The name khash originates from the Armenian verb xašel, which means "to boil". The dish, initially called khashoy, is mentioned by a number of medieval Armenian authors, including Grigor Magistros, Mkhitar Heratsi, and Yesayi Nchetsi. The Persian term pāče literally means "trotter". The combination of a sheep's head and trotters is called kalle-pāče, which literally means "head trotter" in Persian.
Khash is a purist meal with great parsimony in ingredients. The feet are depilated, cleaned, kept in cold water in order to get rid of bad smell, and boiled in water all night long, until the water has become a thick broth and the meat has separated from the bones. No salt or spices are added during the boiling process. The dish is served hot. One may add salt, garlic, lemon juice, or vinegar according to one's taste. Dried lavash is often crumbled into the broth to add substance. Khash is generally served with a variety of other foods, such as hot green and yellow peppers, pickles, radishes, cheese, and fresh greens such as cress. The meal is almost always accompanied by vodka and mineral water. In Georgia, Khashi is served together with onions, milk, salt and chacha. Usually they eat this dish early morning, or during hangovers. In the medieval Armenian medical textbook Relief of Fevers, khash was described as a dish with healing properties, e.g., against snuffle. It was recommended to eat it while drinking wine. In case of ailment, khash from the legs of a yeanling was advised. Formerly a nutritious winter food, it is now considered a delicacy, and is enjoyed as a festive winter meal. Modern-day convention in Armenia dictates that it should be consumed during the month that has an r in its name, thus excluding May, June, July, and August. Khash is traditionally consumed during cold months in Azerbaijan and Georgia. In the South Caucasus, khash is often seen as a food to be consumed in the mornings after a party, as it is known to battle hangovers and eaten with a "hair of the dog" vodka chaser. There is much ritual involved in khash parties. Many participants abstain from eating the previous evening, and insist upon using only their hands to consume the unusual meal. Because of the potency and strong smell of the meal, and because it is eaten early in the mornings and so often enjoyed in conjunction with alcohol, khash is usually served on the weekend or on holidays.
In Iran
Kalle-pache consists of a sheep's head and trotters, and is typically seasoned with lemon and cinnamon. Usually consumed as a breakfast soup, kalle-pache is traditional to Afghanistan and Iran. In Iran, kalle-pache is usually cooked in specialty stores, and is served in the morning. It is especially consumed during cold seasons. To prepare kalle-pache, the sheep's head and trotters are collected, cooked, and treated as per the recipe.
In Israel
During winter it is very common to eat sheep or cow parts soup with onions and spices, especially the legs which is called 'Maraq regel' it is usually accompanied with an alcoholic drink.
Pacha is a traditional Iraqi dish made from sheep's head, trotters, and stomach; all boiled slowly and served with bread sunken in the broth. The cheeks and tongues are considered the best parts. Many people prefer not to eat the eyeballs which could be removed before cooking. The stomach lining would be filled with rice and lamb and stitched with a sewing thread. Sheep brain is also included. The dish is known in Kuwait, Bahrain, and other Persian Gulf countries as Pacheh . A variation of that is found in other Arab countries such as in Egypt and is known as kawari', Egyptians eat cow brain and sheep brain.
In Albania
's popular pache consists of a sheep's or any cattle's head, that is boiled until meat comes off easily. It is then stewed with garlic, onion, black pepper, and vinegar. Sometimes a little flour is added to thicken the stew. It is also frequently cooked with cattle feet or tripe. It makes a hot and hearty winter stew.
In Turkey
In Turkish culinary culture, pacha is used for cow, sheep, or goat hooves, and the term kelle paça is used for "head pacha". Sometimes the term dil paça is also used for tongue soup, while "meat pacha" is made with gerdan. In Turkey, the word kelle refers to a sheep's head roasted in the oven, which is served after grilling at specialized offal restaurants.
In Greece
The Greek version, called patsás, may be seasoned with red wine vinegar and garlic, or thickened with avgolémono. The Greek version sometimes uses calf feet with the tripe. Specialized tavernas serving patsa are known as patsatzidika. Because patsas has the reputation of remedying hang-over and aiding digestion, patsatzidika are often working overnight, serving people returning home after dinner or clubbing.