bhavaprakasha [21], it is explained that, if
the Kasa is neglected without proper
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2 Ch.Chi.18/6-8 11 Harsh Mohan (ed’s) Textbook of pathology, sixth edition, Published

by Jaypee brothers medical publishers(P)LT
3 Su.U.52/20 Dalhanatika
12 http://www.anti-aging-today.org
4 Ch.chi.18/8
13 Ibidem (8) Madhava Nidana, Panchanidana Lakshanam, (1/5-
5 M.N.11/2 6).p.32
6 Graham Devereux. ABC of chronic obstructive pulmonary disease, 14 Ibidem (7), Ashtanga Hridaya, Nidana Sthana, Sarvaroganidana
Published by Adhyaya (1/5).p.441
7 Ch.Chi.18/24 15 Ch.Chi.18/108
8 Su.su.15/5[1] 16 Ch.Chi.18/133
9 Ch.su.17/76-77 17 Ch.chi.18/24

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 Available online at:http://ija.kibanresearchpublications.com/index.php/IJA
18 K.George Mathew & Praveen Aggarwal (ed’s) Medicine, pre manual
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Adhyaya (8/19).227

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Nidana (3/37).471

21 Ibidem (14) Bhavaprakasha Samhita, Madhyama Khanda,

Kasarogadhikara (12/18).

22 Ch.Chi.18/187

23 Ch.V.7/30

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